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| 2. |
- Donker, D. W., et al.
(författare)
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Echocardiography in extracorporeal life support : A key player in procedural guidance, tailoring and monitoring
- 2018
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Ingår i: Perfusion. - : Sage Publications. - 0267-6591 .- 1477-111X. ; 33:1_suppl, s. 31-41
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Tidskriftsartikel (refereegranskat)abstract
- Extracorporeal life support (ECLS) is a mainstay of current practice in severe respiratory, circulatory or cardiac failure refractory to conventional management. The inherent complexity of different ECLS modes and their influence on the native pulmonary and cardiovascular system require patient-specific tailoring to optimize outcome. Echocardiography plays a key role throughout the ECLS care, including patient selection, adequate placement of cannulas, monitoring, weaning and follow-up after decannulation. For this purpose, echocardiographers require specific ECLS-related knowledge and skills, which are outlined here.
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| 3. |
- Weinstock, Joshua S, et al.
(författare)
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Aberrant activation of TCL1A promotes stem cell expansion in clonal haematopoiesis.
- 2023
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Ingår i: Nature. - 1476-4687. ; 616:7958, s. 755-763
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Tidskriftsartikel (refereegranskat)abstract
- Mutations in a diverse set of driver genes increase the fitness of haematopoietic stem cells (HSCs), leading to clonal haematopoiesis1. These lesions are precursors for blood cancers2-6, but the basis of their fitness advantage remains largely unknown, partly owing to a paucity of large cohorts in which the clonal expansion rate has been assessed by longitudinal sampling. Here, to circumvent this limitation, we developed a method to infer the expansion rate from data from a single time point. We applied this method to 5,071 people with clonal haematopoiesis. A genome-wide association study revealed that a common inherited polymorphism in the TCL1A promoter was associated with a slower expansion rate in clonal haematopoiesis overall, but the effect varied by driver gene. Those carrying this protective allele exhibited markedly reduced growth rates or prevalence of clones with driver mutations in TET2, ASXL1, SF3B1 and SRSF2, butthis effect was not seen inclones withdriver mutations in DNMT3A. TCL1A was not expressed in normal or DNMT3A-mutated HSCs, but the introduction of mutations in TET2 or ASXL1 led to the expression of TCL1A protein and the expansion of HSCs in vitro. The protective allele restricted TCL1A expression and expansion of mutant HSCs, as did experimentalknockdown of TCL1A expression. Forced expression of TCL1A promoted the expansion of human HSCs in vitro and mouse HSCs in vivo. Our results indicate that the fitness advantage of several commonly mutated driver genes in clonal haematopoiesis may be mediated by TCL1A activation.
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| 4. |
- Braganca, F. M. Serra, et al.
(författare)
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Improving gait classification in horses by using inertial measurement unit (IMU) generated data and machine learning
- 2020
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Ingår i: Scientific Reports. - : Springer Nature. - 2045-2322. ; 10:1
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Tidskriftsartikel (refereegranskat)abstract
- For centuries humans have been fascinated by the natural beauty of horses in motion and their different gaits. Gait classification (GC) is commonly performed through visual assessment and reliable, automated methods for real-time objective GC in horses are warranted. In this study, we used a full body network of wireless, high sampling-rate sensors combined with machine learning to fully automatically classify gait. Using data from 120 horses of four different domestic breeds, equipped with seven motion sensors, we included 7576 strides from eight different gaits. GC was trained using several machine-learning approaches, both from feature-extracted data and from raw sensor data. Our best GC model achieved 97% accuracy. Our technique facilitated accurate, GC that enables in-depth biomechanical studies and allows for highly accurate phenotyping of gait for genetic research and breeding. Our approach lends itself for potential use in other quadrupedal species without the need for developing gait/animal specific algorithms.
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| 7. |
- Meuwese, CL, et al.
(författare)
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The hemodynamic effect of different left ventricular unloading techniques during veno-arterial extracorporeal life support: a systematic review and meta-analysis
- 2020
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Ingår i: Perfusion. - : SAGE Publications. - 1477-111X .- 0267-6591. ; 35:7, s. 664-671
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Tidskriftsartikel (refereegranskat)abstract
- Pulmonary edema and left ventricular thrombosis may arise during veno-arterial extracorporeal life support due to an increase in cardiac load. This mechanical stress can be reduced through different left ventricular unloading techniques. We set out to quantitatively summarize the hemodynamic effects of available methods in patients treated with veno-arterial extracorporeal life support. Methods: Literature was systematically searched for studies reporting left ventricular unloading during veno-arterial extracorporeal life support as reflected by changes in left atrial pressure, pulmonary capillary wedge pressure, diastolic pulmonary artery pressure, or left ventricular end-diastolic pressure. For studies including ⩾10 patients per group, changes in these parameters were pooled using (1) standardized mean differences and (2) ratio of means. Assessment of potential bias was performed for all studies. Results: Eight studies met the inclusion criteria. Reported techniques included use of intra-aortic balloon pump (n = 1), micro-axial blood pump (Impella®, n = 2), left ventricular venting (n = 1), and atrial septostomy (n = 4). Overall, left ventricular unloading was associated with a statistically significant reduction in preload parameters (standardized mean differences = −1.05 (95% confidence interval = −1.24 to −0.86) and ratio of means = 0.60 (0.47 to 0.76)). Effect sizes were strongest for micro-axial blood pump and atrial septostomy (standardized mean differences = −1.11 (−1.55 to −0.68) and −1.22 (−1.47 to −0.96), and ratio of means = 0.58 (0.39 to 0.86) and 0.54 (0.36 to 0.83), respectively). Conclusion: Left ventricular unloading was associated with a significant reduction in left ventricular preload parameters in the setting of veno-arterial extracorporeal life support. This effect may be most pronounced for micro-axial blood pump and atrial septostomy.
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| 8. |
- Zuber, S., et al.
(författare)
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What Should We Agree on about the Repugnant Conclusion?
- 2021
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Ingår i: Utilitas. - : Cambridge University Press. - 0953-8208 .- 1741-6183. ; 33:4, s. 379-383
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Tidskriftsartikel (refereegranskat)abstract
- The Repugnant Conclusion is an implication of some approaches to population ethics. It states, in Derek Parfit's original formulation, For any possible population of at least ten billion people, all with a very high quality of life, there must be some much larger imaginable population whose existence, if other things are equal, would be better, even though its members have lives that are barely worth living. (Parfit 1984: 388) Copyright © The Author(s), 2021. Published by Cambridge University Press.
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| 9. |
- Barkholt, L M, et al.
(författare)
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Stool cultures obtained before liver transplantation are useful for choice of perioperative antibiotic prophylaxis
- 1997
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Ingår i: Transplant International. - : Frontiers Media SA. - 0934-0874 .- 1432-2277. ; 10:6, s. 432-438
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Tidskriftsartikel (refereegranskat)abstract
- Bacterial infections, especially cholangitis, are still common complications after liver transplantation (LTx). During recent years, multiresistant enterococci have become a nosocomial problem in transplant units. The present prospective study on 26 patients, including 24 patients with chronic liver disease, demonstrated that enterococci were the predominant micro-organism involved in post-LTx bacterial infections. They were cultured in the feces and in other sites of 10 out of 13 (77%) patients who underwent extensive examinations. Ampicillin-resistant Enterococcus faecium strains were isolated in urine or feces of 2 of the 13 patients prior to LTx. Similarly, resistance to ampicillin and gentamicin, the empirically used antibiotics for patients with fever of unknown origin, was found in E. faecium strains in 3 and 2 patients, respectively. Moreover, multiresistant E. faecium and E. faecalis strains were demonstrated in 46% of the patients in the postoperative period (3 months). However, no vancomycin-resistant enterococci were isolated. The use of antibiotics within 4 months prior to LTx significantly increased the risk of developing ampicillin-resistant bacteria at the time of LTx and of infections with bacteria of enteric origin after LTx (P = 0.03 and 0.01, respectively). We conclude that stool and urine cultures performed prior to LTX may be useful for selecting prophylactic antibiotic regimens.
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| 12. |
- Jager, R, et al.
(författare)
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Capture Hi-C identifies the chromatin interactome of colorectal cancer risk loci
- 2015
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Ingår i: Nature communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 6, s. 6178-
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Tidskriftsartikel (refereegranskat)abstract
- Multiple regulatory elements distant from their targets on the linear genome can influence the expression of a single gene through chromatin looping. Chromosome conformation capture implemented in Hi-C allows for genome-wide agnostic characterization of chromatin contacts. However, detection of functional enhancer–promoter interactions is precluded by its effective resolution that is determined by both restriction fragmentation and sensitivity of the experiment. Here we develop a capture Hi-C (cHi-C) approach to allow an agnostic characterization of these physical interactions on a genome-wide scale. Single-nucleotide polymorphisms associated with complex diseases often reside within regulatory elements and exert effects through long-range regulation of gene expression. Applying this cHi-C approach to 14 colorectal cancer risk loci allows us to identify key long-range chromatin interactions in cis and trans involving these loci.
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| 13. |
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| 14. |
- Larsson, M, et al.
(författare)
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When Life-Saving Is Life-Threatening
- 2014
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Ingår i: SCIENCE TRANSLATIONAL MEDICINE. - 1946-6234. ; 6:222
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 15. |
- Maksuti, Elira, 1986-, et al.
(författare)
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Hydraulic forces contribute to left ventricular diastolic filling
- 2016
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Myocardial active relaxation and restoring forces are known determinants of left ventricular (LV) diastolic function. We hypothesize the existence of an additional mechanism involved in LV filling, namely, a hydraulic force contributing to the longitudinal motion of the atrioventricular (AV) plane. A prerequisite for the presence of a net hydraulic force during diastole is that the atrial short-axis area (ASA) is smaller than the ventricular short-axis area (VSA). We aimed (a) to illustrate this mechanism in an analogous physical model, (b) to measure the ASA and VSA throughout the cardiac cycle in healthy volunteers using cardiovascular magnetic resonance imaging, and (c) to calculate the magnitude of the hydraulic force. The physical model illustrated that the anatomical difference between ASA and VSA provides the basis for generating a hydraulic force during diastole. In volunteers, VSA was greater than ASA during 75-100% of diastole. The hydraulic force was the same order of magnitude as the peak driving force of LV (1-3N vs 5-10N). Hydraulic forces are a consequence of left heart anatomy and aid LV diastolic filling. These findings suggest that the relationship between ASA and VSA, and the resulting hydraulic forces, should be considered when characterizing diastolic function and dysfunction.
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| 16. |
- Maksuti, Elira, et al.
(författare)
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Hydraulic forces contribute to left ventricular diastolic filling
- 2017
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Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 7, s. 43505-43505
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Tidskriftsartikel (refereegranskat)abstract
- Myocardial active relaxation and restoring forces are known determinants of left ventricular (LV) diastolic function. We hypothesize the existence of an additional mechanism involved in LV filling, namely, a hydraulic force contributing to the longitudinal motion of the atrioventricular (AV) plane. A prerequisite for the presence of a net hydraulic force during diastole is that the atrial short-axis area (ASA) is smaller than the ventricular short-axis area (VSA). We aimed (a) to illustrate this mechanism in an analogous physical model, (b) to measure the ASA and VSA throughout the cardiac cycle in healthy volunteers using cardiovascular magnetic resonance imaging, and (c) to calculate the magnitude of the hydraulic force. The physical model illustrated that the anatomical difference between ASA and VSA provides the basis for generating a hydraulic force during diastole. In volunteers, VSA was greater than ASA during 75-100% of diastole. The hydraulic force was estimated to be 10-60% of the peak driving force of LV filling (1-3 N vs 5-10 N). Hydraulic forces are a consequence of left heart anatomy and aid LV diastolic filling. These findings suggest that the relationship between ASA and VSA, and the associated hydraulic force, should be considered when characterizing diastolic function and dysfunction.
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| 20. |
- Steding-Ehrenborg, Katarina, et al.
(författare)
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Hydraulic force is a novel mechanism of diastolic function which may contribute to decreased diastolic filling in HFpEF and facilitate filling in HFrEF
- 2021
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Ingår i: Journal of Applied Physiology. - : American Physiological Society. - 1522-1601 .- 8750-7587. ; 130:4, s. 993-1000
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A hydraulic force generated by blood moving the atrio-ventricular plane is a novel mechanism of diastolic function. The direction and magnitude of the force is dependent on the geometrical relationship between the left atrium and ventricle and is measured as the short-axis atrio-ventricular area difference (AVAD). In short, the net hydraulic force acts from a larger area towards a smaller. It is currently unknown how cardiac remodeling affects this mechanism. The aim of the study was therefore to investigate this diastolic mechanism in patients with pathological or physiological remodeling.METHODS: 70 subjects (n=11 heart failure with preserved ejection fraction (HFpEF), n=10 heart failure with reduced ejection fraction (HFrEF), n=7 signs of isolated diastolic dysfunction, n=10 hypertrophic cardiomyopathy (HCM), n=10 cardiac amyloidosis, n=18 triathletes and n=14 controls) were included. Subjects underwent Cardiac MR and short-axis images of the left atrium and ventricle were delineated. AVAD was calculated as ventricular area minus atrial area and used as an indicator of net hydraulic force.RESULTS: At the onset of diastole, AVAD in HFpEF was median -9.2 cm2 versus -4.4 cm2 in controls, p=0.02). The net hydraulic force was directed towards the ventricle for both, but larger in HFpEF. HFrEF was the only group with a positive median value 11.6 cm2 and net hydraulic force was throughout diastole directed towards the atrium.CONCLUSION: The net hydraulic force may impede cardiac filling throughout diastole in HFpEF, worsening diastolic dysfunction. In contrast, it may work favorably in patients with dilated ventricles and aid ventricular filling.
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| 21. |
- Vigneron, Pierre-Baptiste, et al.
(författare)
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8.5-fm resonances in an amplified slow-light fiber Bragg grating for high-precision metrology
- 2020
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Ingår i: Optical, Opto-Atomic, and Entanglement-Enhanced Precision Metrology II. - San Fransisco : SPIE - International Society for Optical Engineering.
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Konferensbidrag (refereegranskat)abstract
- Fiber Bragg gratings (FBGs) with strong apodized index modulations behave like an in-line Fabry-Perot interferometer and exhibit a series of narrow resonances in the short-wavelength portion of their transmission spectrum. These resonances have proven invaluable for detecting extremely small strains (30-femtostrain/√Hz level) or temperature changes (millidegreeC/√Hz level). The sensitivity of these fiber sensors is limited by the linewidth and peak transmission of the resonance used to interrogate the sensor, which are themselves limited by the intrinsic loss of the grating. In this work, significantly narrower and stronger resonances are demonstrated by introducing a small amount of optical gain in the FBG to offset the intrinsic loss and create a resonator with a much smaller net internal loss. The fiber Bragg grating is written in an Er-doped single-mode fiber and optically pumped to provide the required gain. The device reported here is a 6.5-mm grating with an AC index modulation of 1.59×10-3. With only 30 μW of pump power absorbed by the grating (32.6 mW launched), the fundamental resonance of the FBG was observed to narrow from 737 fm in the absence of pump to a record linewidth of 8.5 fm. The measured peak transmission of the resonance improved from ~-37 dB to -0.2 dB. A new model that predicts the slow-light resonance spectrum of a slow-light grating in the presence of optical gain is presented. This model is in good quantitative agreement with the measured evolution of the resonance linewidth as the pump power and the power of the laser that probes the resonance lineshape are varied.
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| 22. |
- Vigneron, Pierre-Baptiste, et al.
(författare)
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Loss-compensated slow-light fiber Bragg grating with 22-km/s group velocity
- 2020
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Ingår i: Optics Letters. - 0146-9592 .- 1539-4794. ; 45:11, s. 3179-3182
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Tidskriftsartikel (refereegranskat)abstract
- This Letter reports the behavior of the slow-light resonances of a strong apodized fiber Bragg grating (FBG) in which the intrinsic loss is compensated for by a small internal gain. The 6.5-mm FBG, written with a femtosecond laser in an Er-doped single-mode fiber, was pumped at similar to 4475 nm just below the lasing threshold to offset most of its intrinsic loss, thereby narrowing its resonances. The fundamental slow-light resonance was measured to have a linewidth of 8.5 fm, or a record group velocity of similar to 22 km/s, and a peak transmission near unity (-0.2 dB). The measured dependencies of the linewidth and peak transmission on pump power agree well with a new model that predicts the transmission spectrum of loss-compensated FBGs in the presence of pump and signal saturation.
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