| 1. |
- Bergström, Göran, 1964, et al.
(författare)
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Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population
- 2021
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Ingår i: Circulation. - Philadelphia : American Heart Association. - 0009-7322 .- 1524-4539. ; 144:12, s. 916-929
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Tidskriftsartikel (refereegranskat)abstract
- Background: Early detection of coronary atherosclerosis using coronary computed tomography angiography (CCTA), in addition to coronary artery calcification (CAC) scoring, may help inform prevention strategies. We used CCTA to determine the prevalence, severity, and characteristics of coronary atherosclerosis and its association with CAC scores in a general population.Methods: We recruited 30 154 randomly invited individuals age 50 to 64 years to SCAPIS (the Swedish Cardiopulmonary Bioimage Study). The study includes individuals without known coronary heart disease (ie, no previous myocardial infarctions or cardiac procedures) and with high-quality results from CCTA and CAC imaging performed using dedicated dual-source CT scanners. Noncontrast images were scored for CAC. CCTA images were visually read and scored for coronary atherosclerosis per segment (defined as no atherosclerosis, 1% to 49% stenosis, or ≥50% stenosis). External validity of prevalence estimates was evaluated using inverse probability for participation weighting and Swedish register data.Results: In total, 25 182 individuals without known coronary heart disease were included (50.6% women). Any CCTA-detected atherosclerosis was found in 42.1%; any significant stenosis (≥50%) in 5.2%; left main, proximal left anterior descending artery, or 3-vessel disease in 1.9%; and any noncalcified plaques in 8.3% of this population. Onset of atherosclerosis was delayed on average by 10 years in women. Atherosclerosis was more prevalent in older individuals and predominantly found in the proximal left anterior descending artery. Prevalence of CCTA-detected atherosclerosis increased with increasing CAC scores. Among those with a CAC score >400, all had atherosclerosis and 45.7% had significant stenosis. In those with 0 CAC, 5.5% had atherosclerosis and 0.4% had significant stenosis. In participants with 0 CAC and intermediate 10-year risk of atherosclerotic cardiovascular disease according to the pooled cohort equation, 9.2% had CCTA-verified atherosclerosis. Prevalence estimates had excellent external validity and changed marginally when adjusted to the age-matched Swedish background population.Conclusions: Using CCTA in a large, random sample of the general population without established disease, we showed that silent coronary atherosclerosis is common in this population. High CAC scores convey a significant probability of substantial stenosis, and 0 CAC does not exclude atherosclerosis, particularly in those at higher baseline risk.
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| 2. |
- Bergström, Göran, et al.
(författare)
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Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population
- 2021
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Ingår i: Circulation. - : Wolters Kluwer. - 0009-7322 .- 1524-4539. ; 144:12, s. 916-929
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Tidskriftsartikel (refereegranskat)abstract
- Background: Early detection of coronary atherosclerosis using coronary computed tomography angiography (CCTA), in addition to coronary artery calcification (CAC) scoring, may help inform prevention strategies. We used CCTA to determine the prevalence, severity, and characteristics of coronary atherosclerosis and its association with CAC scores in a general population.Methods: We recruited 30 154 randomly invited individuals age 50 to 64 years to SCAPIS (the Swedish Cardiopulmonary Bioimage Study). The study includes individuals without known coronary heart disease (ie, no previous myocardial infarctions or cardiac procedures) and with high-quality results from CCTA and CAC imaging performed using dedicated dual-source CT scanners. Noncontrast images were scored for CAC. CCTA images were visually read and scored for coronary atherosclerosis per segment (defined as no atherosclerosis, 1% to 49% stenosis, or ≥50% stenosis). External validity of prevalence estimates was evaluated using inverse probability for participation weighting and Swedish register data.Results: In total, 25 182 individuals without known coronary heart disease were included (50.6% women). Any CCTA-detected atherosclerosis was found in 42.1%; any significant stenosis (≥50%) in 5.2%; left main, proximal left anterior descending artery, or 3-vessel disease in 1.9%; and any noncalcified plaques in 8.3% of this population. Onset of atherosclerosis was delayed on average by 10 years in women. Atherosclerosis was more prevalent in older individuals and predominantly found in the proximal left anterior descending artery. Prevalence of CCTA-detected atherosclerosis increased with increasing CAC scores. Among those with a CAC score >400, all had atherosclerosis and 45.7% had significant stenosis. In those with 0 CAC, 5.5% had atherosclerosis and 0.4% had significant stenosis. In participants with 0 CAC and intermediate 10-year risk of atherosclerotic cardiovascular disease according to the pooled cohort equation, 9.2% had CCTA-verified atherosclerosis. Prevalence estimates had excellent external validity and changed marginally when adjusted to the age-matched Swedish background population.Conclusions: Using CCTA in a large, random sample of the general population without established disease, we showed that silent coronary atherosclerosis is common in this population. High CAC scores convey a significant probability of substantial stenosis, and 0 CAC does not exclude atherosclerosis, particularly in those at higher baseline risk.
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| 3. |
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| 4. |
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| 5. |
- Fransson, Göran, 1968-, et al.
(författare)
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On the Swedish National Grade School for Digital Technologies in Education – GRADE : Expectations and experiences of doctorial students and supervisors
- 2018
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Ingår i: ICERI2018 Proceedings. - Sevilla : IATED. - 9788409059485 ; , s. 769-774
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Konferensbidrag (refereegranskat)abstract
- The Swedish National Graduate School for Digital Technologies in Education (GRADE) is a cooperative venture between six Swedish universities established during 2018. Within the field of educational sciences and in the area of digital technologies in education, GRADE aims to strengthen the expertise in the area and to increase national and international cooperation in research training activities.Over a number of years, and from multitude of sources (cf. Brown & Davis, 2004; Fisher, Higgins & Loveless, 2006; Kafai & Resnick 1996), research has stressed that increased digitalization in schools leads to a complexity that needs to be taken into account on different levels, from different perspectives and with different designs, methodologies and theoretical perspectives (cf. Olofsson, Lindberg, Fransson & Hauge, 2015; Price, Jewitt & Brown, 2013; Tondeur, Valcke & van Braak, 2008). At a micro-level, the learning situation of students, teachers and school-leaders changes and it becomes important to deepen the knowledge about the impact digital technologies has on the fundamental conditions for teaching and learning of different school subjects (cf. Chun, Kern & Smith 2016; Leung & Baccaglini-Frank, 2017). On a macro-level, conditions for education as such changes and digital technologies becomes an important object of study as agents of change (Wong & Li, 2008). The digitalization of K-12 schools has long been highlighted in policy as a necessity (cf. Kirkman et al, 2002; OECD, 2010). However, research and evaluations (cf. Fransson et al, 2012; OECD, 2015; Wastiau et al, 2013) show that many substantial challenges remain. One of the fundamental pillars of GRADE is the interdisciplinary approach. Several disciplines are present (Applied IT, Curriculum studies, Education, Informatics, Technology and Learning, Educational work, Work-interated Learning) in researching digital technologies in K-12 schools with the ambition to contribute to the continued implementation, integration and use of digital technologies in Swedish K-12 schools that stems from the evidence-based knowledge produced within the activities of GRADE. The research within GRADE will be characterized by close cooperation with stakeholders from school practice, with the aim to contribute to concrete school development. In GRADE, a multi-level approach that involves multiple layers or levels of school activities will be encouraged. When possible, studies will be longitudinal. This will imply studies from an organizational and management perspective, e.g. studies of school leaders and other members of senior management positions responsible for digital technology use and implementation. Also implied are studies of teachers' teaching practices and didactical considerations, as well as studies of the students in classrooms and their learning using digital technologies. This will also imply that several issues with a bearing on the digitalization of education, for example regarding school policy, teaching, learning, assessment and professional development will be researched from different perspectives and with different methodological approaches. In this paper, these points of departure will be explored based on the expectations and experiences of the first twelve admitted doctoral students and their supervisors.
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| 6. |
- Ivarsson, Sten-A., et al.
(författare)
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Glutamate decarboxylase antibodies in non-diabetic pregnancy precedes insulin-dependent diabetes in the mother but not necessarily in the offspring
- 1997
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Ingår i: Autoimmunity. - 0891-6934. ; 26:4, s. 261-269
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Tidskriftsartikel (refereegranskat)abstract
- We studied the risk for diabetes of glutamate decarboxylase (GAD65Ab) and islet cell (ICA) autoantibodies in non-diabetic pregnant mothers and their children. Pregnancy and cord blood sera were collected in 1970-87 from about 35,000 mothers who delivered a child in the city of Malmo, Sweden. A total of 42 mothers were identified in 1988 who, 1-18 years after their pregnancies, had developed either insulin-dependent (n = 22) or non-insulin dependent (n = 20) diabetes mellitus. First, in 123 pregnant mothers selected as controls, 0.8% had GAD65Ab and 0.8% ICA. Second, among the mothers with non-insulin dependent diabetes, 7/20 (35%) had GAD65Ab eight months to 13 years, 10 months before clinical diagnosis. Third, in mothers who later developed insulin-dependent diabetes, 12/22 (55%) had GAD65Ab and 10/22 (45%) had ICA in pregnancies preceding the clinical diagnosis by 13 months to 9 years, 4 months. In 1996, none of the children born to the 42 mothers have developed diabetes. GAD65Ab and ICA in non-diabetic pregnancies may predict insulin-dependent diabetes in the mother but not necessarily in the offspring.
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| 7. |
- Ng, Nawi, 1974, et al.
(författare)
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Sustainable Behavior Change for Health Supported by Person-Tailored, Adaptive, Risk-Aware Digital Coaching in a Social Context: Study Protocol for the STAR-C Research Programme
- 2021
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Ingår i: Frontiers in Public Health. - : Frontiers Media SA. - 2296-2565. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The Vasterbotten Intervention Programme (VIP) in the Region Vasterbotten Sweden is one of the very few cardiovascular disease (CVD) prevention programmes globally that is integrated into routine primary health care. The VIP has been shown as a cost-effective intervention to significantly reduce CVD mortality. However, little is known about the effectiveness of a digital solution to tailor risk communication strategies for supporting behavioral change. STAR-C aims to develop and evaluate a technical platform for personalized digital coaching that will support behavioral change aimed at preventing CVD. Methods: STAR-C employs a mixed-methods design in seven multidisciplinary projects, which runs in two phases during 2019-2024: (i) a formative intervention design and development phase, and (ii) an intervention implementation and evaluation phase. In the 1st phase, STAR-C will model the trajectories of health behaviors and their impact on CVDs (Project 1), evaluate the role of the social environment and social networks on behavioral change (Project 2) and assess whether and how social media facilitates the spread of health information beyond targeted individuals and stimulates public engagement in health promotion (Project 3). The findings will be utilized in carrying out the iterative, user-centered design, and development of a person-tailored digital coaching platform (Project 4). In the 2nd phase, STAR-C will evaluate the implementation of the coaching programme and its effectiveness for promoting behavioral change and the spreading of health information across social networks and via social media (Project 5). The cost-effectiveness (Project 6) and ethical issues (Project 7) related to the coaching programme intervention will be evaluated. Discussion: The STAR-C research programme will address the knowledge and practice research gaps in the use of information technologies in health promotion and non-communicable disease (NCD) prevention programmes in order to narrow the health inequality gaps. Ethics: STAR-C has received approval from the Swedish Ethical Review Authority (Dnr. 2019-02924;2020-02985). Dissemination: The collaboration between Umea University and Region Vasterbotten will ensure the feasibility of STAR-C in the service delivery context. Results will be communicated with decision-makers at different levels of society, stakeholders from other regions and healthcare professional organizations, and through NGOs, local and social media platforms.
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| 8. |
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| 9. |
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| 10. |
- Andersson, Roger, et al.
(författare)
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Analysis of the relationship between UV-absorbance of solute contents during a dialysis session
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- In this paper, the influence from patient anamnesis and haemodialysis session specifications onto the relationship between obtained ultra violet (UV) absorbance and urea concentration in the spent dialysate were discussed. A characterisation of the relationship was done by an intercept value and a slope. Recently, a new a dialysate monitoring device, using UV- absorbance, been developed by our group which has found a relationship between the UV- absorbance and waste products in the dialysate but this relationship vary between patients. In the present investigation, 13 patients performing totally 84 sessions were characterised using 31 possible affecting parameters. Using a multi-regression analysis 11 parameters were found significant as affecting parameters. In a novel mathematical model approach the obtained UV- absorbance and incorporating possible affecting parameters we could predict urea concentration from the UV-absorption in the spent dialysate in the total material of patients and dialysis sessions. For all the 84 sessions R2 between 0.938 and 0.996 were obtained. A performed analysis of variance rejects the assumption of equal conditions for the relationship between diabetics and non-diabetics patients in the material (F=5.2 for intercept and F=14.4 for slope). The urea concentration could be estimated with an accuracy of 11% (one standard deviation) which is normally clinically sufficient. The non-invasive UV -absorption method therefore seems to have great potential for monitoring and control haemodialysis sessions.
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| 11. |
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| 12. |
- Andersson, Roger, et al.
(författare)
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Non-invasive monitoring of haemodynamic changes in haemodialysis patients using photoplethysmography (PPG)
- 2002
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Presently there is no simple non-invasive method to monitor haemodynamic changes during haemodialysis but such a method is highly needed. This study aims at investigating the possibility to monitor such changes during a single haemodialysis session using a photoplethysmography method (PPG). This non-invasive method illuminates a proportion of the patients skin and the received PPG-signal reflects local blood flow. The haemodialysis sessions were performed as in normal routine with more frequently performed blood pressure measurements by an oscillometric method or with continuous intra arterial blood pressure measurements. The obtained PPG-signals are linked to the blood pressure changes and are affected by the ultrafiltration rate and drugs administrated during the session. The relation between the blood pressure changes and the changes in the different PPG components seems however to be complex and need to be investigate further. The PPG-method shows promises, which is emphasised by the strong need of a non-invasive monitoring method.
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| 13. |
- Baldanzi, Gabriel, et al.
(författare)
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OSA Is Associated With the Human Gut Microbiota Composition and Functional Potential in the Population-Based Swedish CardioPulmonary bioImage Study
- 2023
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Ingår i: Chest. - : Elsevier. - 0012-3692 .- 1931-3543. ; 164:2, s. 503-516
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Obstructive sleep apnea (OSA) is a common sleep-breathing disorder linked to increased risk of cardiovascular disease. Intermittent hypoxia and intermittent airway obstruction, hallmarks of OSA, have been shown in animal models to induce substantial changes to the gut microbiota composition and subsequent transplantation of fecal matter to other animals induced changes in blood pressure and glucose metabolism.RESEARCH QUESTION: Does obstructive sleep apnea in adults associate with the composition and metabolic potential of the human gut microbiota?STUDY DESIGN AND METHODS: We used respiratory polygraphy data from up to 3,570 individuals aged 50-64 from the population-based Swedish CardioPulmonary bioImage Study combined with deep shotgun metagenomics of fecal samples to identify cross-sectional associations between three OSA parameters covering apneas and hypopneas, cumulative sleep time in hypoxia and number of oxygen desaturation events with gut microbiota composition. Data collection about potential confounders was based on questionnaires, on-site anthropometric measurements, plasma metabolomics, and linkage with the Swedish Prescribed Drug Register.RESULTS: We found that all three OSA parameters were associated with lower diversity of species in the gut. Further, the OSA-related hypoxia parameters were in multivariable-adjusted analysis associated with the relative abundance of 128 gut bacterial species, including higher abundance of Blautia obeum and Collinsela aerofaciens. The latter species was also independently associated with increased systolic blood pressure. Further, the cumulative time in hypoxia during sleep was associated with the abundance of genes involved in nine gut microbiota metabolic pathways, including propionate production from lactate. Lastly, we observed two heterogeneous sets of plasma metabolites with opposite association with species positively and negatively associated with hypoxia parameters, respectively.INTERPRETATION: OSA-related hypoxia, but not the number of apneas/hypopneas, is associated with specific gut microbiota species and functions. Our findings lay the foundation for future research on the gut microbiota-mediated health effects of OSA.
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| 14. |
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| 15. |
- Bergstrand, Sara, et al.
(författare)
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Blood flow measurements at different depths using photoplethysmography and laser Doppler techniques
- 2009
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Ingår i: Skin research and technology. - : Wiley-Blackwell. - 0909-752X .- 1600-0846. ; 15:2, s. 139-147
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Tidskriftsartikel (refereegranskat)abstract
- Background/purpose: This study has evaluated a multi-parametric system combining laser Doppler flowmetry and photoplethysmography in a single probe for the simultaneous measurement of blood flow at different depths in the tissue. This system will be used to facilitate the understanding of pressure ulcer formation and in the evaluation of pressure ulcer mattresses.Methods: The blood flow in the tissue over the sacrum was measured before, during and after loading with 37.5 mmHg, respectively, 50.0 mmHg. The evaluation of the system consisted of one clinical part, and the other part focusing on the technicalities of the probe prototype.Results: An increase in blood flow while loading was the most common response, but when the blood flow decreased during loading it was most affected at the skin surface and the blood flow responses may be different due to depths of measurement. Reactive hyperaemia may occur more frequently in the superficial layers of the tissue.Conclusion: The study showed that the new system is satisfactory for measuring tissue blood flow at different depths. The laser Doppler complements the photoplethysmography, and further development of the system into a thin flexible probe with the ability to measure a larger area is required.
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| 16. |
- Bergstrand, Sara, et al.
(författare)
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Existence of Tissue Blood Flow in Response to External Pressure in the Sacral Region of Elderly Individuals - Using an Optical Probe Prototype
- 2010
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Ingår i: MICROCIRCULATION. - : Taylor and Francis. - 1073-9688 .- 1549-8719. ; 17:4, s. 311-319
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Tidskriftsartikel (refereegranskat)abstract
- Pandgt;Objective: The aim was to investigate the existence of sacral tissue blood flow at different depths in response to external pressure and compression in elderly individuals using a newly developed optical probe prototype. Methods: The tissue blood flow and tissue thickness in the sacral area were measured during load in 17 individuals using laser Doppler flowmetry and photoplethysmography in a combined probe, and digital ultrasound. Results: The mean age was 68.6 +/- 7.0 years. While loading, the mean compression was 60.3 +/- 11.9%. The number of participants with existing blood flow while loading increased with increased measurement depth. None had enclosed blood flow deep in the tissue and at the same time an existing more superficial blood flow. Correlation between tissue thickness and BMI in unloaded and loaded sacral tissue was shown: r = 0.68 (P = 0.003) and r = 0.68 (P = 0.003). Conclusions: Sacral tissue is highly compressed by external load. There seems to be a difference in responses to load in the different tissue layers, as occluded blood flow in deeper tissue layers do not occur unless the blood flow in the superficial tissue layers is occluded.
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| 17. |
- Bergstrand, Sara, et al.
(författare)
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Pressure-induced vasodilation and reactive hyperemia at different depths in sacral tissue under clinically relevant conditions
- 2014
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Ingår i: Microcirculation. - : John Wiley & Sons. - 1073-9688 .- 1549-8719. ; 21:8, s. 761-771
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To characterize pressure-induced vasodilatation and reactive hyperemia at different sacral tissue depths in different populations under clinically relevant pressure exposure.METHODS: Forty-two subjects (< 65 years), 38 subjects (≥ 65 years), and 35 patients (≥ 65 years) participated. Interface pressure, skin temperature, and blood flow at tissue depths of 1 mm, 2 mm, and 10 mm (using laser Doppler flowmetry and photoplethysmography) were measured in the sacral tissue before, during, and after load in a supine position.RESULTS: pressure-induced vasodilatation and reactive hyperemia were observed at three tissue depths. At 10 mm depth, the proportion of subjects with a lack of pressure-induced vasodilatation was higher compared to superficial depths. The patients had higher interface pressure during load than the healthy individuals, but there were no significant differences in blood flow. Twenty-nine subjects in all three study groups were identified with a lack of pressure-induced vasodilatation and reactive hyperemia.CONCLUSIONS: pressure-induced vasodilatation and reactive hyperemia can be measured at different tissue depths. A lack of these responses was found in healthy individuals as well as in patients indicating an innate susceptibility in some individuals, and are potential important factors to evaluate in order to better understand the etiology of pressure ulcers.
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| 18. |
- Bergstrand, Sara, 1978-
(författare)
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Preventing pressure ulcers by assessment of the microcirculation in tissue exposed to pressure
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to combine optical methods into a system with the ability to simultaneously measure blood flow changes at different tissue depths. The goal of such a system was to reveal vascular mechanisms relevant to pressure ulcer etiology under clinically relevant conditions and in relation to the evaluation of pressure-redistribution support surfaces.This thesis consists of four quantitative, cross-sectional studies measuring blood flow responses before, during, and after pressure exposure of the sacral tissue. Two optical methods – photoplethysmography and laser Doppler flowmetry – were combined in a newly developed system that has the ability to discriminate blood flows at different tissue depths. Studies I and II explored blood flow responses at different depths in 17 individuals. In Study I the blood flow was related to tissue thickness and tissue compression during pressure exposure of ≥ 220 mmHg. In Study II, the sacral tissue was loaded with 37.5 mmHg and 50.0 mmHg, and the variation in blood flow was measured. Studies III and IV included 42 healthy individuals < 65 years, 38 healthy individuals ≥ 65 years, and 35 patients ≥ 65 years. Study III included between-subject comparisons of blood flow and pressure between individuals in the three study groups lying in supine positions on a standard hospital mattress. Study IV added within-subject comparisons while the individual was lying on four different types of mattress. The studies explored the vascular phenomena pressure-induced vasodilation (PIV) and reactive hyperemia (RH).The most common blood flow response to tissue exposure in this thesis was PIV, although a decrease in blood flow (a lack of PIV) was observed in some individuals. The patients tended to have higher interface pressure during pressure exposure than the healthy groups but no differences in blood flow responses were seen. Our results showed that pressure levels that are normally considered to be harmless could have a significant effect on the microcirculation in different tissue structures. Differences in individual blood flow responses in terms of PIV and RH were seen, and a larger proportion of individuals lacked these responses in the deeper tissue structures compared to more superficial tissue structures.This thesis identified PIV and RH that are important vascular mechanisms for pressure ulcer development and revealed for the first time that PIV and RH are present at different depths under clinically relevant conditions. The thesis also identified a population of individuals not previously identified who lack both PIV and RH and seem to be particularly vulnerable to pressure exposure. Further, this thesis has added a new perspective to the microcirculation in pressure ulcer etiology in terms of blood flow regulation and endothelial function that are anchored in clinically relevant studies. Finally, the evaluation of pressureredistribution support surfaces in terms of mean blood flow during and after tissue exposure was shown to be unfeasible, but the assessment of PIV and RH could provide a new possibility for measuring individual physiological responses that are known to be related to pressure ulcer development.
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| 19. |
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| 20. |
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| 21. |
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| 22. |
- Brattmyr, Martin, et al.
(författare)
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Clinically representative therapy for Nordic adult outpatients with common mental health problems : A systematic review and meta-analysis
- 2024
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Ingår i: Scandinavian Journal of Psychology. - : John Wiley & Sons. - 0036-5564 .- 1467-9450. ; 65:2, s. 311-320
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Forskningsöversikt (refereegranskat)abstract
- There is a knowledge gap regarding clinically representative therapy given in routine settings, that is treatment as usual (TAU), for patients with common mental health problems (CMHP). This review and meta-analysis aimed to investigate what characterizes clinically representative therapy in Nordic routine clinics and meta-analyze the outcome of such treatment. Databases (PubMed, EMBASE, PsychINFO, and SveMed+) were searched for TAU, CMHP, and Nordic countries, together with backward and forward search in Scopus (7 November 2022). Studies were either randomized controlled trials (RCT) or open trials, using prospective study designs, examining heterogeneous outpatient groups in routine treatment. Within- and between-group effect sizes (ES), using random effects model, and moderator analyses were calculated. Eleven studies (n = 1,413), demonstrated a small to moderate within-group ES with high heterogeneity (g = 0.49, I2 = 90%). ESs in RCTs were significantly smaller than in open trials. TAU had a marginally smaller ES (g = −0.21; adjusted for publication bias g = −0.06) compared to a broad set of clinical interventions. Clinically representative therapy in the Nordic countries demonstrated a wide variety of characteristics and also a marginally lower ES compared to other interventions. The ESs were smaller than other meta-analyses examining evidence-based treatments in routine treatment.
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| 23. |
- Edner, Anna, et al.
(författare)
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Does a magnetic blanket induce changes in muscular blood flow, skin temperature and muscular tension in horses?
- 2015
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Ingår i: Equine Veterinary Journal. - : Wiley. - 0425-1644 .- 2042-3306. ; 47:3, s. 302-307
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Tidskriftsartikel (refereegranskat)abstract
- Reasons for performing studyStatic magnetic blankets are often claimed to induce increases in blood flow, reduce muscle tension and tenderness, and be beneficial in both prevention and treatment of musculoskeletal injuries in horses. However, there are no studies that confirm alleged beneficial effects of magnets on muscles of the back in healthy horses. ObjectivesTo investigate whether static magnets sewn into a blanket affect back muscle blood flow, skin temperature, mechanical nociceptive threshold (MNT) and behaviour in healthy horses. Study designProspective, randomised, blinded, placebo-controlled crossover study. MethodsThe following outcome measurements of the back of 10 healthy horses were performed; blood flow by photoplethysmography, skin temperature by use of thermistors in conjunction with digital infrared thermography, and MNTs by algometry. The horses behaviour was filmed during the procedure and scored on an ethogram. Measurements were performed repeatedly for a 30min baseline period. Thereafter a blanket with active, static magnets (900 gauss) or placebo magnets was placed on the horse and measurements were performed for a 60min treatment period and a 30min post treatment period. The study procedure was repeated on the consecutive day, when the horse received the alternative treatment. ResultsBlood flow in muscle, skin temperatures, MNTs and behavioural traits did not differ between active and placebo magnetic blankets. Skin temperature increased similarly during both active and placebo blanket treatment. ConclusionsIn healthy horses, magnetic blankets did not induce additional significant effects on muscle blood flow, skin temperature, MNTs and behaviour when compared with nonmagnetic blankets.
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| 24. |
- Ekström, Magnus Pär, et al.
(författare)
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The association of body mass index, weight gain and central obesity with activity-related breathlessness : the Swedish Cardiopulmonary Bioimage Study
- 2019
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Ingår i: Thorax. - : BMJ Publishing Group Ltd. - 0040-6376 .- 1468-3296. ; 74:10, s. 958-964
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Breathlessness is common in the population, especially in women and associated with adverse health outcomes. Obesity (body mass index (BMI) >30 kg/m(2)) is rapidly increasing globally and its impact on breathlessness is unclear.Methods: This population-based study aimed primarily to evaluate the association of current BMI and self-reported change in BMI since age 20 with breathlessness (modified Research Council score >= 1) in the middle-aged population. Secondary aims were to evaluate factors that contribute to breathlessness in obesity, including the interaction with spirometric lung volume and sex.Results: We included 13 437 individuals; mean age 57.5 years; 52.5% women; mean BMI 26.8 (SD 4.3); mean BMI increase since age 20 was 5.0 kg/m(2); and 1283 (9.6%) reported breathlessness. Obesity was strongly associated with increased breathlessness, OR 3.54 (95% CI, 3.03 to 4.13) independent of age, sex, smoking, airflow obstruction, exercise level and the presence of comorbidities. The association between BMI and breathlessness was modified by lung volume; the increase in breathlessness prevalence with higher BMI was steeper for individuals with lower forced vital capacity (FVC). The higher breathlessness prevalence in obese women than men (27.4% vs 12.5%; p<0.001) was related to their lower FVC. Irrespective of current BMI and confounders, individuals who had increased in BMI since age 20 had more breathlessness.Conclusion: Breathlessness is independently associated with obesity and with weight gain in adult life, and the association is stronger for individuals with lower lung volumes.
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| 25. |
- Engström, Gunnar, et al.
(författare)
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Pulmonary function and atherosclerosis in the general population : causal associations and clinical implications
- 2024
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Ingår i: European Journal of Epidemiology. - : Springer Nature. - 0393-2990 .- 1573-7284. ; 39:1, s. 35-49
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Tidskriftsartikel (refereegranskat)abstract
- Reduced lung function is associated with cardiovascular mortality, but the relationships with atherosclerosis are unclear. The population-based Swedish CArdioPulmonary BioImage study measured lung function, emphysema, coronary CT angiography, coronary calcium, carotid plaques and ankle-brachial index in 29,593 men and women aged 50–64 years. The results were confirmed using 2-sample Mendelian randomization. Lower lung function and emphysema were associated with more atherosclerosis, but these relationships were attenuated after adjustment for cardiovascular risk factors. Lung function was not associated with coronary atherosclerosis in 14,524 never-smokers. No potentially causal effect of lung function on atherosclerosis, or vice versa, was found in the 2-sample Mendelian randomization analysis. Here we show that reduced lung function and atherosclerosis are correlated in the population, but probably not causally related. Assessing lung function in addition to conventional cardiovascular risk factors to gauge risk of subclinical atherosclerosis is probably not meaningful, but low lung function found by chance should alert for atherosclerosis.
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| 26. |
- Fosgerau, M., et al.
(författare)
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A note on the invariance of the distribution of the maximum
- 2018
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Ingår i: Journal of Mathematical Economics. - : Elsevier. - 0304-4068 .- 1873-1538. ; 74, s. 56-61
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Tidskriftsartikel (refereegranskat)abstract
- Many models in economics involve discrete choices where a decision-maker selects the best alternative from a finite set. Viewing the array of values of the alternatives as a random vector, the decision-maker draws a realization and chooses the alternative with the highest value. The analyst is then interested in the choice probabilities and in the value of the best alternative. The random vector has the invariance property if the distribution of the value of a specific alternative, conditional on that alternative being chosen, is the same, regardless of which alternative is considered. This note shows that the invariance property holds if and only if the marginal distributions of the random components are positive powers of each other, even when allowing for quite general statistical dependence among the random components. We illustrate the analytical power of the invariance property by way of examples.
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| 27. |
- Fosgerau, Mogens, et al.
(författare)
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Invariance of the distribution of the maximum
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Many models in economics involve probabilistic choices where each decision-maker selects the best alternative from a finite set. Viewing the value of each alternative as a random variable, the analyst is then interested in the choice probabilities, that is, the probability for an alternative to give the maximum value. Much analytical power can be gained, both for positive and normative analysis, if the maximum value is statistically independent of which alternative obtains the highest value. This note synthesizes and generalizes previous results on this invariance property. We provide characterizations of this property within a wide class of distributions that comprises the McFadden GEV class, show implications in several directions, and establish connections with copulas. We illustrate the usefulness of the invariance property by way of a few examples.
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| 28. |
- Fridolin, Ivo, et al.
(författare)
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Measurement of solutes in dialysate using UV absorption
- 2001
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Ingår i: Proceedings of SPIE, the International Society for Optical Engineering. - : SPIE. - 0277-786X .- 1996-756X. ; 4263, s. 40-47
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this work was to describe a new method for optical monitoring of solutes in a spent dialysate. The method utilizes UV light absorption employing a commercially available spectrophotometer. Measurements were performed both on collected dialysate samples and on-line. The concentration of several removed solutes and electrolytes in the serum and in the dialysate was determined simultaneously using standard laboratory techniques. During on-line monitoring the spectrophotometer was connected to the fluid outlet of the dialysis machine. On-line measurements during a single hemodialysis session demonstrated a possibility to monitor deviations in the dialysator performance (e.g. dialysator in bypass). The experimental results indicated a good correlation between UV absorption and several removed solutes (urea, creatinine) in the spent dialysate. The correlation coefficient for urea and creatinine concentrations in the dialysate was very high for every individual treatment. The UV absorbance correlates well to the concentrations of several solutes thought to be uremic toxins. The results indicate that the technique can be used as a continuous, on-line method for monitoring deviations in the dialysator performance and may estimate the removal of the overall toxins. In the future, the new method will be used to evaluate parameters describing delivery of the prescribed treatment dose such as KT/V and Urea Reduction Rate (URR).
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| 29. |
- Fridolin, Ivo, et al.
(författare)
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On-line monitoring of solutes in dialysate using adsorption of ultraviolet radiation : technical description
- 2002
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Ingår i: International Journal of Artificial Organs. - 0391-3988 .- 1724-6040. ; 25:8, s. 748-761
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE:The aim of this work was to describe a new optical method for monitoring solutes in a spent dialysate using absorption of UV radiation.METHOD:The method utilises UV-absorbance determined in the spent dialysate using a spectrophotometrical set-up. Measurements were performed both on collected dialysate samples and on-line. During on-line monitoring, a spectrophotometer was connected to the fluid outlet of the dialysis machine, with all spent dialysate passing through a specially-designed cuvette for optical single-wavelength measurements. The concentrations of several substances of various molecular sizes, electrical charge, transport mechanism, etc. were determined in the dialysate and in the blood using standard laboratory techniques. The correlation coefficient between UV-absorbance of the spent dialysate and concentration of the substances in the spent dialysate and in the blood was calculated from data based on the collected samples.RESULTS:The obtained on-line UV-absorbance curve demonstrates the possibility to follow a single hemodialysis session continuously and to monitor deviations in the dialysator performance using UV-absorbance. The experimental results indicate a very good correlation between UV-absorbance and several small waste solutes removed such as urea, creatinine and uric acid in the spent dialysate and in the blood for every individual treatment at a fixed wavelength of 285 nm. Moreover, a good correlation between the UV-absorbance and substances like potassium, phosphate and beta2-microglobulin was obtained. The lowest correlation was achieved for sodium, calcium, glucose, vitamin B12 and albumin.CONCLUSIONS:A technique for on-line monitoring of solutes in the spent dialysate utilising the UV-absorbance was developed. On-line monitoring during a single hemodialysis session exploiting UV-absorbance represents a possibility to follow a single hemodialysis session continuously and monitor deviations in dialysis efficiency (e.g. changes in blood flow and clearance). The UV-absorbance correlates well to the concentration of several solutes known to accumulate in dialysis patients indicating that the technique can be used to estimate the removal of retained substances.
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| 30. |
- Fridolin, Ivo, 1971-, et al.
(författare)
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On-line monitoring of solutes in dialysate using wavelength-dependent absorption of ultraviolet radiation
- 2003
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Ingår i: Medical and Biological Engineering and Computing. - 0140-0118 .- 1741-0444. ; 41:3, s. 263-270
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to assess the wavelength dependence of the UV absorbance during monitoring of different compounds in the dialysate. UV absorbance was determined by using a double-beam spectrophotometer on dialysate samples taken at pre-determined times during dialysis, over a wavelength range of 180–380 nm. Concentrations of several removed substances, such as urea, creatinine, uric acid, phosphate and β 2-microglobulin, were determined in the blood and in the spent dialysate samples using standard laboratory techniques. Millimolar extinction coefficients, for urea, creatinine, monosodium phosphate and uric acid were determined during laboratory bench experiments. The correlation between UV absorbance and substances both in the dialysate and in the blood was calculated at all wavelengths. A time-dependent UV absorbance was determined on the collected dialysate samples from a single dialysis session over a wavelength range of 200–330 nm. The highest contribution from observed compounds relative to the mean value of the absorbance was found around 300 nm and was approximately 70%. The main contribution to the total absorbance from uric acid was confirmed at this wavelength. The highest correlation for uric acid, creatinine and urea was obtained at wavelengths from 280 nm to 320 nm, both in the spent dialysate and in the blood. The wavelength region with the highest correlation for phosphate and β 2-microglobulin, with a suitable UV-absorbance dynamic range, was from 300 to 330 nm. In the wavelength range of 220–270 nm the highest absorbance sensitivity for the observed substances was obtained. A suitable wavelength range for instrumental design seems tobe around 290–330 nm. The relatively high correlation between UV absorbance and the substances in the spent dialysate and in the blood indicates that the UV-absorbance technique can estimate the removal of several retained solutes known to accumulate in dialysis patients.
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| 31. |
- Fridolin, Ivo, et al.
(författare)
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Optical non-invasive technique for vessel imaging : I. Experimental results
- 2000
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Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 0031-9155 .- 1361-6560. ; 45:12, s. 3765-3778
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Tidskriftsartikel (refereegranskat)abstract
- This paper investigates some prerequisites for vessel imaging based on diffuse reflectance measurements in order to develop an optical non-invasive method for the imaging and monitoring of vessels.The method utilizes near-infrared (NIR) radiation (890 nm) from a light emitting diode. The light is guided into the tissue via an optical fibre (diameter 1.0 mm). The backscattered light is collected by an optical fibre of the same type and detected by an optical power meter. The fibres are moved over the skin in two directions with the aid of two motors operated by a microcomputer. Spatially resolved reflectance at the skin surface could be presented as a vessel-map in a colour-coded form on a computer screen.Experimental results indicate that the vessel imaging facility depends upon source-detector separation, relative position and vessel depth, and does not depend essentially on the radiant power from the light source. It is shown that, by a proper choice of probe parameters, one can improve the vessel identification ability.After vessel imaging the technique can potentially be used to monitor several physiological parameters on a selected vascular bed or to distinguish between injured and healthy tissue by monitoring local blood flow, oxygen saturation and the recirculation, pre- and post-operatively.
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| 32. |
- Fridolin, Ivo, 1971-, et al.
(författare)
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Optical non-invasive technique for vessel imaging : II. A simplified photon diffusion analysis
- 2000
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Ingår i: Physics in Medicine and Biology. - : Institute of Physics (IOP). - 0031-9155 .- 1361-6560. ; 45:12, s. 3779-3792
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this paper is to explain theoretically the origin of previously presented experimental results by an optical non-invasive method using NIR for imaging blood vessels based on a specific combination of several physical parameters. The theoretical model is based on the diffusion approximation derived from the transport theory deep in a bulk tissue. An analytical solution was obtained describing photon behaviour under certain conditions during vessel identification. The modelled results indicate that the vessel identification facility depends upon source-detector separation and vessel depth, and does not depend essentially on the radiant power from the light source. The solution offers a relatively simple theoretical explanation of the experimental results and can be applied to several other clinical applications using similar technical solutions.
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| 33. |
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| 34. |
- Glasin, Joakim, et al.
(författare)
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Wireless vitals : Proof of concept for wireless patient monitoring in an emergency department setting
- 2019
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Ingår i: Journal of Biophotonics. - : Wiley-VCH Verlagsgesellschaft. - 1864-063X .- 1864-0648. ; 12:4
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Tidskriftsartikel (refereegranskat)abstract
- Vital sign assessment is a common task in emergency medicine, but resources for continuous monitoring are restricted, data is often recorded manually, and entangled wires cause frustration. Therefore, we designed a small, wireless photoplethysmographic device capable of continuously assessing pulse, respiratory frequency and oxygen saturation on the sternum and tested the performance and feasibility in an emergency department setting. Fifty (56.3 20.2 years), consenting emergency patients (29 male) were recruited. Heart rate, respiratory rate and oxygen saturation were recorded simultaneously using the device and standard monitoring equipment. Data was compared using Bland-Altman plotting (heart rate, respiratory rate) and mean difference (oxygen saturation). The bias for heart- and respiratory rate was 0.4 (limits of agreements -11.3, 12.2 and -6.1, 7.0). Mean difference for oxygen saturation was -0.21 +/- 2.35%. This may be the first wireless device to use photoplethysmography on the sternum for vital sign assessment. We noted good agreement with standard monitors, but lack of standardization in data processing between monitoring systems may limit the generalizability of these findings. Although further improvements are needed, the feasibility of this approach provides proof of concept for a new paradigm of large scale, wireless patient monitoring.
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| 35. |
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| 36. |
- Hagblad, Jimmie, et al.
(författare)
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A technique based on laser Doppler flowmetry and photoplethysmography for simultaneously monitoring blood flow at different tissue depths
- 2010
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Ingår i: Medical and Biological Engineering and Computing. - : Springer Science Business Media. - 0140-0118 .- 1741-0444. ; 48:5, s. 415-422
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to validate a non-invasive optical probe for simultaneous blood flow measurement at different vascular depths combining three photoplethysmography (PPG) channels and laser Doppler flowmeter (LDF). Wavelengths of the PPG were near-infrared 810 nm with source-to-detector separation of 10 and 25 mm, and green 560 nm with source-to-detector separation of 4 mm. The probe is intended for clinical studies of pressure ulcer aetiology. The probe was placed over the trapezius muscle, and depths from the skin to the trapezius muscle were measured using ultrasound and varied between 3.8 and 23 mm in the 11 subjects included. A provocation procedure inducing a local enhancement of blood flow in the trapezius muscle was used. Blood flows at rest and post-exercise were compared. It can be concluded that this probe is useful as a tool for discriminating between blood flows at different vascular tissue depths. The vascular depths reached for the different channels in this study were at least 23 mm for the near-infrared PPG channel (source-to-detector separation 25 mm), 10-15 mm for the near-infrared PPG channel (separation 10 mm), and shallower than 4 mm for both the green PPG channel (separation 4 mm) and LDF.
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| 37. |
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| 38. |
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| 39. |
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| 40. |
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| 41. |
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| 42. |
- Hagblad, Jimmie, et al.
(författare)
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Technical issues related to the long-term monitoring of blood flow at different depths using LDF and PPG
- 2012
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Ingår i: Physiological Measurement. - : Institute of Physics. - 0967-3334 .- 1361-6579. ; 33:6, s. 985-996
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate an integrated probe using LDF and multiple PPG, for the long-term aspects of skin temperature and blood flow variations at different tissue depths, and especially to investigate whether the presence of the probe affects the temperature. Measurements of temperature and blood flow were performed over 60 min on the lower back of ten subjects, lying on a mattress. The surface temperature of the skin was also measured before and after the 60 min period, and repeated with three probe configurations with the probe switched on, turned off and in the absence of a probe. A general increase in the blood flow was found to occur during the 60 min interval at all depths reached by this probe, but with variations over time. No difference was found in temperatures recorded for the different probe configurations. According to our measurements, the presence of the probe does not affect the skin surface temperature at 60 min. Our investigation shows that skin temperature can be expected to increase and approach the body core temperature by just lying in supine position on the mattress. The increase in temperature and blood flow that is known to occur, possibly attributable to pressure-induced vasodilatation, must be taken into consideration when performing these kinds of measurements.
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| 43. |
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| 44. |
- Hallman, David, 1979-, et al.
(författare)
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Effects of static contraction and cold stimulation on cardiovascular autonomic indices, trapezius blood flow and muscle activity in chronic neck-shoulder pain
- 2011
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Ingår i: European Journal of Applied Physiology. - : Springer Science and Business Media LLC. - 1439-6319 .- 1439-6327. ; 111:8, s. 1725-1735
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to investigate reactions in trapezius muscle blood flow (MBF), muscle activity, heart rate variability (HRV) and systemic blood pressure (BP) to autonomic tests in subjects with chronic neck-shoulder pain and healthy controls. Changes in muscle activity and blood flow due to stress and unfavourable muscle loads are known underlying factors of work-related muscle pain. Aberration of the autonomic nervous system (ANS) is considered a possible mechanism. In the present study, participants (n = 23 Pain, n = 22 Control) performed autonomic tests which included a resting condition, static hand grip test (HGT) at 30% of maximal voluntary contraction, a cold pressor test (CPT) and a deep breathing test (DBT). HRV was analysed in time and frequency domains. MBF and muscle activity were recorded from the upper trapezius muscles using photoplethysmography and electromyography (EMG). The pain group showed reduced low frequency-HRV (LF) and SDNN during rest, as well as a blunted BP response and increased LF-HRV during HGT (a dagger systolic 22 mm Hg; a dagger LF(nu) 27%) compared with controls (a dagger systolic 27; a dagger LF(nu) 6%). Locally, the pain group had attenuated trapezius MBF in response to HGT (Pain 122% Control 140%) with elevated trapezius EMG following HGT and during CPT. In conclusion, only HGT showed differences between groups in systemic BP and HRV and alterations in local trapezius MBF and EMG in the pain group. Findings support the hypothesis of ANS involvement at systemic and local levels in chronic neck-shoulder pain.
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| 45. |
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| 46. |
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| 47. |
- Jönsson, Björn, 1951-, et al.
(författare)
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A new probe for ankle systolic pressure measurement using Photoplethysmography (PPG)
- 2005
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Ingår i: Annals of Biomedical Engineering. - : Springer Science and Business Media LLC. - 0090-6964 .- 1573-9686. ; 33:2, s. 232-239
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Tidskriftsartikel (refereegranskat)abstract
- An automated method for ankle systolic pressure measurement, less operator dependent than the standard continuous wave (CW) Doppler technique, would imply an advantage both in patient measurements and in epidemiological studies. We present a new photoplethysmographic (PPG) probe that uses near-infrared light (880 nm) to detect pulsatory blood flow underneath the distal end of a standard pneumatic cuff. The probe is adapted to the anatomical conditions at the ankle, permitting recording of pressures in both ankle arteries separately. The validity of the equipment was tested with CW Doppler-derived systolic pressures and invasive blood pressure measurements for reference. In 20 healthy subjects, visual analysis of the PPG curves revealed a mean difference between CW Doppler and PPG measurements of –0.5 mmHg (SD 6.9). Corresponding results for the anterior and posterior tibial arteries separately were –1.8 mmHg (SD 6.2) and 0.9 mmHg (SD 7.3), respectively. A correct probe position was essential for the results. In direct recordings from the dorsalis pedis artery in 10 intensive care patients, PPG underestimated systolic pressure in the anterior tibial artery by 4.5 mmHg (SD 12.1). With further development, the PPG probe, integrated in the pneumatic cuff, may simplify measurements of ankle systolic pressures.
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| 48. |
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| 49. |
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| 50. |
- Jönsson, Björn, 1951-, et al.
(författare)
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Automatic ankle pressure measurements using PPG in ankle-brachial pressure index determination
- 2005
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Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1078-5884 .- 1532-2165. ; 30:4, s. 395-401
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo evaluate a new technique using a photoplethysmographic (PPG) probe for automatic ankle pressure measurements.DesignComparative study on two techniques for ankle pressure measurement.SettingUniversity hospital.MaterialThirty-five patients with leg arterial disease and eight healthy volunteers. Ankle-brachial indices (ABPI) were measured using conventional CW Doppler technique and PPG-based prototype equipment for the ankle pressure recordings.Chief outcome measuresABPIs calculated from CW Doppler and PPG ankle pressure measurements. The PPG signals were analysed both by visual judgement and by a software based, automatic algorithm.Main resultsThe mean difference between ABPIs calculated from CW Doppler recordings and PPG (visual analysis) was −0.01 (limits of agreement (±two standard deviations) +0.16 to −0.19). The correlation coefficient was 0.93. When the algorithm was used, the mean difference (CW Doppler−PPG) was 0.05 (limits of agreement 0.28 to −0.18, r=0.89).ConclusionsThe PPG method is a promising technique with an inherent potential for automatisation of the ankle pressure measurements, thereby reducing the observer-dependency in ABPI recordings.
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