| 1. |
- Goodall, G., et al.
(författare)
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Biphasic insulin aspart 70/30 vs. insulin glargine in insulin naïve type 2 diabetes patients : modelling the long-term health economic implications in a Swedish setting
- 2008
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Ingår i: International journal of clinical practice (Esher). - : Wiley-Blackwell Publishing Inc.. - 1368-5031 .- 1742-1241. ; 62:6, s. 869-876
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To evaluate the long-term clinical and economic outcomes of biphasic insulin aspart 70/30 (BIAsp 70/30) treatment vs. insulin glargine in insulin naïve, type 2 diabetes patients failing oral antidiabetic drugs in a Swedish setting.METHODS: A published and validated computer simulation model (the CORE Diabetes Model) was used to project life expectancy, quality-adjusted life expectancy (QALE) and costs over patient lifetimes. Cohort characteristics [54.5% male, mean age 52.4 years, 9 years mean diabetes duration, mean glycosylated haemoglobin (HbA1c) 9.77%] and treatment effects were based on results from the Initiate Insulin by Aggressive Titration and Education (INITIATE) clinical trial. Direct medical costs were accounted in 2006 Swedish Kronor (SEK) and economic and clinical benefits were discounted at 3% per annum.RESULTS: Biphasic insulin aspart 70/30 treatment when compared with insulin glargine treatment was associated with improvements in discounted life expectancy of 0.21 years (13.10 vs. 12.89 years) and QALE of 0.21 quality-adjusted life years (QALYs) (9.16 vs. 8.96 QALYs). Reductions in the incidence of diabetes-related complications in the BIAsp 70/30 treatment arm led to reduced total costs of SEK 10,367 when compared with insulin glargine (SEK 396,475 vs. SEK 406,842) over patient lifetimes. BIAsp 70/30 treatment was projected to be dominant (cost and lifesaving) when compared with insulin glargine in the base case analysis.CONCLUSIONS: Biphasic insulin aspart 70/30 treatment was associated with improved clinical outcomes and reduced costs compared with insulin glargine treatment over patient lifetimes. These results were driven by improved HbA1c levels associated with BIAsp 70/30 compared with insulin glargine and the accompanying reduction in diabetes-related complications despite increases in body mass index.
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| 2. |
- Koens, Lisette H, et al.
(författare)
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A Screening Tool to Quickly Identify Movement Disorders in Patients with Inborn Errors of Metabolism
- 2023
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Ingår i: Movement Disorders. - : Wiley. - 0885-3185 .- 1531-8257. ; 38:4, s. 646-653
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Movement disorders are frequent in patients with inborn errors of metabolism (IEMs) but poorly recognized, particularly by nonmovement disorder specialists. We propose an easy-to-use clinical screening tool to help recognize movement disorders.OBJECTIVE: The aim is to develop a user-friendly rapid screening tool for nonmovement disorder specialists to detect moderate and severe movement disorders in patients aged ≥4 years with IEMs.METHODS: Videos of 55 patients with different IEMs were scored by experienced movement disorder specialists (n = 12). Inter-rater agreements were determined on the presence and subtype of the movement disorder. Based on ranking and consensus, items were chosen to be incorporated into the screening tool.RESULTS: A movement disorder was rated as present in 80% of the patients, with a moderate inter-rater agreement (κ =0.420, P < 0.001) on the presence of a movement disorder. When considering only moderate and severe movement disorders, the inter-rater agreement increased to almost perfect (κ = 0.900, P < 0.001). Dystonia was most frequently scored (27.3%) as the dominant phenotype. Treatment was mainly suggested for patients with moderate or severe movement disorders. Walking, observations of the arms, and drawing a spiral were found to be the most informative tasks and were included in the screening tool.CONCLUSIONS: We designed a screening tool to recognize movement disorders in patients with IEMs. We propose that this screening tool can contribute to select patients who should be referred to a movement disorder specialist for further evaluation and, if necessary, treatment of the movement disorder. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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| 4. |
- Sedarsky, David, 1976, et al.
(författare)
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Numerical simulation of primary atomization: Interaction with experimental analysis
- 2013
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Ingår i: Atomization and Sprays. - 1044-5110. ; 23:12, s. 1103-1138
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Tidskriftsartikel (refereegranskat)abstract
- This paper focuses on recent developments in numerical simulations and experimental techniques applied to jet atomization. Interface tracking based on coupled level-set, VOF, and ghost fluid approaches is presented, together with experimental methods including morphological analysis, multi-scale analysis, and laser correlation velocimetry. Experimental diagnostics and analysis are applied and validated against images provided by numerical simulations, allowing comparisons between experimental data, combined experimental techniques and simulated images, and pure numerical results. © 2013 by Begell House, Inc.
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| 5. |
- Anderson, Bruce, et al.
(författare)
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Opposing effects of plant traits on diversification
- 2023
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Ingår i: iScience. - : Cell Press. - 2589-0042. ; 26:4
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Tidskriftsartikel (refereegranskat)abstract
- Species diversity can vary dramatically across lineages due to differences in speciation and extinction rates. Here, we explore the effects of several plant traits on diversification, finding that most traits have opposing effects on diversification. For example, outcrossing may increase the efficacy of selection and adaptation but also decrease mate availability, two processes with contrasting effects on lineage persistence. Such opposing trait effects can manifest as differences in diversification rates that depend on ecological context, spatiotemporal scale, and associations with other traits. The complexity of pathways linking traits to diversification suggests that the mechanistic underpinnings behind their correlations may be difficult to interpret with any certainty, and context dependence means that the effects of specific traits on diversification are likely to differ across multiple lineages and timescales. This calls for taxonomically and context-controlled approaches to studies that correlate traits and diversification.
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| 6. |
- Lounnaci, K., et al.
(författare)
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Image processing techniques for velocity, interface complexity, and droplet production measurement in the near-nozzle region of a diesel spray
- 2015
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Ingår i: Atomization and Sprays. - 1044-5110. ; 25:9, s. 753-775
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Tidskriftsartikel (refereegranskat)abstract
- An ultrafast shadow imaging arrangement using a double-pulsed femtosecond laser system in concert with a frame transfer CCD was used to record time-correlated image-pairs in the near-nozzle region of a dissymmetric diesel jet issuing from a single-hole injector. A region-matching procedure was applied to produce velocity maps of the spray. The time-correlated image data were binarized and segmented to produce comparative data sets which isolate the jet core and the surrounding droplet cloud. The velocity mapping process was applied to these segmented data sets, a variable characterizing the degree of atomization of the jet was defined by means of statistical analysis, and the curvature scale space of the jet core edge was used to extract a measure of its complexity.
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| 7. |
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| 8. |
- Pierrat, V, et al.
(författare)
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Variations in patterns of care across neonatal units and their associations with outcomes in very preterm infants: the French EPIPAGE-2 cohort study
- 2020
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Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 10:6, s. e035075-
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Tidskriftsartikel (refereegranskat)abstract
- To describe patterns of care for very preterm (VP) babies across neonatal intensive care units (NICUs) and associations with outcomes.DesignProspective cohort study, EPIPAGE-2.SettingFrance, 2011.Participants53 (NICUs); 2135 VP neonates born at 27 to 31 weeks.Outcome measuresClusters of units, defined by the association of practices in five neonatal care domains – respiratory, cardiovascular, nutrition, pain management and neurodevelopmental care. Mortality at 2 years corrected age (CA) or severe/moderate neuro-motor or sensory disabilities and proportion of children with scores below threshold on the neurodevelopmental Ages and Stages Questionnaire (ASQ).MethodsHierarchical cluster analysis to identify clusters of units. Comparison of outcomes between clusters, after adjustment for potential cofounders.ResultsThree clusters were identified: Cluster 1 with higher proportions of neonates free of mechanical ventilation at 24 hours of life, receiving early enteral feeding, and neurodevelopmental care practices (26 units; n=1118 babies); Cluster 2 with higher levels of patent ductus arteriosus and pain screening (11 units; n=398 babies); Cluster 3 with higher use of respiratory, cardiovascular and pain treatments (16 units; n=619 babies). No difference was observed between clusters for the baseline maternal and babies’ characteristics. No differences in outcomes were observed between Clusters 1 and 3. Compared with Cluster 1, mortality at 2 years CA or severe/moderate neuro-motor or sensory disabilities was lower in Cluster 2 (adjusted OR 0.46, 95% CI 0.25 to 0.84) but with higher proportion of children with an ASQ below threshold (adjusted OR 1.49, 95% CI 1.07 to 2.08).ConclusionIn French NICUs, care practices for VP babies were non-randomly associated. Differences between clusters were poorly explained by unit or population differences, but were associated with mortality and development at 2 years. Better understanding these variations may help to improve outcomes for VPT babies, as it is likely that some of these discrepancies are unwarranted.
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| 9. |
- Purwar, H., et al.
(författare)
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Collinear, two-color optical Kerr effect shutter for ultrafast time-resolved imaging
- 2014
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Ingår i: Optics Express. - : The Optical Society. - 1094-4087 .- 1094-4087. ; 22:13, s. 15778-15790
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Tidskriftsartikel (refereegranskat)abstract
- Imaging with ultrashort exposure times is generally achieved with a crossed-beam geometry. In the usual arrangement, an off-axis gating pulse induces birefringence in a medium exhibiting a strong Kerr response (commonly carbon disulfide) which is followed by a polarizer aligned to fully attenuate the on-axis imaging beam. By properly timing the gate pulse, imaging light experiences a polarization change allowing time-dependent transmission through the polarizer to form an ultrashort image. The crossed-beam system is effective in generating short gate times, however, signal transmission through the system is complicated by the crossing angle of the gate and imaging beams. This work presents a robust ultrafast time-gated imaging scheme based on a combination of type-I frequency doubling and a collinear optical arrangement in carbon disulfide. We discuss spatial effects arising from crossed-beam Kerr gating, and examine the imaging spatial resolution and transmission timing affected by collinear activation of the Kerr medium, which eliminates crossing angle spatial effects and produces gate times on the order of 1 ps. In addition, the collinear, two-color system is applied to image structure in an optical fiber and a gasoline fuel spray, in order to demonstrate image formation utilizing ballistic or refracted light, selected on the basis of its transmission time. (C) 2014 Optical Society of America
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| 10. |
- Roze, S., et al.
(författare)
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Cost-effectiveness of sensor-augmented pump therapy versus standard insulin pump therapy in patients with type 1 diabetes in Denmark
- 2017
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Ingår i: Diabetes Research and Clinical Practice. - : Elsevier BV. - 0168-8227. ; 128, s. 6-14
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Tidskriftsartikel (refereegranskat)abstract
- Aims The use of continuous subcutaneous insulin infusion (CSII) in type 1 diabetes (T1D) has increased in recent years. Sensor-augmented pump therapy (SAP) with low glucose suspend (LGS) (allowing temporary suspension of insulin delivery if blood glucose level falls below a pre-defined threshold level) provides additional benefits over CSII alone, but is associated with higher acquisition costs. Therefore, a cost-effectiveness analysis of SAP + LGS versus CSII in patients with T1D was performed. Methods Analyses were performed using the CORE Diabetes Model in two different patient cohorts in Denmark, one with hyperglycemia at baseline and one with increased risk for hypoglycemic events. Clinical input data were sourced from published literature. The analysis was performed over a lifetime time horizon from a societal perspective. Future costs and clinical outcomes were discounted at 3% per annum. Results In patients who were hyperglycemic at baseline the use of SAP + LGS versus CSII resulted in improved quality-adjusted life expectancy (12.44 versus 10.99 quality-adjusted life years [QALYs]) but higher mean lifetime costs (DKK 2,027,316 versus DKK 1,801,293) leading to an incremental cost-effectiveness ratio (ICER) of DKK 156,082 per QALY gained. For patients at increased risk for hypoglycemic events the ICER for SAP + LGS versus CSII was DKK 89,868 per QALY gained. Conclusions The ICER for SAP + LGS versus CSII falls below commonly cited willingness-to-pay thresholds. Therefore, in Denmark, the use of SAP + LGS is likely to be considered cost-effective relative to CSII for patients with T1D who are either hyperglycemic, despite CSII use, or who experience frequent severe hypoglycemic events.
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| 11. |
- Willemsen, Suzan, et al.
(författare)
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The role of advanced glycation end-products and their receptor on outcome in heart failure patients with preserved and reduced ejection fraction
- 2012
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Ingår i: American Heart Journal. - : Elsevier. - 0002-8703 .- 1097-6744. ; 164:5, s. 742-U146
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Advanced glycation end products (AGEs) are increased in patients with heart failure (HF). We studied the predictive value of plasma AGEs N-E-(carboxymethyl) lysine (CML), pentosidine, and the soluble form of its receptor (sRAGE) in a large HF population. less thanbrgreater than less thanbrgreater thanMethods In 580 patients hospitalized with HF, plasma AGEs were measured before discharge when patients were clinically stable. Patients were followed for a period of 18 months. Primary end point was a composite of death and HF admissions. CML was determined by liquid chromatography mass spectrometry, pentosidine by high-performance liquid chromatography and sRAGE by sequential sandwich immunoassay. less thanbrgreater than less thanbrgreater thanResults Mean age was 71 +/- 11 years, 62% were men, and mean left ventricular ejection fraction was 0.32 +/- 0.14. At baseline, mean CML level was 2.16 +/- 0.73 mu mol/L, median pentosidine was 0.043 (0.030-0.074) mu mol/L, and median sRAGE level was 2.92 (1.90-4.59) ng/mL. CML and pentosidine levels were independently related to the composite end-point (HR, 1.20 per SD; 95% CI, 1.05-1.37; P = .01 and HR, 1.15 per SD; 95% CI, 1.00-1.31; P = .045, respectively) and HF hospitalization (HR, 1.27 per SD; 95% CI, 1.10-1.48; P = .001 and HR, 1.27 per SD; 95% CI, 1.10-1.47; P = .001, respectively). Furthermore, CML levels were independently related to increased mortality (P = .006). Whereas sRAGE levels were univariately predictive for outcome, in multivariate models sRAGE did not reach statistical significance. less thanbrgreater than less thanbrgreater thanDiscussion In HF patients, both CML and pentosidine predict HF hospitalization and the combined primary end-point (mortality or HF-hospitalization), whereas sRAGE did not predict events. In addition, CML was significantly and independently associated with a higher risk for mortality. (Am Heart J 2012;164:742-749.e3.)
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