| 1. |
- Bergström, Göran, 1964, et al.
(författare)
-
Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population
- 2021
-
Ingår i: Circulation. - Philadelphia : American Heart Association. - 0009-7322 .- 1524-4539. ; 144:12, s. 916-929
-
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.
|
|
| 2. |
- Bergström, Göran, et al.
(författare)
-
Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population
- 2021
-
Ingår i: Circulation. - : Wolters Kluwer. - 0009-7322 .- 1524-4539. ; 144:12, s. 916-929
-
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.
|
|
| 3. |
- Eriksson, Jan W, et al.
(författare)
-
Tissue-specific glucose partitioning and fat content in prediabetes and type 2 diabetes: whole-body PET/MRI during hyperinsulinemia
- 2021
-
Ingår i: European journal of endocrinology. - : Bioscientifica. - 0804-4643 .- 1479-683X. ; 184:6, s. 879-899
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To obtain direct quantifications of glucose turnover, volumes an d fat content of several tissues in the development of type 2 diabetes (T2D) using a novel integrated a pproach for whole-body imaging. Design and methods: Hyperinsulinemic-euglycemic clamps and simultaneous whole-body integrated [18F]FDG-PET/MRI with automated analyses were performed in control (n = 12), prediabetes (n = 16) and T2D (n = 13) subjects matched for age, sex and BMI. Results: Whole-body glucose uptake (Rd) was reduced by approximately 25% in T2D vs control subjects, and partitioning to brain was increased from 3.8% of total Rd in co ntrols to 7.1% in T2D. In liver, subcutaneous AT, thigh muscle, total tissue glucose metabolic rates (MRglu) and their % of total Rd were reduced in T2D compared to contr ol subjects. The prediabetes group had intermediate findings. Total MRglu in heart, visceral AT, gluteus and calf muscle was similar across groups. Whole-body insulin sensitivity asses sed as glucose infusion rate correlated with liver MR glu but inversely with brain MRglu. Liver fat content correlated with MRglu in brain but inversely with MRglu in other tissues. Calf muscle fat was inversely associated with MR glu only in the same muscle group. Conclusions: This integrated imaging approach provides detailed quantification of tissue-specific glucose metabolism. During T2D development, insulin-stimulated glucose disposal is impaired and increasingly shifted away from muscle, liver and fat toward the brain. Altered glucose handling in the brain and liver fat accumulation may aggravate insulin resistance in several organs. © 2021 BioScientifica Ltd.. All rights reserved.
|
|
| 4. |
- Fibiger, Linda, et al.
(författare)
-
Conflict, violence, and warfare among early farmers in Northwestern Europe
- 2023
-
Ingår i: Proceedings of the National Academy of Sciences. - : Proceedings of the National Academy of Sciences. - 1091-6490 .- 0027-8424. ; 120:4, s. 1-9
-
Tidskriftsartikel (refereegranskat)abstract
- Bioarchaeological evidence of interpersonal violence and early warfare presents important insights into conflict in past societies. This evidence is critical for understanding the motivations for violence and its effects on opposing and competing individuals and groups across time and space. Selecting the Neolithic of northwestern Europe as an area for study, the present paper examines the variation and societal context for the violence recorded in the human skeletal remains from this region as one of the most important elements of human welfare. Compiling data from various sources, it becomes apparent that violence was endemic in Neolithic Europe, sometimes reaching levels of intergroup hostilities that ended in the utter destruction of entire communities. While the precise comparative quantification of healed and unhealed trauma remains a fundamental problem, patterns emerge that see conflict likely fostered by increasing competition between settled and growing communities, e.g., for access to arable land for food production. The further development of contextual information is paramount in order to address hypotheses on the motivations, origins, and evolution of violence as based on the study of human remains, the most direct indicator for actual small- and large-scale violence.
|
|
| 5. |
- Hultman, Martin, et al.
(författare)
-
Driver sleepiness detection with deep neural networks using electrophysiological data
- 2021
-
Ingår i: Physiological Measurement. - : IOP PUBLISHING LTD. - 0967-3334 .- 1361-6579. ; 42:3
-
Tidskriftsartikel (refereegranskat)abstract
- Objective. The objective of this paper is to present a driver sleepiness detection model based on electrophysiological data and a neural network consisting of convolutional neural networks and a long short-term memory architecture. Approach. The model was developed and evaluated on data from 12 different experiments with 269 drivers and 1187 driving sessions during daytime (low sleepiness condition) and night-time (high sleepiness condition), collected during naturalistic driving conditions on real roads in Sweden or in an advanced moving-base driving simulator. Electrooculographic and electroencephalographic time series data, split up in 16 634 2.5 min data segments was used as input to the deep neural network. This probably constitutes the largest labeled driver sleepiness dataset in the world. The model outputs a binary decision as alert (defined as <= 6 on the Karolinska Sleepiness Scale, KSS) or sleepy (KSS >= 8) or a regression output corresponding to KSS epsilon [1-5, 6, 7, 8, 9]. Main results. The subject-independent mean absolute error (MAE) was 0.78. Binary classification accuracy for the regression model was 82.6% as compared to 82.0% for a model that was trained specifically for the binary classification task. Data from the eyes were more informative than data from the brain. A combined input improved performance for some models, but the gain was very limited. Significance. Improved classification results were achieved with the regression model compared to the classification model. This suggests that the implicit order of the KSS ratings, i.e. the progression from alert to sleepy, provides important information for robust modelling of driver sleepiness, and that class labels should not simply be aggregated into an alert and a sleepy class. Furthermore, the model consistently showed better results than a model trained on manually extracted features based on expert knowledge, indicating that the model can detect sleepiness that is not covered by traditional algorithms.
|
|
| 6. |
|
|
| 7. |
- Picher, Ciara, et al.
(författare)
-
Fit for Duty Assessment of Driver Fatigue based on Statistical Modelling of Cardiovascular Parameters
- 2023
-
Ingår i: SNE Simulation Notes Europe. - : ARGESIM. - 2306-0271. ; 33:4, s. 157-166
-
Tidskriftsartikel (refereegranskat)abstract
- Driver fatigue is a risk factor for road crashes. Fit for duty technologies could play a pivotal role in countering these crashes. Heart rate variability (HRV) and the pulse wave shape are influenced by the autonomic nervous system and are therefore affected by fatigue. This work focusses on modelling their relationship with fatigue and is based on data recorded in a simulated driving study. Six different multivariate linear regression models, using either stepwise variable selection or principal component analysis, are presented in this study. To account for differences in physiology, individual participant baselines for HRV and pulse wave parameters are introduced. Stepwise regression using any kind of baseline yields the most promising results. The most promising predictors are the ratio LFHF between low and high frequency components of HRV and heart rate. Finally, a stepwise regression model with a baseline, which has an adjusted R2 statistic of 0.17, is proposed for further use. Nevertheless, further research with an extended dataset is necessary, incorporating a more diverse participant group and a higher number of recordings from severely sleepy drivers.
|
|
| 8. |
- Tagesson, Torbern, et al.
(författare)
-
Recent divergence in the contributions of tropical and boreal forests to the terrestrial carbon sink
- 2020
-
Ingår i: Nature Ecology and Evolution. - : Springer Science and Business Media LLC. - 2397-334X. ; 4, s. 202-209
-
Tidskriftsartikel (refereegranskat)abstract
- Anthropogenic land use and land cover changes (LULCC) have a large impact on the global terrestrial carbon sink, but this effect is not well characterized according to biogeographical region. Here, using state-of-the-art Earth observation data and a dynamic global vegetation model, we estimate the impact of LULCC on the contribution of biomes to the terrestrial carbon sink between 1992 and 2015. Tropical and boreal forests contributed equally, and with the largest share of the mean global terrestrial carbon sink. CO2 fertilization was found to be the main driver increasing the terrestrial carbon sink from 1992 to 2015, but the net effect of all drivers (CO2 fertilization and nitrogen deposition, LULCC and meteorological forcing) caused a reduction and an increase, respectively, in the terrestrial carbon sink for tropical and boreal forests. These diverging trends were not observed when applying a conventional LULCC dataset, but were also evident in satellite passive microwave estimates of aboveground biomass. These datasets thereby converge on the conclusion that LULCC have had a greater impact on tropical forests than previously estimated, causing an increase and decrease of the contributions of boreal and tropical forests, respectively, to the growing terrestrial carbon sink.
|
|
| 9. |
- Veit-Haibach, Patrick, et al.
(författare)
-
International EANM-SNMMI-ISMRM consensus recommendation for PET/MRI in oncology
- 2023
-
Ingår i: European Journal of Nuclear Medicine and Molecular Imaging. - : Springer Nature. - 1619-7070 .- 1619-7089. ; 50:12, s. 3513-3537
-
Tidskriftsartikel (refereegranskat)abstract
- The Society of Nuclear Medicine and Molecular Imaging (SNMMI) is an international scientific and professional organization founded in 1954 to promote the science, technology, and practical application of nuclear medicine. The European Association of Nuclear Medicine (EANM) is a professional non-profit medical association that facilitates communication worldwide between individuals pursuing clinical and research excellence in nuclear medicine. The EANM was founded in 1985. The merged International Society for Magnetic Resonance in Medicine (ISMRM) is an international, nonprofit, scientific association whose purpose is to promote communication, research, development, and applications in the field of magnetic resonance in medicine and biology and other related topics and to develop and provide channels and facilities for continuing education in the field.The ISMRM was founded in 1994 through the merger of the Society of Magnetic Resonance in Medicine and the Society of Magnetic Resonance Imaging. SNMMI, ISMRM, and EANM members are physicians, technologists, and scientists specializing in the research and practice of nuclear medicine and/or magnetic resonance imaging.The SNMMI, ISMRM, and EANM will periodically define new guidelines for nuclear medicine practice to help advance the science of nuclear medicine and/or magnetic resonance imaging and to improve the quality of service to patients throughout the world. Existing practice guidelines will be reviewed for revision or renewal, as appropriate, on their fifth anniversary or sooner, if indicated. Each practice guideline, representing a policy statement by the SNMMI/EANM/ISMRM, has undergone a thorough consensus process in which it has been subjected to extensive review. The SNMMI, ISMRM, and EANM recognize that the safe and effective use of diagnostic nuclear medicine imaging and magnetic resonance imaging requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guideline by those entities not providing these services is not authorized.These guidelines are an educational tool designed to assist practitioners in providing appropriate care for patients. They are not inflexible rules or requirements of practice and are not intended, nor should they be used, to establish a legal standard of care. For these reasons and those set forth below, the SNMMI, the ISMRM, and the EANM caution against the use of these guidelines in litigation in which the clinical decisions of a practitioner are called into question.The ultimate judgment regarding the propriety of any specific procedure or course of action must be made by the physician or medical physicist in light of all the circumstances presented. Thus, there is no implication that an approach differing from the guidelines, standing alone, is below the standard of care. To the contrary, a conscientious practitioner may responsibly adopt a course of action different from that set forth in the guidelines when, in the reasonable judgment of the practitioner, such course of action is indicated by the condition of the patient, limitations of available resources, or advances in knowledge or technology subsequent to publication of the guidelines.The practice of medicine includes both the art and the science of the prevention, diagnosis, alleviation, and treatment of disease. The variety and complexity of human conditions make it impossible to always reach the most appropriate diagnosis or to predict with certainty a particular response to treatment.Therefore, it should be recognized that adherence to these guidelines will not ensure an accurate diagnosis or a successful outcome. All that should be expected is that the practitioner will follow a reasonable course of action based on current knowledge, available resources, and the needs of the patient to deliver effective and safe medical care. The sole purpose of these guidelines is to assist practitioners in achieving this objective.
|
|
| 10. |
- Wanhainen, Anders, et al.
(författare)
-
The effect of ticagrelor on growth of small abdominal aortic aneurysms-a randomized controlled trial
- 2020
-
Ingår i: Cardiovascular Research. - : Oxford University Press (OUP). - 0008-6363 .- 1755-3245. ; 116:2, s. 450-456
-
Tidskriftsartikel (refereegranskat)abstract
- Aims: To evaluate if ticagrelor, an effective platelet inhibitor without known non-responders, could inhibit growth of small abdominal aortic aneurysms (AAAs). Methods and results: In this multi-centre randomized controlled trial, double-blinded for ticagrelor and placebo, acetylic salicylic acid naive patients with AAA and with a maximum aortic diameter 35-49mm were included. The primary outcome was mean reduction in log-transformed AAA volume growth rate (%) measured with magnetic resonance imaging (MRI) at 12months compared with baseline. Secondary outcomes include AAA-diameter growth rate and intraluminal thrombus (ILT) volume enlargement rate. A total of 144 patients from eight Swedish centres were randomized (72 in each group). MRI AAA volume increase was 9.1% for the ticagrelor group and 7.5% for the placebo group (P=0.205) based on intention-to-treat analysis, and 8.5% vs. 7.4% in a per-protocol analysis (P=0.372). MRI diameter change was 2.5mm vs. 1.8mm (P=0.113), US diameter change 2.3mm vs. 2.2mm (P=0.778), and ILT volume change 12.9% vs. 10.4% (P=0.590). Conclusion: In this RCT, platelet inhibition with ticagrelor did not reduce growth of small AAAs. Whether the ILT has an important pathophysiological role for AAA growth cannot be determined based on this study due to the observed lack of thrombus modulating effect of ticagrelor.
|
|
