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- Golledge, J., et al.
(författare)
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Lack of an effective drug therapy for abdominal aortic aneurysm
- 2020
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Ingår i: Journal of Internal Medicine. - : WILEY. - 0954-6820 .- 1365-2796. ; 288:1, s. 6-22
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Forskningsöversikt (refereegranskat)abstract
- Abdominal aortic aneurysm (AAA) rupture is a common cause of death in adults. CurrentAAAtreatment is by open surgical or endovascular aneurysm repair. Rodent model and human epidemiology, and genetic and observational studies over the last few decades have highlighted the potential of a number of drug therapies, including medications that lower blood pressure, correct dyslipidaemia, or inhibit thrombosis, inflammation or matrix remodelling, as approaches to managing smallAAA. This review summarizes priorAAApathogenesis data from animal and human studies aimed at identifying targets for the development of drug therapies. The review also systematically assesses past randomized placebo-controlled drug trials in patients with smallAAAs. Eleven previously published randomized-controlled clinical trials testing different drug therapies aimed at slowingAAAprogression were identified. Five of the trials tested antibiotics and three trials assessed medications that lower blood pressure. Meta-analyses of these trials suggested that neither of these approaches limitAAAgrowth. Allocation to blood pressure-lowering medication was associated with a small reduction inAAArupture or repair, compared to placebo (relative risk 0.94, 95% confidence intervals 0.89, 1.00,P = 0.047). Three further trials assessed the effect of a mast cell inhibitor, fibrate or platelet aggregation inhibition and reported no effect onAAAgrowth or clinical events. Past trials were noted to have a number of design issues, particularly small sample sizes and limited follow-up. Much larger trials are needed to properly test potential therapeutic approaches if a convincingly effective medical therapy forAAAis to be identified.
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| 2. |
- Nordanstig, Joakim, et al.
(författare)
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Peripheral arterial disease (PAD)-A challenging manifestation of atherosclerosis
- 2023
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Ingår i: Preventive Medicine. - : Academic Press. - 0091-7435 .- 1096-0260. ; 171
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Tidskriftsartikel (refereegranskat)abstract
- The diagnosis of peripheral arterial disease (PAD) is not always evident as symptoms and signs may show great variation. As all grades of PAD are linked to both an increased risk for cardiovascular complications and adverse limb events, awareness of the condition and knowledge about diagnostic measures, prevention and treatment is crucial. This article presents in a condensed form information on PAD and its management.
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| 3. |
- Singh, T. P., et al.
(författare)
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Comparison of peak wall stress and peak wall rupture index in ruptured and asymptomatic intact abdominal aortic aneurysms
- 2020
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Ingår i: British Journal of Surgery. - : Oxford University Press (OUP). - 0007-1323 .- 1365-2168. ; 108:6, s. 652-658
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Tidskriftsartikel (refereegranskat)abstract
- Background: Previous studies have suggested that finite element analysis (FEA) can estimate the rupture risk of an abdominal aortic aneurysm (AAA); however, the value of biomechanical estimates over measurement of AAA diameter alone remains unclear. This study aimed to compare peak wall stress (PWS) and peak wall rupture index (PWRI) in participants with ruptured and asymptomatic intact AAAs. Methods: The reproducibility of semiautomated methods for estimating aortic PWS and PWRI from CT images was assessed. PWS and PWRI were estimated in people with ruptured AAAs and those with asymptomatic intact AAAs matched by orthogonal diameter on a 1 : 2 basis. Spearman's correlation coefficient was used to assess the association between PWS or PWRI and AAA diameter. Independent associations between PWS or PWRI and AAA rupture were identified by means of logistic regression analyses. Results: Twenty individuals were included in the analysis of reproducibility. The main analysis included 50 patients with an intact AAA and 25 with a ruptured AAA. Median orthogonal diameter was similar in ruptured and intact AAAs (82·3 (i.q.r. 73·5–92·0) versus 81·0 (73·2–92·4) mm respectively; P = 0·906). Median PWS values were 286·8 (220·2–329·6) and 245·8 (215·2–302·3) kPa respectively (P = 0·192). There was no significant difference in PWRI between the two groups (P = 0·982). PWS and PWRI correlated positively with orthogonal diameter (both P < 0·001). Participants with high PWS, but not PWRI, were more likely to have a ruptured AAA after adjusting for potential confounders (odds ratio 5·84, 95 per cent c.i. 1·22 to 27·95; P = 0·027). This association was not maintained in all sensitivity analyses. Conclusion: High aortic PWS had an inconsistent association with greater odds of aneurysm rupture in patients with a large AAA.
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| 6. |
- Watterson, William J., et al.
(författare)
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The roles of an aluminum underlayer in the biocompatibility and mechanical integrity of vertically aligned carbon nanotubes for interfacing with retinal neurons
- 2020
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Ingår i: Micromachines. - 2072-666X. ; 11:6
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Tidskriftsartikel (refereegranskat)abstract
- Retinal implant devices are becoming an increasingly realizable way to improve the vision of patients blinded by photoreceptor degeneration. As an electrode material that can improve restored visual acuity, carbon nanotubes (CNTs) excel due to their nanoscale topography, flexibility, surface chemistry, and double-layer capacitance. If vertically aligned carbon nanotubes (VACNTs) are biocompatible with retinal neurons and mechanically robust, they can further improve visual acuity-most notably in subretinal implants-because they can be patterned into high-aspect-ratio, micrometer-size electrodes. We investigated the role of an aluminum (Al) underlayer beneath an iron (Fe) catalyst layer used in the growth of VACNTs by chemical vapor deposition (CVD). In particular, we cultured dissociated retinal cells for three days in vitro (DIV) on unfunctionalized and oxygen plasma functionalized VACNTs grown from a Fe catalyst (Fe and Fe + Pl preparations, where Pl signifies the plasma functionalization) and an Fe catalyst with an Al underlayer (Al/Fe and Al/Fe + Pl preparations). The addition of the Al layer increased the mechanical integrity of the VACNT interface and enhanced retinal neurite outgrowth over the Fe preparation. Unexpectedly, the extent of neurite outgrowth was significantly greater in the Al/Fe than in the Al/Fe+Pl preparation, suggesting plasma functionalization can negatively impact biocompatibility for some VACNT preparations. Additionally, we show our VACNT growth process for the Al/Fe preparation can support neurite outgrowth for up to 7 DIV. By demonstrating the retinal neuron biocompatibility, mechanical integrity, and pattern control of our VACNTs, this work offers VACNT electrodes as a solution for improving the restored visual acuity provided by modern retinal implants.
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| 7. |
- Martin, Maria A., et al.
(författare)
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Ten new insights in climate science 2021 : a horizon scan
- 2021
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Ingår i: Global Sustainability. - : Cambridge University Press (CUP). - 2059-4798. ; 4, s. 1-20
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Forskningsöversikt (refereegranskat)abstract
- Non-technical summary: We summarize some of the past year's most important findings within climate change-related research. New research has improved our understanding about the remaining options to achieve the Paris Agreement goals, through overcoming political barriers to carbon pricing, taking into account non-CO2 factors, a well-designed implementation of demand-side and nature-based solutions, resilience building of ecosystems and the recognition that climate change mitigation costs can be justified by benefits to the health of humans and nature alone. We consider new insights about what to expect if we fail to include a new dimension of fire extremes and the prospect of cascading climate tipping elements.Technical summary: A synthesis is made of 10 topics within climate research, where there have been significant advances since January 2020. The insights are based on input from an international open call with broad disciplinary scope. Findings include: (1) the options to still keep global warming below 1.5 °C; (2) the impact of non-CO2 factors in global warming; (3) a new dimension of fire extremes forced by climate change; (4) the increasing pressure on interconnected climate tipping elements; (5) the dimensions of climate justice; (6) political challenges impeding the effectiveness of carbon pricing; (7) demand-side solutions as vehicles of climate mitigation; (8) the potentials and caveats of nature-based solutions; (9) how building resilience of marine ecosystems is possible; and (10) that the costs of climate change mitigation policies can be more than justified by the benefits to the health of humans and nature.Social media summary: How do we limit global warming to 1.5 °C and why is it crucial? See highlights of latest climate science.
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| 8. |
- Thomas, Zoë A., et al.
(författare)
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Tipping elements and amplified polar warming during the Last Interglacial
- 2020
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Ingår i: Quaternary Science Reviews. - : Elsevier BV. - 0277-3791. ; 233
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Forskningsöversikt (refereegranskat)abstract
- Irreversible shifts of large-scale components of the Earth system (so-called ‘tipping elements’) on policy-relevant timescales are a major source of uncertainty for projecting the impacts of future climate change. The high latitudes are particularly vulnerable to positive feedbacks that amplify change through atmosphere-ocean-ice interactions. Unfortunately, the short instrumental record does not capture the full range of past or projected climate scenarios (a situation particularly acute in the high latitudes). Natural archives from past periods warmer than present day, however, can be used to explore drivers and responses to forcing, and provide data against which to test models, thereby offering insights into the future. The Last Interglacial (129–116,000 years before present) — the warmest interglacial of the last 800,000 years — was the most recent period during which global temperatures were comparable with low-end 21st Century projections (up to 2 °C warmer, with temperature increase amplified over polar latitudes), providing a potentially useful analogue for future change. Substantial environmental changes happened during this time. Here we synthesise the nature and timing of potential high-latitude tipping elements during the Last Interglacial, including sea ice, extent of the boreal forest, permafrost, ocean circulation, and ice sheets/sea level. We also review the thresholds and feedbacks that likely operated through this period. Notably, substantial ice mass loss from Greenland, the West Antarctic, and possibly sectors of the East Antarctic drove a 6–9 m rise in global sea level. This was accompanied by reduced summer sea-ice extent, poleward-extended boreal forest, and reduced areas of permafrost. Despite current chronological uncertainties, we find that tipping elements in the high latitudes all experienced rapid and abrupt change (within 1–2 millennia of each other) across both hemispheres, while recovery to prior conditions took place over multi-millennia. Our synthesis demonstrates important feedback loops between tipping elements, amplifying polar and global change during the Last Interglacial. The high sensitivity and tight interconnections between polar tipping elements suggests that they could exhibit similar thresholds of vulnerability in the future, particularly if the aspirations of the Paris Agreement are not met.
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