| 1. |
- Kim, Joon Tae, et al.
(författare)
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Dual antiplatelet Use for extended period taRgeted to AcuTe ischemic stroke with presumed atherosclerotic OrigiN (DURATION) trial : Rationale and design
- 2023
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Ingår i: International Journal of Stroke. - : SAGE Publications. - 1747-4930 .- 1747-4949. ; 18:8, s. 1015-1020
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Tidskriftsartikel (refereegranskat)abstract
- Rationale: The optimal duration of dual antiplatelet therapy (DAPT) with clopidogrel-aspirin for the large artery atherosclerotic (LAA) stroke subtype has been debated. Aims: To determine whether the 1-year risk of recurrent vascular events could be reduced by a longer duration of DAPT in patients with the LAA stroke subtype. Methods and study design: A total of 4806 participants will be recruited to detect a statistically significant relative risk reduction of 22% with 80% power and a two-sided alpha error of 0.05, including a 10% loss to follow-up. This is a registry-based, multicenter, prospective, randomized, open-label, blinded end point study designed to evaluate the efficacy and safety of a 12-month duration of DAPT compared with a 3-month duration of DAPT in the LAA stroke subtype. Patients will be randomized (1:1) to either DAPT for 12 months or DAPT for 3 months, followed by monotherapy (either aspirin or clopidogrel) for the remaining 9 months. Study outcomes: The primary efficacy outcome of the study is a composite of stroke (ischemic or hemorrhagic), myocardial infarction, and all-cause mortality for 1 year after the index stroke. The secondary efficacy outcomes are (1) stroke, (2) ischemic stroke or transient ischemic attack, (3) hemorrhagic stroke, and (4) all-cause mortality. The primary safety outcome is major bleeding. Discussion: This study will help stroke physicians determine the appropriate duration of dual therapy with clopidogrel-aspirin for patients with the LAA stroke subtype. Trial registration: URL: https://cris.nih.go.kr/cris. CRIS Registration Number: KCT0004407.
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| 2. |
- Kwon, Hyuk Sung, et al.
(författare)
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Early increment of soluble triggering receptor expressed on myeloid cells 2 in plasma might be a predictor of poor outcome after ischemic stroke
- 2020
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Ingår i: Journal of clinical neuroscience. - : ELSEVIER SCI LTD. - 0967-5868 .- 1532-2653. ; 73, s. 215-218
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Tidskriftsartikel (refereegranskat)abstract
- Soluble triggering receptor expressed on myeloid cells 2 (sTREM2) is derived from cleavage of TREM2, which is expressed on the cell surface of microlgia and other tissue-specific macrophages. In the present study, the changes in the sTREM2 levels after ischemic stroke (IS) and their association with clinical outcomes were evaluated. A total of 43 patients diagnosed with non-cardioembolic IS between June 2011 and May 2014 were consecutively included in this study. Patients treated with intravenous thrombolysis or intra-arterial thrombectomy were excluded. Plasma samples were collected three times (days 1, 7, and 90) after ictus. The sTREM2 level was measured in the samples using the highly sensitive solid-phase proximity ligation assay (SP-PLA). Among the 43 subjects, higher initial NIH stroke scale (NIHSS) score (P = 0.005), early increment of sTREM2 (P < 0.001), and late decrement of sTREM2 (P = 0.002), were more common in patients with poor outcome. Based on multivariate analysis, initial NIHSS score (P = 0.015) and early increment of sTREM2 (P = 0.032) were independently associated with poor outcome. The results from the present study indicate that increment of sTREM2 level at the early phase was a predictor of poor outcome. Serial follow-up of sTREM2 may aid prognosis after stroke.
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| 3. |
- Cho, Eun, et al.
(författare)
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Clinical experience of tensor-valued diffusion encoding for microstructure imaging by diffusional variance decomposition in patients with breast cancer
- 2022
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Ingår i: Quantitative Imaging in Medicine and Surgery. - : AME Publishing Company. - 2223-4292 .- 2223-4306. ; 12:3, s. 2002-2017
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Tidskriftsartikel (refereegranskat)abstract
- Background: Diffusion-weighted imaging plays a key role in magnetic resonance imaging (MRI) of breast tumors. However, it remains unclear how to interpret single diffusion encoding with respect to its link with tissue microstructure. The purpose of this retrospective cross-sectional study was to use tensor-valued diffusion encoding to investigate the underlying microstructure of invasive ductal carcinoma (IDC) and evaluate its potential value in a clinical setting. Methods: We retrospectively reviewed biopsy-proven breast cancer patients who underwent preoperative breast MRI examination from July 2020 to March 2021. We reviewed the MRI of 29 patients with 30 IDCs, including analysis by diffusional variance decomposition enabled by tensor-valued diffusion encoding. The diffusion parameters of mean diffusivity (MD), total mean kurtosis (MKT), anisotropic mean kurtosis (MKA), isotropic mean kurtosis (MKI), macroscopic fractional anisotropy (FA), and microscopic fractional anisotropy (μFA) were estimated. The parameter differences were compared between IDC and normal fibroglandular breast tissue (FGBT), as well as the association between the diffusion parameters and histopathologic items. Results: The mean value of MD in IDCs was significantly lower than that of normal FGBT (1.07±0.27 vs. 1.34±0.29, P<0.001); however, MKT, MKA, MKI, FA, and μFA were significantly higher (P<0.005). Among all the diffusion parameters, MKI was positively correlated with the tumor size on both MRI and pathological specimen (rs=0.38, P<0.05 vs. rs=0.54, P<0.01), whereas MKT had a positive correlation with the tumor size in the pathological specimen only (rs=0.47, P<0.02). In addition, the lymph node (LN) metastasis group had significantly higher MKT, MKA, and μFA compared to the metastasis negative group (P<0.05). Conclusions: Tensor-valued diffusion encoding enables a useful non-invasive method for characterizing breast cancers with information on tissue microstructures. Particularly, μFA could be a potential imaging biomarker for evaluating breast cancers prior to surgery or chemotherapy.
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| 4. |
- Schweiker, Marcel, et al.
(författare)
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Evaluating assumptions of scales for subjective assessment of thermal environments – Do laypersons perceive them the way, we researchers believe?
- 2020
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Ingår i: Energy and Buildings. - : Elsevier BV. - 0378-7788. ; 211
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Tidskriftsartikel (refereegranskat)abstract
- People's subjective response to any thermal environment is commonly investigated by using rating scales describing the degree of thermal sensation, comfort, and acceptability. Subsequent analyses of results collected in this way rely on the assumption that specific distances between verbal anchors placed on the scale exist and that relationships between verbal anchors from different dimensions that are assessed (e.g. thermal sensation and comfort) do not change. Another inherent assumption is that such scales are independent of the context in which they are used (climate zone, season, etc.). Despite their use worldwide, there is indication that contextual differences influence the way the scales are perceived and therefore question the reliability of the scales’ interpretation. To address this issue, a large international collaborative questionnaire study was conducted in 26 countries, using 21 different languages, which led to a dataset of 8225 questionnaires. Results, analysed by means of robust statistical techniques, revealed that only a subset of the responses are in accordance with the mentioned assumptions. Significant differences appeared between groups of participants in their perception of the scales, both in relation to distances of the anchors and relationships between scales. It was also found that respondents’ interpretations of scales changed with contextual factors, such as climate, season, and language. These findings highlight the need to carefully consider context-dependent factors in interpreting and reporting results from thermal comfort studies or post-occupancy evaluations, as well as to revisit the use of rating scales and the analysis methods used in thermal comfort studies to improve their reliability.
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| 5. |
- Hellwig, Runa T., et al.
(författare)
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Design of adaptive opportunities for people in buildings
- 2022
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Ingår i: Routledge Handbook of Resilient Thermal Comfort. - London : Routledge. - 9781003244929 ; , s. 193-209
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Adaptive opportunities for people are a key element in the adaptive thermal comfort approach. Research has led to a broad and solid foundation of knowledge, but design processes on how to support people’s behavioural control through building design are still missing. This chapter presents a design process for incorporating adaptive opportunities and discusses how such an approach enhances thermal resilience. The design process is facilitated with tools and exemplary design or operation actions for stakeholders. Non-energy using adaptive opportunities and the passive performance a building affords are the means to enhance not only human thermal comfort in buildings but also human resilience. This is because they offer people concrete options for acting and supporting their belief in their ability and skills to act in case of extreme weather events and can hence facilitate physiological adaptation. They are therefore paramount to build a resilient human-building interaction in a changing environment.
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| 6. |
- Hellwig, Runa T., et al.
(författare)
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Guidelines to bridge the gap between adaptive thermal comfort theory and building design and operation practice
- 2020
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Ingår i: 11th Windsor Conference: Resilient Comfort, WINDSOR 2020 - Proceedings. ; , s. 529-545
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Konferensbidrag (refereegranskat)abstract
- Adaptive thermal comfort guidelines have been developed within the work of Annex 69: “Strategy and practice of adaptive thermal comfort in low energy buildings”. The guidelines have been established based on a framework for adopting adaptive thermal comfort principles in building design and operation developed by the authors. The guidelines target building practitioners, addressing the critical interrelated role building planners, building operators and occupants play. A successful adaptive thermal comfort design, in which design for human thermal adaptation is foreseen, planned, and carefully embedded in the design and operation intent, is based on broad knowledge and understanding of the multiple quantifiable and non-quantifiable factors influencing human perception, as well as human building interaction. Adaptive building design follows a user-centric integrated design approach and therefore it is critical to consider the occupants' and the operators' role in buildings already in the design phase. This paper focuses on three main challenges identified earlier and how these are addressed in the guidelines, i.e. i) updating prevailing knowledge about human thermophysiology and adaptation, ii) developing a procedure for design of adaptive opportunities, and iii) providing guidance for operational planning and operation of adaptive buildings. The challenge for future research remains to assess the magnitude of how specific design decisions affect particular adaptive mechanisms.
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| 7. |
- Teli, Despoina, 1980, et al.
(författare)
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Teaching the concept of adaptive thermal comfort in building design education
- 2020
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Ingår i: 16th Conference of the International Society of Indoor Air Quality and Climate: Creative and Smart Solutions for Better Built Environments, Indoor Air 2020.
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Konferensbidrag (refereegranskat)abstract
- Traditional building design education in the disciplines of building services, civil engineering, mechanical engineering, etc. focusses on quantifiable factors, i.e. factors which can be subject of calculation, simulation and dimensioning. Since non-quantifiable factors are not part of calculation or simulation models, there is a tendency that they are not adequately considered in education and, as a result, in building planning and operation. In the case of human thermal comfort, building professionals are required to understand the mechanisms and impact of non-quantifiable factors related to human thermal comfort and health, most of which are part of the adaptive thermal comfort concept. This paper identifies the challenges in teaching the concept of adaptive thermal comfort through a collection of lived experiences of the authors. The paper then proposes appropriate intended learning outcomes and teaching methods to equip students with the background knowledge, understanding and skills required to consider human adaptation in their designs. It is widely accepted that integrated design is a precondition for a building design that functions well, offers sufficient comfort for their users and can be operated in a sustainable way. Integrated building design requires that different disciplines work closely together and understand and respect their different focus areas and languages. Herein the case of human thermal comfort requires engineers who understand the mechanisms and impact of non-quantifiable factors on human well-being indoors. Within the work of Annex 69: “Strategy and practice of adaptive thermal comfort in low energy buildings” we developed a framework and a guideline for adopting adaptive thermal comfort principles in design and operation of buildings, which may serve as a complementary tool in an integrated design process and inclusion of adaptive thermal comfort in education.
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