| 1. |
- Korsholm, Kasper, et al.
(författare)
-
Left Atrial Appendage Occlusion versus Novel Oral Anticoagulation for Stroke Prevention in Atrial Fibrillation: Rationale and Design of the Multicenter Randomized Occlusion-AF Trial.
- 2021
-
Ingår i: American heart journal. - : Elsevier BV. - 1097-6744 .- 0002-8703. ; 243, s. 28-38
-
Tidskriftsartikel (refereegranskat)abstract
- The prevalence of atrial fibrillation (AF) is increasing globally, which is a major clinical and public health concern due to the five-fold increased risk of stroke. Oral anticoagulation with novel oral anticoagulants (NOACs) is the current primary option for stroke prevention in patients with AF, although it increases the risk of major bleeding. Patients with prior ischemic cerebrovascular events are at particularly high risk of both recurrent ischemic events and major bleeding. Left atrial appendage occlusion (LAAO) provides an alternative option for stroke prevention in high-risk patients, however, with currently limited evidence. Thus, randomized trials comparing LAAO to NOACs are needed.The Occlusion-AF trial is designed to assess whether LAAO is non-inferior to NOAC therapy for reduction of the combined endpoint of stroke, systemic embolism, major bleeding (Bleeding Academic Research Consortium ≥ 3) and all-cause mortality in patients with AF and a recent ischemic stroke or transient ischemic attack (TIA).Investigator-initiated multicenter, multinational, randomized open-label non-inferiority trial with blinded outcome evaluation (PROBE design). Patients with documented AF, and an ischemic stroke or TIA within 6 months will be eligible for enrollment. Major exclusion criteria are modified Rankin Scale > 3 at enrollment, glomerular filtration rate < 15 ml/min, and life-expectancy less than 2 years. A total of 750 patients will be randomized 1:1 to receive either a NOAC or LAAO using the Amplatzer Amulet (Abbott, MN, USA) or Watchman FLX (Boston Scientific, MN, USA) with subsequent life-long aspirin 75 mg daily. Follow-up will be based on in-office and telephone follow-up in combination with long-term follow-up (10 years) through national hospital discharge registries in the individual Nordic countries. The primary outcome will be a composite endpoint of stroke, systemic embolism, major bleeding (BARC ≥ 3) and all-cause mortality at 2-year follow-up.The Occlusion-AF trial is designed to compare LAAO to NOAC therapy for secondary stroke prevention in AF patients with a high risk of recurrent thromboembolic events, i.e. with previous ischemic stroke or TIA, and otherwise eligible for anticoagulation. The results are expected to contribute significantly to the understanding of the effects of LAAO compared to the standard contemporary pharmacological treatment in these patients.
|
|
| 2. |
- Marciniak, Magdalena, et al.
(författare)
-
Impact of Stripe Shape on the Reflectivity of Monolithic High Contrast Gratings
- 2021
-
Ingår i: ACS Photonics. - : American Chemical Society (ACS). - 2330-4022. ; 8:11, s. 3173-3184
-
Tidskriftsartikel (refereegranskat)abstract
- Monolithic high contrast gratings (MHCGs) composed of a one-dimensional grating patterned in a monolithic layer provide up to 100% optical power reflectance and can be fabricated in almost any semiconductor and dielectric material used in modern optoelectronics. MHCGs enable monolithic integration, polarization selectivity, and versatile phase tuning. They can be from 10 to 20 times thinner than distributed Bragg reflectors. The subwavelength dimensions of MHCGs significantly reduce the possibility of ensuring the smoothness of the sidewalls of the MHCG stripes and make precise control of the shape of the MHCG stripe cross-section difficult during the etching process. The question is then whether it is more beneficial to improve the etching methods to obtain a perfect cross-section shape, as assumed by the design, or whether it is possible to find geometrical parameters that enable high optical power reflectance using the shape that a given etching method provides. Here, we present a numerical study supported by the experimental characterization of MHCGs fabricated in various materials using a variety of common surface nanometer-scale shaping methods. We demonstrate that MHCG stripes with an arbitrary cross-section shape can provide optical power reflectance of nearly 100%, which greatly relaxes their fabrication requirements. Moreover, we show that optical power reflectance exceeding 99% with a record spectral bandwidth of more than 20% can be achieved for quasi-Trapezoidal cross-sections of MHCGs. We also show that sidewall corrugations of the MHCG stripes have only a slight impact on MHCG optical power reflectance if the amplitude of the corrugation is less than 16% of the MHCG period. This level of stripe fabrication precision can be achieved using the most current surface etching methods. Our results are significant for the design and production of a variety of photonic devices employing MHCGs. The flexibility with regard to cross-section shape facilitates the reliable fabrication of highly reflective subwavelength grating mirrors. This in turn will enable the manufacture of monolithically integrated high-quality-factor optical micro-and nanocavity devices.
|
|
| 3. |
|
|
| 4. |
- Blauenfeldt, Rolf Ankerlund, et al.
(författare)
-
Remote Ischemic Conditioning for Acute Stroke : The RESIST Randomized Clinical Trial
- 2023
-
Ingår i: JAMA. - 0098-7484. ; 330:13, s. 1236-1246
-
Tidskriftsartikel (refereegranskat)abstract
- Importance: Despite some promising preclinical and clinical data, it remains uncertain whether remote ischemic conditioning (RIC) with transient cycles of limb ischemia and reperfusion is an effective treatment for acute stroke. Objective: To evaluate the effect of RIC when initiated in the prehospital setting and continued in the hospital on functional outcome in patients with acute stroke. Design, Setting, and Participants: This was a randomized clinical trial conducted at 4 stroke centers in Denmark that included 1500 patients with prehospital stroke symptoms for less than 4 hours (enrolled March 16, 2018, to November 11, 2022; final follow-up, February 3, 2023). Intervention: The intervention was delivered using an inflatable cuff on 1 upper extremity (RIC cuff pressure, ≤200 mm Hg [n = 749] and sham cuff pressure, 20 mm Hg [n = 751]). Each treatment application consisted of 5 cycles of 5 minutes of cuff inflation followed by 5 minutes of cuff deflation. Treatment was started in the ambulance and repeated at least once in the hospital and then twice daily for 7 days among a subset of participants. Main Outcomes and Measures: The primary end point was improvement in functional outcome measured as a shift across the modified Rankin Scale (mRS) score (range, 0 [no symptoms] to 6 [death]) at 90 days in the target population with a final diagnosis of ischemic or hemorrhagic stroke. Results: Among 1500 patients who were randomized (median age, 71 years; 591 women [41%]), 1433 (96%) completed the trial. Of these, 149 patients (10%) were diagnosed with transient ischemic attack and 382 (27%) with a stroke mimic. In the remaining 902 patients with a target diagnosis of stroke (737 [82%] with ischemic stroke and 165 [18%] with intracerebral hemorrhage), 436 underwent RIC and 466 sham treatment. The median mRS score at 90 days was 2 (IQR, 1-3) in the RIC group and 1 (IQR, 1-3) in the sham group. RIC treatment was not significantly associated with improved functional outcome at 90 days (odds ratio [OR], 0.95; 95% CI, 0.75 to 1.20, P =.67; absolute difference in median mRS score, -1; -1.7 to -0.25). In all randomized patients, there were no significant differences in the number of serious adverse events: 169 patients (23.7%) in the RIC group with 1 or more serious adverse events vs 175 patients (24.3%) in the sham group (OR, 0.97; 95% CI, 0.85 to 1.11; P =.68). Upper extremity pain during treatment and/or skin petechia occurred in 54 (7.2%) in the RIC group and 11 (1.5%) in the sham group. Conclusions and Relevance: RIC initiated in the prehospital setting and continued in the hospital did not significantly improve functional outcome at 90 days in patients with acute stroke. Trial Registration: ClinicalTrials.gov Identifier: NCT03481777.
|
|
| 5. |
- Hjort, Marcus, 1988-, et al.
(författare)
-
Biomarker Concentrations and Their Temporal Changes in Patients With Myocardial Infarction and Nonobstructive Compared With Obstructive Coronary Arteries : Results From the PLATO Trial
- 2023
-
Ingår i: Journal of the American Heart Association. - : American heart association. - 2047-9980. ; 12:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The pathobiology of myocardial infarction (MI) with nonobstructive coronary arteries (MINOCA) is often uncertain. Investigating biomarker concentrations and their changes may offer novel pathophysiological insights.Methods and Results: In this post hoc study of the PLATO (Platelet Inhibition and Patient Outcomes) trial, concentrations of hs‐cTnT (high‐sensitivity cardiac troponin T), NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide), hs‐CRP (high‐sensitivity C‐reactive protein), and GDF‐15 (growth differentiation factor 15) were measured in patients with MINOCA at baseline (n=554) and at 1‐month follow‐up (n=107). For comparisons, biomarkers were also measured in patients with MI with obstructive (stenosis ≥50%) coronary artery disease (baseline: n=11 106; follow‐up: n=2755]). Adjusted linear regression models were used to compare concentrations and their short‐ and long‐term changes. The adjusted geometric mean ratios (GMRs) in patients with MINOCA (median age, 61 years; 50.4% women) indicated lower hs‐cTnT (GMR, 0.77 [95% CI, 0.68–0.88]) but higher hs‐CRP (GMR, 1.21 [95% CI, 1.08–1.37]) and GDF‐15 concentrations (GMR, 1.06 [95% CI, 1.02–1.11]) at baseline compared with patients with MI with obstructive coronary artery disease, whereas NT‐proBNP concentrations were similar. Temporal decreases in hs‐cTnT, NT‐proBNP, and hs‐CRP concentrations until 1‐month follow‐up were more pronounced in patients with MINOCA. At follow‐up, patients with MINOCA had lower concentrations of hs‐cTnT (GMR, 0.71 [95% CI, 0.60–0.84]), NT‐proBNP (GMR, 0.45 [95% CI, 0.36–0.56]), and hs‐CRP (GMR, 0.68 [95% CI, 0.53–0.86]). One‐month GDF‐15 concentrations were similar between both groups with MI.Conclusions: Biomarker concentrations suggest greater initial inflammatory activity, similar degree of myocardial dysfunction, and less pronounced myocardial injury during the acute phase of MINOCA compared with MI with obstructive coronary artery disease but also faster myocardial recovery.CLINICAL TRAIL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00391872.
|
|
| 6. |
- Kropp, Heather, et al.
(författare)
-
Shallow soils are warmer under trees and tall shrubs across Arctic and Boreal ecosystems
- 2021
-
Ingår i: Environmental Research Letters. - : IOP Publishing. - 1748-9326. ; 16:1
-
Tidskriftsartikel (refereegranskat)abstract
- Soils are warming as air temperatures rise across the Arctic and Boreal region concurrent with the expansion of tall-statured shrubs and trees in the tundra. Changes in vegetation structure and function are expected to alter soil thermal regimes, thereby modifying climate feedbacks related to permafrost thaw and carbon cycling. However, current understanding of vegetation impacts on soil temperature is limited to local or regional scales and lacks the generality necessary to predict soil warming and permafrost stability on a pan-Arctic scale. Here we synthesize shallow soil and air temperature observations with broad spatial and temporal coverage collected across 106 sites representing nine different vegetation types in the permafrost region. We showed ecosystems with tall-statured shrubs and trees (>40 cm) have warmer shallow soils than those with short-statured tundra vegetation when normalized to a constant air temperature. In tree and tall shrub vegetation types, cooler temperatures in the warm season do not lead to cooler mean annual soil temperature indicating that ground thermal regimes in the cold-season rather than the warm-season are most critical for predicting soil warming in ecosystems underlain by permafrost. Our results suggest that the expansion of tall shrubs and trees into tundra regions can amplify shallow soil warming, and could increase the potential for increased seasonal thaw depth and increase soil carbon cycling rates and lead to increased carbon dioxide loss and further permafrost thaw.
|
|
| 7. |
- Liu, Zhendong, 1983-, et al.
(författare)
-
Study on the Characterization of Degraded Catenary in Sweden to Enhance Safety and Reliability
- 2020
-
Ingår i: The Dynamics of Vehicles on Roads and Tracks - Proceedings of the 26th Symposium of the International Association for Vehicle System Dynamics, IAVSD 2019. - Cham : Springer Nature. ; , s. 212-219
-
Konferensbidrag (refereegranskat)abstract
- Sweden has many catenary systems designed to be used for 40–60 years. Normally they can meet basic operational requirement within this period, but after a long time in service the catenary structures get weakened. Today there are about 40 incidents on catenary breaking each year, which leads to disastrous consequences to the railway network. The significant dynamic interaction of the pantograph-catenary system, together with mechanical wear, chemical corrosion, thermal softening, environmental disturbances, multiple-pantograph operation and increased traffic volume, can significantly weaken the physical strength of the catenaries and result in fatigue and structural damage. To reflect the catenary degradation, a study on the catenary dynamic-fatigue is performed with some factors considered, e.g. material softening due to high temperature and annealing, and cross-section losses due to wear, structural defects and small damages. This study finds that among all Swedish catenary systems the soft catenary system SYT 7.0/9.8 is relatively weak and its messenger wire is the most vulnerable component. The results show that the dynamic tensile load is dependent on position and operational speed. The weakened material strength due to high temperature and annealing have the main responsibility for the system failures. In the end, this paper suggests that, besides the regular visual inspections to the catenary structure, it is necessary to measure and control the degradation of physical strength of the key components to ensure safety and reliability in operation and also to extend the catenary service life.
|
|
| 8. |
- Maslik, Jan, et al.
(författare)
-
Soft, Stretchable and Wireless Sensor Patch with Digitally Printed Liquid Metal Alloy Interconnects
- 2022
-
Ingår i: 2022 IMAPS Nordic Conference on Microelectronics Packaging (NordPac). - : Institute of Electrical and Electronics Engineers (IEEE). - 9789189711396 - 9781665491778
-
Konferensbidrag (refereegranskat)abstract
- Characteristics of high electrical conductivity, high strain tolerance and resistance to fatigue are vital for electronic circuits of on-skin wearable systems. Gallium-based liquid metals offer a unique combination of these characteristics making them excellent alternatives to conventional conductive stretchable inks. In order to obtain better wearing experience, it is advantageous to fabricate devices using breathable materials. However, effective automation solutions for the production of high-resolution digitally patterned circuits for soft and stretchable devices remain a challenge. The presented manufacturing strategy involves adopting a needle dispensing technique for the precise patterning of liquid metal conductors. The circuitry is deposited onto a soft, thin and highly breathable polyurethane medical film. Further, we investigate and map conditions of reliable printing of liquid metal on the polyurethane film for two sizes of dispensing needles with inner diameters of 150 μm and 360 μm. Despite the increased porosity and surface roughness associated with the high breathability of the film, it is possible to reliably deposit liquid metal interconnects with a line width and height below 100 μm. The technological solution results in a first demonstrator presented: an electrophysiological patch.
|
|
| 9. |
- Olsson, Niklas, 1982-, et al.
(författare)
-
Kontaktledningsanläggningen : Hantering av fordon för att minska risken för kontaktledningsnedrivningar
- 2020
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Skadad kontaktledning bidrar till i genomsnitt 7000 mer förseningstimmar per år och därigenom omfattande samhällskostnader. I en stor del av kontaktledningshaverierna har föraren, via sitt agerande, stor möjlighet att påverka anläggningens robusthet. Det här utbildningsmaterialet riktar sig framförallt till förare och växlare hos järnvägsoperatörer. Materialet syftar till en ökad förståelse för och en förbättrad hantering av kontaktledningsanläggningar. Målet är att minska förseningar till följd av skador på kontaktledningen
|
|
| 10. |
- Risum, Malene, et al.
(författare)
-
Introduction of a Comprehensive Diagnostic and Interdisciplinary Management Approach in Haematological Patients with Mucormycosis : A Pre and Post-Intervention Analysis
- 2020
-
Ingår i: Journal of Fungi. - : MDPI. - 2309-608X. ; 6:4
-
Tidskriftsartikel (refereegranskat)abstract
- Mucormycosis is a life threatening infection in patients with haematological disease. We introduced a Mucorales-PCR and an aggressive, multidisciplinary management approach for mucormycosis during 2016-2017 and evaluated patient outcomes in 13 patients diagnosed and treated in 2012-2019. Management principle: repeated surgical debridement until biopsies from the resection margins were clean as defined by negative Blankophor microscopy, Mucorales-PCR (both reported within 24 h), and cultures. Cultured isolates underwent EUCAST E.Def 9.3.1 susceptibility testing. Antifungal therapy (AFT) (mono/combination) combined with topical AFT (when possible) was given according to the minimal inhibitory concentration (MIC), severity of the infection, and for azoles, specifically, it was guided by therapeutic drug monitoring. The outcome was evaluated by case record review. All patients underwent surgery guided by diagnostic biopsies from tissue and resection margins (195 samples in total). Comparing 2012-2015 and 2016-2019, the median number of patients of surgical debridements was 3 and 2.5 and of diagnostic samples: microscopy/culture/PCR was 3/3/6 and 10.5/10/10.5, respectively. The sensitivity of microscopy (76%) and Mucorales-PCR (70%) were similar and microscopy was superior to that of culture (53%; p = 0.039). Initial systemic AFT was liposomal amphotericin B (n = 12) or posaconazole (n = 1) given as monotherapy (n = 4) or in combination with isavuconazole/posaconazole (n = 3/6) and terbinafine (n = 3). Nine patients received topical amphotericin B. All received isavuconazole or posaconazole consolidation therapy (n = 13). Mucormycosis related six month mortality was 3/5 in 2012-2015 and 0/7 patients in 2016-2019 (one patient was lost for follow-up). Implementation of combination therapy (systemic+topical AFT/combination systemic AFT) and aggressive surgical debridement guided by optimised diagnostic tests may improve the outcome of mucormycosis in haematologic patients.
|
|
| 11. |
- Verdel, Nina, et al.
(författare)
-
A Comparison of a Novel Stretchable Smart Patch for Measuring Runner’s Step Rates with Existing Measuring Technologies
- 2022
-
Ingår i: Sensors. - : MDPI. - 1424-8220. ; 22:13
-
Tidskriftsartikel (refereegranskat)abstract
- A novel wearable smart patch can monitor various aspects of physical activity, including the dynamics of running, but like any new device developed for such applications, it must first be tested for validity. Here, we compare the step rate while running in place as measured by this smart patch to the corresponding values obtained utilizing ‘‘gold standard’’ MEMS accelerometers in combination with bilateral force plates equipped with HBM load cells, as well as the values provided by a three-dimensional motion capture system and the Garmin Dynamics Running Pod. The 15 healthy, physically active volunteers (age = 23 ± 3 years; body mass = 74 ± 17 kg, height = 176 ± 10 cm) completed three consecutive 20-s bouts of running in place, starting at low, followed by medium, and finally at high intensity, all self-chosen. Our major findings are that the rates of running in place provided by all four systems were valid, with the notable exception of the fast step rate as measured by the Garmin Running Pod. The lowest mean bias and LoA for these measurements at all rates were associated consistently with the smart patch.
|
|
| 12. |
- Verdel, Nina, et al.
(författare)
-
Reliability and validity of running step rate derived from a novel wearable Smart Patch
- 2024
-
Ingår i: IEEE Sensors Journal. - : IEEE. - 1530-437X .- 1558-1748. ; 24:9, s. 14343-14351
-
Tidskriftsartikel (refereegranskat)abstract
- A novel, wearable, stretchable Smart Patch can monitor various aspects of physical activity, including the dynamics of running. However, like any new device developed for such applications, it must first be tested for validity and reliability. Here, we compare the step rate while running on a treadmill measured by this smart patch with the corresponding values obtained with the ”gold standard” OptoGait, as well as with other devices commonly used to assess running dynamics, i.e., the MEMS accelerometer and commercially available and widely used Garmin Running Dynamic Pod. The 14 healthy, physically active volunteers completed two identical sessions with a 5-minute rest between. Each session involved two one-minute runs at 11 km/h and 14 km/h separated by a one-min rest. The major finding was that the Smart Patch demonstrated fair to good test-retest reliability. The best test-retest reliability for the Running Pod was observed in connection with running at 11 km/h and both velocities combined (good and excellent, respectively) and for the OptoGait when running at 14 km/h (good). The best concurrent validity was achieved with the Smart Patch, as reflected in the highest Pearson correlation coefficient for this device when running at 11 or 14 km/h, as well as for both velocities combined. In conclusion, this study demonstrates that the novel wearable Smart Patch shows promising reliability and excellent concurrent validity in measuring step rate during treadmill running, making it a viable tool for both research and practical applications in sports and exercise science.
|
|
| 13. |
- Wang, Bei, et al.
(författare)
-
Supercooled Liquid Ga Stretchable Electronics
- 2023
-
Ingår i: Advanced Functional Materials. - : Wiley-VCH Verlagsgesellschaft. - 1616-301X .- 1616-3028. ; 33:29
-
Tidskriftsartikel (refereegranskat)abstract
- By controlling the properties of its medium, supercooled liquid Ga (SLGa) based stretchable remains stretchable at -22 degrees C, i.e., 52 degrees C below its thermo-dynamic melting point of Ga. Thus far, our oldest deposited SLGa circuit and film have remained liquids for 2 years at room temperature. The study investi-gates the crystallization of SLGa triggered by the surface energy of nucleation agents, temperature, circuit cross-section, and mechanical impact. Based on these parameters, a method is presented to integrate electronic components with SLGa circuits without compromising its supercooling effect. Further, the large stiffness variation induced by phase transition is demonstrated in dif-ferent applications. For the desired stiffness variation, the crystallization rate can be controlled by varying the temperature and cross-section area. Finally, spray-printing an ink of microscale SLGa microscale particles can confor-mally pattern Ga on a rough surface, e.g., to fabricate a stretchable array of SLGa microelectrodes. A smart patch with stretchable SLGa electrode arrays records human electrocardiogram signals in cold water and does not stain the skin after use. Its low and stable impedance in water will enable novel applications in wearable electronics.
|
|
| 14. |
- Ydrefors, Lisa, et al.
(författare)
-
Parametrisation of a rolling resistance model for extending the brush tyre model
- 2024
-
Ingår i: International Journal of Vehicle Design. - : Inderscience Publishers. - 0143-3369 .- 1741-5314. ; 94:1-2, s. 38-56
-
Tidskriftsartikel (refereegranskat)abstract
- A rolling resistance model (RRM) has been created and parametrised with the purpose of modelling tyre rolling resistance within complete vehicle dynamics simulations. The RRM is based on a combination of the Masing and Zener models to simulate the Payne effect and the viscoelastic properties of rubber. The parametrised model is able to recreate the relationship between the rolling resistance and the tyre deformation well and it has a low computational power requirement. Today the model is limited to simulation of free-rolling tyres on a flat surface, but it can be extended to also include the effects of changes in operating conditions such as wheel angles or road surface.
|
|
