| 1. |
- Malinovschi, Andrei, 1978-, et al.
(author)
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Consequences of Using Post- or Prebronchodilator Reference Values in Interpreting Spirometry
- 2023
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In: American Journal of Respiratory and Critical Care Medicine. - : American Thoracic Society. - 1073-449X .- 1535-4970. ; 208:4, s. 461-471
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Journal article (peer-reviewed)abstract
- RATIONALE: Post-bronchodilator (BD) spirometry is used for diagnosis of chronic obstructive pulmonary disease (COPD). However, pre-BD reference values are used for spirometry interpretation.OBJECTIVES: To compare the resulting prevalence rates of abnormal spirometry and study the consequences of using pre- or post-BD reference values generated within the Swedish CArdioPulmonary bioImage Study (SCAPIS) when interpreting post-BD spirometry in a general population.METHODS: SCAPIS reference values for post-BD and pre-BD spirometry were based on 10,156 and 1,498 never-smoking, healthy participants, respectively. We studied the associations of abnormal spirometry, defined by using pre- or post-BD reference values, with respiratory burden in the SCAPIS general population (28,851 individuals).MEASUREMENTS AND MAIN RESULTS: Bronchodilation resulted in higher predicted median and lower limit of normal (LLN) for FEV1/FVC ratio. The prevalence of post-BD FEV1/FVC < pre-bronchodilator LLN was 4.8% and that of post-BD FEV1/FVC < post-bronchodilator LLN was 9.9% for the general population. An additional 5.1% was identified as having an abnormal post-BD FEV1/FVC ratio and this group had more respiratory symptoms, emphysema (13.5% vs. 4.1%, p<0.001) and self-reported physician-diagnosed COPD (2.8% vs. 0.5%, p<0.001) than subjects with post-BD FEV1/FVC ratio > LLN for both pre- and post-bronchodilation).CONCLUSIONS: Pre- and post-bronchodilator spirometry reference values differ with regard to FEV1/FVC ratio. Use of post-bronchodilator reference values doubled the population prevalence of airflow obstruction; this was related to a higher respiratory burden. Using post-bronchodilator reference values when interpreting post-bronchodilator spirometry might enable identification of individuals with mild disease and be clinically relevant.
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| 2. |
- Aaltonen, H. Laura, et al.
(author)
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Airspace dimension assessment with nanoparticles as a proposed biomarker for emphysema
- 2021
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In: Thorax. - : BMJ. - 0040-6376 .- 1468-3296. ; 76:10, s. 1040-1043
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Journal article (peer-reviewed)abstract
- Airspace dimension assessment with nanoparticles (AiDA) is a novel method to measure distal airspace radius non-invasively. In this study, AiDA radii were measured in 618 individuals from the population-based Swedish CArdiopulmonary BioImaging Study, SCAPIS. Subjects with emphysema detected by computed tomography were compared to non-emphysematous subjects. The 47 individuals with mainly mild-to-moderate visually detected emphysema had significantly larger AiDA radii, compared with non-emphysematous subjects (326±48 μm vs 291±36 μm); OR for emphysema per 10 μm: 1.22 (1.13-1.30, p<0.0001). Emphysema according to CT densitometry was similarly associated with larger radii compared with non-emphysematous CT examinations (316±41 μm vs 291 μm±26 μm); OR per 10 μm: 1.16 (1.08-1.24, p<0.0001). The results are in line with comparable studies. The results show that AiDA is a potential biomarker for emphysema in individuals in the general population.
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| 3. |
- Bjöersdorff, Mimmi, et al.
(author)
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Detection of lymph node metastases in patients with prostate cancer: Comparing conventional and digital F-18 -fluorocholine PET-CT using histopathology as a reference
- 2022
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In: Clinical Physiology and Functional Imaging. - : Wiley. - 1475-0961 .- 1475-097X.
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Journal article (peer-reviewed)abstract
- Background: Positron emission tomography-computed tomography (PET-CD with [F-18]-fluorocholine (FCH) is used to detect and stage metastatic lymph nodes in patients with prostate cancer. Improvements to hardware and software have recently been made. We compared the capability of detecting regional lymph node metastases using conventional and digital silicon photomultiplier (SiPM)-based PET-CT technology for FCH. Extended pelvic lymph node dissection (ePLND) histopathology was used as a reference method. Methods: The study retrospectively examined 177 patients with intermediate or high-risk prostate cancer who had undergone staging with FCH PET-CT before ePLND. Images were obtained with either the conventional Philips Gemini PET-CT (n = 93) or the digital SiPM-based GE Discovery MI PET-CT (n = 84) and compared. Results: Images that were obtained using the Philips Gemini PET-CT system showed 19 patients (20%) with suspected lymph node metastases, whereas the GE Discovery MI PET-CT revealed 36 such patients (43%). The sensitivity, specificity, and positive and negative predictive values were 0.3, 0.84, 0.47, and 0.72 for the Philips Gemini, while they were 0.58, 0.62, 0.31, and 0.83 for the GE Discovery MI, respectively. The areas under the curves in a receiver operating characteristic curve analysis were similar between the two PET-CT systems (0.57 for Philips Gemini and 0.58 for GE Discovery MI, p = 0.89). Conclusions: Marked differences in sensitivity and specificity were found for the different PET-CT systems, although the overall diagnostic performance was similar. These differences are probably due to differences in both hardware and software, including reconstruction algorithms, and should be considered when new technology is introduced.
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| 4. |
- Casselbrant, Andreas, et al.
(author)
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Common physiologic and proteomic biomarkers in pulmonary and coronary artery disease
- 2022
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In: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 17:3
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Journal article (peer-reviewed)abstract
- OBJECTIVE: Chronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD) are leading causes of global morbidity and mortality. There is a well-known comorbidity between COPD and CAD, which is only partly explained by smoking and other known common risk factors. In order to better understand the relationship between COPD and CAD, we analyzed myocardial perfusion, pulmonary function and novel cardiovascular biomarkers in patients with symptoms suggesting myocardial ischemia.METHODS: A total of 396 subjects from the Swedish Biomarkers and Genetics CardioPulmonary Physiology Study (BiG CaPPS) were included, all of whom had been referred to myocardial perfusion imaging due to suspected myocardial ischemia. Subjects performed myocardial perfusion imaging (MPI), pulmonary function tests (PFT) and analysis of 92 proteomic biomarkers, previously associated with cardiovascular disease. Linear regression was used to study the relationship between MPI and PFT results and proteomic biomarkers.RESULTS: Subjects with CAD (n = 159) had lower diffusing capacity (DLCO) than patients without CAD (6.64 versus 7.17 mmol/(min*kPa*l); p = 0.004) in models adjusted for common covariates such as smoking, but also diabetes and brain natriuretic peptide (BNP). The association remained significant after additional adjustment for forced expiratory volume in one second (FEV1) (p = 0.009). Subjects with CAD, compared with subjects without CAD, had higher total airway resistance (0.37 vs 0.36 kPa/(l/s); p = 0.036). Among 92 protein biomarkers, nine were associated with a combined diagnosis of CAD and airflow obstruction: VSIG2, KIM1, FGF-23, REN, XCL1, GIF, ADM, TRAIL-R2 and PRSS8.SIGNIFICANCE: Diffusing capacity for carbon monoxide is decreased in patients with CAD, independently of decreased FEV1, diabetes, and elevated BNP. Several cardiovascular biomarkers are associated with co-existent CAD and airflow obstruction, but none with airflow obstruction only. The current findings indicate that the interaction between CAD and lung function is complex, including mechanisms beyond the known association between CAD and reduced ventilation.
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| 5. |
- Dobric, Julia, et al.
(author)
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Physical activity changes the deposited fractions of particles in the respiratory tract of adults and children
- 2022
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In: ; , s. 45-45
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Conference paper (peer-reviewed)abstract
- Exposure to ambient air pollution can cause a numberof health problems and may be particularly dangerous to susceptible population groups such as children. Health effects caused by air pollution are criticallydependent on both the deposited fraction (DF) of the inhaled particles and in what region of the respiratory tract the deposition takes place. With increasing physical activity, the breathing pattern is altered and the airflow in the respiratory tract increase, this affects the DF and deposition site. In this study we investigated changes in DF at increasing physical activity for three population groups: ~5 and 10 year-old children, and adults.Our results indicate that the variation in total DF with physical activity is minor, but that the DF for the UFPs increase in the AI region at higher activity levels. This is important since the removal of particles in the AI region is not effective and UFPs are believed to pose a specific health risk. Therefore, activity patterns and DF of different population groups need to be considered when estimating particle dose and evaluating health risks.
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| 6. |
- Dobric, Julia, et al.
(author)
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Preschool Children’s Inhalation Rates Estimated from Accelerometers—A Tool to Estimate Children’s Exposure to Air Pollution
- 2022
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In: Aerosol and Air Quality Research. - : AAGR Aerosol and Air Quality Research. - 1680-8584 .- 2071-1409. ; 22:8
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Journal article (peer-reviewed)abstract
- Children are particularly sensitive to air pollution exposure, and their personal exposures may differ significantly from those of adults. One key factor for understanding the personal inhaled dose of air pollutants is the respiratory minute ventilation (Ve). To estimate the amount of particles circulated through the lungs, 24 h averages of Ve are often used. These averages poorly capture variations in Ve during the day, and between individuals. We here develop and implement a concept to assess individual Ve of children, with minimal impact on their natural activity and movement pattern by using ActiGraph GT3X+ accelerometers. Activity of 136 preschool children in the ages 3 to 5 years was logged using accelerometers while the children attended their preschools during a week. A linear regression equation is developed and used for estimating Ve from the accelerometer data retrieved for each individual child. The results show large variations in weekly average Ve between individuals, ranging from 0.33 to 0.48 L min–1 kg–1. Over the days the averages of the individuals’ 1st and 3rd quartiles were 0.28 and 0.48 L min–1 kg–1, respectively. Outdoor activities resulted in a 17% higher Ve than indoor activities, which may be important to consider when estimating the inhaled dose of air pollutants since pollution levels and particle toxicities can be different indoors and outdoors. The observations motivate the use of individual values of Ve in exposure assessments and suggest that accelerometers are a suitable tool for estimating children’s individual Ve in their natural environment. Combined with time resolved local air pollution monitoring, these measurements can provide the basis of a more precise estimate of children’s inhaled dose of air pollutants. © The Author(s).
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| 7. |
- Ek, Staffan, et al.
(author)
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Relative Age Effect of Sport Academy Adolescents, a Physiological Evaluation
- 2020
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In: Sports. - Basel : MDPI. - 2075-4663. ; 8:1
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Journal article (peer-reviewed)abstract
- The relationship between birth quarter distribution and physiological characteristics related to athletic skills, in adolescent sport academy students has not been fully investigated. In a cross-sectional study, we recruited 86 boys and 52 girls aged 12-14 years during their first term at a sport academy school. We measured body size, cardiac size, pulmonary function, body composition, lower body power, cardiorespiratory fitness parameters, and running endurance by standard methods and analyzed these estimates in relation to birth quarter by ANOVA. Birth quarter distribution in our cohort was compared with birth quarter distribution in the same ages in the whole of Sweden and analyzed by logistic regression. The academy had an overrepresentation of students born in the first quartile of the year compared to those born in the last quartile (odds ratio 2.3 (95% CI: 1.1-4.7)). When comparing the physiological characteristics between birth quarters, uniformity is prominent since out of 26 performed physiological and anthropometric tests only four showed statistically significant group differences. We thus believe that the selection process to the sport academy favours athletes with higher chronological age, i.e., a so-called relative age effect is present. © 2020 MDPI (Basel, Switzerland).
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| 8. |
- Engström, Gunnar, et al.
(author)
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Pulmonary function and atherosclerosis in the general population : causal associations and clinical implications
- 2024
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In: European Journal of Epidemiology. - : Springer Nature. - 0393-2990 .- 1573-7284. ; 39:1, s. 35-49
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Journal article (peer-reviewed)abstract
- Reduced lung function is associated with cardiovascular mortality, but the relationships with atherosclerosis are unclear. The population-based Swedish CArdioPulmonary BioImage study measured lung function, emphysema, coronary CT angiography, coronary calcium, carotid plaques and ankle-brachial index in 29,593 men and women aged 50–64 years. The results were confirmed using 2-sample Mendelian randomization. Lower lung function and emphysema were associated with more atherosclerosis, but these relationships were attenuated after adjustment for cardiovascular risk factors. Lung function was not associated with coronary atherosclerosis in 14,524 never-smokers. No potentially causal effect of lung function on atherosclerosis, or vice versa, was found in the 2-sample Mendelian randomization analysis. Here we show that reduced lung function and atherosclerosis are correlated in the population, but probably not causally related. Assessing lung function in addition to conventional cardiovascular risk factors to gauge risk of subclinical atherosclerosis is probably not meaningful, but low lung function found by chance should alert for atherosclerosis.
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| 9. |
- Fridolfsson, Jonatan, 1992, et al.
(author)
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Physical activity spectrum discriminant analysis—A method to compare detailed patterns between groups
- 2021
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In: Scandinavian Journal of Medicine and Science in Sports. - : Wiley. - 0905-7188 .- 1600-0838. ; 31:12, s. 2333-2342
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Journal article (peer-reviewed)abstract
- Investigating physical activity (PA) patterns as a detailed intensity spectrum instead of crude intensity categories have improved the ability to analyze the relationship between measured PA and health variables. The aim of this methodological study was to introduce and investigate the utility of using detailed PA intensity spectrum compared to crude PA intensity categories for comparison of PA between groups and between repeated measures. The study sample consisted of two groups of children, where one group was scheduled for extended physical education (PE) by daily classes while the other group followed usual PE schedule. Accelerometer data was processed into traditional crude PA intensity categories and into detailed PA intensity spectrum. Multivariate partial least squares regression for discriminant analysis (PLS-DA) was applied for PA intensity spectrum group comparison and compared to traditional univariate statistical analysis. Repeated measures were investigated using independent PLS-DA as well as multilevel PLS-DA for paired analysis. While traditional analysis of crude PA intensity categories was unable to find any group differences, multivariate analysis of the PA intensity spectrum identified statistically significant differences. By the extension of multilevel PLS-DA for paired comparison, a clear difference in the PA intensity spectrum was demonstrated between repeated measures. In conclusion, analysis of detailed PA intensity spectrum demonstrates utility for comparing detailed PA data between groups and between repeated measures in interventional and observational research.
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| 10. |
- Garpered, Sabine, et al.
(author)
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Evaluation of 18F-FDG uptake in lung parenchyma compensating for tissue fraction : Comparison between non-enhanced low dose CT and intravenous contrast-enhanced diagnostic CT
- 2020
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In: Nuklearmedizin. - : Georg Thieme Verlag KG. - 0029-5566 .- 2567-6407. ; 59:1, s. 20-25
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Journal article (peer-reviewed)abstract
- AIM: To determine how the presence of intravenous (IV) contrast-enhanced CT influences SUV measurements corrected for both attenuation and tissue fraction. MATERIAL AND METHODS: Eighteen patients with different malignancies, free from lung disorders, lung cancer or metastasis, were prospectively recruited when referred for staging with combined 18F-FDG-PET/CT examination. A non-enhanced low-dose CT over the chest was immediately followed by a whole-body IV contrast-enhanced diagnostic CT and finally the PET acquisition. PET data were reconstructed with attenuation correction based on the two CT data sets. The lungs were segmented in the CT images and lung density was measured. Uptake of 18F-FDG in lung parenchyma was recorded using both non-enhanced and IV contrast-enhanced CT as well as with and without compensation for lung aeration. A comparison of SUV values of corrected and uncorrected PET images was performed. RESULTS: There was no significant difference between low dose PET/CT and IV contrast-enhanced PET/CT when removing the impact of air fraction (p = 0.093 for the right lung and p = 0.085 for the left lung). When tissue fraction was not corrected for, there was a significant difference between low dose PET/CT and IV contrast enhanced PET/CT used for attenuation correction (p = 0.006 for the right lung and p = 0.015 for the left lung). CONCLUSION: There was only a marginal effect on the assessement of SUV in the lung tissue when using IV contrast enhanced CT for attenuation correction when the air fraction was accounted for.
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| 11. |
- Gren, Louise, et al.
(author)
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Lung function and self-rated symptoms in healthy volunteers after exposure to hydrotreated vegetable oil (HVO) exhaust with and without particles
- 2022
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In: Particle and Fibre Toxicology. - : Springer Science and Business Media LLC. - 1743-8977. ; 19:1
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Journal article (peer-reviewed)abstract
- Background: Diesel engine exhaust causes adverse health effects. Meanwhile, the impact of renewable diesel exhaust, such as hydrotreated vegetable oil (HVO), on human health is less known. Nineteen healthy volunteers were exposed to HVO exhaust for 3 h in a chamber with a double-blind, randomized setup. Exposure scenarios comprised of HVO exhaust from two modern non-road vehicles with 1) no aftertreatment system ('HVOPM+NOx' PM1: 93 mu g-m(-3), EC: 54 mu g-m(-3), NO: 3.4 ppm, -NO2: 0.6 ppm), 2) an aftertreatment system containing a diesel oxidation catalyst and a diesel particulate filter ('HVONOx' PM1: similar to 1 mu g-m(-3), NO: 2.0 ppm, -NO2: 0.7 ppm) and 3) filtered air (FA) as control. The exposure concentrations were in line with current EU occupational exposure limits (OELs) of NO, -NO2, formaldehyde, polycyclic aromatic hydrocarbons (PAHs), and the future OEL (2023) of elemental carbon (EC). The effect on nasal patency, pulmonary function, and self-rated symptoms were assessed. Calculated predicted lung deposition of HVO exhaust particles was compared to data from an earlier diesel exhaust study. Results: The average total respiratory tract deposition of PM1 during -HVO(PM+ NO)x was 27 mu g-h(-1). The estimated deposition fraction of HVO PM1 was 40-50% higher compared to diesel exhaust PM1 from an older vehicle (earlier study), due to smaller particle sizes of the -HVOPM+ NOx exhaust. Compared to FA, exposure to -HVOPM+ NOx and -HVONOx caused higher incidence of self-reported symptoms (78%, 63%, respectively, vs. 28% for FA, p < 0.03). Especially, exposure to -HVOPM+ NOx showed 40-50% higher eye and throat irritation symptoms. Compared to FA, a decrement in nasal patency was found for the -HVONOx exposures (- 18.1, 95% CI: - 27.3 to - 8.8 L-min(-1), p < 0.001), and for the -HVOPM+ NOx (- 7.4 (- 15.6 to 0.8) L -min(-1), p = 0.08). Overall, no clinically significant change was indicated in the pulmonary function tests (spirometry, peak expiratory flow, forced oscillation technique). Conclusion: Short-term exposure to HVO exhaust concentrations corresponding to EU OELs for one workday did not cause adverse pulmonary function changes in healthy subjects. However, an increase in self-rated mild irritation symptoms, and mild decrease in nasal patency after both HVO exposures, may indicate irritative effects from exposure to HVO exhaust from modern non-road vehicles, with and without aftertreatment systems.
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| 12. |
- Hill, Mattias, et al.
(author)
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Functional and structural impairments of the pulmonary system in middle-aged people with cervical and upper thoracic spinal cord injuries
- 2023
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In: Journal of Spinal Cord Medicine. - : Informa UK Limited. - 2045-7723 .- 1079-0268. ; 46:5, s. 732-741
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Journal article (peer-reviewed)abstract
- OBJECTIVES: To describe functional and structural impairments of the pulmonary system in middle-aged people with cervical and upper thoracic spinal cord injuries (SCI), and compare findings to the general population. To determine if the neurological level of injury (NLI) is related to functional and structural impairments, and if age is related to structural impairments.DESIGN: Cross-sectional study with matched controls. Data from the Swedish SPinal Cord Injury Study on Cardiopulmonary and Autonomic Impairment (SPICA). Matched control data were obtained from the Swedish CArdioPulmonary bioImage Study (SCAPIS).SETTING: Outpatient SCI unit in southern Sweden.PARTICIPANTS: 25 people (20% women, mean age 58 years, mean time since injury 28 years, NLIs C2-T6, American Spinal Injury Association Impairment Scale A-C).INTERVENTIONS: Not applicable.OUTCOME MEASURES: Lung function was assessed with spirometry, diffusing capacity and impulse oscillometry. Structural assessments were performed with computed tomography.RESULTS: Pulmonary function was generally worse compared to the controls. Structural impairments were common (75% of the participants and 65% of the controls; P = 0.36, NS). NLI was significantly related to some of the functional and structural impairments.CONCLUSIONS: Middle-aged people with long-term cervical and upper thoracic SCI can have substantial pulmonary functional impairments, whereas structural impairments do not differ considerably from the general population. Further larger and longitudinal studies should focus on the clinical impact of these impairments over time.
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| 13. |
- Jarenbäck, Linnea, et al.
(author)
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Single-nucleotide polymorphisms in the sulfatase-modifying factor 1 gene are associated with lung function and COPD
- 2022
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In: ERJ open research. - : European Respiratory Society (ERS). - 2312-0541. ; 8
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Journal article (peer-reviewed)abstract
- Single nucleotide polymorphisms (SNPs) in various genes have been shown to associate with COPD, suggesting a role in disease pathogenesis. Sulfatase modifying factor (SUMF1) is a key modifier in connective tissue remodelling, and we have shown previously that several SNPs in SUMF1 are associated with COPD. The aim of this study was to investigate the association between SUMF1 SNPs and advanced lung function characteristics. Never-, former and current smokers with (n=154) or without (n=405) COPD were genotyped for 21 SNPs in SUMF1 and underwent spirometry, body plethysmography, diffusing capacity of the lung for carbon monoxide ( D LCO) measurement and impulse oscillometry. Four SNPs (rs793391, rs12634248, rs2819590 and rs304092) showed a significantly decreased odds ratio of having COPD when heterozygous for the variance allele, together with a lower forced expiratory volume in 1 s (FEV 1) and FEV 1/forced vital capacity (FVC) ratio and an impaired peripheral resistance and reactance. Moreover, individuals homozygous for the variance allele of rs3864051 exhibited a strong association to COPD, a lower FEV 1/FVC, FEV 1 and D LCO, and an impaired peripheral resistance and reactance. Other SNPs (rs4685744, rs2819562, rs2819561 and rs11915920) were instead associated with impaired lung volumes and exhibited a lower FVC, total lung capacity and alveolar volume, in individuals having the variance allele. Several SNPs in the SUMF1 gene are shown to be associated with COPD and impaired lung function. These genetic variants of SUMF1 may cause a deficient sulfation balance in the extracellular matrix of the lung tissue, thereby contributing to the development of COPD.
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| 14. |
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| 15. |
- Kharraziha, Isabella, et al.
(author)
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Impaired cerebral oxygenation in heart failure patients at rest and during head-up tilt testing
- 2021
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In: ESC Heart Failure. - : Wiley. - 2055-5822. ; 8:1, s. 586-594
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Journal article (peer-reviewed)abstract
- AIMS: Heart failure (HF) confers potentially negative effects on the brain and autonomic nervous system. The measurement cerebral tissue oxygen saturation (SctO2 ) may aid in understanding such effects. We aimed to investigate if compensated HF affects SctO2 at rest and during orthostatic challenge.METHODS AND RESULTS: Non-invasive haemodynamic monitoring and near-infrared spectroscopy were applied during head-up tilt (HUT) in 61 HF patients [mean (SD) 71 (11) years, 82% male, New York Heart Association (NYHA) class I-III] and 60 controls [60 (12) years, 42% male). Group differences in continuous variables were compared using Student's t-test. Associations between HF and SctO2 were studied using multivariable linear regression models adjusted for age, sex, diabetes, smoking, systolic blood pressure (SBP), and heart rate in supine position and after 10 min of HUT. Mean SctO2 was lower in HF patients compared with controls both in the supine position (67 vs. 71%; P < 0.001) and after 10 min of HUT (64 vs. 69%; P < 0.001). The HUT-induced SctO2 decrease was greater in HF patients compared with controls (P = 0.026). SBP did not change in neither HF patients nor controls during HUT, whereas diastolic blood pressure and heart rate increased in both groups. HF was associated with lower SctO2 in supine (B = -2.5%, P = 0.023) and after 10 min of HUT (B = -2.6%, P = 0.007) after multivariable adjustments.CONCLUSIONS: Cerebral tissue oxygenation is lower in HF patients both at rest and during orthostasis compared with subjects without HF. Future studies should test if the lower cerebral oxygenation associates with negative prognosis and with impaired cognitive function.
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| 16. |
- Kisiel, Marta A., 1984-, et al.
(author)
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Airspace Dimension Assessment for early detection of lung function impairment in the peripheral airways of firefighters
- 2023
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In: ERJ Open Research. - : European Respiratory Society. - 2312-0541. ; 9:2
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Journal article (peer-reviewed)abstract
- Introduction Firefighters have increased risk of chronic respiratory disease. Standard clinical techniques used in medical checkups may not detect the earliest microstructural changes in peripheral airways. A new technique called Airspace Dimension Assessment (AiDA) has been shown to enable early detection of emphysema in COPD. This method may be useful in the occupational setting to detect early pulmonary changes and enable prevention. The aim of the present study was to evaluate whether AiDA detects changes in the most peripheral airways of firefighters.Methods AiDA, measuring the effective airspace radius (rAiDA) and zero-second recovery (R0), was used as a complement to other standardised lung function measures in 21 male firefighters and 16 age-matched male controls.Results There were significant differences in rAiDA and R0 between firefighters (mean±sd rAiDA 0.301±0.024 mm; mean±sd R0 0.336±0.116 arbitrary units) and controls (mean±sd rAiDA 0.276±0.044 mm; mean±sd R0 0.5760.168 arbitrary units), p=0.03 and p<0.001, respectively. Higher forced vital capacity was found in firefighters (mean 101% of predicted) than in controls (mean 93% of predicted; p=0.03). No significant differences were found with regard to either the ratio between forced expiratory volume in 1 s and forced vital capacity or forced expiratory volume in 1 s. The majority of firefighters had diffusing capacity of the lung for carbon monoxide, oscillometry and single-breath nitrogen washout values within the normal ranges.Conclusion AiDA parameters can provide information on early pulmonary peripheral changes that may not be seen with standard techniques used in screening of pulmonary function.
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| 17. |
- Linell, Julia, et al.
(author)
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Alterations of particle deposition in the respiratory tract at increasing activity
- 2023
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Conference paper (other academic/artistic)abstract
- The deposited dose of particles in the respiratory tract is an important factor for understanding health effects of aerosol particles. It is a combination of the exposure, volume of inhaled air and particle deposition. At increasing activity the minute ventilation ( volume of breath x number of breaths ) increase . Little is known about if and how this affects the regional particle deposition.
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| 18. |
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| 19. |
- Linell, Julia, et al.
(author)
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Effects of breathing variables on modelled particle lung deposition at physical activity for children and adults
- 2023
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In: Air Quality, Atmosphere and Health. - : Springer Science and Business Media B.V.. - 1873-9318 .- 1873-9326.
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Journal article (peer-reviewed)abstract
- The respiratory tract deposited fraction (DF) is the link between exposure and health effects of airborne particles. Here, we investigate how breathing pattern alterations at increasing physical activity affect DF in different regions of the respiratory tract and compare DF between adults and children (5 and 10 years old). We performed a literature review on the alteration of tidal volume with minute ventilation at increasing physical activity and used the results to model the size resolved (0.001–10 µm) DF, primarily using the deposition models from NCRP and Yeh and Schum (1980), but also MPPD. We found a shift in the deposited size distribution with increasing physical activity—DF of ultrafine particles increased in the alveolar region and decreased in the other regions, while DF of coarser particles decreased in the alveolar region and increased in the extra-thoracic region. Children had a 10–20% higher DF of ultrafine particles in the alveolar region compared to adults. We also present parametrizations of the daily average size resolved (0.005–5 µm) DF, accounting for varying physical activity throughout the day and oral/nasal breathing. These can be applied to any size distribution to estimate deposited doses. We found that deposited mass and number doses were more than twice as high for 5-year-olds compared to adults when normalized for body weight, primarily caused by their higher weight normalized minute ventilation. This demonstrates the importance of studying children’s exposure to air pollution and not only rely on data from adults.
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| 20. |
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| 21. |
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| 22. |
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| 23. |
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| 24. |
- Luoto, Johannes, et al.
(author)
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Emphysema severity index (ESI) associated with respiratory death in a large Swedish general population
- 2022
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In: Respiratory Medicine. - : Elsevier BV. - 0954-6111. ; 200
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Journal article (peer-reviewed)abstract
- Recently, it has been shown and validated that presence and severity of emphysema on computed tomography could be estimated by a novel spirometry based index, the emphysema severity index (ESI). However, the clinical relevance of the index has not been established. We conducted cox-regression analyses with adjustment for age, smoking, sex, forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) to study whether ESI was associated with all-cause, respiratory and non-respiratory 10-year mortality. Study population was all participants with acceptable spirometry from the Gott Åldrande i Skåne study, a Swedish general population aged 65–102 years old. ESI is expressed as a continuous numeric parameter on a scale ranging from 0 to 10. Out of the 4453 participants in the main study, 3974 was included in the final analysis. Higher age, higher ESI, lower FEV1 and male sex increased hazard of respiratory death. ESI was significantly correlated to respiratory death but not non-respiratory death, while high age, male sex and low FEV1 was associated with non-respiratory as well as respiratory death. Current smoking habits increased the hazard of respiratory death but did not reach significance (p 0.066) One unit increase in ESI increased hazard of all-cause death by 20% (p 0.0002) and hazard of respiratory death by 57% (p < 0.0001). The ESI is a novel clinical marker of emphysema severity that is associated with respiratory death specifically. Since it can be derived from standard spirometry there are potential benefits for clinical practice in terms of more individualised prognosis and treatment alternatives.
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| 25. |
- Ly, John, et al.
(author)
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Post-reconstruction enhancement of [18F]FDG PET images with a convolutional neural network
- 2021
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In: EJNMMI Research. - : Springer Science and Business Media LLC. - 2191-219X. ; 11:1
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Journal article (peer-reviewed)abstract
- Background: The aim of the study was to develop and test an artificial intelligence (AI)-based method to improve the quality of [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET) images. Methods: A convolutional neural network (CNN) was trained by using pairs of excellent (acquisition time of 6 min/bed position) and standard (acquisition time of 1.5 min/bed position) or sub-standard (acquisition time of 1 min/bed position) images from 72 patients. A test group of 25 patients was used to validate the CNN qualitatively and quantitatively with 5 different image sets per patient: 4 min/bed position, 1.5 min/bed position with and without CNN, and 1 min/bed position with and without CNN. Results: Difference in hotspot maximum or peak standardized uptake value between the standard 1.5 min and 1.5 min CNN images fell short of significance. Coefficient of variation, the noise level, was lower in the CNN-enhanced images compared with standard 1 min and 1.5 min images. Physicians ranked the 1.5 min CNN and the 4 min images highest regarding image quality (noise and contrast) and the standard 1 min images lowest. Conclusions: AI can enhance [18F]FDG-PET images to reduce noise and increase contrast compared with standard images whilst keeping SUVmax/peak stability. There were significant differences in scoring between the 1.5 min and 1.5 min CNN image sets in all comparisons, the latter had higher scores in noise and contrast. Furthermore, difference in SUVmax and SUVpeak fell short of significance for that pair. The improved image quality can potentially be used either to provide better images to the nuclear medicine physicians or to reduce acquisition time/administered activity.
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