| 1. |
- Naghavi, Mohsen, et al.
(författare)
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Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013
- 2015
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Ingår i: The Lancet. - 1474-547X .- 0140-6736. ; 385:9963, s. 117-171
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Tidskriftsartikel (refereegranskat)abstract
- Background Up-to-date evidence on levels and trends for age-sex-specifi c all-cause and cause-specifi c mortality is essential for the formation of global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013) we estimated yearly deaths for 188 countries between 1990, and 2013. We used the results to assess whether there is epidemiological convergence across countries. Methods We estimated age-sex-specifi c all-cause mortality using the GBD 2010 methods with some refinements to improve accuracy applied to an updated database of vital registration, survey, and census data. We generally estimated cause of death as in the GBD 2010. Key improvements included the addition of more recent vital registration data for 72 countries, an updated verbal autopsy literature review, two new and detailed data systems for China, and more detail for Mexico, UK, Turkey, and Russia. We improved statistical models for garbage code redistribution. We used six different modelling strategies across the 240 causes; cause of death ensemble modelling (CODEm) was the dominant strategy for causes with sufficient information. Trends for Alzheimer's disease and other dementias were informed by meta-regression of prevalence studies. For pathogen-specifi c causes of diarrhoea and lower respiratory infections we used a counterfactual approach. We computed two measures of convergence (inequality) across countries: the average relative difference across all pairs of countries (Gini coefficient) and the average absolute difference across countries. To summarise broad findings, we used multiple decrement life-tables to decompose probabilities of death from birth to exact age 15 years, from exact age 15 years to exact age 50 years, and from exact age 50 years to exact age 75 years, and life expectancy at birth into major causes. For all quantities reported, we computed 95% uncertainty intervals (UIs). We constrained cause-specific fractions within each age-sex-country-year group to sum to all-cause mortality based on draws from the uncertainty distributions. Findings Global life expectancy for both sexes increased from 65.3 years (UI 65.0-65.6) in 1990, to 71.5 years (UI 71.0-71.9) in 2013, while the number of deaths increased from 47.5 million (UI 46.8-48.2) to 54.9 million (UI 53.6-56.3) over the same interval. Global progress masked variation by age and sex: for children, average absolute diff erences between countries decreased but relative diff erences increased. For women aged 25-39 years and older than 75 years and for men aged 20-49 years and 65 years and older, both absolute and relative diff erences increased. Decomposition of global and regional life expectancy showed the prominent role of reductions in age-standardised death rates for cardiovascular diseases and cancers in high-income regions, and reductions in child deaths from diarrhoea, lower respiratory infections, and neonatal causes in low-income regions. HIV/AIDS reduced life expectancy in southern sub-Saharan Africa. For most communicable causes of death both numbers of deaths and age-standardised death rates fell whereas for most non-communicable causes, demographic shifts have increased numbers of deaths but decreased age-standardised death rates. Global deaths from injury increased by 10.7%, from 4.3 million deaths in 1990 to 4.8 million in 2013; but age-standardised rates declined over the same period by 21%. For some causes of more than 100 000 deaths per year in 2013, age-standardised death rates increased between 1990 and 2013, including HIV/AIDS, pancreatic cancer, atrial fibrillation and flutter, drug use disorders, diabetes, chronic kidney disease, and sickle-cell anaemias. Diarrhoeal diseases, lower respiratory infections, neonatal causes, and malaria are still in the top five causes of death in children younger than 5 years. The most important pathogens are rotavirus for diarrhoea and pneumococcus for lower respiratory infections. Country-specific probabilities of death over three phases of life were substantially varied between and within regions. Interpretation For most countries, the general pattern of reductions in age-sex specifi c mortality has been associated with a progressive shift towards a larger share of the remaining deaths caused by non-communicable disease and injuries. Assessing epidemiological convergence across countries depends on whether an absolute or relative measure of inequality is used. Nevertheless, age-standardised death rates for seven substantial causes are increasing, suggesting the potential for reversals in some countries. Important gaps exist in the empirical data for cause of death estimates for some countries; for example, no national data for India are available for the past decade.
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| 2. |
- Vedantham, H. K., et al.
(författare)
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Lunar occultation of the diffuse radio sky : LOFAR measurements between 35 and 80 MHz
- 2015
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Ingår i: Monthly notices of the Royal Astronomical Society. - : Oxford University Press (OUP). - 0035-8711 .- 1365-2966. ; 450, s. 2291-2305
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Tidskriftsartikel (refereegranskat)abstract
- We present radio observations of the Moon between 35 and 80 MHz to demonstrate a novel technique of interferometrically measuring large-scale diffuse emission extending far beyond the primary beam (global signal) for the first time. In particular, we show that (i) the Moon appears as a negative-flux source at frequencies 35 < ν < 80 MHz since it is ‘colder’ than the diffuse Galactic background it occults, (ii) using the (negative) flux of the lunar disc, we can reconstruct the spectrum of the diffuse Galactic emission with the lunar thermal emission as a reference, and (iii) that reflected RFI (radio-frequency interference) is concentrated at the centre of the lunar disc due to specular nature of reflection, and can be independently measured. Our RFI measurements show that (i) Moon-based Cosmic Dawn experiments must design for an Earth-isolation of better than 80 dB to achieve an RFI temperature <1 mK, (ii) Moon-reflected RFI contributes to a dipole temperature less than 20 mK for Earth-based Cosmic Dawn experiments, (iii) man-made satellite-reflected RFI temperature exceeds 20 mK if the aggregate scattering cross-section of visible satellites exceeds 175 m2 at 800 km height, or 15 m2 at 400 km height. Currently, our diffuse background spectrum is limited by sidelobe confusion on short baselines (10–15 per cent level). Further refinement of our technique may yield constraints on the redshifted global 21 cm signal from Cosmic Dawn (40 > z > 12) and the Epoch of Reionization (12 > z > 5).
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| 3. |
- Camilo, F., et al.
(författare)
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Revival of the Magnetar PSR J1622-4950: Observations with MeerKAT, Parkes, XMM-Newton, Swift, Chandra, and NuSTAR
- 2018
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Ingår i: Astrophysical Journal. - : American Astronomical Society. - 1538-4357 .- 0004-637X. ; 856:2
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Tidskriftsartikel (refereegranskat)abstract
- New radio (MeerKAT and Parkes) and X-ray (XMM-Newton, Swift, Chandra, and NuSTAR) observations of PSR J1622-4950 indicate that the magnetar, in a quiescent state since at least early 2015, reactivated between 2017 March 19 and April 5. The radio flux density, while variable, is approximately 100 larger than during its dormant state. The X-ray flux one month after reactivation was at least 800 larger than during quiescence, and has been decaying exponentially on a 111 19 day timescale. This high-flux state, together with a radio-derived rotational ephemeris, enabled for the first time the detection of X-ray pulsations for this magnetar. At 5%, the 0.3-6 keV pulsed fraction is comparable to the smallest observed for magnetars. The overall pulsar geometry inferred from polarized radio emission appears to be broadly consistent with that determined 6-8 years earlier. However, rotating vector model fits suggest that we are now seeing radio emission from a different location in the magnetosphere than previously. This indicates a novel way in which radio emission from magnetars can differ from that of ordinary pulsars. The torque on the neutron star is varying rapidly and unsteadily, as is common for magnetars following outburst, having changed by a factor of 7 within six months of reactivation.
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| 4. |
- Ciardi, B., et al.
(författare)
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Simulating the 21 cm forest detectable with LOFAR and SKA in the spectra of high-z GRBs
- 2015
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Ingår i: Monthly notices of the Royal Astronomical Society. - : Oxford University Press (OUP). - 0035-8711 .- 1365-2966. ; 453:1, s. 101-105
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Tidskriftsartikel (refereegranskat)abstract
- We investigate the feasibility of detecting 21 cm absorption features in the afterglow spectra of high redshift long Gamma Ray Bursts (GRBs). This is done employing simulations of cosmic reionization, together with estimates of the GRB radio afterglow flux and the instrumental characteristics of the LOw Frequency ARray (LOFAR). We find that absorption features could be marginally (with a S/N larger than a few) detected by LOFAR at z greater than or similar to 7 if the GRB is a highly energetic event originating from Pop III stars, while the detection would be easier if the noise were reduced by one order of magnitude, i.e. similar to what is expected for the first phase of the Square Kilometre Array (SKA1-low). On the other hand, more standard GRBs are too dim to be detected even with ten times the sensitivity of SKA1-low, and only in the most optimistic case can a S/N larger than a few be reached at z greater than or similar to 9.
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| 5. |
- Feigin, VL, et al.
(författare)
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Update on the Global Burden of Ischemic and Hemorrhagic Stroke in 1990-2013: The GBD 2013 Study
- 2015
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Ingår i: Neuroepidemiology. - : S. Karger AG. - 1423-0208 .- 0251-5350. ; 45:3, s. 161-176
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Tidskriftsartikel (refereegranskat)abstract
- <b><i>Background:</i></b> Global stroke epidemiology is changing rapidly. Although age-standardized rates of stroke mortality have decreased worldwide in the past 2 decades, the absolute numbers of people who have a stroke every year, and live with the consequences of stroke or die from their stroke, are increasing. Regular updates on the current level of stroke burden are important for advancing our knowledge on stroke epidemiology and facilitate organization and planning of evidence-based stroke care. <b><i>Objectives:</i></b> This study aims to estimate incidence, prevalence, mortality, disability-adjusted life years (DALYs) and years lived with disability (YLDs) and their trends for ischemic stroke (IS) and hemorrhagic stroke (HS) for 188 countries from 1990 to 2013. <b><i>Methodology:</i></b> Stroke incidence, prevalence, mortality, DALYs and YLDs were estimated using all available data on mortality and stroke incidence, prevalence and excess mortality. Statistical models and country-level covariate data were employed, and all rates were age-standardized to a global population. All estimates were produced with 95% uncertainty intervals (UIs). <b><i>Results:</i></b> In 2013, there were globally almost 25.7 million stroke survivors (71% with IS), 6.5 million deaths from stroke (51% died from IS), 113 million DALYs due to stroke (58% due to IS) and 10.3 million new strokes (67% IS). Over the 1990-2013 period, there was a significant increase in the absolute number of DALYs due to IS, and of deaths from IS and HS, survivors and incident events for both IS and HS. The preponderance of the burden of stroke continued to reside in developing countries, comprising 75.2% of deaths from stroke and 81.0% of stroke-related DALYs. Globally, the proportional contribution of stroke-related DALYs and deaths due to stroke compared to all diseases increased from 1990 (3.54% (95% UI 3.11-4.00) and 9.66% (95% UI 8.47-10.70), respectively) to 2013 (4.62% (95% UI 4.01-5.30) and 11.75% (95% UI 10.45-13.31), respectively), but there was a diverging trend in developed and developing countries with a significant increase in DALYs and deaths in developing countries, and no measurable change in the proportional contribution of DALYs and deaths from stroke in developed countries. <b><i>Conclusion:</i></b> Global stroke burden continues to increase globally. More efficient stroke prevention and management strategies are urgently needed to halt and eventually reverse the stroke pandemic, while universal access to organized stroke services should be a priority.
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| 6. |
- Asad, K. M. B., et al.
(författare)
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Polarization leakage in epoch of reionization windows - I. Low Frequency Array observations of the 3C196 field
- 2015
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Ingår i: Monthly notices of the Royal Astronomical Society. - : Oxford University Press (OUP). - 0035-8711 .- 1365-2966. ; 451:4, s. 3709-3727
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Tidskriftsartikel (refereegranskat)abstract
- Detection of the 21-cm signal coming from the epoch of reionization (EoR) is challenging especially because, even after removing the foregrounds, the residual Stokes I maps contain leakage from polarized emission that can mimic the signal. Here, we discuss the instrumental polarization of Low Frequency Array (LOFAR) and present realistic simulations of the leakages between Stokes parameters. From the LOFAR observations of polarized emission in the 3C196 field, we have quantified the level of polarization leakage caused by the nominal model beam of LOFAR, and compared it with the EoR signal using power spectrum analysis. We found that at 134-166 MHz, within the central 4A degrees of the field the (Q, U) -> I leakage power is lower than the EoR signal at k < 0.3 Mpc(-1). The leakage was found to be localized around a Faraday depth of 0, and the rms of the leakage as a fraction of the rms of the polarized emission was shown to vary between 0.2 and 0.3 per cent, both of which could be utilized in the removal of leakage. Moreover, we could define an 'EoR window' in terms of the polarization leakage in the cylindrical power spectrum above the point spread function (PSF)-induced wedge and below k(ayen) similar to 0.5 Mpc(-1), and the window extended up to k(ayen) similar to 1 Mpc(-1) at all k(aSyen) when 70 per cent of the leakage had been removed. These LOFAR results show that even a modest polarimetric calibration over a field of view of a parts per thousand(2) 4A degrees in the future arrays like Square Kilometre Array will ensure that the polarization leakage remains well below the expected EoR signal at the scales of 0.02-1 Mpc(-1).
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| 7. |
- Jelić, V., et al.
(författare)
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Linear polarization structures in LOFAR observations of the interstellar medium in the 3C 196 field
- 2015
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 583
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Tidskriftsartikel (refereegranskat)abstract
- Aims: This study aims to characterize linear polarization structures in LOFAR observations of the interstellar medium (ISM) in the 3C 196 field, one of the primary fields of the LOFAR-Epoch of Reionization key science project.Methods: We have used the high band antennas (HBA) of LOFAR to image this region and rotation measure (RM) synthesis to unravel the distribution of polarized structures in Faraday depth.Results: The brightness temperature of the detected Galactic emission is 5-15 K in polarized intensity and covers the range from -3 to +8 rad m(-2) in Faraday depth. The most interesting morphological feature is a strikingly straight filament at a Faraday depth of +0.5 rad m(-2) running from north to south, right through the centre of the field and parallel to the Galactic plane. There is also an interesting system of linear depolarization canals conspicuous in an image showing the peaks of Faraday spectra. We used the Westerbork Synthesis Radio Telescope (WSRT) at 350 MHz to image the same region. For the first time, we see some common morphology in the RM cubes made at 150 and 350 MHz. There is no indication of diffuse emission in total intensity in the interferometric data, in line with results at higher frequencies and previous LOFAR observations. Based on our results, we determined physical parameters of the ISM and proposed a simple model that may explain the observed distribution of the intervening magneto-ionic medium.Conclusions: The mean line-of-sight magnetic field component, B-parallel to, is determined to be 0.3 +/- 0.1 mu G and its spatial variation across the 3C 196 field is 0.1 mu G. The filamentary structure is probably an ionized filament in the ISM, located somewhere within the Local Bubble. This filamentary structure shows an excess in thermal electron density (n(e)B(parallel to) > 6.2 cm(-3) mu G) compared to its surroundings.
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| 8. |
- Patil, A. H., et al.
(författare)
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Upper Limits on the 21cm Epoch of Reionization Power Spectrum from One Night with LOFAR
- 2017
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Ingår i: Astrophysical Journal. - : American Astronomical Society. - 0004-637X .- 1538-4357. ; 838:1
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Tidskriftsartikel (refereegranskat)abstract
- We present the first limits on the Epoch of Reionization 21 cm H I power spectra, in the redshift range z = 7.910.6, using the Low-Frequency Array (LOFAR) High-Band Antenna (HBA). In total, 13.0 hr of data were used from observations centered on the North Celestial Pole. After subtraction of the sky model and the noise bias, we detect a non-zero Delta(2)(I)=(56 +/- 13 mK)(2) (1-sigma) excess variance and a best 2-sigma upper limit of Delta(2)(21) < (79.6 mK)(2) at k = 0.053 h cMpc(-1) in the range z = 9.610.6. The excess variance decreases when optimizing the smoothness of the direction- and frequency-dependent gain calibration, and with increasing the completeness of the sky model. It is likely caused by (i) residual side-lobe noise on calibration baselines, (ii) leverage due to nonlinear effects, (iii) noise and ionosphere-induced gain errors, or a combination thereof. Further analyses of the excess variance will be discussed in forthcoming publications.
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| 9. |
- Heinz, D., et al.
(författare)
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GaInN Quantum Wells as Optochemical Transducers for Chemical Sensors and Biosensors
- 2017
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Ingår i: IEEE Journal of Selected Topics in Quantum Electronics. - : Institute of Electrical and Electronics Engineers (IEEE). - 1558-4542 .- 1077-260X. ; 23:2, s. 15-23
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Tidskriftsartikel (refereegranskat)abstract
- In this paper, investigations on gallium indium nitride (GaInN) quantum well structures as optochemical transducers in (bio) chemical sensing are presented. In contrast to the conventional electrical read-out of III-nitride-based sensors, a purely optical photoluminescence read-out is performed. A significant spectral shift of the quantum well photoluminescence is observed with varying surface modification. The spectral photoluminescence shift can be attributed to an externally induced quantum confined Stark effect caused by the adsorbed species deposited on the quantum well surface. In order to improve the sensitivity of the transducer elements, different chemical surface treatments are studied. In particular, optical sensing experiments with reducing and oxidizing gases are performed in order to investigate the quantum well photoluminescence response. Additionally, optical investigations of the iron-storage molecule ferritinwith varying iron load are presented. The iron load of this molecule is generally considered as a superior biomarker for severe illnesses, such as Alzheimer's disease. In contrast to conventional fluorescent labels, GaInN quantum wells provide a much more stable luminescence signal, and hence, are promising candidates for next generation bioanalytical sensor structures.
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| 10. |
- Huerta, E. A., et al.
(författare)
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Enabling real-time multi-messenger astrophysics discoveries with deep learning
- 2019
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Ingår i: Nature reviews physics. - : Springer Science and Business Media LLC. - 2522-5820. ; 1:10, s. 600-608
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Forskningsöversikt (refereegranskat)abstract
- Multi-messenger astrophysics is a fast-growing, interdisciplinary field that combines data, which vary in volume and speed of data processing, from many different instruments that probe the Universe using different cosmic messengers: electromagnetic waves, cosmic rays, gravitational waves and neutrinos. In this Expert Recommendation, we review the key challenges of real-time observations of gravitational wave sources and their electromagnetic and astroparticle counterparts, and make a number of recommendations to maximize their potential for scientific discovery. These recommendations refer to the design of scalable and computationally efficient machine learning algorithms; the cyber-infrastructure to numerically simulate astrophysical sources, and to process and interpret multi-messenger astrophysics data; the management of gravitational wave detections to trigger real-time alerts for electromagnetic and astroparticle follow-ups; a vision to harness future developments of machine learning and cyber-infrastructure resources to cope with the big-data requirements; and the need to build a community of experts to realize the goals of multi-messenger astrophysics. A group of experts suggests ways in which deep learning can be used to enhance the potential for discovery in multi-messenger astrophysics.
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| 11. |
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| 12. |
- Hanly, John G., et al.
(författare)
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A Longitudinal Analysis of Outcomes of Lupus Nephritis in an International Inception Cohort Using a Multistate Model Approach
- 2016
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Ingår i: Arthritis & Rheumatology. - : Wiley. - 2326-5191 .- 2326-5205. ; 68:8, s. 1932-1944
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To study bidirectional change and predictors of change in estimated glomerular filtration rate (GFR) and proteinuria in lupus nephritis (LN) using a multistate modeling approach. Methods: Patients in the Systemic Lupus International Collaborating Clinics inception cohort were classified annually into estimated GFR state 1 (>60 ml/minute), state 2 (30–60 ml/minute), or state 3 (3.0 gm/day), or end-stage renal disease (ESRD) or death. Using multistate modeling, relative transition rates between states indicated improvement and deterioration. Results: Of 1,826 lupus patients, 700 (38.3%) developed LN. During a mean ± SD follow-up of 5.2 ± 3.5 years, the likelihood of improvement in estimated GFR and estimated proteinuria was greater than the likelihood of deterioration. After 5 years, 62% of patients initially in estimated GFR state 3 and 11% of patients initially in estimated proteinuria state 3 transitioned to ESRD. The probability of remaining in the initial states 1, 2, and 3 was 85%, 11%, and 3%, respectively, for estimated GFR and 62%, 29%, and 4%, respectively, for estimated proteinuria. Male sex predicted improvement in estimated GFR states; older age, race/ethnicity, higher estimated proteinuria state, and higher renal biopsy chronicity scores predicted deterioration. For estimated proteinuria, race/ethnicity, earlier calendar years, damage scores without renal variables, and higher renal biopsy chronicity scores predicted deterioration; male sex, presence of lupus anticoagulant, class V nephritis, and mycophenolic acid use predicted less improvement. Conclusion: In LN, the expected improvement or deterioration in renal outcomes can be estimated by multistate modeling and is preceded by identifiable risk factors. New therapeutic interventions for LN should meet or exceed these expectations.
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| 13. |
- Hanly, John G., et al.
(författare)
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Cerebrovascular Events in Systemic Lupus Erythematosus : Results From an International Inception Cohort Study
- 2018
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Ingår i: Arthritis Care and Research. - : Wiley. - 2151-464X .- 2151-4658. ; 70:10, s. 1478-1487
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To determine the frequency, characteristics, and outcomes of cerebrovascular events (CerVEs), as well as clinical and autoantibody associations in a multiethnic/racial inception cohort of patients with systemic lupus erythematosus (SLE). Methods: A total of 1,826 patients were assessed annually for 19 neuropsychiatric (NP) events, including 5 types of CerVEs: 1) stroke, 2) transient ischemia, 3) chronic multifocal ischemia, 4) subarachnoid/intracranial hemorrhage, and 5) sinus thrombosis. Global disease activity (Systemic Lupus Erythematosus Disease [SLE] Activity Index 2000), damage scores (SLE International Collaborating Clinics/American College of Rheumatology Damage Index), and Short Form 36 (SF-36) scores were collected. Time to event, linear and logistic regressions, and multistate models were used as appropriate. Results: CerVEs were the fourth most frequent NP event: 82 of 1,826 patients had 109 events; of these events, 103 were attributed to SLE, and 44 were identified at the time of enrollment. The predominant events were stroke (60 of 109 patients) and transient ischemia (28 of 109 patients). CerVEs were associated with other NP events attributed to SLE, non–SLE-attributed NP events, African ancestry (at US SLICC sites), and increased organ damage scores. Lupus anticoagulant increased the risk of first stroke and sinus thrombosis and transient ischemic attack. Physician assessment indicated resolution or improvement in the majority of patients, but patients reported sustained reduction in SF-36 summary and subscale scores following a CerVE. Conclusion: CerVEs, the fourth most frequent NP event in SLE, are usually attributable to lupus. In contrast to good physician-reported outcomes, patients reported a sustained reduction in health-related quality of life following a CerVE.
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| 14. |
- Hanly, John G., et al.
(författare)
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Mood Disorders in Systemic Lupus Erythematosus: Results From an International Inception Cohort Study
- 2015
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Ingår i: Arthritis & Rheumatology. - : Wiley. - 2326-5191 .- 2326-5205. ; 67:7, s. 1837-1847
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo examine the frequency, characteristics, and outcome of mood disorders, as well as clinical and autoantibody associations, in a multiethnic/racial, prospective inception cohort of patients with systemic lupus erythematosus (SLE). MethodsPatients were assessed annually for mood disorders (4 types, according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) and 18 other neuropsychiatric events. Global disease activity scores (SLE Disease Activity Index 2000 [SLEDAI-2K]), damage scores (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index [SDI]), and Short Form 36 subscales, mental and physical component summary scores were collected. Time to event, linear and ordinal regressions, and multi-state models were used as appropriate. ResultsAmong the 1,827 patients with SLE, 88.9% were female, and 48.9% were Caucasian. The mean SD age of the patients was 35.1 +/- 13.3 years, disease duration was 5.6 +/- 4.8 months, and the length of followup was 4.7 +/- 3.5 years. During the course of the study, 863 (47.2%) of the 1,827 patients had 1,627 neuropsychiatric events. Mood disorders occurred in 232 (12.7%) of 1,827 patients, and 98 (38.3%) of 256 mood disorder events were attributed to SLE. The estimated cumulative incidence of any mood disorder after 10 years was 17.7% (95% confidence interval 15.1, 20.2%). A greater risk of mood disorder was associated with concurrent neuropsychiatric events (P0.01), and a lower risk was associated with Asian race/ethnicity (P=0.01) and treatment with immunosuppressive drugs (P=0.003). Mood disorders were associated with lower mental health and mental component summary scores but not with the SLEDAI-2K, SDI, or lupus autoantibodies. Among the 232 patients with depression, 168 (72.4%) were treated with antidepressants. One hundred twenty-six (49.2%) of 256 mood disorders resolved in 117 (50.4%) of 232 patients. ConclusionMood disorders, the second most frequent neuropsychiatric event in patients with SLE, have a negative impact on health-related quality of life and improve over time. The lack of association with global SLE disease activity, cumulative organ damage, and lupus autoantibodies emphasizes the multifactorial etiology of mood disorders and a role for non-lupus-specific therapies.
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| 15. |
- Hanly, John G., et al.
(författare)
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Psychosis in Systemic Lupus Erythematosus : Results From an International Inception Cohort Study
- 2019
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Ingår i: Arthritis and Rheumatology. - : Wiley. - 2326-5191 .- 2326-5205. ; 71:2, s. 281-289
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To determine, in a large, multiethnic/multiracial, prospective inception cohort of patients with systemic lupus erythematosus (SLE), the frequency, attribution, clinical, and autoantibody associations with lupus psychosis and the short- and long-term outcomes as assessed by physicians and patients. Methods: Patients were evaluated annually for 19 neuropsychiatric (NP) events including psychosis. Scores on the Systemic Lupus Erythematosus Disease Activity Index 2000, the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index, and the Short Form 36 (SF-36) were recorded. Time to event and linear regressions were used as appropriate. Results: Of 1,826 SLE patients, 88.8% were female and 48.8% were Caucasian. The mean ± SD age was 35.1 ± 13.3 years, the mean ± SD disease duration was 5.6 ± 4.2 months, and the mean ± SD follow-up period was 7.4 ± 4.5 years. There were 31 psychotic events in 28 of 1,826 patients (1.53%), and most patients had a single event (26 of 28 [93%]). In the majority of patients (20 of 25 [80%]) and events (28 of 31 [90%]), psychosis was attributed to SLE, usually either in the year prior to or within 3 years of SLE diagnosis. Positive associations (hazard ratios [HRs] and 95% confidence intervals [95% CIs]) with lupus psychosis were previous SLE NP events (HR 3.59 [95% CI 1.16–11.14]), male sex (HR 3.0 [95% CI 1.20–7.50]), younger age at SLE diagnosis (per 10 years) (HR 1.45 [95% CI 1.01–2.07]), and African ancestry (HR 4.59 [95% CI 1.79–11.76]). By physician assessment, most psychotic events resolved by the second annual visit following onset, in parallel with an improvement in patient-reported SF-36 summary and subscale scores. Conclusion: Psychosis is an infrequent manifestation of NPSLE. Generally, it occurs early after SLE onset and has a significant negative impact on health status. As determined by patient and physician report, the short- and long-term outlooks are good for most patients, although careful follow-up is required.
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| 16. |
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| 17. |
- Parker, Ben, et al.
(författare)
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Impact of early disease factors on metabolic syndrome in systemic lupus erythematosus: data from an international inception cohort
- 2015
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Ingår i: Annals of the Rheumatic Diseases. - : BMJ. - 1468-2060 .- 0003-4967. ; 74:8, s. 1530-1536
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Tidskriftsartikel (refereegranskat)abstract
- Background The metabolic syndrome (MetS) may contribute to the increased cardiovascular risk in systemic lupus erythematosus (SLE). We examined the association between MetS and disease activity, disease phenotype and corticosteroid exposure over time in patients with SLE. Methods Recently diagnosed (< 15 months) patients with SLE from 30 centres across 11 countries were enrolled into the Systemic Lupus International Collaborating Clinics (SLICC) Inception Cohort from 2000 onwards. Baseline and annual assessments recorded clinical, laboratory and therapeutic data. A longitudinal analysis of factors associated with MetS in the first 2 years of follow-up was performed using random effects logistic regression. Results We studied 1150 patients with a mean (SD) age of 34.9 (13.6) years and disease duration at enrolment of 24.2 (18.0) weeks. In those with complete data, MetS prevalence was 38.2% at enrolment, 34.8% at year 1 and 35.4% at year 2. In a multivariable random effects model that included data from all visits, prior MetS status, baseline renal disease, SLICC Damage Index > 1, higher disease activity, increasing age and Hispanic or Black African race/ethnicity were independently associated with MetS over the first 2 years of follow-up in the cohort. Conclusions MetS is a persistent phenotype in a significant proportion of patients with SLE. Renal lupus, active inflammatory disease and damage are SLE-related factors that drive MetS development while antimalarial agents appear to be protective from early in the disease course.
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| 18. |
- Ali, Asad A., et al.
(författare)
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On the stability and convergence of a sliding-window variable-regularization recursive-least-squares algorithm
- 2016
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Ingår i: International journal of adaptive control and signal processing (Print). - : John Wiley & Sons. - 0890-6327 .- 1099-1115. ; 30:5, s. 715-735
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Tidskriftsartikel (refereegranskat)abstract
- A sliding-window variable-regularization recursive-least-squares algorithm is derived, and its convergence properties, computational complexity, and numerical stability are analyzed. The algorithm operates on a finite data window and allows for time-varying regularization in the weighting and the difference between estimates. Numerical examples are provided to compare the performance of this technique with the least mean squares and affine projection algorithms. Copyright (c) 2015 John Wiley & Sons, Ltd.
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| 19. |
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| 20. |
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| 21. |
- Azam, Asad Muhammad, et al.
(författare)
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Analysis of degradation in UHMWPE a comparative study among the various commercial and laboratory grades UHMWPE
- 2016
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Ingår i: 14TH INTERNATIONAL SYMPOSIUM ON ADVANCED MATERIALS (ISAM 2015). - : IOP PUBLISHING LTD.
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Konferensbidrag (refereegranskat)abstract
- Oxidative degradation of the ultra-high molecular weight polyethylene ( UHMWPE) limits the life of implants. This degradation can be monitored to estimate the service life of UHMWPE following the standard protocols as defined by American Standards for Testing Materials ( ASTM). In this work, a comparative study has been carried on two commercially available UHMWPE grades i. e. GUR 1020 and GUR 1050 and one laboratory grade UHMWPE which was purchased from Sigma Aldrich. These powder samples were pressed while using hot press with controlled heating and cooling setup in open air under 200 bar of external pressure. These sheets were then subjected to accelerated aging in an oven at 80 degrees C for three weeks. The degradation of the UHMWPE was monitored by ATR-FTIR techniquefor three weeks. The oxidation index ( OI) measurement showed that the commercial grade UHMWPE i. e. GUR-1020 and GUR-1050 degrade more as compared to laboratory grade UHMWPE. The values of OI after three weeks of accelerating aging were found 0.18, 0.14, and 0.09 for GUR-1020, GUR-1050, and Sigma Aldrich, respectively. In addition to this, it was found that commercial grades of UHMWPE suffer more structural alterations as compared to laboratory grade one. We hope that these results will be of particular and fundamental importance for the researchers and orthopaedic industry.
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| 22. |
- Bin Asad, S M Sayeed, et al.
(författare)
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A Review of Particle Image Velocimetry for Fish Migration
- 2016
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Ingår i: World Journal of Mechanics. - : Scientific Research Publishing, Inc.. - 2160-049X .- 2160-0503. ; 6:4, s. 131-149
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Tidskriftsartikel (refereegranskat)abstract
- Understanding the flow characteristic in fishways is crucial for efficient fish migration. Flow characteristic measurements can generally provide quantitative information of velocity distributions in such passages; Particle Image Velocimetry (PIV) has become one of the most versatile techniques to disclose flow fields in general and in fishways, in particular. This paper firstly gives an overview of fish migration along with fish ladders and then the application of PIV measurements on the fish migration process. The overview shows that the quantitative and detailed turbulent flow information in fish ladders obtained by PIV is critical for analyzing turbulent properties andvalidating numerical results.
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| 23. |
- Bin Asad, S M Sayeed, 1985-, et al.
(författare)
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Experimental study of the flow past submerged half-cylinders
- 2017
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Ingår i: AIP Conference Proceedings. - : American Institute of Physics (AIP). - 0094-243X .- 1551-7616. ; 1851
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Tidskriftsartikel (refereegranskat)abstract
- This investigation studies the details of the flow behind and over two identical semicircular cylinderspositioned in tandem. Laser Doppler Velocimetry (LDV) measurements are carried out in a laboratory waterflume using two different gap ratios (Sp/d = 1 and Sp/d = 0.5; where Sp indicates distance between the cylindersand d indicates cylinder diameter) under two different flow situations. These LDV measurement are used toderive velocities, formation length and Power spectral density for the various flow conditions. Flowvisualizations are also added in this investigation. The results indicate that the flow is significantly affected dueto gap ratios.
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| 24. |
- Bin Asad, S M Sayeed, 1985-
(författare)
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Laser Based Flow Measurements to Evaluate Hydraulic Conditions for Migrating Fish and Benthic Fauna
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Hydropower is one of the main sources for Sweden’s energy, which is clean and renewable. It is a clean energy source because no fuels are burned which does not pollute the air and it is a renewable energy source as it only uses natural water cycle for generating energy. However, hydropower has some consequences in nature, such as creating dams in rivers and changing water flow directions, which alters the natural behaviour of the river. These problems are mostly studied from a biological point of view but more detailed studies are required from a fundamental fluid mechanics point of view. For instance, fish migrates when an ecological imbalance is created and one of the reasons for this imbalance is having dams for hydropower that alter the natural flow of the river. This flow alteration of the river flow has other environmental effects such as flow alteration changes benthic (bottom) structure of the riverbed or stream that affects the fish and invertebrates. Fishes, as well as invertebrates, are adapted for different flows and habitats but flow alteration affects their life cycles. Therefore, flow measurements when the flow is altered due to the hydropower are one of the important issues concerning environmental problems. These flow measurements in the lab scale can increase the understanding of what happens in a river when the flow is altered.Flow characteristic measurements can provide quantitative information on the velocity distribution in the altered flow. Recent studies suggest that turbulence created due to flow alteration has a major effect on fish migration, for example, attracting fishes to enter fishway. This is why obtaining flow information from well-defined turbulent flows, such as flow past cylindrical objects is one of the prime objectives of work. However, flow alteration due to the dam for hydropower production has a significant environmental effect on the river ecosystem. Lotic species often adapt to prevailing flow conditions; and as a crude example, two species of caddis larvae: Hydropsyche instabilis and Plectrocnemia conspersa respectively are found to thrive on fast and slow-moving water flows. For some instances, changes in river velocity may merely mean the relocation of one species whilst the flourishing of another. Therefore, flow measurement in stones embedded riverbed in lab scale is another important objective of this work.Particle Image Velocimetry (PIV) and Laser Doppler Velocimetry (LDV) have become the most popular and promising techniques for these types of non-contact flow measurements. PIV techniques are used to visualize and measure the flow characteristic in a selected area while LDV techniques are suited for point-based measurement. The works included in this thesis are reviewing PIV techniques previously used in fish movement related studies, LDV measurements both at upstream (bow wake) and downstream wake of vertical cylindrical obstructions, Computational Fluid Dynamics (CFD) simulations to supplement wake information and PIV measurements over the horizontal semicircular cylinders to explore wall shear stress. Apart from this, flow visualization was also included in this work. The results from all these works can be useful to evaluate hydraulic conditions for migrating fish and benthic fauna.
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| 25. |
- Bin Asad, S M Sayeed
(författare)
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Laser-based Measurements connected to Fish Migration
- 2016
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Hydropower is one of the main sources for Sweden’s energy, which is clean and renewable. It is a clean energy source because no fuels are burned which does not pollute the air and it is a renewable energy source as it only uses natural water cycle for generating energy. However, hydropower has some consequences in nature, such as creating dams in rivers and changing water flow directions, which lead to some problems for migrating fishes. These fish migration problems are mostly studied from a biological point of view but more detailed studies are required from a fundamental fluid mechanics point of view. Fish migrates when ecological imbalance is created and one of the reasons for this imbalance is having dams for hydropower. Some dams have fishways or fish ladders to allow fish to migrate past the dam and during swimming or passing this fishway or fish ladder, fish has to tackle some sort of flow obstructions like, turbine intakes, stones and concrete structures etc. Fluid flow characteristics in fish ladders or fishways during fish migration is crucial for designing effective fishways to migrate fishes effectively. Flow characteristic measurements can provide quantitative information of the velocity distribution in fish ladders, which has strong correlation with the attraction of of fish. Recent research suggests that turbulence also has a large effect on fish migration. This is why obtaining flow information from well-defined turbulent flows, such as flow past cylindrical objects is the prime aim of these measurements.Particle Image Velocimetry (PIV) and Laser Doppler Velocimetry (LDV) have become the most popular and promising techniques for these types of non-contact measurements. PIV techniques are used to visualize and measure the flow characteristic in a selected area while LDV techniques are suited for point-based measurement. The works included in this thesis are reviewing PIV techniques previously used in fish movement related studies, LDV measurements both at upstream (bow wake) and downstream wake of cylindrical obstructions and finally Computational Fluid Dynamics (CFD) for validation of experimental measurements. The results find relatively acceptable agreement between CFD and experiments with some disparities.
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| 26. |
- Bin Asad, S M Sayeed, 1985-, et al.
(författare)
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Study the Flow behind a Semi-Circular Step Cylinder (Laser Doppler Velocimetry (LDV) and Computational Fluid Dynamics (CFD))
- 2017
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Ingår i: Energies. - Basel, Switzerland : MDPI. - 1996-1073. ; 10:3
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Tidskriftsartikel (refereegranskat)abstract
- Laser Doppler Velocimetry (LDV) measurements, flow visualizations and unsteadyReynolds-Averaged Navier-Stokes (RANS) Computational Fluid Dynamics (CFD) simulations havebeen carried out to study the turbulent wake that is formed behind a semi-circular step cylinder ata constant flow rate. The semi-circular cylinder has two diameters, a so-called step cylinder. Theresults from the LDV measurements indicate that wake length and vortex shedding frequency varieswith the cylinder diameter. This implies that a step cylinder can be used to attract fish of differentsize. By visualizations of the formation of a recirculation region and the well-known von Kármánvortex street behind the cylinder are disclosed. The simulation results predict the wake length andshedding frequency well for the flow behind the large cylinder but fail to capture the dynamics ofthe flow near the step in diameter to some extent and the flow behind the small cylinder to a largerextent when compared with measurements.
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| 27. |
- Bin Asad, S M Sayeed, 1985-, et al.
(författare)
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Velocity distribution measurements in a fishway like open channel by Laser Doppler Anemometry (LDA)
- 2016
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Konferensbidrag (refereegranskat)abstract
- Experiments in an open channel flume with placing a vertical half cylinder barrier have been performed in order to investigate how the upstream velocity profiles are affected by a barrier. An experimental technique using Laser Doppler Velocimetry (LDV) was adopted to measure these velocity distributions in the channel for four different discharge rates. Velocity profiles were measured very close to wall and at 25, 50 and 100 mm upstream of the cylinder wall. For comparing these profiles with well-known logarithmic velocity profiles, velocity profiles were also measured in smooth open channel flow for all same four discharge rates. The results indicate that regaining the logarithmic velocity profiles upstream of the half cylindrical barrier occurs at 100 mm upstream of the cylinder wall.
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| 28. |
- Bin Asad, S M Sayeed, 1985-, et al.
(författare)
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Wall shear stress measurement on curve objects with PIV in connection to benthic fauna in regulated rivers
- 2019
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Ingår i: Water. - : MDPI. - 2073-4441. ; 11:4
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Tidskriftsartikel (refereegranskat)abstract
- The flow characteristics in the vicinity of a set of half-cylinders of different sizes simulating benthic objects were studied experimentally using particle image velocimetry (PIV). The cylinders were mounted on the bottom of an open channel, and the influence of the flow speed on the distribution of the shear stress along the bottom geometry was investigated. Of special interest was how the shear stress changes close to the wall as a function of the flow speed and cylinder arrangement. It was found that the shear stress varies significantly as a function of position. This implies habitat heterogeneity allowing benthic invertebrates with different shear stress tolerance exists when the bottom consists of differently sized stones. It was also shown that direct measurements of near wall velocity gradients are necessary to accurately calculate the wall shear stress for more complex geometries.
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| 29. |
- Bourre-Tessier, Josiane, et al.
(författare)
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Electrocardiographic Findings in Systemic Lupus Erythematosus: Data From an International Inception Cohort
- 2015
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Ingår i: Arthritis Care and Research. - : Wiley. - 2151-4658 .- 2151-464X. ; 67:1, s. 128-135
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To estimate the early prevalence of various electrocardiographic (EKG) abnormalities in patients with systemic lupus erythematosus (SLE) and to evaluate possible associations between repolarization changes (increased corrected QT [QTc] and QT dispersion [QTd]) and clinical and laboratory variables, including the anti-Ro/SSA level and specificity (52 or 60 kd). Methods. We studied adult SLE patients from 19 centers participating in the Systemic Lupus International Collaborating Clinics (SLICC) Inception Registry. Demographics, disease activity (Systemic Lupus Erythematosus Disease Activity Index 2000 [SLEDAI-2K]), disease damage (SLICC/American College of Rheumatology Damage Index [SDI]), and laboratory data from the baseline or first followup visit were assessed. Multivariate logistic and linear regression models were used to asses for any cross-sectional associations between anti-Ro/SSA and EKG repolarization abnormalities. Results. For the 779 patients included, mean +/- SD age was 35.2 +/- 13.8 years, 88.4% were women, and mean +/- SD disease duration was 10.5 +/- 14.5 months. Mean +/- SD SLEDAI-2K score was 5.4 +/- 5.6 and mean +/- SD SDI score was 0.5 +/- 1.0. EKG abnormalities were frequent and included nonspecific ST-T changes (30.9%), possible left ventricular hypertrophy (5.4%), and supraventricular arrhythmias (1.3%). A QTc >= 440 msec was found in 15.3%, while a QTc >= 460 msec was found in 5.3%. Mean +/- SD QTd was 34.2 +/- 14.7 msec and QTd >= 40 msec was frequent (38.1%). Neither the specificity nor the level of anti-Ro/SSA was associated with QTc duration or QTd, although confidence intervals were wide. Total SDI was significantly associated with a QTc interval exceeding 440 msec (odds ratio 1.38 [95% confidence interval 1.06, 1.79]). Conclusion. A substantial proportion of patients with recent-onset SLE exhibited repolarization abnormalities, although severe abnormalities were rare.
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| 31. |
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| 32. |
- Jaffari, G. Hassnain, et al.
(författare)
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Extrinsic contributions to the dielectric response in sintered BaTiO3 nanostructures in paraelectric and ferroelectric regimes
- 2017
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Ingår i: Physica. B, Condensed matter. - : ELSEVIER SCIENCE BV. - 0921-4526 .- 1873-2135. ; 525, s. 70-77
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Tidskriftsartikel (refereegranskat)abstract
- Post sintering studies of BaTiO3 (BTO) nanoparticles are presented in detail. Bulk nanostructures were prepared via three different compaction processes, namely, uniaxial cold pressing (UCP), Cold Isostatic Pressing (CIP) and Spark Plasma Sintering (SPS). Effect of compaction technique on microstructures have been investigated and correlated with electrical response for each sample. In addition to the transport properties, temperature and frequency dependent dielectric response of variously sintered samples and bulk counterpart was recorded. Several aspects have been identified that are essential to be taken into account in order to completely understand physical processes. Drastically distinct features were observed in paraelectric (PE) regime well above ferroelectric (FE)-PE transition temperature. These features include intra grain conduction with a reduction in the magnitude of PE to FE peak dielectric constant magnitude. Role of strain, grain boundary conduction associated with observation of Maxwell Wagner relaxation and hopping conduction in dielectric and ferroelectric response have been observed and discussed. Densification with presence of oxygen vacancies, significantly enhances conductivity associated with the hopping of the carriers, in turn deteriorated ferroelectric response.
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| 33. |
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| 34. |
- Kim, Haesook T., et al.
(författare)
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Prognostic Score and Cytogenetic Risk Classification for Chronic Lymphocytic Leukemia Patients : Center for International Blood and Marrow Transplant Research Report
- 2019
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Ingår i: Clinical Cancer Research. - : AMER ASSOC CANCER RESEARCH. - 1078-0432 .- 1557-3265. ; 25:16, s. 5143-5155
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To develop a prognostic model and cytogenetic risk classification for previously treated patients with chronic lymphocytic leukemia (CLL) undergoing reduced intensity conditioning (RIC) allogeneic hematopoietic cell transplantation (HCT).Experimental Design: We performed a retrospective analysis of outcomes of 606 patients with CLL who underwent RIC allogeneic HCT between 2008 and 2014 reported to the Center for International Blood and Marrow Transplant Research.Results: On the basis of multivariable models, disease status, comorbidity index, lymphocyte count, and white blood cell count at HCT were selected for the development of prognostic model. Using the prognostic score, we stratified patients into low-, intermediate-, high-, and very-high-risk [4-year progression-free survival (PFS) 58%, 42%, 33%, and 25%, respectively, P < 0.0001; 4-year overall survival (OS) 70%, 57%, 54%, and 38%, respectively, P < 0.0001]. We also evaluated karyotypic abnormalities together with del(17p) and found that del(17p) or >= 5 abnormalities showed inferior PFS. Using a multivariable model, we classified cytogenetic risk into low, intermediate, and high (P < 0.0001). When the prognostic score and cytogenetic risk were combined, patients with low prognostic score and low cytogenetic risk had prolonged PFS (61% at 4 years) and OS (75% at 4 years).Conclusions: In this large cohort of patients with previously treated CLL who underwent RIC HCT, we developed a robust prognostic scoring system of HCT outcomes and a novel cytogenetic-based risk stratification system. These prognostic models can be used for counseling patients, comparing data across studies, and providing a benchmark for future interventions. For future study, we will further validate these models for patients receiving targeted therapies prior to HCT.
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| 35. |
- Klyuchnikov, Evgeny, et al.
(författare)
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Reduced-Intensity Allografting as First Transplantation Approach in Relapsed/Refractory Grades One and Two Follicular Lymphoma Provides Improved Outcomes in Long-Term Survivors
- 2015
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Ingår i: Biology of blood and marrow transplantation. - : Elsevier BV. - 1083-8791 .- 1523-6536. ; 21:12, s. 2091-2099
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Tidskriftsartikel (refereegranskat)abstract
- This study was conducted to compare long-term outcomes in patients with refractory/relapsed grades 1 and 2 follicular lymphoma (FL) after allogeneic (allo) versus autologous (auto) hematopoietic cell transplantation (HCT) in the rituximab era. Adult patients with relapsed/refractory grades 1 and 2 FL undergoing first reduced-intensity allo-HCT or first autograft during 2000 to 2012 were evaluated. A total of 518 rituximab-treated patients were included. Allo-HCT patients were younger and more heavily pretreated, and more patients had advanced stage and chemoresistant disease. The 5-year adjusted probabilities, comparing auto-HCT versus allo-HCT groups for nonrelapse mortality (NRM) were 5% versus 26% (P <.0001); relapse/progression: 54% versus 20% (P <.0001); progression-free survival (PFS): 41% versus 58% (P <.001), and overall survival (OS): 74% versus 66% (P =.05). Auto-HCT was associated with a higher risk of relapse/progression beyond 5 months after HCT (relative risk [RR], 4.4; P <.0001) and worse PFS (RR, 2.9; P <.0001) beyond 11 months after HCT. In the first 24 months after HO', auto-HCT was associated with improved OS (RR,.41; P <.0001), but beyond 24 months, it was associated with inferior OS (RR, 2.2; P =.006). A landmark analysis of patients alive and progression-free at 2 years after HO' confirmed these observations, showing no difference in further NRM between both groups, but there was significantly higher risk of relapse/progression (RR, 7.3; P <.0001) and inferior PFS (RR, 3.2; P <.0001) and OS (RR, 2.1; P =.04) after auto-HCT. The 10-year cumulative incidences of second hematological malignancies after allo-HCT and auto-HCT were 0% and 7%, respectively. Auto-HCT and reduced-intensity conditioned allo-HCT as first transplantation approach can provide durable disease control in grades 1 and 2 FL patients. Continued disease relapse risk after auto-HCT translates into improved PFS and OS after allo-HCT in long-term survivors.
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| 36. |
- Little, Jayne, et al.
(författare)
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Glucocorticoid use and factors associated with variability in this use in the Systemic Lupus International Collaborating Clinics Inception Cohort
- 2018
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Ingår i: Rheumatology (United Kingdom). - : Oxford University Press (OUP). - 1462-0324 .- 1462-0332. ; 57:4, s. 677-687
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. To describe glucocorticoid (GC) use in the SLICC inception cohort and to explore factors associated with GC use. In particular we aimed to assess temporal trends in GC use and to what extent physician-related factors may influence use. Methods. Patients were recruited within 15 months of diagnosis of SLE from 33 centres between 1999 and 2011 and continue to be reviewed annually. Descriptive statistics were used to detail oral and parenteral GC use. Cross sectional and longitudinal analyses were performed to explore factors associated with GC use at enrolment and over time. Results. We studied 1700 patients with a mean (S.D.) follow-up duration of 7.26 (3.82) years. Over the entire study period, 1365 (81.3%) patients received oral GCs and 447 (26.3%) received parenteral GCs at some point. GC use was strongly associated with treatment centre, age, race/ethnicity, sex, disease duration and disease activity. There was no change in the proportion of patients on GCs or the average doses of GC used over time according to year of diagnosis. Conclusion. GCs remain a cornerstone in SLE management and there have been no significant changes in their use over the past 10-15 years. While patient and disease factors contribute to the variation in GC use, between-centre differences suggest that physician-related factors also contribute. Evidence-based treatment algorithms are needed to inform a more standardized approach to GC use in SLE.
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| 39. |
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| 40. |
- Wirestam, Lina, 1986-, et al.
(författare)
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Osteopontin and disease activity in patients with recent-onset systemic Lupus Erythematosus : Results from the SLICC Inception Cohort
- 2019
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Ingår i: Journal of Rheumatology. - : The Journal of Rheumatology. - 0315-162X .- 1499-2752. ; 46:5, s. 492-500
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Tidskriftsartikel (refereegranskat)abstract
- Objective. In cross-sectional studies, elevated osteopontin (OPN) levels have been proposed to reflect, and/or precede, progressive organ damage and disease severity in systemic lupus erythematosus (SLE). We aimed, in a cohort of patients with recent-onset SLE, to determine whether raised serum OPN levels precede damage and/or are associated with disease activity or certain disease phenotypes. Methods. We included 344 patients from the Systemic Lupus International Collaborating Clinics (SLICC) Inception Cohort who had 5 years of followup data available. All patients fulfilled the 1997 American College of Rheumatology (ACR) criteria. Baseline sera from patients and from age- and sex-matched population-based controls were analyzed for OPN using ELISA. Disease activity and damage were assessed at each annual followup visit using the SLE Disease Activity Index 2000 (SLEDAI-2K) and the SLICC/ACR damage index (SDI), respectively. Results. Compared to controls, baseline OPN was raised 4-fold in SLE cases (p < 0.0001). After relevant adjustments in a binary logistic regression model, OPN levels failed to significantly predict global damage accrual defined as SDI ≥ 1 at 5 years. However, baseline OPN correlated with SLEDAI-2K at enrollment into the cohort (r = 0.27, p < 0.0001), and patients with high disease activity (SLEDAI-2K ≥ 5) had raised serum OPN (p < 0.0001). In addition, higher OPN levels were found in patients with persistent disease activity (p = 0.0006), in cases with renal involvement (p < 0.0001) and impaired estimated glomerular filtration rate (p = 0.01). Conclusion. The performance of OPN to predict development of organ damage was not impressive. However, OPN associated significantly with lupus nephritis and with raised disease activity at enrollment, as well as over time.
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