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1.	Aghanim, N., et al. (författare) Planck 2018 results I. Overview and the cosmological legacy of Planck 2020 Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 641 Tidskriftsartikel (refereegranskat)abstract The European Space Agency's Planck satellite, which was dedicated to studying the early Universe and its subsequent evolution, was launched on 14 May 2009. It scanned the microwave and submillimetre sky continuously between 12 August 2009 and 23 October 2013, producing deep, high-resolution, all-sky maps in nine frequency bands from 30 to 857 GHz. This paper presents the cosmological legacy of Planck, which currently provides our strongest constraints on the parameters of the standard cosmological model and some of the tightest limits available on deviations from that model. The 6-parameter Lambda CDM model continues to provide an excellent fit to the cosmic microwave background data at high and low redshift, describing the cosmological information in over a billion map pixels with just six parameters. With 18 peaks in the temperature and polarization angular power spectra constrained well, Planck measures five of the six parameters to better than 1% (simultaneously), with the best-determined parameter (theta (*)) now known to 0.03%. We describe the multi-component sky as seen by Planck, the success of the Lambda CDM model, and the connection to lower-redshift probes of structure formation. We also give a comprehensive summary of the major changes introduced in this 2018 release. The Planck data, alone and in combination with other probes, provide stringent constraints on our models of the early Universe and the large-scale structure within which all astrophysical objects form and evolve. We discuss some lessons learned from the Planck mission, and highlight areas ripe for further experimental advances.
2.	Aghanim, N., et al. (författare) Planck 2018 results III. High Frequency Instrument data processing and frequency maps 2020 Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 641 Tidskriftsartikel (refereegranskat)abstract This paper presents the High Frequency Instrument (HFI) data processing procedures for the Planck 2018 release. Major improvements in mapmaking have been achieved since the previous Planck 2015 release, many of which were used and described already in an intermediate paper dedicated to the Planck polarized data at low multipoles. These improvements enabled the first significant measurement of the reionization optical depth parameter using Planck-HFI data. This paper presents an extensive analysis of systematic effects, including the use of end-to-end simulations to facilitate their removal and characterize the residuals. The polarized data, which presented a number of known problems in the 2015 Planck release, are very significantly improved, especially the leakage from intensity to polarization. Calibration, based on the cosmic microwave background (CMB) dipole, is now extremely accurate and in the frequency range 100-353 GHz reduces intensity-to-polarization leakage caused by calibration mismatch. The Solar dipole direction has been determined in the three lowest HFI frequency channels to within one arc minute, and its amplitude has an absolute uncertainty smaller than 0.35 mu K, an accuracy of order 10(-4). This is a major legacy from the Planck HFI for future CMB experiments. The removal of bandpass leakage has been improved for the main high-frequency foregrounds by extracting the bandpass-mismatch coefficients for each detector as part of the mapmaking process; these values in turn improve the intensity maps. This is a major change in the philosophy of frequency maps, which are now computed from single detector data, all adjusted to the same average bandpass response for the main foregrounds. End-to-end simulations have been shown to reproduce very well the relative gain calibration of detectors, as well as drifts within a frequency induced by the residuals of the main systematic effect (analogue-to-digital convertor non-linearity residuals). Using these simulations, we have been able to measure and correct the small frequency calibration bias induced by this systematic effect at the 10(-4) level. There is no detectable sign of a residual calibration bias between the first and second acoustic peaks in the CMB channels, at the 10(-3) level.
3.	Aghanim, N., et al. (författare) Planck 2018 results V. CMB power spectra and likelihoods 2020 Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 641 Tidskriftsartikel (refereegranskat)abstract We describe the legacy Planck cosmic microwave background (CMB) likelihoods derived from the 2018 data release. The overall approach is similar in spirit to the one retained for the 2013 and 2015 data release, with a hybrid method using different approximations at low (l< 30) and high (l >= 30) multipoles, implementing several methodological and data-analysis refinements compared to previous releases. With more realistic simulations, and better correction and modelling of systematic effects, we can now make full use of the CMB polarization observed in the High Frequency Instrument (HFI) channels. The low-multipole EE cross-spectra from the 100 GHz and 143 GHz data give a constraint on the Lambda CDM reionization optical-depth parameter tau to better than 15% (in combination with the TT low-l data and the high-l temperature and polarization data), tightening constraints on all parameters with posterior distributions correlated with tau. We also update the weaker constraint on tau from the joint TEB likelihood using the Low Frequency Instrument (LFI) channels, which was used in 2015 as part of our baseline analysis. At higher multipoles, the CMB temperature spectrum and likelihood are very similar to previous releases. A better model of the temperature-to-polarization leakage and corrections for the effective calibrations of the polarization channels (i.e., the polarization efficiencies) allow us to make full use of polarization spectra, improving the Lambda CDM constraints on the parameters theta(MC), omega(c), omega(b), and H-0 by more than 30%, and n(s) by more than 20% compared to TT-only constraints. Extensive tests on the robustness of the modelling of the polarization data demonstrate good consistency, with some residual modelling uncertainties. At high multipoles, we are now limited mainly by the accuracy of the polarization efficiency modelling. Using our various tests, simulations, and comparison between different high-multipole likelihood implementations, we estimate the consistency of the results to be better than the 0.5 sigma level on the Lambda CDM parameters, as well as classical single-parameter extensions for the joint likelihood (to be compared to the 0.3 sigma levels we achieved in 2015 for the temperature data alone on Lambda CDM only). Minor curiosities already present in the previous releases remain, such as the differences between the best-fit Lambda CDM parameters for the l< 800 and l> 800 ranges of the power spectrum, or the preference for more smoothing of the power-spectrum peaks than predicted in Lambda CDM fits. These are shown to be driven by the temperature power spectrum and are not significantly modified by the inclusion of the polarization data. Overall, the legacy Planck CMB likelihoods provide a robust tool for constraining the cosmological model and represent a reference for future CMB observations.
4.	Aghanim, N., et al. (författare) Planck 2018 results VI. Cosmological parameters 2020 Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 641 Tidskriftsartikel (refereegranskat)abstract We present cosmological parameter results from the final full-mission Planck measurements of the cosmic microwave background (CMB) anisotropies, combining information from the temperature and polarization maps and the lensing reconstruction. Compared to the 2015 results, improved measurements of large-scale polarization allow the reionization optical depth to be measured with higher precision, leading to significant gains in the precision of other correlated parameters. Improved modelling of the small-scale polarization leads to more robust constraints on many parameters, with residual modelling uncertainties estimated to affect them only at the 0.5 sigma level. We find good consistency with the standard spatially-flat 6-parameter Lambda CDM cosmology having a power-law spectrum of adiabatic scalar perturbations (denoted base Lambda CDM in this paper), from polarization, temperature, and lensing, separately and in combination. A combined analysis gives dark matter density Omega (c)h(2)=0.120 +/- 0.001, baryon density Omega (b)h(2)=0.0224 +/- 0.0001, scalar spectral index n(s)=0.965 +/- 0.004, and optical depth tau =0.054 +/- 0.007 (in this abstract we quote 68% confidence regions on measured parameters and 95% on upper limits). The angular acoustic scale is measured to 0.03% precision, with 100 theta (*)=1.0411 +/- 0.0003. These results are only weakly dependent on the cosmological model and remain stable, with somewhat increased errors, in many commonly considered extensions. Assuming the base-Lambda CDM cosmology, the inferred (model-dependent) late-Universe parameters are: Hubble constant H-0=(67.4 +/- 0.5) km s(-1) Mpc(-1); matter density parameter Omega (m)=0.315 +/- 0.007; and matter fluctuation amplitude sigma (8)=0.811 +/- 0.006. We find no compelling evidence for extensions to the base-Lambda CDM model. Combining with baryon acoustic oscillation (BAO) measurements (and considering single-parameter extensions) we constrain the effective extra relativistic degrees of freedom to be N-eff=2.99 +/- 0.17, in agreement with the Standard Model prediction N-eff=3.046, and find that the neutrino mass is tightly constrained to Sigma m(nu)< 0.12 eV. The CMB spectra continue to prefer higher lensing amplitudes than predicted in base CDM at over 2 sigma, which pulls some parameters that affect the lensing amplitude away from the Lambda CDM model; however, this is not supported by the lensing reconstruction or (in models that also change the background geometry) BAO data. The joint constraint with BAO measurements on spatial curvature is consistent with a flat universe, Omega (K)=0.001 +/- 0.002. Also combining with Type Ia supernovae (SNe), the dark-energy equation of state parameter is measured to be w(0)=-1.03 +/- 0.03, consistent with a cosmological constant. We find no evidence for deviations from a purely power-law primordial spectrum, and combining with data from BAO, BICEP2, and Keck Array data, we place a limit on the tensor-to-scalar ratio r(0.002)< 0.06. Standard big-bang nucleosynthesis predictions for the helium and deuterium abundances for the base-CDM cosmology are in excellent agreement with observations. The Planck base-Lambda CDM results are in good agreement with BAO, SNe, and some galaxy lensing observations, but in slight tension with the Dark Energy Survey's combined-probe results including galaxy clustering (which prefers lower fluctuation amplitudes or matter density parameters), and in significant, 3.6 sigma, tension with local measurements of the Hubble constant (which prefer a higher value). Simple model extensions that can partially resolve these tensions are not favoured by the Planck data.
5.	Aghanim, N., et al. (författare) Planck 2018 results XII. Galactic astrophysics using polarized dust emission 2020 Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 641 Tidskriftsartikel (refereegranskat)abstract Observations of the submillimetre emission from Galactic dust, in both total intensity I and polarization, have received tremendous interest thanks to the Planck full-sky maps. In this paper we make use of such full-sky maps of dust polarized emission produced from the third public release of Planck data. As the basis for expanding on astrophysical studies of the polarized thermal emission from Galactic dust, we present full-sky maps of the dust polarization fraction p, polarization angle psi, and dispersion function of polarization angles ?. The joint distribution (one-point statistics) of p and N-H confirms that the mean and maximum polarization fractions decrease with increasing N-H. The uncertainty on the maximum observed polarization fraction, (max) = 22.0(-1.4)(+3.5) p max = 22 . 0 - 1.4 + 3.5 % at 353 GHz and 80 ' resolution, is dominated by the uncertainty on the Galactic emission zero level in total intensity, in particular towards diffuse lines of sight at high Galactic latitudes. Furthermore, the inverse behaviour between p and ? found earlier is seen to be present at high latitudes. This follows the ?proportional to p(-1) relationship expected from models of the polarized sky (including numerical simulations of magnetohydrodynamical turbulence) that include effects from only the topology of the turbulent magnetic field, but otherwise have uniform alignment and dust properties. Thus, the statistical properties of p, psi, and ? for the most part reflect the structure of the Galactic magnetic field. Nevertheless, we search for potential signatures of varying grain alignment and dust properties. First, we analyse the product map ?xp, looking for residual trends. While the polarization fraction p decreases by a factor of 3-4 between N-H=10(20) cm(-2) and N-H=2x10(22) cm(-2), out of the Galactic plane, this product ?xp only decreases by about 25%. Because ? is independent of the grain alignment efficiency, this demonstrates that the systematic decrease in p with N-H is determined mostly by the magnetic-field structure and not by a drop in grain alignment. This systematic trend is observed both in the diffuse interstellar medium (ISM) and in molecular clouds of the Gould Belt. Second, we look for a dependence of polarization properties on the dust temperature, as we would expect from the radiative alignment torque (RAT) theory. We find no systematic trend of ?xp with the dust temperature T-d, whether in the diffuse ISM or in the molecular clouds of the Gould Belt. In the diffuse ISM, lines of sight with high polarization fraction p and low polarization angle dispersion ? tend, on the contrary, to have colder dust than lines of sight with low p and high ?. We also compare the Planck thermal dust polarization with starlight polarization data in the visible at high Galactic latitudes. The agreement in polarization angles is remarkable, and is consistent with what we expect from the noise and the observed dispersion of polarization angles in the visible on the scale of the Planck beam. The two polarization emission-to-extinction ratios, R-P/p and R-S/V, which primarily characterize dust optical properties, have only a weak dependence on the column density, and converge towards the values previously determined for translucent lines of sight. We also determine an upper limit for the polarization fraction in extinction, p(V)/E(B-V), of 13% at high Galactic latitude, compatible with the polarization fraction p approximate to 20% observed at 353 GHz. Taken together, these results provide strong constraints for models of Galactic dust in diffuse gas.
6.	Akrami, Y., et al. (författare) Planck 2018 results IX. Constraints on primordial non-Gaussianity 2020 Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 641 Tidskriftsartikel (refereegranskat)abstract We analyse the Planck full-mission cosmic microwave background (CMB) temperature and E-mode polarization maps to obtain constraints on primordial non-Gaussianity (NG). We compare estimates obtained from separable template-fitting, binned, and optimal modal bispectrum estimators, finding consistent values for the local, equilateral, and orthogonal bispectrum amplitudes. Our combined temperature and polarization analysis produces the following final results: (local)(NL) = -0.9 +/- 5.1 f NL local = - 0.9 +/- 5.1 ; f(NL)(equil) = -26 +/- 47 f NL equil = - 26 +/- 47 ; and f(NL)(ortho) = -38 +/- 24 f NL ortho = - 38 +/- 24 (68% CL, statistical). These results include low-multipole (4 <= l< 40) polarization data that are not included in our previous analysis. The results also pass an extensive battery of tests (with additional tests regarding foreground residuals compared to 2015), and they are stable with respect to our 2015 measurements (with small fluctuations, at the level of a fraction of a standard deviation, which is consistent with changes in data processing). Polarization-only bispectra display a significant improvement in robustness; they can now be used independently to set primordial NG constraints with a sensitivity comparable to WMAP temperature-based results and they give excellent agreement. In addition to the analysis of the standard local, equilateral, and orthogonal bispectrum shapes, we consider a large number of additional cases, such as scale-dependent feature and resonance bispectra, isocurvature primordial NG, and parity-breaking models, where we also place tight constraints but do not detect any signal. The non-primordial lensing bispectrum is, however, detected with an improved significance compared to 2015, excluding the null hypothesis at 3.5. Beyond estimates of individual shape amplitudes, we also present model-independent reconstructions and analyses of the Planck CMB bispectrum. Our final constraint on the local primordial trispectrum shape is g(NL)(local) = (-5.8 +/- 6.5) x 10(4) g NL local = ( - 5.8 +/- 6.5 ) x 10 4 (68% CL, statistical), while constraints for other trispectrum shapes are also determined. Exploiting the tight limits on various bispectrum and trispectrum shapes, we constrain the parameter space of different early-Universe scenarios that generate primordial NG, including general single-field models of inflation, multi-field models (e.g. curvaton models), models of inflation with axion fields producing parity-violation bispectra in the tensor sector, and inflationary models involving vector-like fields with directionally-dependent bispectra. Our results provide a high-precision test for structure-formation scenarios, showing complete agreement with the basic picture of the Lambda CDM cosmology regarding the statistics of the initial conditions, with cosmic structures arising from adiabatic, passive, Gaussian, and primordial seed perturbations.
7.	Akrami, Y., et al. (författare) Planck 2018 results VII. Isotropy and statistics of the CMB 2020 Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 641 Tidskriftsartikel (refereegranskat)abstract Analysis of the Planck 2018 data set indicates that the statistical properties of the cosmic microwave background (CMB) temperature anisotropies are in excellent agreement with previous studies using the 2013 and 2015 data releases. In particular, they are consistent with the Gaussian predictions of the Lambda CDM cosmological model, yet also confirm the presence of several so-called anomalies on large angular scales. The novelty of the current study, however, lies in being a first attempt at a comprehensive analysis of the statistics of the polarization signal over all angular scales, using either maps of the Stokes parameters, Q and U, or the E-mode signal derived from these using a new methodology (which we describe in an appendix). Although remarkable progress has been made in reducing the systematic effects that contaminated the 2015 polarization maps on large angular scales, it is still the case that residual systematics (and our ability to simulate them) can limit some tests of non-Gaussianity and isotropy. However, a detailed set of null tests applied to the maps indicates that these issues do not dominate the analysis on intermediate and large angular scales (i.e., l less than or similar to 400). In this regime, no unambiguous detections of cosmological non-Gaussianity, or of anomalies corresponding to those seen in temperature, are claimed. Notably, the stacking of CMB polarization signals centred on the positions of temperature hot and cold spots exhibits excellent agreement with the Lambda CDM cosmological model, and also gives a clear indication of how Planck provides state-of-the-art measurements of CMB temperature and polarization on degree scales.
8.	Akrami, Y., et al. (författare) Planck 2018 results X. Constraints on inflation 2020 Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 641 Tidskriftsartikel (refereegranskat)abstract We report on the implications for cosmic inflation of the 2018 release of the Planck cosmic microwave background (CMB) anisotropy measurements. The results are fully consistent with those reported using the data from the two previous Planck cosmological releases, but have smaller uncertainties thanks to improvements in the characterization of polarization at low and high multipoles. Planck temperature, polarization, and lensing data determine the spectral index of scalar perturbations to be n(s)=0.9649 +/- 0.0042 at 68% CL. We find no evidence for a scale dependence of n(s), either as a running or as a running of the running. The Universe is found to be consistent with spatial flatness with a precision of 0.4% at 95% CL by combining Planck with a compilation of baryon acoustic oscillation data. The Planck 95% CL upper limit on the tensor-to-scalar ratio, r(0.002)< 0.10, is further tightened by combining with the BICEP2/Keck Array BK15 data to obtain r(0.002)< 0.056. In the framework of standard single-field inflationary models with Einstein gravity, these results imply that: (a) the predictions of slow-roll models with a concave potential, V(phi) < 0, are increasingly favoured by the data; and (b) based on two different methods for reconstructing the inflaton potential, we find no evidence for dynamics beyond slow roll. Three different methods for the non-parametric reconstruction of the primordial power spectrum consistently confirm a pure power law in the range of comoving scales 0.005 Mpc(-1)k less than or similar to 0.2 Mpc(-1). A complementary analysis also finds no evidence for theoretically motivated parameterized features in the Planck power spectra. For the case of oscillatory features that are logarithmic or linear in k, this result is further strengthened by a new combined analysis including the Planck bispectrum data. The new Planck polarization data provide a stringent test of the adiabaticity of the initial conditions for the cosmological fluctuations. In correlated, mixed adiabatic and isocurvature models, the non-adiabatic contribution to the observed CMB temperature variance is constrained to 1.3%, 1.7%, and 1.7% at 95% CL for cold dark matter, neutrino density, and neutrino velocity, respectively. Planck power spectra plus lensing set constraints on the amplitude of compensated cold dark matter-baryon isocurvature perturbations that are consistent with current complementary measurements. The polarization data also provide improved constraints on inflationary models that predict a small statistically anisotropic quadupolar modulation of the primordial fluctuations. However, the polarization data do not support physical models for a scale-dependent dipolar modulation. All these findings support the key predictions of the standard single-field inflationary models, which will be further tested by future cosmological observations.
9.	Aghanim, N., et al. (författare) Planck 2018 results VIII. Gravitational lensing 2020 Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 641 Tidskriftsartikel (refereegranskat)abstract We present measurements of the cosmic microwave background (CMB) lensing potential using the final Planck 2018 temperature and polarization data. Using polarization maps filtered to account for the noise anisotropy, we increase the significance of the detection of lensing in the polarization maps from 5 sigma to 9 sigma. Combined with temperature, lensing is detected at 40 sigma. We present an extensive set of tests of the robustness of the lensing-potential power spectrum, and construct a minimum-variance estimator likelihood over lensing multipoles 8 <= L <= 400 (extending the range to lower L compared to 2015), which we use to constrain cosmological parameters. We find good consistency between lensing constraints and the results from the Planck CMB power spectra within the Lambda CDM model. Combined with baryon density and other weak priors, the lensing analysis alone constrains (8)Omega (0.25)(m) = 0.589 +/- 0.020 sigma 8 Omega m 0.25 = 0.589 +/- 0.020 (1 sigma errors). Also combining with baryon acoustic oscillation data, we find tight individual parameter constraints, sigma (8)=0.811 +/- 0.019, H-0 = 67.9(-1.3)(+1.2) km s(-1) Mpc(-1) H 0 = 67 . 9 - 1.3 + 1.2 .> km s - 1 . Mpc - 1 , and Omega (m) = 0.303(-0.018)(+0.016) Omega m = 0 . 303 - 0.018 + 0.016 . Combining with Planck CMB power spectrum data, we measure sigma (8) to better than 1% precision, finding sigma (8)=0.811 +/- 0.006. CMB lensing reconstruction data are complementary to galaxy lensing data at lower redshift, having a different degeneracy direction in sigma (8)-Omega (m) space; we find consistency with the lensing results from the Dark Energy Survey, and give combined lensing-only parameter constraints that are tighter than joint results using galaxy clustering. Using the Planck cosmic infrared background (CIB) maps as an additional tracer of high-redshift matter, we make a combined Planck-only estimate of the lensing potential over 60% of the sky with considerably more small-scale signal. We additionally demonstrate delensing of the Planck power spectra using the joint and individual lensing potential estimates, detecting a maximum removal of 40% of the lensing-induced power in all spectra. The improvement in the sharpening of the acoustic peaks by including both CIB and the quadratic lensing reconstruction is detected at high significance.
10.	Akrami, Y., et al. (författare) Planck 2018 results : XI. Polarized dust foregrounds 2020 Ingår i: Astronomy and Astrophysics. - : EDP SCIENCES S A. - 0004-6361 .- 1432-0746. ; 641 Tidskriftsartikel (refereegranskat)abstract The study of polarized dust emission has become entwined with the analysis of the cosmic microwave background (CMB) polarization in the quest for the curl-like B-mode polarization from primordial gravitational waves and the low-multipole E-mode polarization associated with the reionization of the Universe. We used the new Planck PR3 maps to characterize Galactic dust emission at high latitudes as a foreground to the CMB polarization and use end-to-end simulations to compute uncertainties and assess the statistical significance of our measurements. We present PlanckEE, BB, and TE power spectra of dust polarization at 353 GHz for a set of six nested high-Galactic-latitude sky regions covering from 24 to 71% of the sky. We present power-law fits to the angular power spectra, yielding evidence for statistically significant variations of the exponents over sky regions and a difference between the values for the EE and BB spectra, which for the largest sky region are alpha (EE)=-2.42 +/- 0.02 and alpha (BB)=-2.54 +/- 0.02, respectively. The spectra show that the TE correlation and E/B power asymmetry discovered by Planck extend to low multipoles that were not included in earlier Planck polarization papers due to residual data systematics. We also report evidence for a positive TB dust signal. Combining data from Planck and WMAP, we have determined the amplitudes and spectral energy distributions (SEDs) of polarized foregrounds, including the correlation between dust and synchrotron polarized emission, for the six sky regions as a function of multipole. This quantifies the challenge of the component-separation procedure that is required for measuring the low-l reionization CMB E-mode signal and detecting the reionization and recombination peaks of primordial CMB B modes. The SED of polarized dust emission is fit well by a single-temperature modified black-body emission law from 353 GHz to below 70 GHz. For a dust temperature of 19.6 K, the mean dust spectral index for dust polarization is beta (P)(d) = 1.53 +/- 0.02 beta d P = 1.53 +/- 0.02 . The difference between indices for polarization and total intensity is beta (P)(d)-beta (I)(d) = 0.05 +/- 0.03 beta d P - beta d I =0.05 +/- 0.03 . By fitting multi-frequency cross-spectra between Planck data at 100, 143, 217, and 353 GHz, we examine the correlation of the dust polarization maps across frequency. We find no evidence for a loss of correlation and provide lower limits to the correlation ratio that are tighter than values we derive from the correlation of the 217- and 353 GHz maps alone. If the Planck limit on decorrelation for the largest sky region applies to the smaller sky regions observed by sub-orbital experiments, then frequency decorrelation of dust polarization might not be a problem for CMB experiments aiming at a primordial B-mode detection limit on the tensor-to-scalar ratio r similar or equal to 0.01 at the recombination peak. However, the Planck sensitivity precludes identifying how difficult the component-separation problem will be for more ambitious experiments targeting lower limits on r.
11.	Akrami, Y., et al. (författare) Planck 2018 results II. Low Frequency Instrument data processing 2020 Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 641 Tidskriftsartikel (refereegranskat)abstract We present a final description of the data-processing pipeline for the Planck Low Frequency Instrument (LFI), implemented for the 2018 data release. Several improvements have been made with respect to the previous release, especially in the calibration process and in the correction of instrumental features such as the effects of nonlinearity in the response of the analogue-to-digital converters. We provide a brief pedagogical introduction to the complete pipeline, as well as a detailed description of the important changes implemented. Self-consistency of the pipeline is demonstrated using dedicated simulations and null tests. We present the final version of the LFI full sky maps at 30, 44, and 70 GHz, both in temperature and polarization, together with a refined estimate of the solar dipole and a final assessment of the main LFI instrumental parameters.
12.	Akrami, Y., et al. (författare) Planck 2018 results IV. Diffuse component separation 2020 Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 641 Tidskriftsartikel (refereegranskat)abstract We present full-sky maps of the cosmic microwave background (CMB) and polarized synchrotron and thermal dust emission, derived from the third set of Planck frequency maps. These products have significantly lower contamination from instrumental systematic effects than previous versions. The methodologies used to derive these maps follow closely those described in earlier papers, adopting four methods (Commander, NILC, SEVEM, and SMICA) to extract the CMB component, as well as three methods (Commander, GNILC, and SMICA) to extract astrophysical components. Our revised CMB temperature maps agree with corresponding products in the Planck 2015 delivery, whereas the polarization maps exhibit significantly lower large-scale power, reflecting the improved data processing described in companion papers; however, the noise properties of the resulting data products are complicated, and the best available end-to-end simulations exhibit relative biases with respect to the data at the few percent level. Using these maps, we are for the first time able to fit the spectral index of thermal dust independently over 3 degrees regions. We derive a conservative estimate of the mean spectral index of polarized thermal dust emission of beta (d)=1.55 +/- 0.05, where the uncertainty marginalizes both over all known systematic uncertainties and different estimation techniques. For polarized synchrotron emission, we find a mean spectral index of beta (s)=-3.1 +/- 0.1, consistent with previously reported measurements. We note that the current data processing does not allow for construction of unbiased single-bolometer maps, and this limits our ability to extract CO emission and correlated components. The foreground results for intensity derived in this paper therefore do not supersede corresponding Planck 2015 products. For polarization the new results supersede the corresponding 2015 products in all respects.
13.	Akrami, Y., et al. (författare) Planck intermediate results : LVII. Joint Planck LFI and HFI data processing 2020 Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 643 Tidskriftsartikel (refereegranskat)abstract We present the NPIPE processing pipeline, which produces calibrated frequency maps in temperature and polarization from data from the Planck Low Frequency Instrument (LFI) and High Frequency Instrument (HFI) using high-performance computers. NPIPE represents a natural evolution of previous Planck analysis efforts, and combines some of the most powerful features of the separate LFI and HFI analysis pipelines. For example, following the LFI 2018 processing procedure, NPIPE uses foreground polarization priors during the calibration stage in order to break scanning-induced degeneracies. Similarly, NPIPE employs the HFI 2018 time-domain processing methodology to correct for bandpass mismatch at all frequencies. In addition, NPIPE introduces several improvements, including, but not limited to: inclusion of the 8% of data collected during repointing manoeuvres; smoothing of the LFI reference load data streams; in-flight estimation of detector polarization parameters; and construction of maximally independent detector-set split maps. For component-separation purposes, important improvements include: maps that retain the CMB Solar dipole, allowing for high-precision relative calibration in higher-level analyses; well-defined single-detector maps, allowing for robust CO extraction; and HFI temperature maps between 217 and 857 GHz that are binned into 0′.9 pixels (Nside = 4096), ensuring that the full angular information in the data is represented in the maps even at the highest Planck resolutions. The net effect of these improvements is lower levels of noise and systematics in both frequency and component maps at essentially all angular scales, as well as notably improved internal consistency between the various frequency channels. Based on the NPIPE maps, we present the first estimate of the Solar dipole determined through component separation across all nine Planck frequencies. The amplitude is (3366.6 ± 2.7) μK, consistent with, albeit slightly higher than, earlier estimates. From the large-scale polarization data, we derive an updated estimate of the optical depth of reionization of τ = 0.051 ± 0.006, which appears robust with respect to data and sky cuts. There are 600 complete signal, noise and systematics simulations of the full-frequency and detector-set maps. As a Planck first, these simulations include full time-domain processing of the beam-convolved CMB anisotropies. The release of NPIPE maps and simulations is accompanied with a complete suite of raw and processed time-ordered data and the software, scripts, auxiliary data, and parameter files needed to improve further on the analysis and to run matching simulations.
14.	Akrami, Y., et al. (författare) Planck intermediate results LV. Reliability and thermal properties of high-frequency sources in the Second Planck Catalogue of Compact Sources 2020 Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 644 Tidskriftsartikel (refereegranskat)abstract We describe an extension of the most recent version of the Planck Catalogue of Compact Sources (PCCS2), produced using a new multi-band Bayesian Extraction and Estimation Package (BeeP). BeeP assumes that the compact sources present in PCCS2 at 857 GHz have a dust-like spectral energy distribution (SED), which leads to emission at both lower and higher frequencies, and adjusts the parameters of the source and its SED to fit the emission observed in Planck's three highest frequency channels at 353, 545, and 857 GHz, as well as the IRIS map at 3000 GHz. In order to reduce confusion regarding diffuse cirrus emission, BeeP's data model includes a description of the background emission surrounding each source, and it adjusts the confidence in the source parameter extraction based on the statistical properties of the spatial distribution of the background emission. BeeP produces the following three new sets of parameters for each source: (a) fits to a modified blackbody (MBB) thermal emission model of the source; (b) SED-independent source flux densities at each frequency considered; and (c) fits to an MBB model of the background in which the source is embedded. BeeP also calculates, for each source, a reliability parameter, which takes into account confusion due to the surrounding cirrus. This parameter can be used to extract sub-samples of high-frequency sources with statistically well-understood properties. We define a high-reliability subset (BeeP/base), containing 26 083 sources (54.1% of the total PCCS2 catalogue), the majority of which have no information on reliability in the PCCS2. We describe the characteristics of this specific high-quality subset of PCCS2 and its validation against other data sets, specifically for: the sub-sample of PCCS2 located in low-cirrus areas; the Planck Catalogue of Galactic Cold Clumps; the Herschel GAMA15-field catalogue; and the temperature- and spectral-index-reconstructed dust maps obtained with Planck's Generalized Needlet Internal Linear Combination method. The results of the BeeP extension of PCCS2, which are made publicly available via the Planck Legacy Archive, will enable the study of the thermal properties of well-defined samples of compact Galactic and extragalactic dusty sources.
15.	Akrami, Y., et al. (författare) Planck intermediate results LVI. Detection of the CMB dipole through modulation of the thermal Sunyaev-Zeldovich effect : Eppur si muove II 2020 Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 644 Tidskriftsartikel (refereegranskat)abstract The largest temperature anisotropy in the cosmic microwave background (CMB) is the dipole, which has been measured with increasing accuracy for more than three decades, particularly with the Planck satellite. The simplest interpretation of the dipole is that it is due to our motion with respect to the rest frame of the CMB. Since current CMB experiments infer temperature anisotropies from angular intensity variations, the dipole modulates the temperature anisotropies with the same frequency dependence as the thermal Sunyaev-Zeldovich (tSZ) effect. We present the first, and significant, detection of this signal in the tSZ maps and find that it is consistent with direct measurements of the CMB dipole, as expected. The signal contributes power in the tSZ maps, which is modulated in a quadrupolar pattern, and we estimate its contribution to the tSZ bispectrum, noting that it contributes negligible noise to the bispectrum at relevant scales.
16.	Pesková, R. E., et al. (författare) Second language and mother tongue education for immigrant children in Nordic educational policies : Search for a common nordic dimension 2024 Ingår i: Scrutinising the Nordic Dimension in Education. - : Taylor & Francis Group. - 9781040108161 - 9781032674537 ; , s. 190-207 Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract The purpose of this chapter is to investigate whether and how a common Nordic dimension underlies existing policies on second language (L2) and immigrant mother tongue (L1) education. Our research question was: What do policy documents in the five Nordic countries say about L2 and L1 instruction? The theoretical foundation lies in the research fields of language policies and social justice. Document analysis was used to analyze policy documents. Our results show that there is a common Nordic dimension regarding L2 and L1 instruction, demonstrated through an explicit ambition to provide opportunities for the education of immigrant students in L2 and L1. However, there are differences between the Nordic countries in their commitment to principles of social justice, and how the policies are implemented.
17.	Adamson, Carly, et al. (författare) Dapagliflozin for Heart Failure According to Body Mass Index : The DELIVER Trial. 2022 Ingår i: European heart journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 43:41, s. 4406-4417 Tidskriftsartikel (refereegranskat)abstract AIMS: Obesity is common and associated with unique phenotypic features in heart failure with preserved ejection fraction (HFpEF). Therefore, understanding the efficacy and safety of new therapies in HFpEF patients with obesity is important. The effects of dapagliflozin were examined according to body mass index (BMI) among patients in the Dapagliflozin Evaluation to Improve the LIVEs of Patients With PReserved Ejection Fraction Heart Failure trial. METHODS AND RESULTS: Body mass index was analysed by World Health Organization (WHO) categories and as a continuous variable using restricted cubic splines. Body mass index ranged from 15.2 to 50 kg/m2 with a mean value of 29.8 (standard deviation +/- 6.1) kg/m2. The proportions, by WHO category, were: normal weight 1343 (21.5%); overweight 2073 (33.1%); Class I obesity 1574 (25.2%); Class II obesity 798 (12.8%); and Class III obesity 415 (6.6%). Compared with placebo, dapagliflozin reduced the risk of the primary outcome to a similar extent across these categories: hazard ratio (95% confidence interval): 0.89 (0.69-1.15), 0.87 (0.70-1.08), 0.74 (0.58-0.93), 0.78 (0.57-1.08), and 0.72 (0.47-1.08), respectively (P-interaction = 0.82). The placebo-corrected change in Kansas City Cardiomyopathy Questionnaire total symptom score with dapagliflozin at 8 months was: 0.9 (-1.1, 2.8), 2.5 (0.8, 4.1), 1.9 (-0.1, 3.8), 2.7 (-0.5, 5.8), and 8.6 (4.0, 13.2) points, respectively (P-interaction = 0.03). The placebo-corrected change in weight at 12 months was: -0.88 (-1.28, -0.47), -0.65 (-1.04, -0.26), -1.42 (-1.89, -0.94), -1.17 (-1.94, -0.40), and -2.50 (-4.4, -0.64) kg (P-interaction = 0.002). CONCLUSIONS: Obesity is common in patients with HFpEF and is associated with higher rates of heart failure hospitalization and worse health status. Treatment with dapagliflozin improves cardiovascular outcomes across the spectrum of BMI, leads to greater symptom improvement in patients with obesity, compared with those without, and has the additional benefit of causing modest weight loss.
18.	Avesani, C, et al. (författare) ADHERENCE TO NUTRITIONAL RECOMMENDATIONS AS EXPRESSED BY PATIENTS ON HEMODIALYSIS, THEIR INFORMAL CARERS AND HEALTHCARE PROFESSIONALS-THE GOODRENAL PROJECT 2022 Ingår i: NEPHROLOGY DIALYSIS TRANSPLANTATION. - 0931-0509. ; 37, s. I410-I411 Konferensbidrag (övrigt vetenskapligt/konstnärligt)
19.	Brueggemann, AB, et al. (författare) Changes in the incidence of invasive disease due to Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis during the COVID-19 pandemic in 26 countries and territories in the Invasive Respiratory Infection Surveillance Initiative: a prospective analysis of surveillance data 2021 Ingår i: The Lancet. Digital health. - : Elsevier. - 2589-7500. ; 3:6, s. E360-E370 Tidskriftsartikel (refereegranskat)
20.	Finoguenov, A., et al. (författare) CODEX clusters : Survey, catalog, and cosmology of the X-ray luminosity function 2020 Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 638 Tidskriftsartikel (refereegranskat)abstract Context. Large area catalogs of galaxy clusters constructed from ROSAT All-Sky Survey provide the basis for our knowledge of the population of clusters thanks to long-term multiwavelength efforts to follow up observations of these clusters.Aims. The advent of large area photometric surveys superseding previous, in-depth all-sky data allows us to revisit the construction of X-ray cluster catalogs, extending the study to lower cluster masses and higher redshifts and providing modeling of the selection function.Methods. We performed a wavelet detection of X-ray sources and made extensive simulations of the detection of clusters in the RASS data. We assigned an optical richness to each of the 24 788 detected X-ray sources in the 10 382 square degrees of the Baryon Oscillation Spectroscopic Survey area using red sequence cluster finder redMaPPer version 5.2 run on Sloan Digital Sky Survey photometry. We named this survey COnstrain Dark Energy with X-ray (CODEX) clusters.Results. We show that there is no obvious separation of sources on galaxy clusters and active galactic nuclei (AGN) based on the distribution of systems on their richness. This is a combination of an increasing number of galaxy groups and their selection via the identification of X-ray sources either by chance or by groups hosting an AGN. To clean the sample, we use a cut on the optical richness at the level corresponding to the 10% completeness of the survey and include it in the modeling of the cluster selection function. We present the X-ray catalog extending to a redshift of 0.6.Conclusions. The CODEX suvey is the first large area X-ray selected catalog of northern clusters reaching fluxes of 10−13 ergs s−1 cm−2. We provide modeling of the sample selection and discuss the redshift evolution of the high end of the X-ray luminosity function (XLF). Our results on z < 0.3 XLF agree with previous studies, while we provide new constraints on the 0.3 < z < 0.6 XLF. We find a lack of strong redshift evolution of the XLF, provide exact modeling of the effect of low number statistics and AGN contamination, and present the resulting constraints on the flat ΛCDM.
21.	Honkanen, EA, et al. (författare) Dopamine transporter binding in symptomatic controls and healthy volunteers: Considerations for neuroimaging trials 2021 Ingår i: NeuroImage. Clinical. - : Elsevier BV. - 2213-1582. ; 32, s. 102807- Tidskriftsartikel (refereegranskat)
22.	Kjellberg, A, et al. (författare) COVID-19-Induced Acute Respiratory Distress Syndrome Treated with Hyperbaric Oxygen: Interim Safety Report from a Randomized Clinical Trial (COVID-19-HBO) 2023 Ingår i: Journal of clinical medicine. - 2077-0383. ; 12:14 Tidskriftsartikel (refereegranskat)
23.	Laflamme, L, et al. (författare) TREND IN OLDER ADULTS' INTENTIONAL AND UNINTENTIONAL POISONINGS. POPULATION-BASED STUDY IN SWEDEN 2022 Ingår i: INJURY PREVENTION. - : BMJ Publishing Group Ltd. - 1353-8047. ; 28, s. A23-A24 Konferensbidrag (övrigt vetenskapligt/konstnärligt)
24.	Lesen, E, et al. (författare) Rationale, design and feasibility of conducting a real-world study of outcomes in patients with a history of MI receiving extended DAPT with ticagrelor 60 mg 2020 Ingår i: PHARMACOEPIDEMIOLOGY AND DRUG SAFETY. - 1053-8569. ; 29, s. 129-129 Konferensbidrag (övrigt vetenskapligt/konstnärligt)
25.	Lexén, Jenny, et al. (författare) ProScale - A life cycle oriented method to assess toxicological potentials of product systems (2017) : Guidance Document version 1.5 2021 Rapport (övrigt vetenskapligt/konstnärligt)abstract The ProScale method was developed in an industrial consortium with expertise both from the Life Cycle Assessment and Risk Assessment areas. ProScale is intended as an easy-to-use and widely applicable method that can cover both human and eco-toxicity aspects. Currently available in this report is a module for assessing direct exposure related Human Toxicity Potentials in a life cycle perspective compatible with Life Cycle Assessments including Product Environmental Footprint (PEF).The ProScale methodology is based on chemical hazard described by substance classification (H-phrases) in the GHS/CLP classification system, occupational exposure limits (OEL) or Derived No Effect Levels (DNEL), and an exposure dose based on ECETOC Tiered Risk Assessment (TRA). ProScale scores are derived separately for inhalative, oral and dermal exposure routes. The document provides scientific background as well as practical guidance to the practitioner to carry out a ProScale assessment.
26.	Lindholm, C, et al. (författare) COMPARISON OF MRD-MARKERS USING MUTATION-SPECIFIC DDPCR IN BONE MARROWAND PERIPHERAL BLOOD AFTER ALLOGENEIC STEM CELL TRANSPLANTATION IN PATIENTS WITH MDS 2023 Ingår i: LEUKEMIA RESEARCH. - 0145-2126. ; 128 Konferensbidrag (övrigt vetenskapligt/konstnärligt)
27.	Mesa-Gresa, P, et al. (författare) PSYCHOLOGICAL WELLBEING IN HAEMODIALYSIS PATIENTS: COMPARING PERSPECTIVES FROM PATIENTS, CAREGIVERS AND HEALTHCARE PROFESSIONALS-THE GOODRENAL PROJECT 2022 Ingår i: NEPHROLOGY DIALYSIS TRANSPLANTATION. - 0931-0509. ; 37, s. I672-I672 Konferensbidrag (övrigt vetenskapligt/konstnärligt)
28.	Mesa-Gresa, P, et al. (författare) SELF-REPORTED PERCEPTIONS OF HAEMODIALYSIS PATIENTS' COGNITIVE STATE - THE GOODRENAL PROJECT 2022 Ingår i: NEPHROLOGY DIALYSIS TRANSPLANTATION. - 0931-0509. ; 37, s. I666-I666 Konferensbidrag (övrigt vetenskapligt/konstnärligt)
29.	Segura-Orti, E, et al. (författare) GOODRENAL: A FEASIBILITY STUDY OF AN INTRADIALYTIC HOLISTIC VIRTUAL-REALITY PLATFORM 2023 Ingår i: NEPHROLOGY DIALYSIS TRANSPLANTATION. - 0931-0509. ; 38, s. I1205-I1206 Konferensbidrag (övrigt vetenskapligt/konstnärligt)
30.	Segura-Orti, E, et al. (författare) GOODRENAL: HOLISTIC PATIENT CARE INTRADIALYSIS PROGRAM IN HEMODIALYSIS THROUGH A VIRTUAL HEALTH PLATFORM 2021 Ingår i: NEPHROLOGY DIALYSIS TRANSPLANTATION. - 0931-0509. ; 36, s. 364-364 Konferensbidrag (övrigt vetenskapligt/konstnärligt)
31.	Shaw, D, et al. (författare) Trends in invasive bacterial diseases during the first 2 years of the COVID-19 pandemic: analyses of prospective surveillance data from 30 countries and territories in the IRIS Consortium 2023 Ingår i: The Lancet. Digital health. - : Elsevier. - 2589-7500. ; 5:9, s. e582-e593 Tidskriftsartikel (refereegranskat)
32.	Voisin, Sarah, et al. (författare) Exercise is associated with younger methylome and transcriptome profiles in human skeletal muscle 2024 Ingår i: Aging Cell. - 1474-9726. ; , s. 1-15 Tidskriftsartikel (refereegranskat)abstract Exercise training prevents age-related decline in muscle function. Targeting epigenetic aging is a promising actionable mechanism and late-life exercise mitigates epigenetic aging in rodent muscle. Whether exercise training can decelerate, or reverse epigenetic aging in humans is unknown. Here, we performed a powerful meta-analysis of the methylome and transcriptome of an unprecedented number of human skeletal muscle samples (n = 3176). We show that: (1) individuals with higher baseline aerobic fitness have younger epigenetic and transcriptomic profiles, (2) exercise training leads to significant shifts of epigenetic and transcriptomic patterns toward a younger profile, and (3) muscle disuse "ages" the transcriptome. Higher fitness levels were associated with attenuated differential methylation and transcription during aging. Furthermore, both epigenetic and transcriptomic profiles shifted toward a younger state after exercise training interventions, while the transcriptome shifted toward an older state after forced muscle disuse. We demonstrate that exercise training targets many of the age-related transcripts and DNA methylation loci to maintain younger methylome and transcriptome profiles, specifically in genes related to muscle structure, metabolism, and mitochondrial function. Our comprehensive analysis will inform future studies aiming to identify the best combination of therapeutics and exercise regimes to optimize longevity.
33.	Adamson, Carly, et al. (författare) Efficacy of Dapagliflozin in Heart Failure with Reduced Ejection Fraction According to Body Mass Index. 2021 Ingår i: European journal of heart failure. - : Wiley. - 1388-9842 .- 1879-0844. ; 23:10, s. 1662-1672 Tidskriftsartikel (refereegranskat)abstract AIMS: In heart failure with reduced ejection fraction (HFrEF), there is an ’obesity paradox’, where survival is better in patients with a higher body mass index (BMI) and weight loss is associated with worse outcomes. We examined the effect of a sodium-glucose co-transporter 2 inhibitor according to baseline BMI in the Dapagliflozin And Prevention of Adverse- outcomes in Heart Failure trial (DAPA-HF). METHODS AND RESULTS: Body mass index was examined using standard categories, i.e. underweight ($<$18.5 kg/m(2) ); normal weight (18.5-24.9 kg/m(2) ); overweight (25.0-29.9 kg/m(2) ); obesity class I (30.0-34.9 kg/m(2) ); obesity class II (35.0-39.9 kg/m(2) ); and obesity class III ($>$/=40 kg/m(2) ). The primary outcome in DAPA-HF was the composite of worsening heart failure or cardiovascular death. Overall, 1348 patients (28.4%) were under/normal- weight, 1722 (36.3%) overweight, 1013 (21.4%) obesity class I and 659 (13.9%) obesity class II/III. The unadjusted hazard ratio (95% confidence interval) for the primary outcome with obesity class 1, the lowest risk group, as reference was: under/normal-weight 1.41 (1.16-1.71), overweight 1.18 (0.97-1.42), obesity class II/III 1.37 (1.10-1.72). Patients with class I obesity were also at lowest risk of death. The effect of dapagliflozin on the primary outcome and other outcomes did not vary by baseline BMI, e.g. hazard ratio for primary outcome: under/normal-weight 0.74 (0.58-0.94), overweight 0.81 (0.65-1.02), obesity class I 0.68 (0.50-0.92), obesity class II/III 0.71 (0.51-1.00) (P-value for interaction = 0.79). The mean decrease in weight at 8 months with dapagliflozin was 0.9 (0.7-1.1) kg (P $<$ 0.001). CONCLUSION: We confirmed an ’obesity survival paradox’ in HFrEF. We showed that dapagliflozin was beneficial across the wide range of BMI studied. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov NCT03036124.
34.	Adamson, Carly, et al. (författare) IGFBP-7 and Outcomes in Heart Failure With Reduced Ejection Fraction : Findings From DAPA-HF. 2023 Ingår i: JACC. Heart failure. - : Elsevier BV. - 2213-1779 .- 2213-1787. ; 11:3, s. 291-304 Tidskriftsartikel (refereegranskat)abstract BACKGROUND: Insulin-like growth factor-binding protein-7 (IGFBP-7) has been proposed as a potential prognostic biomarker in heart failure (HF), but the association between elevation in IGFBP-7 and HF outcomes in ambulant patients with heart failure with reduced ejection fraction (HFrEF) is unknown. OBJECTIVES: The authors addressed this question in a post hoc analysis of the DAPA-HF (Dapagliflozin and Prevention of Adverse Outcomes in Heart Failure) trial. METHODS: The primary outcome was a composite of cardiovascular death or a worsening HF event. The risk of adverse outcome was compared across tertiles of IGFBP-7 concentration by means of Cox proportional hazard models adjusted for N-terminal pro-B- type natriuretic peptide (NT-proBNP) and high-sensitivity troponin T (hsTnT). The efficacy of randomized treatment across IGFBP-7 tertiles was assessed. Change in IGFBP-7 at 12 months was compared with the use of geometric means. RESULTS: A total of 3,158 patients had IGFBP-7 measured at baseline, and 2,493 had a repeated measure at 12 months. Patients in the highest tertile of IGFBP-7 had evidence of more advanced HFrEF. The adjusted HR for the primary endpoint in tertile 3, compared with tertile 1, was 1.48 (95% CI: 1.17-1.88). There was no modification of the benefit of dapagliflozin by baseline IGFBP-7 (P interaction = 0.34). Dapagliflozin did not change IGFBP-7 levels over 1 year (P = 0.34). CONCLUSIONS: Higher IGFBP-7 in patients with HFrEF was associated with worse clinical profile and an increased risk of adverse clinical outcomes. IGFBP-7 provided prognostic information incremental to clinical variables, NT-proBNP, and hsTnT. The benefit of dapagliflozin was not modulated by IGFBP-7 level. (Study to Evaluate the Effect of Dapagliflozin on the Incidence of Worsening Heart Failure or Cardiovascular Death in Patients With Chronic Heart Failure [DAPA-HF]; NCT03036124).
35.	Adamson, Carly, et al. (författare) Liver Tests and Outcomes in Heart Failure with Reduced Ejection Fraction : Findings from DAPA-HF. 2022 Ingår i: European journal of heart failure. - : Wiley. - 1388-9842 .- 1879-0844. ; 24:10, s. 1856-1868 Tidskriftsartikel (refereegranskat)abstract AIMS: Reflecting both increased venous pressure and reduced cardiac output, abnormal liver tests are common in patients with severe heart failure and are associated with adverse clinical outcomes. We aimed to investigate the prognostic significance of abnormal liver tests in ambulatory patients with heart failure with reduced ejection fraction (HFrEF), explore any treatment interaction between bilirubin and sodium- glucose cotransporter 2 (SGLT2) inhibitors and examine change in liver tests with SGLT2 inhibitor treatment. METHODS AND RESULTS: We explored these objectives in the Dapagliflozin And Prevention of Adverse outcomes in Heart Failure (DAPA-HF) trial, with focus on bilirubin. We calculated the incidence of cardiovascular death or worsening heart failure by bilirubin tertile. Secondary cardiovascular outcomes were examined, along with the change in liver tests at the end-of-study visit. Baseline bilirubin was available in 4720 patients (99.5%). Participants in the highest bilirubin tertile (T3) have more severe HFrEF (lower left ventricular ejection fraction, higher N-terminal pro-B-type natriuretic peptide [NT-proBNP] and worse New York Heart Association class), had a greater burden of atrial fibrillation but less diabetes. Higher bilirubin (T3 vs. T1) was associated with worse outcomes even after adjustment for other predictive variables, including NT-proBNP and troponin T (adjusted hazard ratio for the primary outcome 1.73 [95% confidence interval 1.37-2.17], p $<$ 0.001; and 1.52 [1.12-2.07], p = 0.01 for cardiovascular death). Baseline bilirubin did not modify the benefits of dapagliflozin. During follow-up, dapagliflozin had no effect on liver tests. CONCLUSION: Bilirubin concentration was an independent predictor of worse outcomes but did not modify the benefits of dapagliflozin in HFrEF. Dapagliflozin was not associated with change in liver tests. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov NCT03036124.
36.	Avesani, CM, et al. (författare) A Comparative Analysis of Nutritional Assessment Using Global Leadership Initiative on Malnutrition Versus Subjective Global Assessment and Malnutrition Inflammation Score in Maintenance Hemodialysis Patients 2022 Ingår i: Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation. - : Elsevier BV. - 1532-8503. ; 32:4, s. 476-482 Tidskriftsartikel (refereegranskat)
37.	Bhatt, Ankeet S., et al. (författare) Operational Challenges and Mitigation Measures during the COVID-19 Pandemic-Lessons from DELIVER. 2023 Ingår i: American heart journal. ; 263, s. 133-140 Tidskriftsartikel (refereegranskat)abstract BACKGROUND: Catastrophic disruptions in care delivery threaten the operational efficiency and potentially the validity of clinical research efforts, in particular randomized clinical trials. Most recently, the COVID-19 pandemic affected essentially all aspects of care delivery and clinical research conduct. While consensus statements and clinical guidance documents have detailed potential mitigation measures, few real- world experiences detailing clinical trial adaptations to the COVID-19 pandemic exist, particularly among, large, global registrational cardiovascular trials. METHODS: We outline the operational impact of COVID-19 and resultant mitigation measures in the Dapagliflozin Evaluation to Improve the LIVEs of Patients with Preserved Ejection Fraction Heart Failure (DELIVER) trial, one of the largest and most globally diverse experiences with COVID-19 of any cardiovascular clinical trial to date. Specifically, we address the needed coordination between academic investigators, trial leadership, clinical sites, and the supporting sponsor to ensure the safety of participants and trial staff, to maintain the fidelity of trial operations, and to prospectively adapt statistical analyses plans to evaluate the impact of COVID-19 and the pandemic at large on trial participants. These discussions included key operational issues such as ensuring delivery of study medications, adaptations to study visits, enhanced COVID-19 related endpoint adjudication, and protocol and analytical plan revisions. CONCLUSION: Our findings may have important implications for establishing consensus on prospective contingency planning in future clinical trials. CLINICALTRIAL: gov: NCT03619213. CLINICALTRIAL: GOV: NCT03619213.
38.	Butt, Jawad H., et al. (författare) Atrial Fibrillation and Dapagliflozin Efficacy in Patients With Preserved or Mildly Reduced Ejection Fraction. 2022 Ingår i: Journal of the American College of Cardiology. - : Elsevier BV. - 0735-1097. ; 80:18, s. 1705-1717 Tidskriftsartikel (refereegranskat)abstract BACKGROUND: Atrial fibrillation (AF) is common in heart failure (HF), is associated with worse outcomes compared with sinus rhythm, and may modify the effects of therapy. OBJECTIVES: This study examined the effects of dapagliflozin according to the presence or not of AF in the DELIVER (Dapagliflozin Evaluation to Improve the LIVEs of Patients With PReserved Ejection Fraction Heart Failure) trial. METHODS: A total of 6,263 patients with HF with New York Heart Association functional class II-IV, left ventricular ejection fraction $>$40%, evidence of structural heart disease, and elevated N-terminal pro-B-type natriuretic peptide levels were randomized to dapagliflozin or placebo. Clinical outcomes and the effect of dapagliflozin, according to AF status, were examined. The primary outcome was a composite of cardiovascular death or worsening HF. RESULTS: Of the 6,261 patients with data on baseline AF, 43.3% had no AF, 18.0% had paroxysmal AF, and 38.7% had persistent/permanent AF. The risk of the primary endpoint was higher in patients with AF, especially paroxysmal AF, driven by a higher rate of HF hospitalization: no AF, HF hospitalization rate per 100 person-years (4.5 [95% CI: 4.0-5.1]), paroxysmal AF (7.5 [95% CI: 6.4-8.7]), and persistent/permanent AF (6.4 [95% CI: 5.7-7.1]) (P $<$ 0.001). The benefit of dapagliflozin on the primary outcome was consistent across AF types: no AF, HR: 0.89 (95% CI: 0.74-1.08); paroxysmal AF, HR: 0.75 (95% CI: 0.58-0.97); persistent/permanent AF, HR: 0.79 (95% CI: 0.66-0.95) (Pinteraction = 0.49). Consistent effects were observed for HF hospitalization, cardiovascular death, all-cause mortality, and improvement in the KCCQ- TSS. CONCLUSIONS: In DELIVER, the beneficial effects of dapagliflozin compared with placebo on clinical events and symptoms were consistent, irrespective of type of AF at baseline. (Dapagliflozin Evaluation to Improve the LIVEs of Patients With PReserved Ejection Fraction Heart Failure. [DELIVER]; NCT03619213).
39.	Butt, Jawad H., et al. (författare) Efficacy and Safety of Dapagliflozin According to Frailty in Heart Failure With Reduced Ejection Fraction : A Post Hoc Analysis of the DAPA- HF Trial. 2022 Ingår i: Annals of internal medicine. ; 175:6, s. 820-830 Tidskriftsartikel (refereegranskat)abstract BACKGROUND: Frailty may modify the risk-benefit profile of certain treatments, and frail patients may have reduced tolerance to treatments. OBJECTIVE: To investigate the efficacy of dapagliflozin according to frailty status, using the Rockwood cumulative deficit approach, in DAPA- HF (Dapagliflozin and Prevention of Adverse Outcomes in Heart Failure). DESIGN: Post hoc analysis of a phase 3 randomized clinical trial. (ClinicalTrials.gov: NCT03036124). SETTING: 410 sites in 20 countries. PATIENTS: Patients with symptomatic heart failure (HF) with a left ventricular ejection fraction of 40% or less and elevated natriuretic peptide. INTERVENTION: Addition of once-daily 10 mg of dapagliflozin or placebo to guideline-recommended therapy. MEASUREMENTS: The primary outcome was worsening HF or cardiovascular death. RESULTS: Of the 4744 patients randomly assigned in DAPA-HF, a frailty index (FI) was calculable in 4742. In total, 2392 patients (50.4%) were in FI class 1 (FI $<$/=0.210; not frail), 1606 (33.9%) in FI class 2 (FI 0.211 to 0.310; more frail), and 744 (15.7%) in FI class 3 (FI $>$/=0.311; most frail). The median follow-up time was 18.2 months. Dapagliflozin reduced the risk for worsening HF or cardiovascular death, regardless of FI class. The differences in event rate per 100 person-years for dapagliflozin versus placebo from lowest to highest FI class were -3.5 (95% CI, -5.7 to -1.2), -3.6 (CI, -6.6 to -0.5), and -7.9 (CI, -13.9 to -1.9). Consistent benefits were observed for other clinical events and health status, but the absolute reductions were generally larger in the most frail patients. Study drug discontinuation and serious adverse events were not more frequent with dapagliflozin than placebo, regardless of FI class. LIMITATION: Enrollment criteria precluded the inclusion of very high-risk patients. CONCLUSION: Dapagliflozin improved all outcomes examined, regardless of frailty status. However, the absolute reductions were larger in more frail patients. PRIMARY FUNDING SOURCE: AstraZeneca.
40.	Butt, Jawad H., et al. (författare) Efficacy and Safety of Dapagliflozin According to Frailty in Patients With Heart Failure : A Prespecified Analysis of the DELIVER Trial. 2022 Ingår i: Circulation. ; 146:16, s. 1210-1224 Tidskriftsartikel (refereegranskat)abstract BACKGROUND: Frailty is increasing in prevalence. Because patients with frailty are often perceived to have a less favorable risk/benefit profile, they may be less likely to receive new pharmacologic treatments. We investigated the efficacy and tolerability of dapagliflozin according to frailty status in patients with heart failure with mildly reduced or preserved ejection fraction randomized in DELIVER (Dapagliflozin Evaluation to Improve the Lives of Patients With Preserved Ejection Fraction Heart Failure). METHODS: Frailty was measured using the Rockwood cumulative deficit approach. The primary end point was time to a first worsening heart failure event or cardiovascular death. RESULTS: Of the 6263 patients randomized, a frailty index (FI) was calculable in 6258. In total, 2354 (37.6%) patients had class 1 frailty (FI $<$/=0.210; ie, not frail), 2413 (38.6%) had class 2 frailty (FI 0.211-0.310; ie, more frail), and 1491 (23.8%) had class 3 frailty (FI $>$/=0.311; ie, most frail). Greater frailty was associated with a higher rate of the primary end point (per 100 person-years): FI class 1, 6.3 (95% CI 5.7-7.1); class 2, 8.3 (7.5-9.1); and class 3, 13.4 (12.1-14.7; P$<$0.001). The effect of dapagliflozin (as a hazard ratio) on the primary end point from FI class 1 to 3 was 0.85 (95% CI, 0.68-1.06), 0.89 (0.74-1.08), and 0.74 (0.61-0.91), respectively (Pinteraction=0.40). Although patients with a greater degree of frailty had worse Kansas City Cardiomyopathy Questionnaire scores at baseline, their improvement with dapagliflozin was greater than it was in patients with less frailty: placebo-corrected improvement in Kansas City Cardiomyopathy Questionnaire Overall Summary Score at 4 months in FI class 1 was 0.3 (95% CI, -0.9 to 1.4); in class 2, 1.5 (0.3-2.7); and in class 3, 3.4 (1.7-5.1; Pinteraction=0.021). Adverse reactions and treatment discontinuation, although more frequent in patients with a greater degree of frailty, were not more common with dapagliflozin than with placebo irrespective of frailty class. CONCLUSIONS: In DELIVER, frailty was common and associated with worse outcomes. The benefit of dapagliflozin was consistent across the range of frailty studied. The improvement in health-related quality of life with dapagliflozin occurred early and was greater in patients with a higher level of frailty. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT03619213.
41.	Butt, Jawad H., et al. (författare) Efficacy and Safety of Dapagliflozin in Heart Failure With Reduced Ejection Fraction According to N-Terminal Pro-B-Type Natriuretic Peptide : Insights From the DAPA-HF Trial. 2021 Ingår i: Circulation. Heart failure. ; 14:12 Tidskriftsartikel (refereegranskat)abstract BACKGROUND: Effective therapies for HFrEF usually reduce NT-proBNP (N-terminal pro-B-type natriuretic peptide) levels, and it is important to establish whether new treatments are effective across the range of NT- proBNP. METHODS: We evaluated both these questions in the DAPA-HF (Dapagliflozin and Prevention of Adverse Outcomes in Heart Failure) trial. Patients in New York Heart Association functional class II to IV with a left ventricular ejection fraction $<$/=40% and a NT-proBNP level $>$/=600 pg/mL ($>$/=600 ng/L; $>$/=400 pg/mL if hospitalized for HF within the previous 12 months or $>$/=900 pg/mL if atrial fibrillation/flutter) were eligible. The primary outcome was the composite of an episode of worsening HF or cardiovascular death. RESULTS: Of the 4744 randomized patients, 4742 had an available baseline NT-proBNP measurement (median, 1437 pg/mL [interquartile range, 857-2650 pg/mL]). Compared with placebo, treatment with dapagliflozin significantly reduced NT-proBNP from baseline to 8 months (absolute least-squares mean reduction, -303 pg/mL [95% CI, -457 to -150 pg/mL]; geometric mean ratio, 0.92 [95% CI, 0.88-0.96]). Dapagliflozin reduced the risk of worsening HF or cardiovascular death, irrespective of baseline NT-proBNP quartile; the hazard ratio for dapagliflozin versus placebo, from lowest to highest quartile was 0.43 (95% CI, 0.27-0.67), 0.77 (0.56-1.04), 0.78 (0.60-1.01), and 0.78 (0.64-0.95); P for interaction=0.09. Consistent benefits were observed for all-cause mortality. Compared with placebo, dapagliflozin increased the proportion of patients with a meaningful improvement ($>$/=5 points) in Kansas City Cardiomyopathy Questionnaire total symptom score (P for interaction=0.99) and decreased the proportion with a deterioration $>$/=5 points (P for interaction=0.87) across baseline NT-proBNP quartiles. CONCLUSIONS: In patients with HFrEF, dapagliflozin reduced NT-proBNP by 300 pg/mL after 8 months of treatment compared with placebo. In addition, dapagliflozin reduced the risk of worsening HF and death, and improved symptoms, across the spectrum of baseline NT-proBNP levels included in DAPA-HF. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03036124.
42.	Castelo-Branco, Anna, et al. (författare) Non-infectious comorbidity in patients with multiple sclerosis : A national cohort study in Sweden 2020 Ingår i: Multiple Sclerosis Journal, Experimental, Translational and Clinical. - California, USA : Sage Publications. - 2055-2173. ; , s. 1-10 Tidskriftsartikel (refereegranskat)abstract Background: Comorbidity is of significant concern in multiple sclerosis (MS). Few population-based studies have reported conditions occurring in MS after diagnosis, especially in contemporary cohorts.Objective: To explore incident comorbidity, mortality and hospitalizations in MS, stratified by age and sex.Methods: In a Swedish population-based cohort study 6602 incident MS patients (aged ≥18 years) and 61,828 matched MS-free individuals were identified between 1 January 2008 and 31 December 2016, using national registers. Incidence rates (IRs) and incidence rate ratios (IRRs) with 95% CI were calculated for each outcome.Results: IRs of cardiovascular disease (CVD) were higher among MS patients than MS-free individuals, (major adverse CVD: IRR 1.42; 95% CI 1.12-1.82; hemorrhagic/ischemic stroke: 1.46; 1.05-2.02; transient ischemic attack: 1.65; 1.09-2.50; heart failure: 1.55; 1.15-2.10); venous thromboembolism: 1.42; 1.14-1.77). MS patients also had higher risks of several non-CVDs such as autoimmune conditions (IRR 3.83; 3.01-4.87), bowel dysfunction (2.16; 1.86-2.50), depression (2.38; 2.11-2.68), and fractures (1.32; 1.19-1.47), as well as being hospitalized and to suffer from CVD-related deaths ((1.91; 1.00-3.65), particularly in females (3.57; 1.58-8.06)).Conclusion: MS-patients experience a notable comorbidity burden which emphasizes the need for integrated disease management in order to improve patient care and long-term outcomes of MS.
43.	Chapman, Mark A., et al. (författare) Skeletal Muscle Transcriptomic Comparison between Long-Term Trained and Untrained Men and Women 2020 Ingår i: Cell Reports. - : Elsevier BV. - 2211-1247. ; 31:12 Tidskriftsartikel (refereegranskat)abstract To better understand the health benefits of lifelong exercise in humans, we conduct global skeletal muscle transcriptomic analyses of long-term endurance- (9 men, 9 women) and strength-trained (7 men) humans compared with age-matched untrained controls (7 men, 8 women). Transcriptomic analysis, Gene Ontology, and genome-scale metabolic modeling demonstrate changes in pathways related to the prevention of metabolic diseases, particularly with endurance training. Our data also show prominent sex differences between controls and that these differences are reduced with endurance training. Additionally, we compare our data with studies examining muscle gene expression before and after a months-long training period in individuals with metabolic diseases, This analysis reveals that training shifts gene expression in individuals with impaired metabolism to become more similar to our endurance-trained group. Overall, our data provide an extensive examination of the accumulated transcriptional changes that occur with decades-long training and identify important "exercise-responsive" genes that could attenuate metabolic disease.
44.	Chen, Z, et al. (författare) Low-Plasma Insulin-Like Growth Factor-1 Associates With Increased Mortality in Chronic Kidney Disease Patients With Reduced Muscle Strength 2023 Ingår i: Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation. - 1532-8503. ; 33:2, s. 298-306 Tidskriftsartikel (refereegranskat)
45.	Chen, ZM, et al. (författare) Low-Plasma Insulin-Like Growth Factor-1 Associates With Increased Mortality in Chronic Kidney Disease Patients With Reduced Muscle Strength 2023 Ingår i: Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation. - : Elsevier BV. - 1532-8503. ; 33:2, s. 298-306 Tidskriftsartikel (refereegranskat)
46.	Christiansen, Line I., et al. (författare) Insulin-Like Growth Factor-1 Supplementation Promotes Brain Maturation in Preterm Pigs 2023 Ingår i: eNeuro. - 2373-2822. ; 10:4 Tidskriftsartikel (refereegranskat)abstract Very preterm infants show low levels of insulin-like growth factor-1 (IGF-1), which is associated with postnatal growth restriction and poor neurologic outcomes. It remains unknown whether supplemental IGF-1 may stimulate neurode-velopment in preterm neonates. Using cesarean-delivered preterm pigs as a model of preterm infants, we investi-gated the effects of supplemental IGF-1 on motor function and on regional and cellular brain development. Pigs were treated with 2.25 mg/kg/d recombinant human IGF-1/IGF binding protein-3 complex from birth until day 5 or 9 before the collection of brain samples for quantitative immunohistochemistry (IHC), RNA sequencing, and quantitative PCR analyses. Brain protein synthesis was measured using in vivo labeling with [2H5] phenylalanine. We showed that the IGF-1 receptor was widely distributed in the brain and largely coexisted with immature neurons. Region-spe-cific quantification of IHC labeling showed that IGF-1 treatment promoted neuronal differentiation, increased subcorti-cal myelination, and attenuated synaptogenesis in a region-dependent and time-dependent manner. The expression levels of genes involved in neuronal and oligodendrocyte maturation, and angiogenic and transport functions were al-tered, reflecting enhanced brain maturation in response to IGF-1 treatment. Cerebellar protein synthesis was increased by 19% at day 5 and 14% at day 9 after IGF-1 treatment. Treatment had no effect on Iba1+ microglia or regional brain weights and did not affect motor development or the expression of genes related to IGF-1 signaling. In conclusion, the data show that supplemental IGF-1 promotes brain maturation in newborn preterm pigs. The results provide further support for IGF-1 supplementation therapy in the early postnatal period in preterm infants.
47.	Cordtz, Rene Lindholm, et al. (författare) Haematological malignancies in patients with psoriatic arthritis overall and treated with TNF inhibitors : a Nordic cohort study 2022 Ingår i: RMD Open. - : BMJ Publishing Group Ltd. - 2056-5933. ; 8:2 Tidskriftsartikel (refereegranskat)abstract Objectives To evaluate the risk of haematological malignancies in patients with psoriatic arthritis (PsA) overall, and in relation to treatment with tumour necrosis factor inhibitors (TNFi).Methods We identified that patients with PsA starting a first TNFi from the clinical rheumatology registers (CRR) in the five Nordic countries (n=10 621) and biologics-naive PsA patients from (1) the CRR (n=18 705) and (2) the national patient registers (NPR, n=27 286, Sweden and Denmark) from 2006 through 2019. For Sweden and Denmark, general population comparators were matched 5:1 to PsA patients on birth year, year at start of follow-up and sex. By linkage to the national cancer registers in all countries, we collected information on haematological malignancies overall, and categorised into lymphoid or myeloid types. We estimated incidence rate ratios (IRRs) with 95% CIs using modified Poisson regression for TNFi-treated versus biologics-naive PsA patients and versus the general population adjusted for age, sex, calendar period and country.Results During 59 827 person-years, 40 haematological malignancies occurred among TNFi-treated patients with PsA resulting in a pooled IRR of 0.96 (0.68-1.35) versus biologics-naive PsA from CRR and an IRR of 0.84 (0.64-1.10) versus biologics-naive PsA from NPR. The IRR of haematological malignancies in PsA overall versus general population comparators was 1.35 (1.17-1.55). The estimates were largely similar for lymphoid and myeloid malignancies.Conclusions Treatment with TNFi in patients with PsA was not associated with an increased incidence of haematological malignancies. Conversely, a moderately increased underlying risk was seen in patients with PsA compared with the general population.
48.	Cunningham, Jonathan W., et al. (författare) Dapagliflozin in Patients Recently Hospitalized With Heart Failure and Mildly Reduced or Preserved Ejection Fraction. 2022 Ingår i: Journal of the American College of Cardiology. - : Elsevier BV. - 0735-1097. ; 80:14, s. 1302-1310 Tidskriftsartikel (refereegranskat)abstract BACKGROUND: Patients recently hospitalized for heart failure (HF) are at high risk for rehospitalization and death. OBJECTIVES: The purpose of this study was to investigate clinical outcomes and response to dapagliflozin in patients with HF with mildly reduced or preserved left ventricular ejection fraction (LVEF) who were enrolled during or following hospitalization. METHODS: The DELIVER (Dapagliflozin Evaluation to Improve the LIVES of Patients With PReserved Ejection Fraction Heart Failure) trial randomized patients with HF and LVEF $>$40% to dapagliflozin or placebo. DELIVER permitted randomization during or shortly after hospitalization for HF in clinically stable patients off intravenous HF therapies. This prespecified analysis investigated whether recent HF hospitalization modified risk of clinical events or response to dapagliflozin. The primary outcome was worsening HF event or cardiovascular death. RESULTS: Of 6,263 patients in DELIVER, 654 (10.4%) were randomized during HF hospitalization or within 30 days of discharge. Recent HF hospitalization was associated with greater risk of the primary outcome after multivariable adjustment (HR: 1.88; 95% CI: 1.60-2.21; P $<$ 0.001). Dapagliflozin reduced the primary outcome by 22% in recently hospitalized patients (HR: 0.78; 95% CI: 0.60-1.03) and 18% in patients without recent hospitalization (HR: 0.82; 95% CI: 0.72-0.94; Pinteraction = 0.71). Rates of adverse events, including volume depletion, diabetic ketoacidosis, or renal events, were similar with dapagliflozin and placebo in recently hospitalized patients. CONCLUSIONS: Dapagliflozin safely reduced risk of worsening HF or cardiovascular death similarly in patients with and without history of recent HF hospitalization. Starting dapagliflozin during or shortly after HF hospitalization in patients with mildly reduced or preserved LVEF appears safe and effective. (Dapagliflozin Evaluation to Improve the LIVEs of Patients With PReserved Ejection Fraction Heart Failure [DELIVER]; NCT03619213).
49.	Dewan, Pooja, et al. (författare) Effects of Dapagliflozin in Heart Failure with Reduced Ejection Fraction and Chronic Obstructive Pulmonary Disease : An Analysis of DAPA-HF. 2021 Ingår i: European journal of heart failure. - : Wiley. - 1388-9842 .- 1879-0844. ; 23:4, s. 632-643 Tidskriftsartikel (refereegranskat)abstract AIMS: Chronic obstructive pulmonary disease (COPD) is an important comorbidity in heart failure (HF) with reduced ejection fraction (HFrEF), associated with worse outcomes and often suboptimal treatment because of under-prescription of beta-blockers. Consequently, additional effective therapies are especially relevant in patients with COPD. The aim of this study was to examine outcomes related to COPD in a post hoc analysis of the Dapagliflozin And Prevention of Adverse-outcomes in Heart Failure (DAPA-HF) trial. METHODS AND RESULTS: We examined whether the effects of dapagliflozin in DAPA-HF were modified by COPD status. The primary outcome was the composite of an episode of worsening HF or cardiovascular death. Overall, 585 (12.3%) of the 4744 patients randomized had a history of COPD. Patients with COPD were more likely to be older men with a history of smoking, worse renal function, and higher baseline N-terminal pro B-type natriuretic peptide, and less likely to be treated with a beta-blocker or mineralocorticoid receptor antagonist. The incidence of the primary outcome was higher in patients with COPD than in those without [18.9 (95% confidence interval 16.0-22.2) vs. 13.0 (12.1-14.0) per 100 person-years; hazard ratio (HR) for COPD vs. no COPD 1.44 (1.21-1.72); P $<$ 0.001]. The effect of dapagliflozin, compared with placebo, on the primary outcome, was consistent in patients with [HR 0.67 (95% confidence interval 0.48-0.93)] and without COPD [0.76 (0.65-0.87); interaction P-value 0.47]. CONCLUSIONS: In DAPA-HF, one in eight patients with HFrEF had concomitant COPD. Participants with COPD had a higher risk of the primary outcome. The benefit of dapagliflozin on all pre-specified outcomes was consistent in patients with and without COPD. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov ID NCT03036124.
50.	Docherty, Kieran F., et al. (författare) Effect of Dapagliflozin, Compared With Placebo, According to Baseline Risk in DAPA-HF. 2022 Ingår i: JACC. Heart failure. - : Elsevier BV. - 2213-1779. ; 10:2, s. 104-118 Tidskriftsartikel (refereegranskat)abstract OBJECTIVES: The authors sought to examine the effect of dapagliflozin across the spectrum of risk in patients enrolled in DAPA-HF. BACKGROUND: In the DAPA-HF (Dapagliflozin And Prevention of Adverse-outcomes in Heart Failure) trial, the sodium-glucose cotransporter 2 inhibitor dapagliflozin decreased the risk of worsening HF events and cardiovascular death in patients with HF and reduced ejection fraction. METHODS: The MAGGIC (Meta-analysis Global Group in Chronic Heart Failure) and the PARADIGM-HF (Prospective comparison of ARNI with ACEI to Determine Impact on Global Mortality and morbidity in Heart Failure) PREDICT-HF (Risk of Events and Death in the Contemporary Treatment of Heart Failure) risk models were used to categorize patients according to risk score quintiles. The authors analyzed rates of the primary composite outcome of a worsening HF event or cardiovascular death, its components, and all-cause mortality according to risk quintile and whether risk modified the effect of dapagliflozin. RESULTS: The MAGGIC score was available for 4,740 of 4,744 patients in DAPA-HF (median score 22 [IQR: 18-25]). A1-point increase was associated with an 8.2% (95% CI: 6.9%-9.4%) higher relative risk of the primary endpoint (P $<$ 0.001). The benefit of dapagliflozin over placebo for the primary endpoint was similar across the spectrum of MAGGIC risk score (interaction P = 0.71). Applying the overall relative risk reduction (26%) with dapagliflozin added to standard therapy resulted in 7 fewer patients in the highest MAGGIC risk quintile experiencing a primary outcome, compared with 2 in the lowest quintile, per 100 person-years of treatment. The findings with PREDICT-HF were similar, although this model led to better risk discrimination. CONCLUSIONS: The benefits of dapagliflozin were consistent across the broad spectrum of baseline risk in DAPA-HF.

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