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  • Mullier, G.A., et al. (författare)
  • Measurements of jet observables sensitive to b -quark fragmentation in t t ¯ events at the LHC with the ATLAS detector
  • 2022
  • Ingår i: Physical Review D. - : American Physical Society (APS). - 2470-0010 .- 2470-0029. ; 106:3
  • Tidskriftsartikel (refereegranskat)abstract
    • Several observables sensitive to the fragmentation of b quarks into b hadrons are measured using 36 fb-1 of s=13 TeV proton-proton collision data collected with the ATLAS detector at the LHC. Jets containing b hadrons are obtained from a sample of dileptonic tt¯ events, and the associated set of charged-particle tracks is separated into those from the primary pp interaction vertex and those from the displaced b-decay secondary vertex. This division is used to construct observables that characterize the longitudinal and transverse momentum distributions of the b hadron within the jet. The measurements have been corrected for detector effects and provide a test of heavy-quark-fragmentation modeling at the LHC in a system where the top-quark decay products are color connected to the proton beam remnants. The unfolded distributions are compared with the predictions of several modern Monte Carlo parton-shower generators and generator tunes, and a wide range of agreement with the data is observed, with p values varying from 5×10-4 to 0.98. These measurements complement similar measurements from e+e- collider experiments in which the b quarks originate from a color singlet Z/γ∗. © 2022 CERN.
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  • Balintescu, A., et al. (författare)
  • Glycaemic control and sepsis risk in adults with type 1 diabetes
  • 2023
  • Ingår i: Diabetes Obesity & Metabolism. - : Wiley. - 1462-8902 .- 1463-1326. ; 25:7, s. 1942-1949
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims: To study the association between glycated haemoglobin (HbA1c) and sepsis in adults with type 1 diabetes, and to explore the relationship between HbA1c and mortality among individuals who developed sepsis.Materials and Methods: We included 33 549 adult individuals with type 1 diabetes recorded in the Swedish National Diabetes Register between January 2005 and December 2015. We used multivariable Cox regression and restricted cubic spline analyses to study the relationship between HbA1c values and sepsis occurrence and association between HbA1c and mortality among those with sepsis.Results: In total, 713 (2.1%) individuals developed sepsis during the study period. Com-pared with the HbA1c reference interval of 48-52 mmol/mol (6.5-6.9%), the adjusted hazard ratio for sepsis was: 2.50 [95% confidence interval (CI) 1.18-5.29] for HbA1c <43 mmol/mol; 1.88 (95% CI 0.96-3.67) for HbA1c 43-47 mmol/mol; 1.78 (95% CI 1.09-2.89) for HbA1c 53-62 mmol/mol; 1.86 (95% CI 1.14-3.03) for HbA1c 63-72 mmol/mol; 3.15 (95% CI 1.91-5.19) for HbA1c 73-82 mmol/mol; and 4.26 (95% CI 2.53-7.16) for HbA1c >82 mmol/mol. On multivariable restricted cubic spline analy-sis, we found a J-shaped association between HbA1c and sepsis risk, with the lowest risk observed at HbA1c of approximately 53 mmol/mol. We found no association between HbA1c and mortality among those individuals who developed sepsis.Conclusions: In our nationwide observational study of adult individuals with type 1 diabetes we found a J-shaped relationship between HbA1c and risk of sepsis, with the lowest risk at HbA1c levels about 53 mmol/mol (7.0%). HbA1c was not associ-ated with mortality in individuals affected by sepsis.
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  • Balintescu, A., et al. (författare)
  • Prevalence and impact of chronic dysglycemia in intensive care unit patients-A retrospective cohort study
  • 2021
  • Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172 .- 1399-6576. ; 65:1, s. 82-91
  • Tidskriftsartikel (refereegranskat)abstract
    • Background The prevalence of chronic dysglycemia (diabetes and prediabetes) in patients admitted to Swedish intensive care units (ICUs) is unknown. We aimed to determine the prevalence of such chronic dysglycemia and asses its impact on blood glucose control and patient-centered outcomes in critically ill patients. Methods In this retrospective observational cohort study, we obtained glycated hemoglobin A1c (HbA1c) in patients admitted to four tertiary ICUs in Sweden between March and August 2016. Based on previous diabetes history and HbA1c we determined the prevalence of chronic dysglycemia. We used multivariable regression analyses to study the association of chronic dysglycemia with the time-weighted average blood glucose concentration, glycemic lability index (GLI), and development of hypoglycemia (co-primary outcomes), and with ICU length of stay, mechanical ventilation duration, renal replacement therapy (RRT) use, vasopressor use, ICU-acquired infections, and mortality (exploratory clinical outcomes). Results Of 943 patients, 312 (33%) had chronic dysglycemia. Of these 312 patients, 84 (27%) had prediabetes, 43 (14%) had undiagnosed diabetes and 185 (59%) had known diabetes. Chronic dysglycemia was independently associated with higher time-weighted average blood glucose concentration (P < .001), higher GLI (P < .001), and hypoglycemia (P < .001). Chronic dysglycemia was independently associated with RRT use (adjusted odds ratio 1.97, 95% CI 1.24-3.13,P = .004) but not with other exploratory clinical outcomes. Conclusions In four tertiary Swedish ICUs, measurement of HbA1c showed that one-third of patients had chronic dysglycemia. Chronic dysglycemia was associated with marked derangements in glycemic control, and a greater need for renal replacement therapy.
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  • Hedberg, P, et al. (författare)
  • Clinical phenotypes and outcomes of SARS-CoV-2, influenza, RSV and seven other respiratory viruses: a retrospective study using complete hospital data
  • 2022
  • Ingår i: Thorax. - : BMJ. - 1468-3296 .- 0040-6376. ; 77:2, s. 154-163
  • Tidskriftsartikel (refereegranskat)abstract
    • An understanding of differences in clinical phenotypes and outcomes COVID-19 compared with other respiratory viral infections is important to optimise the management of patients and plan healthcare. Herein we sought to investigate such differences in patients positive for SARS-CoV-2 compared with influenza, respiratory syncytial virus (RSV) and other respiratory viruses.MethodsWe performed a retrospective cohort study of hospitalised adults and children (≤15 years) who tested positive for SARS-CoV-2, influenza virus A/B, RSV, rhinovirus, enterovirus, parainfluenza viruses, metapneumovirus, seasonal coronaviruses, adenovirus or bocavirus in a respiratory sample at admission between 2011 and 2020.ResultsA total of 6321 adult (1721 SARS-CoV-2) and 6379 paediatric (101 SARS-CoV-2) healthcare episodes were included in the study. In adults, SARS-CoV-2 positivity was independently associated with younger age, male sex, overweight/obesity, diabetes and hypertension, tachypnoea as well as better haemodynamic measurements, white cell count, platelet count and creatinine values. Furthermore, SARS-CoV-2 was associated with higher 30-day mortality as compared with influenza (adjusted HR (aHR) 4.43, 95% CI 3.51 to 5.59), RSV (aHR 3.81, 95% CI 2.72 to 5.34) and other respiratory viruses (aHR 3.46, 95% CI 2.61 to 4.60), as well as higher 90-day mortality, ICU admission, ICU mortality and pulmonary embolism in adults. In children, patients with SARS-CoV-2 were older and had lower prevalence of chronic cardiac and respiratory diseases compared with other viruses.ConclusionsSARS-CoV-2 is associated with more severe outcomes compared with other respiratory viruses, and although associated with specific patient and clinical characteristics at admission, a substantial overlap precludes discrimination based on these characteristics.
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  • Backman, Filip, 1991-, et al. (författare)
  • Charged-hadron production in pp, p plus Pb, Pb plus Pb, and Xe plus Xe collisions at √sNN=5 TeV with the ATLAS detector at the LHC
  • 2023
  • Ingår i: Journal of High Energy Physics (JHEP). - : Springer Nature. - 1126-6708 .- 1029-8479. ; :7
  • Tidskriftsartikel (refereegranskat)abstract
    • This paper presents measurements of charged-hadron spectra obtained in pp, p+Pb, and Pb+Pb collisions at √s or √sNN = 5.02 TeV, and in Xe+Xe collisions at √sNN = 5.44 TeV. The data recorded by the ATLAS detector at the LHC have total integrated luminosities of 25 pb−1, 28 nb−1, 0.50 nb−1, and 3 μb−1, respectively. The nuclear modification factors RpPb and RAA are obtained by comparing the spectra in heavy-ion and pp collisions in a wide range of charged-particle transverse momenta and pseudorapidity. The nuclear modification factor RpPb shows a moderate enhancement above unity with a maximum at pT ≈ 3 GeV; the enhancement is stronger in the Pb-going direction. The nuclear modification factors in both Pb+Pb and Xe+Xe collisions feature a significant, centrality-dependent suppression. They show a similar distinct pT-dependence with a local maximum at pT ≈ 2 GeV and a local minimum at pT ≈ 7 GeV. This dependence is more distinguishable in more central collisions. No significant |η|-dependence is found. A comprehensive comparison with several theoretical predictions is also provided. They typically describe RAA better in central collisions and in the pT range from about 10 to 100 GeV.
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  • Diaz-Galvan, P., et al. (författare)
  • Differential response to donepezil in MRI subtypes of mild cognitive impairment
  • 2023
  • Ingår i: Alzheimer's Research & Therapy. - 1758-9193. ; 15:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundDonepezil is an approved therapy for the treatment of Alzheimer's disease (AD). Results across clinical trials have been inconsistent, which may be explained by design-methodological issues, the pathophysiological heterogeneity of AD, and diversity of included study participants. We investigated whether response to donepezil differs in mild cognitive impaired (MCI) individuals demonstrating different magnetic resonance imaging (MRI) subtypes.MethodsFrom the Hippocampus Study double-blind, randomized clinical trial, we included 173 MCI individuals (donepezil = 83; placebo = 90) with structural MRI data, at baseline and at clinical follow-up assessments (6-12-month). Efficacy outcomes were the annualized percentage change (APC) in hippocampal, ventricular, and total grey matter volumes, as well as in the AD cortical thickness signature. Participants were classified into MRI subtypes as typical AD, limbic-predominant, hippocampal-sparing, or minimal atrophy at baseline. We primarily applied a subtyping approach based on continuous scale of two subtyping dimensions. We also used the conventional categorical subtyping approach for comparison.ResultsDonepezil-treated MCI individuals showed slower atrophy rates compared to the placebo group, but only if they belonged to the minimal atrophy or hippocampal-sparing subtypes. Importantly, only the continuous subtyping approach, but not the conventional categorical approach, captured this differential response.ConclusionsOur data suggest that individuals with MCI, with hippocampal-sparing or minimal atrophy subtype, may have improved benefit from donepezil, as compared with MCI individuals with typical or limbic-predominant patterns of atrophy. The newly proposed continuous subtyping approach may have advantages compared to the conventional categorical approach. Future research is warranted to demonstrate the potential of subtype stratification for disease prognosis and response to treatment.
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  • G., Aad, et al. (författare)
  • Measurement of the tt¯ production cross-section and lepton differential distributions in eμ dilepton events from pp collisions at √s=13TeV with the ATLAS detector
  • 2020
  • Ingår i: European Physical Journal C. - : Springer Science and Business Media LLC. - 1434-6044 .- 1434-6052. ; 80:6
  • Tidskriftsartikel (refereegranskat)abstract
    • The inclusive top quark pair (tt¯) production cross-section σtt¯ has been measured in proton–proton collisions at s=13TeV, using 36.1 fb- 1 of data collected in 2015–2016 by the ATLAS experiment at the LHC. Using events with an opposite-charge eμ pair and b-tagged jets, the cross-section is measured to be: σtt¯=826.4±3.6(stat)±11.5(syst)±15.7(lumi)±1.9(beam)pb,where the uncertainties reflect the limited size of the data sample, experimental and theoretical systematic effects, the integrated luminosity, and the LHC beam energy, giving a total uncertainty of 2.4%. The result is consistent with theoretical QCD calculations at next-to-next-to-leading order. It is used to determine the top quark pole mass via the dependence of the predicted cross-section on mtpole, giving mtpole=173.1-2.1+2.0GeV. It is also combined with measurements at s=7TeV and s=8TeV to derive ratios and double ratios of tt¯ and Z cross-sections at different energies. The same event sample is used to measure absolute and normalised differential cross-sections as functions of single-lepton and dilepton kinematic variables, and the results are compared with predictions from various Monte Carlo event generators. © 2020, CERN for the benefit of the ATLAS collaboration.
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  • Holmqvist, Jacob, et al. (författare)
  • Patterns and determinants of blood transfusion in intensive care in Sweden between 2010 and 2018: A nationwide, retrospective cohort study
  • 2022
  • Ingår i: Transfusion. - : Wiley. - 0041-1132 .- 1537-2995. ; 62:6, s. 1188-1198
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Intensive care unit (ICU) patients are transfused with blood products for a number of reasons, from massive ongoing hemorrhage, to mild anemia following blood sampling, combined with bone marrow depression due to critical illness. There's a paucity of data on transfusions in ICUs and most studies are based on audits or surveys. The aim of this study was to provide a complete picture of ICU-related transfusions in Sweden. Methods We conducted a register based retrospective cohort study with data on all adult patient admissions from 82 of 84 Swedish ICUs between 2010 and 2018, as recorded in the Swedish Intensive Care Register. Transfusions were obtained from the SCANDAT-3 database. Descriptive statistics were computed, characterizing transfused and nontransfused patients. The distribution of blood use comparing different ICUs was investigated by computing the observed proportion of ICU stays with a transfusion, as well as the expected proportion. Results In 330,938 ICU episodes analyzed, at least one transfusion was administered for 106,062 (32%). For both red-cell units and plasma, the fraction of patients who were transfused decreased during the study period from 31.3% in 2010 to 24.6% in 2018 for red-cells, and from 16.6% in 2010 to 9.4% in 2018 for plasma. After adjusting for a range of factors, substantial variation in transfusion frequency remained, especially for plasma units. Conclusion Despite continuous decreases in utilization, transfusions remain common among Swedish ICU patients. There is considerable unexplained variation in transfusion rates. More research is needed to establish stronger critiera for when to transfuse ICU patients.
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  • Lloyd-Donald, P, et al. (författare)
  • Comparison of Thromboelastography and Conventional Coagulation Tests in Patients With Severe Liver Disease
  • 2020
  • Ingår i: Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis. - : SAGE Publications. - 1938-2723. ; 26, s. 1076029620925915-
  • Tidskriftsartikel (refereegranskat)abstract
    • Thromboelastography (TEG) may provide rapid and clinically important coagulation information in acutely ill patients with chronic liver disease (CLD). Our objective was to describe the relationship between TEG and conventional coagulation tests (CCTs), which has not been previously explored in this population. Methods: In acutely ill patients with severe CLD (Child-Pugh score > 9, category C), we conducted a prospective observational study investigating coagulation assessment as measured by both CCTs and TEG. We used quantile regression to explore 30 associations between TEG parameters and corresponding CCTs. We compared TEG and CCT measures of coagulation initiation, clot formation, clot strength, and fibrinolysis. Results: We studied 34 patients on a total of 109 occasions. We observed inconsistent associations between TEG and CCT measures of coagulation initiation: TEG (citrated kaolin [CK] assay) standard reaction time and international normalized ratio: R 2 = 0.117 ( P = .044). Conversely, there were strong and consistent associations between tests of clot formation: TEG (CK) kinetics time and fibrinogen: R 2 = 0.202 ( P < .0001) and TEG (CK) α angle and fibrinogen 0.263 ( P < .0001). We also observed strong associations between tests of clot strength, specifically TEG MA and conventional fibrinogen levels, across all TEG assays: MA (CK) and fibrinogen: R 2 = 0.485 ( P < .0001). There were no associations between TEG and D-dimer levels. Conclusions: In acutely ill patients with CLD, there are strong and consistent associations between TEG measures of clot formation and clot strength and conventional fibrinogen levels. There are weak and/or inconsistent associations between TEG and all other conventional measures of coagulation.
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  • Martensson, T., et al. (författare)
  • Clinical relevance of endoscopy with histopathological assessment in children with suspected gastrointestinal graft-versus-host disease
  • 2020
  • Ingår i: Clinical Transplantation. - : Wiley. - 0902-0063 .- 1399-0012. ; 34:7
  • Tidskriftsartikel (refereegranskat)abstract
    • Endoscopy with histopathological assessment is an established practice to confirm gastrointestinal graft-versus-host disease (GI-GVHD). However, the clinical relevance of this approach in children is incompletely evaluated. In a retrospective cohort study, we investigated the frequency of treatment changes in response to histopathological findings in all children (<18 years) in Sweden who underwent endoscopy for suspected GI-GVHD (2000-2013) after receiving hematopoietic stem cell transplantation. Sixty-eight children with ninety-one endoscopic occasions were enrolled. At the time of endoscopy, anti-GI-GVHD treatment was ongoing in 71% (65/91). In 18% (12/65) with ongoing treatment, no histopathological evidence of GI-GVHD or another cause to justify anti-GI-GVHD treatment was found. In 48% (44/91), endoscopy with histopathological assessment led to changes in the treatment regimen. Re-endoscopy was more frequent among those with treatment changes, versus unchanged treatment, 39% (17/44) and 13% (6/47), respectively (P = .007). Histopathological findings generating treatment changes were as follows: GI-GVHD in 68% (30/44), normal histology in 25% (11/44), and an alternative diagnosis in 7% (3/44). In conclusion, this study supports that endoscopy with histopathological assessment should be considered in all children with suspected GI-GVHD.
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