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- Aaen, J., et al.
(author)
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Is the presence of foraminal stenosis associated with outcome in lumbar spinal stenosis patients treated with posterior microsurgical decompression
- 2023
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In: ACTA NEUROCHIRURGICA. - 0001-6268. ; 165, s. 2121-2129
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Journal article (peer-reviewed)abstract
- Background We aim to investigate associations between preoperative radiological findings of lumbar foraminal stenosis with clinical outcomes after posterior microsurgical decompression in patients with predominantly central lumbar spinal stenosis (LSS). Methods The study was an additional analysis in the NORDSTEN Spinal Stenosis Trial. In total, 230 men and 207 women (mean age 66.8 ( SD 8.3)) were included. All patients underwent an MRI including T1- and T2-weighted sequences. Grade of foraminal stenosis was dichotomized into none to moderate (0-1) and severe (2-3) category using Lee's classification system. The Oswestry Disability Index (ODI), Zurich Claudication Questionnaire (ZCQ), and numeric rating scale (NRS) for back and leg pain were collected at baseline and at 2-year follow-up. Primary outcome was a reduction of 30% or more on the ODI score. Secondary outcomes included the mean improvement on the ODI, ZCQ, and NRS scores. We performed multivariable regression analyses with the radiological variates foraminal stenosis, Pfirrmann grade, Schizas score, dural sac cross-sectional area, and the possible plausible confounders: patients' gender, age, smoking status, and BMI. Results The cohort of 437 patients presented a high degree of degenerative changes at baseline. Of 414 patients with adequate imaging of potential foraminal stenosis, 402 were labeled in the none to moderate category and 12 in the severe category. Of the patients with none to moderate foraminal stenosis, 71% achieved at least 30% improvement in ODI. Among the patients with severe foraminal stenosis, 36% achieved at least 30% improvement in ODI. A significant association between severe foraminal stenosis and less chance of reaching the target of 30% improvement in the ODI score after surgery was detected: OR 0.22 (95% CI 0.06, 0.83), p=0.03. When investigating outcome as continuous variables, a similar association between severe foraminal stenosis and less improved ODI with a mean difference of 9.28 points (95%CI 0.47, 18.09; p=0.04) was found. Significant association between severe foraminal stenosis and less improved NRS pain in the lumbar region was also detected with a mean difference of 1.89 ( 95% CI 0.30, 3.49; p=0.02). No significant association was suggested between severe foraminal stenosis and ZCQ or NRS leg pain. Conclusion In patients operated with posterior microsurgical decompression for LSS, a preoperative severe lumbar foraminal stenosis was associated with higher proportion of patients with less than 30% improvement in ODI. Trial registration The study is registered at ClinicalTrials. gov (22.11.2013) under the identifier NCT02007083.
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2. |
- Aarhus, Mathies, 1986
(author)
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Prefigurative Poetics: Language Writing’s New Sentence and the Politics of the New Left
- 2023
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In: Orbit: A Journal of American Literature. - 2398-6786. ; 11:1, s. 1-22
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Journal article (peer-reviewed)abstract
- This article argues that prefiguration is an essential concept for understanding the postwar avant-garde’s affiliation with social movements. Against the backdrop of important recent arguments that link Language writing to the failings and inner conflicts of the 1960s, this essay claims that Language writing was bred out of a complex dialogue with the New Left as both a result of a disillusionment with political speech and an attempt to carry on the New Left’s democratic experiments. I show how the technique invented by Ron Silliman and other American West Coast poets called The New Sentence not only was a way of posturing in the established language of the New Left, but actively sought to continue the political legacy of the 1960s in much more direct ways than previously acknowledged. Most importantly, the New Sentence inherited the notion of prefigurative politics and the hopes that such a politics, if transferred to poetic form, could enact change by constructing an alternative model of society. As a merger between New Left politics and institutional critique, the New Sentence—and other avant-garde strategies after ‘68—prefigures new ways of life through aesthetic form.
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4. |
- Aasvang, Gunn Marit, et al.
(author)
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Burden of disease due to transportation noise in the Nordic countries.
- 2023
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In: Environmental research. - 1096-0953. ; 231:Pt 1
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Journal article (peer-reviewed)abstract
- Environmental noise is of increasing concern for public health. Quantification of associated health impacts is important for regulation and preventive strategies.To estimate the burden of disease (BoD) due to road traffic and railway noise in four Nordic countries and their capitals, in terms of DALYs (Disability-Adjusted Life Years), using comparable input data across countries.Road traffic and railway noise exposure was obtained from the noise mapping conducted according to the Environmental Noise Directive (END) as well as nationwide noise exposure assessments for Denmark and Norway. Noise annoyance, sleep disturbance and ischaemic heart disease were included as the main health outcomes, using exposure-response functions from the WHO, 2018 systematic reviews. Additional analyses included stroke and type 2 diabetes. Country-specific DALY rates from the Global Burden of Disease (GBD) study were used as health input data.Comparable exposure data were not available on a national level for the Nordic countries, only for capital cities. The DALY rates for the capitals ranged from 329 to 485 DALYs/100,000 for road traffic noise and 44 to 146 DALY/100,000 for railway noise. Moreover, the DALY estimates for road traffic noise increased with up to 17% upon inclusion of stroke and diabetes. DALY estimates based on nationwide noise data were 51 and 133% higher than the END-based estimates, for Norway and Denmark, respectively.Further harmonization of noise exposure data is required for between-country comparisons. Moreover, nationwide noise models indicate that DALY estimates based on END considerably underestimate national BoD due to transportation noise. The health-related burden of traffic noise was comparable to that of air pollution, an established risk factor for disease in the GBD framework. Inclusion of environmental noise as a risk factor in the GBD is strongly encouraged.
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5. |
- Abadikhah, Marie, 1992, et al.
(author)
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Effect of anode material and dispersal limitation on the performance and biofilm community in microbial electrolysis cells
- 2023
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In: Biofilm. - 2590-2075. ; 6
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Journal article (peer-reviewed)abstract
- In a microbial electrolysis cell (MEC), the oxidization of organic compounds is facilitated by an electrogenic biofilm on the anode surface. The biofilm community composition determines the function of the system. Both deterministic and stochastic factors affect the community, but the relative importance of different factors is poorly understood. Anode material is a deterministic factor as materials with different properties may select for different microorganisms. Ecological drift is a stochastic factor, which is amplified by dispersal limitation between communities. Here, we compared the effects of three anode materials (graphene, carbon cloth, and nickel) with the effect of dispersal limitation on the function and biofilm community assembly. Twelve MECs were operated for 56 days in four hydraulically connected loops and shotgun metagenomic sequencing was used to analyse the microbial community composition on the anode surfaces at the end of the experiment. The anode material was the most important factor affecting the performance of the MECs, explaining 54–80 % of the variance observed in peak current density, total electric charge generation, and start-up lag time, while dispersal limitation explained 10–16 % of the variance. Carbon cloth anodes had the highest current generation and shortest lag time. However, dispersal limitation was the most important factor affecting microbial community structure, explaining 61–98 % of the variance in community diversity, evenness, and the relative abundance of the most abundant taxa, while anode material explained 0–20 % of the variance. The biofilms contained nine Desulfobacterota metagenome-assembled genomes (MAGs), which made up 64–89 % of the communities and were likely responsible for electricity generation in the MECs. Different MAGs dominated in different MECs. Particularly two different genotypes related to Geobacter benzoatilyticus competed for dominance on the anodes and reached relative abundances up to 83 %. The winning genotype was the same in all MECs that were hydraulically connected irrespective of anode material used.
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- Abd Alrahman, Yehia, 1986, et al.
(author)
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Language Support for Verifying Reconfigurable Interacting Systems
- 2023
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In: International Journal on Software Tools for Technology Transfer (STTT). - 1433-2779 .- 1433-2787.
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Journal article (peer-reviewed)abstract
- Reconfigurable interacting systems consist of a set of autonomous agents, with integrated interaction capabilities that feature opportunistic interaction. Agents seemingly reconfigure their interactions interfaces by forming collectives, and interact based on mutual interests. Finding ways to design and analyse the behaviour of these systems is a vigorously pursued research goal. In this article, we provide a modeling and analysis environment for the design of such system. Our tool offers simulation and verification to facilitate native reasoning about the domain concepts of such systems. We present our tool named R-CHECK. R-CHECK supports a high-level input language with matching enumerative and symbolic semantics, and provides a modelling convenience for features such as reconfiguration, coalition formation, self-organisation, etc. For analysis, users can simulate the designed system and explore arising traces. Our included model checker permits reasoning about interaction protocols and joint missions.
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7. |
- Abdelhak, Ahmed, et al.
(author)
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Prognostic performance of blood neurofilament light chain protein in hospitalized COVID-19 patients without major central nervous system manifestations: an individual participant data meta-analysis.
- 2023
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In: Journal of neurology. - : Springer. - 1432-1459 .- 0340-5354. ; 270:7, s. 3315-3328
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Journal article (peer-reviewed)abstract
- To investigate the prognostic value of blood neurofilament light chain protein (NfL) levels in the acute phase of coronavirus disease 2019 (COVID-19).We conducted an individual participant data (IPD) meta-analysis after screening on MEDLINE and Scopus to May 23rd2022. We included studies with hospitalized adult COVID-19 patients without major COVID-19-associated central nervous system (CNS) manifestations and with a measurement of blood NfL in the acute phase as well as data regarding at least one clinical outcome including intensive care unit (ICU)admission, need of mechanical ventilation (MV) and death. We derived the age-adjusted measures NfL Z scores and conducted mixed-effects modelling to test associations between NfL Z scores and other variables, encompassing clinical outcomes. Summary receiver operating characteristic curves (SROCs) were used to calculate the area under the curve (AUC) for blood NfL.We identified 382 records, of which 7 studies were included with a total of 669 hospitalized COVID-19 cases (mean age 66.2±15.0years, 68.1% males). Median NfL Z score at admission was elevated compared to the age-corrected reference population (2.37, IQR: 1.13-3.06, referring to 99th percentile in healthy controls). NfL Z scores were significantly associated with disease duration and severity. Higher NfL Z scores were associated with ahigher likelihood of ICU admission, need ofMV, and death. SROCs revealed AUCs of 0.74, 0.80 and 0.71 for mortality, need ofMV and ICU admission, respectively.Blood NfL levels were elevated in the acute phase of COVID-19 patients without major CNS manifestations and associated with clinical severity and poor outcome. The marker might ameliorate the performance of prognostic multivariable algorithms in COVID-19.
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- Abdin, A., et al.
(author)
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Efficacy of ivabradine in heart failure patients with a high-risk profile (analysis from the SHIFT trial)
- 2023
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In: Esc Heart Failure. - 2055-5822. ; 10:5, s. 2895-2902
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Journal article (peer-reviewed)abstract
- AimsEarly start and patient profile-oriented heart failure (HF) management has been recommended. In this post hoc analysis from the SHIFT trial, we analysed the treatment effects of ivabradine in HF patients with systolic blood pressure (SBP) < 110 mmHg, resting heart rate (RHR) & GE; 75 b.p.m., left ventricular ejection fraction (LVEF) & LE; 25%, New York Heart Association (NYHA) Class III/IV, and their combination. Methods and resultsThe SHIFT trial enrolled 6505 patients (LVEF & LE; 35% and RHR & GE; 70 b.p.m.), randomized to ivabradine or placebo on the background of guideline-defined standard care. Compared with placebo, ivabradine was associated with a similar relative risk reduction of the primary endpoint (cardiovascular death or HF hospitalization) in patients with SBP < 110 and & GE;110 mmHg [hazard ratio (HR) 0.89, 95% confidence interval (CI) 0.74-1.08 vs. HR 0.80, 95% CI 0.72-0.89, P interaction = 0.34], LVEF & LE; 25% and >25% (HR 0.85, 95% CI 0.72-1.01 vs. HR 0.80, 95% CI 0.71-0.90, P interaction = 0.53), and NYHA III-IV and II (HR 0.83, 95% CI 0.74-0.94 vs. HR 0.81, 95% CI 0.69-0.94, P interaction = 0.79). The effect was more pronounced in patients with RHR & GE; 75 compared with <75 (HR 0.76, 95% CI 0.68-0.85 vs. HR 0.97, 95% CI 0.81-0.1.16, P interaction = 0.02). When combining these profiling parameters, treatment with ivabradine was also associated with risk reductions comparable with patients with low-risk profiles for the primary endpoint (relative risk reduction 29%), cardiovascular death (11%), HF death (49%), and HF hospitalization (38%; all P values for interaction: 0.40). No safety concerns were observed between study groups. ConclusionsOur analysis shows that RHR reduction with ivabradine is effective and improves clinical outcomes in HF patients across various risk indicators such as low SBP, high RHR, low LVEF, and high NYHA class to a similar extent and without safety concern.
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10. |
- Abe, C., et al.
(author)
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Mania-related effects on structural brain changes in bipolar disorder - a narrative review of the evidence
- 2023
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In: Molecular Psychiatry. - 1359-4184. ; 28:57, s. 2674-2682
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Journal article (peer-reviewed)abstract
- Cross-sectional neuroimaging studies show that bipolar disorder is associated with structural brain abnormalities, predominantly observed in prefrontal and temporal cortex, cingulate gyrus, and subcortical regions. However, longitudinal studies are needed to elucidate whether these abnormalities presage disease onset or are consequences of disease processes, and to identify potential contributing factors. Here, we narratively review and summarize longitudinal structural magnetic resonance imaging studies that relate imaging outcomes to manic episodes. First, we conclude that longitudinal brain imaging studies suggest an association of bipolar disorder with aberrant brain changes, including both deviant decreases and increases in morphometric measures. Second, we conclude that manic episodes have been related to accelerated cortical volume and thickness decreases, with the most consistent findings occurring in prefrontal brain areas. Importantly, evidence also suggests that in contrast to healthy controls, who in general show age-related cortical decline, brain metrics remain stable or increase during euthymic periods in bipolar disorder patients, potentially reflecting structural recovering mechanisms. The findings stress the importance of preventing manic episodes. We further propose a model of prefrontal cortical trajectories in relation to the occurrence of manic episodes. Finally, we discuss potential mechanisms at play, remaining limitations, and future directions.
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