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Svensson J, Peolsson A, Hermansen A, Cross JJ, Abbott A, Cleland JA, Kierkegaard M, Halvorsen M, Dedering Å. The effect of neck-specific exercise and prescribed physical activity on headache and dizziness in individuals with cervical radiculopathy: Further analyses of a randomized study with a 1-year follow-up. Physiother Theory Pract 2024; 40:714-726. [PMID: 36594595 DOI: 10.1080/09593985.2022.2158697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 12/05/2022] [Accepted: 12/05/2022] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To evaluate the effect of neck-specific exercise (NSE) compared to prescribed physical activity (PPA) on headache and dizziness in individuals with cervical radiculopathy (CR). Also, to investigate associations between headache or dizziness and pain, neck muscle endurance (NME), neck mobility, physical activity, and fear avoidance beliefs. METHODS Individuals randomized to either NSE or PPA were selected to a headache subgroup (n = 59) and/or a dizziness subgroup (n = 73). Data were evaluated, according to headache and/or dizziness outcomes at baseline and at 3, 6, and 12-month follow-ups. RESULTS No significant between-group differences were found between NSE and PPA in either subgroup. In the headache subgroup, significant within-group improvements were seen at all follow-ups for NSE (p < .001) and from baseline to 3 (p = .037) and 12 (p = .003) months for PPA. For dizziness, significant within-group improvements were seen from baseline to 3 months for NSE (p = .021) and from baseline to 3 (p = .001) and 6 (p = .044) months for PPA. Multiple regression models showed significant associations at baseline between headache intensity and neck pain (adjusted R-square = 0.35, p < .001), and for dizziness with neck pain and dorsal NME (adjusted R-square = 0.34, p < .001). CONCLUSION NSE and PPA show similar improvements in headache intensity and dizziness in individuals with CR. Headache intensity is associated with neck pain, and dizziness with neck pain and dorsal NME, highlighting the importance of these factors when evaluating headache and dizziness.
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Affiliation(s)
- Jard Svensson
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Campus US, Linköping, Sweden
- Department of Neurosurgery, Linköping University Hospital, Region Östergötland, Linköping, Sweden
| | - Anneli Peolsson
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Campus US, Linköping, Sweden
- Occupational and Environmental Medicine Center, Department of Health, Medicine and Caring Sciences, Unit of Clinical Medicine, Linköping University, Campus US, Linköping, Sweden
| | - Anna Hermansen
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Campus US, Linköping, Sweden
| | - Jeremy J Cross
- Doctor or Physiotherapy Program, Bond Institute of Health and Sport, Bond University, Robina, Australia
| | - Allan Abbott
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Campus US, Linköping, Sweden
- Department of Orthopaedics, Linköping University Hospital, Region Östergötland, Linköping, Sweden
| | - Joshua A Cleland
- Doctor of Physical Therapy Program, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Marie Kierkegaard
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden
- Academic Specialist Center, Stockholm Health Services, Region Stockholm, Stockholm, Sweden
| | - Marie Halvorsen
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden
- Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physiotherapy Karolinska University Hospital, Stockholm, Sweden
| | - Åsa Dedering
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden
- The Health and Medical Care Administration, Region Dalarna, Falun, Sweden
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Svensson J, Ibfelt EH, Carstensen B, Neu A, Cinek O, Skrivarhaug T, Rami-Merhar B, Feltbower RG, Castell C, Konrad D, Gillespie K, Jarosz-Chobot P, Marčiulionytė D, Rosenbauer J, Bratina N, Ionescu-Tirgoviste C, Gorus F, Kocova M, de Beaufort C, Patterson CC. Age-period-cohort modelling of type 1 diabetes incidence rates among children included in the EURODIAB 25-year follow-up study. Acta Diabetol 2023; 60:73-82. [PMID: 36205797 DOI: 10.1007/s00592-022-01977-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/15/2022] [Indexed: 01/07/2023]
Abstract
AIMS Specific patterns in incidence may reveal environmental explanations for type 1 diabetes incidence. We aimed to study type 1 diabetes incidence in European childhood populations to assess whether an increase could be attributed to either period or cohort effects. METHODS Nineteen EURODIAB centres provided single year incidence data for ages 0-14 in the 25-year period 1989-2013. Case counts and person years were classified by age, period and cohort (APC) in 1-year classes. APC Poisson regression models of rates were fitted using restricted cubic splines for age, period and cohort per centre and sex. Joint models were fitted for all centres and sexes, to find a parsimonious model. RESULTS A total of 57,487 cases were included. In ten and seven of the 19 centres the APC models showed evidence of nonlinear cohort effects or period effects, respectively, in one or both sexes and indications of sex-specific age effects. Models showed a positive linear increase ranging from approximately 0.6 to 6.6%/year. Centres with low incidence rates showed the highest overall increase. A final joint model showed incidence peak at age 11.6 and 12.6 for girls and boys, respectively, and the rate-ratio was according to sex below 1 in ages 5-12. CONCLUSION There was reasonable evidence for similar age-specific type 1 diabetes incidence rates across the EURODIAB population and peaks at a younger age for girls than boys. Cohort effects showed nonlinearity but varied between centres and the model did not contribute convincingly to identification of environmental causes of the increase.
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Affiliation(s)
- J Svensson
- Diabetes Technology Research, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730, Herlev, Denmark.
- Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark.
| | - E H Ibfelt
- Clinical Epidemiology Research, Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - B Carstensen
- Clinical Epidemiology Research, Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - A Neu
- University Children´S Hospital, Tübingen, Germany
| | - O Cinek
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czechia
| | - T Skrivarhaug
- Division of Adolescent and Paediatric Medicine, Institute of Clinical Medicine, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - B Rami-Merhar
- Department of Pediatric and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - R G Feltbower
- Leeds Institute for Data Analytics, School of Medicine, University of Leeds, Leeds, UK
| | - C Castell
- Department of Health, Government of Catalonia, Barcelona, Spain
| | - D Konrad
- Division of Paediatric Endocrinology and Diabetology and Children's Research Center, University Children's Hospital, University of Zurich, Zurich, Switzerland
| | - K Gillespie
- Diabetes and Metabolism, Bristol Medical School, University of Bristol, Bristol, UK
| | - P Jarosz-Chobot
- Department of Children's Diabetology, Medical University of Silesia, Katowice, Poland
| | - D Marčiulionytė
- Institute of Endocrinology, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Institute of Microbiology and Virology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - J Rosenbauer
- German Diabetes Center, Institute of Biometrics and Epidemiology, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - N Bratina
- Diabetes & Metabolic Diseases, Department of Endocrinology, University Children's Hospital, Ljubljana, Slovenia
| | - C Ionescu-Tirgoviste
- National Institute of Diabetes Nutrition and Metabolic Diseases, NC Paulescu, Bucharest, Romania
| | - F Gorus
- Diabetes Research Center, Brussels Free University - Vrije Universiteit Brussel, Brussels, Belgium
| | - M Kocova
- Department of Endocrinology and Genetics, University Children's Hospital, Skopje, North Macedonia
| | - C de Beaufort
- Department of Paediatric Diabetes and Endocrinology, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - C C Patterson
- Centre for Public Health, Queen's University Belfast, Belfast, UK
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Orsini S, Milillo A, Lichtenegger H, Varsani A, Barabash S, Livi S, De Angelis E, Alberti T, Laky G, Nilsson H, Phillips M, Aronica A, Kallio E, Wurz P, Olivieri A, Plainaki C, Slavin JA, Dandouras I, Raines JM, Benkhoff J, Zender J, Berthelier JJ, Dosa M, Ho GC, Killen RM, McKenna-Lawlor S, Torkar K, Vaisberg O, Allegrini F, Daglis IA, Dong C, Escoubet CP, Fatemi S, Fränz M, Ivanovski S, Krupp N, Lammer H, Leblanc F, Mangano V, Mura A, Rispoli R, Sarantos M, Smith HT, Wieser M, Camozzi F, Di Lellis AM, Fremuth G, Giner F, Gurnee R, Hayes J, Jeszenszky H, Trantham B, Balaz J, Baumjohann W, Cantatore M, Delcourt D, Delva M, Desai M, Fischer H, Galli A, Grande M, Holmström M, Horvath I, Hsieh KC, Jarvinen R, Johnson RE, Kazakov A, Kecskemety K, Krüger H, Kürbisch C, Leblanc F, Leichtfried M, Mangraviti E, Massetti S, Moissenko D, Moroni M, Noschese R, Nuccilli F, Paschalidis N, Ryno J, Seki K, Shestakov A, Shuvalov S, Sordini R, Stenbeck F, Svensson J, Szalai S, Szego K, Toublanc D, Vertolli N, Wallner R, Vorburger A. Inner southern magnetosphere observation of Mercury via SERENA ion sensors in BepiColombo mission. Nat Commun 2022; 13:7390. [PMID: 36450728 PMCID: PMC9712576 DOI: 10.1038/s41467-022-34988-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 11/14/2022] [Indexed: 12/03/2022] Open
Abstract
Mercury's southern inner magnetosphere is an unexplored region as it was not observed by earlier space missions. In October 2021, BepiColombo mission has passed through this region during its first Mercury flyby. Here, we describe the observations of SERENA ion sensors nearby and inside Mercury's magnetosphere. An intermittent high-energy signal, possibly due to an interplanetary magnetic flux rope, has been observed downstream Mercury, together with low energy solar wind. Low energy ions, possibly due to satellite outgassing, were detected outside the magnetosphere. The dayside magnetopause and bow-shock crossing were much closer to the planet than expected, signature of a highly eroded magnetosphere. Different ion populations have been observed inside the magnetosphere, like low latitude boundary layer at magnetopause inbound and partial ring current at dawn close to the planet. These observations are important for understanding the weak magnetosphere behavior so close to the Sun, revealing details never reached before.
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Affiliation(s)
- S Orsini
- Institute of Space Astrophysics and Planetology, INAF, Roma, Italy.
| | - A Milillo
- Institute of Space Astrophysics and Planetology, INAF, Roma, Italy
| | - H Lichtenegger
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - A Varsani
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - S Barabash
- Swedish Institute of Space Physics, Kiruna, Sweden
| | - S Livi
- Southwest Research Institute, San Antonio, TX, USA
- University of Michigan, Department of Climate and Space Sciences and Engineering, Ann Arbor, MI, USA
| | - E De Angelis
- Institute of Space Astrophysics and Planetology, INAF, Roma, Italy
| | - T Alberti
- Institute of Space Astrophysics and Planetology, INAF, Roma, Italy
| | - G Laky
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - H Nilsson
- Swedish Institute of Space Physics, Kiruna, Sweden
| | - M Phillips
- Southwest Research Institute, San Antonio, TX, USA
| | - A Aronica
- Institute of Space Astrophysics and Planetology, INAF, Roma, Italy
| | - E Kallio
- Aalto University, Department of Electronics and Nanoengineering, School of Electrical Engineering, Helsinki, Finland
| | - P Wurz
- University of Bern, Institute of Physics, Bern, Switzerland
| | | | | | - J A Slavin
- University of Michigan, Department of Climate and Space Sciences and Engineering, Ann Arbor, MI, USA
| | - I Dandouras
- Institut de Recherche en Astrophysique et Planétologie, CNRS, CNES, Université de Toulouse, Toulouse, France
| | - J M Raines
- University of Michigan, Department of Climate and Space Sciences and Engineering, Ann Arbor, MI, USA
| | | | - J Zender
- ESA-ESTEC, Noordwijk, The Netherlands
| | | | - M Dosa
- Wigner Research Centre for Physics, Budapest, Hungary
| | - G C Ho
- The Johns Hopkins University Applied Physics Laboratory, Laurel, MD, 20723, USA
| | - R M Killen
- NASA/Goddard Space Flight Center, Greenbelt, MD, 20771, USA
| | | | - K Torkar
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - O Vaisberg
- IKI Space Research Institute, Moscow, Russia
| | - F Allegrini
- Southwest Research Institute, San Antonio, TX, USA
- University of Texas at San Antonio, Department of Physics and Astronomy, San Antonio, TX, USA
| | - I A Daglis
- National and Kapodistrian University of Athens, Department of Physics, Athens, Greece
- Hellenic Space Center, Athens, Greece
| | - C Dong
- Princeton Plasma Physics Laboratory and Department of Astrophysical Sciences, Princeton University, Princeton, NJ, USA
| | | | - S Fatemi
- Department of Physics, Umeå University, Umeå, Sweden
| | - M Fränz
- Max-Planck-Institut für Sonnensystemforschung, MPS, 37077, Göttingen, Germany
| | - S Ivanovski
- Astronomincal Observatory, INAF, Trieste, Italy
| | - N Krupp
- Max-Planck-Institut für Sonnensystemforschung, MPS, 37077, Göttingen, Germany
| | - H Lammer
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | | | - V Mangano
- Institute of Space Astrophysics and Planetology, INAF, Roma, Italy
| | - A Mura
- Institute of Space Astrophysics and Planetology, INAF, Roma, Italy
| | - R Rispoli
- Institute of Space Astrophysics and Planetology, INAF, Roma, Italy
| | - M Sarantos
- NASA/Goddard Space Flight Center, Greenbelt, MD, 20771, USA
| | - H T Smith
- The Johns Hopkins University Applied Physics Laboratory, Laurel, MD, 20723, USA
| | - M Wieser
- Swedish Institute of Space Physics, Kiruna, Sweden
| | | | | | - G Fremuth
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - F Giner
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - R Gurnee
- Laboratory for Atmospheric and Space Physics, Boulder, CO, USA
| | - J Hayes
- The Johns Hopkins University Applied Physics Laboratory, Laurel, MD, 20723, USA
| | - H Jeszenszky
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - B Trantham
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - J Balaz
- Institute of Experimental Physics SAS, Slovak Academy of Sciences, 040 01, Košice, Slovakia
| | - W Baumjohann
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | | | | | - M Delva
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - M Desai
- Southwest Research Institute, San Antonio, TX, USA
| | - H Fischer
- Max-Planck-Institut für Sonnensystemforschung, MPS, 37077, Göttingen, Germany
| | - A Galli
- University of Bern, Institute of Physics, Bern, Switzerland
| | - M Grande
- Aberystwyth University, Aberystwyth, Ceredigion, UK
| | - M Holmström
- Swedish Institute of Space Physics, Kiruna, Sweden
| | - I Horvath
- Wigner Research Centre for Physics, Budapest, Hungary
| | - K C Hsieh
- University of Arizona, Tucson, AZ, USA
| | - R Jarvinen
- Aalto University, Department of Electronics and Nanoengineering, School of Electrical Engineering, Helsinki, Finland
- Finnish Meteorological Institute FMI, Helsinki, Finland
| | - R E Johnson
- University of Virginia, Charlottesville, VA, 22904, USA
| | - A Kazakov
- Institute of Space Astrophysics and Planetology, INAF, Roma, Italy
| | - K Kecskemety
- Wigner Research Centre for Physics, Budapest, Hungary
| | - H Krüger
- Max-Planck-Institut für Sonnensystemforschung, MPS, 37077, Göttingen, Germany
| | - C Kürbisch
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | | | - M Leichtfried
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | | | - S Massetti
- Institute of Space Astrophysics and Planetology, INAF, Roma, Italy
| | - D Moissenko
- IKI Space Research Institute, Moscow, Russia
| | - M Moroni
- Institute of Space Astrophysics and Planetology, INAF, Roma, Italy
| | - R Noschese
- Institute of Space Astrophysics and Planetology, INAF, Roma, Italy
| | - F Nuccilli
- Institute of Space Astrophysics and Planetology, INAF, Roma, Italy
| | - N Paschalidis
- NASA/Goddard Space Flight Center, Greenbelt, MD, 20771, USA
| | - J Ryno
- Finnish Meteorological Institute FMI, Helsinki, Finland
| | - K Seki
- University of Tokyo, Department of Earth and Planetary Science, Graduate School of Science, Tokyo, Japan
| | - A Shestakov
- IKI Space Research Institute, Moscow, Russia
| | - S Shuvalov
- IKI Space Research Institute, Moscow, Russia
| | - R Sordini
- Institute of Space Astrophysics and Planetology, INAF, Roma, Italy
| | - F Stenbeck
- Swedish Institute of Space Physics, Kiruna, Sweden
| | - J Svensson
- Swedish Institute of Space Physics, Kiruna, Sweden
| | - S Szalai
- Wigner Research Centre for Physics, Budapest, Hungary
| | - K Szego
- Wigner Research Centre for Physics, Budapest, Hungary
| | - D Toublanc
- Institut de Recherche en Astrophysique et Planétologie, CNRS, CNES, Université de Toulouse, Toulouse, France
| | - N Vertolli
- Institute of Space Astrophysics and Planetology, INAF, Roma, Italy
| | - R Wallner
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - A Vorburger
- University of Bern, Institute of Physics, Bern, Switzerland
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Flom E, Krychowiak M, Schmitz O, König R, Barbui T, Henke F, Jakubowski M, Kwak S, Loch S, Muñoz Burgos J, Svensson J. Bayesian modeling of collisional-radiative models applicable to thermal helium beam plasma diagnostics. Nuclear Materials and Energy 2022. [DOI: 10.1016/j.nme.2022.101269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Sorbye H, Knappskog S, Grob T, Venizelos A, Amstutz U, Hjortland G, Lothe I, Kersten C, Hofsli E, Sundlov A, Elvebakken H, Garresori H, Couvelard A, Svensson J, Perren A. 890MO Mutation spectrum in liquid versus solid biopsies from advanced digestive neuroendocrine carcinoma patients. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Einarsson E, Pierantoni M, Novak V, Svensson J, Isaksson H, Englund M. Phase-contrast enhanced synchrotron micro-tomography of human meniscus tissue. Osteoarthritis Cartilage 2022; 30:1222-1233. [PMID: 35750240 DOI: 10.1016/j.joca.2022.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/27/2022] [Accepted: 06/13/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the feasibility of synchrotron radiation-based phase contrast enhanced micro-computed tomography (SR-PhC-μCT) for imaging of human meniscus. Quantitative parameters related to fiber orientation and crimping were evaluated as potential markers of tissue degeneration. DESIGN Human meniscus specimens from 10 deceased donors were prepared using different preparation schemes: fresh frozen and thawed before imaging or fixed and paraffin-embedded. The samples were imaged using SR-PhC-μCT with an isotropic voxel size of 1.625 μm. Image quality was evaluated by visual inspection and spatial resolution. Fiber voxels were defined using a grey level threshold and a structure tensor analysis was applied to estimate collagen fiber orientation. The area at half maximum (FAHM) was calculated from angle histograms to quantify orientation distribution. Crimping period was calculated from the power spectrum of image profiles of crimped fibers. Parameters were compared to degenerative stage as evaluated by Pauli histopathological scoring. RESULTS Image quality was similar between frozen and embedded samples and spatial resolutions ranged from 5.1 to 5.8 μm. Fiber structure, including crimping, was clearly visible in the images. Fibers appeared to be less organized closer to the tip of the meniscus. Fiber density might decrease slightly with degeneration. FAHM and crimping period did not show any clear association with histopathological scoring. CONCLUSION SR-PhC-μCT is a feasible technique for high-resolution 3D imaging of fresh frozen meniscus tissue. Further work is needed to establish quantitative parameters that relate to tissue degeneration, but this imaging technique is promising for future studies of meniscus structure and biomechanical response.
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Affiliation(s)
- E Einarsson
- Medical Radiation Physics, Department of Translational Medicine, Lund University, Malmö, Sweden; Clinical Epidemiology Unit, Orthopedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
| | - M Pierantoni
- Department of Biomedical Engineering, Lund University, Lund, Sweden
| | - V Novak
- Swiss Light Source, Paul Scherrer Institute, Villigen, Switzerland
| | - J Svensson
- Medical Radiation Physics, Department of Translational Medicine, Lund University, Malmö, Sweden; Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
| | - H Isaksson
- Department of Biomedical Engineering, Lund University, Lund, Sweden
| | - M Englund
- Clinical Epidemiology Unit, Orthopedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
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Ivic R, Vicente V, Kurland L, Svensson J, Sahdev Klintemård R, Castrén M, Bohm K. Pre-hospital emergency nurse specialist's experiences in caring for patients with non-specific chief complaints in the ambulance - A qualitative interview study. Int Emerg Nurs 2022; 63:101178. [PMID: 35738055 DOI: 10.1016/j.ienj.2022.101178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 04/05/2022] [Accepted: 05/04/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Pre-hospital emergency nurse (PEN) specialists are faced with patients presenting with non-specific chief complaints (NSC) to the emergency medical service (EMS) on a daily basis. These patients are often elderly and one in three has a serious condition and their acuity is not recognized. OBJECTIVE The aim of the current study was to explore PEN specialists' experiences in caring for patients presenting with non-specific chief complaints. DESIGN A qualitative study design with eleven individual interviews of PENs, between 2018 and 2020. Qualitative content analysis was used. RESULTS The analyses generated three categories including subcategories. The categories were "Unexplained suffering". "Systematic approach and experience enhances medical safety". "Organizational processes can be optimized". The relation between the categories compiled as ́In-depth systematic assessment is perceived to reduce suffering and increases patient safetý. CONCLUSION The PENs experiences in caring for patients presenting with non-specific chief complaints show that an in-depth systematic assessment may lead to a meaningful caring encounter which enables the identification of the cause of the chief complaint. Experience and a systematic approach were considered as essential to enhance medical safety. This could be strengthened through feedback on the nurse's care provided by care managers and employers. To optimize organizational processes, the development of the opportunity to convey the patient to different levels of care can be an important component.
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Affiliation(s)
- R Ivic
- Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden; Academic Emergency Medical Service, Region Stockholm, Stockholm, Sweden.
| | - V Vicente
- Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden.
| | - L Kurland
- Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden; Örebro University, Department for Medical Sciences, Örebro, Sweden.
| | | | | | - M Castrén
- Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden; Emergency Medicine, Helsinki University and Department of Emergency Medicine and Services, Helsinki University Hospital, Helsinki, Finland.
| | - K Bohm
- Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden; Department of Emergency Medicine, Södersjukhuset, Stockholm, Sweden.
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Svensson J, Ohlsson C, Karlsson MK, Lorentzon M, Lewerin C, Mellström D. Subclinical hyperthyroidism is associated with increased risk of vertebral fractures in older men. Osteoporos Int 2021; 32:2257-2265. [PMID: 34013460 PMCID: PMC8563553 DOI: 10.1007/s00198-021-05964-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 04/14/2021] [Indexed: 11/30/2022]
Abstract
UNLABELLED In elderly men included in MrOS-Sweden, subclinical hyperthyroidism (SHyper) was markedly associated with increased risk of vertebral fractures. INTRODUCTION Overt hyperthyroidism is associated with increased risk of fractures. However, only a few studies have investigated whether SHyper is associated with fracture risk in elderly men. We therefore investigated if SHyper was a risk factor for fractures in Swedish men. METHODS We followed (median 9.8 years) elderly men (n = 1856; mean age 75, range 69-81 years) participating in the Gothenburg and Malmö subcohorts of the prospective, population-based MrOS-Sweden study. The statistical analyses included Cox proportional hazards regression. SHyper was defined as serum thyroid-stimulating hormone (TSH) < 0.45 mIU/L (n = 38). RESULTS SHyper was associated with increased risk of all fractures [n = 456; hazard ratio (HR) adjusted for age, study center, and levothyroxine treatment = 1.99, 95% confidence interval (CI): 1.20-3.32], major osteoporotic fractures (MOF, n = 338; HR 2.44, 95% CI: 1.42-4.21), and vertebral fractures (n = 176; HR 3.79, 95% CI: 2.02-7.11). These associations remained after full adjustment for covariates including total hip bone mineral density and in subanalyses including only men with serum free thyroxine ≤ the upper normal limit. However, after exclusion of men receiving levothyroxine treatment, the associations with all fractures and MOF lost significance. CONCLUSIONS In elderly Swedish men, there was a strong association between SHyper and increased risk of vertebral fractures, whereas the associations with all incident fractures and MOF need to be confirmed in further studies.
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Affiliation(s)
- J Svensson
- Center for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Department of Internal Medicine, Region Västra Götaland, Skaraborg Central Hospital, Skövde, Sweden.
- Department of Internal Medicine, Sahlgrenska University Hospital, Gröna Stråket 8, SE-413 45, Gothenburg, Sweden.
| | - C Ohlsson
- Center for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Drug Treatment, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - M K Karlsson
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences and Orthopedics, Lund University, Malmö, Sweden
| | - M Lorentzon
- Center for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - C Lewerin
- Department of Hematology and Coagulation, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - D Mellström
- Center for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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9
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Wahlström J, Magnusson C, Brolin Låftman S, Svensson J. Parental alcohol use and self-reported health among Swedish adolescents aged 10-18 years. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Including harm that is inflicted upon the drinker's social environment is vital when calculating the cost of harmful alcohol use to society. Knowledge about the true damage of alcohol is important in order to implement adequate public health responses. Research on children of alcoholics has demonstrated that parental alcohol misuse may affect offspring negatively in several ways. Studies on the general youth population have found that parental drinking is associated with offspring alcohol use. However, the links to offspring health are less explored. The aim of the study was to examine the associations between parental drinking and children's psychological complaints, somatic complaints, and perceived stress.
Methods
Data were obtained from the nationally representative Swedish Level-of Living survey of 2010. Parents and children (aged 10-18) living together completed surveys independently. The study sample consisted of 905 children, with information from at least one parent, in 627 households. Children's self-reports of psychological complaints, somatic complaints, and perceived stress were coded into binary measures and used as dependent variables. Based on self-reports of frequency and quantity of alcohol use, parents were categorised into abstainers, low consumers, moderate drinkers, and heavy drinkers. Gender, family structure, and parent-reported socioeconomic conditions were included as control variables. Binary logistic regression analyses were performed.
Results
In the fully adjusted models, children with heavy drinking parents were more likely to report psychological complaints (OR 2.52, p < 0.01), somatic complaints (OR 1.96, p < 0.01), and feeling stressed (OR 1.68, p < 0.05), compared to children whose parents were classified as moderate drinkers.
Conclusions
The study showed that children living with heavy drinking parents were more likely to report adverse health. Implementing policies that aim to protect these children may be beneficial.
Key messages
Children living with heavy drinking parents were more likely to report psychological complaints, somatic complaints, and perceived stress. Living with heavy drinking parents may affect children’s health negatively, and measures to mitigate the harms these children experience ought to be considered.
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Affiliation(s)
- J Wahlström
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - C Magnusson
- Swedish Institute for Social Research, Stockholm University, Stockholm, Sweden
| | - S Brolin Låftman
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - J Svensson
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
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10
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Brolin Låftman S, Magnusson C, Olsson G, Svensson J, Wahlström J, Modin B. Problematic alcohol use in the family and adolescents’ stress-related complaints. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
A non-negligible proportion of children grow up in families where problematic alcohol use is present. From a resilience perspective and for the implementation of effective interventions, it is relevant to examine to what extent favourable conditions in other contexts may buffer against such family adversities. The aim of the current study was to examine the relationship between problematic familial alcohol use and offspring stress-related complaints. Another aim was to explore whether teacher ratings of the school's degree of student focus can buffer against negative health consequences of problem drinking at home.
Methods
Data were drawn from four cross-sectional surveys conducted in 2014 and in 2016 among 8,728 students (∼15-16 years) and 2,024 teachers in 147 Stockholm senior-level school units, with linked school-level register information. Stress-related complaints were measured from students' reports on the weekly co-occurrence of stomach-ache and headache. Teachers' ratings of the school's student focus were measured by an index based on four items which was aggregated to the school level. Student-level sociodemographic characteristics were included as control variables along with the schools' composition and student-teacher ratio. Two-level binary logistic regression analyses were performed.
Results
Problematic familial alcohol use was associated with an increased likelihood of stress-related complaints among students (OR 1.74, 95% CI 1.44-2.10). The cross-level interaction revealed that this association was weaker among students in schools with higher levels of student focus.
Conclusions
The study showed that the association between problematic familial alcohol use and students' stress-related complaints was less pronounced in schools with higher teacher ratings of student focus. This finding indicates that favourable conditions in schools can buffer against problematic conditions in the family, thus serving a compensatory role.
Key messages
Students reporting problematic familial alcohol use were more likely to suffer from stress-related complaints. High teacher ratings of the school’s student focus buffered against the association between problematic familial alcohol use and stress-related complaints.
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Affiliation(s)
- S Brolin Låftman
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - C Magnusson
- Swedish Institute for Social Research, Stockholm University, Stockholm, Sweden
| | - G Olsson
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - J Svensson
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - J Wahlström
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - B Modin
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
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11
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Beidler CD, Smith HM, Alonso A, Andreeva T, Baldzuhn J, Beurskens MNA, Borchardt M, Bozhenkov SA, Brunner KJ, Damm H, Drevlak M, Ford OP, Fuchert G, Geiger J, Helander P, Hergenhahn U, Hirsch M, Höfel U, Kazakov YO, Kleiber R, Krychowiak M, Kwak S, Langenberg A, Laqua HP, Neuner U, Pablant NA, Pasch E, Pavone A, Pedersen TS, Rahbarnia K, Schilling J, Scott ER, Stange T, Svensson J, Thomsen H, Turkin Y, Warmer F, Wolf RC, Zhang D. Publisher Correction: Demonstration of reduced neoclassical energy transport in Wendelstein 7-X. Nature 2021; 598:E5. [PMID: 34642470 PMCID: PMC8550957 DOI: 10.1038/s41586-021-04023-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- C D Beidler
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany.
| | - H M Smith
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - A Alonso
- Laboratorio Nacional de Fusion, CIEMAT, Madrid, Spain
| | - T Andreeva
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - J Baldzuhn
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | | | - M Borchardt
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - S A Bozhenkov
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - K J Brunner
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - H Damm
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - M Drevlak
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - O P Ford
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - G Fuchert
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - J Geiger
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - P Helander
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - U Hergenhahn
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany.,Fritz-Haber-Institut der Max-Planck-Gesellschaft, Berlin, Germany
| | - M Hirsch
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - U Höfel
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - Ye O Kazakov
- Laboratory for Plasma Physics (LPP), École royale militaire/Koninklijke Militaire School (ERM/KMS), Brussels, Belgium
| | - R Kleiber
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - M Krychowiak
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - S Kwak
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - A Langenberg
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - H P Laqua
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - U Neuner
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - N A Pablant
- Princeton Plasma Physics Laboratory, Princeton, NJ, USA
| | - E Pasch
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - A Pavone
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - T S Pedersen
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - K Rahbarnia
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - J Schilling
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - E R Scott
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - T Stange
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - J Svensson
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - H Thomsen
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - Y Turkin
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - F Warmer
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - R C Wolf
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - D Zhang
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
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12
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Rydén T, Emma W, Van Essen M, Svensson J, Bernhardt P. IMPROVEMENTS OF 111IN SPECT IMAGES RECONSTRUCTED WITH SPARSELY ACQUIRED PROJECTIONS BY DEEP LEARNING GENERATED SYNTHETIC PROJECTIONS. Radiat Prot Dosimetry 2021; 195:152-157. [PMID: 33885130 PMCID: PMC8507466 DOI: 10.1093/rpd/ncab056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 03/16/2021] [Accepted: 03/19/2021] [Indexed: 06/03/2023]
Abstract
The aim was to improve single-photon emission computed tomography (SPECT) quality for sparsely acquired 111In projections by adding deep learning generated synthetic intermediate projections (SIPs). Method: The recently constructed deep convolutional network for generating synthetic intermediate projections (CUSIP) was used for improving 20 sparsely acquired 111In-octreotide SPECTs. Reconstruction was performed with 120 (120P) or 30 (30P) projections, or 120 projections with 90 SIPs generated from 30 projections (30-120SIP). The SPECT reconstructions were performed with attenuation, scatter and collimator response corrections. Postfiltered 30P reconstructed SPECT was also analyzed. Image quality were quantitatively evaluated with root-mean-square error, peak signal-to-noise ratio and structural similarity index metrics. Result: The 30-120SIP reconstructed SPECT had statistically significant improved image quality parameters compared to 30P reconstructed SPECT with and without post filtering. The images visual appearance was similar to slightly filtered 120P SPECTs. Thereby, substantial acquisition time reduction with SIPs seems possible without image quality degradation.
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Affiliation(s)
- T Rydén
- Department of Medical Physics and Bioengineering, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
| | - W Emma
- Department of Medical Physics and Bioengineering, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
| | - M Van Essen
- Department of Clinical Physiology, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
| | - J Svensson
- Department of Oncology, Institution of Clinical Science, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden
| | - P Bernhardt
- Department of Medical Physics and Bioengineering, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
- Department of Medical Radiation Sciences, Institution of Clinical Science, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden
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13
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Tenninge S, Mogos H, Eriksson E, Netterling H, Pelander S, Johansson M, Alamdari F, Huge Y, Aljabery F, Svensson J, Styrke J, Sherif A. Control computerized tomography in neoadjuvant chemotherapy for muscle invasive urinary bladder cancer, has no value for treatment decisions and low correlation with nodal status. Scand J Urol 2021; 55:455-460. [PMID: 34590930 DOI: 10.1080/21681805.2021.1981996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Control computerized tomography (cCT) is routinely used in many cystectomy centres before the final treatment cycle in patients with muscle-invasive urinary bladder cancer (MIBC) undergoing neoadjuvant chemotherapy (NAC). This is for evaluating response or nonresponse to NAC treatment. In a real-world retrospective cohort, we intended to evaluate the frequency of changed individual treatment strategies following cCT and to investigate any discrepancies between cCT-results on nodal staging and final pN-stages. METHODS We performed a retrospective data-based, multicenter study of 242 MIBC-patients, staged cT2N0M0-cT4aN0M0, having undergone NAC and radical cystectomy (RC) between 2008 and 2019 at four Swedish cystectomy centres. Statistical analysis was performed using IBM SPSS statistics 26. RESULTS Overall, 139/242 patients were examined with cCT. Six patients were staged as progressive at cCT and 5/139 (3.6%) underwent a change of previously planned treatment strategy. 2/6 patients with suspected progression (33%) did not change strategy and underwent all preplanned NAC-cycles plus RC. Only 1/6 patients assigned as progressive at the cCT, showed progression in the postoperative pathology specimen. In total 133/139 patients were considered being without progress on cCT, yet 28/133 (21%) presented with nodal progression at postoperative pathology examinations. Only 1/29 patients with histopathologically verified nodal dissemination were detected with cCT, thus 28/29 (96.6%) with pN + were undetected. The sensitivity for cCT to predict pTNM was 17% CI [0%-64%] and the specificity was 78% CI [71%-86%]. CONCLUSIONS CCT prior to the final treatment cycle of NAC in MIBC, leads to a low percentage of treatment strategy changes and cCT cannot accurately predict pN-status.
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Affiliation(s)
- S Tenninge
- Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden
| | - H Mogos
- Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden
| | - E Eriksson
- Department of Radiation Sciences, Diagnostic Radiology, Umeå University, Umeå, Sweden
| | - H Netterling
- Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden
| | - S Pelander
- Department of Clinical and Experimental Medicine, Division of Urology, Linköping University, Linköping, Sweden
| | - M Johansson
- Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden.,Department of Urology, Sundsvall Hospital, Sundsvall, Sweden
| | - F Alamdari
- Department of Urology, Västmanland Hospital, Västerås, Sweden
| | - Y Huge
- Department of Clinical and Experimental Medicine, Division of Urology, Linköping University, Linköping, Sweden
| | - F Aljabery
- Department of Clinical and Experimental Medicine, Division of Urology, Linköping University, Linköping, Sweden
| | - J Svensson
- Department of Statistics, Umeå School of Business, Economics and Statistics, Umeå University, Umeå, Sweden
| | - J Styrke
- Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden.,Department of Urology, Sundsvall Hospital, Sundsvall, Sweden
| | - A Sherif
- Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden
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14
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Beidler CD, Smith HM, Alonso A, Andreeva T, Baldzuhn J, Beurskens MNA, Borchardt M, Bozhenkov SA, Brunner KJ, Damm H, Drevlak M, Ford OP, Fuchert G, Geiger J, Helander P, Hergenhahn U, Hirsch M, Höfel U, Kazakov YO, Kleiber R, Krychowiak M, Kwak S, Langenberg A, Laqua HP, Neuner U, Pablant NA, Pasch E, Pavone A, Pedersen TS, Rahbarnia K, Schilling J, Scott ER, Stange T, Svensson J, Thomsen H, Turkin Y, Warmer F, Wolf RC, Zhang D. Demonstration of reduced neoclassical energy transport in Wendelstein 7-X. Nature 2021; 596:221-226. [PMID: 34381232 PMCID: PMC8357633 DOI: 10.1038/s41586-021-03687-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 06/02/2021] [Indexed: 02/07/2023]
Abstract
Research on magnetic confinement of high-temperature plasmas has the ultimate goal of harnessing nuclear fusion for the production of electricity. Although the tokamak1 is the leading toroidal magnetic-confinement concept, it is not without shortcomings and the fusion community has therefore also pursued alternative concepts such as the stellarator. Unlike axisymmetric tokamaks, stellarators possess a three-dimensional (3D) magnetic field geometry. The availability of this additional dimension opens up an extensive configuration space for computational optimization of both the field geometry itself and the current-carrying coils that produce it. Such an optimization was undertaken in designing Wendelstein 7-X (W7-X)2, a large helical-axis advanced stellarator (HELIAS), which began operation in 2015 at Greifswald, Germany. A major drawback of 3D magnetic field geometry, however, is that it introduces a strong temperature dependence into the stellarator's non-turbulent 'neoclassical' energy transport. Indeed, such energy losses will become prohibitive in high-temperature reactor plasmas unless a strong reduction of the geometrical factor associated with this transport can be achieved; such a reduction was therefore a principal goal of the design of W7-X. In spite of the modest heating power currently available, W7-X has already been able to achieve high-temperature plasma conditions during its 2017 and 2018 experimental campaigns, producing record values of the fusion triple product for such stellarator plasmas3,4. The triple product of plasma density, ion temperature and energy confinement time is used in fusion research as a figure of merit, as it must attain a certain threshold value before net-energy-producing operation of a reactor becomes possible1,5. Here we demonstrate that such record values provide evidence for reduced neoclassical energy transport in W7-X, as the plasma profiles that produced these results could not have been obtained in stellarators lacking a comparably high level of neoclassical optimization.
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Affiliation(s)
- C D Beidler
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany.
| | - H M Smith
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - A Alonso
- Laboratorio Nacional de Fusion, CIEMAT, Madrid, Spain
| | - T Andreeva
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - J Baldzuhn
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | | | - M Borchardt
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - S A Bozhenkov
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - K J Brunner
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - H Damm
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - M Drevlak
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - O P Ford
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - G Fuchert
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - J Geiger
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - P Helander
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - U Hergenhahn
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
- Fritz-Haber-Institut der Max-Planck-Gesellschaft, Berlin, Germany
| | - M Hirsch
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - U Höfel
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - Ye O Kazakov
- Laboratory for Plasma Physics (LPP), École royale militaire/Koninklijke Militaire School (ERM/KMS), Brussels, Belgium
| | - R Kleiber
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - M Krychowiak
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - S Kwak
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - A Langenberg
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - H P Laqua
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - U Neuner
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - N A Pablant
- Princeton Plasma Physics Laboratory, Princeton, NJ, USA
| | - E Pasch
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - A Pavone
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - T S Pedersen
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - K Rahbarnia
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - J Schilling
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - E R Scott
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - T Stange
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - J Svensson
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - H Thomsen
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - Y Turkin
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - F Warmer
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - R C Wolf
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
| | - D Zhang
- Max-Planck-Institut für Plasmaphysik, Greifswald, Germany
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15
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Rutegård M, Lindqvist M, Svensson J, Nordin P, Haapamäki MM. Chronic pain after open inguinal hernia repair: expertise-based randomized clinical trial of heavyweight or lightweight mesh. Br J Surg 2021; 108:138-144. [PMID: 33711123 PMCID: PMC10364858 DOI: 10.1093/bjs/znaa049] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/08/2020] [Accepted: 09/20/2020] [Indexed: 11/14/2022]
Abstract
BACKGROUND There is a shortage of high-quality studies regarding choice of mesh in open anterior inguinal hernia repair in relation to long-term chronic pain. The authors hypothesized that heavyweight compared with lightweight mesh causes increased postoperative pain. METHODS An RCT was undertaken between 2007 and 2009 at two sites in Sweden. Men aged 25 years or older with an inguinal hernia evaluated in the outpatient clinic were randomized in an unblinded fashion to heavyweight or lightweight mesh for open anterior inguinal hernia repair. Data on pain affecting daily activities, as measured by the Short-Form Inguinal Pain Questionnaire 9-12 years after surgery, were collected as the primary outcome. Differences between groups were evaluated by generalized odds and numbers needed to treat. RESULTS A total of 412 patients were randomized; 363 were analysed with 320 questionnaires sent out. A total of 271 questionnaires (84.7 per cent) were returned; of these, 121 and 150 patients were in the heavyweight and lightweight mesh groups respectively. Pain affecting daily activities was more pronounced in patients randomized to heavyweight versus lightweight mesh (generalized odds 1.33, 95 per cent c.i. 1.10 to 1.61). This translated into a number needed to treat of 7.06 (95 per cent c.i. 4.28 to 21.44). Two reoperations for recurrence were noted in the heavyweight mesh group, and one in the lightweight mesh group. CONCLUSION A large-pore lightweight mesh causes significantly less pain affecting daily activities a decade after open anterior inguinal hernia repair. Registration number: NCT00451893 (http://www.clinicaltrials.gov).
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Affiliation(s)
- M Rutegård
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden.,Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden
| | - M Lindqvist
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden
| | - J Svensson
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden.,Department of Statistics, Umeå School of Business, Economics and Statistics, Umeå University, Umeå, Sweden
| | - P Nordin
- Department of Surgical and Perioperative Sciences, Surgery, Östersund Research Unit, Umeå University, Östersund, Sweden
| | - M M Haapamäki
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden
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16
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Eckerström C, Svensson J, Kettunen P, Jonsson M, Eckerström M. Evaluation of the ATN model in a longitudinal memory clinic sample with different underlying disorders. Alzheimers Dement (Amst) 2021; 13:e12031. [PMID: 33816750 PMCID: PMC8015813 DOI: 10.1002/dad2.12031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/06/2020] [Accepted: 03/06/2020] [Indexed: 11/10/2022]
Abstract
INTRODUCTION To evaluate the usefulness of the 2018 NIA-AA (National Institute on Aging and Alzheimer's Association) research framework in a longitudinal memory clinic study with different clinical outcomes and underlying disorders. METHODS We included 420 patients with mild cognitive impairment or subjective cognitive impairment. During the follow up, 27% of the patients converted to dementia, with the majority converting to Alzheimer's disease (AD) or mixed dementia. Based on the baseline values of the cerebrospinal fluid biomarkers, the patients were classified into one of the eight possible ATN groups (amyloid beta [Aβ] aggregation [A], tau aggregation reflecting neurofibrillary tangles [T], and neurodegeneration [N]). RESULTS The majority of the patients converting to AD and mixed dementia were in ATN groups positive for A (71%). The A+T+N+ group was highly overrepresented among converters to AD and mixed dementia. Patients converting to dementias other than AD or mixed dementia were evenly distributed across the ATN groups. DISCUSSION Our findings provide support for the usefulness of the ATN system to detect incipient AD or mixed dementia.
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Affiliation(s)
- C. Eckerström
- Department of Psychiatry and NeurochemistrySahlgrenska AcademyInstitute of Neuroscience and PhysiologyUniversity of GothenburgSweden
- Department of Immunology and Transfusion MedicineRegion Västra GötalandSahlgrenska University HospitalSweden
| | - J. Svensson
- Department of Internal Medicine, Institute of Medicine, Sahlgrenska AcademyUniversity of GothenburgSweden
| | - P. Kettunen
- Department of Psychiatry and NeurochemistrySahlgrenska AcademyInstitute of Neuroscience and PhysiologyUniversity of GothenburgSweden
| | - M. Jonsson
- Department of Psychiatry and NeurochemistrySahlgrenska AcademyInstitute of Neuroscience and PhysiologyUniversity of GothenburgSweden
| | - M. Eckerström
- Department of Psychiatry and NeurochemistrySahlgrenska AcademyInstitute of Neuroscience and PhysiologyUniversity of GothenburgSweden
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17
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Pablant NA, Langenberg A, Alonso JA, Bitter M, Bozhenkov SA, Ford OP, Hill KW, Kring J, Marchuck O, Svensson J, Traverso P, Windisch T, Yakusevitch Y. Correction and verification of x-ray imaging crystal spectrometer analysis on Wendelstein 7-X through x-ray ray tracing. Rev Sci Instrum 2021; 92:043530. [PMID: 34243399 DOI: 10.1063/5.0043513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/25/2021] [Indexed: 06/13/2023]
Abstract
X-ray ray tracing is used to develop ion-temperature corrections for the analysis of the X-ray Imaging Crystal Spectrometer (XICS) used at Wendelstein 7-X (W7-X) and perform verification on the analysis methods. The XICS is a powerful diagnostic able to measure ion-temperature, electron-temperature, plasma flow, and impurity charge state densities. While these systems are relatively simple in design, accurate characterization of the instrumental response and validation of analysis techniques are difficult to perform experimentally due to the requirement of extended x-ray sources. For this reason, a ray tracing model has been developed that allows characterization of the spectrometer and verification of the analysis methods while fully considering the real geometry of the XICS system and W7-X plasma. Through the use of ray tracing, several important corrections have been found that must be accounted for in order to accurately reconstruct the ion-temperature profiles. The sources of these corrections are described along with their effect on the analyzed profiles. The implemented corrections stem from three effects: (1) effect of sub-pixel intensity distribution during de-curving and spatial binning, (2) effect of sub-pixel intensity distribution during forward model evaluation and generation of residuals, and (3) effect of defocus and spherical aberrations on the instrumental response. Possible improvements to the forward model and analysis procedures are explored, along with a discussion of trade-offs in terms of computational complexity. Finally, the accuracy of the tomographic inversion technique in stellarator geometry is investigated, providing for the first time a verification exercise for inversion accuracy in stellarator geometry and a complete XICS analysis tool-chain.
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Affiliation(s)
- N A Pablant
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08540, USA
| | - A Langenberg
- Max-Planck-Institut für Plasmaphysik, Greifswald 17491, Germany
| | - J A Alonso
- Laboratorio Nacional de Fusión, CIEMAT, Madrid 28040, Spain
| | - M Bitter
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08540, USA
| | - S A Bozhenkov
- Max-Planck-Institut für Plasmaphysik, Greifswald 17491, Germany
| | - O P Ford
- Max-Planck-Institut für Plasmaphysik, Greifswald 17491, Germany
| | - K W Hill
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08540, USA
| | - J Kring
- Auburn University, Auburn, Alabama 36849, USA
| | - O Marchuck
- Institut für Energie und Klimaforschung, Plasmaphysik, Forschungszentrum Jülich, Jülich 52425, Germany
| | - J Svensson
- Max-Planck-Institut für Plasmaphysik, Greifswald 17491, Germany
| | - P Traverso
- Auburn University, Auburn, Alabama 36849, USA
| | - T Windisch
- Max-Planck-Institut für Plasmaphysik, Greifswald 17491, Germany
| | - Y Yakusevitch
- University of California Santa Barbara, Santa Barbara, California 93106, USA
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18
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Kwak S, Hergenhahn U, Höfel U, Krychowiak M, Pavone A, Svensson J, Ford O, König R, Bozhenkov S, Fuchert G, Pasch E, Brunner KJ, Knauer J, Kornejew P, Trimiño Mora H, Pedersen TS. Bayesian inference of spatially resolved Z eff profiles from line integrated bremsstrahlung spectra. Rev Sci Instrum 2021; 92:043505. [PMID: 34243367 DOI: 10.1063/5.0043777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/12/2021] [Indexed: 06/13/2023]
Abstract
In nuclear fusion research, the effective ion charge Zeff, which characterizes the overall content of impurities, can be experimentally derived from the plasma electron-ion bremsstrahlung, given the electron density ne and temperature Te. At Wendelstein 7-X, a multichannel near-infrared spectrometer is installed to collect the plasma bremsstrahlung along 27 lines of sight covering more than half the plasma cross section, which provides information on Zeff over the entire plasma radius. To infer spatially resolved Zeff profiles, a Bayesian model is developed in the Minerva framework. Zeff, ne, and Te profiles are modeled as Gaussian processes, whose smoothness is determined by hyperparameters. These profiles are transformed to fields in Cartesian coordinates, given the poloidal magnetic flux surfaces calculated by the variational moments equilibrium code. Given all these physical quantities, the model predicts line-of-sight integrals of near-infrared bremsstrahlung spectra. The model includes the predictive (forward) models of the interferometer, Thomson scattering system, and visible and near-infrared spectrometers. Given the observations of all these diagnostics, the posterior probability distribution of Zeff profiles is calculated and shown as an inference solution. The smoothness (gradient) of the profiles is optimally chosen by Bayesian Occam's razor. Furthermore, wall reflections can significantly pollute the measurements of the plasma bremsstrahlung, which leads to over-estimation of Zeff values in the edge region. In the first results presented in this work, this problem does not appear, and the posterior samples of Zeff profiles are overall plausible and consistent with Zeff values inferred, given the data from the single-channel visible spectrometer.
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Affiliation(s)
- Sehyun Kwak
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - U Hergenhahn
- Fritz-Haber-Institut der Max-Planck-Gesellschaft, 14195 Berlin, Germany
| | - U Höfel
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - M Krychowiak
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - A Pavone
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - J Svensson
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - O Ford
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - R König
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - S Bozhenkov
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - G Fuchert
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - E Pasch
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - K J Brunner
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - J Knauer
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - P Kornejew
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | | | - T S Pedersen
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
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19
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Pavone A, Svensson J, Krychowiak M, Hergenhahn U, Winters V, Kornejew P, Kwak S, Hoefel U, Koenig R, Wolf RC. Neural network surrogates of Bayesian diagnostic models for fast inference of plasma parameters. Rev Sci Instrum 2021; 92:033531. [PMID: 33820062 DOI: 10.1063/5.0043772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 02/28/2021] [Indexed: 06/12/2023]
Abstract
We present a framework for training artificial neural networks (ANNs) as surrogate Bayesian models for the inference of plasma parameters from diagnostic data collected at nuclear fusion experiments, with the purpose of providing a fast approximation of conventional Bayesian inference. Because of the complexity of the models involved, conventional Bayesian inference can require tens of minutes for analyzing one single measurement, while hundreds of thousands can be collected during a single plasma discharge. The ANN surrogates can reduce the analysis time down to tens/hundreds of microseconds per single measurement. The core idea is to generate the training data by sampling them from the joint probability distribution of the parameters and observations of the original Bayesian model. The network can be trained to learn the reconstruction of plasma parameters from observations and the model joint probability distribution from plasma parameters and observations. Previous work has validated the application of such a framework to the former case at the Wendelstein 7-X and Joint European Torus experiments. Here, we first give a description of the general methodological principles allowing us to generate the training data, and then we show an example application of the reconstruction of the joint probability distribution of an effective ion charge Zeff-bremsstrahlung model from data collected at the latest W7-X experimental campaign. One key feature of such an approach is that the network is trained exclusively on data generated with the Bayesian model, requiring no experimental data. This allows us to replicate the training scheme and generate fast, surrogate ANNs for any validated Bayesian diagnostic model.
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Affiliation(s)
- A Pavone
- Max-Planck-Institute for Plasma Physics, Greifswald 17491, Germany
| | - J Svensson
- Max-Planck-Institute for Plasma Physics, Greifswald 17491, Germany
| | - M Krychowiak
- Max-Planck-Institute for Plasma Physics, Greifswald 17491, Germany
| | - U Hergenhahn
- Max-Planck-Institute for Plasma Physics, Greifswald 17491, Germany
| | - V Winters
- Max-Planck-Institute for Plasma Physics, Greifswald 17491, Germany
| | - P Kornejew
- Max-Planck-Institute for Plasma Physics, Greifswald 17491, Germany
| | - S Kwak
- Max-Planck-Institute for Plasma Physics, Greifswald 17491, Germany
| | - U Hoefel
- Max-Planck-Institute for Plasma Physics, Greifswald 17491, Germany
| | - R Koenig
- Max-Planck-Institute for Plasma Physics, Greifswald 17491, Germany
| | - R C Wolf
- Max-Planck-Institute for Plasma Physics, Greifswald 17491, Germany
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20
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Ibfelt EH, Vistisen D, Falberg Rønn P, Pørksen S, Madsen M, Kremke B, Svensson J. Association between glycaemic outcome and BMI in Danish children with type 1 diabetes in 2000-2018: a nationwide population-based study. Diabet Med 2021; 38:e14401. [PMID: 32918312 DOI: 10.1111/dme.14401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 08/19/2020] [Accepted: 09/03/2020] [Indexed: 10/23/2022]
Abstract
AIM To describe the development of HbA1c and BMI over time in Danish children with type 1 diabetes; and to investigate the association between HbA1c and BMI including influence of age, gender, diabetes duration, severe hypoglycaemia and treatment method. METHODS We used the nationwide Danish Registry of Childhood and Adolescent Diabetes, DanDiabKids, including annual registrations of all children with diabetes treated at Danish hospitals. With linear mixed-effects models and splines we analyzed the HbA1c and BMI development over time as well as the association between HbA1c and BMI including effects of gender, age, disease duration, hypoglycaemia and treatment method. BMI z-scores were calculated for these analyses. RESULTS For the period from 2000 to 2018, 6097 children with type 1 diabetes were identified from the DanDiabKids database. The median (interquartile range) HbA1c level was 65 (57-74) mmol/mol (8.1%) and the median BMI z-score was 0.85 in girls and 0.67 in boys. A non-linear association was found between HbA1c and BMI z-score, with the highest BMI z-score observed for HbA1c values in the range of approximately 60-70 mmol/mol (7.6-6.8%). The association was modified by gender, age and diabetes duration. Severe hypoglycaemia and insulin pump treatment had a small positive impact on BMI z-score. CONCLUSION The association between HbA1c and BMI z-score was non-linear, with the highest BMI z-score being observed for intermediate HbA1c levels; however, specific patterns depended on gender, age and diabetes duration.
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Affiliation(s)
- E H Ibfelt
- Steno Diabetes Centre Copenhagen, Gentofte, Denmark
| | - D Vistisen
- Steno Diabetes Centre Copenhagen, Gentofte, Denmark
| | | | - S Pørksen
- Zealand University Hospital, Roskilde, Denmark
- Steno Diabetes Centre Sjaelland, Holbaek, Denmark
| | - M Madsen
- Aalborg University Hospital, Aalborg, Denmark
| | - B Kremke
- Randers Regional Hospital, Randers, Denmark
| | - J Svensson
- Herlev and Gentofte Hospital, Herlev, Denmark
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21
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Orsini S, Livi SA, Lichtenegger H, Barabash S, Milillo A, De Angelis E, Phillips M, Laky G, Wieser M, Olivieri A, Plainaki C, Ho G, Killen RM, Slavin JA, Wurz P, Berthelier JJ, Dandouras I, Kallio E, McKenna-Lawlor S, Szalai S, Torkar K, Vaisberg O, Allegrini F, Daglis IA, Dong C, Escoubet CP, Fatemi S, Fränz M, Ivanovski S, Krupp N, Lammer H, Leblanc F, Mangano V, Mura A, Nilsson H, Raines JM, Rispoli R, Sarantos M, Smith HT, Szego K, Aronica A, Camozzi F, Di Lellis AM, Fremuth G, Giner F, Gurnee R, Hayes J, Jeszenszky H, Tominetti F, Trantham B, Balaz J, Baumjohann W, Brienza D, Bührke U, Bush MD, Cantatore M, Cibella S, Colasanti L, Cremonese G, Cremonesi L, D'Alessandro M, Delcourt D, Delva M, Desai M, Fama M, Ferris M, Fischer H, Gaggero A, Gamborino D, Garnier P, Gibson WC, Goldstein R, Grande M, Grishin V, Haggerty D, Holmström M, Horvath I, Hsieh KC, Jacques A, Johnson RE, Kazakov A, Kecskemety K, Krüger H, Kürbisch C, Lazzarotto F, Leblanc F, Leichtfried M, Leoni R, Loose A, Maschietti D, Massetti S, Mattioli F, Miller G, Moissenko D, Morbidini A, Noschese R, Nuccilli F, Nunez C, Paschalidis N, Persyn S, Piazza D, Oja M, Ryno J, Schmidt W, Scheer JA, Shestakov A, Shuvalov S, Seki K, Selci S, Smith K, Sordini R, Svensson J, Szalai L, Toublanc D, Urdiales C, Varsani A, Vertolli N, Wallner R, Wahlstroem P, Wilson P, Zampieri S. SERENA: Particle Instrument Suite for Determining the Sun-Mercury Interaction from BepiColombo. Space Sci Rev 2021; 217:11. [PMID: 33487762 PMCID: PMC7803725 DOI: 10.1007/s11214-020-00787-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 12/03/2020] [Indexed: 06/12/2023]
Abstract
The ESA-JAXA BepiColombo mission to Mercury will provide simultaneous measurements from two spacecraft, offering an unprecedented opportunity to investigate magnetospheric and exospheric particle dynamics at Mercury as well as their interactions with solar wind, solar radiation, and interplanetary dust. The particle instrument suite SERENA (Search for Exospheric Refilling and Emitted Natural Abundances) is flying in space on-board the BepiColombo Mercury Planetary Orbiter (MPO) and is the only instrument for ion and neutral particle detection aboard the MPO. It comprises four independent sensors: ELENA for neutral particle flow detection, Strofio for neutral gas detection, PICAM for planetary ions observations, and MIPA, mostly for solar wind ion measurements. SERENA is managed by a System Control Unit located inside the ELENA box. In the present paper the scientific goals of this suite are described, and then the four units are detailed, as well as their major features and calibration results. Finally, the SERENA operational activities are shown during the orbital path around Mercury, with also some reference to the activities planned during the long cruise phase.
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Affiliation(s)
- S Orsini
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | - S A Livi
- Southwest Research Institute, San Antonio, TX USA
- Department of Climate and Space Sciences and Engineering, University of Michigan, Ann Arbor, MI USA
| | - H Lichtenegger
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - S Barabash
- Swedish Institute of Space Physics, Kiruna, Sweden
| | - A Milillo
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | - E De Angelis
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | - M Phillips
- Southwest Research Institute, San Antonio, TX USA
| | - G Laky
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - M Wieser
- Swedish Institute of Space Physics, Kiruna, Sweden
| | | | | | - G Ho
- The Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723 USA
| | - R M Killen
- NASA/Goddard Space Flight Center, Greenbelt, MD 20771 USA
| | - J A Slavin
- Department of Climate and Space Sciences and Engineering, University of Michigan, Ann Arbor, MI USA
| | - P Wurz
- Physics Institute, University of Bern, Bern, Switzerland
| | | | - I Dandouras
- Institut de Recherche en Astrophysique et Planétologie, CNRS, CNES, Université de Toulouse, Toulouse, France
| | - E Kallio
- School of Electrical Engineering, Department of Electronics and Nanoengineering, Aalto University, Helsinki, Finland
| | | | - S Szalai
- Wigner Research Centre for Physics, Budapest, Hungary
| | - K Torkar
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - O Vaisberg
- IKI Space Research Institute, Moscow, Russia
| | - F Allegrini
- Southwest Research Institute, San Antonio, TX USA
| | - I A Daglis
- Department of Physics, National and Kapodistrian University of Athens, Athens, Greece
- Hellenic Space Center, Athens, Greece
| | - C Dong
- Department of Astrophysical Sciences and Princeton Plasma Physics Laboratory, Princeton University, Princeton, NJ USA
| | | | - S Fatemi
- Swedish Institute of Space Physics, Kiruna, Sweden
| | - M Fränz
- Max-Planck-Institut für Sonnensystemforschung, MPS, 37077 Göttingen, Germany
| | - S Ivanovski
- Astronomical Observatory, INAF, Trieste, Italy
| | - N Krupp
- Max-Planck-Institut für Sonnensystemforschung, MPS, 37077 Göttingen, Germany
| | - H Lammer
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | | | - V Mangano
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | - A Mura
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | - H Nilsson
- Swedish Institute of Space Physics, Kiruna, Sweden
| | - J M Raines
- Department of Climate and Space Sciences and Engineering, University of Michigan, Ann Arbor, MI USA
| | - R Rispoli
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | - M Sarantos
- NASA/Goddard Space Flight Center, Greenbelt, MD 20771 USA
| | - H T Smith
- The Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723 USA
| | - K Szego
- Wigner Research Centre for Physics, Budapest, Hungary
| | - A Aronica
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | | | | | - G Fremuth
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - F Giner
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - R Gurnee
- Laboratory for Atmospheric and Space Physics, Boulder, CO USA
| | - J Hayes
- The Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723 USA
| | - H Jeszenszky
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | | | - B Trantham
- Southwest Research Institute, San Antonio, TX USA
| | - J Balaz
- Institute of Experimental Physics SAS, Slovak Academy of Sciences, 040 01 Košice, Slovakia
| | - W Baumjohann
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - D Brienza
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | - U Bührke
- Max-Planck-Institut für Sonnensystemforschung, MPS, 37077 Göttingen, Germany
| | - M D Bush
- Physics Institute, University of Bern, Bern, Switzerland
| | | | - S Cibella
- Istituto di Struttura della Materia (CNR-ISM), 00133 Roma, Italy
| | - L Colasanti
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | - G Cremonese
- Astronomical Observatory, INAF, Padova, Italy
| | | | - M D'Alessandro
- Istituto di Struttura della Materia (CNR-ISM), 00133 Roma, Italy
| | | | - M Delva
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - M Desai
- Southwest Research Institute, San Antonio, TX USA
| | - M Fama
- Comisión Nacional de Energía Atómica, cnea, Centro Atómico Bariloche, Bariloche, Argentina
| | - M Ferris
- Southwest Research Institute, San Antonio, TX USA
| | - H Fischer
- Max-Planck-Institut für Sonnensystemforschung, MPS, 37077 Göttingen, Germany
| | - A Gaggero
- Istituto di Struttura della Materia (CNR-ISM), 00133 Roma, Italy
| | - D Gamborino
- Physics Institute, University of Bern, Bern, Switzerland
| | - P Garnier
- Institut de Recherche en Astrophysique et Planétologie, CNRS, CNES, Université de Toulouse, Toulouse, France
| | - W C Gibson
- Southwest Research Institute, San Antonio, TX USA
| | - R Goldstein
- Southwest Research Institute, San Antonio, TX USA
| | - M Grande
- Aberystwyth University, Aberystwyth, Ceredigion SY23 3FL UK
| | - V Grishin
- IKI Space Research Institute, Moscow, Russia
| | - D Haggerty
- The Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723 USA
| | - M Holmström
- Swedish Institute of Space Physics, Kiruna, Sweden
| | - I Horvath
- Wigner Research Centre for Physics, Budapest, Hungary
| | - K-C Hsieh
- University of Arizona, Tucson, AZ USA
| | - A Jacques
- NASA/Goddard Space Flight Center, Greenbelt, MD 20771 USA
| | - R E Johnson
- University of Virginia, Charlottesville, VA 22904 USA
| | - A Kazakov
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | - K Kecskemety
- Wigner Research Centre for Physics, Budapest, Hungary
| | - H Krüger
- Max-Planck-Institut für Sonnensystemforschung, MPS, 37077 Göttingen, Germany
| | - C Kürbisch
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | | | | | - M Leichtfried
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | | | - A Loose
- Max-Planck-Institut für Sonnensystemforschung, MPS, 37077 Göttingen, Germany
| | - D Maschietti
- Istituto Fotonica e Nanotecnologie, CNR-IFN, Roma, Italy
| | - S Massetti
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | | | - G Miller
- Southwest Research Institute, San Antonio, TX USA
| | - D Moissenko
- IKI Space Research Institute, Moscow, Russia
| | - A Morbidini
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | - R Noschese
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | - F Nuccilli
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | - C Nunez
- Southwest Research Institute, San Antonio, TX USA
| | - N Paschalidis
- NASA/Goddard Space Flight Center, Greenbelt, MD 20771 USA
| | - S Persyn
- Southwest Research Institute, San Antonio, TX USA
| | - D Piazza
- Physics Institute, University of Bern, Bern, Switzerland
| | - M Oja
- Swedish Institute of Space Physics, Kiruna, Sweden
| | - J Ryno
- Finnish Meteorological Institute FMI, Helsinki, Finland
| | - W Schmidt
- Finnish Meteorological Institute FMI, Helsinki, Finland
| | | | - A Shestakov
- IKI Space Research Institute, Moscow, Russia
| | - S Shuvalov
- IKI Space Research Institute, Moscow, Russia
| | - K Seki
- Department of Earth and Planetary Science, Graduate School of Science, University of Tokyo, Tokyo, Japan
| | - S Selci
- Istituto di Struttura della Materia (CNR-ISM), 00133 Roma, Italy
| | - K Smith
- Southwest Research Institute, San Antonio, TX USA
| | - R Sordini
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | | | - L Szalai
- Wigner Research Centre for Physics, Budapest, Hungary
| | - D Toublanc
- Institut de Recherche en Astrophysique et Planétologie, CNRS, CNES, Université de Toulouse, Toulouse, France
| | - C Urdiales
- Southwest Research Institute, San Antonio, TX USA
| | - A Varsani
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - N Vertolli
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | - R Wallner
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - P Wahlstroem
- Physics Institute, University of Bern, Bern, Switzerland
| | - P Wilson
- Southwest Research Institute, San Antonio, TX USA
| | - S Zampieri
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
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Kiss N, Minderjahn M, Reismann J, Svensson J, Wester T, Hauptmann K, Schad M, Kallarackal J, von Bernuth H, Reismann M. Use of gene expression profiling to identify candidate genes for pretherapeutic patient classification in acute appendicitis. BJS Open 2021; 5:6073400. [PMID: 33609379 PMCID: PMC7893459 DOI: 10.1093/bjsopen/zraa045] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/06/2020] [Accepted: 10/24/2020] [Indexed: 12/11/2022] Open
Abstract
Background Phlegmonous and gangrenous appendicitis represent independent pathophysiological entities with different clinical courses ranging from spontaneous resolution to septic disease. However, reliable predictive methods for these clinical phenotypes have not yet been established. In an attempt to provide pathophysiological insights into the matter, a genomewide gene expression analysis was undertaken in patients with acute appendicitis. Methods Peripheral blood mononuclear cells were isolated and, after histological confirmation of PA or GA, analysed for genomewide gene expression profiling using RNA microarray technology and subsequent pathway analysis. Results Samples from 29 patients aged 7–17 years were included. Genomewide gene expression analysis was performed on 13 samples of phlegmonous and 16 of gangrenous appendicitis. From a total of 56 666 genes, 3594 were significantly differently expressed. Distinct interaction between T and B cells in the phlegmonous appendicitis group was suggested by overexpression of T cell receptor α and β subunits, CD2, CD3, MHC II, CD40L, and the B cell markers CD72 and CD79, indicating an antiviral mechanism. In the gangrenous appendicitis group, expression of genes delineating antibacterial mechanisms was found. Conclusion These results provide evidence for different and independent gene expression in phlegmonous and gangrenous appendicitis in general, but also suggest distinct immunological patterns for the respective entities. In particular, the findings are compatible with previous evidence of spontaneous resolution in phlegmonous and progressive disease in gangrenous appendicitis.
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Affiliation(s)
- N Kiss
- Department of Paediatric Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - M Minderjahn
- Department of Paediatric Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - J Reismann
- Department of Paediatric Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - J Svensson
- Department of Paediatric Surgery, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - T Wester
- Department of Paediatric Surgery, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - K Hauptmann
- Institute of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - M Schad
- OakLabs, Hennigsdorf, Germany
| | | | - H von Bernuth
- Department of Paediatric Pulmonology and Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - M Reismann
- Department of Paediatric Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
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23
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Grahl M, Spring A, Andreeva T, Bluhm T, Bozhenkov S, Dumke S, Geiger J, Grulke O, Grün M, Holtz A, Höfel U, Laqua H, Lewerentz M, Riemann H, Schilling J, von Stechow A, Svensson J, Winter A. W7-X logbook REST API for processing experimental metadata and data enrichment at the Wendelstein 7-X stellarator. Fusion Engineering and Design 2020. [DOI: 10.1016/j.fusengdes.2020.111819] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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24
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Matos F, Svensson J, Pavone A, Odstrčil T, Jenko F. Deep learning for Gaussian process soft x-ray tomography model selection in the ASDEX Upgrade tokamak. Rev Sci Instrum 2020; 91:103501. [PMID: 33138591 DOI: 10.1063/5.0020680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 09/29/2020] [Indexed: 06/11/2023]
Abstract
Gaussian process tomography (GPT) is a method used for obtaining real-time tomographic reconstructions of the plasma emissivity profile in tokamaks, given some model for the underlying physical processes involved. GPT can also be used, thanks to Bayesian formalism, to perform model selection, i.e., comparing different models and choosing the one with maximum evidence. However, the computations involved in this particular step may become slow for data with high dimensionality, especially when comparing the evidence for many different models. Using measurements collected by the Soft X-Ray (SXR) diagnostic in the ASDEX Upgrade tokamak, we train a convolutional neural network to map SXR tomographic projections to the corresponding GPT model whose evidence is highest. We then compare the network's results, and the time required to calculate them, with those obtained through analytical Bayesian formalism. In addition, we use the network's classifications to produce tomographic reconstructions of the plasma emissivity profile.
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Affiliation(s)
- F Matos
- Max Planck Institute for Plasma Physics, Boltzmannstr. 2, 85748 Garching, Germany
| | - J Svensson
- Max Planck Institute for Plasma Physics, Wendelsteinstr. 1, 17491 Greifswald, Germany
| | - A Pavone
- Max Planck Institute for Plasma Physics, Wendelsteinstr. 1, 17491 Greifswald, Germany
| | - T Odstrčil
- Plasma Science and Fusion Center, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - F Jenko
- Max Planck Institute for Plasma Physics, Boltzmannstr. 2, 85748 Garching, Germany
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25
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Afghahi MD H, Nasic S, Alhomsi K, Rydell H, Hadimeri H, Svensson J. SAT-268 IN PATIENTS WITH DIABETES AND END STAGE RENAL DISEASE, ASSOCIATION BETWEEN BODY MASS INDEX AND RISK OF MORTALITY IS DIFFERENT IN HEMODIALYSIS AND PERITONEAL DIALYSIS. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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26
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Tjörnstrand J, Neuman P, Svensson J, Lundin B, Dahlberg LE, Tiderius CJ. Osteoarthritis development related to cartilage quality-the prognostic value of dGEMRIC after anterior cruciate ligament injury. Osteoarthritis Cartilage 2019; 27:1647-1652. [PMID: 31279937 DOI: 10.1016/j.joca.2019.06.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 05/22/2019] [Accepted: 06/13/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Rupture of the anterior cruciate ligament (ACL) increases the risk of developing osteoarthritis (OA). Delayed Gadolinium enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) investigates cartilage integrity through T1-analysis after intravenous contrast injection. A high dGEMRIC index represents good cartilage quality. The main purpose of this prospective cohort study was to investigate the prognostic value of the dGEMRIC index regarding future knee OA. METHOD 31 patients with ACL injury (mean age 27 ± 6.7 (±SD) years, 19 males) were examined after 2 years with 1.5T dGEMRIC of femoral cartilage. Re-examination 14 years post-injury included weight-bearing knee radiographs, Lysholm and Knee Osteoarthritis Outcome Score (KOOS). RESULTS At the 14-year follow up radiographic OA (ROA) was present in 68% and OA symptoms (SOA) in 42% of the injured knees. The dGEMRIC index of the medial compartment was lower in knees that developed medial ROA, 325 ± 68 (ms±SD) vs 376 ± 47 (51 (7-94)) (difference of means (95% confidence interval (CI))), in patients that developed symptomatic OA (SOA), 327 ± 61 vs 399 ± 42 (52 (11-93)), and poor knee function 337 ± 54 vs 381 ± 52 (48 (7-89)) compared to those that did not develop ROA, SOA or poor function. The dGEMRIC index correlated negatively with the OARSI osteophyte score in medial (r = -0.44, P = 0.01) and lateral (r = -0.38, P = 0.03) compartments. CONCLUSION The associations between a low dGEMRIC index and future ROA, as well as SOA, are in agreement with previous studies and indicate that dGEMRIC has a prognostic value for future knee OA.
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Affiliation(s)
- J Tjörnstrand
- Orthopedics, Department of Clinical Sciences, Lund University, Skåne University Hospital, SE-221 85 Lund, Sweden.
| | - P Neuman
- Department of Orthopedics, Clinical Sciences, Lund University, Skåne University Hospital, SE-205 02 Malmö, Sweden
| | - J Svensson
- Department of Medical Imaging and Physiology, Skåne University Hospital, SE-221 85 Lund, Sweden; Medical Radiation Physics, Department of Translational Medicine, Lund University, SE-205 02 Malmö, Sweden
| | - B Lundin
- Department of Medical Imaging and Physiology, Skåne University Hospital, SE-221 85 Lund, Sweden
| | - L E Dahlberg
- Orthopedics, Department of Clinical Sciences, Lund University, Skåne University Hospital, SE-221 85 Lund, Sweden
| | - C J Tiderius
- Orthopedics, Department of Clinical Sciences, Lund University, Skåne University Hospital, SE-221 85 Lund, Sweden
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27
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Sörelius K, Svensson J, Matthiessen P, Rutegård J, Rutegård M. A nationwide study on the incidence of mesenteric ischaemia after surgery for rectal cancer demonstrates an association with high arterial ligation. Colorectal Dis 2019; 21:925-931. [PMID: 31062468 DOI: 10.1111/codi.14674] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Accepted: 04/08/2019] [Indexed: 02/06/2023]
Abstract
AIM The incidence of mesenteric ischaemia after resection for rectal cancer has not been investigated in a population-based setting. The use of high ligation of the inferior mesenteric artery might cause such ischaemia, as the bowel left in situ depends on collateral blood supply after a high tie. METHOD The Swedish Colorectal Cancer Registry was used to identify all patients subjected to an abdominal resection for rectal cancer during the years 2007-2017 inclusive. Mesenteric ischaemia within the first 30 postoperative days was recorded, classified as either stoma necrosis or colonic necrosis. Multivariable logistic regression was used to estimate odds ratios (ORs) with 95% confidence intervals (CIs) for mesenteric ischaemia in relation to high tie, with adjustment for confounding. RESULTS Some 14 657 patients were included, of whom 59 (0.40%) had a reoperation for any type of mesenteric ischaemia, divided into 34 and 25 cases of stoma necrosis and colonic necrosis, respectively. Compared with patients who did not require reoperation for mesenteric ischaemia following rectal cancer surgery, the proportion having high tie was greater (54.2% vs 38.5%; P = 0.032). The adjusted OR for reoperation due to any mesenteric ischaemia with high tie was 2.26 (95% CI 1.34-3.79), while the corresponding estimates for stoma and colonic necrosis, respectively, were 1.60 (95% CI 0.81-3.17) and 3.69 (95% CI 1.57-8.66). CONCLUSION The incidence of reoperation for mesenteric ischaemia after abdominal resection for rectal cancer is low, but the use of a high tie might increase the risk of colonic necrosis demanding surgery.
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Affiliation(s)
- K Sörelius
- Department of Surgical Sciences, Section of Vascular Surgery, Uppsala University, Uppsala, Sweden
| | - J Svensson
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden.,Department of Statistics, Umeå School of Business, Economics and Statistics, Umeå University, Umeå, Sweden
| | - P Matthiessen
- Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - J Rutegård
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden
| | - M Rutegård
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden.,Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden
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28
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Zhang D, König R, Feng Y, Burhenn R, Brezinsek S, Jakubowski M, Buttenschön B, Niemann H, Pavone A, Krychowiak M, Kwak S, Svensson J, Gao Y, Pedersen TS, Alonso A, Baldzuhn J, Beidler CD, Biedermann C, Bozhenkov S, Brunner KJ, Damm H, Hirsch M, Giannone L, Drewelow P, Effenberg F, Fuchert G, Hammond KC, Höfel U, Killer C, Knauer J, Laqua HP, Laube R, Pablant N, Pasch E, Penzel F, Rahbarnia K, Reimold F, Thomsen H, Winters V, Wagner F, Klinger T. First Observation of a Stable Highly Dissipative Divertor Plasma Regime on the Wendelstein 7-X Stellarator. Phys Rev Lett 2019; 123:025002. [PMID: 31386539 DOI: 10.1103/physrevlett.123.025002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Indexed: 06/10/2023]
Abstract
For the first time, the optimized stellarator Wendelstein 7-X has operated with an island divertor. An operation regime in hydrogen was found in which the total plasma radiation approached the absorbed heating power without noticeable loss of stored energy. The divertor thermography recorded simultaneously a strong reduction of the heat load on all divertor targets, indicating almost complete power detachment. This operation regime was stably sustained over several energy confinement times until the preprogrammed end of the discharge. The plasma radiation is mainly due to oxygen and is located at the plasma edge. This plasma scenario is reproducible and robust at various heating powers, plasma densities, and gas fueling locations. These experimental results show that the island divertor concept actually works and displays good power dissipation potential, producing a promising exhaust concept for the stellarator reactor line.
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Affiliation(s)
- D Zhang
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - R König
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - Y Feng
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - R Burhenn
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - S Brezinsek
- Forschungszentrum Jülich GmbH, IEK-4 52425 Jülich, Germany
| | - M Jakubowski
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - B Buttenschön
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - H Niemann
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - A Pavone
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - M Krychowiak
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - S Kwak
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - J Svensson
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - Y Gao
- Forschungszentrum Jülich GmbH, IEK-4 52425 Jülich, Germany
| | - T S Pedersen
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - A Alonso
- Laboratorio Nacional de Fusion CIEMAT, 28040 Madrid, Spain
| | - J Baldzuhn
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - C D Beidler
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - C Biedermann
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - S Bozhenkov
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - K J Brunner
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - H Damm
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - M Hirsch
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - L Giannone
- Max-Planck-Institut für Plasmaphysik, 85748 Garching, Germany
| | - P Drewelow
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - F Effenberg
- University of Wisconsin, Madison, Wisconsin 53706, USA
| | - G Fuchert
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - K C Hammond
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - U Höfel
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - C Killer
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - J Knauer
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - H P Laqua
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - R Laube
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - N Pablant
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08540, USA
| | - E Pasch
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - F Penzel
- Max-Planck-Institut für Plasmaphysik, 85748 Garching, Germany
| | - K Rahbarnia
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - F Reimold
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - H Thomsen
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - V Winters
- University of Wisconsin, Madison, Wisconsin 53706, USA
| | - F Wagner
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - T Klinger
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
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Langenberg A, Svensson J, Marchuk O, Fuchert G, Bozhenkov S, Damm H, Pasch E, Pavone A, Thomsen H, Pablant NA, Burhenn R, Wolf RC. Inference of temperature and density profiles via forward modeling of an x-ray imaging crystal spectrometer within the Minerva Bayesian analysis framework. Rev Sci Instrum 2019; 90:063505. [PMID: 31255024 DOI: 10.1063/1.5086283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 06/06/2019] [Indexed: 06/09/2023]
Abstract
At the Wendelstein 7-X stellarator, the X-ray imaging crystal spectrometer provides line integrated measurements of ion and electron temperatures, plasma flows, as well as impurity densities from a spectroscopic analysis of tracer impurity radiation. In order to infer the actual profiles from line integrated data, a forward modeling approach has been developed within the Minerva Bayesian analysis framework. In this framework, the inversion is realized on the basis of a complete forward model of the diagnostic, including error propagation and utilizing Gaussian processes for generation and inference of arbitrary shaped plasma parameter profiles. For modeling of line integrated data as measured by the detector, the installation geometry of the spectrometer, imaging properties of the crystal, and Gaussian detection noise are considered. The inversion of line integrated data is achieved using the maximum posterior method for plasma parameter profile inference and a Markov chain Monte Carlo sampling of the posterior distribution for calculating uncertainties of the inference process. The inversion method shows a correct and reliable inference of temperature and impurity density profiles from synthesized data within the estimated uncertainties along the whole plasma radius. The application to measured data yields a good match of derived electron temperature profiles to data of the Thomson scattering diagnostic for central electron temperatures between 2 and 5 keV using argon impurities.
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Affiliation(s)
- A Langenberg
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - J Svensson
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - O Marchuk
- Forschungszentrum Jülich GmbH, Institut für Energie- und Klimaforschung-Plasmaphysik, 52425 Jülich, Germany
| | - G Fuchert
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - S Bozhenkov
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - H Damm
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - E Pasch
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - A Pavone
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - H Thomsen
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - N A Pablant
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08543, USA
| | - R Burhenn
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - R C Wolf
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
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Olsson E, Folkesson E, Peterson P, Önnerfjord P, Tjörnstrand J, Hughes HV, Englund M, Svensson J. Ultra-high field magnetic resonance imaging parameter mapping in the posterior horn of ex vivo human menisci. Osteoarthritis Cartilage 2019; 27:476-483. [PMID: 30552967 PMCID: PMC7610687 DOI: 10.1016/j.joca.2018.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 11/26/2018] [Accepted: 12/03/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the relationship between meniscus magnetic resonance (MR) relaxation parameters and meniscus degradation through quantitative imaging of ex vivo posterior horns of menisci from subjects with and without knee osteoarthritis (OA). DESIGN We sampled medial and lateral menisci from ten medial compartment knee OA patients (mean age 63 years) undergoing total knee replacement and from ten deceased donors (references, mean age 51 years). MR relaxation parameters T2*, T2 and T1 of the posterior horn were measured at a 9.4 T scanner. Comparisons were made between OA patients and references (with adjustment for age) as well as between medial and lateral menisci from the same knees. RESULTS Mean values (standard deviation) of mean T2* were 13 (3.8), 6.9 (2.3), 7.2 (1.9) and 7.2 (1.7) ms for the medial and lateral patient menisci and the medial and lateral reference menisci, respectively. Corresponding values were 17 (3.7), 9.0 (2.2), 12 (4) and 9.0 (1.3) ms for T2 and 1810 (150), 1630 (30), 1580 (90) and 1560 (50) ms for T1. All three relaxation times were significantly longer in medial OA menisci compared to the other groups. Among medial reference menisci, relaxation times (mainly T1) tended to increase with age. CONCLUSIONS MR relaxation times T2*, T2 and T1 in the posterior horn are longer in the medial menisci of patients with end-stage medial compartment knee OA compared to the corresponding lateral menisci and to reference menisci. The meniscus seems to undergo intrasubstance alterations related to both OA and ageing.
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Affiliation(s)
- E Olsson
- Medical Radiation Physics, Department of Translational Medicine, Lund University, Malmö, Sweden,Clinical Epidemiology Unit, Orthopedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - E Folkesson
- Clinical Epidemiology Unit, Orthopedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden,Rheumatology and Molecular Skeletal Biology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - P Peterson
- Medical Radiation Physics, Department of Translational Medicine, Lund University, Malmö, Sweden
| | - P Önnerfjord
- Rheumatology and Molecular Skeletal Biology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - J Tjörnstrand
- Orthopedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden,Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
| | - HV Hughes
- Clinical Epidemiology Unit, Orthopedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - M Englund
- Clinical Epidemiology Unit, Orthopedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - J Svensson
- Medical Radiation Physics, Department of Translational Medicine, Lund University, Malmö, Sweden,Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
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Linderholm BK, Ekholm M, Wännstig AK, Lundstedt D, Carlsson L, Tzikas AK, Svensson J, Kristiansson H, Filges S, Ståhlberg A. Abstract P1-16-09: Low-dose chemotherapy (CT) + bevacizumab (Bev) combined with unchanged endocrine treatment (ET) in patients with recurrent luminal breast cancer progressing during ET – Effect determined by standard imaging and changes in ctDNA and CTC during treatment. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-16-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Several mechanisms are involved in the development of endocrine resistance, such as mutations in the ESR1, PIK3CA, and TP53 genes and/or up-regulation of tyrosine kinase receptors such as the endothelial growth factor (VEGF) receptor. Preclinical data have revealed that sensitivity to endocrine therapy may be restored if these pathways are blocked.
Aims: To investigate the progression-free survival (PFS), overall response rate (ORR), and the toxicity of the study treatment. To use circulating tumor cells (CTC) and circulating tumor DNA (ct-DNA) at base-line and during treatment for next generation sequencing (NGS) to investigate whether changes in tumor mutations or in levels of CTC/ct-DNA correlate to treatment efficacy.
Patients and methods: Thirty-two patients aged 46-77 years with confirmed advanced breast cancer (ABC) progressing during ET were included. Treatment consisted of unchanged ET with the addition of cyclophosphamide 50mg x 1 and capecitabine 500mg x 3 daily + bevacizumab 15mg/kg iv. every third week (q21). Blood samples for analysis of CTC and ctDNA were collected at base-line, after the 1st and 2nd course, and at progression. CTC were isolated by use of an immune-magnetic selection (ADNA-test) and sequenced by NGS. ctDNA were analysed by the SiMSen-Seq (Simple Multiplexed PCR-based barcoding of DNA for Sensitive mutation detection using Sequencing) that allows mutant frequencies < 0.1% to be detected.
Results: One patient did not start treatment and 2 were not evaluable. Palliative chemotherapy (1-2 lines) had been delivered before inclusion to 28% and > 1 line of palliative ET to 58% of the patients. A total of 72% (n=21) of the patients had visceral disease (of whom 7 had liver metastases), and 28% (n=8) patients bone-only disease. Median PFS was 9.1 months (range 2.1-59.3 months). Best responses were: 1 patient (3%) received complete remission; 7 patients (24%) partial response; 16 patients (55%) SD (of whom 12 had CB, defined as SD > 24 weeks), and 5 (17%) had progressive disease. The ORR (defined as CR, PR, or CB) was 69%. The most common toxicity was hypertension (62%), that resulted in termination in 2 patients, and 1 patient stopped treatment due to thrombocytopenia. Other side-effects were proteinuria grade 1-3 (24%); hand-foot-syndrome grade 1-2 (45%); mucositis grade 1 (14%); nausea grade 1 (14%) and diarrhea grade 1-3 (10%). CTC was isolated in 12 patients (37%). Three out of the 5 patients with PD at 12 weeks had detectable CTCs at base-line. Base-line ESR1, PIK3CA and TP53 mutations were found in CTC from 2 patients (17%), 7 patients (58%), and 5 patients (42%), respectively, but did not correlate to response.
Conclusion: The treatment was well tolerated with an ORR of 69%, which is considered very good in this setting. CTCs were only isolated in 37% of the patients which is comparable to previously reported results in metastatic luminal breast cancer and thus not a feasible method for monitoring treatment effect. Results on levels of consecutive ctDNA, as well as mutation pattern in relation treatment effect will be presented.
Citation Format: Linderholm BK, Ekholm M, Wännstig A-K, Lundstedt D, Carlsson L, Tzikas A-K, Svensson J, Kristiansson H, Filges S, Ståhlberg A. Low-dose chemotherapy (CT) + bevacizumab (Bev) combined with unchanged endocrine treatment (ET) in patients with recurrent luminal breast cancer progressing during ET – Effect determined by standard imaging and changes in ctDNA and CTC during treatment [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-16-09.
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Affiliation(s)
- BK Linderholm
- Institution of Clinical Sciences, Sahlgrenska University Hospital, Gothenburg, Sweden; Ryhov County Hospital, Jönköping, Sweden; Sundsvalls Hospital, Sundsvall, Sweden; Sahlgrenska Cancer Center, Gothenburg University, Gothenburg, Sweden
| | - M Ekholm
- Institution of Clinical Sciences, Sahlgrenska University Hospital, Gothenburg, Sweden; Ryhov County Hospital, Jönköping, Sweden; Sundsvalls Hospital, Sundsvall, Sweden; Sahlgrenska Cancer Center, Gothenburg University, Gothenburg, Sweden
| | - A-K Wännstig
- Institution of Clinical Sciences, Sahlgrenska University Hospital, Gothenburg, Sweden; Ryhov County Hospital, Jönköping, Sweden; Sundsvalls Hospital, Sundsvall, Sweden; Sahlgrenska Cancer Center, Gothenburg University, Gothenburg, Sweden
| | - D Lundstedt
- Institution of Clinical Sciences, Sahlgrenska University Hospital, Gothenburg, Sweden; Ryhov County Hospital, Jönköping, Sweden; Sundsvalls Hospital, Sundsvall, Sweden; Sahlgrenska Cancer Center, Gothenburg University, Gothenburg, Sweden
| | - L Carlsson
- Institution of Clinical Sciences, Sahlgrenska University Hospital, Gothenburg, Sweden; Ryhov County Hospital, Jönköping, Sweden; Sundsvalls Hospital, Sundsvall, Sweden; Sahlgrenska Cancer Center, Gothenburg University, Gothenburg, Sweden
| | - A-K Tzikas
- Institution of Clinical Sciences, Sahlgrenska University Hospital, Gothenburg, Sweden; Ryhov County Hospital, Jönköping, Sweden; Sundsvalls Hospital, Sundsvall, Sweden; Sahlgrenska Cancer Center, Gothenburg University, Gothenburg, Sweden
| | - J Svensson
- Institution of Clinical Sciences, Sahlgrenska University Hospital, Gothenburg, Sweden; Ryhov County Hospital, Jönköping, Sweden; Sundsvalls Hospital, Sundsvall, Sweden; Sahlgrenska Cancer Center, Gothenburg University, Gothenburg, Sweden
| | - H Kristiansson
- Institution of Clinical Sciences, Sahlgrenska University Hospital, Gothenburg, Sweden; Ryhov County Hospital, Jönköping, Sweden; Sundsvalls Hospital, Sundsvall, Sweden; Sahlgrenska Cancer Center, Gothenburg University, Gothenburg, Sweden
| | - S Filges
- Institution of Clinical Sciences, Sahlgrenska University Hospital, Gothenburg, Sweden; Ryhov County Hospital, Jönköping, Sweden; Sundsvalls Hospital, Sundsvall, Sweden; Sahlgrenska Cancer Center, Gothenburg University, Gothenburg, Sweden
| | - A Ståhlberg
- Institution of Clinical Sciences, Sahlgrenska University Hospital, Gothenburg, Sweden; Ryhov County Hospital, Jönköping, Sweden; Sundsvalls Hospital, Sundsvall, Sweden; Sahlgrenska Cancer Center, Gothenburg University, Gothenburg, Sweden
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Birkebaek NH, Kahlert J, Bjarnason R, Drivvoll AK, Johansen A, Konradsdottir E, Pundziute-Lyckå A, Samuelsson U, Skrivarhaug T, Svensson J. Body mass index standard deviation score and obesity in children with type 1 diabetes in the Nordic countries. HbA 1c and other predictors of increasing BMISDS. Pediatr Diabetes 2018; 19:1198-1205. [PMID: 29781227 DOI: 10.1111/pedi.12693] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2017] [Revised: 03/30/2018] [Accepted: 04/30/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Intensified insulin therapy may increase body weight and cause obesity. This study compared body mass index standard deviation score (BMISDS) and obesity rate in children with type 1 diabetes (T1D) in Denmark, Iceland, Norway and Sweden, and uncovered predictors for increasing BMISDS. METHODS Data registered in the Nordic national childhood diabetes databases during the period 2008-2012 on children below 15 years with T1D for more than 3 months were compiled, including information on gender, age, diabetes duration, hemoglobin A1c (HbA1c ), insulin dose, severe hypoglycemia (SH), treatment modality, height and weight. The Swedish reference chart for BMI was used for calculating BMISDS. RESULTS Totally, 11 025 children (48% females) (30 994 registrations) were included. Medians by the last recorded examination were: age, 13.5 years; diabetes duration, 4.3 years; HbA1c , 7.9% (63 mmol/mol); insulin dose, 0.8 IU/kg/d and BMISDS, 0.70. Obesity rate was 18.5%. Adjusted mean BMISDS (BMISDS adj) was inversely related to HbA1c and directly to diabetes duration. Higher BMISDS adj was found in those with an insulin dose above 0.6 IU/kg/d, and in girls above 10 years. Pump users had higher BMISDS adj than pen users, and patients with registered SH had higher BMISDS adj than patients without SH (both P < .001). CONCLUSION Obesity rate in children with T1D in the Nordic countries is high, however, with country differences. Low HbA1c , long diabetes duration, higher insulin dose, pump treatment and experiencing a SH predicted higher BMISDS. Diabetes caregivers should balance the risk of obesity and the benefit of a very low HbA1c.
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Affiliation(s)
- N H Birkebaek
- Department of Paediatrics, Aarhus University Hospital, Aarhus University, Aarhus, Denmark
| | - J Kahlert
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - R Bjarnason
- Landspitali University Hospital, and Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - A K Drivvoll
- Division of Paediatrics and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - A Johansen
- Department of Growth and Reproduction, Rigshospitalet, Copenhagen, Denmark
| | - E Konradsdottir
- Landspitali University Hospital, and School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | | | - U Samuelsson
- Department of Pediatrics, Linköbing University Hospital, Linköping, Sweden
| | - T Skrivarhaug
- Division of Paediatrics and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - J Svensson
- Department of Paediatrics, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
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Langenberg A, Pablant NA, Wegner T, Traverso P, Marchuk O, Bräuer T, Geiger B, Fuchert G, Bozhenkov S, Pasch E, Grulke O, Kunkel F, Killer C, Nicolai D, Satheeswaran G, Hollfeld KP, Schweer B, Krings T, Drews P, Offermanns G, Pavone A, Svensson J, Alonso JA, Burhenn R, Wolf RC. Prospects of X-ray imaging spectrometers for impurity transport: Recent results from the stellarator Wendelstein 7-X (invited). Rev Sci Instrum 2018; 89:10G101. [PMID: 30399890 DOI: 10.1063/1.5036536] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 05/28/2018] [Indexed: 06/08/2023]
Abstract
This paper reports on the design and the performance of the recently upgraded X-ray imaging spectrometer systems, X-ray imaging crystal spectrometer and high resolution X-ray imaging spectrometer, installed at the optimized stellarator Wendelstein 7-X. High resolution spectra of highly ionized, He-like Si, Ar, Ti, and Fe as well as H-like Ar have been observed. A cross comparison of ion and electron temperature profiles derived from a spectral fit and tomographic inversion of Ar and Fe spectra shows a reasonable match with both the spectrometers. The also measured impurity density profiles of Ar and Fe have peaked densities at radial positions that are in qualitative agreement with the expectations from the He-like impurity fractional abundances, given the measured temperature profiles. Repeated measurements of impurity decay times have been demonstrated with an accuracy of 1 ms via injection of non-recycling Ti, Fe, and Mo impurities using a laser blow-off system.
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Affiliation(s)
- A Langenberg
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - N A Pablant
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08543, USA
| | - Th Wegner
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - P Traverso
- Auburn University, Auburn, Alabama 36849, USA
| | - O Marchuk
- Department of Physics, PPFE, Technical University of Denmark DTU, DK-2800 Lyngby, Denmark
| | - T Bräuer
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - B Geiger
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - G Fuchert
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - S Bozhenkov
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - E Pasch
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - O Grulke
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - F Kunkel
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - C Killer
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - D Nicolai
- Forschungszentrum Jülich GmbH, Institut für Energie- und Klimaforschung-Plasmaphysik, 52425 Jülich, Germany
| | - G Satheeswaran
- Forschungszentrum Jülich GmbH, Institut für Energie- und Klimaforschung-Plasmaphysik, 52425 Jülich, Germany
| | - K P Hollfeld
- Forschungszentrum Jülich GmbH, Institut für Energie- und Klimaforschung-Plasmaphysik, 52425 Jülich, Germany
| | - B Schweer
- Forschungszentrum Jülich GmbH, Institut für Energie- und Klimaforschung-Plasmaphysik, 52425 Jülich, Germany
| | - T Krings
- Forschungszentrum Jülich GmbH, Institut für Energie- und Klimaforschung-Plasmaphysik, 52425 Jülich, Germany
| | - P Drews
- Forschungszentrum Jülich GmbH, Institut für Energie- und Klimaforschung-Plasmaphysik, 52425 Jülich, Germany
| | - G Offermanns
- Forschungszentrum Jülich GmbH, Institut für Energie- und Klimaforschung-Plasmaphysik, 52425 Jülich, Germany
| | - A Pavone
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - J Svensson
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - J A Alonso
- Laboratorio Nacional de Fusión, Asociación EURATOM-CIEMAT, Madrid, Spain
| | - R Burhenn
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
| | - R C Wolf
- Max-Planck-Institut für Plasmaphysik, 17491 Greifswald, Germany
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Fredheim S, Foli-Andersen P, Laerkholm G, Svensson J, Juhl CB, Olsen B, Pilgaard K, Johannesen J. Adrenaline and cortisol levels are lower during nighttime than daytime hypoglycaemia in children with type 1 diabetes. Acta Paediatr 2018. [PMID: 29520851 DOI: 10.1111/apa.14310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
AIM We investigated children's counter regulatory hormone profiles during a hyperinsulinaemic hypoglycaemic clamp procedure at day and night. METHODS In 2013, we assessed the counter regulatory response to hypoglycaemia in eight outpatients with type 1 diabetes, recruited from the Herlev Hospital, Denmark, at a mean age of 9.6 ± 2.3 years. Hyperinsulinaemic 80 mU/m2 /min clamps were performed with a stepwise reduction in plasma glucose from euglycaemia (7-9 mmol/L) to hypoglycaemia (<3.5 mmol/L) and the glucose nadir (≤2.2 mmol/L) during the day and night. Adrenaline, cortisol, glucagon and growth hormone levels were assessed. RESULTS Adrenaline and growth hormone levels were higher during the day versus the night (p = 0.04 and p = 0.01, respectively). However, at the glucose nadir, the level of adrenaline was lower during the night than the day (0.6 ± 0.2 versus 1.9 ± 0.5 nmol/L, p = 0.016) and cortisol was lower during the day than the night (42 ± 15 versus 319 ± 81 nmol/L, p = 0.016). No differences were demonstrated for glucagon and growth hormone levels based on the same criteria. CONCLUSION The adrenaline response was blunted during nocturnal iatrogenic hypoglycaemia in our study cohort, and no increase in cortisol levels was demonstrated.
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Affiliation(s)
- S Fredheim
- Department of Paediatrics; CPH-Direct; Copenhagen University Hospital, Herlev and Gentofte; Herlev Denmark
| | - P Foli-Andersen
- Department of Paediatrics; CPH-Direct; Copenhagen University Hospital, Herlev and Gentofte; Herlev Denmark
| | - G Laerkholm
- Department of Paediatrics; CPH-Direct; Copenhagen University Hospital, Herlev and Gentofte; Herlev Denmark
| | - J Svensson
- Department of Paediatrics; CPH-Direct; Copenhagen University Hospital, Herlev and Gentofte; Herlev Denmark
- Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
| | - CB Juhl
- HypoSafe A/S; Lyngby Denmark
| | - B Olsen
- Department of Paediatrics; CPH-Direct; Copenhagen University Hospital, Herlev and Gentofte; Herlev Denmark
| | - K Pilgaard
- Department of Paediatrics; CPH-Direct; Copenhagen University Hospital, Herlev and Gentofte; Herlev Denmark
| | - J Johannesen
- Department of Paediatrics; CPH-Direct; Copenhagen University Hospital, Herlev and Gentofte; Herlev Denmark
- Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
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Wang T, Mazon D, Svensson J, Li D, Jardin A, Verdoolaege G. Incorporating magnetic equilibrium information in Gaussian process tomography for soft X-ray spectroscopy at WEST. Rev Sci Instrum 2018; 89:10F103. [PMID: 30399849 DOI: 10.1063/1.5039152] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 07/14/2018] [Indexed: 06/08/2023]
Abstract
Gaussian process tomography (GPT) [J. Svensson, JET Internal Report EFDA-JET-PR(11)24, 2011 and D. Li, J. Svensson, H. Thomsen, F. Medina, A. Werner, and R. Wolf, Rev. Sci. Instrum. 84, 083506 (2013)] is a recently developed tomography method applied earlier to soft X-ray (SXR) spectroscopy on WEST-Tungsten (W) Environment in Steady-state Tokamak. The short execution time of the algorithm makes GPT an important candidate for providing real-time information on impurity transport and for fast MHD control. In earlier work, GPT has shown its flexibility by providing good reconstruction results without background information about the magnetic equilibrium. On the other hand, information about the magnetic flux surface geometry can in general be useful for additional regularization of the solution. In this paper, we develop a way to take into account the equilibrium information, by constructing a covariance matrix of the prior Gaussian process depending on the flux surface geometry. The GPT method is validated using synthetic SXR emissivity profiles relevant to WEST plasmas and compares favorably with the classical algorithm based on minimization of the Fisher information.
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Affiliation(s)
- T Wang
- Southwestern Institute for Physics, CNNC, C-610200 Chengdu, China
| | - D Mazon
- Institute for Magnetic Fusion Research, CEA, F-13115 Saint-Paul-lez-Durance, France
| | - J Svensson
- Max-Planck-Institut für Plasmaphysik, D-17491 Greifswald, Germany
| | - D Li
- Southwestern Institute for Physics, CNNC, C-610200 Chengdu, China
| | - A Jardin
- Institute for Magnetic Fusion Research, CEA, F-13115 Saint-Paul-lez-Durance, France
| | - G Verdoolaege
- Department of Applied Physics, Ghent University, B-9000 Ghent, Belgium
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Pavone A, Svensson J, Langenberg A, Pablant N, Hoefel U, Kwak S, Wolf RC. Bayesian uncertainty calculation in neural network inference of ion and electron temperature profiles at W7-X. Rev Sci Instrum 2018; 89:10K102. [PMID: 30399785 DOI: 10.1063/1.5039286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 07/16/2018] [Indexed: 06/08/2023]
Abstract
We make use of a Bayesian description of the neural network (NN) training for the calculation of the uncertainties in the NN prediction. Having uncertainties on the NN prediction allows having a quantitative measure for trusting the NN outcome and comparing it with other methods. Within the Bayesian framework, the uncertainties can be calculated under different approximations. The NN has been trained with the purpose of inferring ion and electron temperature profile from measurements of a X-ray imaging diagnostic at W7-X. The NN has been trained in such a way that it constitutes an approximation of a full Bayesian model of the diagnostic, implemented within the Minerva framework. The network has been evaluated using measured data and the uncertainties calculated under different approximations have been compared with each other, finding that neglecting the noise on the NN input can lead to an underestimation of the error bar magnitude in the range of 10%-30%.
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Affiliation(s)
- A Pavone
- Max-Planck-Institute for Plasma Physics, Greifswald 17491, Germany
| | - J Svensson
- Max-Planck-Institute for Plasma Physics, Greifswald 17491, Germany
| | - A Langenberg
- Max-Planck-Institute for Plasma Physics, Greifswald 17491, Germany
| | - N Pablant
- Princenton Plasma Physics Lab, Princeton, New Jersey 08543, USA
| | - U Hoefel
- Max-Planck-Institute for Plasma Physics, Greifswald 17491, Germany
| | - S Kwak
- Max-Planck-Institute for Plasma Physics, Greifswald 17491, Germany
| | - R C Wolf
- Max-Planck-Institute for Plasma Physics, Greifswald 17491, Germany
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He S, Blombäck M, Boström F, Wallen H, Svensson J, Östlund A. An increased tendency in fibrinogen activity and its association with a hypo-fibrinolytic state in early stages after injury in patients without acute traumatic coagulopathy (ATC). J Thromb Thrombolysis 2018; 45:477-485. [PMID: 29564685 PMCID: PMC5889778 DOI: 10.1007/s11239-018-1642-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Acute traumatic coagulopathy (ATC) diagnosed by prolongation of APTT and/or PT/INR involves alterations in platelet activity, coagulation and fibrinolysis. However, data showing the haemostatic situation in injured patients without ATC are scarce. To assess whether haemostatic impairment is also present in injured patients without ATC, ten injured patients without ATC and ten normal individuals were examined. The patients were sampled on arrival at the emergency department 0, 2, 12 h after surgical or other intervention. Thrombin generation, fibrin formation and fibrin proteolysis were determined via several laboratory methods, using tissue factor as the coagulation trigger. Thrombograms demonstrated that trauma accelerated both thrombin generation and decay. In the presence of unaffected peak thrombin levels, these two contradictory effects cancelled each other out, leading to the global endogenous thrombin potential (ETP) remaining normal. Under the mediation of normal ETP, fibrin network permeability (Ks) kept the reference levels in the two groups of subjects. Fibrinogen (FBG) activity (Clauss) rose with time from 0 to 2 h and 12 h, which significantly slowed down Clot Lysis Potential as determined by an in vitro method with exogenous t-PA. Summary: the main haemostatic impairment in the present patients concerned an increased tendency in FBG activity. Since an increase in FBG is a biomarker of acute inflammation and also predicts greater fibrin production which down-regulates fibrinolysis, we suggest that during early stages after injury, patients without ATC may suffer from worsening inflammation and confront enhancement of thrombosis risk due to dysfunction of fibrinolysis.
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Affiliation(s)
- S He
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Building 8-9, 6th floor, 18288, Stockholm, Sweden.
| | - M Blombäck
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Building 8-9, 6th floor, 18288, Stockholm, Sweden.,Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - F Boström
- Department of Clinical Immunology and Transfusion Medicine, Karolinska Institutet, Stockholm, Sweden
| | - H Wallen
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Building 8-9, 6th floor, 18288, Stockholm, Sweden
| | - J Svensson
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Building 8-9, 6th floor, 18288, Stockholm, Sweden
| | - A Östlund
- Perioperative Medicine and Intensive Care, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.,Department of Physiology and Pharmacology, Section for Anesthesiology and Intensive Care Medicine, Karolinska Institutet, Stockholm, Sweden
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Wang T, Mazon D, Svensson J, Li D, Jardin A, Verdoolaege G. Gaussian process tomography for soft x-ray spectroscopy at WEST without equilibrium information. Rev Sci Instrum 2018; 89:063505. [PMID: 29960552 DOI: 10.1063/1.5023162] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Gaussian process tomography (GPT) is a recently developed tomography method based on the Bayesian probability theory [J. Svensson, JET Internal Report EFDA-JET-PR(11)24, 2011 and Li et al., Rev. Sci. Instrum. 84, 083506 (2013)]. By modeling the soft X-ray (SXR) emissivity field in a poloidal cross section as a Gaussian process, the Bayesian SXR tomography can be carried out in a robust and extremely fast way. Owing to the short execution time of the algorithm, GPT is an important candidate for providing real-time reconstructions with a view to impurity transport and fast magnetohydrodynamic control. In addition, the Bayesian formalism allows quantifying uncertainty on the inferred parameters. In this paper, the GPT technique is validated using a synthetic data set expected from the WEST tokamak, and the results are shown of its application to the reconstruction of SXR emissivity profiles measured on Tore Supra. The method is compared with the standard algorithm based on minimization of the Fisher information.
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Affiliation(s)
- T Wang
- Southwestern Institute for Physics, CNNC, C-610200 Chengdu, China
| | - D Mazon
- Institute for Magnetic Fusion Research, CEA, F-13115 Saint-Paul-lez-Durance, France
| | - J Svensson
- Max-Planck-Institut für Plasmaphysik, D-17491 Greifswald, Germany
| | - D Li
- Southwestern Institute for Physics, CNNC, C-610200 Chengdu, China
| | - A Jardin
- Institute for Magnetic Fusion Research, CEA, F-13115 Saint-Paul-lez-Durance, France
| | - G Verdoolaege
- Department of Applied Physics, Ghent University, B-9000 Ghent, Belgium
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Thorsen SU, Pipper CB, Johannesen J, Mortensen HB, Pociot F, Svensson J. '25-Hydroxyvitamin D, Autoantigenic and Total Antibody Concentrations: Results from a Danish Case-control Study of Newly Diagnosed Patients with Childhood Type 1 Diabetes and their Healthy Siblings'. Scand J Immunol 2017; 87:46-53. [PMID: 29125655 DOI: 10.1111/sji.12632] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Accepted: 11/05/2017] [Indexed: 01/03/2023]
Abstract
B cells have recently entered the stage as an important accessory player in type 1 diabetes (T1D) etiopathogenesis. Experimental studies suggest regulatory functions of vitamin D on B cells. However, only a few human studies, with considerable methodological limitations, have been conducted within this field. Our objective was to investigate whether higher 25-hydroxyvitamin D (25(OH)D) concentrations were inversely associated with β-cell autoantigens glutamic acid decarboxylase (isoform 65) (GADA) and insulinoma-associated antigen-2A (IA-2A). Further, we also wanted to examine the relationship between 25(OH)D and total antibody concentrations. We randomly selected 500 patients with newly diagnosed T1D and 500 siblings for 25(OH)D, antibody and genetic analysis from the population-based Danish Registry of Childhood and Adolescent Diabetes. The relative change (RC) in the mean concentration of GADA, IA-2A and antibody isotypes by a 10 nmol/l increase in 25(OH)D concentration was modelled by a robust log-normal regression model. We found no association between 25(OH)D and GADA [adjusted RC per 10 nmol/l increase: 1.00; 95% confidence interval (CI): 0.98-1.02] and IA-2A [adjusted RC per 10 nmol/l increase: 0.92; CI: 0.76-1.12]. Further, 25(OH)D was not associated with the total concentration of antibody isotypes [immunoglobulin (Ig)A, IgE, IgG and IgM]. All null findings were unaltered after adjustment for genetic variation in the vitamin D pathway. Physiological concentrations of 25(OH)D are unlikely to have a clinically important effect on antibody concentrations in a paediatric population of newly diagnosed patients with T1D and their healthy siblings.
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Affiliation(s)
- S U Thorsen
- Copenhagen Diabetes Research Center (CPH-DIRECT), Department of Paediatrics, Herlev Hospital, University of Copenhagen, Herlev, Denmark
| | - C B Pipper
- Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen K, Denmark
| | - J Johannesen
- Copenhagen Diabetes Research Center (CPH-DIRECT), Department of Paediatrics, Herlev Hospital, University of Copenhagen, Herlev, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen N, Denmark
| | - H B Mortensen
- Copenhagen Diabetes Research Center (CPH-DIRECT), Department of Paediatrics, Herlev Hospital, University of Copenhagen, Herlev, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen N, Denmark
| | - F Pociot
- Copenhagen Diabetes Research Center (CPH-DIRECT), Department of Paediatrics, Herlev Hospital, University of Copenhagen, Herlev, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen N, Denmark
| | - J Svensson
- Copenhagen Diabetes Research Center (CPH-DIRECT), Department of Paediatrics, Herlev Hospital, University of Copenhagen, Herlev, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen N, Denmark
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Arshad SA, Cordey JG, McDonald DC, Farthing J, Joffrin E, Hellermann MV, Roach CM, Svensson J. Chapter 11: Data Validation, Analysis, and Applications for Fusion Plasmas. Fusion Science and Technology 2017. [DOI: 10.13182/fst08-a1683] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- S. A. Arshad
- EFDA-CSU, Culham Science Centre, Abingdon, Oxfordshire OX14 3DB, United Kingdom
- EURATOM0UKAEA Fusion Association, Culham Science Centre, Abingdon, Oxfordshire OX14 3DB, United Kingdom
| | - J. G. Cordey
- EURATOM0UKAEA Fusion Association, Culham Science Centre, Abingdon, Oxfordshire OX14 3DB, United Kingdom
| | - D. C. McDonald
- EURATOM0UKAEA Fusion Association, Culham Science Centre, Abingdon, Oxfordshire OX14 3DB, United Kingdom
| | - J. Farthing
- EURATOM0UKAEA Fusion Association, Culham Science Centre, Abingdon, Oxfordshire OX14 3DB, United Kingdom
| | - E. Joffrin
- Association EURATOM0CEA sur la fusion, F-13108 St. Paul Lez Durance, France
| | - M. von Hellermann
- FOM Instituut voor Plasmafysica, EURATOM Association, TEC, Postbus 1207, NL-3430 BE, Nieuwegein, The Netherlands
| | - C. M. Roach
- EURATOM0UKAEA Fusion Association, Culham Science Centre, Abingdon, Oxfordshire OX14 3DB, United Kingdom
| | - J. Svensson
- IPP Greifswald, Max-Planck-Institut für Plasmaphysik, Wendelsteinstr. 1, D-17491 Greifswald, Germany
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Langenberg A, Svensson J, Thomsen H, Marchuk O, Pablant NA, Burhenn R, Wolf RC. Forward Modeling of X-Ray Imaging Crystal Spectrometers Within the Minerva Bayesian Analysis Framework. Fusion Science and Technology 2017. [DOI: 10.13182/fst15-181] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- A. Langenberg
- Max-Planck-Institut für Plasmaphysik, Greifswald 17491, Germany
| | - J. Svensson
- Max-Planck-Institut für Plasmaphysik, Greifswald 17491, Germany
| | - H. Thomsen
- Max-Planck-Institut für Plasmaphysik, Greifswald 17491, Germany
| | - O. Marchuk
- Forschungszentrum Jülich GmbH, Institut für Energie- und Klimaforschung-Plasmaphysik, Jülich 52425, Germany
| | - N. A. Pablant
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08540
| | - R. Burhenn
- Max-Planck-Institut für Plasmaphysik, Greifswald 17491, Germany
| | - R. C. Wolf
- Max-Planck-Institut für Plasmaphysik, Greifswald 17491, Germany
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Sandahl K, Nielsen LB, Svensson J, Johannesen J, Pociot F, Mortensen HB, Hougaard P, Broe R, Rasmussen ML, Grauslund J, Peto T, Olsen BS. Increased mortality in a Danish cohort of young people with Type 1 diabetes mellitus followed for 24 years. Diabet Med 2017; 34:380-386. [PMID: 27027777 DOI: 10.1111/dme.13124] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/29/2016] [Indexed: 11/28/2022]
Abstract
AIM To determine the mortality rate in a Danish cohort of children and adolescents diagnosed with Type 1 diabetes mellitus compared with the general population. METHODS In 1987 and 1989 we included 884 children and 1020 adolescents aged 20 years and under, corresponding to 75% of all Danish children and adolescents with Type 1 diabetes, in two nationwide studies in Denmark. Those who had participated in both investigations (n = 720) were followed until 1 January 2014, using the Danish Civil Registration System on death certificates and emigration. We derived the expected number of deaths in the cohort, using population data values from Statistics Denmark to calculate the standardized mortality ratio. Survival analysis was performed using Cox proportional hazards model. RESULTS During the 24 years of follow-up, 49 (6.8%) patients died, resulting in a standardized mortality ratio of 4.8 (95% confidence interval 3.5, 6.2) compared with the age-standardized general population. A 1% increase in baseline HbA1c (1989), available in 718 of 720 patients, was associated with all-cause mortality (hazard ratio = 1.38; 95% confidence interval 1.2, 1.6; P < 0.0001). Type 1 diabetes with multiple complications was the most common reported cause of death (36.7%). CONCLUSION We found an increased mortality rate in this cohort of children and adolescents with Type 1 diabetes compared with the general population. The only predictor for increased risk of death up to 24 years after inclusion was the HbA1c level in 1989. This emphasizes the importance of achieving optimal metabolic control in young people with Type 1 diabetes.
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Affiliation(s)
- K Sandahl
- Department of Paediatrics, Herlev Hospital, University of Copenhagen, Herlev, Denmark
| | - L B Nielsen
- Department of Paediatrics, Herlev Hospital, University of Copenhagen, Herlev, Denmark
| | - J Svensson
- Department of Paediatrics, Herlev Hospital, University of Copenhagen, Herlev, Denmark
| | - J Johannesen
- Department of Paediatrics, Herlev Hospital, University of Copenhagen, Herlev, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - F Pociot
- Department of Paediatrics, Herlev Hospital, University of Copenhagen, Herlev, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - H B Mortensen
- Department of Paediatrics, Herlev Hospital, University of Copenhagen, Herlev, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - P Hougaard
- Department of Epidemiology, Biostatistics and Biodemography, Odense University Hospital, Odense, Denmark
| | - R Broe
- Department of Ophthalmology, Odense University Hospital, Odense, Denmark
- The Clinical Research Institute, University of Southern Denmark, Odense, Denmark
- OPEN Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - M L Rasmussen
- Department of Ophthalmology, Odense University Hospital, Odense, Denmark
- The Clinical Research Institute, University of Southern Denmark, Odense, Denmark
- OPEN Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - J Grauslund
- Department of Ophthalmology, Odense University Hospital, Odense, Denmark
- The Clinical Research Institute, University of Southern Denmark, Odense, Denmark
- OPEN Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - T Peto
- Department of Ophthalmology, Odense University Hospital, Odense, Denmark
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - B S Olsen
- Department of Paediatrics, Herlev Hospital, University of Copenhagen, Herlev, Denmark
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Moen F, Svensson J, Steen Carlsson K. Assessing the value of cancer treatments from real world data—Issues, empirical examples and lessons learnt. J Cancer Policy 2017. [DOI: 10.1016/j.jcpo.2016.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Timpka J, Svensson J, Nilsson MH, Pålhagen S, Hagell P, Odin P. Workforce unavailability in Parkinson's disease. Acta Neurol Scand 2017; 135:332-338. [PMID: 27072284 DOI: 10.1111/ane.12602] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Individuals with Parkinson's disease (PD) become unavailable in the workforce earlier than comparable members of the general population. This may result in significant social insurance expenses, but as workforce participation can be a source for social interaction and a vital part of the personal identity, there are likely to be personal implications extending far beyond the economic aspects. This study aimed to identify aspects that may contribute to workforce unavailability in people with PD. MATERIALS & METHODS This was a cross-sectional registry study using data from the Swedish national quality registry for PD and included persons with PD in Skåne County, Sweden who were younger than 65 years. Variables were selected from the registry based on earlier studies and clinical experience and were tested for association with unavailability in the workforce: first in a series of simple regression analyses and then in a multiple logistic regression analysis. RESULTS A total of 99 persons with PD-of whom 59 were available and 40 were unavailable in the workforce-were included in the study. Age (OR per year: 1.47, 95% CI: 1.18-1.85; P < 0.01) and anxiety (OR: 6.81, 95% CI: 1.20-38.67; P = 0.03) were significant contributing factors for unavailability in the workforce. CONCLUSIONS Based on the findings in this exploratory study, anxiety-a potentially modifiable factor-and age may be contributing factors for workforce unavailability in PD. However, prospective studies are warranted to confirm the findings and the causation of the association between anxiety and workforce unavailability needs to be clarified.
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Affiliation(s)
- J. Timpka
- Department of Clinical Sciences Lund, Neurology; Faculty of Medicine; Lund University; Lund Sweden
- Department of Neurology; Skåne University Hospital; Lund Sweden
| | - J. Svensson
- The Swedish Institute for Health Economics (IHE); Lund Sweden
| | - M. H. Nilsson
- Department of Health Sciences; Faculty of Medicine; Lund University; Lund Sweden
- Memory Clinic; Skåne University Hospital; Malmö Sweden
| | - S. Pålhagen
- Department of Clinical Sciences Lund, Neurology; Faculty of Medicine; Lund University; Lund Sweden
- Department of Neurology; Karolinska University Hospital; Huddinge Sweden
| | - P. Hagell
- School of Health and Society; Kristianstad University; Kristianstad Sweden
| | - P. Odin
- Department of Clinical Sciences Lund, Neurology; Faculty of Medicine; Lund University; Lund Sweden
- Department of Neurology; Skåne University Hospital; Lund Sweden
- Department of Neurology; Central Hospital; Bremerhaven Germany
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Birkebaek NH, Drivvoll AK, Aakeson K, Bjarnason R, Johansen A, Samuelsson U, Skrivarhaug T, Thorsson AV, Svensson J. Incidence of severe hypoglycemia in children with type 1 diabetes in the Nordic countries in the period 2008-2012: association with hemoglobin A 1c and treatment modality. BMJ Open Diabetes Res Care 2017; 5:e000377. [PMID: 28761652 PMCID: PMC5530237 DOI: 10.1136/bmjdrc-2016-000377] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 04/11/2017] [Accepted: 04/17/2017] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Treatment of type 1 diabetes has been intensified aiming at normalizing blood glucose, which may increase the risk of severe hypoglycemia (SH). We aimed to compare the incidence of SH events in the four Nordic countries Denmark, Iceland, Norway and Sweden, and to assess the influence of hemoglobin A1c (HbA1c) and treatment modalities on the frequency of SH; particularly, to explore if a HbA1c target ≤6.7% (50 mmol/mol) is feasible. RESEARCH DESIGN AND METHODS Data on children below 15 years with a diabetes duration more than 1 year, registered in the national childhood diabetes databases in the four Nordic countries from 2008 to 2012, were compiled. Data completeness was more than 95%. RESULTS Totally 8806 (48% females) patients with 29 715 person years were included, mean age and diabetes duration were 11 years and 5.1 years, respectively. The overall rate of SH was 6.0 per 100 patient-years, and did not change during the study period. The Swedish population constantly had the lowest SH incidence while it decreased significantly in the Danish population. HbA1c decreased significantly over time (p<0.01), while the number of pump users increased (p<0.01). Stratifying for HbA1c levels showed the lowest risk of SH in patients with HbA1c ≤6.7% (≤50 mmol/mol), but in the statistical models adjusting for possible confounders the difference between the HbA1c groups disappeared. Pump users had the lowest SH risk, also after adjusting for possible confounders. CONCLUSIONS Risk of SH differs between the Nordic countries with the lowest risk in Sweden. Pump therapy was associated with decreased risk of SH. The low HbA1c group had the same or a lower risk of SH compared with the highest HbA1c groups. A target HbA1c ≤6.7% (≤50 mmol/mol) seems achievable without increasing the risk of SH.
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Affiliation(s)
- NH Birkebaek
- Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark
| | - AK Drivvoll
- Norwegian Childhood Diabetes Registry, Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - K Aakeson
- Department of Pediatrics, County Hospital Ryhov, Jönköping, Sweden
| | - R Bjarnason
- Medical Center, Landspitali University Hospital, Reykjavik, Iceland
- Department of Pediatrics, University of Iceland, Reykjavik, Iceland
| | - A Johansen
- Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - U Samuelsson
- Department of Pediatrics, Linköping University Hospital, Linköping, Sweden
| | - T Skrivarhaug
- Norwegian Childhood Diabetes Registry, Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - AV Thorsson
- Medical Center, Landspitali University Hospital, Reykjavik, Iceland
- Department of Pediatrics, University of Iceland, Reykjavik, Iceland
| | - J Svensson
- Copenhagen Diabetes Research Center (CPH-DIRECT), Department of Children and Adolescents, Copenhagen University Hospital, Herlev, Denmark
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Krychowiak M, Adnan A, Alonso A, Andreeva T, Baldzuhn J, Barbui T, Beurskens M, Biel W, Biedermann C, Blackwell BD, Bosch HS, Bozhenkov S, Brakel R, Bräuer T, Brotas de Carvalho B, Burhenn R, Buttenschön B, Cappa A, Cseh G, Czarnecka A, Dinklage A, Drews P, Dzikowicka A, Effenberg F, Endler M, Erckmann V, Estrada T, Ford O, Fornal T, Frerichs H, Fuchert G, Geiger J, Grulke O, Harris JH, Hartfuß HJ, Hartmann D, Hathiramani D, Hirsch M, Höfel U, Jabłoński S, Jakubowski MW, Kaczmarczyk J, Klinger T, Klose S, Knauer J, Kocsis G, König R, Kornejew P, Krämer-Flecken A, Krawczyk N, Kremeyer T, Książek I, Kubkowska M, Langenberg A, Laqua HP, Laux M, Lazerson S, Liang Y, Liu SC, Lorenz A, Marchuk AO, Marsen S, Moncada V, Naujoks D, Neilson H, Neubauer O, Neuner U, Niemann H, Oosterbeek JW, Otte M, Pablant N, Pasch E, Sunn Pedersen T, Pisano F, Rahbarnia K, Ryć L, Schmitz O, Schmuck S, Schneider W, Schröder T, Schuhmacher H, Schweer B, Standley B, Stange T, Stephey L, Svensson J, Szabolics T, Szepesi T, Thomsen H, Travere JM, Trimino Mora H, Tsuchiya H, Weir GM, Wenzel U, Werner A, Wiegel B, Windisch T, Wolf R, Wurden GA, Zhang D, Zimbal A, Zoletnik S. Overview of diagnostic performance and results for the first operation phase in Wendelstein 7-X (invited). Rev Sci Instrum 2016; 87:11D304. [PMID: 27910389 DOI: 10.1063/1.4964376] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Wendelstein 7-X, a superconducting optimized stellarator built in Greifswald/Germany, started its first plasmas with the last closed flux surface (LCFS) defined by 5 uncooled graphite limiters in December 2015. At the end of the 10 weeks long experimental campaign (OP1.1) more than 20 independent diagnostic systems were in operation, allowing detailed studies of many interesting plasma phenomena. For example, fast neutral gas manometers supported by video cameras (including one fast-frame camera with frame rates of tens of kHz) as well as visible cameras with different interference filters, with field of views covering all ten half-modules of the stellarator, discovered a MARFE-like radiation zone on the inboard side of machine module 4. This structure is presumably triggered by an inadvertent plasma-wall interaction in module 4 resulting in a high impurity influx that terminates some discharges by radiation cooling. The main plasma parameters achieved in OP1.1 exceeded predicted values in discharges of a length reaching 6 s. Although OP1.1 is characterized by short pulses, many of the diagnostics are already designed for quasi-steady state operation of 30 min discharges heated at 10 MW of ECRH. An overview of diagnostic performance for OP1.1 is given, including some highlights from the physics campaigns.
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Affiliation(s)
- M Krychowiak
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - A Adnan
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - A Alonso
- Laboratorio Nacional de Fusión, CIEMAT, Avenida Complutense, Madrid, Spain
| | - T Andreeva
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - J Baldzuhn
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - T Barbui
- University of Wisconsin, Engineering Drive, Madison, Wisconsin 53706, USA
| | - M Beurskens
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - W Biel
- Forschungszentrum Jülich GmbH, Institut für Energie- und Klimaforschung - Plasmaphysik, Partner of the Trilateral Euregio Cluster (TEC), 52425 Jülich, Germany
| | - C Biedermann
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - B D Blackwell
- Australian National University, Acton ACT, 2601 Canberra, Australia
| | - H S Bosch
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - S Bozhenkov
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - R Brakel
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - T Bräuer
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - B Brotas de Carvalho
- Instituto de Plasmas e Fusao Nuclear, Avenue Rovisco Pais 1, 1049-001 Lisboa, Portugal
| | - R Burhenn
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - B Buttenschön
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - A Cappa
- Laboratorio Nacional de Fusión, CIEMAT, Avenida Complutense, Madrid, Spain
| | - G Cseh
- Wigner Research Centre for Physics, Konkoly Thege 29-33, H-1121 Budapest, Hungary
| | - A Czarnecka
- Institute of Plasma Physics and Laser Microfusion, Hery Street 23, 01-497 Warsaw, Poland
| | - A Dinklage
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - P Drews
- Forschungszentrum Jülich GmbH, Institut für Energie- und Klimaforschung - Plasmaphysik, Partner of the Trilateral Euregio Cluster (TEC), 52425 Jülich, Germany
| | - A Dzikowicka
- University of Szczecin, al. Papieża Jana Pawła II 22A, Szczecin, Poland
| | - F Effenberg
- University of Wisconsin, Engineering Drive, Madison, Wisconsin 53706, USA
| | - M Endler
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - V Erckmann
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - T Estrada
- Laboratorio Nacional de Fusión, CIEMAT, Avenida Complutense, Madrid, Spain
| | - O Ford
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - T Fornal
- Institute of Plasma Physics and Laser Microfusion, Hery Street 23, 01-497 Warsaw, Poland
| | - H Frerichs
- University of Wisconsin, Engineering Drive, Madison, Wisconsin 53706, USA
| | - G Fuchert
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - J Geiger
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - O Grulke
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - J H Harris
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - H J Hartfuß
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - D Hartmann
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - D Hathiramani
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - M Hirsch
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - U Höfel
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - S Jabłoński
- Institute of Plasma Physics and Laser Microfusion, Hery Street 23, 01-497 Warsaw, Poland
| | - M W Jakubowski
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - J Kaczmarczyk
- Institute of Plasma Physics and Laser Microfusion, Hery Street 23, 01-497 Warsaw, Poland
| | - T Klinger
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - S Klose
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - J Knauer
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - G Kocsis
- Wigner Research Centre for Physics, Konkoly Thege 29-33, H-1121 Budapest, Hungary
| | - R König
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - P Kornejew
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - A Krämer-Flecken
- Forschungszentrum Jülich GmbH, Institut für Energie- und Klimaforschung - Plasmaphysik, Partner of the Trilateral Euregio Cluster (TEC), 52425 Jülich, Germany
| | - N Krawczyk
- Institute of Plasma Physics and Laser Microfusion, Hery Street 23, 01-497 Warsaw, Poland
| | - T Kremeyer
- University of Wisconsin, Engineering Drive, Madison, Wisconsin 53706, USA
| | - I Książek
- Opole University, pl. Kopernika 11a, 45-040 Opole, Poland
| | - M Kubkowska
- Institute of Plasma Physics and Laser Microfusion, Hery Street 23, 01-497 Warsaw, Poland
| | - A Langenberg
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - H P Laqua
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - M Laux
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - S Lazerson
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08543, USA
| | - Y Liang
- Forschungszentrum Jülich GmbH, Institut für Energie- und Klimaforschung - Plasmaphysik, Partner of the Trilateral Euregio Cluster (TEC), 52425 Jülich, Germany
| | - S C Liu
- Forschungszentrum Jülich GmbH, Institut für Energie- und Klimaforschung - Plasmaphysik, Partner of the Trilateral Euregio Cluster (TEC), 52425 Jülich, Germany
| | - A Lorenz
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - A O Marchuk
- Forschungszentrum Jülich GmbH, Institut für Energie- und Klimaforschung - Plasmaphysik, Partner of the Trilateral Euregio Cluster (TEC), 52425 Jülich, Germany
| | - S Marsen
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - V Moncada
- CEA, IRFM, F-13108 Saint-Paul-lez-Durance, France
| | - D Naujoks
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - H Neilson
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08543, USA
| | - O Neubauer
- Forschungszentrum Jülich GmbH, Institut für Energie- und Klimaforschung - Plasmaphysik, Partner of the Trilateral Euregio Cluster (TEC), 52425 Jülich, Germany
| | - U Neuner
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - H Niemann
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - J W Oosterbeek
- Eindhoven University of Technology, P.O. Box 513, 5600 MB Eindhoven, The Netherlands
| | - M Otte
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - N Pablant
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08543, USA
| | - E Pasch
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - T Sunn Pedersen
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - F Pisano
- University of Cagliari, Via Università, 40, 09124 Cagliari, Italy
| | - K Rahbarnia
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - L Ryć
- Institute of Plasma Physics and Laser Microfusion, Hery Street 23, 01-497 Warsaw, Poland
| | - O Schmitz
- University of Wisconsin, Engineering Drive, Madison, Wisconsin 53706, USA
| | - S Schmuck
- Culham Science Centre, Abingdon OX14 3DB, United Kingdom
| | - W Schneider
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - T Schröder
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - H Schuhmacher
- Physikalisch-Technische Bundesanstalt, Bundesallee 100, 38116 Braunschweig, Germany
| | - B Schweer
- Forschungszentrum Jülich GmbH, Institut für Energie- und Klimaforschung - Plasmaphysik, Partner of the Trilateral Euregio Cluster (TEC), 52425 Jülich, Germany
| | - B Standley
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - T Stange
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - L Stephey
- University of Wisconsin, Engineering Drive, Madison, Wisconsin 53706, USA
| | - J Svensson
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - T Szabolics
- Wigner Research Centre for Physics, Konkoly Thege 29-33, H-1121 Budapest, Hungary
| | - T Szepesi
- Wigner Research Centre for Physics, Konkoly Thege 29-33, H-1121 Budapest, Hungary
| | - H Thomsen
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - J-M Travere
- CEA, IRFM, F-13108 Saint-Paul-lez-Durance, France
| | - H Trimino Mora
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - H Tsuchiya
- NIFS National Institute for Fusion Science, 322-6 Oroshi-cho, Toki 509-5292, Japan
| | - G M Weir
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - U Wenzel
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - A Werner
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - B Wiegel
- Physikalisch-Technische Bundesanstalt, Bundesallee 100, 38116 Braunschweig, Germany
| | - T Windisch
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - R Wolf
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - G A Wurden
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - D Zhang
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - A Zimbal
- Physikalisch-Technische Bundesanstalt, Bundesallee 100, 38116 Braunschweig, Germany
| | - S Zoletnik
- Wigner Research Centre for Physics, Konkoly Thege 29-33, H-1121 Budapest, Hungary
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Paterson RW, Heywood WE, Heslegrave AJ, Magdalinou NK, Andreasson U, Sirka E, Bliss E, Slattery CF, Toombs J, Svensson J, Johansson P, Fox NC, Zetterberg H, Mills K, Schott JM. A targeted proteomic multiplex CSF assay identifies increased malate dehydrogenase and other neurodegenerative biomarkers in individuals with Alzheimer's disease pathology. Transl Psychiatry 2016; 6:e952. [PMID: 27845782 PMCID: PMC5314115 DOI: 10.1038/tp.2016.194] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 07/31/2016] [Indexed: 12/12/2022] Open
Abstract
Alzheimer's disease (AD) is the most common cause of dementia. Biomarkers are required to identify individuals in the preclinical phase, explain phenotypic diversity, measure progression and estimate prognosis. The development of assays to validate candidate biomarkers is costly and time-consuming. Targeted proteomics is an attractive means of quantifying novel proteins in cerebrospinal and other fluids, and has potential to help overcome this bottleneck in biomarker development. We used a previously validated multiplexed 10-min, targeted proteomic assay to assess 54 candidate cerebrospinal fluid (CSF) biomarkers in two independent cohorts comprising individuals with neurodegenerative dementias and healthy controls. Individuals were classified as 'AD' or 'non-AD' on the basis of their CSF T-tau and amyloid Aβ1-42 profile measured using enzyme-linked immunosorbent assay; biomarkers of interest were compared using univariate and multivariate analyses. In all, 35/31 individuals in Cohort 1 and 46/36 in Cohort 2 fulfilled criteria for AD/non-AD profile CSF, respectively. After adjustment for multiple comparisons, five proteins were elevated significantly in AD CSF compared with non-AD CSF in both cohorts: malate dehydrogenase; total APOE; chitinase-3-like protein 1 (YKL-40); osteopontin and cystatin C. In an independent multivariate orthogonal projection to latent structures discriminant analysis (OPLS-DA), these proteins were also identified as major contributors to the separation between AD and non-AD in both cohorts. Independent of CSF Aβ1-42 and tau, a combination of these biomarkers differentiated AD and non-AD with an area under curve (AUC)=0.88. This targeted proteomic multiple reaction monitoring (MRM)-based assay can simultaneously and rapidly measure multiple candidate CSF biomarkers. Applying this technique to AD we demonstrate differences in proteins involved in glucose metabolism and neuroinflammation that collectively have potential clinical diagnostic utility.
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Affiliation(s)
- R W Paterson
- Dementia Research Centre, Institute of Neurology, University College London, London, UK,Department of Neurodegeneration, University College London, Dementia Research Centre, Queen Square, London WC1N3BG, UK. E-mail:
| | - W E Heywood
- Centre for Translational Omics, Genetics and Genomic Medicine Programme, Institute of Child Health, University College London, London, UK
| | - A J Heslegrave
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
| | - N K Magdalinou
- Lila Weston Institute, University College London Institute of Neurology, London, UK
| | - U Andreasson
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - E Sirka
- Centre for Translational Omics, Genetics and Genomic Medicine Programme, Institute of Child Health, University College London, London, UK
| | - E Bliss
- Centre for Translational Omics, Genetics and Genomic Medicine Programme, Institute of Child Health, University College London, London, UK
| | - C F Slattery
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - J Toombs
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
| | - J Svensson
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Department of Endocrinology, Skaraborg Central Hospital, Skövde, Sweden
| | - P Johansson
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Department of Neuropsychiatry, Skaraborg Central Hospital, Falköping, Sweden
| | - N C Fox
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - H Zetterberg
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK,Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - K Mills
- Dementia Research Centre, Institute of Neurology, University College London, London, UK,Centre for Translational Omics, Genetics and Genomic Medicine Programme, Institute of Child Health, University College London, London, UK
| | - J M Schott
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
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48
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Andersen AJB, Ostenfeld A, Pipper CB, Olsen BS, Hertz AM, Jørgensen LK, Høgsmose J, Svensson J. Optimum bolus wizard settings in insulin pumps in children with Type 1 diabetes. Diabet Med 2016; 33:1360-5. [PMID: 26773826 DOI: 10.1111/dme.13064] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/11/2016] [Indexed: 10/22/2022]
Abstract
AIM To evaluate current insulin pump settings in an optimally regulated paediatric population using bolus wizard. METHODS We used a retrospective study design to analyse data from 124 children on insulin pump therapy who had optimum HbA1c levels [< 59 mmol/mol (< 7.5%)] and no history of severe hypoglycaemic events. Bolus wizard settings were used to calculate the insulin to carbohydrate factors and insulin sensitivity factors. Multiple regression analysis was used to analyse the variables associated with the calculation factors. RESULTS Insulin to carbohydrate factor varied from 276 in the youngest group to 424 in the oldest group, and increased according to age. Insulin sensitivity factor was highest in the group aged 6 to < 12 years, with a value of 125. Age, amount of carbohydrates, number of boluses per day and insulin per kg were all significantly associated with both calculation factors. Furthermore, duration of insulin pump treatment was significantly associated with insulin sensitivity factor and percentage bolus/basal was significantly associated with insulin to carbohydrate factor. Gender, diabetes duration and BMI were not associated with any of the calculation factors. CONCLUSION Optimum insulin pump settings at pump initiation depend on both insulin requirements and use of the pump. Settings need to be individualized because the standardized calculation factors are not constant for children. There is a need to develop specific age- and insulin dose-dependent calculation factors.
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Affiliation(s)
- A J B Andersen
- Faculty of Health and Medical Sciences, University of Copenhagen, Herlev, Denmark.
| | - A Ostenfeld
- Paediatric Department, Copenhagen University Hospital, Herlev, Denmark
| | - C B Pipper
- Section of Biostatistics, Institute of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - B S Olsen
- Paediatric Department, Copenhagen University Hospital, Herlev, Denmark
| | - A M Hertz
- Paediatric Department, Copenhagen University Hospital, Herlev, Denmark
| | - L K Jørgensen
- Paediatric Department, Copenhagen University Hospital, Herlev, Denmark
| | - J Høgsmose
- Paediatric Department, Copenhagen University Hospital, Herlev, Denmark
| | - J Svensson
- Paediatric Department, Copenhagen University Hospital, Herlev, Denmark
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49
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Måsson S, Johansson E, Svensson J, Olsson LE, Ståhlberg F, Petersson JS, Golman K. Echo-planar MR imaging of dissolved hyperpolarized 129Xe: Potential for MR angiography. Acta Radiol 2016. [DOI: 10.1258/rsmacta.43.5.455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Purpose: The feasibility of hyperpolarized 129Xe for fast MR angiography (MRA) was evaluated using the echo-planar imaging (EPI) technique. Material and Methods: Hyperpolarized Xe gas was dissolved in ethanol, a carrier agent with high solubility for Xe (Ostwald solubility coefficient 2.5) and long relaxation times. The dissolved Xe was injected as a bolus into a flow phantom where the mean flow velocity was 15 cm/s. Ultrafast EPI images with 44 ms scan time were acquired of the flowing bolus and the signal-to-noise ratios (SNR) were measured. Results: The relaxation times of hyperpolarized Xe in ethanol were measured to T1=160±11 s and T2≈20 s. The resulting images of the flowing liquid were of reasonable quality and had an SNR of about 70. Conclusion: Based on the SNR of the obtained Xe EPI images, it was estimated that rapid in vivo MRA with 129Xe may be feasible, provided that an efficient, biologically acceptable carrier for Xe can be found and polarization levels of more than 25% can be achieved in isotopically enriched 129Xe.
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Affiliation(s)
- S. Måsson
- Department of Experimental Research, Malmö University Hospital, Sweden
| | - E. Johansson
- Department of Radiation Physics, Lund University Hospital, Sweden
| | - J. Svensson
- Department of Radiation Physics, Malmö University Hospital, Malmö, Sweden
| | - L. E. Olsson
- Department of Radiation Physics, Malmö University Hospital, Malmö, Sweden
| | - F. Ståhlberg
- Department of Radiology, Lund University Hospital, Malmö, Sweden
| | | | - K. Golman
- Amersham Health R&D, Medeon, Malmö, Sweden
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50
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Thorsen SU, Pipper CB, Alberdi-Saugstrup M, Nielsen S, Cohen A, Lundqvist M, Thygesen LC, Ascherio A, Svensson J. No association between vitamin D levels around time of birth and later risk of developing oligo- and polyarticular juvenile idiopathic arthritis: a Danish case–cohort study. Scand J Rheumatol 2016; 46:104-111. [DOI: 10.1080/03009742.2016.1178325] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- SU Thorsen
- Copenhagen Diabetes Research Centre (CPH-DIRECT), Department of Paediatrics, Herlev University Hospital, Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - CB Pipper
- Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - M Alberdi-Saugstrup
- Paediatric Rheumatology Clinic, Rigshospitalet, Copenhagen, Denmark
- Department of Paediatrics, Næstved Hospital, Næstved, Denmark
| | - S Nielsen
- Paediatric Rheumatology Clinic, Rigshospitalet, Copenhagen, Denmark
| | - A Cohen
- Department of Congenital Disorders, Statens Serum Institute, Copenhagen, Denmark
| | - M Lundqvist
- Department of Congenital Disorders, Statens Serum Institute, Copenhagen, Denmark
| | - LC Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - A Ascherio
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - J Svensson
- Copenhagen Diabetes Research Centre (CPH-DIRECT), Department of Paediatrics, Herlev University Hospital, Herlev, Denmark
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