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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
31

Designing k-Space Filters to Improve Spatiotemporal Resolution with Sector-Wise Golden Angle (SWIG) / Design av k-space filter för förbättrad spatiotemporal upplösning med sektorsvis gyllene vinkel

Ström Seez, Jonas January 2022 (has links)
The aim of this thesis is to design and evaluate k-space weighting filters for simultaneously improving the spatial and temporal resolution of cardiovascular MRI, with the ultimate goal of improving the accuracy of quantitative flow measurements, which are important for diagnosis and follow-up of heart dysfunction. Two different k-space filters were implemented and evaluated retrospectively to already acquired data. In addition, evaluation was performed with respect to tapering of the filters in the radial k-space direction, as well as accelerated imaging using undersampling. To better utilize the properties of the golden-angle acquisition, a k-space filter was also implemented where the temporal footprint increased in discrete steps, referred to as rings. The temporal footprint of each ring was calculated according to the Fibonacci sequence, and the starting position for each ring was computed to satisfy the Nyquist criterion. The k-space filters were evaluated in comparison to non-filtered reconstructions of cine and phase-contrast images. Motion-mode images were created from the cine images and used to evaluate the edge sharpness of the septal wall indicating the spatial resolution of the image. Phase-contrast images were used to measure peak flow velocity over the mitral valve, and the myocardial velocity in the early and late filling phases. The resolution of the peak is highly dependent on the temporal resolution. Measuring the peak velocity gave an indication of the temporal resolution, which could be compared to non-filter reconstructions. This study showed that k-space filters adapted to the Nyquist criterion improve the temporal resolution of peak velocity measures. Further investigation is justified to conclude if the performance exceeded the best performing method without k-space filters. However, the k-space filter showed substantial agreement with the best performing temporal footprint without k-space filter. / Syftet med arbetet är att designa och utvärdera k-space viktade filter för att förbättra den spatiala och temporala upplösningen av kardiovaskulär MRI, med målet att förbättra noggrannheten i kvantitativa flödesmätningar, som är viktiga för diagnos och uppföljning av hjärtdysfunktion. Två typer av k-space filter skapades och utvärderades retrospektivt på redan inhämtade data. Dessutom utfördes utvärdering med avseende på avsmalning av filtren i den radiella k-rymdsriktningen, såväl som accelererad avbildning med undersampling. För att bättre utnyttja egenskaperna hos den gyllene vinkeln skapades det ena k-rumsfilter så att det temporala fotavtrycket ökade i diskreta steg, så kallade ringar. Det temporala fotavtrycket för varje ring beräknades enligt Fibonacci talen, och startpositionen för varje ring beräknades så att den uppfyllde Nyquistkriteriet. k-Spacefiltren utvärderades i jämförelse med icke-filtrerade rekonstruktioner av tidsupplösta, anatomiska bilder (cine) och tidsupplösta faskontrastbilder. Bilder i motion-mode skapades från cine-bilderna och användes för att utvärdera kantskärpan av hjärtats skiljevägg (septum), vilket användes som en indikator för bildens spatiala upplösning. Faskontrastbilder användes för att mäta den maximala flödeshastigheten över mitralisklaffen och myokardiets hastighet i den tidiga och sena fyllnadsfasen. Maximal flödeshastighet är starkt beroende av den temporala upplösningen och gav därav en indikation på den temporala upplösningen. Denna studie visade att k-rumsfilter anpassade till Nyquist-kriteriet förbättrar den temporala upplösningen av topphastigheten. Ytterligare undersökning behövs dock för att säkerställa att prestandan översteg den bäst presterande metoden utan k-rumsfilter. Bilder rekonstruerade med filtret visade dock god överensstämmelse med det minsta temporala fotavtrycket, utan filter.
32

The role of fibroblast growth factor-23 in chronic kidney disease-mineral and bone disorder

Mirza, Majd A. I. January 2010 (has links)
Fibroblast growth factor-23 (FGF23) was initially identified as the causative factor of autosomal dominant hypophosphatemic rickets. Further studies confirmed that FGF23 is predominantly expressed in the osteocytes and osteoblasts of bone and that circulating FGF23 acts on the kidney to inhibit renal phosphate reabsorption and 1,25(OH)2D3 hydroxylation. With the progression of chronic kidney disease (CKD), the kidneys become insufficient to maintain a normal systemic mineral homeostasis, resulting in various abnormalities of bone and mineral metabolism, generally referred to as Chronic Kidney Disease – Mineral and Bone Disorders (CKD-MBD). FGF23 increases early in the course of CKD in order to maintain normal serum phosphate levels; long before a significant increase in serum phosphate can be detected. Recent studies suggest that increased FGF23 levels are associated with progression of CKD, mortality, and the development of refractory secondary hyperparathyroidism. Because FGF23 is the very earliest marker of CKD-MBD, it is of particular interest to evaluate the relation between FGF23 and CKD-MBD abnormalities, in the setting of early CKD and also in individuals with normal renal function. In the present work, we show that FGF23 is linked to several dynamic measurements of vascular function, including endothelial dysfunction, arterial stiffness, and atherosclerosis. FGF23 is also positively associated with left ventricular mass index and an increased risk of having left ventricular hypertrophy. All associations were independent of serum phosphate and were strengthened in subjects with diminished renal function. Furthermore, we found significant evidence for an association between higher FGF23 and increased fat mass and dyslipidemia, which could represent a novel pathway linking FGF23 to cardiovascular disease. Finally, we show that FGF23 is a significant predictor of future fracture risk. Although these associations could be reflecting the increased risk associated with hyperphosphatemia and calcitriol deficiency, current evidence points towards FGF23 being more than an innocent bystander. At the very least, FGF23 holds promise of being a bio-marker of cardiovascular status and phosphate-related toxicity both in CKD and in the general population, and might be a therapeutic target that could improve the fatal prognosis in CKD patients.
33

Vegansk kost och typ 2-diabetes / Vegan diet and type 2-diabetes

Holm, Tilda, Svensson, Patrik January 2021 (has links)
Introduktion: Kardiovaskulära sjukdomar är en av de vanligaste sjukdomarna världen över och står årligen för 18 miljoner dödsfall, en tredjedel av alla dödsfall. En av dessa sjukdomar är diabetes som en av elva i världen har i någon form och mörkertalet är stort. Typ 2-diabetes (T2D) kan vara ärftlig men är också påverkbart. Riskfaktorerna kan förebyggas genom en hälsosam livsstil som innefattar fysisk aktivitet och hälsosam kost, som kan reducera övervikt. En skyddsfaktor är frukt och grönsaker, något som en vegansk diet till stora delar består av. Syfte: Syftet med denna studie är att genom två perspektiv (primär- och sekundärprevention) undersöka om en vegansk kost minskar risken för T2D. Metod: Med en strukturerad litteraturstudie har datainsamling skett via databaser PubMed och Cochrane Library. Vald analysmetod var innehållsanalys. Resultat: Från 21 granskade artiklar framkom sex olika kategorier: 1) Prevention, prevalens och incidens av T2D (veganer löper lägre risk att drabbas av T2D); 2) Vikt, BMI och kroppsmått (en vegansk kost främjar viktnedgång och sänkt BMI vid övervikt); 3) Blodvärden och blodtryck (både systoliskt och diastoliskt blodtryck, HbA1c, glukos, c-peptid, betacellsfunktion och insulinkänslighet förbättras av en vegansk kost); 4) Hormoner (GLP-1, GIP, PYY och amylin optimeras av en vegansk kost); 5) Metabolism (TMAO minskar medan och postprandial metabolism stärks av vegansk kost); och 6) Kolesterol (vegansk kost förbättrar värden för LDL, HDL samt triglycerider). Slutsats: I sin helhet visade resultatet på att en vegansk kost kan minska risken för T2D bland vuxna (≥18 år) på både primär och sekundär nivå. / Introduction: Cardiovascular disease (CVD) is one of the most common diseases worldwide and accounts for 18 million deaths annually, which is one-third of all deaths. One risk factor for CVD is type 2 diabetes (T2D). Globally, one in eleven persons has T2D and undetected cases are high. T2D can be hereditary but people can also be susceptible to T2D. The risk factors can be prevented through a healthy lifestyle including physical activity and healthy diet, which can reduce obesity. A protective factor is dietary intake of fruits and vegetables, something that a vegan diet largely contains. Aim: The aim of this study is to investigate through two perspectives (primary and secondary prevention) whether a vegan diet reduces the risk of T2D. Methods: A systematic literature review accomplished data collection using two databases, PubMed and the Cochrane Library. The analysis method chosen was content analysis. Results: Of 21 articles reviewed, six different categories emerged: 1) prevention, prevalence and incidence of type 2 diabetes (vegans are at lower risk of developing T2D); 2) body weight, body mass index (BMI) and body measurements (a vegan diet promotes weight loss, decreased BMI); 3) Blood values and blood pressure (systolic and diastolic blood pressure, HbA1c , glucose, c-peptide, beta cell function and insulin sensitivity are enhanced by a vegan diet); 4) Hormones (GLP-1, GIP, PYY and amylin are optimized by a vegan diet); 5) Metabolism (TMAO decreases and postprandial metabolism is enhanced by vegan diet); and 6) Cholesterol (vegan diet improves LDL, HDL and triglycerides). Conclusion: The results showed that a vegan diet can reduce the risk of type 2-diabetes among adults (≥18 years) at both primary and secondary levels.
34

Validation of Simultaneous T1 and T2 Mapping Using Cardiac Magnetic Resonance Fingerprinting in Self-Constructed Phantoms : An Analysis of the Reproducibility and Accuracy / Validering av simultan T1- och T2-karaktärisering med hjälp av Cardiac Magnetic Resonance Fingerprinting i egentillverkade fantom : En analys av reproducerbarheten och noggrannhet

Meesan, Sasithon January 2023 (has links)
Quantitative cardiac magnetic resonance imaging (CMR) has gained traction within both the clinical and research field due to high prevalence of cardiovascular diseases. Cardiac magnetic resonance fingerprinting (cMRF) is a novel approach introduced to address the limitation associated with evaluation of multiparametric quantitative CMR. cMRF enables simultaneous and co-registered estimation of tissue relaxation times, T1 and T2, in a single acquisition, making it a more time-efficient approach to multiparametric quantitative CMR. Nevertheless, cMRF has not gained widespread adaption due to insufficient evidence regarding its performance in accurately quantifying tissue characteristics. This study aims to evaluate the accuracy and reproducibility of a single cMRF sequence described by Hamilton et. al. using self-constructed phantoms to validate the sequence performance for cardiac imaging. The objective was to construct in-vitro phantoms with physiological combinations of T1 and T2 markers. The phantoms were then imaged using gold standard and conventional mapping sequences to establish reference values for comparison. The measurements obtained from the two distinct cMRF reconstruction approaches were then compared to these reference values and to each other to evaluate the accuracy. The statistical assessments did not find a statistically significant difference between neither the cMRF sequence and conventional mapping techniques, nor cMRF and the gold-standard method, when compared in in-vitro phantoms with physiological combinations of T1 and T2. / Kvantitativ kardiovaskulär magnetresonans (CMR) har fått ökad uppmärksamhet inom både den kliniska- och forskningsfältet på grund av hög förekomst av hjärt- och kärlsjukdomar. För att åtgärda begränsningarna vid utvärdering av multiparametrisk kvantitativ CMR, introducerades cardiac magnetic resonance fingerprinting (cMRF) som en ny metod. cMRF möjliggör simultan och samregistrerad uppskattning av vävnadens relaxationstider, T1 och T2, i samma insamling, vilket gör det till en mer tidseffektiv metod för multiparametrisk kvantitativ CMR. Trots detta är kliniska implementeringen av cMRF inte utbredd på grund av otillräckligt bevis för dess utförande vid exakt kvantifiering av vävnadsegenskaper. Syftet med denna studie är att bedöma noggrannheten hos en cMRF-sekvens som utvecklats av Hamilton et al. genom att använda egentillverkade fantomer för att verifiera hur effektiv sekvensen är för avbildning av hjärtat. Målet är att konstruera in vitro-fantom med fysiologiska kombinationer av  T1- och T2-markörer. Dessa fantomer avbildades med hjälp av referensmetoder och konventionell karaktärisering för att etablera jämförelsevärden. Mätningarna som erhölls från de två distinkta cMRF-rekonstruktionsmetoderna jämfördes sedan statistiskt med jämförelsevärdena och med varandra för att utvärdera mätnoggrannheten. De statistiska bedömningarna kunde inte påvisa en skillnad mellan varken cMRF-sekvensen och konventionella metoder, eller referensmetod, vid jämförelse i in vitro-fantom med fysiologiska kombinationer av T1- och T2-värden.
35

VO2peak/THV-ratio differ between heart failure patients with preserved ejection fraction and healthy controls

Nilsson, Calle January 2017 (has links)
Heart failure is a term for a group of complex symtoms characterized by reduced heart function. One of these syndromes, referred to as heart failure with preserved ejection fraction (HFpEF), has increased in prevalence compared to other types of heart failures during the recent years. A concern is the difficulty in diagnosing patients with HFpEF, since current tools are considered insufficient. The aim of this thesis was to examine Peak Oxygen Uptake (VO2peak) in relation to Total Heart Volume (THV) among heart failure patients with preserved ejection fraction (HFpEF, EF >40 %) compared to healthy controls. THV was acquired by delineating images acquired using cardiovascular magnetic resonance imaging, while VO2peak was measured in oxygen curves acquired from cardiopulmonary exercise tests. Ratios were calculated by dividing VO2peak with THV. In order to determine if blood hemoglobin concentration (b-Hb) could affect the ratio, ratios were adjusted to b-Hb using an adjusting factor. Mean THV was nearly 250 ml larger in HFpEF patients compared to the controls. Patients’ mean VO2peak was more than 1000 ml lower compared to the controls. Mean VO2peak/THV ratio calculated for the patients were less than half of that calculated for the controls. Adjusting the ratio to b-Hb did not affect the ratios significantly. The study was limited by the size of the test group, but the findings suggest that a VO2peak/THV ratio can be used to separate HFpEF patients from healthy controls. / Hjärtsvikt är ett begrepp för en grupp med komplexa symtom och kännetecknas av försämrad hjärtfunktion. Ett av dessa syndrom, hjärtsvikt med bevarad ejektionsfraktion (HFpEF), har ökat i prevalens jämfört med andra varianter av hjärtsvikt under de senaste åren. Ett problem är de svårigheter som finns med att diagnosticera patienter med HFpEF, då nuvarande verktyg inte är tillräckliga. Syftet med detta examensarbete var att undersöka maximalt syreupptag (VO2peak) i förhållande till total hjärtvolym (THV) bland hjärtsviktspatienter med bevarad ejektionsfraktion (HFpEF, EF >40 %) jämfört med friska kontroller. THV erhölls genom att utlinjera bilder tagna med hjälp av magnetisk resonanstomografi, medan VO2peak mättes i syrevolymkurvor som registrerats under ergospirometri-undersökningar. Index beräknades genom att dividera VO2peak med THV. För att undersöka huruvida halten hemoglobin i blodet (b-Hb) kunde påverka index justerades index mot b-Hb med hjälp av en justeringsfaktor. Medel-THV var nästan 250 ml större hos HFpEF-patienter jämfört med kontroller. Medel-VO2peak var mer än 1000 ml lägre hos patienterna jämfört med kontroller. Medel VO2peak/THV-index som beräknats för patienter var mindre än hälften så högt som index beräknat för kontroller. Att justera index mot b-Hb påverkade inte index signifikant. Studien begränsades av mängden deltagare, men fynden indikerar att VO2peak/THV-index kan användas för att skilja HFpEF-patienter från friska kontroller.
36

Family caregiving for persons with heart failure : Perspectives of family caregivers, persons with heart failure and registered nurses

Gusdal, Annelie K January 2017 (has links)
Heart failure is a growing public health problem associated with significant morbidity and mortality. Family support positively affects outcomes for the person with heart failure while also leading to caregiver burden. Registered nurses have a key role in supporting and meeting the needs of family caregivers. The overall aim was to explore the situation and needs of family caregivers to a person with heart failure, and explore requisites and ways of supporting and involving family caregivers in heart failure nursing care. Two interview studies, one web survey study and one intervention study were conducted between 2012 and 2017. A total of 22 family caregivers, eight persons with heart failure and 331 registered nurses participated in the studies. Family caregivers' daily life was characterized by worry, uncertainty and relational incongruence but salutogenic behaviours restored new strength and motivation to care. Family caregivers experienced that their caregiving was taken for granted by health care professionals. Family caregivers expressed a need for a permanent health care contact and more involvement in the planning and implementation of their near one’s health care together with health care professionals. Registered nurses acknowledged family caregivers’ burden, lack of knowledge and relational incongruence. A registered nurse was suggested as a permanent health care contact to improve continuity and security. Registered nurses neither acknowledged family caregivers as a resource nor their need for involvement. Registered nurses working in primary health care centres, in nurse-led heart failure clinics, with district nurse specialization, with education in cardiac nursing care held the most supportive attitudes toward family involvement in heart failure nursing care. Family health conversations via telephone in nurse-led heart failure clinics were found to successfully support and involve families. The conversations enhanced nurse-family relationship and relations within the family. They also provided registered nurses with new, relevant knowledge and understanding about the family as a whole. Family health conversations via telephone were feasible to both families and registered nurses, although fewer and shorter conversations were preferred by registered nurses. This thesis highlights the divergence between family caregivers’ experiences and needs, and registered nurses’ perceptions about family caregivers’ situation and attitudes toward the importance of family involvement. It adds to the knowledge on the importance to acknowledge family caregivers as a resource and to support and involve them in heart failure nursing care. One feasible and successful way is to conduct Family health conversations via telephone in nurse-led heart failure clinics.
37

Preventing fatal effects of overworking : Product design solution

Adawi, Rahim January 2018 (has links)
“Overworking to death” is a phenomenon that has been noticeable in developing countries. The cause of death is mainly through ischemic strokes. While the victims’ occupations differed, they all shared a common characteristic, being positioned in a sedentary work, ranging from IT workers to doctors. This project’s aim was to develop a product that prevented or decreased the strokes that derived from sedentary overwork. This was mainly tackled by preventing one of the three causes of developing blood props, slowed blood flow. In order to gather rich data of the phenomenon, a qualitative study was conducted in China, during two months. By doing an extensive structured sampling, information rich data could be gathered during a short period of time. Data were derived from observations, questionnaires and an interview, which then was interpreted to customer needs and the final product specification. The final product became a trouser with an in built dynamic compression mechanic, that can compress the veins mostly during sitting activities, in order to prevent blood stasis. The compression mechanic works like the Chinese finger trap; compressing the calves while sitting and stretching the legs forward. It is made only out of polysaccharides fibres; cotton and corn. / "Guolaosi" eller död från överarbete är ett fenomen som i regel uppkommer bland utvecklingsländer. Dödsorsaken är huvudsakligen genom stroke. Offrens yrken varierar allt från professorer, IT-arbetare till läkare. De delar dock en sak gemensamt; att arbeta under långa perioder stillasittande. Projektets mål var att utveckla en produkt som minskar dödliga följderna av sedentära överarbete, genom att förebygga en av de tre orsakerna för att utveckla blodproppar; saktad blodström. Målgruppen var då kineser av de yrken som hade tidigare drabbats av fenomenet. För att samla informationsrika data om fenomenet genomfördes en kvalitativ studie i Kina under två månader. Genom att göra en omfattande strukturerad provtagning kunde informationsrika data samlas under en kort tidsperiod. Fältstudien bestod av observationer, frågeformulär och en intervju, som då tolkades till kundbehov och eventuellt produktspecifikationen. Den slutliga produkten kom att bli ett par byxor med en inbyggd dynamisk komprimeringsmekanism, som kan komprimera venerna under sittande aktiviteter, för att förhindra saktad blodström. Kompressionsmekanismen fungerar som den kinesiska fingerfällan. Den komprimerar blodkärlen medan personen sitter och sträcker benen framåt. Produkten är konstruerad på så sätt att den kan tillverkas endast av polysackariders tråd, från bomull och majs. Vilket är lämpligt för Kinas lokala resurser.

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