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  • 1. Ekström, Magnus
    et al.
    Jogreus, Claes
    Blekinge Institute of Technology, School of Engineering, Department of Mathematics and Natural Sciences.
    Ström, Kerstin
    Comorbidity and Sex-Related Differences in Mortality in Oxygen-Dependent Chronic Obstructive Pulmonary Disease2012In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 7, no 4Article in journal (Refereed)
    Abstract [en]

    Background: It is not known why survival differs between men and women in oxygen-dependent chronic obstructive pulmonary disease (COPD). The present study evaluates differences in comorbidity between men and women, and tests the hypothesis that comorbidity contributes to sex-related differences in mortality in oxygen-dependent COPD. Methods: National prospective study of patients aged 50 years or older, starting long-term oxygen therapy (LTOT) for COPD in Sweden between 1992 and 2008. Comorbidities were obtained from the Swedish Hospital Discharge Register. Sex-related differences in comorbidity were estimated using logistic regression, adjusting for age, smoking status and year of inclusion. The effect of comorbidity on overall mortality and the interaction between comorbidity and sex were evaluated using Cox regression, adjusting for age, sex, Pa-O2 breathing air, FEV1, smoking history and year of inclusion. Results: In total, 8,712 patients (55% women) were included and 6,729 patients died during the study period. No patient was lost to follow-up. Compared with women, men had significantly more arrhythmia, cancer, ischemic heart disease and renal failure, and less hypertension, mental disorders, osteoporosis and rheumatoid arthritis (P<0.05 for all odds ratios). Comorbidity was an independent predictor of mortality, and the effect was similar for the sexes. Women had lower mortality, which remained unchanged even after adjusting for comorbidity; hazard ratio 0.73 (95% confidence interval, 0.68-0.77; P<0.001). Conclusions: Comorbidity is different in men and women, but does not explain the sex-related difference in mortality in oxygen-dependent COPD.

  • 2.
    Jaworski, Jacek
    et al.
    Blekinge Institute of Technology, Faculty of Engineering, Department of Applied Signal Processing.
    Bates, Jason
    University of Vermont, USA.
    Sources of breathing pattern variability in the respiratory feedback control loop2019In: Journal of Theoretical Biology, ISSN 0022-5193, E-ISSN 1095-8541, Vol. 469, p. 148-162Article in journal (Refereed)
    Abstract [en]

    The variability of the breath-to-breath breathing pattern, and its alterations in disease, may hold information of physiologic and/or diagnostic value. We hypothesized that this variability arises from the way that noise is processed within the respiratory feedback control loop, and that pathologic alterations to specific components within the system give rise to characteristic alterations in breathing pattern variability. We explored this hypothesis using a computational model of the respiratory control system that integrates mechanical factors, gas exchange processes, and chemoreceptor signals to simulate breathing patterns subject to the influences of random variability in each of the system components. We found that the greatest changes in the coefficient of variation (CV) of both breathing amplitude and timing were caused by increases in lung resistance and impairments in gas exchange, both common features of pulmonary disease. This suggests that breathing pattern variability may reflect discernible deterministic processes involved in the control of breathing. © 2019 Elsevier Ltd

  • 3.
    Sandberg, Jacob
    et al.
    Lunds Universitet, SWE.
    Lansing, Robert
    University of Arizona, USA.
    Anderberg, Peter
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Currow, David
    Cancer Institute NSW, AUS.
    Sundh, Josefin
    Örebro Universitet, SWE.
    Ahmadi, Zainab
    Lunds Universitet, SWE.
    Palmqvist, Sebastian
    Skåne University Hospital, SWE.
    Ekström, Magnus
    Lunds Universitet, SWE.
    Relating Experienced To Recalled breathlessness Observational (RETRO) study: A prospective study using a mobile phone application2019In: BMJ Open Respiratory Research, ISSN 2052-4439, Vol. 6, no 1, article id e000370Article in journal (Refereed)
    Abstract [en]

    Background: Breathlessness, the subjective sensation of breathing discomfort, is common and appears in the daily life of people with cardiorespiratory diseases. Physicians often rely on patient's history based on symptom recall. The relation between recalled and experienced breathlessness is still poorly understood. This paper presents the protocol for a study primarily aimed at evaluating the relationship between experienced breathlessness and (1) recalled breathlessness and (2) predicted future breathlessness. Methods: A mobile phone application will be used to collect data during daily life. Medically stable participants, ≥18 years of age with mean daily breathlessness of Numerical Rating Scale (NRS) 3/10 and able to use a mobile phone with internet will rate their breathlessness intensity on a 0-10 NRS prompted the user several times daily for 1 week. Participants will recall their breathlessness each day and week. Multivariable random effects regression models will be used for statistical analyses. Results: Results of the study will be submitted for publication in peer-reviewed journals and presented at relevant conferences. Discussion: This protocol describes a study aimed at investigating previously unknown areas of the experience and recall of breathlessness using a new method of data collection. © 2019 Author(s).

  • 4.
    Silvanius, Mårten
    et al.
    Blekinge Institute of Technology, Faculty of Engineering, Department of Mechanical Engineering.
    Mitchell, Simon
    University of Auckland, NZL.
    Pollock, Neal
    Université Laval Québec, CAN.
    Frånberg, Oskar
    Blekinge Institute of Technology, Faculty of Engineering, Department of Mechanical Engineering.
    Gennser, Mikael
    KTH.
    Lindén, Jerry
    Swedish Armed Forces Diving and Naval Medicine Centre, SWE.
    Mesley, Peter
    Lust for Rust Diving, NZL.
    Gant, Nicholas
    University of Auckland, NZL.
    The performance of 'temperature stick' carbon dioxide absorbent monitors in diving rebreathers2019In: Diving and Hyperbaric Medicine, ISSN 1833-3516, Vol. 49, no 1, p. 48-56Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Diving rebreathers use canisters containing soda lime to remove carbon dioxide (CO2) from expired gas. Soda lime has a finite ability to absorb CO₂. Temperature sticks monitor the exothermic reaction between CO₂ and soda lime to predict remaining absorptive capacity. The accuracy of these predictions was investigated in two rebreathers that utilise temperature sticks. METHODS: Inspiration and rEvo rebreathers filled with new soda lime were immersed in water at 19°C and operated on mechanical circuits whose ventilation and CO₂-addition parameters simulated dives involving either moderate exercise (6 MET) throughout (mod-ex), or 90 minutes of 6 MET exercise followed by 2 MET exercise (low-ex) until breakthrough (inspired PCO₂ [PiCO₂] = 1 kPa). Simulated dives were conducted at surface pressure (sea-level) (low-ex: Inspiration, n = 5; rEvo, n = 5; mod-ex: Inspiration, n = 7, rEvo, n = 5) and at 3-6 metres' sea water (msw) depth (mod-ex protocol only: Inspiration, n = 8; rEvo, n = 5). RESULTS: Operated at surface pressure, both rebreathers warned appropriately in four of five low-ex tests but failed to do so in the 12 mod-ex tests. At 3-6 msw depth, warnings preceded breakthrough in 11 of 13 mod-ex tests. The rEvo warned conservatively in all five tests (approximately 60 minutes prior). Inspiration warnings immediately preceded breakthrough in six of eight tests, but were marginally late in one test and 13 minutes late in another. CONCLUSION: When operated at even shallow depth, temperature sticks provided timely warning of significant CO₂ breakthrough in the scenarios examined. They are much less accurate during simulated exercise at surface pressure. Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.

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