| 1. |
- Arvidsson, Ida, et al.
(författare)
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Comparing a pre-defined versus deep learning approach for extracting brain atrophy patterns to predict cognitive decline due to Alzheimer’s disease in patients with mild cognitive symptoms
- 2024
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Ingår i: Alzheimer's Research and Therapy. - 1758-9193. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Predicting future Alzheimer’s disease (AD)-related cognitive decline among individuals with subjective cognitive decline (SCD) or mild cognitive impairment (MCI) is an important task for healthcare. Structural brain imaging as measured by magnetic resonance imaging (MRI) could potentially contribute when making such predictions. It is unclear if the predictive performance of MRI can be improved using entire brain images in deep learning (DL) models compared to using pre-defined brain regions. Methods: A cohort of 332 individuals with SCD/MCI were included from the Swedish BioFINDER-1 study. The goal was to predict longitudinal SCD/MCI-to-AD dementia progression and change in Mini-Mental State Examination (MMSE) over four years. Four models were evaluated using different predictors: (1) clinical data only, including demographics, cognitive tests and APOE ε4 status, (2) clinical data plus hippocampal volume, (3) clinical data plus all regional MRI gray matter volumes (N = 68) extracted using FreeSurfer software, (4) a DL model trained using multi-task learning with MRI images, Jacobian determinant images and baseline cognition as input. A double cross-validation scheme, with five test folds and for each of those ten validation folds, was used. External evaluation was performed on part of the ADNI dataset, including 108 patients. Mann-Whitney U-test was used to determine statistically significant differences in performance, with p-values less than 0.05 considered significant. Results: In the BioFINDER cohort, 109 patients (33%) progressed to AD dementia. The performance of the clinical data model for prediction of progression to AD dementia was area under the curve (AUC) = 0.85 and four-year cognitive decline was R2 = 0.14. The performance was improved for both outcomes when adding hippocampal volume (AUC = 0.86, R2 = 0.16). Adding FreeSurfer brain regions improved prediction of four-year cognitive decline but not progression to AD (AUC = 0.83, R2 = 0.17), while the DL model worsened the performance for both outcomes (AUC = 0.84, R2 = 0.08). A sensitivity analysis showed that the Jacobian determinant image was more informative than the MRI image, but that performance was maximized when both were included. In the external evaluation cohort from ADNI, 23 patients (21%) progressed to AD dementia. The results for predicted progression to AD dementia were similar to the results for the BioFINDER test data, while the performance for the cognitive decline was deteriorated. Conclusions: The DL model did not significantly improve the prediction of clinical disease progression in AD, compared to regression models with a single pre-defined brain region.
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| 2. |
- de Rojas, I., et al.
(författare)
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Common variants in Alzheimer’s disease and risk stratification by polygenic risk scores
- 2021
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Ingår i: Nature Communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- Genetic discoveries of Alzheimer’s disease are the drivers of our understanding, and together with polygenetic risk stratification can contribute towards planning of feasible and efficient preventive and curative clinical trials. We first perform a large genetic association study by merging all available case-control datasets and by-proxy study results (discovery n = 409,435 and validation size n = 58,190). Here, we add six variants associated with Alzheimer’s disease risk (near APP, CHRNE, PRKD3/NDUFAF7, PLCG2 and two exonic variants in the SHARPIN gene). Assessment of the polygenic risk score and stratifying by APOE reveal a 4 to 5.5 years difference in median age at onset of Alzheimer’s disease patients in APOE ɛ4 carriers. Because of this study, the underlying mechanisms of APP can be studied to refine the amyloid cascade and the polygenic risk score provides a tool to select individuals at high risk of Alzheimer’s disease. © 2021, The Author(s).
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| 3. |
- Ekberg, Mayvor, et al.
(författare)
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Lika som bär? : Det religiösa landskapet i Hortlax och Nykarleby
- 2016
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Baserat på intervjuer och enkätstudier i Hortlax (Norrbotten) och Nykarleby (Österbotten) visas att likheter snarare än skillnader kännetecknar de båda befolkningsgruppernas inställning till religiösa frågor och till majoritetskyrkan. Å ena sidan är detta förvånande, i och med att de båda landskapen har tillhört olika stater i mer än 200 år, å andra sidan är det förväntat, eftersom trafiken över Bottniska viken varit intensiv under dessa 200 år.
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| 4. |
- Flink, Ida, 1980-, et al.
(författare)
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Context sensitive regulation of pain and emotion : Development and initial validation of a scale for context insensitive avoidance
- 2017
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Ingår i: Scandinavian Journal of Pain. - : Walter de Gruyter. - 1877-8860 .- 1877-8879. ; 17, s. 220-225
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: Context insensitivity has been put forward as a potential mechanism explaining the high co-occurrence of pain and emotional distress. In the pain literature, the concept has only been introduced at a theoretical level and an assessment tool for exploring its impact is lacking. In an interpersonal setting, a core aspect of context sensitivity and insensitivity concerns when to disclose and when to avoid expressing pain and related distress. Both context insensitive disclosure and context insensitive avoidance may hamper interpersonal support and fuel the problem. This exploratory study describes an attempt to develop a self-report instrument to assess tendencies to disclose vs. avoid expressions of pain and related distress, as well as self-perceived adjustment of disclosure vs. avoidance to the context.METHODS: A pool of items was systematically developed to assess different aspects of context insensitivity, including disclosure vs. avoidance of expression. 105 participants with persistent pain were recruited at pain rehabilitation clinics (80% of the sample) and in a university setting (20% of the sample). The participants responded to the pool of items as well as to a number of validated self-report instruments covering pain, pain-related disability, pain catastrophizing, emotion regulation tendencies, self-compassion and pain acceptance. The analyses explored the factorial structure of the initial instrument, as well as the criterion and construct validity.RESULTS: The analyses confirmed a stable underlying structure of the initial scale, with four distinct factors explaining 64.4% of the total variance. However, the criterion and construct validity could only be confirmed for one of the factors, which contained items reflecting context insensitive avoidance of expression. Consequently, only this factor, demonstrating very good internal consistency, was kept in the final version of the instrument which was named context insensitive avoidance (CIA).CONCLUSIONS: We found support for the final version of our instrument, capturing one prominent aspect of context insensitivity. Avoidance of expression was related to higher ratings of pain, disability, catastrophizing and suppression as well as to lower levels of self-compassion. We encourage further studies to explore the impact of context insensitive avoidance for regulating pain and associated negative emotions. Yet, more research is needed that goes beyond self-report and includes other aspects of context. It is urgent to develop systematic ways for assessing context insensitivity, as it will enhance our understanding of regulatory strategies as potential transdiagnostic mechanisms in pain and emotion.IMPLICATIONS: This tool for assessing contextually insensitive avoidance of expression could potentially be used both clinically and in future research to advance our understanding of comorbid problems with pain and emotional distress. Further research is needed to develop methods for assessing other aspects of context insensitivity to fully understand its impact in patients suffering from pain.
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| 5. |
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| 6. |
- Flink, Ida, 1980-, et al.
(författare)
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Responding to social cues : An experimental paradigm exploring the link between context sensitivity and pain
- 2019
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Ingår i: British Journal of Health Psychology. - : Wiley-Blackwell. - 1359-107X .- 2044-8287. ; 24:2, s. 443-459
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The term context sensitivity refers to whether a response is in tune with the ever changing demands of the context, while insensitivity is the lack of responding to these cues. To date, we know little about how well patients with pain respond emotionally to changes in the cues provided by the social context, that is, how emotionally context (in)sensitive they are and if this is related to problem severity. The aim of this experimental study was to test a method for determining levels of context sensitivity in individuals with subacute and chronic pain and to explore the link between context (in)sensitivity and pain-related problems. We operationalized context (in)sensitivity as participants' emotional responses (observed facial expressions and self-reported affect) and pain bothersomeness in these contexts and explored the association between these context-(in)sensitive social-emotional responses and pain-related problems.METHODS: Sixty-two participants with pain were cued to talk openly about three different topics consecutively in a counterbalanced order: (1) their pain, (2) a negative non-pain topic, and (3) a positive non-pain topic. We measured the participants' emotional responses (observed facial expressions and self-reported affect) and pain bothersomeness across these contexts and explored the effect of social-emotional responding on pain-related problems.RESULTS: The results showed that, irrespective of individuals' baseline levels of pain bothersomeness, positive affect, and negative affect, those who reacted with more negative affect and pain bothersomeness when prompted to discuss a positive topic had higher levels of pain-related problems. Moreover, those who showed more negative facial expressions and pain bothersomeness when prompted to discuss a negative non-pain topic also had higher levels of pain-related problems.CONCLUSIONS: These findings highlight a link between sensitivity to the social context and the severity of a pain problem. We showed that individuals with greater problem severity were less sensitive to social cues in their emotional responses, as compared to individuals with less pain-related problems. As predicted, context-insensitive responding appears to be most strongly associated with pain-related problems when dealing with negative emotions. Although the cross-sectional nature of the study prohibits causal conclusions, our findings demonstrate a link and future research is clearly needed to unravel the role of context sensitivity in the development of pain over time.Statement of contributionWhat is already known on this subject?Responding to social cues seems to be important for adaptation to pain. The term context sensitivity refers to whether a response is in tune with the provided social cue. To date, we know little about how well patients with persistent pain respond emotionally to changes in the social context, that is, how context (in)sensitive they are and if this is linked to problem severity.What does this study add?A test of a method for determining levels of context sensitivity in individuals with persistent pain.Information about to what extent individuals with chronic pain respond context sensitively.Knowledge on the link between social context sensitivity and level of pain problems.
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| 7. |
- Flink, Ida, 1980-, et al.
(författare)
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The role of context sensitivity in pain and emotion : Definition of the construct, importance and implications for treatment
- 2016
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Chronic pain is closely linked to emotional distress and patients suffering from both problems are worse off than individuals with only one of the entities. Emotion regulation has been proposed as a core transdiagnostic process which may explain the high levels of comorbidity between pain and emotional complaints. One way of regulating pain and negative emotions is in the presence of others. By sharing your personal experiences, you may get emotional support which relieves suffering. However, it is important to know where, when and with whom to share; in other terms, to be context sensitive. The opposite, context insensitivity, has been related to prolonged and exaggerated emotional distress, for instance after the death of a beloved one (Bonnano et al., 2004). The theory, importance and potential clinical implications of context sensitivity in theare a of pain and emotional distress will serve the basis for the presentation by Dr. Ida Flink, and data from an ongoing project on this topic will be presented.
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| 8. |
- Gideonsson, Ida, et al.
(författare)
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Long-term follow-up of tamoxifen treatment and the use of imaging in psammocarcinoma : a case report, review of the literature and discussion of diagnostic and therapeutic challenges
- 2023
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Ingår i: Current Oncology. - : MDPI. - 1198-0052 .- 1718-7729. ; 30:12, s. 10260-10271
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Tidskriftsartikel (refereegranskat)abstract
- Psammocarcinoma (PsC) represents a rare form of low-grade serous tumor of the ovary or peritoneum. Although ovarian cancer generally has a poor prognosis in its late stages, PsC seems to have a more indolent course. We present a patient with a history of unspecific abdominal pain for more than a year, with sudden acute onset of severe inguinal pain. On admission to the hospital, a computed tomography (CT) revealed a pelvic mass of suspected ovarian origin. Radical surgery was attempted but not achieved due to widespread tumor growth. Histopathological evaluation revealed estrogen receptor-positive stage III PsC. Tamoxifen treatment was thus initiated, still maintaining stable disease 10 years later. The patient has undergone extensive radiological work-up, including CT, chest X-ray, 18F-fluoro-deoxy-glucose positron emission tomography (PET)/CT, 99mTc- hydroxymethylene diphosphonate (HDP) bone scintigraphy, 18F-fluoro-thymidine (FLT) PET/CT, Tc-99m depreotide scintigraphy and magnetic resonance imaging. In conclusion, we demonstrate that PsC has characteristic radiological features and different imaging modalities can be suitable in different clinical situations. In contrast to most other ovarian cancers, PsC does not always warrant adjuvant chemotherapy, even in advanced stages. This emphasizes the need for a deeper knowledge of the biological behavior of this rare tumor, to select the optimal treatment strategy.
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| 9. |
- Kieler, Ida Nordang, et al.
(författare)
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Genome wide association study in Swedish Labrador retrievers identifies genetic loci associated with hip dysplasia and body weight
- 2024
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Ingår i: Scientific Reports. - : Springer Nature. - 2045-2322. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Genome wide association studies (GWAS) have been utilized to identify genetic risk loci associated with both simple and complex inherited disorders. Here, we performed a GWAS in Labrador retrievers to identify genetic loci associated with hip dysplasia and body weight. Hip dysplasia scores were available for 209 genotyped dogs. We identified a significantly associated locus for hip dysplasia on chromosome 24, with three equally associated SNPs (p = 4.3 x 10-7) in complete linkage disequilibrium located within NDRG3, a gene which in humans has been shown to be differentially expressed in osteoarthritic joint cartilage. Body weight, available for 85 female dogs, was used as phenotype for a second analysis. We identified two significantly associated loci on chromosome 10 (p = 4.5 x 10-7) and chromosome 31 (p = 2.5 x 10-6). The most associated SNPs within these loci were located within the introns of the PRKCE and CADM2 genes, respectively. PRKCE has been shown to play a role in regulation of adipogenesis whilst CADM2 has been associated with body weight in multiple human GWAS. In summary, we identified credible candidate loci explaining part of the genetic inheritance for hip dysplasia and body weight in Labrador retrievers with strong candidate genes in each locus previously implicated in the phenotypes investigated.
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| 10. |
- Runge, Ida, 1976-
(författare)
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"Jag vill gärna ha hjälp, men ta inte mina barn" : Föräldraskap hos föräldrar med intellektuell funktionsnedsättning
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Parents with intellectual disabilities are seldomly heard in research about parenting. Based on the parents’ own voices, this thesis contributes to deepened knowledge about parenting among persons with intellectual disability. By listening to twenty-three parents, my purpose has been to illuminate how parents themselves understand their parenting. The study is mainly based on an interactionist perspective and focuses on how parenting is done. To deal with the stigmatizing perceptions and to ward off a perceived threat that the children may be taken from them, the parents use several strategies. These strategies function as a way of counteracting the questioning of their parenting, but above all the parents emphasize giving their children a good childhood. In general, the parents experience that their care practices work well when children’s needs are practical and arise in a routinized close to everyday reality. With higher demands on the ability to improvise and financial resources, care is perceived as a greater challenge. Experiences of being listened to and receiving support can counteract feelings of being made suspicious and can promote autonomy and security. But the support can also give rise to feelings of dependence. This is especially valid for women.
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