| 1. |
- Albano, Amanda, et al.
(författare)
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Echocardio-variability - Low and high frequency beat-to-beat variability in echocardiographic signals
- 2013
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Ingår i: Computing in Cardiology 2013. - 9781479908844 ; , s. 767-770
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Konferensbidrag (refereegranskat)abstract
- Measurement signals originating from the cardiovascular system are known to comprise oscillating components and beat-to-beat variability, e.g., heart-rate variability and blood pressure variability. In clinical echocardiographic procedures, typically only a few cardiac cycles are acquired. This pilot study analyses the beat-to-beat variability of echocardiographic variables (echocardio-variability) in minute long acquisitions.
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| 2. |
- Dictor, Michael, et al.
(författare)
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Strong lymphoid nuclear expression of SOX11 transcription factor defines lymphoblastic neoplasms, mantle cell lymphoma and Burkitt's lymphoma.
- 2009
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Ingår i: Haematologica. - : Ferrata Storti Foundation (Haematologica). - 1592-8721 .- 0390-6078. ; 94:11, s. 1563-1568
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: We surveyed lymphomas to determine the range of expression of the mantle cell lymphoma-associated SOX11 transcription factor and its relation to cyclin D1. DESIGN AND METHODS: On hundred and seventy-two specimens were immunostained for the SOX11 N and C termini. Cyclin D1 was detected by immunohistochemistry and quantitative reverse transcriptase polymerase chain reaction; in situ hybridization for t(11;14) was applied when needed. RESULTS: Nuclear SOX11 was strongly expressed in most B and T-lymphoblastic leukemia/lymphomas and half of childhood Burkitt's lymphomas, but only weakly expressed in some hairy cell leukemias. Chronic lymphocytic leukemia/lymphoma, marginal zone, follicular and diffuse large B-cell lymphomas were negative for SOX11, as were all cases of intermediate Burkitt's lymphomas/diffuse large B-cell lymphoma, myeloma, Hodgkin's lymphomas and mature T-cell and NK/T-cell lymphomas. CONCLUSIONS: In addition to mantle cell lymphoma, SOX11 is strongly expressed only in lymphoblastic malignancies and Burkitt's lymphomas. Its expression is independent of cyclin D1 (except for weak expression in hairy cell leukemias) and unlikely to be due to translocations in lymphoid neoplasia.
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| 3. |
- Grönlund, Christer, 1975-, et al.
(författare)
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Significant beat-to-beat variability of E/e’ irrespective of respiration
- 2013
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Ingår i: International cardiovascular forum. - : Barcaray Publishing. - 2409-3424 .- 2410-2636. ; 1:2, s. 88-89
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Tidskriftsartikel (refereegranskat)abstract
- The E/e’ ratio is commonly used in Doppler echocardiographic examinations to estimate the pulmonary capillary wedge pressure. The rationale of using this ratio is to combine left ventricular (LV) filling (E) and relaxation (e’) velocities to indirectly assess left atrial pressure. However, the accuracy of this index has recently been questioned, particularly in patients with controlled heart failure. Likewise, the potential beat-to-beat variability of such measurements remains undetermined. The cardiovascular system is subject to several oscillations with the potential of influencing LV function and its intra-cavitary pressures, hence measurements of its filling and relaxation velocities. The aim of this pilot study was to assess the beat-to-beat variability of the E/e’ ratio in one minute long examination in healthy subjects, and patients with various severity of amyloid heart disease. The results show that despite critical application of the standard echocardiographic recording recommendations, E/e’ beat-to-beat variability was 36 % (22 to 50%) in healthy subjects and 17 % (11-26%) in patients, and where the most severe amyloid heart disease had the least variability. Thus, clinical use of a single or few cardiac beats might not necessarily reflect an accurate ratio between the two velocities, and hence casts doubt over their diagnostic value.
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| 4. |
- Gustavsson, Sandra, et al.
(författare)
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Can echocardiography and ECG discriminate hereditary transthyretin V30M amyloidosis from hypertrophic cardiomyopathy?
- 2015
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Ingår i: Amyloid. - : Informa UK Limited. - 1350-6129 .- 1744-2818. ; 22:3, s. 163-170
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Hereditary transthyretin (ATTR) amyloidosis with increased left ventricular wall thickness could easily be misdiagnosed by echocardiography as hypertrophic cardiomyopathy (HCM). Our aim was to create a diagnostic tool based on echocardiography and ECG that could optimise identification of ATTR amyloidosis. Methods: Data were analysed from 33 patients with biopsy proven ATTR amyloidosis and 30 patients with diagnosed HCM. Conventional features from ECG were acquired as well as two dimensional and Doppler echocardiography, speckle tracking derived strain and tissue characterisation analysis. Classification trees were used to select the most important variables for differentiation between ATTR amyloidosis and HCM. Results: The best classification was obtained using both ECG and echocardiographic features, where a QRS voltage >30 mm was diagnostic for HCM, whereas in patients with QRS voltage <30 mm, an interventricular septal/posterior wall thickness ratio (IVSt/PWt) >1.6 was consistent with HCM and a ratio <1.6 supported the diagnosis of ATTR amyloidosis. This classification presented both high sensitivity (0.939) and specificity (0.833). Conclusion: Our study proposes an easily interpretable classification method for the differentiation between HCM and increased left ventricular myocardial thickness due to ATTR amyloidosis. Our combined echocardiographic and ECG model could increase the ability to identify ATTR cardiac amyloidosis in clinical practice.
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| 5. |
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| 6. |
- Gustavsson, Sara, 1985, et al.
(författare)
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Linear Maximum Likelihood Regression Analysis For Untransformed Log-Normally Distributed Data
- 2012
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Ingår i: Open Journal of Statistics. - : Scientific Research Publishing, Inc.. - 2161-718X .- 2161-7198. ; 2:4, s. 389-400
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Tidskriftsartikel (refereegranskat)abstract
- Medical research data are often skewed and heteroscedastic. It has therefore become practice to log-transform data in regression analysis, in order to stabilize the variance. Regression analysis on log-transformed data estimates the relative effect, whereas it is often the absolute effect of a predictor that is of interest. We propose a maximum likelihood (ML)-based approach to estimate a linear regression model on log-normal, heteroscedastic data. The new method was evaluated with a large simulation study. Log-normal observations were generated according to the simulation models and parameters were estimated using the new ML method, ordinary least-squares regression (LS) and weighed least-squares regression (WLS). All three methods produced unbiased estimates of parameters and expected response, and ML and WLS yielded smaller standard errors than LS. The approximate normality of the Wald statistic, used for tests of the ML estimates, in most situations produced correct type I error risk. Only ML and WLS produced correct confidence intervals for the estimated expected value. ML had the highest power for tests regarding
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| 7. |
- Haghighi, Mona, et al.
(författare)
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A Comparison of Rule-based Analysis with Regression Methods in Understanding the Risk Factors for Study Withdrawal in a Pediatric Study
- 2016
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Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- Regression models are extensively used in many epidemiological studies to understand the linkage between specific outcomes of interest and their risk factors. However, regression models in general examine the average effects of the risk factors and ignore subgroups with different risk profiles. As a result, interventions are often geared towards the average member of the population, without consideration of the special health needs of different subgroups within the population. This paper demonstrates the value of using rule-based analysis methods that can identify subgroups with heterogeneous risk profiles in a population without imposing assumptions on the subgroups or method. The rules define the risk pattern of subsets of individuals by not only considering the interactions between the risk factors but also their ranges. We compared the rule-based analysis results with the results from a logistic regression model in The Environmental Determinants of Diabetes in the Young (TEDDY) study. Both methods detected a similar suite of risk factors, but the rule-based analysis was superior at detecting multiple interactions between the risk factors that characterize the subgroups. A further investigation of the particular characteristics of each subgroup may detect the special health needs of the subgroup and lead to tailored interventions.
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| 8. |
- Hybelius, Jonna, 1993-, et al.
(författare)
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A unified Internet-delivered exposure treatment for undifferentiated somatic symptom disorder : single-group prospective feasibility trial
- 2022
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Ingår i: Pilot and Feasibility Studies. - : Springer Science and Business Media LLC. - 2055-5784. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Background: Exposure-based psychological treatment appears to have beneficial effects for several patient groups that commonly report distress related to persistent somatic symptoms. Yet exposure-based treatment is rarely offered in routine care. This may be because existing treatment protocols have been developed for specific symptom clusters or specific unwanted responses to somatic symptoms, and many clinics do not have the resources to offer all these specialised treatments in parallel. In preparation for a randomised controlled trial, we investigated the feasibility of a new and unified Internet-delivered exposure treatment (OSF.io: cnbwj) for somatic symptom disorder regardless of somatic symptom domain (e.g. cardiopulmonary, fatigue, gastrointestinal, pain), combination of unwanted emotions (e.g. anger, anxiety, fear, shame) and whether somatic symptoms are medically explained or not. We hypothesised that a wide spectrum of subgroups would show interest, that the treatment would be rated as credible, that adherence would be adequate, that the measurement strategy would be acceptable and that there would be no serious adverse events.Methods: Single-group prospective cohort study where 33 self-referred adults with undifferentiated DSM-5 somatic symptom disorder took part in 8 weeks of unified Internet-delivered exposure treatment delivered via a web platform hosted by a medical university. Self-report questionnaires were administered online before treatment, each week during treatment, post treatment and 3 months after treatment.Results: Participants reported a broad spectrum of symptoms. The Credibility/Expectancy mean score was 34.5 (SD = 7.0, range: 18–47). Participants completed 91% (150/165) of all modules and 97% of the participants (32/33) completed at least two exposure exercises. The average participant rated the adequacy of the rationale as 8.4 (SD = 1.5) on a scale from 0 to 10. The post-treatment assessment was completed by 97% (32/33), and 84% (27/32) rated the measurement strategy as acceptable. The Client Satisfaction Questionnaire mean score was 25.3 (SD = 4.7, range: 17–32) and no serious adverse events were reported. Reductions in subjective somatic symptom burden (the Patient Health Questionnaire 15; d = 0.90) and symptom preoccupation (the somatic symptom disorder 12; d = 1.17) were large and sustained.Conclusions: Delivering a unified Internet-delivered exposure-based treatment protocol for individuals with undifferentiated somatic symptom disorder appears to be feasible.
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| 9. |
- Jederud, Sandra
(författare)
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New manifestations of the practice-theory dilemma – consequences of ‘the practice turn’ in teacher education
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis comprises four studies that concern the specific part of practicum within teacher education, its relation to the university-based components and how new organizational ideas entail different consequences for student teachers’ opportunities for learning the profession. The overall purpose is to analyze policies related to learning in practice and shed light on what implications are involved when reorganizing Swedish teacher education within the ‘practice turn’. More explicitly, the purpose is to illuminate two manifestations of a more practice-based teacher education – paired practicum within specific practice schools and work-integrated teacher education, where student-teachers are employed as teachers while attending courses at university. Two concepts of knowledge are used as the main theoretical framework; spectator knowledge and participant knowledge, and the concept of boundary crossing and enfolded learning mechanisms. The data are extracted from policy documents regarding the two latest teacher education reforms in 2001 and 2009, as well as from interviews with different parties pertaining within the above two manifestations of the practice turn. Study I concerns whether there are signs of a practice turn in national policy regarding teacher education and how this is addressed in local policy. The study focuses on what is expressed regarding the opportunities student teachers are provided with in order to learn the profession of teaching. Study II explores how pre-school student teachers perceive their opportunities for learning within paired practicum at specific practice schools. Study III also addresses paired practicum within specific practice schools, but data is collected from mentors within upper secondary school regarding their perception of this way of organizing practice. Finally, Study IV concerns a work-integrated teacher education programme and how teacher educators perceive students´ opportunities for learning when they move between the contexts of work and university. The results mainly show that there is an ambivalence concerning what should be given the most value regarding student teachers´ opportunities for learning. Findings also show that the manifestations of ‘the practice turn’ imply a shifting of positions for student-teachers as well as mentors and university teachers. The four studies also identify that the organizational structures of practice have implications for what opportunities for learning students are provided with. Thus, structural changes regarding practice within teacher education enfold that adequate curriculum changes are needed. Furthermore, changes at an organizational level at university, at the connected specific practice schools, and in the workplaces where work-integrated student-teachers are employed are needed.
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| 10. |
- Kleinau, Sandra, et al.
(författare)
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Importance of CD23 for collagen-induced arthritis : delayed onset and reduced severity in CD23-deficient mice
- 1999
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Ingår i: Journal of Immunology. - 0022-1767 .- 1550-6606. ; 162:7, s. 4266-4270
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Tidskriftsartikel (refereegranskat)abstract
- Increased expression of the low affinity receptor for IgE, FcepsilonRII/CD23 has been observed in rheumatoid arthritis. In view of this, we have investigated the expression and influence of CD23 in collagen-induced arthritis (CIA), an animal model for rheumatoid arthritis. CD23+ cells were analyzed in lymph nodes of DBA/1 mice immunized with bovine collagen type II (BCII) in CFA or with CFA only. The percentage of CD23+ lymph node cells was increased in both BCII/CFA- and CFA-immunized mice at 1, 3, and 7 wk after immunization compared with unimmunized mice, indicating a role for the adjuvant to trigger general inflammation and CD23 expression. To investigate the functional role of CD23 in CIA, CD23-deficient mice on the DBA/1 genetic background were studied. After immunization with BCII/CFA, these mice developed CIA with delayed onset and reduced severity compared with wild-type mice. These findings suggest that an increased number of CD23+ cells is part of an inflammatory response and that CD23 expression is of pathogenic importance in the arthritic process.
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