| 1. |
- Baltes, Peter, et al.
(författare)
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Small-bowel capsule endoscopy in patients with Meckel's diverticulum : clinical features, diagnostic workup, and findings. A European multicenter I-CARE study
- 2023
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Ingår i: Gastrointestinal Endoscopy. - : Elsevier BV. - 0016-5107. ; 97:5, s. 3-926
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Tidskriftsartikel (refereegranskat)abstract
- Background and Aims: Meckel's diverticulum (MD) may remain silent or be associated with adverse events such as GI bleeding. The main aim of this study was to evaluate indicative small-bowel capsule endoscopy (SBCE) findings, and the secondary aim was to describe clinical presentation in patients with MD. Methods: This retrospective European multicenter study included patients with MD undergoing SBCE from 2001 until July 2021. Results: Sixty-nine patients with a confirmed MD were included. Median age was 32 years with a male-to-female ratio of approximately 3:1. GI bleeding or iron-deficiency anemia was present in nearly all patients. Mean hemoglobin was 7.63 ± 1.8 g/dL with a transfusion requirement of 52.2%. Typical capsule endoscopy (CE) findings were double lumen (n = 49 [71%]), visible entrance into the MD (n = 49 [71%]), mucosal webs (n = 30 [43.5%]), and bulges (n = 19 [27.5%]). Two or more of these findings were seen in 48 patients (69.6%). Ulcers were detected in 52.2% of patients (n = 36). In 63.8% of patients (n = 44), a combination of double lumen and visible entrance into the MD was evident, additionally revealing ulcers in 39.1% (n = 27). Mean percent SB (small bowel) transit time for the first indicative image of MD was 57% of the total SB transit time. Conclusions: Diagnosis of MD is rare and sometimes challenging, and a preoperative criterion standard does not exist. In SBCE, the most frequent findings were double-lumen sign and visible diverticular entrance, sometimes together with ulcers.
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| 2. |
- Bayurova, Ekaterina, et al.
(författare)
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HIV-1 Reverse Transcriptase Promotes Tumor Growth and Metastasis Formation via ROS-Dependent Upregulation of Twist
- 2019
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Ingår i: Oxidative Medicine and Cellular Longevity. - : Hindawi Limited. - 1942-0900 .- 1942-0994. ; 2019
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Tidskriftsartikel (refereegranskat)abstract
- HIV-induced immune suppression results in the high prevalence of HIV/AIDS-associated malignancies including Kaposi sarcoma, non-Hodgkin lymphoma, and cervical cancer. HIV-infected people are also at an increased risk of non-AIDS-defining malignancies not directly linked to immune suppression but associated with viral infections. Their incidence is increasing despite successful antiretroviral therapy. The mechanism behind this phenomenon remains unclear. Here, we obtained daughter clones of murine mammary gland adenocarcinoma 4T1luc2 cells expressing consensus reverse transcriptase of HIV-1 subtype A FSU_A strain (RT_A) with and without primary mutations of drug resistance. In in vitro tests, mutations of resistance to nucleoside inhibitors K65R/M184V reduced the polymerase, and to nonnucleoside inhibitors K103N/G190S, the RNase H activities of RT_A. Expression of these RT_A variants in 4T1luc2 cells led to increased production of the reactive oxygen species (ROS), lipid peroxidation, enhanced cell motility in the wound healing assay, and upregulation of expression of Vimentin and Twist. These properties, particularly, the expression of Twist, correlated with the levels of expression RT_A and/or the production of ROS. When implanted into syngeneic BALB/C mice, 4T1luc2 cells expressing nonmutated RT_A demonstrated enhanced rate of tumor growth and increased metastatic activity, dependent on the level of expression of RT_A and Twist. No enhancement was observed for the clones expressing mutated RT_A variants. Plausible mechanisms are discussed involving differential interactions of mutated and nonmutated RTs with its cellular partners involved in the regulation of ROS. This study establishes links between the expression of HIV-1 RT, production of ROS, induction of EMT, and enhanced propagation of RT-expressing tumor cells. Such scenario can be proposed as one of the mechanisms of HIV-induced/enhanced carcinogenesis not associated with immune suppression.
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| 3. |
- Boberg, Julia, et al.
(författare)
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Swedish multimodal cohort of patients with anxiety or depression treated with internet-delivered psychotherapy (MULTI-PSYCH)
- 2023
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 13:10
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Tidskriftsartikel (refereegranskat)abstract
- Purpose Depression and anxiety afflict millions worldwide causing considerable disability. MULTI-PSYCH is a longitudinal cohort of genotyped and phenotyped individuals with depression or anxiety disorders who have undergone highly structured internet-based cognitive-behaviour therapy (ICBT). The overarching purpose of MULTI-PSYCH is to improve risk stratification, outcome prediction and secondary preventive interventions. MULTI-PSYCH is a precision medicine initiative that combines clinical, genetic and nationwide register data.Participants MULTI-PSYCH includes 2668 clinically well-characterised adults with major depressive disorder (MDD) (n=1300), social anxiety disorder (n=640) or panic disorder (n=728) assessed before, during and after 12 weeks of ICBT at the internet psychiatry clinic in Stockholm, Sweden. All patients have been blood sampled and genotyped. Clinical and genetic data have been linked to several Swedish registers containing a wide range of variables from patient birth up to 10 years after the end of ICBT. These variable types include perinatal complications, school grades, psychiatric and somatic comorbidity, dispensed medications, medical interventions and diagnoses, healthcare and social benefits, demographics, income and more. Long-term follow-up data will be collected through 2029.Findings to date Initial uses of MULTI-PSYCH include the discovery of an association between PRS for autism spectrum disorder and response to ICBT, the development of a machine learning model for baseline prediction of remission status after ICBT in MDD and data contributions to genome wide association studies for ICBT outcome. Other projects have been launched or are in the planning phase.Future plans The MULTI-PSYCH cohort provides a unique infrastructure to study not only predictors or short-term treatment outcomes, but also longer term medical and socioeconomic outcomes in patients treated with ICBT for depression or anxiety. MULTI-PSYCH is well positioned for research collaboration.
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| 4. |
- Carlbring, Per, et al.
(författare)
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Deposit-limits and online gambling intensity : A randomised controlled trial
- 2019
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Konferensbidrag (refereegranskat)abstract
- Context: Pathological gambling is recognized as a public health issue in a many countries. Consequently, helping individuals control their gambling behaviors is critical. One strategy is setting a pre-committed limit for how much money one can lose, deposit or win. The aim of the study was to compare gambling intensity between online gamblers prompted to set a deposit limit and non-prompted customers.Methods: All customers of the gambling service having registered an account during the study recruitment period were included. Gambling intensity was measured with aggregated net loss, with proportions of limit-setters, sum of deposits and number of gambling days used as secondary outcomes.Intervention: A total of 4328 customers of a gambling operator from Finland were randomized to receive a prompt to set a voluntary deposit limit of optional size either 1) at registration, 2) before or 3) after their first deposit, or 4) to an unprompted control condition.Results: The intervention groups did not differ in either proportion of participants with positive net loss or size of positive net loss. The pooled intervention group did not differ from the control group regarding proportion of gamblers with positive net loss or size of net loss. The intervention groups had higher rates of limit-setters and net loss was highest among participants who had increased/removed a deposit-limit. Conclusions: Prompting online gamblers to set a voluntary deposit limit of optional size did not affect subsequent net loss.
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| 5. |
- Carlbring, Per, et al.
(författare)
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Voluntary deposit-limit as a tool for reducing gambling intensity among customers of an online gambling platform : A randomized controlled trial
- 2018
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Aims: To compare gambling intensity between users of an online gambling service prompted to set a deposit limit and non-prompted customers, in the whole sample and among most active users based on total number of gambling days. Design: A randomized controlled trial with three prompted (N=1098/1110/1055) and one unprompted control condition (N=1065) and gambling activity of each participant followed for 90 days starting at account registration. Setting. A publicly governed online gambling operator from Finland. Interventions: The prompted participants received a one-time prompt to set a voluntary deposit limit of optional size either 1) at-registration, 2) before or 3) after they made their first deposit. Participants in the control condition were not prompted. Participants: All Finnish customers of the gambling service having registered an account during the study recruitment period with online slots as preferred gambling category during the 90 days following the registration. Measures: Gambling intensity was measured with aggregated net loss (NL), with proportions of limit-setters, sum of deposits and number of gambling days used as secondary outcomes. Findings: In the whole sample, the three intervention groups did not differ in either proportion of participants with positive NL (BF10prop=0.007) or size of positive net loss (BF10size=0.016), the results being similar for the most involved gamblers (BF10prop=0.030; BF10size=0.082). The pooled intervention group did not differ from the control group regarding proportion of gamblers with positive NL (OR(95%CI)=0.991(0.836–1.176); p=.921) or size of NL (B(95%CI) =-0.080(-0.229-0.069); p=.291), the results applying to the most involved gamblers (proportion positive NL: OR(95%CI)=0.834(0.492-1.412), p =.498; NL size: B(95%CI)=0.042(-0.359-0.442), p =.838). The three intervention groups had higher rates of limit-setters and NL was highest among participants who have increased/removed a deposit-limit. Conclusion: Prompting users of an online gambling service to set a voluntary deposit limit of optional size did not affect subsequent NL compared to unprompted participants.
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| 6. |
- Chudinova, Ekaterina A., et al.
(författare)
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Adhesion, proliferation, and osteogenic differentiation of human mesenchymal stem cells on additively manufactured Ti6Al4V alloy scaffolds modified with calcium phosphate nanoparticles
- 2019
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Ingår i: Colloids and Surfaces B. - : Elsevier BV. - 0927-7765 .- 1873-4367. ; 176, s. 130-139
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Tidskriftsartikel (refereegranskat)abstract
- In the present study, biocomposites based on 3D porous additively manufactured Ti6Al4V (Ti64) scaffolds modified with biocompatible calcium phosphate nanoparticles (CaPNPs) were investigated. Ti64 scaffolds were manufactured via electron beam melting technology using an Arcam machine. Electrophoretic deposition was used to modify the scaffolds with CaPNPs, which were synthesized by precipitation in the presence of polyethyleneimine (PEI). Dynamic light scattering revealed that the CaP/PEI nanoparticles had an average size of 46 ± 18 nm and a zeta potential of +22 ± 9 mV. Scanning electron microscopy (SEM) revealed that the obtained spherical CaPNPs had an average diameter of approximately 90 nm. The titanium-based scaffolds coated with CaPNPs exhibited improved hydrophilic surface properties, with a water contact angle below 5°. Cultivation of human mesenchymal stem cells (hMSCs) on the CaPNPs-coated Ti64 scaffolds indicated that the improved hydrophilicity was beneficial for the attachment and growth of cells in vitro. The Ti6Al4V/CaPNPs scaffold supported an increase in the alkaline phosphatase (ALP) activity of cells. In addition to the favourable cell proliferation and differentiation, Ti6Al4V/CaPNPs scaffolds displayed increased mineralization compared to non-coated Ti6Al4V scaffolds. Thus, the developed composite 3D scaffolds of Ti6Al4V functionalized with CaPNPs are promising materials for different applications related to bone repair.
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| 7. |
- Ivanova, Ekaterina, et al.
(författare)
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Deposit Limit Prompt in Online Gambling for Reducing Gambling Intensity : A Randomized Controlled Trial
- 2019
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Ingår i: Frontiers in Psychology. - : Frontiers Media SA. - 1664-1078. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Pre-commitment tools – allowing users of gambling services to pre-set a limit for how much money they may spend – are relatively common. However, there exist no clear evidence of their effectiveness in preventing gamblers from spending more money than they otherwise planned. The aim of the study was to compare gambling intensity between users of an online gambling service prompted to set a deposit limit and non-prompted customers, both in the whole sample and among most active users based on the total number of gambling days. Prospective customers of a publicly governed gambling operator from Finland were randomized to receive a prompt to set a voluntary deposit limit of optional size either (1) at registration, (2) before or (3) after their first deposit, or (4) to an unprompted control condition. Data on customers from Finland with online slots as a preferred gambling category (N = 4328) were tracked in the platform for 90 days starting at account registration, gambling intensity being measured with aggregated net loss. The intervention groups did not differ from each other in either proportion of participants with positive net loss or size of positive net loss. The pooled intervention group did not differ from the control group regarding proportion of gamblers with positive net loss (OR = 1.0; p = 0.921) or size of net loss (B = -0.1; p = 0.291). The intervention groups had higher rates of limit-setters compared to the control condition (ORat-registration/pre-deposit/post-deposit = 11.9/9.2/4.1). Customers who have increased/removed a previously set deposit limit had higher net loss than the limit-setters who have not increased/removed their limit (Bat-registration/pre-deposit/post-deposit/control = 0.7/0.6/1.0/1.3), and unprompted limit-setters lost more than unprompted non-setters (B = 1.0). Prompting online gamblers to set a voluntary deposit limit of optional size did not affect subsequent net loss compared to unprompted customers, motivating design and evaluation of alternative pre-commitment tools. Setting a deposit limit without a prompt or increasing/removing a previously set limit may be a marker of gambling problems and may be used to identify customers in need of help.
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| 8. |
- Ivanova, Ekaterina, et al.
(författare)
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Experiences of responsible gambling tools among non-problem gamblers : A survey of active customers of an online gambling platform
- 2019
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Ingår i: Addictive Behaviors Reports. - : Elsevier BV. - 2352-8532. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Responsible gambling (RG) tools, aiming at helping gamblers to avoid gambling-related harms, are common in online gambling platforms. Gambling industry, policy makers, and researchers have warned that RG tools can potentially disturb recreational gamblers, channeling them to less protective operators. No evidence exists to support these concerns, and they can hinder the development of effective RG tools. The current study aimed to investigate the recreational gamblers' experiences of RG tools.Methods: A total of 10,200 active customers of an online gambling service were invited to complete an online survey and rate their overall reactions, attitudes, disturbance and irritation towards RG tools, as well as their inclination to abandon a gambling service due to overexposure to RG tools. N = 1223 surveys were completed.Results: Non-problem gamblers had positive experiences of RG tools. Moderate-risk gamblers had more positive overall reaction and less irritation to previous experiences of RG tools compared to non-problem gamblers. Problem gamblers had least positive attitudes, most disturbance and most irritation towards RG pictures. Non-problem gamblers had lowest rates of having abandoned a service because of perceived overexposure to RG tools (5.2% compared to 25.9% of problem gamblers), with a significant between-group difference (OR [95%CI] = 7.17 [3.61–14.23], p < .001).Conclusions: Non-problem gamblers were not particularly disturbed by RG tools and were not at risk of abandoning online gambling services because of overexposure to RG tools. The study found no grounds for limiting the design and implementation of RG tools due to fears of disturbing recreational gamblers.
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| 9. |
- Ivanova, Ekaterina, et al.
(författare)
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Guided and unguided Acceptance and Commitment Therapy for social anxiety disorder and/or panic disorder provided via the Internet and a smartphone application : A randomized controlled trial
- 2016
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Ingår i: Journal of Anxiety Disorders. - : Elsevier BV. - 0887-6185 .- 1873-7897. ; 44, s. 27-35
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Tidskriftsartikel (refereegranskat)abstract
- Acceptance and Commitment Therapy (ACT) can be effective in treating anxiety disorders, yet there has been no study on Internet-delivered ACT for social anxiety disorder (SAD) and panic disorder (PD), nor any study investigating whether therapist guidance is superior to unguided self-help when supplemented with a smartphone application. In the current trial, n = 152 participants diagnosed with SAD and/or PD were randomized to therapist-guided or unguided treatment, or a waiting-list control group. Both treatment groups used an Internet-delivered ACT-based treatment program and a smartphone application. Outcome measures were self-rated general and social anxiety and panic symptoms. Treatment groups saw reduced general (d = 0.39) and social anxiety (d = 0.70), but not panic symptoms (d = 0.05) compared to the waiting-list group, yet no differences in outcomes were observed between guided and unguided interventions. We conclude that Internet-delivered ACT is appropriate for treating SAD and potentially PD. Smartphone applications may partially compensate for lack of therapist support.
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| 10. |
- Ivanova, Ekaterina, et al.
(författare)
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Guided and unguided CBT for social anxiety disorder and/or panic disorder via the Internet and a smartphone application
- 2015
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Ingår i: Abstracts from the 7th Swedish Congress on internet interventions (SWEsrii). - Linköping : Linköping University Press. ; , s. 9-9
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: As Acceptance and Commitment Therapy (ACT) becomes a part of the clinical practice, the interest for alternative ways of providing it continue to grow. Internet-based CBT, both guided and unguided, has proved to be effective for the treatment of a wide range of psychiatric disorders, including anxiety disorders. Moreover, the tremendous accessibility of smartphones makes them a potentially powerful instrument for providing psychological treatment. The purpose of this study was to investigate the effects of an Internet-based ACT-program for social anxiety disorder and panic disorder using both computers and smartphones, and with and without therapist support. Method: The participants were recruited from the general public by filling out an online screening form, which consisted of LSAS, PDSS-SR, GAD-7, PHQ-9, QOLI (the scales later served as outcome measures) and demographic questions. The individuals who met the inclusion criteria were contacted for a diagnostic telephone interview. The 152 people chosen for participation were then randomized into two treatment groups (guided and unguided) and a waiting list control group. The participants in the treatment groups were given access to an Internet-provided ACT-based treatment program consisting of 8 modules, as well as a smartphone application with content that corresponded to the Internet treatment program. Additionally, the participants in the guided group received minimum therapist support (15 min/week) through the smartphone application from psychology students undergoing their clinical training. The participants worked with the program for 10 weeks. They were evaluated twice during treatment, once after completing treatment, and once again 12-months later as a follow-up measure. A mixed effect model was used to analyze the data. Results: Regardless of diagnosis, as a whole the treated groups showed significant decreases in anxiety, with a moderate within-group effect size. This improvement appeared to be maintained when the groups were evaluated again during the follow-up. The participants suffering primarily from social anxiety disorder showed significant improvements, with moderate within-group effect sizes in both the guided (Cohen's d = 0.79) and unguided group (Cohen's d = 0.71). This improvement also appeared to be maintained when these participants were evaluated during the follow-up. No significant changes were observed in the symptoms of the participants suffering primarily from panic disorder. Discussion: Internet-delivered ACT-based treatment provided via both computer and smartphone can be effective for reducing general anxiety symptoms, as well as social anxiety symptoms. The guided treatment was not clearly superior to the unguided treatment. Some of the study’s uncertainties are likely due to the presence of a large number of different components, which made it difficult to isolate the effects of each individual component.
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| 11. |
- Ivanova, Ekaterina, et al.
(författare)
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Guided and unguided transdiagnostic Acceptance and Commitment Therapy for anxiety disorders provided via a computer and a smartphone application : A randomized controlled trial
- 2016
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Ingår i: EABCT 2016 Abstract Book. ; , s. 530-530
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Konferensbidrag (refereegranskat)abstract
- Technology-assisted psychological treatments are becoming well-known in the scientific networks throughout the world and are being implemented into routine health care in a number of countries. The interest in evaluating the potential of different devices is growing. The main objective of the current study was to evaluate the effects of guided and unguided computerand smartphone-based Acceptance and Commitment Therapy (ACT) for social anxiety disorder (SAD) and panic disorder (PD).A total of 152 participants were randomized into a guided treatment group, an unguided treatment group and a waiting list control group. Both treatment groups got access to a computer-based ACT-treatment and a smartphone application (app) with corresponding content. The eight modules treatment program covered a number of topics such as the nature of anxiety, functional analyses, acceptance, mindfulness and valued actions. The purpose of the app was to make it easier for the participants to access the key points of the program and to do homework assignments in their everyday life. Automatic messages in the app aimed to give feedback to the participants on their work as well as to prompt them to continue with the program. In addition to that, the participants in the guided group got therapist support via the app. The therapists were encouraged to work with each of their patient 15 min/week during the 10 weeks treatment period and focus on motivating, validating and correcting mistakes. On the whole group level GAD-7 was used as the primary outcome measure. LSAS and PDSS-SR were used for subgroup analyses in SAD and PD participants respectively. The measurements were collected at pre-, mid- and post-treatment and at 12-months follow-up.There were no significant differences in adherence between the treatment groups except for significantly higher rates of smartphone usage in the guided group. No significant differences in treatment outcome were found between the treatment groups with moderate within-group effects (Cohen’s d = 0.75 for the guided and Cohen’s d = 0.66 for the unguided group). The treated participants improved significantly in comparison to the control group both on the whole group level (between group Cohen’s d = 0.39) and for the participants suffering primarily from SAD (between group Cohen’s d = 0.70). Within group effect sizes were large for the PD-participants (Cohen’s d = 1.00) but the study was very underpowered in this part.Discussion. The treatment program as it was used in the present study appeared to be effective in treating social anxiety disorder and decreasing general anxiety symptoms, but the effects are smaller than seen in previous studies. The guided treatment was not clearly superior to the unguided one. The study contributes to the growing body of evidence on technology-assisted ACT.Conclusion. Computer- and smartphone-based ACT can be made into an effective treatment for anxiety disorders. A smartphone application seems to have a clear potential to partly compensate for the absence of therapist support which needs to be studied further.
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| 12. |
- Ivanova, Ekaterina, 1987-
(författare)
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Responsible provision of online gambling : Effects, usability and gamblers’ experiences of protective measures implemented in online gambling environments
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Problem gambling is considered a public health problem in many countries and is associated with serious financial and health-related harms for both problem gamblers and significant others. It is possible to create gambling environments that would promote sustainable gambling behaviors and prevent excessive gambling. However, research on the effectiveness of tools for responsible provision of gambling is scarce and the quality of the research is low. Also, there exists a conflict of interest between making a profit when providing gambling and protecting vulnerable customers. The general aim of the project was to study the effects, usability and gamblers’ experiences of tools for responsible provision of online gambling. Study I evaluated the effects of a prompt to set voluntary deposit-limit of optional size among 4,328 customers of an online gambling platform. During the data collection period, all customers from Finland registering an account on the gambling platform were randomized into being prompted to set a deposit-limit either 1) at-registration, 2) before their first deposit, 3) after their first deposit or 4) to an unprompted control group. Gambling intensity, measured with aggregated net loss, was tracked during 90 days after registration. No differences in gambling intensity between the intervention and control groups were found neither on the whole-group level (B (95% CI) =-0.080 (-0.229-0.069), p=.291), nor in the subgroup of the most involved gamblers (B (95% CI) =0.042(-0.359-0.442), p=.838). Study II aimed at predicting gaming freeze (as a proxy parameter for problem gambling) in online gamblers. For the sample of N=2,618 (N=1,309 freezers), a total of 105 predictors were created based on the data tracked by the gambling platform. The analysis was carried out using the machine learning method Random Forest. The predictive accuracy of the model applied to the dataset was 0.615, with a specificity of 0.686 and a sensitivity of 0.543. Study III aimed at investigating non-problem gamblers’ experiences of protective measures. A total of N=10,200 active customers of an online gambling platform were asked to rate their previous experiences of protective tools, their inclination to abandon a gambling service due to perceived overexposure to protective measures and answer questions on their symptoms of problem gambling. N=1,223 responded to the questionnaire, with the majority of the sample being moderate-risk gamblers (38.5%), followed by low-risk gamblers (26.8%), non-problem gamblers (18.9%) and problem gamblers (15.8%). In general, non-problem gamblers were not more disturbed by protective measures than other categories of gamblers. More problem gamblers have previously abandoned a gambling service due to perceived overexposure to protective measures compared to non-problem gamblers (OR(95% CI)= 7.17(3.61-14.23), p<.001). In conclusion, a prompt to set a voluntary deposit-limit of optional size did not appear to be effective in decreasing gambling intensity in online gamblers, indicating the need of evaluating alternative designs. Predicting gaming freezes in the current project resulted in a low accuracy, indicating that gaming freeze is not suitable as a proxy measurement for problem gambling and suggesting the need for collecting subjective data on symptoms of problem gambling. The results of Study III suggest that protective measures can be tested and implemented without the risk of disturbing recreational gamblers.
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| 13. |
- Ivanova, Ekaterina, et al.
(författare)
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Study protocol for a single-blind, parallel-group, randomised, controlled non-inferiority trial of 4-day intensive versus standard cognitive behavioural therapy for adults with obsessive-compulsive disorder
- 2023
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 13:12
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Individual cognitive behavioural therapy (CBT) with exposure and response prevention is an effective treatment for obsessive-compulsive disorder (OCD). However, individual CBT is costly and time-consuming, requiring weekly therapy sessions for 3-4 months. A 4-day intensive version of CBT for OCD delivered in group format has been recently developed in Norway (Bergen 4-day treatment, B4DT). B4DT has shown promising results in several uncontrolled and one small, randomised trial, but its non-inferiority to the gold standard treatment has not been established. Methods and analysis This single-blind, randomised controlled trial including 120 patients (60 per arm) will compare B4DT to individual CBT. The primary outcome is the blind assessor-rated Yale-Brown Obsessive Compulsive Scale (Y-BOCS). We hypothesise that B4DT will be non-inferior to gold standard CBT 15 weeks after treatment start. The non-inferiority margin is set at four points on the Y-BOCS. Secondary outcomes include time to treatment response, cost-effectiveness, response and remission rates, drop-out rates and adverse events. Ethics and dissemination This study has been approved by the Swedish Ethical Review Authority. Hypotheses were specified and analysis code published before data collection started. Results from all analyses will be reported in accordance with the Consolidated Standards of Reporting Trials statement for non-pharmacological trials and Consolidated Health Economic Evaluation Reporting Standards irrespective of outcome. Trial registration number NCT05608278.
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| 14. |
- Ivanova, Ekaterina, et al.
(författare)
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Using the Random Forest Algorithm on Customer Gambling Data for Predicting Gambling Freezes in an Online Gambling Platform
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background. Data on gambling behaviors routinely collected on online gambling platforms can be used to detect individuals at risk of developing or having gambling problems. As only data on gambling activity is available on gambling platforms, it is important to find a proxy measure for gambling problems. Temporarily freezing one or several gambling categories has potential to serve this purpose. Aim. To predict gambling freeze in a sample of active users of an online gambling platform one week before the freeze, based on one week of behavioral data tracked on the platform. Method. N = 105 predictors were created, covering total values, frequencies, variations, and trajectories of monetary and time-related gambling involvement, number and type of games played, point in time when gambling occurred, age, and gender. The random forest algorithm was applied to a sample of N = 2618 gamblers (of which N = 1309 freezers), with the sample divided 70/30 into a training and testing data set. Results. The accuracy of random forest applied to the testing data set was 0.615, with sensitivity of 0.543 and specificity of 0.686. The five most predictive variables were current age, age on registration date, average session length, average sum of winnings per session, and total session length. Discussion. The predictive accuracy of the algorithm in the current study was relatively low, suggesting the need for a more suitable target variable. Also, analyzing data collected during a longer period might be needed to create a tool that could be used to identify at-risk gamblers.
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| 15. |
- Ivanova, Ekaterina V., et al.
(författare)
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Enantio selectivity of resolved Delta and Lambda orthoruthenated 2-phenylpyridine complexes Ru(o-C6H4-2-py)(LL)(2) PF6 (LL = bpy and phen) toward glucose oxidase
- 2006
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Ingår i: Journal of Molecular Catalysis B. - : Elsevier BV. - 1381-1177 .- 1873-3158. ; 41:04-mar, s. 110-116
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Tidskriftsartikel (refereegranskat)abstract
- Cyclometalated 2-phenylpyridine complexes [Ru-II(o-C6H4-2-py)(LL)(2)]PF6, LL=2,2'-bipyridine (1) and 1,10-phenanthroline (2) were resolved into A and A enantiomers using column chromatography on SP Sephadex C-25 in the presence of (+)-2,3-dibenzoyl-D-tartrate. The absolute configuration of enantiomers was established using circular dichroism spectroscopy. The rate constants k(et) for the electron transfer from reduced glucose oxidase (GO from Aspergillus niger) and PQQ-dependent glucose dehydrogenase (GDH) at the generated Ru-III species were measured by cyclic voltammetry and UV-vis spectroscopy. The electron transfer shows enantioselectivity. In the case of GO, the bell-shaped pH profile for the ratio k(Lambda)/k(Delta) has a maximum at pH 7 (k(Lambda)/k(Delta) equals 3.4 and 3.9 for 1 and 2, respectively), but its inversion is observed at pH around 5 and 9. The k(Lambda)/k(Delta) ratio equals 2.0 for 2 and GDH at pH 7. The results of theoretical modeling of biological electron transfer for GO using functional docking Monte-Carlo simulations are presented and analyzed together with the experimental observations.
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| 16. |
- Kraepelien, Martin, et al.
(författare)
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Digital psychological self-care for problematic alcohol use : feasibility of a new clinical concept
- 2023
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Ingår i: BJPsych Open. - : Cambridge University Press. - 2056-4724. ; 9:3
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Tidskriftsartikel (refereegranskat)abstract
- Background: Digital interventions based on cognitive–behavioural therapy and relapse prevention can increase treatment access for people with problematic alcohol use, but for these interventions to be cost-effective, clinician workload needs to remain low while ensuring patient adherence and effects. Digital psychological self-care is the provision of a self-guided digital intervention within a structured care process.Aims: To investigate the feasibility and preliminary effects of digital psychological self-care for reducing alcohol consumption.Method: Thirty-six adults with problematic alcohol use received digital psychological self-care during 8 weeks, including telephone assessments as well as filling out self-rated questionnaires, before, directly after and 3 months after the intervention. Intervention adherence, usefulness, credibility and use of clinician time were assessed, along with preliminary effects on alcohol consumption. The study was prospectively registered as a clinical trial (NCT05037630).Results: Most participants used the intervention daily or several times a week. The digital intervention was regarded as credible and useful, and there were no reported adverse effects. Around 1 h of clinician time per participant was spent on telephone assessments. At the 3-month follow-up, preliminary within-group effects on alcohol consumption were moderate (standardised drinks per week, Hedge's g = 0.70, 95% CI = 0.19–1.21; heavy drinking days, Hedge's g = 0.60, 95% CI = 0.09–1.11), reflecting a decrease from 23 to 13 drinks per week on average.Conclusions: Digital psychological self-care for reducing alcohol consumption appears both feasible and preliminarily effective and should be further optimised and studied in larger trials.
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| 17. |
- Lindner, Philip, et al.
(författare)
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Guided and unguided CBT for social anxiety disorder and/or panic disorder via the Internet and a smartphone application : study protocol for a randomised controlled trial
- 2013
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Ingår i: Trials. - : BioMed Central. - 1745-6215. ; 14:437
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Tidskriftsartikel (refereegranskat)abstract
- Background: Smartphone technology presents a novel and promising opportunity to extend the reach of psychotherapeutic interventions by moving selected parts of the therapy into the real-life situations causing distress. This randomised controlled trial will investigate the effects of a transdiagnostic, Internet-administered cognitive behavioural (iCBT) self-help program for anxiety, supplemented with a smartphone application. The effect of added therapist support will also be studied. Methods/Design: One hundred and fifty participants meeting diagnostic criteria for social anxiety disorder and/or panic disorder will be evenly randomised to either one of three study groups: 1, smartphone-supplemented iCBT with therapist support; 2, smartphone-supplemented iCBT without therapist support; or 3, an active waiting list control group with delayed treatment. Primary outcome measure will be the Generalised Anxiety Disorder 7-item self-rating scale. Secondary measures include other anxiety, depression and quality of life measures. In addition to pre- and post-treatment measurements, the study includes two mid-treatment (days 24 and 48) and two follow-up assessments (12 and 36months) to assess rapid and long-term effects. Discussion: To our knowledge, this is the first study to investigate the effectiveness of smartphone-supplemented iCBT for anxiety disorders. Hence, the findings from this trial will constitute great advancements in the burgeoning and promising field of smartphone-administered psychological interventions. Limitations are discussed.
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| 18. |
- Lindner, Philip, et al.
(författare)
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Studying Gambling Behaviors and Responsible Gambling Tools in a Simulated Online Casino Integrated With Amazon Mechanical Turk : Development and Initial Validation of Survey Data and Platform Mechanics of the Frescati Online Research Casino
- 2021
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Ingår i: Frontiers in Psychology. - : Frontiers Media SA. - 1664-1078 .- 1664-0640. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Online gambling, popular among both problem and recreational gamblers, simultaneously entails both heightened addiction risks as well as unique opportunities for prevention and intervention. There is a need to bridge the growing literature on learning and extinction mechanisms of gambling behavior, with account tracking studies using real-life gambling data. In this study, we describe the development and validation of the Frescati Online Research Casino (FORC): a simulated online casino where games, visual themes, outcome sizes, probabilities, and other variables of interest can be experimentally manipulated to conduct behavioral analytic studies and evaluate the efficacy of responsible gambling tools.Methods: FORC features an initial survey for self-reporting of gambling and gambling problems, along with several games resembling regular real-life casino games, designed to allow Pavlovian and instrumental learning. FORC was developed with maximum flexibility in mind, allowing detailed experiment specification by setting parameters using an online interface, including the display of messages. To allow convenient and rapid data collection from diverse samples, FORC is independently hosted yet integrated with the popular crowdsourcing platform Amazon Mechanical Turk through a reimbursement key mechanism. To validate the survey data quality and game mechanics of FORC, n = 101 participants were recruited, who answered an questionnaire on gambling habits and problems, then played both slot machine and card-draw type games. Questionnaire and trial-by-trial behavioral data were analyzed using standard psychometric tests, and outcome distribution modeling.Results: The expected associations among variables in the introductory questionnaire were found along with good psychometric properties, suggestive of good quality data. Only 6% of participants provided seemingly poor behavioral data. Game mechanics worked as intended: gambling outcomes showed the expected pattern of random sampling with replacement and were normally distributed around the set percentages, while balances developed according to the set return to player rate.Conclusions: FORC appears to be a valid paradigm for simulating online gambling and for collecting survey and behavioral data, offering a valuable compromise between stringent experimental paradigms with lower external validity, and real-world gambling account tracking data with lower internal validity.
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| 19. |
- Lindsäter, Elin, et al.
(författare)
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Characterization of exhaustion disorder and identification of outcomes that matter to patients : Qualitative content analysis of a Swedish national online survey
- 2023
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Ingår i: Stress and Health. - : John Wiley & Sons. - 1532-3005 .- 1532-2998. ; 39:4, s. 813-827
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Tidskriftsartikel (refereegranskat)abstract
- Fatigue is a common presenting problem in healthcare settings, often attributed to chronic psychosocial stress. Understanding of fatigue and development of evidence-based treatments is hampered by a lack of consensus regarding diagnostic definitions and outcomes to be measured in clinical trials. This study aimed to map outcome domains of importance to the Swedish diagnosis stress-induced exhaustion disorder (ED; ICD-10, code F43.8 A). An online survey was distributed nationwide in Sweden to individuals who reported to have been diagnosed with ED and to healthcare professionals working with ED patients. To identify outcome domains, participants replied anonymously to four open-ended questions about symptoms and expectations for ED-treatment. Qualitative content analysis was conducted of a randomized subsample of respondents, using a mathematical model to determine data saturation. Six hundred seventy participants (573 with reported ED, 97 healthcare professionals) completed the survey. Qualitative content analysis of answers supplied by 105 randomized participants identified 87 outcomes of importance to ED encompassing physical, cognitive, and emotional symptoms as well as functional disability. Self-rating scales indicated that many ED participants, beyond reporting fatigue, also reported symptoms of moderate to severe depression, anxiety, insomnia, poor self-rated health, and sickness behavior. This study presents a map of outcome domains of importance for ED. Results shed light on the panorama of issues that individuals with ED deal with and can be used as a step to further understand the condition and to reach consensus regarding outcome domains to measure in clinical trials of chronic stress and fatigue. Preregistration: Open Science Framework (osf.io) with DOI https://doi.org/10.17605/OSF.IO/4VUAG
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| 20. |
- Lindsäter, Elin, et al.
(författare)
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Exhaustion disorder : scoping review of research on a recently introduced stress-related diagnosis
- 2022
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Ingår i: BJPsych Open. - : Cambridge University Press. - 2056-4724. ; 8:5
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundSymptoms related to chronic stress are prevalent and entail high societal costs, yet there is a lack of international consensus regarding diagnostics and treatment. A new stress-related diagnosis, exhaustion disorder, was introduced into the Swedish version of ICD-10 in 2005. Since then, use of the diagnosis has increased rapidly.AimsTo create the first comprehensive synthesis of research on exhaustion disorder to report on the current state of knowledge. Preregistration: Open Science Framework (osf.io), doi 10.17605/OSF.IO/VFDKW.MethodA PRISMA-guided scoping review of all empirical studies of exhaustion disorder was conducted. Searches were run in the MEDLINE, PsycInfo and Web of Science databases. Data were systematically charted and thematically categorised based on primary area of investigation.ResultsEighty-nine included studies were sorted into six themes relating to lived experience of exhaustion disorder (n = 9), symptom presentation and course (n = 13), cognitive functioning (n = 10), biological measures (n = 24), symptom measurement scales (n = 4) and treatment (n = 29). Several studies indicated that individuals with exhaustion disorder experience a range of psychiatric and somatic symptoms beyond fatigue, but robust findings within most thematic categories were scarce. The limited number of studies, lack of replication of findings and methodological limitations (e.g. small samples and scarcity of specified primary outcomes) preclude firm conclusions about the diagnostic construct.ConclusionsMore research is needed to build a solid knowledge base for exhaustion disorder. International collaboration regarding the conceptualisation of chronic stress and fatigue is warranted to accelerate the growth of evidence.
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| 21. |
- Lundström, Lina, et al.
(författare)
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Incompleteness as a clinical characteristic and predictor of treatment outcome in obsessive-compulsive disorder
- 2024
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Ingår i: Journal of Obsessive-Compulsive and Related Disorders. - 2211-3649. ; 42
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Tidskriftsartikel (refereegranskat)abstract
- Incompleteness, that is, a feeling that things are “not just right”, is an understudied symptom of obsessive-compulsive disorder (OCD). We used data from 167 adult individuals with OCD who received internet-delivered cognitive behaviour therapy (ICBT) to examine how incompleteness was associated with clinical characteristics and treatment outcomes. Incompleteness was assessed using the Obsessive-Compulsive Trait Core Dimensions Questionnaire (OCTCDQ). Results showed that the proposed two-factor structure of the OCTCDQ had adequate model/data fit in the present sample. Incompleteness was positively associated with baseline symmetry/ordering symptoms (β = 0.52, [95% CI 0.48 to 0.56], p < 0.001), psychiatric comorbidity (β = 0.23, [95% CI 0.21 to 0.25], p < 0.05) and self-reported symptom severity (Y-BOCS-SR β = 0.35, [95% CI 0.27 to 0.43], p < 0.001; OCI-R β = 0.46, [95% CI 0.34 to 0.59], p < 0.001). Results showed that higher degree of incompleteness predicted a worse treatment outcome on clinician-rated, but not self-rated, measures of symptom severity. Participants with a high (vs. low) degree of incompleteness were less likely to be classified as responders (39% vs. 52%) and remitters (10% vs. 34%) at post-treatment. The results suggest that incompleteness is a clinically relevant feature of OCD, which may require treatment adaptations for some patients but more research is needed to confirm that the findings are not entirely due to measurement error.
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| 22. |
- Mataix-Cols, David, et al.
(författare)
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Operational Definitions of Treatment Response and Remission in Obsessive-Compulsive Disorder Capture Meaningful Improvements in Everyday Life
- 2022
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Ingår i: Psychotherapy and Psychosomatics. - : S. Karger AG. - 0033-3190 .- 1423-0348. ; 91:6, s. 424-430
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The operational definitions of treatment response, partial response, and remission in obsessive-compulsive disorder (OCD) are widely used in clinical trials and regular practice. However, the clinimetric sensitivity of these definitions, that is, whether they identify patients that experience meaningful changes in their everyday life, remains unexplored.Objective: The objective was to examine the clinimetric sensitivity of the operational definitions of treatment response, partial response, and remission in children and adults with OCD.Methods: Pre- and post-treatment data from five clinical trials and three cohort studies of children and adults with OCD (n = 1,528; 55.3% children, 61.1% female) were pooled. We compared (1) responders, partial responders, and non-responders and (2) remitters and non-remitters on self-reported OCD symptoms, clinician-rated general functioning, and self-reported quality of life. Remission was also evaluated against post-treatment diagnostic interviews.Results: Responders and remitters experienced large improvements across validators. Responders had greater improvements than partial responders and non-responders on self-reported OCD symptoms (Cohen’s d 0.65–1.13), clinician-rated functioning (Cohen’s d 0.53–1.03), and self-reported quality of life (Cohen’s d 0.63–0.73). Few meaningful differences emerged between partial responders and non-responders. Remitters had better outcomes across most validators than non-remitters. Remission criteria corresponded well with absence of post-treatment diagnosis (sensitivity/specificity: 93%/83%). Using both the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the Clinical Global Impression Scale yielded more conservative results and more robust changes across validators, compared to only using the Y-BOCS.Conclusions: The current definitions of treatment response and remission capture meaningful improvements in the everyday life of individuals with OCD, whereas the concept of partial response has dubious clinimetric sensitivity.
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| 23. |
- Piementel, Tiago, et al.
(författare)
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SIGMORPHON 2021 Shared Task on Morphological Reinflection: Generalization Across Languages
- 2021
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Ingår i: Proceedings of the 18th SIGMORPHON Workshop on Computational Research in Phonetics, Phonology, and Morphology. August 2021, Online, pp. 229–259. - : Special Interest Group on Computational Morphology and Phonology.
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Konferensbidrag (refereegranskat)abstract
- This year’s iteration of the SIGMORPHON Shared Task on morphological reinflection focuses on typological diversity and cross- lingual variation of morphosyntactic features. In terms of the task, we enrich UniMorph with new data for 32 languages from 13 language families, with most of them be- ing under-resourced: Kunwinjku, Classical Syriac, Arabic (Modern Standard, Egyptian, Gulf), Hebrew, Amharic, Aymara, Magahi, Braj, Kurdish (Central, Northern, Southern), Polish, Karelian, Livvi, Ludic, Veps, Võro, Evenki, Xibe, Tuvan, Sakha, Turkish, In- donesian, Kodi, Seneca, Asháninka, Yanesha, Chukchi, Itelmen, Eibela. We evaluate six systems on the new data and conduct an extensive error analysis of the systems’ predictions. Transformer-based models generally demonstrate superior performance on the majority of languages, achieving >90% accuracy on 65% of them. The languages on which systems yielded low accuracy are mainly underresourced, with a limited amount of data. Most errors made by the systems are due to allomorphy, honorificity, and form variation. In addition, we observe that systems especially struggle to inflect multiword lemmas. The systems also produce misspelled forms or end up in repetitive loops (e.g., RNN-based models). Finally, we report a large drop in systems’ performance on previously unseen lemmas.
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| 24. |
- Rafi, Jonas, et al.
(författare)
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Effects of a workplace prevention program for problem gambling : A cluster-randomized controlled trial
- 2022
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Ingår i: Journal of Gambling Issues. - : Concurrent Disorders Society Press. - 1910-7595. ; 50, s. 73-97
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Tidskriftsartikel (refereegranskat)abstract
- Background and Aims: This study evaluated whether a preventive intervention program for problem gambling would increase managers’ inclination to act when concerned about gambling in the workplace. Design: Cluster- randomized controlled trial. Ten workplaces were randomized to either intervention or control condition. Participants: At the 12-month endpoint, there were n = 136 managers and n = 1594 subordinates in the intervention group, and n = 137 managers and n = 1150 subordinates in the waitlist group. Intervention: The intervention consisted of (1) six hours of skill-development training for managers regarding gambling, problem gambling, gaming, and harmful use of psychoactive drugs, and (2) six to eight hours of assistance in developing or improving workplace gambling policy. Measurements: The primary outcome was the managers’ self-rated (on a 1 to 10 scale) inclination to act when concerned about an employee’s problem gambling 12 months after baseline. Findings: The between-group difference in the managers’ inclination for the full intervention group (M = 8) and the control group (M = 7.4) was not significant at the 12-month follow-up, but it was when only including managers who attended the skill- development training (M = 8.2), d = 0.31, p = .04. Conclusion: A workplace prevention program aimed to increase managers’ inclination to act when they are concerned regarding an employee’s gambling resulted in statistically significant changes for those who attended training, but not for the whole intervention group when non-attendees were included.
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| 25. |
- Rafi, Jonas, et al.
(författare)
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Effects of a workplace prevention program for problem gambling : A cluster-randomized controlled trial
- 2022
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Ingår i: Journal of Gambling Issues. - : Concurrent Disorders Society Press. - 1910-7595. ; :50, s. 73-97
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Tidskriftsartikel (refereegranskat)abstract
- Background and Aims: This study evaluated whether a preventive intervention program for problem gambling would increase managers' inclination to act when concerned about gambling in the workplace.Design: Cluster randomized controlled trial. Ten workplaces were randomized to either intervention or control condition.Participants: At the 12-month endpoint, there were n = 136 managers and n = 1594 subordinates in the intervention group, and n = 137 managers and n = 1150 subordinates in the waitlist group.Intervention: The intervention consisted of (1) six hours of skill-development training for managers regarding gambling, problem gambling, gaming, and harmful use of psychoactive drugs, and (2) six to eight hours of assistance in developing or improving workplace gambling policy.Measurements: The primary outcome was the managers' self-rated (on a 1 to 10 scale) inclination to act when concerned about an employee's problem gambling 12 months after baseline.Findings: The between -group difference in the managers' inclination for the full intervention group (M = 8) and the control group (M = 7.4) was not significant at the 12-month follow-up, but it was when only including managers who attended the skill development training (M = 8.2), d = 0.31, p = .04.Conclusion: A workplace prevention program aimed to increase managers' inclination to act when they are concerned regarding an employee's gambling resulted in statistically significant changes for those who attended training, but not for the whole intervention group when non-attendees were included.
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