| 1. |
- Johansson, Peter, et al.
(författare)
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Effect of selenium and Q10 on the cardiac biomarker NT-proBNP
- 2013
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Ingår i: Scandinavian Cardiovascular Journal. - : Informa Healthcare. - 1401-7431 .- 1651-2006. ; 47:5, s. 281-288
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To investigate whether the effect of 48-month usage of coenzyme Q10 and selenium on cardiac function was different for participants with different levels of cardiac wall tension as measured by plasma levels of N-terminal natriuretic peptide (NT-proBNP) at baseline. Methods. A 48-month randomized double-blind controlled trial in a cohort of community-dwelling elderly (mean age 78 years) was carried out. A total of 443 participants were given coenzyme Q10 combined with selenium, or a placebo. NT-proBNP measured at baseline and 48 months was used to evaluate the cardiac wall tension. Results. After 48 months, supplementation of coenzyme Q10 and selenium had varying impacts depending on the severity of impairment of cardiac function. Analyses of the responses in the different quintiles of baseline NT-proBNP showed that those with active supplementation, and a plasma level of NT-proBNP in the second to fourth quintiles demonstrated significantly reduced NT-proBNP levels (p = 0.022) as well as cardiovascular mortality after 48 months (p = 0.006). Conclusion. Long-term supplementation of coenzyme Q10/selenium reduces NT-proBNP levels and cardiovascular mortality in those with baseline NT-proBNP in the second to fourth quintiles indicating those who gain from supplementation are patients with mild to moderate impaired cardiac function.
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| 2. |
- Johansson, Peter, et al.
(författare)
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Improved health-related quality of life, and more days out of hospital with supplementation with selenium and coenzyme Q10 combined. Results from a double blind, placebo-controlled prospective study
- 2015
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Ingår i: The Journal of Nutrition, Health & Aging. - : SPRINGER FRANCE. - 1279-7707 .- 1760-4788. ; 19:9, s. 870-877
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Tidskriftsartikel (refereegranskat)abstract
- The impact of supplementation with selenium and coenzyme Q10 (CoQ10) on health-care usage and health-related quality of life (Hr-QoL) in community-dwelling elderly people has, to our knowledge, not previously been investigated. To investigate the effect of 48 months supplementation with CoQ10 and selenium on community-dwelling elderly as regards: (I) the number of days out of hospital, and (II) the effect on Hr-QoL. A 48-month double-blind randomized placebo-controlled trial was carried out. A total of 443 participants were given CoQ10 and organic selenium yeast combined, or a placebo. All admissions to the Department of Internal Medicine or Cardiology were evaluated. Hr-QoL were measured with the Short Form-36 (SF-36), the Cardiac Health Profile (CHP) and one item overall-quality of life (overall-QoL). A total of 206 participants were evaluated after 48 months. No changes were found in the number of days out of hospital or Hr-QoL. A sub-analysis of participants matched for age, gender and baseline cardiac wall tension as measured by NT-proBNP was performed. The mean number of days out of hospital was 1779 for those taking the active substance compared to 1533 for those taking the placebo (p=0.03). Those with active substance declined significantly less in the HR-QoL domains of physical role performance (p=0.001), vitality (p=0.001), physical component score (p=0.001), overall QoL (p=0.001), somatic dimension (p=0.001), conative dimension (p=0.001) and global function (p=0.001). In a match-group analysis selenium and CoQ10 increased the number of days out of hospital and slowed the deterioration in Hr-QoL.
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| 3. |
- Ahlstrand, Inger, et al.
(författare)
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Less pain and activity limitations in today's early RA patients compared with patients diagnosed 10 years earlier (the swedish TIRA-project)
- 2014
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Ingår i: EULAR 2014: Scientific Abstracts. - : BMJ. ; , s. 141-142
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Konferensbidrag (refereegranskat)abstract
- Background: Over the last decades the RA-treatment strategies have changed considerably. Routines for early RA diagnosis and instituted disease modifying anti rheumatic drugs (DMARDs) have been established. In the early 2000s biologic agents also became available for treatment purposes. Despite these altered and improved strategies RA patients continue to report pain and activity limitations; women more so than men.Objectives: To study differences regarding pain and activity limitations during the first three years after diagnosis of RA in today's patients compared with patients diagnosed 10 years earlier from a gender perspective.Methods: This study was based on patients recruited to the project “early interventions in RA” (TIRA). In the first cohort (TIRA-1) 320 patients were included during 1996-1998. In the second cohort (TIRA-2) 463 patients were included during 2006-2008. Disease activity score 28 joint count (DAS-28) and medication were registered. Pain intensity (VAS), bodily pain (BP) in Short Form36 (SF-36) and activity limitation (Health Assessment Questionnaire, HAQ) were reported at inclusion and at follow-ups after one, two and three years.Results: Disease activity did not differ between cohorts at inclusion, but was significant lower at the follow ups in the TIRA-2 cohort compared with the TIRA-1 cohort. Patients in TIRA2 were prescribed traditional DMARD:s and biologic agents more frequent than in TIRA-1. The TIRA-2 patients reported significantly higher pain intensity and activity limitations at inclusion but lower pain intensity and activity limitations at all follow-ups than TIRA-1 patients. There were no significant differences between cohorts regarding bodily pain at inclusion, but thereafter the TIRA-2 patients showed significant lower bodily pain than the TIRA-1 patients. Men reported lower activity limitation than women in TIRA-1; otherwise there were no gender differences in TIRA-1. In TIRA-2, there were no significant gender differences regarding pain at inclusion. However, men reported lower pain than women at all follow-ups. Women, in turn, reported significantly higher activity limitations at all time points in TIRA-2. Pain and activity limitations were significantly reduced from inclusion to the one year follow-up but remained stable thereafter.Conclusions: Both women and men in today's early RA patient cohort report lower pain and less activity limitations at the follow ups after diagnosis of RA compared to 10 years earlier. However, both activity limitations and bodily pain are still pronounced.
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| 4. |
- Ahlstrand, Inger, et al.
(författare)
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Pain and activity limitations in women and men with contemporary treated early RA compared to 10 years ago: the Swedish TIRA project
- 2015
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Ingår i: Scandinavian Journal of Rheumatology. - : Informa Healthcare. - 0300-9742 .- 1502-7732. ; 44:4, s. 259-264
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To study differences regarding pain and activity limitations during the 3 years following diagnosis in women and men with contemporary treated early RA compared with their counterparts who were diagnosed 10 years earlier. Method: This study was based on patients recruited to the Early Intervention in RA (TIRA) project. In the first cohort (TIRA-1) 320 patients were included in time for diagnosis during 1996-1998 and 463 patients were included in the second cohort (TIRA-2) during 2006-2009. Disease activity, pain intensity (Visual Analogue Scale, VAS), bodily pain (BP) in the 36-item Short Form Health Survey (SF-36), activity limitations (Health Assessment Questionnaire, HAQ), and medication were reported at inclusion and at follow-up after 1, 2, and 3 years. Results: Disease activity, pain, and activity limitations were pronounced at inclusion across both genders and in both cohorts, with some improvement observed during the first year after diagnosis. Disease activity did not differ between cohorts at inclusion but was significantly lower at the follow-ups in the TIRA-2 cohort, in which the patients were prescribed traditional disease-modifying anti-rheumatic drugs (DMARDs) and biological agents more frequently. In TIRA-2, patients reported significantly lower pain and activity limitations at all follow-ups, with men reporting lower pain than women. Women reported significantly higher activity limitations at all time points in TIRA-2. Conclusions: Pain and activity limitations were still pronounced in the contemporary treated early RA cohort compared with their counterparts diagnosed 10 years earlier and both of these factors need to be addressed in clinical settings.
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| 5. |
- Ahmad, Awais, et al.
(författare)
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Doubtful Clinical Value of Subtyping Anti-U1-RNP Antibodies Regarding the RNP-70 kDa Antigen in Sera of Patients with Systemic Lupus Erythematosus
- 2023
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Ingår i: International Journal of Molecular Sciences. - : MDPI. - 1661-6596 .- 1422-0067. ; 24:12
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Tidskriftsartikel (refereegranskat)abstract
- The detection of antinuclear antibodies is central to the diagnosis and prognosis of systemic lupus erythematosus (SLE), primary Sjogrens syndrome (pSS) and mixed connective tissue disease (MCTD). Anti-U1-RNP and anti-RNP70 antibodies were assayed in the sera of patients with SLE (n = 114), pSS (n = 54) and MCTD (n = 12). In the SLE group, 34/114 (30%) were anti-U1-RNP positive, and 21/114 (18%) were both anti-RNP70 positive and anti-U1-RNP positive. In the MCTD group, 10/12 (83%) were anti-U1-RNP positive, and 9/12 (75%) were anti-RNP70 positive. Only one individual with pSS was antibody positive (for both anti-U1-RNP and anti-RNP70). All anti-RNP70-positive samples were also anti-U1-RNP positive. Anti-U1-RNP-positive subjects with SLE were younger (p < 0.0001); showed lower concentrations of complement protein 3 (p = 0.03); had lower eosinophil (p = 0.0005), lymphocyte (p = 0.006) and monocyte (p = 0.03) counts; and had accrued less organ damage (p = 0.006) than the anti-U1-RNP-negative SLE patients. However, we observed no significant clinical or laboratory parameter differences between the anti-U1-RNP-positive individuals with/without anti-RNP70 in the SLE group. In conclusion, anti-RNP70 antibodies are not exclusive to MCTD but are rarely detected in pSS and healthy individuals. In SLE, anti-U1-RNP antibodies are associated with a clinical phenotype that resembles MCTD, with hematologic involvement and less damage accrual. Based on our results, the clinical value of subtyping anti-RNP70 in anti-U1-RNP-positive sera appears to be of limited value.
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| 6. |
- Alonso, Juan-Manuel, et al.
(författare)
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Preparticipation injury complaint is a risk factor for injury : a prospective study of the Moscow 2013 IAAF Championships.
- 2015
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Ingår i: British Journal of Sports Medicine. - : BMJ Publishing Group. - 0306-3674 .- 1473-0480. ; 49:17, s. 1118-U45
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To determine the health status of athletes before the start of an international athletics championship and to determine whether preparticipation risk factors predicted in-championship injuries.METHODS: At the beginning of the 2013 International Association of Athletics Federations (IAAF) World Championships, all registered athletes (n=1784) were invited to complete a preparticipation health questionnaire (PHQ) on health status during the month preceding the championships. New injuries that occurred at the championships were prospectively recorded.RESULTS: The PHQ was completed by 698 (39%) athletes; 204 (29.2%) reported an injury complaint during the month before the championships. The most common mode of onset of preparticipation injury complaints was gradual (43.6%). Forty-nine athletes in the study reported at least one injury during the championships. Athletes who reported a preparticipation injury complaint were at twofold increased risk for an in-championship injury (OR=2.09; 95% CI 1.16 to 3.77); p=0.014). Those who reported a preparticipation gradual-onset injury complaint were at an almost fourfold increased risk for an in-championship time-loss injury (OR=3.92; 95% CI 1.69 to 9.08); p=0.001). Importantly, the preparticipation injury complaint severity score was associated with the risk of sustaining an in-championship injury (OR=1.14; 95% CI 1.06 to 1.22); p=0.001).SUMMARY AND CONCLUSIONS: About one-third of the athletes participating in the study reported an injury complaint during the month before the championships, which represented a risk factor for sustaining an injury during the championship. This study emphasises the importance of the PHQ as a screening tool to identify athletes at risk of injuries before international championships.
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| 7. |
- Andersson, Hedvig, et al.
(författare)
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Emotional Dysregulation and Trauma Symptoms Mediate the Relationship Between Childhood Abuse and Nonsuicidal Self-Injury in Adolescents
- 2022
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Ingår i: Frontiers in Psychiatry. - : Frontiers Media SA. - 1664-0640. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundNonsuicidal self-injury (NSSI) is common in adolescents. Emotion dysregulation has been identified as a core mechanism in the development and maintenance of NSSI and it is therefore an important target when addressing NSSI. The pathogenic connection between different kinds of childhood abuse, difficulties in emotion regulation and NSSI needs further investigation. The objective of this study was to examine whether difficulties with emotion regulation and trauma symptoms, separately and together, mediate the relationships between sexual, physical and emotional abuse and NSSI. MethodCross-sectional data was collected from 3,169 adolescent high-school students aged 16-19 years (M = 18.12, SD = 0.45). Data from self-reported experiences of childhood abuse, current difficulties with emotion regulation (measured with the Difficulties with Emotion Regulation Scale, DERS-16) and trauma symptoms (measured with the Trauma Symptom Checklist for Children, TSCC), and NSSI were collected. Structural Equation Modeling (SEM) was used to test the proposed relationships between variables. ResultsThe prevalence of life-time NSSI was 27.4%. Prevalence of reported childhood abuse was 9.2, 17.5, and 18.0% for sexual, physical, and emotional abuse, respectively. Childhood abuse, difficulties with emotion regulation and trauma symptoms exhibited significant positive associations with NSSI in adolescents. Emotional dysregulation and trauma symptoms were both found to mediate the relationship between childhood abuse and NSSI. Latent variable models were found to fit data well. ConclusionResults indicate that increased levels of emotional dysregulation and trauma symptoms in relation to childhood abuse contribute to the increased risk of NSSI. Further, results point to some aspects of emotional dysregulation and trauma symptoms being more important in this regard. Clinical implications are discussed.
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| 8. |
- Andin, Josefine, et al.
(författare)
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Deaf signers and hearing non-signers recruit similar networks for arithmetic and phonological tasks
- 2013
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Profoundly deaf individuals sometimes have difficulty with arithmetic and phonological tasks. In the present study we investigate if these differences can be attributed to differences in recruitment of neurobiological networks. Seventeen hearing non-signers (HN) and sixteen deaf signers (DS) matched on age, gender and non-verbal intelligence took part in an fMRI study. In the scanner three digit/letter pairs were visually presented and the participants performed six different blocked tasks tapping processing of digit and letter order, multiplication, subtraction and phonological ability. Data were analysed using two 2x2x2 ANOVAs; process (arithmetic, language) x level (high, low) x group (DS, HN). A main effect of process revealed language networks in the left inferior frontal gryus, supramarginal gyrus, fusiform gyrus and insula. Arithmetic networks included left middle orbital gyrus and superior medial gyrus. A main effect of level revealed low level processing (digit/letter order) in the right middle occipital gyrus and the right precuneus and high level processing (subtraction/multiplication/phonological ability) in left inferior frontal gyrus. There was no main effect of group but a significant task x group interaction in the right temporal pole which in DS (but not HN) was activated more for arithmetic than language processing (pfwe = .022) when multiplication was included in the analysis. This region is implicated in conceptual representation. These results suggest that both arithmetic and language are processed similarly by DS and HN with possible between-group differences in the use of conceptual representation in arithmetic and language tasks.
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| 9. |
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| 10. |
- Andin, Josefine, et al.
(författare)
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Deaf signers use magnitude manipulatioin strategies for mulitplication : fMRI evidence
- 2014
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Evidence suggests that the lag reported in mathematics for deaf signers derives from difficulties related to the verbal system of number processing as described in the triple code model. For hearing individuals the verbal system has been shown to be recruited for both arithmetic and language tasks. In the present study we investigate for the first time neuronal representations of arithmetic in deaf signers. We examine if the neural network supporting arithmetic and language, including the horizontal portion of the intraparietal sulcus (HIPS), the superior parietal lobule (SPL) bilaterally, the left angular gyrus (AG), pars opercularis (POPE) and pars triangularis (PTRI) of the left inferior frontal gyrus (IFG), is differently recruited for deaf and hearing individuals. Imaging data were collected from 16 deaf signers and 16 well-matched hearing nonsigners, using the same stimulus material for all tasks, but with different cues. During multiplication, deaf signers recruited rHIPS more than hearing non-signers, suggesting greater involvement of magnitude manipulation processes related to the quantity system, whereas there was no evidence that the verbal system was recruited. Further, there was no support for the notion of a common representation of phonology for sign and speech as previously suggested.
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| 11. |
- Andin, Josefine
(författare)
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Dealing with Digits : Arithmetic, Memory and Phonology in Deaf Signers
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Deafness has been associated with poor abilities to deal with digits in the context of arithmetic and memory, and language modality-specific differences in the phonological similarity of digits have been shown to influence short-term memory (STM). Therefore, the overall aim of the present thesis was to find out whether language modality-specific differences in phonological processing between sign and speech can explain why deaf signers perform at lower levels than hearing peers when dealing with digits. To explore this aim, the role of phonological processing in digit-based arithmetic and memory tasks was investigated, using both behavioural and neuroimaging methods, in adult deaf signers and hearing non-signers, carefully matched on age, sex, education and non-verbal intelligence. To make task demands as equal as possible for both groups, and to control for material effects, arithmetic, phonological processing, STM and working memory (WM) were all assessed using the same presentation and response mode for both groups. The results suggested that in digit-based STM, phonological similarity of manual numerals causes deaf signers to perform more poorly than hearing non-signers. However, for digit-based WM there was no difference between the groups, possibly due to differences in allocation of resources during WM. This indicates that similar WM for the two groups can be generalized from lexical items to digits. Further, we found that in the present work deaf signers performed better than expected and on a par with hearing peers on all arithmetic tasks, except for multiplication, possibly because the groups studied here were very carefully matched. However, the neural networks recruited for arithmetic and phonology differed between groups. During multiplication tasks, deaf signers showed an increased reliance on cortex of the right parietal lobe complemented by the left inferior frontal gyrus. In contrast, hearing non-signers relied on cortex of the left frontal and parietal lobes during multiplication. This suggests that while hearing non-signers recruit phonology-dependent arithmetic fact retrieval processes for multiplication, deaf signers recruit non-verbal magnitude manipulation processes. For phonology, the hearing non-signers engaged left lateralized frontal and parietal areas within the classical perisylvian language network. In deaf signers, however, phonological processing was limited to cortex of the left occipital lobe, suggesting that sign-based phonological processing does not necessarily activate the classical language network. In conclusion, the findings of the present thesis suggest that language modality-specific differences between sign and speech in different ways can explain why deaf signers perform at lower levels than hearing non-signers on tasks that include dealing with digits.
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| 12. |
- Andin, Josefine, et al.
(författare)
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Greater reliance on magnitude manipulation during mental arithmetic in deaf signers compared to hearing non-signers: fMRI evidence
- 2015
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Konferensbidrag (refereegranskat)abstract
- Evidence suggests that the lag reported in mathematics for deaf signers derives from difficulties related to verbal processing of numbers, whereas magnitude processing seems unaffected by deafness. Neuroimaging evidence from hearing individuals suggests that verbal processing of numbers engages primarily left angular gyrus (lAG), whereas magnitude processing engages primarily the horizontal portion of the right intraparietal sulcus (rHIP). In a ROI analysis of brain imaging data from 16 adult deaf signers and 16 adult hearing non-signers, who did not differ on sex, age or education, we examined if activity in lAG and rHIP changed as a result of task (multiplication vs subtraction) and group (deaf signers and hearing non-signers). We found a significant main effect of brain region (F(1,30) = 117.00, p < .001, η_p^2 = .80) and an interaction effect between region and group (F(1,30) = 20.70, p < .001, η_p^2 = .41). Further analyses showed that there were no significant differences in average activation between groups in lAG (F(1,30) = 0.16, p = .70). However, in rHIP deaf signers showed significantly greater average activation compared to non-signers (F(1,30) = 15.20, p < .001, η_p^2 = .34). There were no significant differences in activation between subtraction and multiplication (F(1,30) = 0.66, p = .42) and no behavioural differences between groups (F(1,30) = 1.70, p = .20). These results suggest that when engaging in arithmetic tasks deaf signers successfully make use of qualitatively difference processes, compared to hearing non-signers, with stronger emphasis on brain regions relating to magnitude manipulation.
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| 13. |
- Andin, Josefine, 1979-, et al.
(författare)
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Multiplication engages phonological networks in Broca's area differently for deaf signers and hearing non-signers
- 2012
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- In hearing individuals, multiplication relies mainly on the phonological loop while subtraction relies on the visuo-spatial sketchpad (VSSP; Lee & Kang, 2002). Little is known about arithmetic neural networks in deaf signers (DS). Since DS often perform worse than hearing non-signers (NH) on arithmetic in general and multiplication in particular (Traxler, 2000), we hypothesized that there are strategic differences between how groups recruit the phonological loop in multiplication, but not in subtraction, leading to differential activation of phonological processing areas in left inferior frontal gyrus (Broca’s area). We investigated this using a blocked fMRI-design in which nine DS and 17 HN matched on age, gender, education and non-verbal intelligence (Raven & Raven, 1998) were tested on tasks of multiplication, subtraction and phonology (rhyme). The contrasts rhyme versus multiplication and rhyme versus subtraction were examined across groups within the region of interest defined by a probability map of Broca’s area (Amunts, 1999). We observed a significant interaction between task (multiplication and rhyme) and group (F = 12.64, p = .034, FWE-corrected), where the HN showed higher activation for rhyme than for multiplication (T = 4.55, p = .001, FWE-corrected) whereas there were no differences in activations between tasks for DS. For subtraction versus rhyme no interaction with group was found. These results suggest that there are differences between DS and HN in the phonology dependent neural networks in Broca’s area used during multiplication, which may be part of the explanation for poorer performance in DS.
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| 14. |
- Andin, Josefine, 1979-, et al.
(författare)
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The neural basis of arithmetic and phonology in deaf signing individuals
- 2019
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Ingår i: Language, Cognition and Neuroscience. - : ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD. - 2327-3798 .- 2327-3801. ; 34:7, s. 813-825
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Tidskriftsartikel (refereegranskat)abstract
- Deafness is generally associated with poor mental arithmetic, possibly due to neuronal differences in arithmetic processing across language modalities. Here, we investigated for the first time the neuronal networks supporting arithmetic processing in adult deaf signers. Deaf signing adults and hearing non-signing peers performed arithmetic and phonological tasks during fMRI scanning. At whole brain level, activation patterns were similar across groups. Region of interest analyses showed that although both groups activated phonological processing regions in the left inferior frontal gyrus to a similar extent during both phonological and multiplication tasks, deaf signers showed significantly more activation in the right horizontal portion of the inferior parietal sulcus. This region is associated with magnitude manipulation along the mental number line. This pattern of results suggests that deaf signers rely more on magnitude manipulation than hearing non-signers during multiplication, but that phonological involvement does not differ significantly between groups.Abbreviations: AAL: Automated Anatomy Labelling; fMRI: functional magnetic resonance imaging; HIPS: horizontal portion of the intraparietal sulcus; lAG: left angular gyrus; lIFG: left inferior frontal gyrus; rHIPS: right horizontal portion of the intraparietal sulcus
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| 15. |
- Andraos, Rama, et al.
(författare)
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Autoantibodies associated with systemic sclerosis in three autoimmune diseases imprinted by type I interferon gene dysregulation: a comparison across SLE, primary Sjogrens syndrome and systemic sclerosis
- 2022
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Ingår i: Lupus Science and Medicine. - : BMJ PUBLISHING GROUP. - 2053-8790. ; 9:1
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveSLE, primary Sjogrens syndrome (pSS) and systemic sclerosis (SSc) are heterogeneous autoimmune diseases with a dysregulated type I interferon (IFN) system. The diseases often show overlapping clinical manifestations, which may result in diagnostic challenges. We asked to which extent SSc-associated autoantibodies are present in SLE and pSS, and whether these link to serum IFN-alpha, clinical phenotypes and sex. Samples with clinical data from patients with SSc and healthy blood donors (HBDs) served as controls. Finally, the diagnostic performance of SSc-associated autoantibodies was evaluated.MethodsSamples from well-characterised subjects with SLE (n=510), pSS (n=116), SSc (n=57) and HBDs (n=236) were analysed using a commercially available immunoassay (EuroLine Systemic Sclerosis Profile (IgG)). IFN-alpha was quantified by ELISA. Self-reported data on Raynauds phenomenon (RP) were available.ResultsWith exceptions for anti-Ro52/SSA and anti-Th/To, SSc-associated autoantibodies were more frequent in SSc than in SLE, pSS and HBDs regardless of sex. IFN-alpha levels correlated with the number of positive SSc-associated autoantibodies (r=0.29, p<0.0001) and associated with Ro52/SSA positivity (p<0.0001). By using data from SLE, SSc and HBDs, RP was significantly associated with topoisomerase I, centromere protein (CENP)-B, RNA polymerase III 11 kDa, RNA polymerase III 155 kDa and PM-Scl100 whereas Ro52/SSA associated inversely with RP. In SLE, CENP-A was associated with immunological disorder, CENP-B with serositis and Ku with lupus nephritis. By combining analysis of ANA (immunofluorescence) with SSc-associated autoantibodies, the diagnostic sensitivity reached 98% and the specificity 33%.ConclusionsThe 13 specificities included in the EuroLine immunoassay are commonly detected in SSc, but they are also frequent among individuals with other diseases imprinted by type I IFNs. These findings are valuable when interpreting serological data on patients with suspected SSc, especially as patients may present with disease manifestations overlapping different rheumatological diseases. In SLE, we observed associations between manifestations and SSc-associated autoantibodies which have not previously been reported.
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| 16. |
- Annerbäck, Eva-Maria, et al.
(författare)
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Child physical abuse : factors influencing the associations between self-reported exposure and self-reported health problems
- 2018
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Ingår i: Child and Adolescent Psychiatry and Mental Health. - : Springer Science and Business Media LLC. - 1753-2000. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Background: Child physical abuse (CPA) is an extensive public health problem because of its associations with poor health outcomes. The aim of this study was to examine which of the background factors of CPA committed by a parent or other caregiver relates to self-reported poor health among girls and boys (13; 15 and 17 years old): perpetrator, last year exposure; severity and frequency; socioeconomic load and foreign background.Methods: In a cross-sectional study in a Swedish county (n = 8024) a path analysis was performed to evaluate a model where all background variables were put as predictors of three health-status variables: mental; physical and general health problems. In a second step a log linear analysis was performed to examine how the distribution over the health-status categories was different for different combinations of background factors.Results: Children exposed to CPA reported poor health to a much higher extent than those who were not exposed. In the path analysis it was found that frequency and severity of abuse (boys only) and having experienced CPA during the last year, was significantly associated with poor health as well as socioeconomic load in the families. Foreign background was significantly negatively associated with all three health indicators especially for girls. Neither mother nor father as perpetrator remained significant in the path analysis, while the results from the log linear analyses showed that mother-abuse did in fact relate to poor general health and mental as well as physical health problems among boys and girls. Father-abuse was associated with poor mental health if severe abuse was reported. Poor mental health was also associated with mild father-abuse if exposure during the last year was reported.Conclusion: Despite the limitations that cross-sectional studies imply, this study provides new knowledge about factors associated with poor health among physically abused children. It describes details of CPA that have significant associations to different aspects of poor health and thus what needs to be addressed by professionals within mental health providers and social services. Understanding how different factors may contribute to different health outcomes for exposed children is important in future research and needs further studies.
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| 17. |
- Aspeqvist, Erik, 1983-, et al.
(författare)
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Measurement and stratification of nonsuicidal self-injury in adolescents
- 2024
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Ingår i: BMC Psychiatry. - : BMC. - 1471-244X. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundNonsuicidal self-injury (NSSI) is highly prevalent in adolescents. In survey and interview studies assessing NSSI, methods of assessment have been shown to influence prevalence estimates. However, knowledge of which groups of adolescents that are identified with different measurement methods is lacking, and the characteristics of identified groups are yet to be investigated. Further, only a handful of studies have been carried out using exploratory methods to identify subgroups among adolescents with NSSI.MethodsThe performance of two prevalence measures (single-item vs. behavioral checklist) in the same cross-sectional community sample (n = 266, age M = 14.21, 58.3% female) of adolescents was compared regarding prevalence estimates and also characterization of the identified groups with lifetime NSSI prevalence. A cluster analysis was carried out in the same sample. Identified clusters were compared to the two groups defined using the prevalence measures.ResultsA total of 118 (44.4%) participants acknowledged having engaged in NSSI at least once. Of these, a group of 55 (20.7%) adolescents confirmed NSSI on a single item and 63 (23.7%) adolescents confirmed NSSI only on a behavioral checklist, while denying NSSI on the single item. Groups differed significantly, with the single-item group being more severely affected and having higher mean scores on difficulties in emotion regulation, self-criticism, number of methods, higher frequency of NSSI, higher rates of suicidal ideation and suicidal behavior and lower mean score on health-related quality of life. All cases with higher severity were not identified by the single-item question. Cluster analysis identified three clusters, two of which fit well with the groups identified by single-item and behavioral checklist measures.ConclusionsWhen investigating NSSI prevalence in adolescents, findings are influenced by the researchers' choice of measures. The present study provides some directions toward what kind of influence to expect given the type of measure used, both with regards to the size of the identified group and its composition. Implications for future research as well as clinical and preventive work are discussed.
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| 18. |
- Bergström, Maria, et al.
(författare)
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The role of support from significant others in the association between disease-related factors and sickness absence in early rheumatoid arthritis : a longitudinal study
- 2021
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Ingår i: Scandinavian Journal of Rheumatology. - : TAYLOR & FRANCIS LTD. - 0300-9742 .- 1502-7732. ; 50:6, s. 427-434
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to analyse how support from significant others affects the associations between disease-related variables and sickness absence during the first 2 years after rheumatoid arthritis (RA) diagnosis. Method: Data from 274 people with RA (73% women) of working age (18-63 years) were retrieved from the Swedish early RA cohort TIRA-2. These data concerned disease-related variables (disease activity, activity limitations, pain intensity, and grip force), sickness absence, and perceived support from significant others. Associations of disease-related variables with sickness absence and how these associations were moderated by support from significant others were analysed using zero-inflated negative binomial regression. Results: During the 2 years after diagnosis, higher disease activity was significantly associated with increased odds of sickness absence, a connection strengthened by perceived support from family during the first year. More perceived support was also directly and significantly associated with increased odds of sickness absence during the first year. Conclusions: Support from significant others is related to sickness absence in RA, specifically during the first year after diagnosis. Although patients report high levels of support from significant others, this does not necessarily lead to more positive work outcomes. Therefore, it is important to consider other aspects of support that might influence work outcomes, e.g. type and quality of support. Future research should investigate these forms of support, and when significant others should be encouraged to support in the rehabilitation process to increase the chances of people with RA having a well-functioning and sustainable work life.
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| 19. |
- Bermon, Stephane, et al.
(författare)
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Lifetime Prevalence of Verbal, Physical, and Sexual Abuses in Young Elite Athletics Athletes
- 2021
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Ingår i: Frontiers in Sports and Active Living. - : Frontiers Media SA. - 2624-9367. ; 3
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Tidskriftsartikel (refereegranskat)abstract
- To examine prevalence of verbal, physical, and sexual abuses in young elite athletes, a cross sectional questionnaire-based survey was conducted during the World Athletics under 20 World Championships. This questionnaire aimed at distinguishing between abuses perpetrated in the context of Athletics from those which were unrelated to Athletics. Four hundred and eighty athletes (52.3%, male) from North America, South America, Europe, Africa, Asia, and Oceania took part in the electronic anonymous survey. Outside Athletics setting, no gender difference was found for the prevalence of verbal, physical, and sexual abuses. However, 45 males (18% of the male population) and 34 females (15% of the female population) athletes reported sexual abuse. Asian athletes reported a slightly higher rate of sexual abuse; three quarters of them being non-touching abuses. Inside Athletics setting, no gender difference was found for the prevalence of verbal, physical, and non-touching sexual abuses. However, 58 males (23%) and 47 females (21%) reported verbal abuses. Thirty-one males (12%) and 20 females (9%) reported physical abuses, whereas 30 males (12%) and 17 females (7%) reported sexual abuses. Physical abuses were slightly more frequent in Asia and in Africa and less frequent in South America. Sexual abuses inside Athletics also differed over regions, and were unexpectedly twice more frequent than expected in Asia and slightly less frequent than expected in Europe. Friends and partners were identified as the more frequent (> 50%) abusers outside or inside the Athletics settings, whereas outside Athletics and inside Athletics, coaches were identified as sexual abuse perpetrators in 8 and 25% of cases, respectively. The prevalence of verbal, physical, or sexual abuses is high but consistent with what has been reported in United Kingdom, Norway, Canada, and Sweden at national level in recreational or elite athletes. Sexual abuse, including touching or penetrative abuses, occurred significantly more often in male athletes when compared to female athletes. This finding invites healthcare and social workers, and policymakers to also consider the risk of sexual abuse of young male athletes in Athletics. These results also call for longitudinal studies on young elite athletes.
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| 20. |
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| 21. |
- Bertills, Karin, et al.
(författare)
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Relationships between physical education (PE) teaching and student self-efficacy, aptitude to participate in PE and functional skills : with a special focus on students with disabilities
- 2018
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Ingår i: Physical Education and Sport Pedagogy. - : Taylor & Francis. - 1740-8989 .- 1742-5786. ; 23:4, s. 387-401
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Tidskriftsartikel (refereegranskat)abstract
- Background: Students with disability show an increasing incidence of school failure. Quality teaching and appropriate support may foster high self-efficacy, a predictive factor for successful school outcomes. Physical Education (PE) can provide students with a context in which self-efficacy and participation are promoted leading to improved academic achievement. The transition into secondary school can be challenging for many students with increased educational demands, developmental changes and individual social identification coinciding. A disability may add to the challenge of success.Methods: Three groups of students, aged 13 years and enrolled in Swedish mainstream schools were targeted (n = 439). Groups included students with 1. A diagnosed disability, 2. Low grades in PE (D–F) and 3. High grades (A–C) in PE. Questionnaires were collected and analyzed from 30/439 students with a diagnosed disability (physical, neuro-developmental and intellectual) from 26 classes, their classmates and their PE-teachers (n = 25). Relationships between student self-reports and PE-teachers’ self-ratings were investigated. Also examined was the potential to which students’ functional skills could predict elevated general school self-efficacy, PE specific self-efficacy and aptitude to participate in PE. Results were compared with the total sample and between the three target groups (n = 121).Results: For students with disabilities, better self-rated teaching skills were related to lower student perceived general school self-efficacy, PE specific self-efficacy and aptitude to participate in PE. The impact of classroom climate in PE was more obvious among students with disabilities. Perceived functional skills were associated with elevated general school self-efficacy, PE specific self-efficacy and aptitude to participate in PE. Better socio-cognitive functional skills had an overall positive effect on all outcomes. Students with disabilities reported results similar to the total sample, the D–F group scored lower and the A–C group higher than the total sample and the disability group. Elevated self-efficacy in PE is six times less probable in students with disabilities, compared to the A–C group.Conclusions: Our findings that better teacher planning and grading skills, are detrimental to students disadvantaged by disability is contradictive. Improving the establishment and communication of adapted learning standards at the transition to secondary school is a crucial and a predictive factor for promoting positive school experiences for students with disability. Students with disabilities need to be assured that the intended learning outcomes can be reached by doing activities differently than their typically functioning peers. Consideration of class composition is suggested as a means of promoting a positive learning climate, which would particularly benefit students with disabilities. Allocation of resources to support student socio-cognitive skills would improve experiences for the D–F group and likely promote a positive learning environment.
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| 22. |
- Björk, Mathilda, et al.
(författare)
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Quality of life and acquired organ damage are intimately related to activity limitations in patients with systemic lupus erythematosus
- 2015
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Ingår i: BMC Musculoskeletal Disorders. - : BioMed Central / Springer Verlag (Germany). - 1471-2474. ; 16:188
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Tidskriftsartikel (refereegranskat)abstract
- Background: Systemic lupus erythematosus (SLE) is an autoimmune multi-organ disease, characterized by episodes of disease flares and remissions over time, which may restrain affected patients ability to perform daily activities. The purpose of the present study was to characterize variation in activity limitations among well-defined SLE patients, and to describe disease phenotypes, acquired organ damage and their relations to activity limitation and self-reported health, respectively. Methods: The disease phenotypes were organized into 4 different clinical groups and logistic regression analyses were used to identify how an elevated health assessment questionnaire (HAQ) score was related to disease variables such as phenotypes, disease activity and damage accrual. Correlation and multiple linear regression analyses were used to examine the association between each group of variables - background variables, disease variables and self-reported measurements - and the degree of elevated HAQ. Results: We found a higher proportion of activity limitation in patients with skin and joint involvement compared to others. The presence of activity limitation, as detected by the HAQ instrument, was significantly associated with quality of life (EuroQol-5D) and accrual of organ damage using the Systemic Lupus International Collaborative Clinics/ACR damage index. Conclusions: The findings highlight the differing requirements of the multi-professional rehabilitation interventions for the various SLE phenotypes in order to optimize the clinical care of the patients.
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| 23. |
- Brismar, Torkel, et al.
(författare)
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Liver Vessel Enhancement by Gd-BOPTA and Gc-EOB-DTPA – a Comparison in Healthy Volunteers.
- 2009
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Ingår i: Acta Radiologica. - : Informa Healthcare. - 0284-1851 .- 1600-0455. ; 50:7, s. 709-715
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Tidskriftsartikel (refereegranskat)abstract
- Background: A thorough understanding of magnetic resonance (MR) contrast media dynamics makes it possible to choose the optimal contrast media for each investigation. Differences in visualizing hepatobiliary function between Gd-BOPTA and Gd-EOB-DTPA have previously been demonstrated, but less has been published regarding differences in liver vessel visualization.Purpose: To compare the liver vessel and liver parenchymal enhancement dynamics of Gd-BOPTA (MultiHance®) and Gd-EOB-DTPA (Primovist®). Material and Methods: The signal intensity of the liver parenchyma, the common hepatic artery, the middle hepatic vein, and a segmental branch of the right portal vein, was obtained in 10 healthy volunteers before contrast media administration, during arterial and portal venous phases, and 10, 20, 30, 40 and 130 minutes after intravenous contrast medium injection, but due to scanner limitations not during the hepatic venous phase. Results: Maximum enhancement of liver parenchyma was observed from the portal venous phase until 130 minutes after Gd-BOPTA administration and from 10 minutes to 40 minutes after Gd-EOB-DTPA. There was no difference in maximum enhancement of liver parenchyma between the two contrast media. When using Gd-BOPTA, the vascular contrast enhancement was still apparent 40 minutes after injection, but had vanished 10 minutes after Gd-EOB-DTPA injection. The maximum difference in signal intensity between the vessels and the liver parenchyma was significantly greater with Gd-BOPTA than with Gd-EOB-DTPA (p<0.0001). Conclusion: At the dosage used in this study Gd-BOPTA yields higher maximum enhancement of the hepatic artery, portal vein and middle hepatic vein during the arterial and the portal venous phase and during the delayed phases than Gd-EOB-DTPA does, whereas there is no difference in liver parenchymal enhancement between the two contrast agents.
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| 24. |
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| 25. |
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| 26. |
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| 27. |
- Dahlqvist Leinhard, Olof, 1978-, et al.
(författare)
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Quantifying differences in hepatic uptake of the liver specific contrast agents Gd-EOB-DTPA and Gd-BOPTA : a pilot study
- 2012
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Ingår i: European Radiology. - : Springer Berlin/Heidelberg. - 0938-7994 .- 1432-1084. ; 22:3, s. 642-653
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To develop and evaluate a procedure for quantifying the hepatocyte-specific uptake of Gd-BOPTA and Gd-EOB-DTPA using dynamic contrast-enhanced (DCE) MRI. Methods Ten healthy volunteers were prospectively recruited and 21 patients with suspected hepatobiliary disease were retrospectively evaluated. All subjects were examined with DCE-MRI using 0.025 mmol/kg of Gd-EOB-DTPA. The healthy volunteers underwent an additional examination using 0.05 mmol/kg of Gd-BOPTA. The signal intensities (SI) of liver and spleen parenchyma were obtained from unenhanced and enhanced acquisitions. Using pharmacokinetic models of the liver and spleen, and an SI rescaling procedure, a hepatic uptake rate, K Hep, estimate was derived. The K Hep values for Gd-EOB-DTPA were then studied in relation to those for Gd-BOPTA and to a clinical classification of the patient’s hepatobiliary dysfunction. Results K Hep estimated using Gd-EOB-DTPA showed a significant Pearson correlation with K Hep estimated using Gd-BOPTA (r = 0.64; P < 0.05) in healthy subjects. Patients with impaired hepatobiliary function had significantly lower K Hep than patients with normal hepatobiliary function (K Hep = 0.09 ± 0.05 min-1 versus K Hep = 0.24 ± 0.10 min−1; P < 0.01). Conclusions A new procedure for quantifying the hepatocyte-specific uptake of T 1-enhancing contrast agent was demonstrated and used to show that impaired hepatobiliary function severely influences the hepatic uptake of Gd-EOB-DTPA. Key Points • The liver uptake of contrast agents may be measured with standard clinical MRI. • Calculation of liver contrast agent uptake is improved by considering splenic uptake. • Liver function affects the uptake of the liver-specific contrast agent Gd-EOB-DTPA. • Hepatic uptake of two contrast agents (Gd-EOB-DTPA, Gd-BOPTA) is correlated in healthy individuals. • This method can be useful for determining liver function, e.g. before hepatic surgery
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| 28. |
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| 29. |
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| 30. |
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| 31. |
- Dahlström, Nils, 1969-, et al.
(författare)
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Contrast-enhanced magnetic resonance cholangiography with Gd-BOPTA and Gd-EOB-DTPA in healthy subjects
- 2007
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Ingår i: Acta Radiologica. - : Informa Healthcare. - 0284-1851 .- 1600-0455. ; 48:4, s. 362-368
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To evaluate the biliary enhancement dynamics of the two gadolinium chelates Gd-BOPTA (MultiHance) and Gd-EOB-DTPA (Primovist) in normal healthy subjects. MATERIAL AND METHODS: Ten healthy volunteers were evaluated with both agents by magnetic resonance (MR) imaging at 1.5T using a breath-hold gradient-echo T1-weighted VIBE sequence. The relative signal intensity (SI) differences between the common hepatic duct (CHD) and liver parenchyma were measured before and 10, 20, 30, 40, 130, 240, and 300 min after contrast medium injection. RESULTS: Biliary enhancement was obvious 10 min post-injection for Gd-EOB-DTPA and was noted at 20 min for Gd-BOPTA. At 40 min delay, Gd-BOPTA reached its peak biliary enhancement, but at neither 30 nor 40 min delay was there any significant difference compared with that of Gd-EOB-DTPA. At later delays, the contrast between CHD and liver continued to increase for Gd-EOB-DTPA, whereas it decreased for Gd-BOPTA. CONCLUSION: The earlier onset and longer duration of a high contrast between CHD and liver for Gd-EOB-DTPA facilitates examination of hepatobiliary excretion. Therefore, Gd-EOB-DTPA may provide adequate hepatobiliary imaging within a shorter time span than Gd-BOPTA and facilitate scheduling at the MR unit. Further studies in patients are required to compare the imaging advantages of Gd-EOB-DTPA and Gd-BOPTA in clinical practice.
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| 32. |
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| 33. |
- Dahlström, Nils, 1969-
(författare)
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Magnetic Resonance Imaging of the Hepatobiliary System Using Hepatocyte-Specific Contrast Media
- 2009
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- There are two Gadolinium-based liver-specific contrast media for Magnetic Resonance Imaging on the market, Gd-BOPTA (MultiHance®, Bracco Imaging, Milan, Italy) and Gd-EOB-DTPA (Primovist®, Bayer Schering Pharma, Berlin, Germany). The aim of this study in two parts was to evaluate the dynamics of biliary, parenchymal and vascular enhancement using these contrast media in healthy subjects. Ten healthy volunteers were examined in a 1.5 T magnetic resonance system using three-dimensional Volumetric Interpolated Breath-Hold (VIBE) sequences for dynamic imaging with both contrast media – at two different occasions – until five hours after injection. The doses given were 0.025 mmol/kg for Gd-EOB-DTPA and 0.1 mmol/kg for Gd-BOPTA. The enhancement over time of the common biliary duct in contrast to the liver parenchyma was analyzed in the first study. This was followed by a study of the image contrasts of the hepatic artery, portal vein and middle hepatic vein versus the liver parenchyma.While Gd-EOB-DTPA gave an earlier and more prolonged enhancement of the biliary duct, Gd-BOPTA achieved higher image contrast for all vessels studied, during the arterial and portal venous phases. There was no significant difference in the maximal enhancement obtained in the liver parenchyma.At the obtained time-points and at the dosage used, the high contrast between the common biliary duct and liver parenchyma had an earlier onset and longer duration for Gd-EOB-DTPA, while Gd-BOPTA achieved higher maximal enhancement of the hepatic artery, portal vein and middle hepatic vein than Gd-EOB-DTPA. Diseases of the liver and biliary system may affect the vasculature, parenchyma, biliary excretion or a combination of these. The clinical context regarding the relative importance of vascular, hepatic parenchymal and biliary processes should determine the choice of contrast media for each patient and examination.
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| 34. |
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| 35. |
- Dahlström, Nils, 1969-
(författare)
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Quantitative Evaluation of Contrast Agent Dynamics in Liver MRI
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The studies presented here evaluate the biliary, parenchymal and vascular enhancement effects of two T1-shortening liver-specific contrast agents, Gd-BOPTA and Gd-EOB-DTPA, in Magnetic Resonance Imaging (MRI) of healthy subjects and of patients.Ten healthy volunteers were examined with both contrast agents in a 1.5 T MRI system using three-dimensional gradient echo sequences for dynamic imaging until five hours after injection. The enhancement of the common hepatic duct in contrast to the liver parenchyma was analyzed in the first study. This was followed by a study of the image contrasts of the hepatic artery, portal vein and middle hepatic vein versus the liver parenchyma.While Gd-EOB-DTPA gave an earlier and more prolonged enhancement and image contrast of the bile duct, Gd-BOPTA achieved higher maximal enhancement and higher image contrast for all vessels studied during the arterial and portal venous phases. There was no significant difference in the maximal enhancement obtained in the liver parenchyma.In a third study, another 10 healthy volunteers were examined with the same protocol in another 1.5 T MRI system. Using signal normalization and a more quantitative, pharmacokinetic analysis, the hepatocyte-specific uptake of Gd-EOB-DTPA and Gd-BOPTA was calculated. A significant between-subjects correlation of the uptake estimates was found and the ratio of these uptake rates was of the same magnitude as has been reported in pre-clinical studies. The procedure also enabled quantitative analysis of vascular enhancement properties of these agents. Gd-BOPTA was found to give higher vessel-to-liver contrast than Gd-EOB-DTPA when recommended doses were given.In the final study, retrospectively gathered datasets from patients with hepatobiliary disease were analyzed using the quantitative estimation of hepatic uptake of Gd-EOB-DTPA described in the third study. The uptake rate estimate provided significant predictive ability in separating normal from disturbed hepatobiliary function, which is promising for future evaluations of regional and global liver disease.In conclusion, the differing dynamic enhancement profiles of the liver-specific contrast agents presented here can be beneficial in one context and challenging in another. Diseases of the liver and biliary system may affect the vasculature, parenchyma or biliary excretion, or a combination of these. The clinical context in terms of the relative importance of vascular, hepatic parenchymal and biliary processes should therefore determine the contrast agent for each patient and examination. A quantitative approach to analysis of contrast-enhanced liver MRI examinations is feasible and may prove valuable for their interpretation.
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| 36. |
- Dahlström, Örjan, et al.
(författare)
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A simple method for heuristic modeling of expert knowledge in chronic disease : identification of prognostic subgroups in rheumatology
- 2008
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Ingår i: eHealth Beyond the Horizon – Get IT There. - : IOS Press. - 9781586038649 - 9781607503330 ; , s. 157-162
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Konferensbidrag (refereegranskat)abstract
- Identification of prognostic subgroups is of key clinical interest at the early stages of chronic disease. The aim of this study is to examine whether representation of physicians' expert knowledge in a simple heuristic model can improve data mining methods in prognostic assessments of patients with rheumatoid arthritis (RA). Five rheumatology consultants' experiences of clinical data patterns among RA patients, as distinguished from healthy reference populations, were formally represented in a simple heuristic model. The model was used in K-mean-clustering to determine prognostic subgroups. Cross-sectional validation using physician's global assessment scores indicated that the simple heuristic model performed better than crude data made in identification of prognostic subgroups of RA patients. A simple heuristic model of experts' knowledge was found useful for semi-automatic data mining in the chronic disease setting. Further studies using categorical baseline data and prospective outcome variables are warranted and will be examined in the Swedish TIRA-program.
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| 37. |
- Dahlström, Örjan, et al.
(författare)
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Clustering as a data mining method in a Web-based system for thoracic surgery
- 2001
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Ingår i: Journal of the Medical Informatics Association. Symposium Supplement. - Washington : Hanley&Belfus. - 1560535369 ; , s. 888-
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Konferensbidrag (refereegranskat)abstract
- Cluster analysis is one way of data mining from large amounts of information. Being able to perform series of analyses, varying clinical criteria and requests, expected results of the clustering might be truly rewarding. Instead of having a few hypotheses prepared and tested, medical experts can be surprised by obtaining a set of hypotheses to further validate and work on.Internet technologies enable a substantial flexibility that can be taken advantage of when implementing a Web-based tool. Division of Medical Informatics together with Linkoping Heart Center of the Linkoping University is developing procedures for multivariate clustering within the Web-based AssistMe1 system.
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| 38. |
- Dahlström, Örjan, et al.
(författare)
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Cognitive training and effects on speech-in noise performance in normal hearing and hearing impaired individuals
- 2015
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Ingår i: CHSCOM2015. - : Linköping University Electronic Press. ; , s. 127-127
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Cognitive training might have potential to improve speech understanding under adverse listening conditions. Here, we have examined the effects of a 5-week computer-based cognitive training program on speech-in-noise-performance, in normal hearing (NH) participants and in participants with mild-to-moderate sensorineural hearing loss (HI).Two groups, matched on gender and age (45-65 years), of 20 participants each (HI and NH respectively) are recruited. Participants perform four test-sessions; inclusion (t0), five weeks (t1), ten weeks (t2) and six months (t3). Training is performed either between t0 and t1, or between t1 and t2 (using a cross-over design), using the computer-based Cogmed training program, approximately 30-40 minutes per day, five days per week, during five weeks. At each session participants are tested in three different ways: (a) cognitive testing (KIPS, SICSPAN, TRT); (b) auditory performance (pure tone-audiometry (air- and bone-conduction) and speech audiometry (HINT, Swedish SPIN-test (SNR +4dB))); (c) cortical activation (MR sessions where participants performed a speech-in-noise task using Hagerman-sentences with steady-state speech-spectrum noise (SSN) and with two competing talkers). MR imaging is performed on a Philips Achieva 1.5 Tesla scanner using a sparse imaging technique in which stimuli are presented during the silent period between successive scans. Participants listen to auditory stimuli under eight different conditions: clear speech, SSN or two competing talkers (each at 90%, 50% and 0% intelligibility), and silent rest. Pre- and post-training, hearing disability is assessed by the Speech-Spatial-Qualities-Questionnaire.The study is on-going and behavioral results as well as results from fMRI will be presented.
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| 39. |
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| 40. |
- Dahlström, Örjan, et al.
(författare)
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Designing a decision support system for existing clinical organizational structures : Considerations from a rheumatology clinic
- 2006
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Ingår i: Journal of medical systems. - : Springer Science and Business Media LLC. - 0148-5598 .- 1573-689X. ; 30:5, s. 325-331
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to identify the social and organizational requirements for a decision support system (DSS) to be implemented in a clinical rheumatology setting, utilizing data-mining techniques. Field observations and focus group interviews were used for data collection. The decision-making was found to be situated, patient-focused, and long-term in nature. At the same time, the main part of peer-to-peer communication was informal. Patient records were involved in almost every decision. The conclusion is that the main challenges, when introducing a DSS at a rheumatology unit, are adapting the system to informal communication structures and integrating it with patient records. Considering incentive structures, understanding workflow and incorporating awareness are relevant issues when addressing these issues in future studies.
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| 41. |
- Dahlström, Örjan, 1973-, et al.
(författare)
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Does retrieval strategy disruption cause general and specific collaborative inhibition?
- 2011
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Ingår i: Memory. - : Taylor and Francis. - 0965-8211 .- 1464-0686. ; 19:2, s. 140-154
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of the experiment on collaborative memory was to investigate if the collaborative inhibition is due to collaborating pair's disruption of each others' retrieval strategies (the retrieval strategy disruption hypothesis, RSD). The participants' (N=36) task was to recall a list of 60 words individually and collaboratively. Retrieval strategies were manipulated by presenting word lists organised either by categories or by country of origin and adoption of retrieval strategies were examined by the adjusted ratio of clustering score. Half of the dyads received word lists organised by the same strategy and half of the dyads received word lists organised by different strategies. The results revealed a main effect of collaboration, i.e., collaborative recalled items were significantly fewer than the sum of the non-redundant individually recalled items. Both conditions (same strategies vs different strategies) suffered to the same extent from collaboration, which did not support the RSD hypothesis. However, focusing on words recalled individually but not collaboratively, dyads with different strategies, as predicted by the RSD, forgot more items during collaboration than did dyads with the same strategy. Additional results suggest that collaborative forgetting is mainly manifested by forgetting of non-overlapping items (as measured by individual recalls).
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| 42. |
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| 43. |
- Dahlström, Örjan, 1973-, et al.
(författare)
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Efficacy of pre-participation cardiac evaluation recommendations among athletes participating in World Athletics Championships
- 2020
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Ingår i: European Journal of Preventive Cardiology. - : Sage Publications. - 2047-4873 .- 2047-4881. ; 27:14, s. 1480-1490
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Tidskriftsartikel (refereegranskat)abstract
- Background Athletes competing in athletics (track and field) at international level may be participating with underlying undiagnosed life-threatening cardiovascular conditions. Our objective was to analyse variations in pre-participation cardiac evaluation prevalence among athletes participating in two International Association of Athletics Federations (IAAF) World Athletics Championships, with regard to the human developmental level and global region of their home countries, as well as athletes’ age category, gender, event group and medical insurance type.Design Cross-sectional web-based survey.MethodsA total of 1785 athletes competing in the IAAF World Under 18 Championships Nairobi 2017 and World Championships London 2017 were invited to complete a pre-participation health questionnaire investigating the experience of a pre-participation cardiac examination.Results A total of 704 (39%) of the athletes participated. Among these, 59% (60% of women; 58% of men) reported that they had been provided at least one type of pre-participation cardiac evaluation. Athletes from very high income countries, Europe and Asia, showed a higher prevalence of at least one pre-participation cardiac evaluation.Conclusions The prevalence of pre-participation cardiac evaluation in low to middle income countries, and the African continent in particular, needs urgent attention. Furthermore, increases in evaluation prevalence should be accompanied by the development of cost-effective methods that can be adopted in all global regions.
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| 44. |
- Dahlström, Örjan, 1973-
(författare)
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Focus on Chronic Disease through Different Lenses of Expertise : Towards Implementation of Patient-Focused Decision Support Preventing Disability: The Example of Early Rheumatoid Arthritis
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Rheumatoid arthritis (RA) is a chronic inflammatory disease. Treatment strategies emphasize early multi-professional interventions to reduce disease activity and to prevent disability, but there is a lack of knowledge on how optimal treatment can be provided to each individual patient.Aim: To elucidate how clinical manifestations of early RA are associated to disease and disability outcomes, to strive for greater potential to establish prognosis in early RA, and to facilitate implementation of decision support through analyses of the decision-making environment in chronic care.Methods: Multivariate statistics and mathematical modelling, as well as field observations and focus group interviews.Results: Decision support: A prognostic tree that predicted patients with a poor prognosis (moderate or high levels of DAS-28) at one year after diagnosis had a performance of 25% sensitivity, 90% specificity and a positive predictive value of 76%. Implementation of a decision support application at a rheumatology unit should include taking into account incentive structures, workflow and awareness, as well as informal communication structures. Prognosis: A considerable part of the variance in disease activity at one year after diagnosis could be explained by disease progression during the first three months after diagnosis. Using different types of knowledge – different expertise – prior to standardized data mining methods was found to be a promising when mining (clinical) data for new patterns that elicit new knowledge. Disease and disability: Women report more fatigue than men in early RA, although the difference is not consistently significant. Fatigue in early RA is closely and rather consistently related to disease activity, pain and activity limitation, as well as to mental health and sleep disturbance.Conclusion: A decision tree was designed to identify patients at risk of poor prognosis at one year after the diagnosis of RA. When constructing prediction rules for good or poor prognosis, including more measures of disease and disability progressions showed promise. Using different types of knowledge – different lenses of expertise – prior to standardized data mining methods was also a promising method when mining (clinical) data for new patterns that elicit new knowledge.
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| 45. |
- Dahlström, Örjan, et al.
(författare)
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Functions of Nonsuicidal Self-Injury: Exploratory and Confirmatory Factor Analyses in a Large Community Sample of Adolescents
- 2015
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Ingår i: Psychological Assessment. - : American Psychological Association (APA). - 1040-3590 .- 1939-134X. ; 27:1, s. 302-313
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Tidskriftsartikel (refereegranskat)abstract
- Given that nonsuicidal self-injury (NSSI) is prevalent in adolescents, structured assessment is an essential tool to guide treatment interventions. The Functional Assessment of Self-Mutilation (FASM) is a self-report scale that assesses frequency, methods, and functions of NSSI. FASM was administered to 3,097 Swedish adolescents in a community sample. With the aim of examining the underlying factor structure of the functions of FASM in this sample, the adolescents with NSSI who completed all function items (n = 836) were randomly divided into 2 subsamples for cross-validation purposes. An exploratory factor analysis (EFA) was followed by a confirmatory factor analysis (CFA) using the mean and variance adjusted weighted least squares (WLSMV) estimator in the Mplus statistical modeling program. The results of the EFA suggested a 3-factor model (social influence, automatic functions, and nonconformist peer identification), which was supported by a good fit in the CFA. Factors differentiated between social/interpersonal and automatic/intrapersonal functions. Based on learning theory and the specific concepts of negative and positive reinforcement, the nonconformist peer identification factor was then split into 2 factors (peer identification and avoiding demands). The resulting 4-factor model showed an excellent fit. Dividing social functions into separate factors (social influence, peer identification, and avoiding demands) can be helpful in clinical practice, where the assessment of NSSI functions is an important tool with direct implications for treatment.
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| 46. |
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| 47. |
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| 48. |
- Dahlström, Örjan, et al.
(författare)
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Is "Football for All" Safe for All? : Cross-Sectional Study of Disparities as Determinants of 1-Year Injury Prevalence in Youth Football Programs
- 2012
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Ingår i: PLOS ONE. - : PLOS. - 1932-6203. ; 7:8, s. e43795-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Football (soccer) is endorsed as a health-promoting physical activity worldwide. When football programs are introduced as part of general health promotion programs, equal access and limitation of pre-participation disparities with regard to injury risk are important. The aim of this study was to explore if disparity with regard to parents’ educational level, player body mass index (BMI), and self-reported health are determinants of football injury in community-based football programs, separately or in interaction with age or gender.Methodology/Principal Findings: Four community football clubs with 1230 youth players agreed to participate in the cross-sectional study during the 2006 season. The study constructs (parents’ educational level, player BMI, and self-reported health) were operationalized into questionnaire items. The 1-year prevalence of football injury was defined as the primary outcome measure. Data were collected via a postal survey and analyzed using a series of hierarchical statistical computations investigating associations with the primary outcome measure and interactions between the study variables. The survey was returned by 827 (67.2%) youth players. The 1-year injury prevalence increased with age. For youths with parents with higher formal education, boys reported more injuries and girls reported fewer injuries than expected; for youths with lower educated parents there was a tendency towards the opposite pattern. Youths reporting injuries had higher standardized BMI compared with youths not reporting injuries. Children not reporting full health were slightly overrepresented among those reporting injuries and underrepresented for those reporting no injury.Conclusion: Pre-participation disparities in terms of parents’ educational level, through interaction with gender, BMI, and self-reported general health are associated with increased injury risk in community-based youth football. When introduced as a general health promotion, football associations should adjust community-based youth programs to accommodate children and adolescents with increased pre-participation injury risk.
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- Dahlström, Örjan, 1973-
(författare)
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Learning during a collaborative final exam
- 2012
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Ingår i: Educational Research and Evaluation. - : Informa UK Limited. - 1380-3611 .- 1744-4187. ; 18:4, s. 321-332
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Tidskriftsartikel (refereegranskat)abstract
- Collaborative testing has been suggested to serve as a good learning activity, for example, compared to individual testing. The aim of the present study was to measure learning at different levels of knowledge during a collaborative final exam in a course in basic methods and statistical procedures. Results on pre- and post-tests taken individually (N = 30) before and after the collaborative part of the final exam confirmed learning effects at the uni- and multi-structural levels, as well as on the relational level of Biggs’ structure of the observed learning outcome (SOLO) taxonomy (Biggs & Collins, 1982). Low performers at pre-test raised their test scores more than high performers. No differences could be generalized at the extended level of knowledge. Results also suggest that it might be preferable to collaborate without first deciding on questions individually. The experimental design can be applied when evaluating learning, at different levels of knowledge, during a variety of learning activities.
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