| 1. |
- Astor, Kim, et al.
(författare)
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Social and emotional contexts predict the development of gaze following in early infancy
- 2020
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Ingår i: Royal Society Open Science. - : The Royal Society. - 2054-5703. ; 7:9
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Tidskriftsartikel (refereegranskat)abstract
- The development of gaze following begins in early infancy and its developmental foundation has been under heavy debate. Using a longitudinal design (N = 118), we demonstrate that attachment quality predicts individual differences in the onset of gaze following, at six months of age, and that maternal postpartum depression predicts later gaze following, at 10 months. In addition, we report longitudinal stability in gaze following from 6 to 10 months. A full path model (using attachment, maternal depression and gaze following at six months) accounted for 21% of variance in gaze following at 10 months. These results suggest an experience-dependent development of gaze following, driven by the infant's own motivation to interact and engage with others (the social-first perspective).
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| 2. |
- Bertilsson, Johan, et al.
(författare)
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Stress Levels Escalate When Repeatedly Performing Tasks Involving Threats
- 2019
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Ingår i: Frontiers in Psychology. - : Frontiers Media SA. - 1664-1078. ; 10, s. 1562-1562
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Tidskriftsartikel (refereegranskat)abstract
- Police work may include performing repeated tasks under the influence of psychological stress, which can affect perceptual, cognitive and motor performance. However, it is largely unknown how repeatedly performing stressful tasks physically affect police officers in terms of heart rate and pupil diameter properties. Psychological stress is commonly assessed by monitoring the changes in these biomarkers. Heart rate and pupil diameter was measured in 12 male police officers when performing a sequence of four stressful tasks, each lasting between 20 and 130 s. The participants were first placed in a dimly illuminated anteroom before allowed to enter a brightly lit room where a scenario was played out. After each task was performed, the participants returned to the anteroom for about 30 s before performing the next sequential task. Performing a repeated sequence of stressful tasks caused a significant increase in heart rate (p = 0.005). The heart rate started to increase already before entering the scenario room and was significantly larger just after starting the task than just before starting the task (p < 0.001). This pattern was more marked during the first tasks (p < 0.001). Issuance of a verbal "abort" command which terminated the tasks led to a significant increase of heart rate (p = 0.002), especially when performing the first tasks (p = 0.002). The pupil diameter changed significantly during the repeated tasks during all phases but in a complex pattern where the pupil diameter reached a minimum during task 2 followed by an increase during tasks 3 and 4 (p ≤ 0.020). During the initial tasks, the pupil size (p = 0.014) increased significantly. The results suggest that being repeatedly exposed to stressful tasks can produce in itself an escalation of psychological stress, this even prior to being exposed to the task. However, the characteristics of both the heart rate and pupil diameter were complex, thus, the findings highlight the importance of studying the effects and dynamics of different stress-generating factors. Monitoring heart rate was found useful to screen for stress responses, and thus, to be a vehicle for indication if and when rotation of deployed personnel is necessary to avoid sustained high stress exposures.
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| 3. |
- Bertilsson, Johan, et al.
(författare)
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Towards systematic and objective evaluation of police officer performance in stressful situations
- 2020
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Ingår i: Police Practice and Research. - : Informa UK Limited. - 1561-4263 .- 1477-271X. ; 21:6, s. 655-669
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Tidskriftsartikel (refereegranskat)abstract
- To ensure a continuous high standard of police units, it is critical to recruit people who perform well in stressful situations. Today, this selection process includes performing a large series of tests, which still may not objectively reveal a person’s capacity to handle a life-threatening situation when subjected to high levels of stress. To obtain more systematic and objective data, 12 police officers were exposed to six scenarios with varying levels of threat while their heart rate and pupil size were monitored. The scenarios were filmed and six expert evaluators assessed the performance of the police officers according to seven predefined criteria. Four of the scenarios included addressing a moderate threat level task and the scenarios were executed in a rapid sequence. Two further scenarios included a familiar firearm drill performed during high and low threat situations. The results showed that there was a large agreement between the experts in how they judged the performance of the police officers (p < 0.001). Performance increased significantly over tasks in four of the seven evaluation criteria (p ≤ 0.037). There was also a significant effect of pupil size (p = 0.004), but not heart rate, when comparing the different sequential scenarios. Moreover, a high level of threat considerably impaired the motor performance of the police officers during the firearms drill (p = 0.002). Finally, the pupil seemed to systematically dilate more when a threat appeared immediately than with a delay in the scenarios (p = 0.007). We conclude that systematic and quantitative judgments from experts provide valuable and reliable information about the performance of participants in realistic and stressful policing scenarios. Furthermore, objective physiological measures of heart rate and pupil size may help to explain and understand why performance sometimes deteriorates.
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| 4. |
- Borenäs, Marcus, et al.
(författare)
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ALK ligand ALKAL2 potentiates MYCN-driven neuroblastoma in the absence of ALK mutation
- 2021
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Ingår i: EMBO Journal. - : John Wiley & Sons. - 0261-4189 .- 1460-2075. ; 40:3
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Tidskriftsartikel (refereegranskat)abstract
- High‐risk neuroblastoma (NB) is responsible for a disproportionate number of childhood deaths due to cancer. One indicator of high‐risk NB is amplification of the neural MYC (MYCN) oncogene, which is currently therapeutically intractable. Identification of anaplastic lymphoma kinase (ALK) as an NB oncogene raised the possibility of using ALK tyrosine kinase inhibitors (TKIs) in treatment of patients with activating ALK mutations. 8–10% of primary NB patients are ALK‐positive, a figure that increases in the relapsed population. ALK is activated by the ALKAL2 ligand located on chromosome 2p, along with ALK and MYCN, in the “2p‐gain” region associated with NB. Dysregulation of ALK ligand in NB has not been addressed, although one of the first oncogenes described was v‐sis that shares > 90% homology with PDGF. Therefore, we tested whether ALKAL2 ligand could potentiate NB progression in the absence of ALK mutation. We show that ALKAL2 overexpression in mice drives ALK TKI‐sensitive NB in the absence of ALK mutation, suggesting that additional NB patients, such as those exhibiting 2p‐gain, may benefit from ALK TKI‐based therapeutic intervention.
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| 5. |
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| 6. |
- Corsini, Christian, et al.
(författare)
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Patient-reported Side Effects 1 Year After Radical Prostatectomy or Radiotherapy for Prostate Cancer : A Register-based Nationwide Study
- 2024
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Ingår i: European Urology Oncology. - : Elsevier. - 2588-9311. ; 7:3, s. 605-613
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Tidskriftsartikel (refereegranskat)abstract
- Background: Data on functional and psychological side effects following curative treatment for prostate cancer are lacking from large, contemporary, unselected, populationbased cohorts. Objective: To assess urinary symptoms, bowel disturbances, erectile dysfunction (ED), and quality of life (QoL) 12 mo after robot -assisted radical prostatectomy (RARP) and radiotherapy (RT) using patient -reported outcome measures in the Swedish prostate cancer database. Design, setting, and participants: This was a nationwide, population -based, cohort study in Sweden of men who underwent primary RARP or RT between January 1, 2018 and December 31, 2020. Outcome measurements and statistical analysis: Absolute proportions and odds ratios (ORs) were calculated using multivariable logistic regression, with adjustment for clinical characteristics. Results and limitations: A total of 2557 men underwent RARP and 1741 received RT. Men who underwent RT were older (69 vs 65 yr) and had more comorbidities at baseline. After RARP, 13% of men experienced incontinence, compared to 6% after RT. The frequency of urinary bother was similar, at 18% after RARP and 18% after RT. Urgency to defecate was reported by 14% of men after RARP and 34% after RT. At 1 yr, 73% of men had ED after RARP, and 77% after RT. High QoL was reported by 85% of men after RARP and 78% of men after RT. On multivariable regression analysis, RT was associated with lower risks of urinary incontinence (OR 0.25, 95% confidence interval [CI] 0.19- 0.33), urinary bother (OR 0.79, 95% CI 0.66-0.95), and ED (OR 0.54, 95% CI 0.46-0.65), but higher risk of bowel symptoms (OR 2.86, 95% CI 2.42-3.39). QoL was higher after RARP than after RT (OR 1.34, 95% CI 1.12-1.61). Conclusions: Short-term specific side effects after curative treatment for prostate cancer significantly differed between RARP and RT in this large and unselected cohort. Nevertheless, the risk of urinary bother was lower after RT, while higher QoL was common after RARP. Patient summary: In our study of patients treated for prostate cancer, urinary bother and overall quality of life are comparable at 1 year after surgical removal of the prostate in comparison to radiotherapy, despite substantial differences in other side effects. (c) 2024 The Authors. Published by Elsevier B.V. on behalf of European Association of Urology. This is an open access article under the CC BY -NC -ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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| 7. |
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| 8. |
- Erlich, Catharina, et al.
(författare)
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Thermochemical characteristics of sugar cane bagasse pellets
- 2005
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Ingår i: Fuel. - : Elsevier BV. - 0016-2361 .- 1873-7153. ; 84:5, s. 569-575
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Tidskriftsartikel (refereegranskat)abstract
- Pelletisation facilitates utilisation of sugar cane bagasse as a fuel and storage for year-round electricity generation. The present work determines thermochemical characteristics of bagasse pellets of different sizes and origins, using various temperatures (600, 750 and 900 degrees C) and gas flow rates (4, 7 and 10 L/min) with varying concentrations of oxygen (5, 10 and 15 %) in mixtures with nitrogen. Of major interest are the effects of raw material, origin and size of pellets, and the treatment conditions on the rate of pyrolysis and the structure and reactivity of char in combustion. The char yield of the larger pellets of high-ash content bagasse was practically independent of treatment conditions. Smaller pellets gave better mechanical stability of the char but lower reactivity.
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| 9. |
- Fransson, Helen, et al.
(författare)
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Development and validation of a new automatic algorithm for quantification of left ventricular volumes and function in gated myocardial perfusion SPECT using cardiac magnetic resonance as reference standard.
- 2011
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Ingår i: Journal of Nuclear Cardiology. - : Springer Science and Business Media LLC. - 1532-6551 .- 1071-3581. ; 18:5, s. 874-885
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: By gating image acquisition in myocardial perfusion SPECT (MPS) to ECG, left ventricular (LV) volumes and function can be determined. Several previous studies have shown that existing MPS software packages underestimate LV volumes compared to cardiac magnetic resonance (CMR). The aim of this study was therefore to develop a new LV segmentation algorithm for gated MPS using CMR as reference standard. METHODS AND RESULTS: A total of 126 patients with suspected coronary artery disease, who underwent both gated MPS and CMR were retrospectively included. The proposed LV segmentation algorithm (Segment) was trained in 26 patients, and tested in 100 patients in comparison to four commercially available MPS software packages (QGS, MyoMetrix, ECTb, and Exini) using CMR as reference standard. Mean bias ± SD between MPS and CMR was for EDV -5% ± 12%, -43% ± 8%, -40% ± 8%, -42% ± 9%, -32% ± 7%, for ESV 0% ± 17%, -41% ± 16%, -34% ± 15%, -54% ± 13%, -41% ± 10%, for EF -2% ± 13%, -1% ± 14%, -7% ± 15%, 17% ± 16%, 10% ± 17% for Segment, QGS, MyoMetrix, ECTb, and Exini, respectively, and for LVM 3% ± 18%, 33% ± 25%, 37% ± 24% for Segment, QGS, and ECTb, respectively. Correlation between MPS by Segment and CMR were for EDV R (2) = 0.89, for ESV R (2) = 0.92, for EF R (2) = 0.69, and for LVM R (2) = 0.72, with no difference compared to the correlation between the other MPS software packages and CMR (EDV R (2) = 0.86-0.92, ESV R (2) = 0.91-0.93, EF R (2) = 0.64-0.65, and LVM R (2) = 0.68-0.70). CONCLUSION: The Segment software quantifies LV volumes and EF by MPS with similar correlation and a low bias compared to other MPS software packages, using CMR as reference standard. Hence, the Segment software shows potential to provide clinically relevant volumes and functional values from MPS.
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| 10. |
- Fransson, Helen, et al.
(författare)
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Validation of an automated method to quantify stress-induced ischemia and infarction in rest-stress myocardial perfusion SPECT.
- 2014
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Ingår i: Journal of Nuclear Cardiology. - : Springer Science and Business Media LLC. - 1532-6551 .- 1071-3581. ; 21:3, s. 503-518
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Tidskriftsartikel (refereegranskat)abstract
- Myocardial perfusion SPECT (MPS) is one of the frequently used methods for quantification of perfusion defects in patients with known or suspected coronary artery disease. This article describes open access software for automated quantification in MPS of stress-induced ischemia and infarction and provides phantom and in vivo validation.
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| 11. |
- Fransson, Marcus, et al.
(författare)
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Case Report : Subtherapeutic Vancomycin and Meropenem Concentrations due to Augmented Renal Clearance in a Patient With Intracranial Infection Caused by Streptococcus intermedius
- 2021
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Ingår i: Frontiers in Pharmacology. - : Frontiers Media SA. - 1663-9812. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Streptococcus intermedius occasionally causes brain abscesses that can be life-threatening, requiring prompt antibiotic and neurosurgical treatment. The source is often dental, and it may spread to the eye or the brain parenchyma. We report the case of a 34-year-old man with signs of apical periodontitis, endophthalmitis, and multiple brain abscesses caused by Streptococcus intermedius. Initial treatment with meropenem and vancomycin was unsuccessful due to subtherapeutic concentrations, despite recommended dosages. Adequate concentrations could be reached only after increasing the dose of meropenem to 16 g/day and vancomycin to 1.5 g x 4. The patient exhibited high creatinine clearance consistent with augmented renal clearance, although iohexol and cystatin C clearances were normal. Plasma free vancomycin clearance followed that of creatinine. A one-day dose of trimethoprim-sulfamethoxazole led to an increase in serum creatinine and a decrease in both creatinine and urea clearances. These results indicate that increased tubular secretion of the drugs was the cause of suboptimal antibiotic treatment. The patient eventually recovered, but his left eye needed enucleation. Our case illustrates that augmented renal clearance can jeopardize the treatment of serious bacterial infections and that high doses of antibiotics are needed to achieve therapeutic concentrations in such cases. The mechanisms for regulation of kidney tubular transporters of creatinine, urea, vancomycin, and meropenem in critically ill patients are discussed.
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| 12. |
- Fransson, Marcus, et al.
(författare)
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Svår traumatisk hjärnskada
- 2020
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Ingår i: Läkartidningen. - Stockholm, Sweden : Sveriges Läkarförbund. - 0023-7205 .- 1652-7518. ; 117
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Tidskriftsartikel (refereegranskat)abstract
- De flesta är ense om att:handläggning ska sträva efter att nå normala fysiologiska förhållandentidig administrering av tranexamsyra minskar mortalitetensteroider och hypotermibehandling inte har en roll ihandläggningeneffekten av blodförtunnande behandling ska reverseras.Åsikterna går isär vad gäller:val mellan hyperton koksaltlösning och mannitol vidförhöjt intrakraniellt tryckval av bedömningsskala för medvetandegrad.
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| 13. |
- Fransson, Per-Anders, et al.
(författare)
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Exploring the Effects of Deep Brain Stimulation and Vision on Tremor in Parkinson's Disease : Benefits from Objective Methods
- 2020
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Ingår i: Journal of NeuroEngineering and Rehabilitation. - : Springer Science and Business Media LLC. - 1743-0003. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Tremor is a cardinal symptom of Parkinson's disease (PD) that may cause severe disability. As such, objective methods to determine the exact characteristics of the tremor may improve the evaluation of therapy. This methodology study aims to validate the utility of two objective technical methods of recording Parkinsonian tremor and evaluate their ability to determine the effects of Deep Brain Stimulation (DBS) of the subthalamic nucleus and of vision.METHODS: We studied 10 patients with idiopathic PD, who were responsive to L-Dopa and had more than 1 year use of bilateral subthalamic nucleus stimulation. The patients did not have to display visible tremor to be included in the study. Tremor was recorded with two objective methods, a force platform and a 3 dimensional (3D) motion capture system that tracked movements in four key proximal sections of the body (knee, hip, shoulder and head). They were assessed after an overnight withdrawal of anti-PD medications with DBS ON and OFF and with eyes open and closed during unperturbed and perturbed stance with randomized calf vibration, using a randomized test order design.RESULTS: Tremor was detected with the Unified Parkinson's Disease Rating Scale (UPDRS) in 6 of 10 patients but only distally (hands and feet) with DBS OFF. With the force platform and the 3D motion capture system, tremor was detected in 6 of 10 and 7 of 10 patients respectively, mostly in DBS OFF but also with DBS ON in some patients. The 3D motion capture system revealed that more than one body section was usually affected by tremor and that the tremor amplitude was non-uniform, but the frequency almost identical, across sites. DBS reduced tremor amplitude non-uniformly across the body. Visual input mostly reduced tremor amplitude with DBS ON.CONCLUSIONS: Technical recording methods offer objective and sensitive detection of tremor that provide detailed characteristics such as peak amplitude, frequency and distribution pattern, and thus, provide information that can guide the optimization of treatments. Both methods detected the effects of DBS and visual input but the 3D motion system was more versatile in that it could detail the presence and properties of tremor at individual body sections.
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| 14. |
- Fransson, Sven Göran, 1949-, et al.
(författare)
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Bilden i vår kliniska vardag
- 2007. - 1
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Ingår i: Svensk Medicin 77. ; , s. 49-70
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 15. |
- Gospic, Katarina, et al.
(författare)
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Altruism costs-the cheap signal from amygdala
- 2014
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Ingår i: Social Cognitive & Affective Neuroscience. - : Oxford University Press (OUP). - 1749-5016 .- 1749-5024. ; 9:9, s. 1325-1332
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Tidskriftsartikel (refereegranskat)abstract
- When people state their willingness to pay for something, the amount usually differs from the behavior in a real purchase situation. The discrepancy between a hypothetical answer and the real act is called hypothetical bias. We investigated neural processes of hypothetical bias regarding monetary donations to public goods using fMRI with the hypothesis that amygdala codes for real costs. Real decisions activated amygdala more than hypothetical decisions. This was observed for both accepted and rejected proposals. The more the subjects accepted real donation proposals the greater was the activity in rostral anterior cingulate cortex-a region known to control amygdala but also neural processing of the cost-benefit difference. The presentation of a charitable donation goal evoked an insula activity that predicted the later decision to donate. In conclusion, we have identified the neural mechanisms underlying real donation behavior, compatible with theories on hypothetical bias. Our findings imply that the emotional system has an important role in real decision making as it signals what kind of immediate cost and reward an outcome is associated with.
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| 16. |
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| 17. |
- Heiberg, Einar, et al.
(författare)
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Longitudinal strain from velocity encoded cardiovascular magnetic resonance: a validation study
- 2013
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Ingår i: Journal of Cardiovascular Magnetic Resonance. - 1097-6647. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Background: Regional myocardial function is typically evaluated by visual assessment by experienced users, or by methods requiring substantial post processing time. Visual assessment is subjective and not quantitative. Therefore, the purpose of this study is to develop and validate a simple method to derive quantitative measures of regional wall function from velocity encoded Cardiovascular Magnetic Resonance (CMR), and provide associated normal values for longitudinal strain. Method: Both fast field echo (FFE) and turbo field echo (TFE) velocity encoded CMR images were acquired in three long axis planes in 36 healthy volunteers (13 women, 23 men), age 35 +/- 12 years. Strain was also quantified in 10 patients within one week after myocardial infarction. The user manually delineated myocardium in one time frame and strain was calculated as the myocardium was tracked throughout the cardiac cycle using an optimization formulation and mechanical a priori assumptions. A phantom experiment was performed to validate the method with optical tracking of deformation as an independent gold standard. Results: There was an excellent agreement between longitudinal strain measured by optical tracking and longitudinal strain measured with TFE velocity encoding. Difference between the two methods was 0.0025 +/- 0.085 (ns). Mean global longitudinal strain in the 36 healthy volunteers was -0.18 +/- 0.10 (TFE imaging). Intra-observer variability for all segments was 0.00 +/- 0.06. Inter-observer variability was -0.02 +/- 0.07 (TFE imaging). The intra-observer variability for radial strain was high limiting the applicability of radial strain. Mean longitudinal strain in patients was significantly lower (-0.15 +/- 0.12) compared to healthy volunteers (p<0.05). Strain (expressed as percentage of normal strain) in infarcted regions was lower compared to remote areas (p<0.01). Conclusion: In conclusion, we have developed and validated a robust and clinically applicable technique that can quantify longitudinal strain and regional myocardial wall function and present the associated normal values for longitudinal strain.
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| 18. |
- Hrastinski, Stefan, 1980-, et al.
(författare)
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Critical Imaginaries and Reflections on Artificial Intelligence and Robots in Postdigital K-12 Education
- 2019
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Ingår i: Postdigital Science and Education. - : Springer Science and Business Media LLC. - 2524-485X .- 2524-4868 .- 2662-5326. ; 1:2, s. 427-445
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Tidskriftsartikel (refereegranskat)abstract
- It is commonly suggested that emerging technologies will revolutionize education. In this paper, two such emerging technologies, artificial intelligence (AI) and educational robots (ER), are in focus. The aim of the paper is to explore how teachers, researchers and pedagogical developers critically imagine and reflect upon how AI and robots could be used in education. The empirical data were collected from discussion groups that were part of a symposium. For both AI and ERs, the need for more knowledge about these technologies, how they could preferably be used, and how the emergence of these technologies might affect the role of the teacher and the relationship between teachers and students, were outlined. Many participants saw more potential to use AI for individualization as compared with ERs. However, there were also more concerns, such as ethical issues and economic interests, when discussing AI. While the researchers/developers to a greater extent imagined ideal future technology-rich educational practices, the practitioners were more focused on imaginaries grounded in current practice.
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| 19. |
- Javanmardi, Niloufar, et al.
(författare)
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Analysis of ALK, MYCN, and the ALK ligand ALKAL2 (FAM150B/AUG alpha) in neuroblastoma patient samples with chromosome arm 2p rearrangements
- 2020
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Ingår i: Genes Chromosomes & Cancer. - : Wiley. - 1045-2257 .- 1098-2264. ; 59:1, s. 50-57
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Tidskriftsartikel (refereegranskat)abstract
- Gain of chromosome arm 2p is a previously described entity in neuroblastoma (NB). This genomic address is home to two important oncogenes in NB-MYCN and anaplastic lymphoma kinase (ALK). MYCN amplification is a critical prognostic factor coupled with poor prognosis in NB. Mutation of the ALK receptor tyrosine kinase has been described in both somatic and familial NB. Here, ALK activation occurs in the context of the full-length receptor, exemplified by activating point mutations in NB. ALK overexpression and activation, in the absence of genetic mutation has also been described in NB. In addition, the recently identified ALK ligand ALKAL2 (previously described as FAM150B and AUG alpha) is also found on the distal portion of 2p, at 2p25. Here we analyze 356 NB tumor samples and discuss observations indicating that gain of 2p has implications for the development of NB. Finally, we put forward the hypothesis that the effect of 2p gain may result from a combination of MYCN, ALK, and the ALK ligand ALKAL2.
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| 20. |
- Jensen, Karin B, et al.
(författare)
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Anxiety and depressive symptoms in fibromyalgia are related to poor perception of health but not to pain sensitivity or cerebral processing of pain.
- 2010
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Ingår i: Arthritis and Rheumatism. - : Wiley. - 0004-3591 .- 1529-0131. ; 62:11, s. 3488-95
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Mood disturbance is common among patients with fibromyalgia (FM), but the influence of psychological symptoms on pain processing in this disorder is unknown. We undertook the present study to investigate the differential effect of depressive symptoms, anxiety, and catastrophizing on 1) pain symptoms and subjective ratings of general health status and 2) sensitivity to pain and cerebral processing of pressure pain.METHODS: Eighty-three women (mean ± SD age 43.8 ± 8.1 years) who fulfilled the American College of Rheumatology 1990 criteria for the classification of FM participated in the study. Patients rated pain intensity (100-mm visual analog scale [VAS]), severity of FM (Fibromyalgia Impact Questionnaire), general health status (Short Form 36), depressive symptoms (Beck Depression Inventory), anxiety (State-Trait Anxiety Inventory), and catastrophizing (Coping Strategies Questionnaire). Experimental pain in the thumb was induced using a computer-controlled pressure stimulator. Event-related functional magnetic resonance imaging was performed during administration of painful stimuli representing 50 mm on a pain VAS, as well as nonpainful pressures.RESULTS: A correlation analysis including all self-ratings showed that depressive symptoms, anxiety, and catastrophizing scores were correlated with one another (P < 0.001), but did not correlate with ratings of clinical pain or with sensitivity to pressure pain. However, the subjective rating of general health was correlated with depressive symptoms and anxiety (P < 0.001). Analyses of imaging results using self-rated psychological measures as covariates showed that brain activity during experimental pain was not modulated by depressive symptoms, anxiety, or catastrophizing.CONCLUSION: Negative mood in FM patients can lead to a poor perception of one's physical health (and vice versa) but does not influence performance on assessments of clinical and experimental pain. Our data provide evidence that 2 partially segregated mechanisms are involved in the neural processing of experimental pain and negative affect.
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| 21. |
- Jensen, Karin B, et al.
(författare)
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Evidence of dysfunctional pain inhibition in Fibromyalgia reflected in rACC during provoked pain.
- 2009
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Ingår i: Pain. - : Ovid Technologies (Wolters Kluwer Health). - 0304-3959 .- 1872-6623. ; 144:1-2, s. 95-100
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Tidskriftsartikel (refereegranskat)abstract
- Over the years, many have viewed Fibromyalgia syndrome (FMS) as a so-called "functional disorder" and patients have experienced a concomitant lack of interest and legitimacy from the medical profession. The symptoms have not been explained by peripheral mechanisms alone nor by specific central nervous system mechanisms. In this study, we objectively evaluated the cerebral response to individually calibrated pain provocations of a pain-free body region (thumbnail). The study comprised 16 female FMS patients and 16 individually age-matched controls. Brain activity was measured using functional magnetic resonance imaging (fMRI) during individually calibrated painful pressures representing 50 mm on a visual analogue scale (VAS) ranging from 0 to 100 mm. Patients exhibited higher sensitivity to pain provocation than controls as they required less pressure to evoke equal pain magnitudes (U(A)=48, p<.002). Despite lower pressures applied in patients at VAS 50 mm, the fMRI-analysis revealed no difference in activity in brain regions relating to attention and affect or regions with sensory projections from the stimulated body area. However, in the primary link in the descending pain regulating system (the rostral anterior cingulate cortex) the patients failed to respond to pain provocation. The attenuated response to pain in this brain region is the first demonstration of a specific brain region where the impairment of pain inhibition in FMS patients is expressed. These results validate previous reports of dysfunctional endogenous pain inhibition in FMS and advance the understanding of the central pathophysiologic mechanisms, providing a new direction for the development of successful treatments in FMS.
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| 22. |
- Jensen, Karin B, et al.
(författare)
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Overlapping structural and functional brain changes in patients with long-term exposure to fibromyalgia pain.
- 2013
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Ingår i: Arthritis and Rheumatism. - : Wiley. - 0004-3591 .- 1529-0131. ; 65:12, s. 3293-303
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: There is vast evidence to support the presence of brain aberrations in patients with fibromyalgia (FM), and it is possible that central plasticity is critical for the transition from acute to chronic pain. The aim of the present study was to investigate the relationship between brain structure and function in patients with FM.METHODS: Functional connectivity of the brain during application of intermittent pressure-pain stimuli and measures of brain structure were compared between 26 patients with FM and 13 age- and sex-matched healthy controls. Magnetic resonance imaging (MRI) was performed to obtain high-resolution anatomic images and functional MRI scans of the brain, which were used for measurements of pain-evoked brain activity.RESULTS: FM patients displayed a distinct overlap between decreased cortical thickness, decreased brain volumes, and decreased functional regional coherence in the rostral anterior cingulate cortex. The morphometric changes were more pronounced with longer exposure to FM pain. In addition, there was evidence of an association between structural and functional changes in the mesolimbic areas of the brain and the severity of comorbid depression symptoms in FM patients.CONCLUSION: The combined integration of structural and functional measures allowed for a unique characterization of the impact of FM pain on the brain. These data may lead to the identification of early structural and functional brain alterations in response to pain, which could be used to develop markers for predicting the development of FM and other pain disorders.
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| 23. |
- Jensen, Karin B, et al.
(författare)
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Patients with fibromyalgia display less functional connectivity in the brain's pain inhibitory network.
- 2012
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Ingår i: Molecular Pain. - : SAGE Publications. - 1744-8069. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There is evidence for augmented processing of pain and impaired endogenous pain inhibition in Fibromyalgia syndrome (FM). In order to fully understand the mechanisms involved in FM pathology, there is a need for closer investigation of endogenous pain modulation. In the present study, we compared the functional connectivity of the descending pain inhibitory network in age-matched FM patients and healthy controls (HC).We performed functional magnetic resonance imaging (fMRI) in 42 subjects; 14 healthy and 28 age-matched FM patients (2 patients per HC), during randomly presented, subjectively calibrated pressure pain stimuli. A seed-based functional connectivity analysis of brain activity was performed. The seed coordinates were based on the findings from our previous study, comparing the fMRI signal during calibrated pressure pain in FM and HC: the rostral anterior cingulate cortex (rACC) and thalamus.RESULTS: FM patients required significantly less pressure (kPa) to reach calibrated pain at 50 mm on a 0-100 visual analogue scale (p < .001, two-tailed). During fMRI scanning, the rACC displayed significantly higher connectivity to the amygdala, hippocampus, and brainstem in healthy controls, compared to FM patients. There were no regions where FM patients showed higher rACC connectivity. Thalamus showed significantly higher connectivity to the orbitofrontal cortex in healthy controls but no regions showed higher thalamic connectivity in FM patients.CONCLUSION: Patients with FM displayed less connectivity within the brain's pain inhibitory network during calibrated pressure pain, compared to healthy controls. The present study provides brain-imaging evidence on how brain regions involved in homeostatic control of pain are less connected in FM patients. It is possible that the dysfunction of the descending pain modulatory network plays an important role in maintenance of FM pain and our results may translate into clinical implications by using the functional connectivity of the pain modulatory network as an objective measure of pain dysregulation.
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| 24. |
- Jensen, Karin B, et al.
(författare)
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Segregating the cerebral mechanisms of antidepressants and placebo in fibromyalgia.
- 2014
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Ingår i: Journal of Pain. - : Elsevier BV. - 1526-5900 .- 1528-8447. ; 15:12, s. 1328-37
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Tidskriftsartikel (refereegranskat)abstract
- UNLABELLED: Antidepressant drugs are commonly used to treat fibromyalgia, but there is little knowledge about their mechanisms of action. The aim of this study was to compare the cerebral and behavioral response to positive treatment effects of antidepressants or placebo. Ninety-two fibromyalgia patients participated in a 12-week, double-blind, placebo-controlled clinical trial with milnacipran, a serotonin-norepinephrine reuptake inhibitor. Before and after treatment, measures of cerebral pain processing were obtained using functional magnetic resonance imaging. Also, there were stimulus response assessments of pressure pain, measures of weekly pain, and fibromyalgia impact. Following treatment, milnacipran responders exhibited significantly higher activity in the posterior cingulum compared with placebo responders. The mere exposure to milnacipran did not explain our findings because milnacipran responders exhibited increased activity also in comparison to milnacipran nonresponders. Stimulus response assessments revealed specific antihyperalgesic effects in milnacipran responders, which was also correlated with reduced clinical pain and with increased activation of the posterior cingulum. A short history of pain predicted positive treatment response to milnacipran. We report segregated neural mechanisms for positive responses to treatment with milnacipran and placebo, reflected in the posterior cingulum. The increase of pain-evoked activation in the posterior cingulum may reflect a normalization of altered default mode network processing, an alteration implicated in fibromyalgia pathophysiology.PERSPECTIVE: This study presents neural and psychophysical correlates to positive treatment responses in patients with fibromyalgia, treated with either milnacipran or placebo. The comparison between placebo responders and milnacipran responders may shed light on the specific mechanisms involved in antidepressant treatment of chronic pain.
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| 25. |
- Kristiansson, Helena, et al.
(författare)
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Dura Management Strategies in the Surgical Treatment of Adult Chiari Type I Malformation : A Retrospective, Multicenter, Population-Based Parallel Cohort Case Series
- 2022
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Ingår i: Operative Neurosurgery. - : Lippincott Williams & Wilkins. - 2332-4252 .- 2332-4260. ; 23:4, s. 304-311
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Symptomatic Chiari I malformation is treated with suboccipital decompression and C1 laminectomy. However, whether the dura should be opened (durotomy) or enlarged with a graft (duraplasty) remains unclear. OBJECTIVE: To compare outcomes in adult Chiari I malformation patients treated with duraplasty, durotomy, or without dural opening ("mini-decompression").METHODS: A retrospective, multicenter, population-based cohort study was performed of all adult patients surgically treated for a Chiari I malformation at 3 regional neurosurgical centers between 2005 and 2017. Three different dura management strategies were favored by the participating hospitals, with data stratified accordingly. The primary outcome was measured using the Chicago Chiari Outcome Scale (CCOS), dichotomized into favorable (CCOS >= 13) or unfavorable (CCOS <= 12). Propensity score matching was used to adjust for potential confounders in outcome comparisons.RESULTS: In total, 318 patients were included, of whom 52% were treated with duraplasty, 37% with durotomy, and 11% with mini-decompression. In total, 285 (90%) showed a favorable surgical outcome (CCOS >= 13). Duraplasty was associated with more favorable CCOS and shorter hospital stay compared with durotomy, both in unadjusted (93% vs 84%. P = .018 and 6.0 vs 8.0 days, P < .001) and adjusted analyses (92% vs 84%, P = .044 and 6.0 vs 8.0 days, P < .001). Mini-decompression was excluded from the adjusted analyses because of its small sample size.CONCLUSION: In this study of adult Chiari I malformation, posterior fossa decompression with duraplasty was associated with more favorable postoperative outcome, as determined by the CCOS, compared with posterior fossa decompression with durotomy alone.
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| 26. |
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| 29. |
- Lundqvist, Peter, et al.
(författare)
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No trace of a single-degenerate companion in late spectra of supernovae 2011fe and 2014J
- 2015
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 577
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Tidskriftsartikel (refereegranskat)abstract
- Aims. This study aims at constraining the origin of the nearby Type Ia supernovae (SNe), 2011fe and 2014J. The two most favoured scenarios for triggering the explosion of the white dwarf supernova progenitor is either mass loss from a non-degenerate companion or merger with another white dwarf. In the former, there could be a significant amount of leftover material from the companion at the centre of the supernova. Detecting such material would therefore favour the single-degenerate scenario. Methods. The left-over material from a possible non-degenerate companion can reveal itself after about one year, and in this study such material was searched for in the spectra of SN 2011fe (at 294 days after the explosion) using the Large Binocular Telescope and for SN 2014J using the Nordic Optical Telescope (315 days past explosion). The observations were interpreted using numerical models simulating the expected line emission from ablated material from the companion star. The spectral lines sought for are H alpha, [O I] lambda 6300, and [Ca II] lambda lambda 7291,7324, and the expected width of these lines is similar to 1000 km s(-1), which in the case of the [Ca II] lines blend to a broader feature. Results. No signs of H alpha, [O I] lambda 6300, or [Ca II] lambda lambda 7291, 7324 could be traced for in any of the two supernovae. When systematic uncertainties are included, the limits on hydrogen-rich ablated gas are 0 : 003 M-circle dot in SN 2011fe and 0 : 0085 M-circle dot in SN 2014J, where the limit for SN 2014J is the second lowest ever, and the limit for SN 2011fe is a revision of a previous limit. Limits are also put on helium-rich ablated gas, and here limits from [O I] lambda 6300 provide the upper mass limits 0 : 002 M-circle dot and 0 : 005 M-circle dot for SNe 2011fe and 2014J, respectively. These numbers are used in conjunction with other data to argue that these supernovae can stem from double-degenerate systems or from single-degenerate systems with a spun-up/spun-down super-Chandrasekhar white dwarf. For SN 2011fe, other types of hydrogen-rich donors can very likely be ruled out, whereas a main-sequence donor system with large intrinsic separation is still possible for SN 2014J. Helium-rich donor systems cannot be ruled out for any of the two supernovae, but the expected short delay time for such progenitors makes this possibility less likely, especially for SN 2011fe. Published data for SNe 1998bu, 2000cx, 2001el, 2005am, and 2005cf are used to constrain their origin. We emphasise that the results of this study depend on the sought-after lines emerging unattenuated from the central regions of the nebula. Detailed radiative transfer calculations with longer line lists than are presently used are needed to confirm that this is, in fact, true. Finally, the broad lines of SNe 2011fe and 2014J are discussed, and it is found that the [Ni II] lambda 7378 emission is redshifted by similar to+ 1300 km s(-1), as opposed to the known blueshift of similar to-1100 km s(-1) for SN 2011fe. [Fe II] lambda 7155 is also redshifted in SN 2014J. SN 2014J belongs to a minority of SNe Ia that both have a nebular redshift of [Fe II] lambda 7155 and [Ni II] lambda 7378, and a slow decline of the Si II lambda 6355 absorption trough just after B-band maximum.
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| 30. |
- Marciszko, Carin, et al.
(författare)
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The social foundation of executive function
- 2020
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Ingår i: Developmental Science. - : John Wiley & Sons, Ltd. - 1363-755X .- 1467-7687. ; 23:3
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Tidskriftsartikel (refereegranskat)abstract
- In this study, we propose that infant social cognition may ‘bootstrap' the successive development of domain‐general cognition in line with the cultural intelligence hypothesis. Using a longitudinal design, 6‐month‐old infants (N = 118) were assessed on two basic social cognitive tasks targeting the abilities to share attention with others and understanding other peoples' actions. At 10 months, we measured the quality of the child's social learning environment, indexed by parent's abilities to provide scaffolding behaviors during a problem‐solving task. Eight months later, the children were followed up with a cognitive test‐battery, including tasks of inhibitory control and working memory. Our results showed that better infant social action understanding interacted with better parental scaffolding skills in predicting simple inhibitory control in toddlerhood. This suggests that infants' who are better at understanding other's actions are also better equipped to make the most of existing social learning opportunities, which in turn may benefit future non‐social cognitive outcomes.
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| 31. |
- Petzke, F, et al.
(författare)
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Using fMRI to evaluate the effects of milnacipran on central pain processing in patients with fibromyalgia.
- 2013
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Ingår i: Scandinavian Journal of Pain. - : Walter de Gruyter GmbH. - 1877-8860 .- 1877-8879. ; 4:2, s. 65-74
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Tidskriftsartikel (refereegranskat)abstract
- Background In recent years, the prescription of serotonin-noradrenalin reuptake inhibitors (SNRIs) for treatment of fibromyalgia (FM) has increased with reports of their efficacy. The SNRI milnacipran is approved by the U.S. Food and Drug Administration (FDA) for treatment of FM, yet, the mechanisms by which milnacipran reduces FM symptoms are unknown. A large number of neuroimaging studies have demonstrated altered brain function in patients with FM but the effect of milnacipran on central pain processing has not been investigated. The primary objective of this study was to assess the effect of milnacipran on sensitivity to pressure-evoked pain in FM. Secondary objectives were to assess the effect of milnacipran on cerebral processing of pressure-evoked pain using fMRI and the tolerability and safety of milnacipran 200 mg/day in FM. Methods 92 patients were randomized to either 13-weeks milnacipran treatment (200 mg/day) or placebo in this double-blind, placebo-controlled multicenter clinical trial. Psychophysical measures and functional MRI (fMRI) assessments were performed before and after treatment using a computer-controlled pressure-pain stimulator. Here, we present the results of several a priori defined statistical analyses. Results Milnacipran-treated patients displayed a trend toward lower pressure-pain sensitivity after treatment, compared to placebo, and the difference was greater at higher pain intensities. A single group fMRI analysis of milnacipran-treated patients indicated increased pain-evoked brain activity in the caudatus nucleus, anterior insula and amygdala after treatment, compared to before treatment; regions implicated in pain inhibitory processes. A 2 × 2 repeated measures fMRI analysis, comparing milnacipran and placebo, before and after treatment, showed that milnacipran-treated patients had greater pain-evoked activity in the precuneus/posterior cingulate cortex after treatment; a region previously implicated in intrinsic brain function and FM pathology. This finding was only significant when uncorrected for multiple comparisons. The safety analysis revealed that patients from both treatment groups had treatment-emergent adverse events where nausea was the most common complaint, reported by 43.5% of placebo patients and 71.7% of milnacipran-treated patients. Patients on milnacipran were more likely to discontinue treatment because of side effects. Conclusions Our results provide preliminary indications of increased pain inhibitory responses in milnacipran-treated FM patients, compared to placebo. The psychophysical assessments did not reach statistical significance but reveal a trend toward higher pressure-pain tolerance after treatment with milnacipran, compared to placebo, especially for higher pain intensities. Our fMRI analyses point toward increased activation of the precuneus/posterior cingulum in patients treated with milnacipran, however results were not corrected for multiple comparisons. The precuneus/posterior cingulum is a key region of the default mode network and has previously been associated with abnormal function in FM. Future studies may further explore activity within the default mode network as a potential biomarker for abnormal central pain processing. Implications The present study provides novel insights for future studies where functional neuroimaging may be used to elucidate the central mechanisms of common pharmacological treatments for chronic pain. Furthermore, our results point toward a potential mechanism for pain normalization in response to milnacipran, involving regions of the default mode network although this finding needs to be replicated in future studies.
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| 32. |
- Sernhede, Ove, 1951, et al.
(författare)
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Mellan resignation och framtidstro : livsvillkor och lärande hos förortens unga
- 2024
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Mellan resignation & framtidstro är en motberättelse mot den stereotypa bilden av ortens unga och mot de politiskt uppmålade visionerna om en mer jämlik stad genom omvandlingar av det urbana rummet och kortsiktiga insatser i skolor. Boken är ett kollektivt resultat av tre forskningsprojekt som alla kretsar kring begränsningar och möjligheter i unga människors livsvillkor och lärande i några av Göteborgs mest stigmatiserade stadsdelar.
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