| 1. |
- John, M. T., et al.
(författare)
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Recommendations for use and scoring of oral health impact profile versions
- 2022
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Ingår i: Journal of Evidence-Based Dental Practice. - Philadelphia, PA, United States : Elsevier. - 1532-3382 .- 1532-3390. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: OHIP's original seven-domain structure does not fit empirical data, but a psychometrically sound and clinically more plausible structure with the four OHRQoL dimensions Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact has emerged. Consequently, use and scoring of available OHIP versions need to be revisited. Aim: We assessed how well the overall construct OHRQoL and its four dimensions were measured with several OHIP versions (20, 19, 14, and 5 items) to derive recommendations which instruments should be used and how to score them. Methods: Data came from the “Dimensions of OHRQoL Project” and used the project's learning sample (5,173 prosthodontic patients and general population subjects with 49-item OHIP data). We computed correlations among OHIP versions’ summary scores. Correlations between OHRQoL dimensions, on one hand, and OHIP versions’ domain scores or OHIP-5′s items, on the other hand, were also computed. OHIP use and scoring recommendations were derived for psychometrically solid but also practical OHRQoL assessment. Results: Summary scores of 5-, 14-, 19- and 49-item versions correlated highly (r = 0.91–0.98), suggesting similar OHRQoL construct measurement across versions. The OHRQoL dimensions Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact were best measured by the OHIP domain scores for Physical Disability, Physical Pain, Psychological Discomfort, and Handicap, respectively. Conclusion: Recommendations were derived which OHIP should be preferably used and how OHIP versions should be scored to capture the overall construct and the dimensions of OHRQoL. Psychometrically solid and practical OHRQoL assessment in all settings across all oral health conditions can be achieved with the 5-item OHIP.
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| 2. |
- Lobbezoo, F, et al.
(författare)
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The Global Need for Easy and Valid Assessment Tools for Orofacial Pain
- 2022
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Ingår i: Journal of Dental Research. - : Sage Publications. - 0022-0345 .- 1544-0591. ; 101:13, s. 1549-1553
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Tidskriftsartikel (refereegranskat)abstract
- The World Health Organization recently adopted a historic resolution (WHA74.5) on the urgent need for global oral health improvement. This resolution is particularly relevant in the perspective of the high prevalence of untreated oral diseases. However, one important aspect has been mentioned only in passing, namely that poor oral health often leads to orofacial pain, which is the most common reason for emergency dental visits worldwide. Therefore, an evidence-based decision-making process on oral health should include data related to orofacial pain complaints. To that end, the availability of reliable and valid assessment tools of orofacial pain and related treatment outcomes is essential. INfORM (International Network for Orofacial Pain and Related Disorders Methodology) of the International Association for Dental Research has been one of the driving forces behind the development and implementation of comprehensive sets of tools for such assessments. However, as a prerequisite for the desired global implementation, reliable and valid tools that are also brief, easy to translate, and culturally adaptable need to be further developed and tested. Some of the groundwork to facilitate this process has already been carried out. In addition, a working group within INfORM has developed a short clinical assessment tool for orofacial pain diagnostics that is near completion and will soon be ready for dissemination. Ultimately, reliable and valid orofacial pain assessment is a necessary step toward the development and implementation of appropriate "best buy" interventions that address this major driver of need for oral health care worldwide.
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| 3. |
- Armstrong, A J, et al.
(författare)
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Long-term Survival and Biomarker Correlates of Tasquinimod Efficacy in a Multicenter Randomized Study of Men with Minimally Symptomatic Metastatic Castration-Resistant Prostate Cancer.
- 2013
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Ingår i: Clinical Cancer Research. - 1078-0432 .- 1557-3265. ; 19:24, s. 6891-6901
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Tasquinimod (Active Biotech) is an oral immunomodulatory, anti-angiogenic, and anti-metastatic agent that delayed metastatic disease progression in a randomized placebo-controlled phase II trial in men with metastatic castration-resistant prostate cancer (mCRPC). Here, we report long-term survival with biomarker correlates from this trial.EXPERIMENTAL DESIGN: Two hundred and one (134 tasquinimod and 67 placebo) men with mCRPC were evaluated. Forty-one men randomized to placebo crossed over to tasquinimod. Survival data were collected with a median follow-up time of 37 months. Exploratory biomarker studies at baseline and over time were collected to evaluate potential mechanism-based correlates with tasquinimod efficacy including progression-free survival (PFS) and overall survival (OS).RESULTS: With 111 mortality events, median OS was 33.4 months for tasquinimod versus 30.4 months for placebo overall, and 34.2 versus 27.1 months in men with bone metastases (n = 136), respectively. Multivariable analysis demonstrated an adjusted HR of 0.52 [95% confidence interval (CI), 0.35-0.78; P = 0.001] for PFS and 0.64 (95% CI, 0.42-0.97; P = 0.034) for OS, favoring tasquinimod. Time-to-symptomatic progression was improved with tasquinimod (P = 0.039, HR = 0.42). Toxicities tended to be mild in nature and improved over time. Biomarker analyses suggested a favorable impact on bone alkaline phosphatase and lactate dehydrogenase (LDH) over time and a transient induction of inflammatory biomarkers, VEGF-A, and thrombospondin-1 levels with tasquinimod. Baseline levels of thrombospondin-1 less than the median were predictive of treatment benefit.CONCLUSIONS: The survival observed in this trial of men with minimally symptomatic mCRPC suggests that the prolongation in PFS with tasquinimod may lead to a survival advantage in this setting, particularly among men with skeletal metastases, and has a favorable risk:benefit ratio.
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| 4. |
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| 5. |
- Edgren, M, et al.
(författare)
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Postoperative radiotherapy after prostatectomy can be associated with severe side effects.
- 2001
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Ingår i: Anticancer research. - 0250-7005. ; 21, s. 2231-
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Tidskriftsartikel (refereegranskat)abstract
- This retrospective study was initiated to evaluate the efficacy and side effects of post-prostatectomy external beam radiation therapy (XRT) with a short time interval between surgery and irradiation in patients with prostate adenocarcinoma. Sixteen patients were investigated. The overall results in this study were 3 deaths due to recurring disease and two relapses after an average follow-up of 60 months. Severe side effects were observed. Two patients required surgical intervention due to severe post-radiotherapy side effects. The reason for this could be the high dose delivered to peripheral organs and/or a too short time interval between surgery and postoperative XRT. The results of this study confirmed that postoperative XRT can improve local control frequency in prostate carcinomas. It is recommended that the time interval between surgery and postoperative radiotherapy should to be 3-6 month.
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| 6. |
- Berglund, Gunilla, et al.
(författare)
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"Between Men" : A psychosocial rehabilitation programme for men with prostate cancer
- 2007
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Ingår i: Acta Oncologica. - : Informa UK Limited. - 0284-186X .- 1651-226X. ; 46:1, s. 83-89
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate the effect of psychosocial rehabilitation on newly diagnosed prostate cancer patients. The “Between Men” programme consisted of seven weekly sessions of physical training (Phys) alone, information (Info) alone or physical training plus information (PhysInfo). After diagnoses, patients (n =211) were consecutively included, stratified and randomised to one of four groups: Phys, Info, PhysInfo or standard care control (C). A nurse specialised in urology, an urologist and a physiotherapist performed the interventions. Patients were followed up during one year with mailed standardised questionnaires. It could not be assumed that the “Between Men” programme had any effect on patients’ anxiety and depression (HADS). Health-related quality of life (HRQOL) was associated with stage of disease but not with psychosocial intervention. Thus, Physical Function (PF), Role Function (RF) and Fatigue (FA) were inferior among patients with, than without, metastases of prostate cancer both at baseline and at the 12-month follow-up. This randomized study did not demonstrate any significant effect of psychosocial rehabilitation among prostate cancer patients. Considering the low rate (1/2), of included/eligible patients a less complicated design (intervention versus control) would have been preferred in order to increase power.
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| 7. |
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| 8. |
- de la Torre, M., et al.
(författare)
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Elevated expression of estramustine binding protein (EMBP) in prostatic intraepithelial neoplasia (PIN) compared with malignant and benign prostatic epithelia
- 1994
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Ingår i: The Prostate. - 0270-4137 .- 1097-0045. ; 25:3, s. 125-31
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Tidskriftsartikel (refereegranskat)abstract
- The expression of estramustine-binding protein (EMBP) was studied immunohistochemically in whole-mount prostate sections. Specimens were taken from the prostates of 15 patients who had undergone total prostatectomy due to localized (TOd-T2 NO MO) prostatic cancer (PC). Almost all the examined whole-mount sections displayed areas with prostatic intraepithelial neoplasia (PIN). PIN is regarded as the main precursor of invasive PC. High- and low-grade PIN expressed EMBP. The average positively stained areas accounted for averages of 69.2% and 48.7%, respectively. High-grade PIN contained the highest EMBP levels of all the investigated (benign and malignant) epithelia, followed by moderately differentiated PC. With regard to areas with PC, the highest levels of EMBP expression (61.3%) were observed in moderately differentiated PC; poorly differentiated PC came second. Of all the examined epithelia, EMBP levels were lowest in well-differentiated PC (25.8%). Normal prostatic epithelia and hyperplasia were characterized by low EMBP expression, although somewhat higher than well-differentiated PC. A moderate expression (45%) was observed in the seminal vesicles. According to these results, EMBP was expressed mainly in the diseased peripheral zone (PZ), where PIN and prostatic cancer have their highest prevalence.
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| 9. |
- Donovan, Michael J., et al.
(författare)
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Personalized prediction of tumor response and cancer progression on prostate needle biopsy
- 2009
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Ingår i: Journal of Urology. - : Ovid Technologies (Wolters Kluwer Health). - 0022-5347 .- 1527-3792. ; 182:1, s. 125-132
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To our knowledge in patients with prostate cancer there are no available tests except clinical variables to determine the likelihood of disease progression. We developed a patient specific, biology driven tool to predict outcome at diagnosis. We also investigated whether biopsy androgen receptor levels predict a durable response to therapy after secondary treatment. MATERIALS AND METHODS: We evaluated paraffin embedded prostate needle biopsy tissue from 1,027 patients with cT1c-T3 prostate cancer treated with surgery and followed a median of 8 years. Machine learning was done to integrate clinical data with biopsy quantitative biometric features. Multivariate models were constructed to predict disease progression with the C index to estimate performance. RESULTS: In a training set of 686 patients (total of 87 progression events) 3 clinical and 3 biopsy tissue characteristics were identified to predict clinical progression within 8 years after prostatectomy with 78% sensitivity, 69% specificity, a C index of 0.74 and a HR of 5.12. Validation in an independent cohort of 341 patients (total of 44 progression events) yielded 76% sensitivity, 64% specificity, a C index of 0.73 and a HR of 3.47. Increased androgen receptor in tumor cells in the biopsy highly significantly predicted resistance to therapy, ie androgen ablation with or without salvage radiotherapy, and clinical failure (p <0.0001). CONCLUSIONS: Morphometry reliably classifies Gleason pattern 3 tumors. When combined with biomarker data, it adds to the hematoxylin and eosin analysis, and prostate specific antigen values currently used to assess outcome at diagnosis. Biopsy androgen receptor levels predict the likelihood of a response to therapy after recurrence and may guide future treatment decisions.
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| 10. |
- Durham, Justin, et al.
(författare)
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Constructing the brief diagnostic criteria for temporomandibular disorders (bDC/TMD) for field testing
- 2024
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842. ; 51:5, s. 785-794
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Tidskriftsartikel (refereegranskat)abstract
- Background: Despite advances in temporomandibular disorders' (TMDs) diagnosis, the diagnostic process continues to be problematic in non-specialist settings.Objective: To complete a Delphi process to shorten the Diagnostic Criteria for TMD (DC/TMD) to a brief DC/TMD (bDC/TMD) for expedient clinical diagnosis and initial management.Methods: An international Delphi panel was created with 23 clinicians representing major specialities, general dentistry and related fields. The process comprised a full day workshop, seven virtual meetings, six rounds of electronic discussion and finally an open consultation at a virtual international symposium.Results: Within the physical axis (Axis 1), the self-report Symptom Questionnaire of the DC/TMD did not require shortening from 14 items for the bDC/TMD. The compulsory use of the TMD pain screener was removed reducing the total number of Axis 1 items by 18%. The DC/TMD Axis 1 10-section examination protocol (25 movements, up to 12 sets of bilateral palpations) was reduced to four sections in the bDC/TMD protocol involving three movements and three sets of palpations. Axis I then resulted in two groups of diagnoses: painful TMD (inclusive of secondary headache), and common joint-related TMD with functional implications. The psychosocial axis (Axis 2) was shortened to an ultra-brief 11 item assessment.Conclusion: The bDC/TMD represents a substantially reduced and likely expedited method to establish (grouping) diagnoses in TMDs. This may provide greater utility for settings requiring less granular diagnoses for the implementation of initial treatment, for example non-specialist general dental practice.
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| 11. |
- Glimelius, Bengt, et al.
(författare)
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U-CAN : a prospective longitudinal collection of biomaterials and clinical information from adult cancer patients in Sweden.
- 2018
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Ingår i: Acta Oncologica. - : Taylor & Francis. - 0284-186X .- 1651-226X. ; 57:2, s. 187-194
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Tidskriftsartikel (refereegranskat)abstract
- Background: Progress in cancer biomarker discovery is dependent on access to high-quality biological materials and high-resolution clinical data from the same cases. To overcome current limitations, a systematic prospective longitudinal sampling of multidisciplinary clinical data, blood and tissue from cancer patients was therefore initiated in 2010 by Uppsala and Umeå Universities and involving their corresponding University Hospitals, which are referral centers for one third of the Swedish population.Material and Methods: Patients with cancer of selected types who are treated at one of the participating hospitals are eligible for inclusion. The healthcare-integrated sampling scheme encompasses clinical data, questionnaires, blood, fresh frozen and formalin-fixed paraffin-embedded tissue specimens, diagnostic slides and radiology bioimaging data.Results: In this ongoing effort, 12,265 patients with brain tumors, breast cancers, colorectal cancers, gynecological cancers, hematological malignancies, lung cancers, neuroendocrine tumors or prostate cancers have been included until the end of 2016. From the 6914 patients included during the first five years, 98% were sampled for blood at diagnosis, 83% had paraffin-embedded and 58% had fresh frozen tissues collected. For Uppsala County, 55% of all cancer patients were included in the cohort.Conclusions: Close collaboration between participating hospitals and universities enabled prospective, longitudinal biobanking of blood and tissues and collection of multidisciplinary clinical data from cancer patients in the U-CAN cohort. Here, we summarize the first five years of operations, present U-CAN as a highly valuable cohort that will contribute to enhanced cancer research and describe the procedures to access samples and data.
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| 12. |
- Häggman-Henrikson, Birgitta, et al.
(författare)
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Even mild catastrophic thinking is related to pain intensity in individuals with painful temporomandibular disorders
- 2021
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 48:11, s. 1193-1200
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Temporomandibular disorders (TMD) are often associated with psychological comorbidities. One such comorbidity is pain catastrophising, that is, exaggeration of negative consequences of a painful event. The aim was to investigate catastrophising in individuals with painful TMD compared to controls and the association between catastrophising and pain intensity, number of pain sites and functional limitations.Methods: A community-based sample of 110 individuals (83 women; 20–69 yrs) with painful TMDs (myalgia/arthralgia as per Diagnostic Criteria for TMD) and 190 age- and gender-matched controls (119 women; 20–69 yrs) from the Public Dental services in Västerbotten, Sweden, participated. Associations between catastrophising and functional jaw limitations, respectively, and painful TMD were evaluated with ordinal regression adjusted for the effect of gender and age. Associations (Spearman's correlation) of the Pain catastrophising Scale (PCS) with Jaw Functional Limitation Scale (JFLS-20), pain site number (whole-body pain map), and characteristic pain intensity (CPI) and intergroup comparisons (Mann-Whitney U test) of these variables were also calculated.Results: Levels of catastrophising were associated with TMD pain (OR 1.6, 95%CI 1.1–2.6). Among individuals with painful TMD, catastrophising was correlated to pain intensity (r=0.458, p<0.01) and functional limitations (r=0.294–0.321, p≤0.002), but not to number of pain sites.Conclusion: Compared to controls, community-based individuals with painful TMD demonstrated higher levels of pain catastrophising, and this catastrophising was associated with increased pain intensity and jaw dysfunction. The relatively low scores of pain catastrophising suggest that even mild catastrophic thinking is associated with pain perception and jaw function, and should be considered in patient management.
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| 13. |
- Häggman-Henrikson, Birgitta, et al.
(författare)
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Impact of Catastrophizing in Patients with Temporomandibular Disorders : A Systematic Review
- 2020
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Ingår i: The Journal of Oral & Facial Pain and Headache. - : Quintessence. - 2333-0384 .- 2333-0376. ; 34:4, s. 379-397B
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Forskningsöversikt (refereegranskat)abstract
- Aims: To assess the prevalence of catastrophizing in patients with temporomandibular disorders (TMD) and the possible associations between catastrophizing and treatment outcome. Methods: This review was registered in the Prospero database (CRD42018114233). Electronic searches were performed in PubMed, Scopus, and PsycINFO from the inception of each database up to October 26, 2018, and were combined with a hand search. Articles focusing on levels of catastrophizing and how catastrophizing affects pain levels and treatment outcomes for patients diagnosed with TMD were included, as well as studies reporting how treatment outcomes were affected by cognitive behavioral treatment as an addition to standard treatment for TMD. Reviews and case reports were excluded. Risk of bias was assessed with the Newcastle-Ottawa scale. Results: The literature search identified 266 articles. After screening of abstracts, the full texts of 59 articles were assessed. Of these, 37 articles, including 4,789 patients with TMD and 6,617 controls, met the inclusion criteria. Higher levels of pain catastrophizing were reported in patients with TMD, with a large effect size (Hedges' g = 0.86) compared to pain-free controls. Furthermore, associations of higher levels of catastrophizing with higher symptom severity and with poorer treatment outcome were reported together with indications of positive effects from cognitive behavioral therapy. Conclusion: The results suggest an association between catastrophizing and TMD that may affect not only symptom severity but also treatment outcome. Assessing levels of pain catastrophizing might therefore be valuable in the assessment and management of patients with TMD.
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| 14. |
- Häggman-Henrikson, Birgitta, et al.
(författare)
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Increasing gender differences in the prevalence and chronification of orofacial pain in the population
- 2020
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Ingår i: Pain. - : Lippincott Williams & Wilkins. - 0304-3959 .- 1872-6623. ; 161:8, s. 1768-1775
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Tidskriftsartikel (refereegranskat)abstract
- Although a fluctuating pattern of orofacial pain across the life span has been proposed, data on its natural course is lacking. The longitudinal course of orofacial pain in the general population was evaluated using data from routine dental check-ups at all Public Dental Health services in Västerbotten, Sweden. In a large population sample, two screening questions were used to identify individuals with pain once a week or more in the orofacial area. Incidence and longitudinal course of orofacial pain were evaluated using annual data for 2010-2017. To evaluate predictors for orofacial pain remaining over time, individuals who reported pain on at least two consecutive dental check-ups were considered persistent. A generalized estimating equation model was used to analyze the prevalence, accounting for repeated observations on the same individuals. In total, 180,308 individuals (equal gender distribution) were examined in 525,707 dental check-ups. More women than men reported orofacial pain (OR 2.58, 95% CI 2.48-2.68), and there was a significant increase in the prevalence of reported pain from 2010 to 2017 in both women and men. Longitudinal data for 135,800 individuals were available for incidence analysis. Women were at higher risk of both developing orofacial pain (IRR 2.37; 95% CI 2.25-2.50) and reporting pain in consecutive check-ups (IRR 2.56, 95% CI 2.29-2.87). In the northern Swedish population studied, the prevalence of orofacial pain increases over time and more so in women, thus indicating increasing differences in gender for orofacial pain.
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| 15. |
- Häggman-Henrikson, Birgitta, et al.
(författare)
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Mind the Gap : A Systematic Review of Implementation of Screening for Psychological Comorbidity in Dental and Dental Hygiene Education.
- 2018
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Ingår i: Journal of Dental Education. - : American Dental Education Association. - 0022-0337 .- 1930-7837. ; 82:10, s. 1065-1076
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Tidskriftsartikel (refereegranskat)abstract
- The biopsychosocial model is advocated as part of a more comprehensive approach in both medicine and dentistry. However, dentists have not traditionally been taught psychosocial screening as part of their predoctoral education. The aim of this systematic review was to provide an overview of published studies on the implementation of screening for psychological comorbidity in dental and dental hygiene education. The term "psychological comorbidity" refers to the degree of coexisting anxiety, depression, or other mental health problems in a patient presenting with a physical condition. The review followed a protocol registered in PROSPERO (CRD42016054083) and was carried out in accordance with the PRISMA guidelines. The methodological quality of the included studies was assessed using a ten-item tool developed for medical education. The electronic search in PubMed, Scopus, and PsycINFO from the inception of each database until December 31, 2016, together with a hand search, identified 1,777 articles. After abstracts were screened, 52 articles were reviewed in full text applying inclusion and exclusion criteria; four articles remained for the qualitative synthesis. Generally, the reported data on specific methods or instruments used for psychological screening were limited. Only one of the included articles utilized a validated screening tool. The results of this systematic review show that published data on the implementation of psychological patient assessment in dental and dental hygiene education are limited. To address this gap, the authors recommend short screening tools such as the Graded Chronic Pain Scale and the Patient Health Questionnaire for Depression and Anxiety. Educating dental and dental hygiene students about easy-to-use, reliable, and validated screening tools for assessing psychological comorbidity warrants more research attention and greater implementation in educational curricula.
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| 16. |
- Häggman-Henrikson, Birgitta, et al.
(författare)
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Prevalence of whiplash trauma in TMD patients : a systematic review
- 2014
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 41:1, s. 59-68
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Forskningsöversikt (refereegranskat)abstract
- The purpose of this systematic review was to describe the prevalence of whiplash trauma in patients with temporomandibular disorders (TMDs) and to describe clinical signs and symptoms in comorbid TMD/whiplash compared with TMD localised to the facial region. A systematic literature search of the PubMed, Cochrane Library and Bandolier databases was carried out for articles published from 1 January 1966 to 31 December 2012. The systematic search identified 129 articles. After the initial screening of abstracts, 32 articles were reviewed in full text applying inclusion and exclusion criteria. Six studies on the prevalence of neck trauma in patients with TMD met the inclusion criteria and were included in the review. Two of the authors evaluated the methodological quality of the included studies. The reported prevalence of whiplash trauma ranged from 84% to 70% (median 35%) in TMD populations, compared with 17-13% in the non-TMD control groups. Compared with patients with TMD localised to the facial region, TMD patients with a history of whiplash trauma reported more TMD symptoms, such as limited jaw opening and more TMD pain, and also more headaches and stress symptoms. In conclusion, the prevalence of whiplash trauma is higher in patients with TMD compared with non-TMD controls. Furthermore, patients with comorbid TMD/whiplash present with more jaw pain and more severe jaw dysfunction compared with TMD patients without a history of head-neck trauma. These results suggest that whiplash trauma might be an initiating and/or aggravating factor as well as a comorbid condition for TMD.
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| 17. |
- Häggman, M, et al.
(författare)
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Morphometric studies of intra-prostatic volume relationships in localized prostatic cancer
- 1997
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Ingår i: British Journal of Urology. - : BLACKWELL SCIENCE LTD. - 0007-1331 .- 1365-2176. ; 80:4, s. 612-617
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To further characterize patterns of tumour growth and the distribution of markers for the aggressiveness of prostate cancer by assessing the relationships among the volume of the 'index' tumour and that of the remaining foci, with pathological
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| 18. |
- Ilgunas, Aurelija, et al.
(författare)
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Conceptualizing the clinical decision-making process in managing temporomandibular disorders : a qualitative study
- 2021
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Ingår i: European Journal of Oral Sciences. - : John Wiley & Sons. - 0909-8836 .- 1600-0722. ; 129:5
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Tidskriftsartikel (refereegranskat)abstract
- Management of patients with temporomandibular disorders (TMD) appears to be more challenging than for other dental conditions. This study aimed to explore the decision-making process in TMD management, and thereby to conceptualize the decision-making process in dentistry. Individual semi-structured interviews were conducted during 2018 and 2019 with a purposive sample of 22 general dental practitioners from the Public Dental Healthcare Services and private practices in the Region of Västerbotten, Northern Sweden. The interviews were analysed using the Grounded Theory approach of Charmaz. Data analysis resulted in the core category 'Combining own competence and others' expectations in the desire to do the right thing'. The dentists showed interest in and a desire to apply professional knowledge, but also reflected on challenges and complexity in the decision-making process forTMD. The challenges were primarily related to organisational factors and lack of self-confidence. This identifies a need for re-organisation of daily clinical management in dentistry, and a need for more postgraduate training to improve self-confidence. The complexity of the decision-making process for TMD makes the study findings applicable in other dental situations.
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| 19. |
- Ilgunas, Aurelia, 1987-
(författare)
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Exploring temporomandibular disorders : longitudinal and qualitative perspectives
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Ideally, all clinical decision-making should enable care provision on the best available scientific evidence, clinical experience, and evaluated risks and benefits. Even though there are validated and evaluated decision tools for identification, diagnostics and treatment of temporomandibular disorders (TMD), patients with TMD still seem to go undetected, undiagnosed and undertreated in dentistry. Reasons for this discrepancy are unclear, but this clearly is a disadvantage for patients with TMD. Therefore, this project aimed to explore TMD in relation to the longitudinal course of the symptoms, dentists’ decision-making, and patients’ experiences.Methods: The project was conducted at the Public Dental Health Services in the Region of Västerbotten, Northern Sweden. Data in the longitudinal studies were based on the screening instrument for TMD, the 3Q/TMD, and included self-reported orofacial pain and jaw dysfunction, specifically jaw catching/locking, from 2010 to 2017 (n=180,308; age 5-104). Descriptive statistics, generalized estimating equation models, and Poisson regression were used for analyses. Data included in the qualitative studies were the transcribed individual interviews with dentists (n=22, age 25-64) and patients (n=16, age 20-65). Analyses were based on the Grounded Theory and the Qualitative Context Analysis.Results: The prevalence of orofacial pain increased over time (p<.01), but the prevalence of jaw catching/locking remained similar. The incidence, prevalence, and persistence of orofacial pain and jaw catching/locking were significantly higher in women than in men (p<.01). Women were at a higher risk for reporting both the first onset and the persistent orofacial pain (IRR 2.37; 95% CI, 2.25-2.50 and IRR 2.56; 95% CI, 2.28-2.87, respectively), and jaw catching/locking (IRR 2.29; 95% CI, 2.11-2.49 and IRR 2.32; 95% CI, 2.04-2.63, respectively) when compared to men. The onset of pain or jaw catching/locking was mostly independent and exclusive, i.e. without the other symptom (84.1%), and was higher for orofacial pain (64.9%) than for jaw catching/locking (19.2%). The decision-making process in the management of TMD was illustrated as an interplay between internal and external elements, where the dentists wished to apply professional knowledge but identified organizational obstacles and lack of self-confidence in their clinical decision-making for TMD. The patients expressed worry and social discomfort as a consequence of TMD. However, they strived to deal with the symptoms on their own as long as possible before seeking help. The challenges to access dental care and to receive suitable management were acknowledged. The right care at the right time was identified more like a wish than a current state of perceived TMD management.Conclusions: The observed longitudinal patterns of orofacial pain and jaw dysfunction indicate increasing prevalence of orofacial pain together with substantial gender differences in TMD. The finding of independent onset of jawcatching/locking and orofacial pain reinforces that these two differ in the pathophysiology. The challenges in decision-making for patients with TMD and perceived suboptimal management of TMD symptoms are partly related to the structural organization of the Public Dental Health Services. Thus, careful review of the current organization is warranted since the treatment-need related to orofacial pain will probably increase.
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| 20. |
- Ilgunas, Aurelia, et al.
(författare)
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Patients' experiences of temporomandibular disorders and related treatment
- 2023
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Ingår i: BMC Oral Health. - : BioMed Central (BMC). - 1472-6831. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Temporomandibular disorders (TMD) are common and therefore managed by dentists on a daily basis. However, patients with TMD consistently go undetected and therefore untreated in dentistry. The reasons for these shortcomings have not been fully explored, specifically with regard to patients’ perspectives. Therefore, this study aimed to explore patients’ experiences of TMD and related treatment, with special focus on the experiences of having TMD, factors related to seeking care, and perspectives on received treatment.Methods: Purposive sampling was used to recruit adult patients at the Public Dental Health services (PDHS) in the Region of Västerbotten, Sweden, during 2019. Individual semi-structured interviews were conducted and analysed using Qualitative Content Analysis. Sixteen patients were interviewed (ten women and six men, 20–65 years). The interviews probed the patients’ perspectives of having TMD, seeking care, and receiving treatment. All participants were also examined according to the Diagnostic Criteria for TMD (DC/TMD) and qualified for at least one DC/TMD diagnosis.Results: The data analysis led to the main theme Seeking care when the situation becomes untenable, but dental care fails to meet all needs. The patients expressed worry and social discomfort because of the symptoms but still strived to have an as normal daily life as possible. However, severe symptoms and associated consequences compelled them to seek professional help. Experiences of distrust together with challenges to access the PDHS were identified and related to the patients’ unfulfilled expectations.Conclusions: Patients’ reported experiences indicate that receiving timely and appropriate care is more of an unfulfilled expectation than the current state of management of patients with TMD in dentistry.
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| 21. |
- Ilgunas, Aurelia, et al.
(författare)
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The longitudinal relationship between jaw catching/locking and pain
- 2023
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Ingår i: Journal of Dental Research. - : Sage Publications. - 0022-0345 .- 1544-0591. ; 102:4, s. 383-390
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Tidskriftsartikel (refereegranskat)abstract
- Orofacial pain and joint-related dysfunction can negatively affect daily jaw function. A common cause for limitations in jaw movements is joint-related dysfunction such as various forms of catching and locking. However, knowledge is limited regarding the development and natural course of joint-related jaw dysfunction and its relationship to the onset and course of orofacial pain. Therefore, the aim was to evaluate the incidence, prevalence, and gender differences in jaw catching/locking over time and in relation to orofacial pain in the general population. Data from 3 validated screening questions on orofacial pain and jaw catching/locking were collected from all routine dental checkups in the Public Dental Health Services in Västerbotten, Sweden, from 2010 to 2017. Logistic generalized estimating equation was used to account for repeated observations and Poisson regression for incidence analysis. In total, 180,308 individuals (aged 5–104 y) were screened in 525,707 dental checkups. In 2010, based on 37,647 individuals, the prevalence of self-reported catching/locking was higher in women than in men (3.2% vs. 1.5%; odds ratio, 2.11; 95% confidence interval [CI], 1.83–2.43), and this relationship and magnitude remained similar throughout the study period. The annual incidence rate was 1.1% in women and 0.5% in men. Women were at a higher risk than men for reporting both first onset (incidence rate ratio [IRR], 2.29; 95% CI, 2.11–2.49) and persistent (IRR, 2.31; 95% CI, 2.04–2.63) catching/locking. For the onset subcohort (n = 135,801), an independent onset of orofacial pain or jaw catching/locking exclusively was reported by 84.1%, whereas a concurrent onset was reported by 13.4%. Our findings of higher incidence, prevalence, and persistence in women than in men indicate that the gender differences seen for orofacial pain are evident also for jaw catching/locking. The findings also suggest independent onset of self-reported catching/locking and orofacial pain, which reinforces the pathophysiological differences between these conditions.
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| 22. |
- John, Mike T., et al.
(författare)
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Mapping Oral Disease Impact with a Common Metric (MOM)—Project summary and recommendations
- 2021
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 48:3, s. 305-307
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Tidskriftsartikel (refereegranskat)abstract
- Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact—the dimensions of oral health-related quality of life—capture dental patients’ oral health problems worldwide and regardless of whether the patient currently suffers from oral diseases or intends to prevent them in the future. Using scores for these dimensions, the project Mapping Oral Disease Impact with a Common Metric (MOM) aims to provide four-dimensional oral health impact information across oral diseases and settings. In this article, project authors summarize MOM’s findings and provide recommendations about how to improve standardized oral health impact assessment. Project MOM’s systematic reviews identified four-dimensional impact information for 189 adult and 22 pediatric patient populations that were contained in 170 publications. A typical functional, pain-related, aesthetical, and psychosocial impact (on a 0-8 impact metric based on two items with a response format 0 = never, 1 = hardly ever, 2 = occasionally, 3 = fairly often, 4 = very often) was about 2 to 3 units. Project MOM provides five recommendations to improve standardized oral health impact assessment for all oral diseases in all settings.
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| 23. |
- Lövgren, Anna, et al.
(författare)
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Associations between screening for functional jaw disturbances and patient reported outcomes on jaw limitations and oral behaviors
- 2023
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Ingår i: Journal of Evidence-Based Dental Practice. - : Elsevier. - 1532-3382 .- 1532-3390. ; 23:3
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Temporomandibular disorders (TMDs) is a collective term for pain and functional disturbances related to the jaw muscles and the temporomandibular joint. In contrast to screening for orofacial pain, knowledge is limited on the association between patient-reported outcomes and screening for joint-related functional jaw disturbances. Therefore, our aim was to evaluate the association between a screening question for functional jaw disturbances, and disease-specific outcome measures for functional jaw limitations and oral behaviors.Methods: This study included 299 individuals (201 women; 20-69 years, median 37.0) in a general population sample from Västerbotten, Northern Sweden in 2014. A single screening question for functional jaw disturbances “Does your jaw lock or become stuck once a week or more?” was used to categorize individuals as cases or controls. Patient-reported outcomes on functional jaw disturbances were assessed with the 20-item jaw functional limitation scale (JFLS-20) and oral behaviors with the 21-item Oral Behaviors Checklist (OBC-21).Results: The strongest predictive probability to have a positive screening outcome was functional jaw limitations related to mobility (AUCboot=0.78, 95 CI:0.71-0.86, P <.001), followed by limitations related to communication (AUCboot = 0.74, 95 CI:0.63-0.80, P <.001) and mastication (AUCboot = 0.73, 95 CI:0.66-0.81, P <.001). The frequency of oral behaviors was not significantly associated with a positive screening outcome (AUCboot = 0.65, 95 CI:0.55-0.72, P =.223).Conclusions: Self-reported functional limitations, but not oral behaviors, are strongly associated with a single screening question for frequent functional jaw disturbances. This finding provides support for incorporating a question on jaw catching/locking once a week or more in screening instruments for TMDs.
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| 24. |
- Lövgren, Anna, et al.
(författare)
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Temporomandibular pain and jaw dysfunction at different ages covering the lifespan - A population based study
- 2016
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Ingår i: European Journal of Pain. - : Wiley. - 1090-3801 .- 1532-2149. ; 20:4, s. 532-540
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundTemporomandibular pain and jaw dysfunction can have a negative effect on daily life, but these conditions are not well recognized in the health care systems. The general aim was to examine the cross-sectional prevalence of frequent temporomandibular pain and jaw dysfunction in men and women across the lifespan.MethodsThe analysis was based on data from 137,718 individuals (mean age 35years, SD 22.7) who answered three questions (3Q/TMD) included in the digital health declaration in the Public Dental Health care in the county of Vasterbotten, Sweden; Q1: Do you have pain in your temple, face, jaw or jaw joint once a week or more?'; Q2: Does it hurt once a week or more when you open your mouth or chew?'; and Q3: Does your jaw lock or become stuck once a week or more?'ResultsThe prevalence of frequent temporomandibular pain (Q1) was 5.2% among women and 1.8% among men (p<0.0001). The prevalence of frequent pain on jaw movement (Q2) was 2.5% among women and 0.9% among men (p<0.0001). The prevalence of frequent locking of the jaw (Q3) was 2.7% among women and 1.2% among men (p<0.0001).ConclusionsThe study shows that the cross-sectional prevalence of temporomandibular pain and jaw dysfunction varies during the lifespan. For men and women, respectively, symptoms increase during adolescence, peak in middle age and then gradually diminish. The prevalence of these symptoms is significantly higher among women except from the first and last decades of a 100-year lifespan.
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| 25. |
- Lövgren, Anna, et al.
(författare)
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The association between myofascial orofacial pain with and without referral and widespread pain
- 2022
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Ingår i: Acta Odontologica Scandinavica. - : Taylor & Francis. - 0001-6357 .- 1502-3850. ; 80:7, s. 481-486
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Pain referral on palpation has been suggested to be a clinical sign of central sensitization potentially associated with widespread pain conditions. Our aim was to evaluate if myofascial pain with referral is a better predictor for widespread pain when compared to no pain or local myofascial pain.Materials and methods: Individuals at the Public Dental services in Västerbotten, Sweden, were randomly invited based on their answers to three screening questions for temporomandibular disorders (TMD). In total, 300 individuals (202 women, 20–69 yrs) were recruited, and examined according to the Diagnostic Criteria for TMD (DC/TMD) after completion of a body pain drawing. Widespread pain was considered present when seven or more pain sites were reported on the widespread pain index. A binary logistic regression model, adjusted for the effect of age and gender were used to evaluate the association between myofascial orofacial pain and widespread pain.Results: Widespread pain was reported by 31.3% of the study sample. There was a 57.3% overlap with myofascial pain. Widespread pain was associated to myofascial orofacial pain with and myofascial orofacial pain (OR 4.83 95% CI 2.62–9.05 and OR 11.62 95% CI 5.18–27.88, respectively).Conclusion: These findings reinforce the existing knowledge on the overlap between painful TMD and other chronic pain conditions.
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| 26. |
- Lövgren, Anna, et al.
(författare)
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The outcome of a temporomandibular joint compression test for the diagnosis of arthralgia is confounded by concurrent myalgia
- 2020
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Ingår i: Clinical Oral Investigations. - : Springer. - 1432-6981 .- 1436-3771. ; 24, s. 97-102
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Pain in the orofacial region may originate from different structures, and one challenge for the clinician is to determine the primary origin of pain reported by the patient. In clinical practice, it is important to discriminate between a temporomandibular joint (TMJ) pain disorder and jaw muscle pain; therefore, tests that are proposed for such purposes warrant evaluation. The aim of the present study was to evaluate the outcome of a TMJ compression test in relation to a Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) arthralgia diagnosis.Methods: A study population (n = 300), randomly selected from the adult population in Västerbotten, Sweden, was examined according to the DC/TMD criteria and with a TMJ compression test. This test is comprised of forceful unilateral biting for 20 s on a wooden spatula in the first molar region. Familiar pain on the contralateral side to the clenching side was considered a positive test outcome.Results: Positive contralateral outcome of the TMJ compression test was associated with an arthralgia diagnosis (B = 1.737; OR 5.7, 95% CI 3.3–9.9). This association was confounded by concurrent myalgia (B = 1.737 → B = 0.996, 42.7%).Conclusion: In a general population, a negative TMJ compression test was strongly associated with the absence of a contralateral TMJ arthralgia diagnosis according to DC/TMD. The association between a positive TMJ compression test and a DC/TMD arthralgia diagnosis was confounded by the presence of myalgia.Clinical relevance: Concurrent myalgia renders the usefulness of the TMJ compression test for predicting an arthralgia diagnosis questionable.
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| 27. |
- Lövgren, Anna, et al.
(författare)
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Validity of three screening questions (3Q/TMD) in relation to the DC/TMD
- 2016
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 43:10, s. 729-736
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Tidskriftsartikel (refereegranskat)abstract
- Temporomandibular disorders (TMD) are common but seem to be largely undetected within general dental care. To improve dentists' awareness of these symptoms, three screening questions (3Q/TMD) have been introduced. Our aim was to validate 3Q/TMD in relation to the diagnostic criteria for TMD (DC/TMD), while taking into account the severity level of the symptoms. The study population consisted of 7831 individuals 20-69 years old, who had their routine dental check-up at the Public Dental Health Service in Västerbotten, Sweden. All patients answered a health declaration, including the 3Q/TMD regarding frequent temporomandibular pain, pain on movement and catching/locking of the jaw. All 3Q-positives (at least one affirmative) were invited for examination in randomised order. For each 3Q-positive, a matched 3Q-negative was invited. In total, 152 3Q-positives and 148 3Q-negatives participated. At examination, participants answered 3Q/TMD a second time, before they were examined and diagnosed according to DC/TMD. To determine symptom's severity, the Graded Chronic Pain Scale and Jaw Functional Limitation Scale-20 (JFLS-20) were used. In total, 74% of 3Q-positives and 16% of 3Q-negatives met the criteria for DC/TMD pain or dysfunction (disc displacements with reduction and degenerative joint disorder were excluded). Fifty-five per cent of 3Q-positives had a TMD diagnosis and CPI score ≥3 or a JFLS-20 score ≥5, compared to 4% of 3Q-negatives. The results show that the 3Q/TMD is an applicable, cost-effective and valid tool for screening a general adult population to recognise patients in need of further TMD examination and management.
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| 28. |
- Manfredini, Daniele, et al.
(författare)
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Standardised Tool for the Assessment of Bruxism
- 2024
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 51:1, s. 29-58
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Forskningsöversikt (refereegranskat)abstract
- Objective: This paper aims to present and describe the Standardised Tool for the Assessment of Bruxism (STAB), an instrument that was developed to provide a multidimensional evaluation of bruxism status, comorbid conditions, aetiology and consequences.Methods: The rationale for creating the tool and the road map that led to the selection of items included in the STAB has been discussed in previous publications.Results: The tool consists of two axes, specifically dedicated to the evaluation of bruxism status and consequences (Axis A) and of bruxism risk and etiological factors and comorbid conditions (Axis B). The tool includes 14 domains, accounting for a total of 66 items. Axis A includes the self-reported information on bruxism status and possible consequences (subject-based report) together with the clinical (examiner report) and instrumental (technology report) assessment. The Subject-Based Assessment (SBA) includes domains on Sleep Bruxism (A1), Awake Bruxism (A2) and Patient's Complaints (A3), with information based on patients' self-report. The Clinically Based Assessment (CBA) includes domains on Joints and Muscles (A4), Intra- and Extra-Oral Tissues (A5) and Teeth and Restorations (A6), based on information collected by an examiner. The Instrumentally Based Assessment (IBA) includes domains on Sleep Bruxism (A7), Awake Bruxism (A8) and the use of Additional Instruments (A9), based on the information gathered with the use of technological devices. Axis B includes the self-reported information (subject-based report) on factors and conditions that may have an etiological or comorbid association with bruxism. It includes domains on Psychosocial Assessment (B1), Concurrent Sleep-related Conditions Assessment (B2), Concurrent Non-Sleep Conditions Assessment (B3), Prescribed Medications and Use of Substances Assessment (B4) and Additional Factors Assessment (B5). As a rule, whenever possible, existing instruments, either in full or partial form (i.e. specific subscales), are included. A user's guide for scoring the different items is also provided to ease administration.Conclusions: The instrument is now ready for on-field testing and further refinement. It can be anticipated that it will help in collecting data on bruxism in such a comprehensive way to have an impact on several clinical and research fields.
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| 29. |
- Manfredini, Daniele, et al.
(författare)
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The development of the Standardised Tool for the Assessment of Bruxism (STAB) : an international road map
- 2024
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 51:1, s. 15-28
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Forskningsöversikt (refereegranskat)abstract
- This paper summarises the background reasoning and work that led to the selection of the items included in the Standardised Tool for the Assessment of Bruxism (STAB), also introducing the list of items. The instrument is currently being tested for face validity and on-field comprehension. The underlying premise is that the different motor activities included in the bruxism spectrum (e.g. clenching vs. grinding, with or without teeth contact) potentially need to be discriminated from each other, based on their purportedly different aetiology, comorbidities and potential consequences. Focus should be on a valid impression of the activities' frequency, intensity and duration. The methods that can be used for the above purposes can be grouped into strategies that collect information from the patient's history (subject-based), from the clinical assessment performed by an examiner (clinically based) or from the use of instruments to measure certain outcomes (instrumentally based). The three strategies can apply to all aspects of bruxism (i.e. status, comorbid conditions, aetiology and consequences). The STAB will help gathering information on many aspects, factors and conditions that are currently poorly investigated in the field of bruxism. To this purpose, it is divided into two axes. Axis A includes the self-reported information on bruxism status and potential consequences (subject-based report) together with the clinical (examiner report) and instrumental assessment (technology report). Axis B includes the self-reported information (subject-based report) on factors and conditions that may have an etiological or comorbid role for bruxism. This comprehensive multidimensional assessment system will allow building predictive model for clinical and research purposes.
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| 30. |
- Pili, Roberto, et al.
(författare)
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Phase II Randomized, Double-Blind, Placebo-Controlled Study of Tasquinimod in Men With Minimally Symptomatic Metastatic Castrate-Resistant Prostate Cancer
- 2011
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Ingår i: Journal of Clinical Oncology. - 0732-183X .- 1527-7755. ; 29:30, s. 4022-4028
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The activity of the novel antitumor agent tasquinimod (TASQ) with S100A9 as a molecular target was investigated in men with metastatic castration-resistant prostate cancer (CRPC) and minimal symptoms. Patients and Methods: We conducted a randomized, double-blind, placebo-controlled phase II trial in men assigned (at a ratio of two to one) to either oral once-daily TASQ 0.25 mg/d escalating to 1.0 mg/d over 4 weeks or placebo. The primary end point was the proportion of patients without disease progression at 6 months, defined by Response Evaluation Criteria in Solid Tumors Group, Prostate Cancer Working Group (PCWG2), or pain criteria, excluding prostate-specific antigen. Results: Two hundred one men (134 assigned to TASQ; 67 to placebo) were evaluable, and baseline characteristics were well balanced. Six-month progression-free proportions for TASQ and placebo groups were 69% and 37%, respectively (P < .001), and median progression-free survival (PFS) was 7.6 versus 3.3 months (P = .0042). In PCWG2 CRPC clinical subgroups, PFS in months was as follows: nodal metastases, 6.1 versus 3.1; bone metastases, 8.8 versus 3.4; and visceral metastases, 6.0 versus 3.0 for patients receiving TASQ versus placebo, respectively. Bone alkaline phosphatase levels were stabilized in the TASQ group, whereas the impact on PSA kinetics was less pronounced. Adverse events (AEs) occurring more frequently in the TASQ arm included GI disorders, fatigue, musculoskeletal pains, and elevations of pancreatic and inflammatory biomarkers. Grade 3 to 4 AEs, including asymptomatic elevations of laboratory parameters, were reported in 40% of patients receiving TASQ versus 10% receiving placebo; deep vein thrombosis (4% v 0%) was more common in the TASQ arm. Conclusion: TASQ significantly slowed progression and improved PFS in patients with metastatic CRPC with an acceptable AE profile.
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| 31. |
- Romell, Jenny, et al.
(författare)
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Virtual histology of dried and mummified biological samples by laboratory phase-contrast tomography
- 2019
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Ingår i: X-Ray Nanoimaging. - : SPIE - The International Society for Optics and Photonics.
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Konferensbidrag (refereegranskat)abstract
- Ancient remains from humans, animals and plants hold valuable information about our history. X-ray imaging methods are often, because of their non-destructive nature, used in the analysis of such samples. The classical x-ray imaging methods, radiography and computed tomography (CT), are based on absorption, which works well for radiodense structures like bone, but gives limited contrast for textiles and soft tissues, which exhibit high x-ray transmission. Destructive methods, such as classical histology, have historically been used for analysing ancient soft tissue but the extent to which it is used today is limited because of the fragility and value of many ancient samples. For detailed, non-destructive analysis of ancient biological samples, we instead propose x-ray phase-contrast CT, which like conventional CT gives volume data but with the possibility of better resolution through the detection of phase shift. Using laboratory x-ray sources, we here demonstrate the capabilities of phase-contrast tomography of dried biological samples. Virtual histological analysis of a mummified human hand from ancient Egypt is performed, revealing remains of adipose cells in situ, which would not be possible with classical histology. For higher resolution, a lab-based nano-CT arrangement based on a nanofocus transmission x-ray source is presented. With an x-ray emission spot of 300 nm the system shows potential for sub-micronresolution 3D imaging. For characterisation of the performance of phase-contrast imaging of dried samples a piece of wood is imaged. Finally, we present the first phase-contrast CT data from our nano-CT system, acquired of the dried head of a bee.
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| 32. |
- Sharma, Sonia, et al.
(författare)
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A new instrument for assessing work-related body mechanics and strain in the general population
- 2023
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Ingår i: Journal of Pain. - : Elsevier. - 1526-5900 .- 1528-8447. ; 24:2, s. 237-250
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Tidskriftsartikel (refereegranskat)abstract
- Clinical pain is often linked to poor body mechanics, with individuals sometimes presenting multiple painful disorders. Such disorders may be influenced by behaviors that affect the general resiliency and health of the musculoskeletal system. We aimed to develop a self-reported scale using the Malmö Diet and Cancer Study questions on work-related body mechanical exposures. An expert panel identified 41 variables having content validity for musculoskeletal problems. Exploratory factor analysis was conducted on a random selection of 50% of the cohort (n=6,789 adults); the remaining was reserved for confirmatory factor analyses (CFA), item response theory (IRT) item calibration, and differential item functioning investigations. Supported by standard measure development methods and fit criteria, the final unidimensional item bank contains 13 items. Overall CFA statistics (root mean square error of approximation=0.09; comparative fit index=0.96; Tucker-Lewis index=0.96; standardized root mean residuals=0.05) indicated excellent single-factor model fit and appropriateness of IRT modeling and calibration. Expert review and item information values (score-precision) guided selection of an 8-item short form with acceptable score-level reliabilities (≥0.70) for T-scores=39-80+. This measure provides reliable assessment of body mechanics strain in adults and can be useful when evaluating different contributions to musculoskeletal problems affecting pain-treatment success in future clinical research. Perspective: This article presents the development and psychometric properties of a new measure, "Work-related Body Mechanics and Strain Scale (WR-BMSS)." The scale has 13-items or alternatively an 8-item short form. This measure could potentially help clinicians who seek to assess how musculoskeletal problems may contribute to patient pain and disability.
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| 33. |
- Sharma, Sonia, et al.
(författare)
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Prevalence of facial pain and headache in Sweden
- 2021
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Ingår i: The Journal of Oral & Facial Pain and Headache. - : Quintessence Publishing. - 2333-0384 .- 2333-0376. ; 35:2, s. 139-149
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To compare the prevalence of facial pain and headache across various regions in Sweden.METHODS: This study involved a comparison of cross-sectional questionnaire studies over a period of 10 years including 128,193 individuals and assessed facial pain, pain on function, and headache. Participants included (1) all Public Dental Service patients aged 16 to 90 years in Västerbotten (n = 57,283) and Gävleborg (n = 60,900); and (2) random samples of residents in Kalmar (n = 3,560) and Skåne (n = 6,450). Facial pain and pain on function were assessed for all participants, and headache was also assessed for participants in Kalmar and Skåne. Descriptive statistics were used to estimate unadjusted prevalence estimates and demographic characteristics. Prevalence estimates were adjusted for age and sex using weighted distributions from the 2015 data in the Swedish population registry before comparisons across the regions.RESULTS: Overall, the prevalence of facial pain and headache were significantly higher in female than in male participants (P < .01). The standardized prevalence of facial pain was 4.9% in Västerbotten, 1.4% in Gävleborg, 4.6% in Kalmar, and 7.6% in Skåne. For headache, the standardized prevalence was 18.9% in Kalmar and 21.3% in Skåne. In Skåne, individuals with facial pain had a 15-fold higher odds of headache than those without.CONCLUSION: In the present Swedish epidemiologic study, the prevalence of facial pain ranged from 1.4% in Gävleborg to 7.6% in Skåne. Besides different sampling frames and other population characteristics, the presence of a high number of immigrants in Skåne may account for some differences in pain prevalence across the Swedish regions.
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| 34. |
- Skunik, M., et al.
(författare)
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Development of hybrid organic-inorganic materials for efficient charging/discharging in electrochemical and photoelectrochemical capacitors
- 2011
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Ingår i: ECS Transactions. - : The Electrochemical Society. - 1938-5862 .- 1938-6737. - 9781607682851 ; :25, s. 93-102
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Tidskriftsartikel (refereegranskat)abstract
- A composite system of poly (3,4-ethylenedioxythiophene)/multi-walled carbon nanotubes has been investigated and characterized as a potential charge storage material for coupled dye-sensitized solar cell/electrochemical capacitor systems. The selected material can easily operate in organic media (lithium triflate/propylene carbonate) giving a specific capacitance of 95 F g -1 and energy density of 3.1 Wh kg -1. The combination of the composite material with dye-sensitized solar cell allows to obtain a photo-rechargeable supercapacitor (photocapacitor), destined to work with dies required organic media (here with N 719 dye). The photocapacitor system was built from mesoporous TiO 2 electrode, typical charge relay consisting of iodine/iodide redox couple and two charge storage electrodes separated by a liquid electrolyte. The system was tested under light illumination of 100 mW cm -2 with xenon lamp equipped with cut-off filters eliminating the ultraviolet and infrared part of the spectra.
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| 35. |
- Visscher, Corine M., et al.
(författare)
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Benefits of implementing pain-related disability and psychological assessment in dental practice for patients with temporomandibular pain and other oral health conditions
- 2018
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Ingår i: The Journal of the American Dental Association (1939). - : Elsevier. - 0002-8177 .- 1943-4723. ; 149:6, s. 422-431
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Tidskriftsartikel (refereegranskat)abstract
- Background. Evidence in the field of dentistry has demonstrated the importance of pain-related disability and psychological assessment in the development of chronic symptoms. The Diagnostic Criteria for Temporomandibular Disorders offer a brief assessment for the diagnostic process in patients with orofacial pain (Axis II). The authors describe relevant outcomes that may guide general oral health care practitioners toward tailored treatment decisions and improved treatment outcomes and provide recommendations for the primary care setting. Methods. The authors conducted a review of the literature to provide an overview of knowledge about Axis II assessment relevant for the general oral health care practitioner. Results. The authors propose 3 domains of the Axis II assessment to be used in general oral health care: pain location (pain drawing), pain intensity and related disability (Graded Chronic Pain Scale [GCPS]), and psychological distress (Patient Health Questionnaire-4 [PHQ-4]). In the case of localized pain, low GCPS scores (0-II), and low PHQ-4 scores (0-5), patients preferably receive treatment in primary care. In the case of widespread pain, high GCPS scores (III-IV), and high PHQ-4 scores (6-12), the authors recommend referral to a multidisciplinary team, especially for patients with temporomandibular disorder (TMD) pain. Conclusions. The authors recommend psychological assessment at first intake of a new adult patient or for patients with persistent TMD pain. The authors recommend the pain-related disability screening tools for all TMD pain symptoms and for dental pain symptoms that persist beyond the normal healing period. Practical Implications. A brief psychological and pain-related disability assessment for patients in primary care may help the general oral health care practitioner make tailored treatment decisions.
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| 36. |
- Yang, Lei, et al.
(författare)
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New Approach for Preparation of Efficient Solid-State Dye-Sensitized Solar Cells by Photoelectrochemical Polymerization in Aqueous Micellar Solution
- 2013
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Ingår i: The Journal of Physical Chemistry Letters. - : American Chemical Society (ACS). - 1948-7185. ; 4:23, s. 4026-4031
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Tidskriftsartikel (refereegranskat)abstract
- Hereby, we present a new, cost-effective, and environmentally friendly method of preparing an efficient solid-state dye-sensitized solar cell (sDSC) using a PEDOT conducting polymer as the hole conductor and a recently developed organic sensitizer. PEDOT is generated and deposited on the dye-sensitized TiO2 electrode by in situ photoelectropolymerization of bis-EDOT in aqueous micellar solution. The advantages of this approach are the use of water as the solvent and the obtainment of a sDSC simply by adding a silver layer on the as-obtained polymer film deposited on dye/TiO2 without the need for electrolytic solution. The sDSC containing the film prepared as above is compared to those where the organic dye is used to generate the same polymer film but in organic solvent. The energy conversion efficiency values of the two cells appear comparable, 4.8% for sDSC prepared in the aqueous-phase polymerized PEDOT and 6% for the sDSC prepared with in organic-phase polymerized PEDOT.
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| 37. |
- Åström, Karl Johan, et al.
(författare)
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Paper Machine Dynamics
- 1974
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Ingår i: 4th IFAC/IFIP International Conference on Digital Computer Applications to Process Control. - Berlin, Heidelberg : Springer Berlin Heidelberg. - 0075-8442. - 9783540066200 ; 93, s. 463-476
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Konferensbidrag (refereegranskat)abstract
- The effective use of modern control theory requires suitable mathematical models of the objects to be controlled and of the disturbances. Paper machines have been controlled digitally for a long time. Digital control of basis weight and moisture content is in fact one of the few examples where a digital computer and sensors form a standard package. In spite of this there are still significant gaps in our knowledge of paper machine dynamics. This paper attempts to fill a few of these. The paper is based on measurements on full scale paper machines and on a pilot plant at the Swedish Forest Products Research Laboratory (STFI). The experiments on the industrial plants were performed using control computers with appropriate instrumentation both on craft paper and newsprint machines. The experiments on the pilot plant were carried out with different fibre, clay and water mixtures. These experiments gave insight into the effect of the pulp characteristics on paper machine dynamics. Optical gauges capable of measuring low fibre concentrations were used in the experiments. This made detailed analysis of the mixing dynamics possible. The possibility of obtaining better control through the incorporation of such gauges could also be evaluated.
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