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| 3. |
- Ali, M, et al.
(författare)
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Protocol for the development of the international population registry for aphasia after stroke (I-PRAISE)
- 2022
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Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 36:4, s. 534-554
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Tidskriftsartikel (refereegranskat)abstract
- Background: We require high-quality information on the current burden, the types of therapy and resources available, methods of delivery, care pathways and long-term outcomes for people with aphasia.Aim: To document and inform international delivery of post-stroke aphasia treatment, to optimise recovery and reintegration of people with aphasia.Methods & Procedures: Multi-centre, prospective, non-randomised, open study, employing blinded outcome assessment, where appropriate, including people with post-stroke aphasia, able to attend for 30 minutes during the initial language assessment, at first contact with a speech and language therapist for assessment of aphasia at participating sites. There is no study-mandated intervention. Assessments will occur at baseline (first contact with a speech and language therapist for aphasia assessment), discharge from Speech and Language Therapy (SLT), 6 and 12-months post-stroke. Our primary outcome is changed from baseline in the Amsterdam Nijmegen Everyday Language Test (ANELT/Scenario Test for participants with severe verbal impairments) at 12-months post-stroke. Secondary outcomes at 6 and 12 months include the Therapy Outcome Measure (TOMS), Subjective Index of Physical and Social Outcome (SIPSO), Aphasia Severity Rating Scale (ASRS), Western Aphasia Battery Aphasia Quotient (WAB-AQ), stroke and aphasia quality of life scale (SAQoL-39), European Quality of Life Scale (EQ-5D), lesion description, General Health Questionnaire (GHQ-12), resource use, and satisfaction with therapy provision and success. We will collect demography, clinical data, and therapy content. Routine neuroimaging and medication administration records will be accessed where possible; imaging will be pseudonymised and transferred to a central reading centre. Data will be collected in a central registry. We will describe demography, stroke and aphasia profiles and therapies available. International individual participant data (IPD) meta-analyses will examine treatment responder rates based on minimal detectable change & clinically important changes from baseline for primary and secondary outcomes at 6 and 12 months. Multivariable meta-analyses will examine associations between demography, therapy, medication use and outcomes, considering service characteristics. Where feasible, costs associated with treatment will be reported. Where available, we will detail brain lesion size and site, and examine correlations with SLT and language outcome at 12 months.Conclusion: International differences in care, resource utilisation and outcomes will highlight avenues for further aphasia research, promote knowledge sharing and optimise aphasia rehabilitation delivery. IPD meta-analyses will enhance and expand understanding, identifying cost-effective and promising approaches to optimise rehabilitation to benefit people with aphasia.
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| 6. |
- Brady, MC, et al.
(författare)
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Precision rehabilitation for aphasia by patient age, sex, aphasia severity, and time since stroke? A prespecified, systematic review-based, individual participant data, network, subgroup meta-analysis
- 2022
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Ingår i: International journal of stroke : official journal of the International Stroke Society. - : SAGE Publications. - 1747-4949. ; 17:10, s. 1067-1077
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Tidskriftsartikel (refereegranskat)abstract
- Stroke rehabilitation interventions are routinely personalized to address individuals’ needs, goals, and challenges based on evidence from aggregated randomized controlled trials (RCT) data and meta-syntheses. Individual participant data (IPD) meta-analyses may better inform the development of precision rehabilitation approaches, quantifying treatment responses while adjusting for confounders and reducing ecological bias. Aim: We explored associations between speech and language therapy (SLT) interventions frequency (days/week), intensity (h/week), and dosage (total SLT-hours) and language outcomes for different age, sex, aphasia severity, and chronicity subgroups by undertaking prespecified subgroup network meta-analyses of the RELEASE database. Methods: MEDLINE, EMBASE, and trial registrations were systematically searched (inception-Sept2015) for RCTs, including ⩾ 10 IPD on stroke-related aphasia. We extracted demographic, stroke, aphasia, SLT, and risk of bias data. Overall-language ability, auditory comprehension, and functional communication outcomes were standardized. A one-stage, random effects, network meta-analysis approach filtered IPD into a single optimal model, examining SLT regimen and language recovery from baseline to first post-intervention follow-up, adjusting for covariates identified a-priori. Data were dichotomized by age (⩽/> 65 years), aphasia severity (mild–moderate/ moderate–severe based on language outcomes’ median value), chronicity (⩽/> 3 months), and sex subgroups. We reported estimates of means and 95% confidence intervals. Where relative variance was high (> 50%), results were reported for completeness. Results: 959 IPD (25 RCTs) were analyzed. For working-age participants, greatest language gains from baseline occurred alongside moderate to high-intensity SLT (functional communication 3-to-4 h/week; overall-language and comprehension > 9 h/week); older participants’ greatest gains occurred alongside low-intensity SLT (⩽ 2 h/week) except for auditory comprehension (> 9 h/week). For both age-groups, SLT-frequency and dosage associated with best language gains were similar. Participants ⩽ 3 months post-onset demonstrated greatest overall-language gains for SLT at low intensity/moderate dosage (⩽ 2 SLT-h/week; 20-to-50 h); for those > 3 months, post-stroke greatest gains were associated with moderate-intensity/high-dosage SLT (3–4 SLT-h/week; ⩾ 50 hours). For moderate–severe participants, 4 SLT-days/week conferred the greatest language gains across outcomes, with auditory comprehension gains only observed for ⩾ 4 SLT-days/week; mild–moderate participants’ greatest functional communication gains were associated with similar frequency (⩾ 4 SLT-days/week) and greatest overall-language gains with higher frequency SLT (⩾ 6 days/weekly). Males’ greatest gains were associated with SLT of moderate (functional communication; 3-to-4 h/weekly) or high intensity (overall-language and auditory comprehension; (> 9 h/weekly) compared to females for whom the greatest gains were associated with lower-intensity SLT (< 2 SLT-h/weekly). Consistencies across subgroups were also evident; greatest overall-language gains were associated with 20-to-50 SLT-h in total; auditory comprehension gains were generally observed when SLT > 9 h over ⩾ 4 days/week. Conclusions: We observed a treatment response in most subgroups’ overall-language, auditory comprehension, and functional communication language gains. For some, the maximum treatment response varied in association with different SLT-frequency, intensity, and dosage. Where differences were observed, working-aged, chronic, mild–moderate, and male subgroups experienced their greatest language gains alongside high-frequency/intensity SLT. In contrast, older, moderate–severely impaired, and female subgroups within 3 months of aphasia onset made their greatest gains for lower-intensity SLT. The acceptability, clinical, and cost effectiveness of precision aphasia rehabilitation approaches based on age, sex, aphasia severity, and chronicity should be evaluated in future clinical RCTs.
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| 10. |
- Lembrechts, Jonas J., et al.
(författare)
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SoilTemp : A global database of near-surface temperature
- 2020
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Ingår i: Global Change Biology. - : Wiley. - 1354-1013 .- 1365-2486. ; 26:11, s. 6616-6629
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Tidskriftsartikel (refereegranskat)abstract
- Current analyses and predictions of spatially explicit patterns and processes in ecology most often rely on climate data interpolated from standardized weather stations. This interpolated climate data represents long-term average thermal conditions at coarse spatial resolutions only. Hence, many climate-forcing factors that operate at fine spatiotemporal resolutions are overlooked. This is particularly important in relation to effects of observation height (e.g. vegetation, snow and soil characteristics) and in habitats varying in their exposure to radiation, moisture and wind (e.g. topography, radiative forcing or cold-air pooling). Since organisms living close to the ground relate more strongly to these microclimatic conditions than to free-air temperatures, microclimatic ground and near-surface data are needed to provide realistic forecasts of the fate of such organisms under anthropogenic climate change, as well as of the functioning of the ecosystems they live in. To fill this critical gap, we highlight a call for temperature time series submissions to SoilTemp, a geospatial database initiative compiling soil and near-surface temperature data from all over the world. Currently, this database contains time series from 7,538 temperature sensors from 51 countries across all key biomes. The database will pave the way toward an improved global understanding of microclimate and bridge the gap between the available climate data and the climate at fine spatiotemporal resolutions relevant to most organisms and ecosystem processes.
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| 11. |
- Wallace, SJ, et al.
(författare)
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A core outcome set for aphasia treatment research: The ROMA consensus statement
- 2019
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Ingår i: International journal of stroke : official journal of the International Stroke Society. - : SAGE Publications. - 1747-4949. ; 14:2, s. 180-185
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Tidskriftsartikel (refereegranskat)abstract
- A core outcome set (COS; an agreed, minimum set of outcomes) was needed to address the heterogeneous measurement of outcomes in aphasia treatment research and to facilitate the production of transparent, meaningful, and efficient outcome data. Objective The Research Outcome Measurement in Aphasia (ROMA) consensus statement provides evidence-based recommendations for the measurement of outcomes for adults with post-stroke aphasia within phases I–IV aphasia treatment studies. Methods This statement was informed by a four-year program of research, which comprised investigation of stakeholder-important outcomes using consensus processes, a scoping review of aphasia outcome measurement instruments, and an international consensus meeting. This paper provides an overview of this process and presents the results and recommendations arising from the international consensus meeting. Results Five essential outcome constructs were identified: Language, communication, patient-reported satisfaction with treatment and impact of treatment, emotional wellbeing, and quality of life. Consensus was reached for the following measurement instruments: Language: The Western Aphasia Battery Revised (WAB-R) (74% consensus); emotional wellbeing: General Health Questionnaire (GHQ)-12 (83% consensus); quality of life: Stroke and Aphasia Quality of Life Scale (SAQOL-39) (96% consensus). Consensus was unable to be reached for measures of communication (where multiple measures exist) or patient-reported satisfaction with treatment or impact of treatment (where no measures exist). Discussion Harmonization of the ROMA COS with other core outcome initiatives in stroke rehabilitation is discussed. Ongoing research and consensus processes are outlined. Conclusion The WAB-R, GHQ-12, and SAQOL-39 are recommended to be routinely included within phases I–IV aphasia treatment studies. This consensus statement has been endorsed by the Collaboration of Aphasia Trialists, the British Aphasiology Society, the German Society for Aphasia Research and Therapy, and the Royal College of Speech Language Therapists.
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| 13. |
- Schweiker, Marcel, et al.
(författare)
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Evaluating assumptions of scales for subjective assessment of thermal environments – Do laypersons perceive them the way, we researchers believe?
- 2020
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Ingår i: Energy and Buildings. - : Elsevier BV. - 0378-7788. ; 211
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Tidskriftsartikel (refereegranskat)abstract
- People's subjective response to any thermal environment is commonly investigated by using rating scales describing the degree of thermal sensation, comfort, and acceptability. Subsequent analyses of results collected in this way rely on the assumption that specific distances between verbal anchors placed on the scale exist and that relationships between verbal anchors from different dimensions that are assessed (e.g. thermal sensation and comfort) do not change. Another inherent assumption is that such scales are independent of the context in which they are used (climate zone, season, etc.). Despite their use worldwide, there is indication that contextual differences influence the way the scales are perceived and therefore question the reliability of the scales’ interpretation. To address this issue, a large international collaborative questionnaire study was conducted in 26 countries, using 21 different languages, which led to a dataset of 8225 questionnaires. Results, analysed by means of robust statistical techniques, revealed that only a subset of the responses are in accordance with the mentioned assumptions. Significant differences appeared between groups of participants in their perception of the scales, both in relation to distances of the anchors and relationships between scales. It was also found that respondents’ interpretations of scales changed with contextual factors, such as climate, season, and language. These findings highlight the need to carefully consider context-dependent factors in interpreting and reporting results from thermal comfort studies or post-occupancy evaluations, as well as to revisit the use of rating scales and the analysis methods used in thermal comfort studies to improve their reliability.
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| 14. |
- Schweiker, Marcel, et al.
(författare)
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The Scales Project, a cross-national dataset on the interpretation of thermal perception scales
- 2019
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Ingår i: Scientific data. - : Springer Science and Business Media LLC. - 2052-4463. ; 6:1
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Tidskriftsartikel (refereegranskat)abstract
- Thermal discomfort is one of the main triggers for occupants' interactions with components of the built environment such as adjustments of thermostats and/or opening windows and strongly related to the energy use in buildings. Understanding causes for thermal (dis-)comfort is crucial for design and operation of any type of building. The assessment of human thermal perception through rating scales, for example in post-occupancy studies, has been applied for several decades; however, long-existing assumptions related to these rating scales had been questioned by several researchers. The aim of this study was to gain deeper knowledge on contextual influences on the interpretation of thermal perception scales and their verbal anchors by survey participants. A questionnaire was designed and consequently applied in 21 language versions. These surveys were conducted in 57 cities in 30 countries resulting in a dataset containing responses from 8225 participants. The database offers potential for further analysis in the areas of building design and operation, psycho-physical relationships between human perception and the built environment, and linguistic analyses.
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| 18. |
- Dean, Kelsey R., et al.
(författare)
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Multi-omic biomarker identification and validation for diagnosing warzone-related post-traumatic stress disorder
- 2020
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Ingår i: Molecular Psychiatry. - : Springer Science and Business Media LLC. - 1359-4184 .- 1476-5578. ; 25:12, s. 3337-3349
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Tidskriftsartikel (refereegranskat)abstract
- Post-traumatic stress disorder (PTSD) impacts many veterans and active duty soldiers, but diagnosis can be problematic due to biases in self-disclosure of symptoms, stigma within military populations, and limitations identifying those at risk. Prior studies suggest that PTSD may be a systemic illness, affecting not just the brain, but the entire body. Therefore, disease signals likely span multiple biological domains, including genes, proteins, cells, tissues, and organism-level physiological changes. Identification of these signals could aid in diagnostics, treatment decision-making, and risk evaluation. In the search for PTSD diagnostic biomarkers, we ascertained over one million molecular, cellular, physiological, and clinical features from three cohorts of male veterans. In a discovery cohort of 83 warzone-related PTSD cases and 82 warzone-exposed controls, we identified a set of 343 candidate biomarkers. These candidate biomarkers were selected from an integrated approach using (1) data-driven methods, including Support Vector Machine with Recursive Feature Elimination and other standard or published methodologies, and (2) hypothesis-driven approaches, using previous genetic studies for polygenic risk, or other PTSD-related literature. After reassessment of ~30% of these participants, we refined this set of markers from 343 to 28, based on their performance and ability to track changes in phenotype over time. The final diagnostic panel of 28 features was validated in an independent cohort (26 cases, 26 controls) with good performance (AUC = 0.80, 81% accuracy, 85% sensitivity, and 77% specificity). The identification and validation of this diverse diagnostic panel represents a powerful and novel approach to improve accuracy and reduce bias in diagnosing combat-related PTSD.
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| 28. |
- Torrisi, Lorenzo, et al.
(författare)
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High intensity laser-generating plasmas in forward direction in thin films and Thomson parabola spectrometer monitorage
- 2010
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Asterix laser at PALS Laboratory of Prague, operating at 1315 nm fundamental wavelength, 300 ps pulse duration, 1016 W/cm2 intensity and single pulse mode, was employed to irradiate thin hydrogenated targets placed in high vacuum. Non-equilibrium plasmas were obtained in forward direction, i.e. along the normal to the target surface on the rear of the irradiated thin films. Plasmas were monitored with different ion detectors, placed around the direction normal to the target. The main detector was a Thomson parabola spectrometer aligned along the normal in forward direction. This spectrometer permits to provide many plasma parameters concerning the involved ions (energy, charge state, mass,...) obtained in a single laser shot. The spectrometer images, obtained by using a MCP coupled to a fast CCD camera, can be processed by a comparison with the simulation data obtained by a proper software. High ion energies and charge states have been obtained as a function of the laser parameters, target thickness and composition and irradiation conditions.
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| 29. |
- Torrisi, Lorenzo, et al.
(författare)
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Proton driven acceleration by intense laser pulses irradiating thin hydrogenated targets
- 2013
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Ingår i: Applied Surface Science. - : Elsevier. - 0169-4332 .- 1873-5584. ; 272, s. 2-5
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Tidskriftsartikel (refereegranskat)abstract
- The Asterix iodine laser of the PALS laboratory in Prague, operating at 1315 nm fundamental frequency, 300 ps pulse duration, 600 J maximum pulse energy and 1016 W/cm2 intensity, is employed to irradiatethin hydrogenated targets placed in high vacuum. Different metallic and polymeric targets allow togenerate multi-energetic and multi-specie ion beams showing peculiar properties. The plasma obtainedby the laser irradiation is monitored, in terms of properties of the emitted charge particles, by using time-of-flight techniques and Thomson parabola spectrometer (TPS). A particular attention is given tothe proton beam production in terms of the maximum energy, emission yield and angular distributionas a function of the laser energy, focal position (FP), target thickness and composition.
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| 31. |
- Bath, PMW, et al.
(författare)
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Baseline characteristics of the 4011 patients recruited into the ‘Efficacy of Nitric Oxide in Stroke’ (ENOS) trial
- 2014
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Ingår i: International journal of stroke : official journal of the International Stroke Society. - : SAGE Publications. - 1747-4949. ; 9:6, s. 711-720
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Tidskriftsartikel (refereegranskat)abstract
- High blood pressure is common in acute stroke and associated with a worse functional outcome. Many patients who present with acute stroke are taking prescribed antihypertensive therapy before their stroke. Aims ENOS tested whether lowering blood pressure and continuing pre-stroke antihypertensive therapy are each safe and effective. Methods This study is an international multi-centre prospective randomized single-blind blinded-endpoint parallel-group partial-factorial controlled trial of transdermal glyceryl trinitrate (a nitric oxide donor, given for seven-days) vs. no glyceryl trinitrate, and of continuing vs. stopping (temporarily for seven-days) pre-stroke antihypertensive drugs if relevant, in patients with acute ischaemic stroke or intracerebral haemorrhage and high systolic blood pressure (140–220 mmHg). Results Recruitment ran from July 2001 to October 2013. Four thousand eleven patients [2097 (52·3%) in the continue/stop arm] were recruited from 173 sites across 23 countries in 5 continents (Asia 14%, Continental Europe 16%, UK 64%). Baseline characteristics include: mean age 70 (standard deviation 12) years; male 57%; mean time from stroke to recruitment 26 ( 13 ) h; mean severity (Scandinavian Stroke Scale) 34 ( 13 ) of 58; mean blood pressure 167 ( 19 )/90 ( 13 ) mmHg; ischaemic stroke 83%; and intracerebral haemorrhage 16%. The main trial results will be presented in May 2014. The results will also be presented in updated Cochrane systematic reviews and included in individual patient data meta-analyses of all relevant randomized controlled trials. Conclusion ENOS is a large completed international trial of blood pressure management in acute stroke and includes patients representative of many stroke services worldwide.
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| 34. |
- Hanson, Michaela, et al.
(författare)
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Facial expressions and other behavioral responses to pleasant andunpleasant tastes in cats (Felis silvestris catus)
- 2016
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Ingår i: Applied Animal Behaviour Science. - : Elsevier. - 0168-1591 .- 1872-9045. ; 181, s. 129-136
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Tidskriftsartikel (refereegranskat)abstract
- The goal of the present study was to assess how cats react to tastes previously reported to be preferredor avoided relative to water. To this end, the facial and behavioral reactions of 13 cats to differentconcentrations of l-Proline and quinine monohydrochloride (QHCl) as well as mixtures with differentconcentrations of the two substances were assessed using a two-bottle preference test of short duration.The cats were videotaped and the frequency and duration of different behaviors were analyzed. Significantdifferences in the cats’ behavior in response to the taste quality of the different solutions included,but were not limited to, Tongue Protrusions (p < 0.039), Mouth smacks (p = 0.008) and Nose Licks (p = 0.011)with four different stimulus concentrations. The cats responded to preferred taste by keeping their Eyeshalf-closed (p = 0.017) for significantly longer periods of time with four different stimulus concentrationscompared to a water control. When encountering mixtures containing l-Proline and QHCl the cats performedTongue protrusion gapes (p < 0.038) significantly more frequently with three different stimulusconcentrations compared to an l-Proline control. A stepwise increase in the concentration of l-Prolinefrom 5 mM to 500 mM in mixtures with 50 M QHCl did not overcome the negative impact of the bittertaste on intake. The results of the present study suggest that behavioral responses provide an additionaldimension and may be more informative than consumption data alone to assess whether cats perceivetastes as pleasant or unpleasant. Thus, the analysis of behavioral responses to different taste qualitiesmay be a useful tool to assess and improve the acceptance of commercial food by cats.
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| 35. |
- Joshi, Dipa, et al.
(författare)
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Olfactory Sensitivity for Enantiomers and Their Racemic Mixtures-A Comparative Study in CD - 1 Mice and Spider Monkeys
- 2006
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Ingår i: Chemical Senses. - : Oxford University Press (OUP). - 0379-864X .- 1464-3553. ; 31:7, s. 655-664
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Tidskriftsartikel (refereegranskat)abstract
- Using a conditioning paradigm, the olfactory sensitivity of six CD-1 mice for the enantiomers of carvone and of limonene as well as for their racemic mixtures was investigated. With all six stimuli, the animals significantly discriminated concentrations 0.1 ppm (parts per million) from the odorless solvent, and with five of the six stimuli, the best-scoring animals were even able to detect concentrations 1 ppb (parts per billion). Five spider monkeys tested in parallel were found to detect the same stimuli at concentrations <1 ppm, and with two of the stimuli, they were also able to discriminate concentrations <1 ppb from the solvent. The results showed 1) both CD-1 mice and spider monkeys to have a well-developed olfactory sensitivity for the stimuli tested, with no systematic difference in performance between species; 2) the effect of chirality on detectability of the enantiomers to be substance specific; 3) no systematic effect of the presence (carvone) or absence (limonene) of a functional carbonyl group on detectability of the enantiomers; and 4) that spider monkeys detected the racemic mixtures of both carvone and limonene at lower concentrations compared to the unmixed compounds, whereas the mice failed to do so. These findings lend support to the growing body of evidence suggesting that between-species comparisons of the relative size of olfactory brain structures do not allow us to reliably predict olfactory sensitivity. As mice and spider monkeys are thought to share a similar number of functional olfactory receptor genes, the findings further suggest that differences in the relative abundance of chiral-specific olfactory receptor types might account for the observed difference in mixture additivity at threshold level between the two species. These threshold data may provide useful information for the choice of adequate stimulus concentrations in electrophysiological or imaging studies of the olfactory system or investigations of the discriminative abilities of mice and spider monkeys.
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| 36. |
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| 37. |
- Keselman, Boris, et al.
(författare)
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Analysis and modelling of mistriage in the Stockholm stroke triage system
- 2022
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Ingår i: European Stroke Journal. - : Sage Publications. - 2396-9873 .- 2396-9881. ; 7:2, s. 126-133
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The Stockholm Stroke Triage System (SSTS) is a prehospital triage system for detection of patients eligible for endovascular thrombectomy (EVT). Assessment of hemiparesis combined with ambulance-hospital teleconsultation is used to route patients directly to the thrombectomy centre. Some patients are not identified and require secondary transport for EVT (undertriage) while others taken to the thrombectomy centre do not undergo EVT (overtriage). The aims of this study were to characterize mistriaged patients, model for and evaluate alternative triage algorithms.Patients and methods: Patients with suspected stroke transported by priority 1 ground ambulance between October 2017 and October 2018 (n = 2905) were included. Three triage algorithms were modelled using prehospital data. Decision curve analysis was performed to calculate net benefit (correctly routing patients for EVT without increasing mistriage) of alternative models vs SSTS.Results: Undertriage for EVT occurred in n = 35/2582 (1.4%) and overtriage in n = 239/323 (74.0%). Compared to correct thrombectomy triages, undertriaged patients were younger and had lower median NIHSS (10 vs 18), despite 62.9% with an M1 occlusion. In overtriaged patients, 77.0% had a stroke diagnosis (29.7% haemorrhagic). Hemiparesis and FAST items face and speech were included in all models. Decision curve analysis showed highest net benefit for SSTS for EVT, but lower for large artery occlusion (LAO) stroke.Discussion: Undertriaged patients had lower NIHSS, likely due to better compensated proximal occlusions. SSTS was superior to other models for identifying EVT candidates, but lacked information allowing comparison to other prehospital scales.Conclusion: Using prehospital data, alternative models did not outperform the SSTS in finding EVT candidates.
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| 38. |
- Keselman, Boris, et al.
(författare)
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The Stockholm Stroke Triage Project : Outcomes of Endovascular Thrombectomy Before and After Triage Implementation
- 2022
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Ingår i: Stroke. - : Lippincott Williams & Wilkins. - 0039-2499 .- 1524-4628. ; 53:2, s. 473-481
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: The Stockholm Stroke Triage System (SSTS) is a prehospital algorithm for detection of endovascular thrombectomy (EVT)-eligible patients, combining symptom severity assessment and ambulance-to-hospital teleconsultation, leading to a decision on primary stroke center bypass. In the Stockholm Region (6 primary stroke centers, 1 EVT center), SSTS implementation in October 2017 reduced onset-to-EVT time by 69 minutes. We compared clinical outcomes before and after implementation of SSTS in an observational study.METHODS: We prospectively recruited patients transported by Code Stroke ambulance within the Stockholm region under the SSTS, treated with EVT during October 2017 to October 2019, and compared to EVT patients from 2 previous years.OUTCOMES: shift in modified Rankin Scale (mRS) scores, mRS score 0 to 1, mRS score 0 to 2, and death (all 3 months), National Institutes of Health Stroke Scale (NIHSS) score change 24-hour post-EVT, recanalization (Thrombolysis in Cerebral Infarction 2b-3), and symptomatic intracranial hemorrhage. mRS outcomes were adjusted for age and baseline NIHSS.RESULTS: Patients with EVT in the SSTS group (n=244) were older and had higher baseline NIHSS versus historical controls (n=187): median age 74 (interquartile range, 63-81) versus 71 (61-78); NIHSS score 17 (11.5-21) versus 15 (10-20). During SSTS, median onset-to-puncture time was 136 versus 205 minutes (P<0.001). Adjusted common odds ratio for lower mRS in SSTS patients was 1.7 (95% CI, 1.2-2.3) versus controls. During SSTS, 83/240 (34.6%) versus 44/186 (23.7%) reached 3-month mRS score 0 to 1 (P=0.014), adjusted common odds ratio 2.3 (95% CI, 1.4-3.6). Median NIHSS change 24-hour post-EVT was 6 versus 4 (P=0.005). Differences in Thrombolysis in Cerebral Infarction, symptomatic intracranial hemorrhage, and death were nonsignificant.CONCLUSIONS: With an onset to arterial puncture time reduction by 69 minutes, outcomes in thrombectomy-treated patients improved significantly after region-wide large artery occlusion triage system implementation. These results warrant replication studies in other geographic and organizational circumstances.
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| 39. |
- Laska, AC, et al.
(författare)
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A randomized controlled trial on very early speech and language therapy in acute stroke patients with aphasia
- 2011
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Ingår i: Cerebrovascular diseases extra. - : S. Karger AG. - 1664-5456. ; 1:1, s. 66-74
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background:</i> Aphasia affects one third of acute stroke patients. There is a considerable spontaneous recovery in aphasia, but impaired communication ability remains a great problem. Communication difficulties are an impediment to rehabilitation. Early treatment of the language deficits leading to increased communication ability would improve rehabilitation. The aim of this study is to elucidate the efficacy of very early speech and language therapy (SLT) in acute stroke patients with aphasia. <i>Methods:</i> A prospective, open, randomized, controlled trial was carried out with blinded endpoint evaluation of SLT, starting within 2 days of stroke onset and lasting for 21 days. 123 consecutive patients with acute, first-ever ischemic stroke and aphasia were randomized. The SLT treatment was Language Enrichment Therapy, and the aphasia tests used were the Norsk grunntest for afasi (NGA) and the Amsterdam-Nijmegen everyday language test (ANELT), both performed by speech pathologists, blinded for randomization. <i>Results:</i> The primary outcome, as measured by ANELT at day 21, was 1.3 in the actively treated patient group and 1.2 among controls. NGA led to similar results in both groups. Patients with a higher level of education (>12 years) improved more on ANELT by day 21 than those with <12 years of education (3.4 vs. 1.0, respectively). In 34 patients in the treatment group and 19 in the control group improvement was ≧1 on ANELT (p < 0.05). There was no difference in the degree of aphasia at baseline except for fluency, which was higher in the group responding to treatment. <i>Conclusions:</i> Very early intensive SLT with the Language Enrichment Therapy program over 21 days had no effect on the degree of aphasia in unselected acute aphasic stroke patients. In aphasic patients with more fluency, SLT resulted in a significant improvement as compared to controls. A higher educational level of >12 years was beneficial.
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| 41. |
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| 42. |
- Laska, AC, et al.
(författare)
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Long-term antidepressant treatment with moclobemide for aphasia in acute stroke patients: a randomised, double-blind, placebo-controlled study
- 2005
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Ingår i: Cerebrovascular diseases (Basel, Switzerland). - : S. Karger AG. - 1015-9770 .- 1421-9786. ; 19:2, s. 125-132
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background and Purpose:</i> Pharmacotherapy aimed at stroke rehabilitation through direct central nervous effects may be assumed to work in a similar way for language recovery and sensory-motor recovery. Some data suggest that antidepressant drugs could be beneficial also for functional improvement. This prompted us to investigate whether regression from aphasia after acute stroke could be enhanced by antidepressive drug therapy. <i>Methods:</i> We randomised 90 acute stroke patients with aphasia to either 600 mg moclobemide or placebo daily for 6 months, within 3 weeks of the onset of stroke. Aphasia was assessed prior to treatment and at 6 months, using Reinvang’s ‘Grunntest for afasi’ and the Amsterdam-Nijmegen-Everyday-Language-Test (ANELT). <i>Result:</i> The degree of aphasia decreased significantly at 6 months, with no difference between the moclobemide- and the placebo-treated groups. Multivariate regression analysis including treatment group, activities of daily living, aetiology of stroke, ANELT, and Reinvang’s coefficient at baseline, and neurological deficit confirmed these results. In all, 13 in the moclobemide and 10 in the placebo group stopped taking the study medication. No further change was found in the 56 aphasic patients followed up for another 6 months with no medication. <i>Conclusions:</i> Compared to placebo, treatment with moclobemide for 6 months did not enhance the regression of aphasia following an acute stroke.
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| 43. |
- Laska, AC, et al.
(författare)
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Recognition of depression in aphasic stroke patients
- 2007
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Ingår i: Cerebrovascular diseases (Basel, Switzerland). - : S. Karger AG. - 1015-9770 .- 1421-9786. ; 24:1, s. 74-79
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background:</i> Data on post-stroke depression in aphasia are scarce. <i>Methods:</i> Eighty-nine acute stroke patients with aphasia of all types were followed for 6 months to investigate if depression can be reliably diagnosed (DSM-IV criteria) and validly assessed by the verbal Montgomery-Åsberg Depression Rating Scale (MADRS) and a global technique (Clinical Global Impressions Rating Scale for Severity). A standard aphasia test was performed. <i>Results:</i> In 60 patients (67%) at baseline and in 100% at 6 months, comprehension allowed a reliable DSM-IV diagnosis. Among these patients MADRS was feasible in 95% at baseline and in 100% at 6 months. The assistance of relatives and staff increases the feasibility and decreases the validity. Depression was identified in 24% during the 6 months. <i>Conclusion:</i> Depression diagnosis and severity rating can reliably be made in the acute phase in at least two thirds of aphasic patients, and feasibility increases over time.
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| 44. |
- Laska, Matthias, 1960-, et al.
(författare)
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Olfactory discrimination ability of CD-1 mice for a large array of enantiomers
- 2007
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Ingår i: Neuroscience. - : Elsevier BV. - 0306-4522 .- 1873-7544. ; 144:1, s. 295-301
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Tidskriftsartikel (refereegranskat)abstract
- With use of a conditioning paradigm, the ability of eight CD-1 mice to distinguish between 15 enantiomeric odor pairs was investigated. The results demonstrate a) that CD-1 mice are capable of discriminating between all odor pairs tested, b) that the enantiomeric odor pairs clearly differed in their degree of discriminability and thus in their perceptual similarity, and c) that pre-training with the rewarded stimuli led to improved initial but not terminal or overall performance. A comparison between the proportion of discriminated enantiomeric odor pairs of the CD-1 mice and those of other species tested in earlier studies on the same discrimination tasks (or on subsets thereof) shows a significant positive correlation between discrimination performance and the number of functional olfactory receptor genes. These findings provide the first evidence of a highly developed ability of CD-1 mice to discriminate between an array of non-pheromonal chiral odorants. Further, they suggest that a species’ olfactory discrimination capabilities for these odorants may be correlated with its number of functional olfactory receptor genes. The data presented here may provide useful information for the interpretation of findings from electrophysiological or imaging studies in the mouse and the elucidation of odor structure-activity relationships.
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| 45. |
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| 46. |
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| 47. |
- Laska, Matthias, 1960-, et al.
(författare)
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Successful acquisition of an olfactory discrimination paradigm by South African fur seals, Arctocephalus pusillus
- 2008
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Ingår i: Physiology and Behavior. - : Elsevier BV. - 0031-9384 .- 1873-507X. ; 93:4-5, s. 1033-1038
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Tidskriftsartikel (refereegranskat)abstract
- The present study demonstrates that South African fur seals, Arctocephalus pusillus, can successfully be trained to discriminate between objects on the basis of odor cues. Using a task based on a food-rewarded two-choice discrimination of simultaneously presented odor stimuli the animals acquired the basic operant conditioning paradigm within 480 to 880 stimulus contacts. Moreover, the fur seals could readily transfer to new S+ and S- stimuli, were capable of distinguishing between fish- and non-fish odors as well as between two fish odors, and were able to remember the reward value of previously learned odor stimuli even after 2- and 15-week breaks. The precision and consistency of the fur seals' performance in tests of discrimination ability and memory demonstrate the suitability of this paradigm for assessing olfactory function in this pinniped. An across-species comparison of several measures of olfactory learning capabilities such as speed of initial task acquisition and ability to master transfer tasks shows that A. pusillus is similar in performance to non-human primates, but inferior to rodents such as mice and rats. The results support the assumption that fur seals may use olfactory cues for social communication and food selection and that the sense of smell may play an hitherto underestimated role in the control of their behavior. © 2008 Elsevier Inc. All rights reserved.
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| 48. |
- Laska, Matthias, 1960-, et al.
(författare)
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Taste difference thresholds for monosodium glutamate and sodium chloride in pigtail macaques (Macaca nemestrina) and spider monkeys (Ateles geoffroyi)
- 2008
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Ingår i: American Journal of Primatology. - : Wiley. - 0275-2565 .- 1098-2345. ; 70:8, s. 839-847
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to determine taste difference thresholds for monosodium glutamate (MSG) and sodium chloride (NaCl) in pigtail macaques (Macaca nemestrina) and spider monkeys (Ateles geoffroyi). Using a two-bottle preference test of brief duration, three animals of each species were presented with four different reference concentrations of 50, 100, 200, and 400 mM of a tastant and tested for their ability to discriminate these from lower concentrations of the same tastant. The just noticeable differences (JNDs), expressed as Weber ratios (ΔI/I), were found to range from 0.1 to 0.5 for MSG and 0.2 to 0.45 for NaCl in the pigtail macaques, with a significant tendency for higher Weber ratios with higher reference concentrations. In the spider monkeys, JNDs ranged from 0.15 to 0.4 for MSG and 0.1 to 0.25 for NaCl, with Weber ratios staying fairly constant across the reference concentrations tested. Thus, the JNDs were found to be generally similar in both species and to be at least as low as those found in humans for MSG and NaCl, as well as those found in spider monkeys for sucrose. The results support the assumption that both pigtail macaques and spider monkeys may use differences in perceived intensity of MSG and NaCl as a criterion for food selection. © 2008 Wiley-Liss, Inc.
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