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1.
  • Af Winklerfelt Hammarberg, Sandra, et al. (författare)
  • Outcomes of psychiatric interviews and self-rated symptom scales in people on sick leave for common mental disorders: an observational study.
  • 2022
  • Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 12:6
  • Tidskriftsartikel (refereegranskat)abstract
    • To investigate the correspondence between diagnoses on sick leave certificates and diagnoses made in structured psychiatric interviews. Secondary aims were to investigate length of sick leave by diagnoses on sick leave certificates, diagnoses made in structured interviews and symptom severity.Observational study consisting of a secondary analysis of data from a randomised controlled trial and an observational study.The regions of Stockholm and Västra Götaland, Sweden.480 people on sick leave for common mental disorders.Participants were examined with structured psychiatric interviews and self-rated symptom severity scales.(1) Sick leave certificate diagnoses, (2) diagnoses from the Mini International Neuropsychiatric Interview and the Self-rated Stress-Induced Exhaustion Disorder (SED) Instrument (s-ED), (3) symptom severity (Montgomery-Asberg Depression Rating Scale-self-rating version and the Karolinska Exhaustion Disorder Scale) and (4) number of sick leave days.There was little correspondence between diagnoses on sick leave certificates and diagnoses made in structured psychiatric interviews. Many participants on sick leave for SED, anxiety disorder or depression fulfilled criteria for other mental disorders. Most on sick leave for SED (76%) and anxiety disorder (67%) had depression (p=0.041). Length of sick leave did not differ by certificate diagnoses. Participants with SED (s-ED) had longer sick leave than participants without SED (144 vs 84 days; 1.72 (1.37-2.16); p<0.001). More severe symptoms were associated with longer sick leave.Diagnoses on sick leave certificates did not reflect the complex and overlapping nature of the diagnoses found in the structured psychiatric interviews. This finding is relevant to the interpretation of information from health data registers, including studies and guidelines based on these data. A result of clinical interest was that more severe symptoms predicted long-term sick leave better than actual diagnoses.
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2.
  • Bager, Jessica, et al. (författare)
  • Prevalence and early-life risk factors for tree nut sensitization and allergy in young adults
  • 2021
  • Ingår i: Clinical and Experimental Allergy. - : John Wiley & Sons. - 0954-7894 .- 1365-2222. ; 51:11, s. 1429-1437
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Tree nut allergy may cause anaphylaxis. There are limited population-based studies on prevalence and early-life risk factors. Methods We evaluated the prevalence of reported symptoms and allergic sensitization to tree nuts at age 24 years in the BAMSE population-based cohort study and assessed early-life factors associated with the development of tree nut allergy. We estimated tree nut allergy prevalence, by analysing questionnaire data on tree nut ingestion and symptoms at age 12, 16 and 24 years, and IgE sensitization at age 24 years to hazelnut, walnut, pecan, cashew, pistachio, Brazil nut, almond extracts and allergen molecules Cor a 1, 9, 14 (hazelnut), Jug r 1 (walnut) and Ana o 3 (cashew). We evaluated eczema, asthma, food allergies, inherited risk of allergy and gender as potential early-life risk factors. Results Data were available for 2215/4089 (54%) BAMSE study participants, for estimation of the prevalence of tree nut sensitization (21.2%), tree nut allergy symptoms (9.8%) and combined sensitization and symptoms (7.9%, 2.1% for storage protein sensitization and symptoms, 4.3% for any sensitization and non-mild symptoms). Sixty-three per cent of sensitized individuals (295/470) were asymptomatic, but only 76/470 (16%) storage protein sensitized individuals. Egg allergy (ORadj 8.50 95% CI 2.15-33.6), eczema (ORadj 2.53 95% CI 1.21-5.32) and asthma (ORadj 5.59 95% CI 2.35-13.3)) at pre-school age were associated with future development of tree nut symptoms and storage protein sensitization. At age 24 years, tree nut allergy was associated with current eczema and with markers of current asthma severity. Sensitization to storage proteins was more strongly associated with symptoms than sensitization to whole extract for all tree nuts evaluated. Conclusions In this Swedish cohort, we found tree nut whole extract sensitization is common but usually asymptomatic. Storage protein sensitization is a more reliable indicator of tree nut symptoms. Tree nut allergy is associated with early onset, persistent and severe atopic disease.
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  • Daniilidou, Makrina, et al. (författare)
  • Alzheimer's disease biomarker profiling in a memory clinic cohort without common comorbidities.
  • 2023
  • Ingår i: Brain communications. - 2632-1297. ; 5:5
  • Tidskriftsartikel (refereegranskat)abstract
    • Alzheimer's disease is a multifactorial disorder with large heterogeneity. Comorbidities such as hypertension, hypercholesterolaemia and diabetes are known contributors to disease progression. However, less is known about their mechanistic contribution to Alzheimer's pathology and neurodegeneration. The aim of this study was to investigate the relationship of several biomarkers related to risk mechanisms in Alzheimer's disease with the well-established Alzheimer's disease markers in a memory clinic population without common comorbidities. We investigated 13 molecular markers representing key mechanisms underlying Alzheimer's disease pathogenesis in CSF from memory clinic patients without diagnosed hypertension, hypercholesterolaemia or diabetes nor other neurodegenerative disorders. An analysis of covariance was used to compare biomarker levels between clinical groups. Associations were analysed by linear regression. Two-step cluster analysis was used to determine patient clusters. Two key markers were analysed by immunofluorescence staining in the hippocampus of non-demented control and Alzheimer's disease individuals. CSF samples from a total of 90 participants were included in this study: 30 from patients with subjective cognitive decline (age 62.4 ± 4.38, female 60%), 30 with mild cognitive impairment (age 65.6 ± 7.48, female 50%) and 30 with Alzheimer's disease (age 68.2 ± 7.86, female 50%). Angiotensinogen, thioredoxin-1 and interleukin-15 had the most prominent associations with Alzheimer's disease pathology, synaptic and axonal damage markers. Synaptosomal-associated protein 25kDa and neurofilament light chain were increased in mild cognitive impairment and Alzheimer's disease patients. Grouping biomarkers by biological function showed that inflammatory and survival components were associated with Alzheimer's disease pathology, synaptic dysfunction and axonal damage. Moreover, a vascular/metabolic component was associated with synaptic dysfunction. In the data-driven analysis, two patient clusters were identified: Cluster 1 had increased CSF markers of oxidative stress, vascular pathology and neuroinflammation and was characterized by elevated synaptic and axonal damage, compared with Cluster 2. Clinical groups were evenly distributed between the clusters. An analysis of post-mortem hippocampal tissue showed that compared with non-demented controls, angiotensinogen staining was higher in Alzheimer's disease and co-localized with phosphorylated-tau. The identification of biomarker-driven endophenotypes in cognitive disorder patients further highlights the biological heterogeneity of Alzheimer's disease and the importance of tailored prevention and treatment strategies.
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5.
  • Dittrich, Anna, 1972, et al. (författare)
  • Association of Chronic Kidney Disease With Plasma NfL and Other Biomarkers of Neurodegeneration: The H70 Birth Cohort Study in Gothenburg.
  • 2023
  • Ingår i: Neurology. - 1526-632X. ; 101:3
  • Tidskriftsartikel (refereegranskat)abstract
    • Studies associate chronic kidney disease (CKD) with neurodegeneration. This study investigated the relationship between kidney function, blood, CSF, and structural brain MRI markers of neurodegeneration in a sample including individuals with and without CKD.Participants from the Gothenburg H70 Birth Cohort Study, with data on plasma neurofilament light (P-NfL), estimated glomerular filtration rate (eGFR), and structural brain MRI were included. Participants were invited to also have the CSF collected. The primary endpoint of this study was to determine any association between CKD and P-NfL. Secondary endpoints included cross-sectional associations between CKD, eGFR, and CSF-derived and MRI-derived markers of neurodegeneration and Alzheimer disease (AD) pathology (MRI: cortical thickness, hippocampal volume, lateral ventricle volume, and white matter lesion volume; CSF: β-amyloid (Aβ) 42, Aβ42/40, Aβ42/p-tau, t-tau, p-tau, and NfL). Participants with P-NfL and eGFR at baseline were re-examined on eGFR, 5.5 (5.3-6.1) years (median; IQR) after the first visit, and the predictive value of P-NfL levels on incident CKD was estimated longitudinally, using a Cox proportional hazards model.We included 744 participants, 668 without CKD (age 71 [70-71] years, 50% males) and 76 with CKD (age 71 [70-71] years, 39% males). Biomarkers from the CSF were analyzed in 313 participants. A total of 558 individuals returned for a re-examination of eGFR (75% response rate, age 76 [76; 77] years, 48% males, 76 new cases of CKD). Participants with CKD had higher P-NfL levels than those with normal kidney function (median; 18.8 vs 14.1 pg/mL, p < 0.001), while MRI and CSF markers were similar between the groups. P-NfL was independently associated with CKD after adjustment for confounding variables, including hypertension and diabetes (OR; 3.231, p < 0.001), in a logistic regression model. eGFR and CSF Aβ 42/40: R = 0.23, p = 0.004 correlated in participants with Aβ42 pathology. P-NfL levels in the highest quartile were associated with incident CKD at follow-up (HR; 2.39 [1.21: 4.72]).In a community-based cohort of 70-year olds, P-NfL was associated with both prevalent and incident CKD, while CSF and/or imaging measures did not differ by CKD status. Participants with CKD and dementia presented similar levels of P-NfL.
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6.
  • Dittrich, Anna, 1972, et al. (författare)
  • Plasma and CSF NfL are differentially associated with biomarker evidence of neurodegeneration in a community-based sample of 70-year-olds
  • 2022
  • Ingår i: Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring. - : Wiley. - 2352-8729. ; 14:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Neurofilament light protein (NfL) in cerebrospinal fluid (CSF) and plasma (P) are suggested to be interchangeable markers of neurodegeneration. However, evidence is scarce from community-based samples. NfL was examined in a small-scale sample of 287 individuals from the Gothenburg H70 Birth cohort 1944 study, using linear models in relation to CSF and magnetic resonance imaging (MRI) biomarker evidence of neurodegeneration. CSF-NfL and P-NfL present distinct associations with biomarker evidence of Alzheimer's disease (AD) pathology and neurodegeneration. P-NfL was associated with several markers that are characteristic of AD, including smaller hippocampal volumes, amyloid beta (A beta)(42), A beta(42/40), and A beta(42)/t-tau (total tau). CSF-NfL demonstrated associations with measures of synaptic and neurodegeneration, including t-tau, phosphorylated tau (p-tau), and neurogranin. Our findings suggest that P-NfL and CSF-NfL may exert different effects on markers of neurodegeneration in a small-scale community-based sample of 70-year-olds.
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  • Dittrich, Anna, 1972, et al. (författare)
  • Proportion of Community-Dwelling Individuals Older Than 70 Years Eligible for Lecanemab Initiation: The Gothenburg H70 Birth Cohort Study.
  • 2024
  • Ingår i: Neurology. - 1526-632X. ; 102:9
  • Tidskriftsartikel (refereegranskat)abstract
    • To determine the prevalence of individuals with Alzheimer disease (AD) eligible for treatment with the recently FDA-approved lecanemab based on data from a population-based sample of 70-year-olds and extrapolate an estimation of individuals eligible in Europe and the United States.Participants from the Gothenburg H70 Birth Cohort Study with clinical data, CSF-amyloid beta 42, and brain MRI analysis were evaluated for eligibility to receive lecanemab treatment according to FDA-approved recommendations, noting factors requiring special consideration. Results were used to extrapolate the number of eligible individuals in Europe and the United States using public demographic data.Thirty (10.3%) of 290 participants met the indication for treatment of whom 18 (6.2%) were eligible and did not present factors requiring special consideration. Our estimate that 6.2% of all 70-year-olds in the full cohort are eligible for treatment extrapolates to an approximation that around 5.9 million Europeans and 2.2 million US residents could be eligible.Information on proportion of individuals eligible for AD treatment with lecanemab in the general public is limited. We provide information on 70-year-olds in Sweden and extrapolate these data to Europe and the United States. This study opens for larger studies on this proportion and implementation of lecanemab treatment.
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  • Marseglia, Anna, et al. (författare)
  • Metabolic Syndrome Is Associated With Poor Cognition : A Population-Based Study of 70-Year-Old Adults Without Dementia
  • 2021
  • Ingår i: The journals of gerontology. Series A, Biological sciences and medical sciences. - : Oxford University Press (OUP). - 1079-5006 .- 1758-535X. ; 76:12, s. 2275-2283
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Individual conditions of metabolic syndrome (MetS) have been related to dementia; however, their combined impact on the preclinical stage is unknown. We investigated the associations between MetS and domain-specific cognitive function as well as the role of sociodemographic, cardiovascular, and genetic factors.Methods: Within the Gothenburg H70 Birth Cohort Study-Birth cohort 1944, 1131 dementia-free participants (aged 70 years) were examined during 2014-2016. MetS (central obesity plus at least 2 factors [reduced HD11.-cholesterol, elevated triglycerides, blood pressure, or blood glucose]) was identified according to the International Diabetes Federation criteria. Five cognitive domains (memory, attention/perceptual speed, executive function, verbal fluency, visuospatial abilities) were generated after z-standardizing raw scores from 10 neuropsychological tests. Education, heart disease, claudication (indicating peripheral atherosclerosis), and apolipoprotein genotype were ascertained by trained staff. Data were analyzed with linear regression models.Results: Overall, 618 participants (55%) had MetS. In multiadjusted linear regressions, MetS was related to poorer performance in attention/ perceptual speed (beta -0.14 [95% CI -0.25, -0.02]), executive function (beta -0.12 [95% CI -0.23, -0.01]), and verbal fluency (beta -0.19 [95% CI -0.30, -0.08]). These associations were present only among individuals who did not carry any APOE-epsilon 4 allele or were highly educated. However, among those with MetS, high education was related to better cognitive performance. MetS together with comorbid heart disease or claudication was associated with even worse cognitive performance than each alone.Conclusions: MetS is associated with poor attention/perceptual speed, executive function, and verbal fluency performance. Education, apolipoprotein E-epsilon 4 allele, and comorbid cardiovascular disease influenced the observed associations.
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  • Marseglia, Anna, et al. (författare)
  • Social Health and Cognitive Change in Old Age : Role of Brain Reserve
  • 2023
  • Ingår i: Annals of Neurology. - : John Wiley & Sons. - 0364-5134 .- 1531-8249. ; 93:4, s. 844-855
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: Individual aspects of social health (SH; eg, network, engagement, support) have been linked to cognitive health. However, their combined effect and the role of the structural properties of the brain (brain reserve [BR]) remain unclear. We investigated the interplay of SH and BR on cognitive change in older adults.Methods: Within the Swedish National Study on Aging and Care–Kungsholmen, 368 dementia-free adults aged ≥60 years with baseline brain magnetic resonance imaging were followed over 12 years to assess cognitive change. A measure of global cognition was computed at each of the 5 waves of assessment by averaging domain-specific Z scores for episodic memory, perceptual speed, semantic memory, and letter and category fluency. An SH composite score was computed at baseline by combining leisure activities and social network. BR was proxied by total brain tissue volume (TBTV). Linear mixed models (adjusted for sociodemographic, vascular, and genetic factors) were used to estimate cognitive trajectories in relation to SH and TBTV. Interaction analysis and stratification were used to examine the interplay between SH and TBTV.Results: Moderate–good SH (n = 245; vs poor, β-slope = 0.01, 95% confidence interval [CI] = 0.002–0.02, p = 0.018) and moderate-to-large TBTV (n = 245; vs small, β-slope = 0.03, 95% CI = 0.02–0.04, p < 0.001) were separately associated with slower cognitive decline. In stratified analysis, moderate–good SH was associated with higher cognitive levels (but not change) only in participants with moderate-to-large TBTV (β-intercept = 0.21, 95% CI = 0.06–0.37, p < 0.01; interaction SH * TBTV, p < 0.05).Interpretation: Our findings highlight the interplay between SH and BR that likely unfolds throughout the entire life course to shape old-age cognitive outcomes. ANN NEUROL 2023
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10.
  • Melen, Erik, et al. (författare)
  • Male sex is strongly associated with IgE-sensitization to airborne but not food allergens : results up to age 24 years from the BAMSE birth cohort
  • 2020
  • Ingår i: Clinical and Translational Allergy. - : BioMed Central. - 2045-7022. ; 75, s. 161-162
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Up to half of the population in high-income countries has allergen-specific IgE antibodies. However, data regarding sex differences of IgE-sensitization from childhood to adulthood is limited. Objective To explore IgE-sensitization to common foods and airborne allergens in relation to sex over time in a population-based cohort followed up to young adulthood. Methods The Swedish population-based birth cohort BAMSE includes 4089 subjects who have been followed regularly with questionnaires and clinical investigations. A recent 24-year follow-up included 3069 participants (75%). Sera collected at 4, 8, 16 and 24 years were analyzed for IgE-antibodies to 14 common foods and airborne allergens. Results At 24 years sensitization to foods had decreased compared to previous follow-ups affecting 8.4%, while sensitization to airborne allergens was more common, affecting 42.2%. Male sex was associated with IgE-sensitization to airborne allergens at all ages (overall OR: 1.68, 95% CI 1.46-1.94) while there was no statistically significant association between sex and sensitization to food allergens (overall OR: 1.10, 95% CI 0.93-1.32). Levels of allergen-specific IgE did not differ significantly between males and females for any of the tested foods or airborne allergens at any age, following adjustment for multiple comparisons. Conclusion IgE-sensitization to airborne allergens increases with age up to young adulthood, whereas sensitization to food allergens seems to level off. Male sex is strongly associated with IgE-sensitization to airborne allergens from early childhood up to young adulthood. In contrast, there is little evidence for associations between sex and IgE-sensitization to foods.
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  • Samuelsson, Jessica, et al. (författare)
  • Associations between dietary patterns and dementia-related neuroimaging markers
  • 2023
  • Ingår i: Alzheimers & Dementia. - : Wiley. - 1552-5260 .- 1552-5279. ; 19:10, s. 4629-4640
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUNDThe exploration of associations between dietary patterns and dementia-related neuroimaging markers can provide insights on food combinations that may impact brain integrity. METHODSData were derived from the Swedish Gothenburg H70 Birth Cohort Study (n = 610). Three dietary patterns were obtained using principal component analysis. Magnetic resonance imaging markers included cortical thickness, an Alzheimer's disease (AD) signature score, small vessel disease, and white matter microstructural integrity. Adjusted linear/ordinal regression analyses were performed. RESULTSA high-protein and alcohol dietary pattern was negatively associated with cortical thickness in the whole brain (Beta: -0.011; 95% confidence interval [CI]: -0.018 to -0.003), and with an Alzheimer's disease cortical thickness signature score (Beta: -0.013; 95% CI: -0.024 to -0.001). A positive association was found between a Mediterranean-like dietary pattern and white matter microstructural integrity (Beta: 0.078; 95% CI: 0.002-0.154). No associations were found with a Western-like dietary pattern. DISCUSSIONDietary patterns may impact brain integrity through neurodegenerative and vascular pathways. HighlightsCertain dietary patterns were associated with dementia-related neuroimaging markers.A Mediterranean dietary pattern was positively associated with white matter microstructure.A high-protein and alcohol pattern was negatively associated with cortical thickness.
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12.
  • Samuelsson, Jessica, et al. (författare)
  • Associations between dietary patterns and structural neuroimaging measures of relevance for dementia : Alzheimer’s Association International Conference (AAIC)
  • 2022
  • Konferensbidrag (refereegranskat)abstract
    • Associations between dietary patterns and structural neuroimaging measures of relevance for dementia Jessica Samuelsson, M.S.c¹, Anna Marseglia, PhD2, Olof Lindberg, PhD2, Eric Westman, PhD2, Silke Kern, MD, PhD¹, Felicia Ahlner M.S.c¹, Elisabet Rothenberg, PhD4, Ingmar Skoog, MD, PhD1,3*, Anna Zettergren, PhD¹* 1Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Sweden, 2 Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden, 3Department of Psychiatry Cognition and Old Age Psychiatry, Sahlgrenska University Hospital, Region Västra Götaland, Mölndal, Sweden, 4Food and Meal Science, Kristianstad University, Kristianstad, Sweden Abstract Background: Diet is one of the lifestyle factors that could influence the risk of developing dementia, but effects of diet on the brain are not fully understood. Investigating associations between dietary patterns and structural neuroimaging measures of relevance for dementia could potentially increase this understanding. Methods: This study includes cross-sectional data from the population-based Gothenburg H70 Birth Cohort Studies based in Sweden, including 610 dementia-free 70-year-olds (born 1944, examined 2014-16) with dietary and magnetic resonance imaging (MRI) data (54 % women). Three dietary patterns were derived with principal component analysis, one labelled Western (e.g., refined cereal products, sweets, savory bakery/fast food), one Mediterranean (e.g., vegetables, fruits, whole grain cereal products) and one Low-fiber and high-alcohol (e.g., red meat/processed red meat, eggs, alcoholic beverages). Magnetic resonance imaging (MRI) measures of cortical thickness, white matter microstructure (based on diffusion tensor imaging), and a small vessel disease score (sum of white matter hyperintensities, lacunes,cerebral microbleeds, perivascular spaces) of relevance for dementia were included. Analyses (linear and ordinal regression models) were adjusted for sex, energy intake, educational level, physical activity level, smoking and body mass index. Results: Results from this study showed a positive association between higher adherence to the Mediterranean dietary pattern and higher white matter microstructural integrity (B 0.077; 95% CI 0.002 – 0.153), and that a higher adherence to the Low-fibre and high-alcohol dietary pattern was negatively associated with total mean cortical thickness (B -0.011; 95% CI -0.019 – -0.003) and an Alzheimer’s disease signature of cortical thickness (mean entorhinal, inferior temporal, middle temporal, and fusiform thickness) (B -0.013; 95% CI -0.024 – -0.001) in the fully adjusted models. No associations were found between the small vessel disease score and the dietary patterns. Nor were there any associations between the western dietary pattern and the MRI measures. Conclusions: The result from this study suggests that there may be an association between diet and dementia-related brain alterations. These findings could be of importance for dementia prevention strategies and for future intervention studies investigating the effect of dietary patterns in relation to dementia incidence.
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  • Tedner, Sandra G., et al. (författare)
  • Development of sensitization to peanut and storage proteins and relation to markers of airway and systemic inflammation : A 24-year follow-up
  • 2023
  • Ingår i: Allergy. European Journal of Allergy and Clinical Immunology. - : John Wiley & Sons. - 0105-4538 .- 1398-9995. ; 78:2, s. 488-499
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundLong-time data of peanut allergy over time is sparse. We aimed to study the longitudinal development of sensitization to peanut extract and storage protein allergen molecules and associations with asthma status, airway and systemic inflammation markers.MethodsThe Swedish birth cohort BAMSE followed 4089 participants with questionnaires, clinical investigations and blood sampling between 0 and 24 years. Information on (i) background factors at 2 months, (ii) peanut allergy symptoms and IgE data (ImmunoCAP) at 4, 8, 16, and 24 years, and (iii) IgE to storage proteins, lung function data including exhaled nitric oxide (FENO) as well as systemic inflammatory markers at 24 years of age were collected.ResultsThe prevalence of peanut extract sensitization, defined as IgE ≥ 0.35 kUA/L, was 5.4%, 8.0%, 7.5%, and 6.2% at 4, 8, 16, and 24 years of age, respectively. Between 8 and 24 years of age, (33/1565) participants developed IgE-ab to peanut extract (median 1,4, range 0.7–2.6 kUA/L), and among those 85% were also sensitized to birch. Only six individuals developed sensitization to Ara h 2 (≥0.1 kUA/L) between 8 and 24 years of age, of whom three had an IgE-ab level between 0.1–0.12 kUA/L. Storage protein sensitization was associated with elevated FENO, blood eosinophils and type 2 inflammation-related systemic proteins.ConclusionSensitization to peanut extract after 4 years of age is mainly induced by birch cross-sensitization and IgE to Ara h 2 rarely emerges after eight years of age. Storage protein sensitization is associated with respiratory and systemic inflammation.
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14.
  • Westin, Johan, et al. (författare)
  • Management of influenza : updated Swedish guidelines for antiviral treatment
  • 2023
  • Ingår i: Infectious Diseases. - : Taylor & Francis Group. - 2374-4235 .- 2374-4243. ; 55:10, s. 725-737
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • Influenza causes seasonal epidemics of respiratory infection in all parts of the world. Manifestations of influenza range from mild upper to severe lower respiratory tract infection. Medical risk groups are defined by factors predisposing for development of severe disease and are recommended annual vaccination as a protective measure. The previous Swedish treatment guidelines for influenza were issued in 2011, and a review of current evidence was deemed relevant. An important reason to revisit the guidelines is the recent approval of a novel drug for influenza treatment, baloxavir. Updated Swedish evidence-based guidelines created by a group of experts from various research areas, for the management of influenza are presented here. The work has been made in collaboration with the Public Health Agency of Sweden and the Swedish Reference Group for AntiViral therapy (RAV). The updated guidelines include guidelines for diagnostics, treatment and prophylaxis in special groups, including management of pregnant women and children with influenza. A new section about infection control has been added. Pharmacological treatment is covered in detail with regards to indication and dosage. Additionally, drug resistance and environmental aspects are discussed.
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15.
  • Westin, Johan, et al. (författare)
  • Management of influenza–updated Swedish guidelines for antiviral treatment
  • 2023
  • Ingår i: Infectious Diseases. - : Taylor & Francis Group. - 2374-4235 .- 2374-4243. ; 55:10, s. 725-737
  • Tidskriftsartikel (refereegranskat)abstract
    • Influenza causes seasonal epidemics of respiratory infection in all parts of the world. Manifestations of influenza range from mild upper to severe lower respiratory tract infection. Medical risk groups are defined by factors predisposing for development of severe disease and are recommended annual vaccination as a protective measure. The previous Swedish treatment guidelines for influenza were issued in 2011, and a review of current evidence was deemed relevant. An important reason to revisit the guidelines is the recent approval of a novel drug for influenza treatment, baloxavir. Updated Swedish evidence-based guidelines created by a group of experts from various research areas, for the management of influenza are presented here. The work has been made in collaboration with the Public Health Agency of Sweden and the Swedish Reference Group for AntiViral therapy (RAV). The updated guidelines include guidelines for diagnostics, treatment and prophylaxis in special groups, including management of pregnant women and children with influenza. A new section about infection control has been added. Pharmacological treatment is covered in detail with regards to indication and dosage. Additionally, drug resistance and environmental aspects are discussed.
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  • Alerby, Eva, et al. (författare)
  • Ömsesidig samverkan mellan pedagogisk forskning och pedagogisk praktik
  • 2010
  • Ingår i: Utbildning på vetenskaplig grund. - Stockholm : Lärarförbundet. - 9789197808835 ; , s. 22-32
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
    • Vad innebär det i praktiken att skolans och förskolans verksamhet skall vila på vetenskaplig grund och beprövad erfarenhet? Det vi tycker är intressant att lyfta fram är på vilket sätt forskningen bedrivs, hur forskningsfrågorna kommer till och hur resultaten kommer den pedagogiska praktiken tillgodo. I denna artikel diskuterar och problematiserar vi relationen mellan den pedagogiska forskningen och förskolans och skolans verksamhet. Diskussionerna exemplifieras från ett konkret forsknings- och samverkansprojekt, där forskning och praktik har gått hand i hand. Vidare ger en forskare, en doktorand, en lärarutbildare, en skolledare och en lärare sin personliga syn på samverkan mellan pedagogisk forskning och praktik.
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19.
  • Badji, A., et al. (författare)
  • Cerebrospinal Fluid Biomarkers, Brain Structural and Cognitive Performances Between Normotensive and Hypertensive Controlled, Uncontrolled and Untreated 70-Year-Old Adults
  • 2022
  • Ingår i: Frontiers in Aging Neuroscience. - : Frontiers Media SA. - 1663-4365. ; 13
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Hypertension is an important risk factor for Alzheimer's disease (AD). The pathophysiological mechanisms underlying the relationship between AD and hypertension are not fully understood, but they most likely involve microvascular dysfunction and cerebrovascular pathology. Although previous studies have assessed the impact of hypertension on different markers of brain integrity, no study has yet provided a comprehensive comparison of cerebrospinal fluid (CSF) biomarkers and structural brain differences between normotensive and hypertensive groups in a single and large cohort of older adults in relationship to cognitive performances.Objective: The aim of the present work was to investigate the differences in cognitive performances, CSF biomarkers and magnetic resonance imaging (MRI) of brain structure between normotensive, controlled hypertensive, uncontrolled hypertensive, and untreated hypertensive older adults from the Gothenburg H70 Birth Cohort Studies.Methods: As an indicator of vascular brain pathology, we measured white matter hyperintensities (WMHs), lacunes, cerebral microbleeds, enlarged perivascular space (epvs), and fractional anisotropy (FA). To assess markers of AD pathology/neurodegeneration, we measured hippocampal volume, temporal cortical thickness on MRI, and amyloid-beta(42), phosphorylated tau, and neurofilament light protein (NfL) in cerebrospinal fluid. Various neuropsychological tests were used to assess performances in memory, attention/processing speed, executive function, verbal fluency, and visuospatial abilities.Results: We found more white matter pathology in hypertensive compared to normotensive participants, with the highest vascular burden in uncontrolled participants (e.g., lower FA, more WMHs, and epvs). No significant difference was found in any MRI or CSF markers of AD pathology/neurodegeneration when comparing normotensive and hypertensive participants, nor among hypertensive groups. No significant difference was found in most cognitive functions between groups.Conclusion: Our results suggest that good blood pressure control may help prevent cerebrovascular pathology. In addition, hypertension may contribute to cognitive decline through its effect on cerebrovascular pathology rather than AD-related pathology. These findings suggest that hypertension is associated with MRI markers of vascular pathology in the absence of a significant decline in cognitive functions.
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20.
  • Benerdal, Malin, et al. (författare)
  • Collaborative arrangements between schools and universities explored through a lens of organizing
  • 2023
  • Konferensbidrag (refereegranskat)abstract
    • Collaborative arrangements between schools and universities explored through a lens of organizingMalin Benerdal1, Anna-Karin Westman21Umeå university, Sweden; 2Mid university, SwedenKnowledge production in collaboration between academia and society has been put forward in governmental policies on research and development to an increasing extent over the last two decades (Jonsson et al., 2022; Skoglund, 2022) in the Nordics and beyond. This article focuses on one such effort, abbreviated ULF in Swedish, aiming at testing different models of collaboration between universities and school organizers in Sweden. It was initiated as a state-funded trial during the years 2017-2021. Drawing on an evaluation of the work at six participating universities, the aim of the paper is to analyze the organizing of the collaborative project focusing on university representative’s experienced efforts and challenges in relation to organizing the collaboration. The framework for analysis builds on literature of partial organization (Ahrne & Brunsson, 2011) and the analysis was conducted in two steps. First, we analyzed the material to determine which organizational elements were present and visible in the setup of the collaboration at the different universities. In the second step we focused on expressions and statements tied to the different elements focusing expressed efforts, solutions and difficulties in relation to the different elements of organization. The material consisted of transcripts from group interviews with 22 representatives from six universities and written responses from a survey.The results indicate a partial organization where the elements of membership, hierarchy and rules being present. Different solutions were sought in relation to the universities and school organizers different contextual conditions, and different solutions to overcome hindrances was evident. The execution of the elements of organization were partly similar, but variation in prerequisites seems to have influenced the design. Thus, illustrating the importance of the contextual circumstances of both universities and schools. As the trial with ULF being prolonged and the previous government declared the intent of permanenting the initiative, the national organization is under reconstruction. It is therefore important to continue following the organizing and the consequences of collaborative initiatives such as ULF. As collaboration and partnerships between universities and school organizers is in demand, not at least from the political level in the Nordic countries, we need to further scrutinize how they are constructed and experienced not least from the outset of power dynamics in play and their consequences.ReferencesAhrne, G., & Brunsson, N. (2011). Organization outside organizations: The significance of partial organization. Organization, 18(1), 83–104. https://doi.org/10.1177/1350508410376256Jonsson, A., Grafström, M., & Klintman, M. (2022). Unboxing knowledge in collaboration between academia and society: A story about conceptions and epistemic uncertainty. Science and Public Policy, scac010. https://doi.org/10.1093/scipol/scac010Skoglund, K. N. (2022). Social interaction of leaders in partnerships between schools and universities: Tensions as support and counterbalance. International Journal of Leadership in Education, 25(5), 747–766. https://doi.org/10.1080/13603124.2020.1797178
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21.
  • Benerdal, Malin, Doktor, 1984-, et al. (författare)
  • Organising for collaboration with schools : experiences from six Swedish universities
  • 2023
  • Ingår i: Scandinavian Journal of Educational Research. - : Routledge. - 0031-3831 .- 1470-1170.
  • Tidskriftsartikel (refereegranskat)abstract
    • Collaboration between universities and schools has been emphasised byboth governments and within educational development research in the Nordic countries. However, educational research has tended to focus onthe practitioners’ perspectives and experiences, i.e., researchers andteachers. Our intention is to contribute to the field with research from another perspective; that of organising for collaboration. This is done by focusing on the experiences of university representatives responsible for the organisation of collaboration within a Swedish nation-wide initiative,the ULF project. Our theoretical framework draws on the literature of partial organisation. The results indicate that the different approaches and solutions used by universities could not only potentially strengthen schools’ opportunities to participate in educational collaboration with universities but also lead to different opportunities, reinforcing previously existing differences between school organisers. The results are discussed in relation to governmental intentions and guidelines.
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22.
  • Benerdal, Malin, Doktor, 1984-, et al. (författare)
  • Utveckling, Lärande, Forskning? : Slutrapport från genomlysningen av försöksverksamheten med ULF-avtal i Umeå-noden
  • 2022
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Hösten 2020 påbörjades en genomlysning av Umeå-nodens försöksverksamhet ULF-avtal (Utveckling, Lärande, Forskning). Genomlysningens syfte var att undersöka hur respektive lärosäte skapar förutsättningar för ULF:s försöksverksamhet med utgångspunkt från nodens gemensamma ställningstaganden som uttryck i nodens ULF-plan; samt identifiera övergripande hinder och möjligheter till samverkan mellan lärosäte och skolhuvudmän inom ramen för utgångspunkterna. I föreliggande rapport redogörs för Umeå-nodens försöksverksamhet ULF ur ett generellt perspektiv, där en samlad bild av lärosätenas arbete med ULF och generella hinder och möjligheter för samverkan synliggörs. Rapporten är en av sju rapporter som författats i genomlysningen, övriga rapporter berör respektive lärosätes ULF-verksamhet. Till Umeå-nodenärutöver Umeå universitet, fem lärosäten knutna; Luleå Tekniska Universitet (LTU), Mittuniversitetet (MIUN), Örebro Universitet (ORU), Mälardalens Högskola (MDH) och Högskolan i Dalarna (HDA). Materialinsamlingen har skett via enkäter, intervjuer och gruppintervjuer med lärosätesrepresentanter och dialogforum med skolhuvudmanna-representanter. Analysen av resultatet har utgått från en organisationsteoretisk modell där bland annat aspekter som struktur, kultur och politik lyfts fram. I Umeå-nodens ULF-plan framhålls vikten av; att testa olika samverkansmodeller, utgå från ett symmetriskt komplementärt förhållningssätt, att skolans behov ska vara vägledande, praktiknära forskning av kvalitet och i nära samverkan med verksamhetsutveckling och att lärarutbildningen involveras i försöksverksamheten. Resultatet indikerar att det finns utmaningar och möjligheter relaterade till samtliga områden i ULF-planen. ULF-arbetet i noden genomsyras att ett undersökande förhållningssätt, med låg grad av styrning och hög grad av delaktighet och inflytande. Det finns en ambition och vilja att samverka och föra dialog, där professioner, kompetenser och erfarenheter tas tillvara. Ambitionen angående symmetrisk komplementär samverkan är sympatisk, samtidigt finns det i samverkan inbyggda gränser och asymmetri där olika praktiker har skilda auktoritet. Den struktur, kultur och politiksom genomsyrar lärosätenas och skolhuvudmännens ULF-arbete får betydelse och påverkar konstruktionerna av ULF-verksamheten, samverkansgränserna och de utmaningar och möjligheter som framträder.
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23.
  • Bergman, Erik, et al. (författare)
  • A full-document analysis of the semantic relation between European Public Assessment Reports and EMA guidelines using a BERT language model
  • 2023
  • Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 18:12
  • Tidskriftsartikel (refereegranskat)abstract
    • In the European Union, the Committee for Medicinal Products for Human Use of the European Medicines Agency (EMA) develop guidelines to guide drug development, supporting development of efficacious and safe medicines. A European Public Assessment Report (EPAR) is published for every medicine application that has been granted or refused marketing authorisation within the EU. In this work, we study the use of text embeddings and similarity metrics to investigate the semantic similarity between EPARs and EMA guidelines. All 1024 EPARs for initial marketing authorisations from 2008 to 2022 was compared to the 669 current EMA scientific guidelines. Documents were converted to plain text and split into overlapping chunks, generating 265,757 EPAR and 27,649 guideline text chunks. Using a Sentence BERT language model, the chunks were transformed into embeddings and fed into an in-house piecewise matching algorithm to estimate the full-document semantic distance. In an analysis of the document distance scores and product characteristics using a linear regression model, EPARs of anti-virals for systemic use (ATC code J05) and antihemorrhagic medicines (B02) present with statistically significant lower overall semantic distance to guidelines compared to other therapeutic areas, also when adjusting for product age and EPAR length. In conclusion, we believe our approach provides meaningful insight into the interplay between EMA scientific guidelines and the assessment made during regulatory review, and could potentially be used to answer more specific questions such as which therapeutic areas could benefit from additional regulatory guidance.
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24.
  • Björkelund, Cecilia, 1948, et al. (författare)
  • [Effects of a care manager organization for care of people with mild-moderate depression in Swedish primary care]. : Vårdsamordnare för depression – effektivt grepp i primärvården - Gav friskare patienter och hälsoekonomiska vinster.
  • 2019
  • Ingår i: Lakartidningen. - 1652-7518. ; 116
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • By strengthening accessibility and continuity and support via a care manager for primary care patients with depression corresponding to 20-30% of a nursing service, patients recovered significantly faster and to a greater extent than in primary care-as-usual. Return to work occurred significantly earlier in the first three months, and net sick leave period was significantly shorter during the following 4-6 months. To introduce a collaborative care organizational change where the care manager is the hub and coordinates care for the patient and makes it possible to adapt the care according to the patient's needs throughout the care process, is thus the individual effort shown to have the greatest efficiency in Swedish primary care to increase the quality of care of depression. This approach, where the clinic and academy work closely and continuously in the development and evaluation phases, makes it possible to rapidly develop new ways of working where consideration is given to the complexity of primary care and the complexity of care needs and care efforts.
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25.
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26.
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27.
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28.
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29.
  • Borda, Miguel German, et al. (författare)
  • Temporal Muscle Thickness: A Practical Approximation for Assessing Muscle Mass in Older Adults
  • 2024
  • Ingår i: JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION. - 1525-8610 .- 1538-9375. ; 25:4
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: Ongoing research has evidenced the importance of muscle measurement in predicting adverse outcomes. Measurement of other muscles is promising in current research. This study aimed to determine the correlation between temporal muscle thickness (TMT) and appendicular lean soft tissue (ALSTI) in older adults. Design: Cross-sectional study. Settings and Participants: Single cohort gathered in Gothenburg, Sweden, consisting of individuals born in 1944 (n = 1203). Methods: We studied 657 magnetic resonance images to measure TMT. Comparisons of TMT with dual -energy X-ray absorptiometry ALSTI (kg/m 2 ) as a reference standard were performed. Finally, TMT associations with cognition evaluated using the Mini -Mental State Examination (MMSE), gait speed, and handgrip strength were explored with linear regressions. Results: The correlation between TMT and ALSTI was weak yet signi ficant (r = 0.277, P < .001). TMT exhibited signi ficant associations with MMSE (estimate = 0.168, P = .002), gait speed (estimate =1.795, P < .001), and ALSTI (estimate = 0.508, P < .001). These associations varied when analyzed by sex. In women, TMT was signi ficantly associated with gait speed (estimate = 1.857, P = .005) and MMSE (estimate = 0.223, P = .003). In men, TMT scores were signi ficantly correlated with ALSTI scores (estimate = 0.571, P < .001). Conclusion and Implications: Repurposing head images can be an accessible alternative to detect muscle mass and ultimately detect sarcopenia. These studies have the potential to trigger interventions or further evaluation to improve the muscle and overall health of individuals. However, additional research is warranted before translating these findings into clinical practice. (c) 2024 AMDA - The Society for Post -Acute and Long -Term Care Medicine.
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30.
  • Borda, Miguel German, et al. (författare)
  • Using magnetic resonance imaging to measure head muscles: An innovative method to opportunistically determine muscle mass and detect sarcopenia
  • 2024
  • Ingår i: Journal of Cachexia, Sarcopenia and Muscle. - 2190-5991 .- 2190-6009. ; 15:1, s. 189-197
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Sarcopenia is associated with multiple adverse outcomes. Traditional methods to determine low muscle mass for the diagnosis of sarcopenia are mainly based on dual-energy X-ray absorptiometry (DXA), whole-body magnetic resonance imaging (MRI) and bioelectrical impedance analysis. These tests are not always available and are rather time consuming and expensive. However, many brain and head diseases require a head MRI. In this study, we aim to provide a more accessible way to detect sarcopenia by comparing the traditional method of DXA lean mass estimation versus the tongue and masseter muscle mass assessed in a standard brain MRI. Methods: The H70 study is a longitudinal study of older people living in Gothenburg, Sweden. In this cross-sectional analysis, from 1203 participants aged 70years at baseline, we included 495 with clinical data and MRI images available. We used the appendicular lean soft tissue index (ALSTI) in DXA images as our reference measure of lean mass. Images from the masseter and tongue were analysed and segmented using 3D Slicer. For the statistical analysis, the Spearman correlation coefficient was used, and concordance was estimated with the Kappa coefficient. Results: The final sample consisted of 495 participants, of which 52.3% were females. We found a significant correlation coefficient between both tongue (0.26) and masseter (0.33) with ALSTI (P<0.001). The sarcopenia prevalence confirmed using the alternative muscle measure in MRI was calculated using the ALSTI (tongue=2.0%, masseter=2.2%, ALSTI=2.4%). Concordance between sarcopenia with masseter and tongue versus sarcopenia with ALSTI as reference has a Kappa of 0.989 (P<0.001) for masseter and a Kappa of 1 for the tongue muscle (P<0.001). Comorbidities evaluated with the Cumulative Illness Rating Scale were significantly associated with all the muscle measurements: ALSTI (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.07–1.26, P<0.001), masseter (OR 1.16, 95% CI 1.07–1.26, P<0.001) and tongue (OR 1.13, 95% CI 1.04–1.22, P=0.002); the higher the comorbidities, the higher the probability of having abnormal muscle mass. Conclusions: ALSTI was significantly correlated with tongue and masseter muscle mass. When performing the sarcopenia diagnostic algorithm, the prevalence of sarcopenia calculated with head muscles did not differ from sarcopenia calculated using DXA, and almost all participants were correctly classified using both methods.
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31.
  • Bousquet, Jean, et al. (författare)
  • Allergic Rhinitis and its Impact on Asthma (ARIA) Phase 4 (2018) : Change management in allergic rhinitis and asthma multimorbidity using mobile technology
  • 2019
  • Ingår i: Journal of Allergy and Clinical Immunology. - : Elsevier. - 0091-6749 .- 1097-6825. ; 143:3, s. 864-879
  • Tidskriftsartikel (refereegranskat)abstract
    • Allergic Rhinitis and its Impact on Asthma (ARIA) has evolved from a guideline by using the best approach to integrated care pathways using mobile technology in patients with allergic rhinitis (AR) and asthma multimorbidity. The proposed next phase of ARIA is change management, with the aim of providing an active and healthy life to patients with rhinitis and to those with asthma multimorbidity across the lifecycle irrespective of their sex or socioeconomic status to reduce health and social inequities incurred by the disease. ARIA has followed the 8-step model of Kotter to assess and implement the effect of rhinitis on asthma multimorbidity and to propose multimorbid guidelines. A second change management strategy is proposed by ARIA Phase 4 to increase self-medication and shared decision making in rhinitis and asthma multimorbidity. An innovation of ARIA has been the development and validation of information technology evidence-based tools (Mobile Airways Sentinel Network [MASK]) that can inform patient decisions on the basis of a self-care plan proposed by the health care professional.
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32.
  • Börjesson, Mikaela, 1987, et al. (författare)
  • Periodate oxidation of xylan-based hemicelluloses and its effect on their thermal properties
  • 2018
  • Ingår i: Carbohydrate Polymers. - : Elsevier BV. - 0144-8617. ; 202, s. 280-287
  • Tidskriftsartikel (refereegranskat)abstract
    • Hemicellulose from pulp mill process water and crop residuals from food production often end up in waste streams or burnt for energy contribution. These waste products contain valuable biopolymers but lack many attributes needed for use in applications such as food and medical or consumer products. This study reports on an investigation of the periodate oxidation of hardwood xylan and arabinoxylan (AX) from wheat bran to produce materials with new functionalities. The study explores how to control the oxidation degree and describes structural differences between the two xylan-based polymers. For the xylan samples, the oxidation resulted in a lowering of the glass transition temperature (Tg), indicating a more flexible chain due to ring-opening of the xylan anhydro-sugar units. For the AX samples, the arabinose side-groups were instead oxidized, hindering oxidation on part of the xylose units, which resulted in a crosslinked network with an unchanged Tgbut reduced intrinsic viscosity.
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33.
  • Börjesson, Mikaela, 1987, et al. (författare)
  • Thermoplastic and flexible films from arabinoxylan
  • 2019
  • Ingår i: ACS Applied Polymer Materials. - : American Chemical Society (ACS). - 2637-6105. ; 1:6, s. 1443-1450
  • Tidskriftsartikel (refereegranskat)abstract
    • Current interest in replacing fossil-fuel-derivedpolymers and materials in favor of renewable materials is high.An inherent difficulty with the use of biomass-derivedpolysaccharides and hemicelluloses in this context, however,is their stiffness and lack offlowability at temperatures relevantfor thermal processing, which severely limits their capacity forthermal processing. Here, we present a modification thatenables a heat-processable arabinoxylan (AX). The modifica-tion involves a ring-opening oxidation to a dialdehyde withsubsequent reduction of the aldehydes to alcohol, to increasethe number of OH groups, followed by an etherification withhydrophobic alkyl chains. The modified AX was successfullycompression molded with heat intofilmswhich becomethermoplastic in behavior and highlyflexibleandflows at temperatures above 130°C. Thefilms are stretchable up to 200%,and their strength and strain deformation are controlled by the degree of oxidation and substitution of the AX polymer. Thesefindings are highly encouraging and open up the potential use of modified AX alone or as a composite in applications thatincludefilms, food packaging, and barriers via hot-melt processing techniques.
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34.
  • Canal-Garcia, Anna, et al. (författare)
  • Dynamic multilayer functional connectivity detects preclinical and clinical Alzheimer's disease
  • 2024
  • Ingår i: CEREBRAL CORTEX. - 1047-3211 .- 1460-2199.
  • Tidskriftsartikel (refereegranskat)abstract
    • Increasing evidence suggests that patients with Alzheimer's disease present alterations in functional connectivity but previous results have not always been consistent. One of the reasons that may account for this inconsistency is the lack of consideration of temporal dynamics. To address this limitation, here we studied the dynamic modular organization on resting-state functional magnetic resonance imaging across different stages of Alzheimer's disease using a novel multilayer brain network approach. Participants from preclinical and clinical Alzheimer's disease stages were included. Temporal multilayer networks were used to assess time-varying modular organization. Logistic regression models were employed for disease stage discrimination, and partial least squares analyses examined associations between dynamic measures with cognition and pathology. Temporal multilayer functional measures distinguished all groups, particularly preclinical stages, overcoming the discriminatory power of risk factors such as age, sex, and APOE epsilon 4 carriership. Dynamic multilayer functional measures exhibited strong associations with cognition as well as amyloid and tau pathology. Dynamic multilayer functional connectivity shows promise as a functional imaging biomarker for both early- and late-stage Alzheimer's disease diagnosis.
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35.
  • Cedres, Nira, et al. (författare)
  • Association of Cerebrovascular and Alzheimer Disease Biomarkers With Cholinergic White Matter Degeneration in Cognitively Unimpaired Individuals
  • 2022
  • Ingår i: Neurology. - 0028-3878 .- 1526-632X. ; 99:15, s. e1619-e1629
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and Objectives Several pathologic processes might contribute to the degeneration of the cholinergic system in aging. We aimed to determine the contribution of amyloid, tau, and cerebrovascular biomarkers toward the degeneration of cholinergic white matter (WM) projections in cognitively unimpaired individuals.Methods The contribution of amyloid and tau pathology was assessed through CSF levels of the Aβ42/40 ratio and phosphorylated tau (p-tau). CSF Aβ38 levels were also measured. Cerebrovascular pathology was assessed using automatic segmentations of WM lesions (WMLs) on MRI. Cholinergic WM projections (i.e., cingulum and external capsule pathways) were modeled using tractography based on diffusion tensor imaging data. Sex and APOE ε4 carriership were also included in the analysis as variables of interest.Results We included 203 cognitively unimpaired individuals from the H70 Gothenburg Birth Cohort Studies (all individuals aged 70 years, 51% female). WM lesion burden was the most important contributor to the degeneration of both cholinergic pathways (increase in mean square error [IncMSE] = 98.8% in the external capsule pathway and IncMSE = 93.3% in the cingulum pathway). Levels of Aβ38 and p-tau also contributed to cholinergic WM degeneration, especially in the external capsule pathway (IncMSE = 28.4% and IncMSE = 23.4%, respectively). The Aβ42/40 ratio did not contribute notably to the models (IncMSE<3.0%). APOE ε4 carriers showed poorer integrity in the cingulum pathway (IncMSE = 21.33%). Women showed poorer integrity of the external capsule pathway (IncMSE = 21.55%), which was independent of amyloid status as reflected by the nonsignificant differences in integrity when comparing amyloid-positive vs amyloid-negative women participants (T201 = −1.55; p = 0.123).Discussion In cognitively unimpaired older individuals, WMLs play a central role in the degeneration of cholinergic pathways. Our findings highlight the importance of WM lesion burden in the elderly population, which should be considered in the development of prevention programs for neurodegeneration and cognitive impairment.
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36.
  • Cedres, N., et al. (författare)
  • Association of Cerebrovascular and Alzheimer Disease Biomarkers With Cholinergic White Matter Degeneration in Cognitively Unimpaired Individuals
  • 2022
  • Ingår i: Neurology. - : Ovid Technologies (Wolters Kluwer Health). - 0028-3878 .- 1526-632X. ; 99:15
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and Objectives Several pathologic processes might contribute to the degeneration of the cholinergic system in aging. We aimed to determine the contribution of amyloid, tau, and cerebrovascular biomarkers toward the degeneration of cholinergic white matter (WM) projections in cognitively unimpaired individuals. Methods The contribution of amyloid and tau pathology was assessed through CSF levels of the A beta(42/40) ratio and phosphorylated tau (p-tau). CSF A beta(38) levels were also measured. Cerebrovascular pathology was assessed using automatic segmentations of WM lesions (WMLs) on MRI. Cholinergic WM projections (i.e., cingulum and external capsule pathways) were modeled using tractography based on diffusion tensor imaging data. Sex and APOE epsilon 4 carriership were also included in the analysis as variables of interest. Results We included 203 cognitively unimpaired individuals from the H70 Gothenburg Birth Cohort Studies (all individuals aged 70 years, 51% female). WM lesion burden was the most important contributor to the degeneration of both cholinergic pathways (increase in mean square error [IncMSE] = 98.8% in the external capsule pathway and IncMSE = 93.3% in the cingulum pathway). Levels of A beta(38) and p-tau also contributed to cholinergic WM degeneration, especially in the external capsule pathway (IncMSE = 28.4% and IncMSE = 23.4%, respectively). The A beta(42/40) ratio did not contribute notably to the models (IncMSE<3.0%). APOE epsilon 4 carriers showed poorer integrity in the cingulum pathway (IncMSE = 21.33%). Women showed poorer integrity of the external capsule pathway (IncMSE = 21.55%), which was independent of amyloid status as reflected by the nonsignificant differences in integrity when comparing amyloid-positive vs amyloid-negative women participants (T-201 = -1.55; p = 0.123). Discussion In cognitively unimpaired older individuals, WMLs play a central role in the degeneration of cholinergic pathways. Our findings highlight the importance of WM lesion burden in the elderly population, which should be considered in the development of prevention programs for neurodegeneration and cognitive impairment.
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37.
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38.
  • Dartora, Caroline, et al. (författare)
  • A deep learning model for brain age prediction using minimally preprocessed T1w images as input
  • 2023
  • Ingår i: Frontiers in Aging Neuroscience. - : Frontiers Media SA. - 1663-4365. ; 15
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: In the last few years, several models trying to calculate the biological brain age have been proposed based on structural magnetic resonance imaging scans (T1-weighted MRIs, T1w) using multivariate methods and machine learning. We developed and validated a convolutional neural network (CNN)-based biological brain age prediction model that uses one T1w MRI preprocessing step when applying the model to external datasets to simplify implementation and increase accessibility in research settings. Our model only requires rigid image registration to the MNI space, which is an advantage compared to previous methods that require more preprocessing steps, such as feature extraction. Methods: We used a multicohort dataset of cognitively healthy individuals (age range = 32.0–95.7 years) comprising 17,296 MRIs for training and evaluation. We compared our model using hold-out (CNN1) and cross-validation (CNN2–4) approaches. To verify generalisability, we used two external datasets with different populations and MRI scan characteristics to evaluate the model. To demonstrate its usability, we included the external dataset’s images in the cross-validation training (CNN3). To ensure that our model used only the brain signal on the image, we also predicted brain age using skull-stripped images (CNN4). Results: The trained models achieved a mean absolute error of 2.99, 2.67, 2.67, and 3.08 years for CNN1–4, respectively. The model’s performance in the external dataset was in the typical range of mean absolute error (MAE) found in the literature for testing sets. Adding the external dataset to the training set (CNN3), overall, MAE is unaffected, but individual cohort MAE improves (5.63–2.25 years). Salience maps of predictions reveal that periventricular, temporal, and insular regions are the most important for age prediction. Discussion: We provide indicators for using biological (predicted) brain age as a metric for age correction in neuroimaging studies as an alternative to the traditional chronological age. In conclusion, using different approaches, our CNN-based model showed good performance using one T1w brain MRI preprocessing step. The proposed CNN model is made publicly available for the research community to be easily implemented and used to study ageing and age-related disorders.
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39.
  • Deralia, Parveen Kumar, 1985, et al. (författare)
  • Hydrophobization of arabinoxylan with n-butyl glycidyl ether yields stretchable thermoplastic materials
  • 2021
  • Ingår i: International Journal of Biological Macromolecules. - : Elsevier BV. - 0141-8130 .- 1879-0003. ; 188, s. 491-500
  • Tidskriftsartikel (refereegranskat)abstract
    • Hemicelluloses are regarded as one of the first candidates for the development of value-added materials due to their renewability, abundance, and functionality. However, because most hemicelluloses are brittle, they can only be processed as a solution and cannot be processed using industrial melt-based polymer processing techniques. In this study, arabinoxylan (AX) was hydrophobized by incorporating butyl glycidyl ether (BuGE) into the hydroxyl groups through the opening of the BuGE epoxide ring, yielding alkoxy alcohols with terminal ethers. The formed BuGE derivatives were melt processable and can be manufactured into stretchable thermoplastic films through compression molding, which has never been done before with hemicellulose modified in a single step. The structural and thermomechanical properties of the one-step synthesis approach were compared to those of a two-step synthesis with a pre-activation step to demonstrate its robustness. The strain at break for the one-step synthesized AX thermoplastic with 3 mol of BuGE is ≈200%. These findings suggest that thermoplastic polymers can be composited with hemicelluloses or that thermoplastic polymers made entirely of hemicelluloses can be designed as packaging and stretchable electronics supports.
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40.
  • Deralia, Parveen Kumar, 1985, et al. (författare)
  • Oxidation Level and Glycidyl Ether Structure Determine Thermal Processability and Thermomechanical Properties of Arabinoxylan-Derived Thermoplastics
  • 2021
  • Ingår i: ACS Applied Bio Materials. - : American Chemical Society (ACS). - 2576-6422. ; 4:4, s. 3133-3144
  • Tidskriftsartikel (refereegranskat)abstract
    • Developing flexible, stretchable, and thermally processable materials for packaging and stretchable electronic applications from polysaccharide-based polymers contributes to the smooth transition of the fossil-based economy to the circular bioeconomy. We present arabinoxylan (AX)-based thermoplastics obtained by ring-opening oxidation and subsequent reduction (dA-AX) combined with hydrophobization with three different glycidyl ethers [n-butyl (BuGE), isopropyl (iPrGE), and 2-ethyl hexyl (EtHGE) glycidyl ether]. We also investigate the relationship between structural composition, thermal processing, and thermomechanical properties. BuGE- A nd iPrGE-etherified dA-AXs showed glass-transition temperatures (Tg) far below their degradation temperatures and gave thermoplastic materials when compression-molded at 140 °C. The BuGE (3 mol)-etherified dA-AX films at 19 and 31% oxidation levels show 244% (±42) and 267% (±72) elongation, respectively. In contrast, iPrGE-dA-AX samples with shorter and branched terminals in the side chains had a maximum of 60% (±19) elongation. No studies have reported such superior elongation of AX thermoplastic films and its relationship with molar substitution and Tg. These findings have implications on the strategic development of chemical modification routes using commercial polymer processing technologies and on fine-tuning structures and properties when specific polysaccharide-based polymers are used to engineer bio-based products for film, packaging, and substrates for stretchable electronic applications.
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41.
  • Deralia, Parveen Kumar, 1985, et al. (författare)
  • Side chains affect the melt processing and stretchability of arabinoxylan biomass-based thermoplastic films
  • 2022
  • Ingår i: Chemosphere. - : Elsevier BV. - 0045-6535 .- 1879-1298. ; 294
  • Tidskriftsartikel (refereegranskat)abstract
    • Hydrophobization of hemicellulose causes melt processing and makes them stretchable thermoplastics. Understanding how native and/or appended side chains in various hemicelluloses after chemical modification affect melt processing and material properties can help in the development of products for film packaging and substrates for stretchable electronics applications. Herein, we describe a one-step and two-step strategy for the fabrication of flexible and stretchable thermoplastics prepared by compression molding of two structurally different arabinoxylans (AX). For one-step synthesis, the n-butyl glycidyl ether epoxide ring was opened to the hydroxyl group, resulting in the introduction of alkoxide side chains. The first step in the two-step synthesis was periodate oxidation. Because the melt processability for AXs having low arabinose to xylose ratio (araf/xylp<0.5) have been limited, two structurally distinct AXs extracted from wheat bran (AXWB, araf/xylp = 3/4) and barley husk (AXBH, araf/xylp = 1/4) were used to investigate the effect of araf/xylp and hydrophobization on the melt processability and properties of the final material. Melt compression processability was achieved in AXBH derived samples. DSC and DMA confirmed that the thermoplastics derived from AXWB and AXBH had dual and single glass transition (Tg) characteristics, respectively, but the thermoplastics derived from AXBH had lower stretchability (maximum 160%) compared to the AXWB samples (maximum 300%). Higher araf/xylp values, and thus longer alkoxide side chains in AXWB-derived thermoplastics, explain the stretchability differences.
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42.
  • Ekman, Urban, et al. (författare)
  • Evaluation of a Novel Psychological Intervention Tailored for Patients With Early Cognitive Impairment (PIPCI) : Study Protocol of a Randomized Controlled Trial
  • 2020
  • Ingår i: Frontiers in Psychology. - : Frontiers Media SA. - 1664-1078. ; 11
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Individuals with early phase cognitive impairment are frequently affected by existential distress, social avoidance and associated health issues (including symptoms of stress, anxiety, and depression). The demand for efficient psychological support is crucial from both an individual and a societal perspective. We have developed a novel psychological intervention (Psychological Intervention tailored for Patients with Cognitive Impairment, PIPCI) manual for providing a non-medical path to enhanced psychological health in the cognitively impaired population. The current article provides specific information on the randomized controlled trial (RCT)-design and methods. The main hypothesis is that participants receiving PIPCI will increase their psychological flexibility (the ability to notice and accept interfering thoughts, emotions, and bodily sensations without acting on them, when this serves action in line with personal values) compared to participants in the active control (cognitive training) group and the waiting list control group. The secondary hypotheses are that participants receiving PIPCI will improve psychological health (stress measures, quality of life, depression, and general health) compared to participants in the active control group and the waiting list control group.Materials and Methods: This three-arm RCT will recruit participants from the cognitive centers at Karolinska University Hospital in Stockholm and randomize approximately 120 individuals in the early phase of cognitive impairment to either an experimental group (psychological intervention once a week for 10 weeks), an active control group (cognitive training once a week for 10 weeks) or a waiting list control group. Intervention outcome will be evaluated with self-report questionnaires on physical and psychological aspects of health, cognitive assessment, biological markers (obtained from blood and saliva) and health care costs. Assessments will be performed at pre- (1 week before the interventions) and post-intervention (1 week after the interventions), as well as at a 6-month follow-up.Discussion: The development of a potentially feasible and effective psychological intervention tailored for early phase cognitive impairment (PIPCI) has the potential to advance the non-pharmacological intervention field. This is especially important given the extensive burden for many affected individuals and their families and the current lack of effective treatments. If the psychological intervention discussed here shows feasibility and efficacy, there is potential for far-reaching healthcare implications for patients with early cognitive impairment at risk of developing dementia.
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43.
  • Ekman, Urban, et al. (författare)
  • The MemClin project : a prospective multi memory clinics study targeting early stages of cognitive impairment
  • 2020
  • Ingår i: BMC Geriatrics. - : BMC. - 1471-2318. ; 20
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: There remains a lack of large-scale clinical studies of cognitive impairment that aim to increase diagnostic and prognostic accuracy as well as validate previous research findings. The MemClin project will amass large quantities of cross-disciplinary data allowing for the construction of robust models to improve diagnostic accuracy, expand our knowledge on differential diagnostics, strengthen longitudinal prognosis, and harmonise examination protocols across centres. The current article describes the Memory Clinic (MemClin) project's study-design, materials and methods, and patient characteristics. In addition, we present preliminary descriptive data from the ongoing data collection.Methods: Nine out of ten memory clinics in the greater Stockholm area, which largely use the same examination methods, are included. The data collection of patients with different stages of cognitive impairment and dementia is coordinated centrally allowing for efficient and secure large-scale database construction. The MemClin project rest directly on the memory clinics examinations with cognitive measures, health parameters, and biomarkers.Results: Currently, the MemClin project has informed consent from 1543 patients. Herein, we present preliminary data from 835 patients with confirmed cognitive diagnosis and neuropsychological test data available. Of those, 239 had dementia, 487 mild cognitive impairment (MCI), and 104 subjective cognitive impairment (SCI). In addition, we present descriptive data on visual ratings of brain atrophy and cerebrospinal fluid markers.Conclusions: Based on our current progress and preliminary data, the MemClin project has a high potential to provide a large-scale database of 1200-1500 new patients annually. This coordinated data collection will allow for the construction of improved diagnostic and prognostic models for neurodegenerative disorders and other cognitive conditions in their naturalistic setting.
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44.
  • Eliasson, Nina, 1965-, et al. (författare)
  • Naturvetenskaplig begreppsförståelse : Fördjupningsrapport om elevsvar i TIMSS 2019
  • 2020
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • I den här rapporten presenteras en fördjupad analys av svenska elevsvar på fyra olika kunskapsfrågor i naturvetenskap som samlats in inom ramen för TIMSS 2019.Rapporten har skrivits av Nina Eliasson och Anna-Karin Westman, Mittuniversitetet, på uppdrag av Skolverket.Syftet med analysen av elevsvaren är att fördjupa förståelsen för vilka kunskaper hos eleverna, innehållsliga såväl som kognitiva, som döljer sig i dessa svar.
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45.
  • Eliasson, Nina, 1965-, et al. (författare)
  • ”Nu kan vi sätta ord på det vi gör” : att utveckla naturvetenskap och teknik i förskolan
  • 2021
  • Ingår i: Forum för forskningsbaserad NT-undervisning. - : Linköpings universitet. - 9789179297206 ; , s. 99-106
  • Bokkapitel (refereegranskat)abstract
    • I detta bidrag delar vi med oss av våra erfarenheter att genomföra fortbildningskurser i naturvetenskap och teknik för pedagoger i förskolan. Syftet med kurserna är att deltagarna ska förvärva kunskaper inom teknik och naturvetenskap och få möjlighet att stärka tilltron till sin förmåga att planera och leda pedagogisk verksamhet om naturvetenskap och teknik. I den här texten beskriver vi hur kursen har genomförts. För att bedöma hur genomförandet av kursen motsvarar fastställda mål har vi utgått ifrån pedagogernas utvärderingar i anslutning till kursavslut. Från utvärderingar och diskussioner med deltagarna kan vi se flera exempel på olika framgångsfaktorer i samband med fortbildning som exempelvis en glädje över att upptäcka naturvetenskapen i det man redan gör på förskolan. Deltagarna beskriver också hur de upplever att de sänkt kraven på sig själva om att alltid kunna leverera de korrekta svaren på barnens frågor. Istället vågar de oftare ställa produktiva frågor och utforska vidare tillsammans med barnen. 
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46.
  •  
47.
  • Gyllenhammar, Måns, et al. (författare)
  • The Association Between Temporal Atrophy and Episodic Memory Is Moderated by Education in a Multi-Center Memory Clinic Sample
  • 2023
  • Ingår i: Journal of Alzheimer's Disease. - 1387-2877 .- 1875-8908. ; 92:2, s. 605-614
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Cognitive reserve (CR) is hypothesized to partially explain the discrepancy between Alzheimer’s disease related brain pathology and cognitive performance. Educational attainment is often used as a proxy for CR.Objective: To examine the association of years of education and the relationship between atrophy in the medial temporal lobe and episodic memory, in a cross-sectional ecological multi-center memory clinic cohort.Methods: Included patients (n = 702) had undergone memory clinic examination and were diagnosed with subjective cognitive impairment (n = 99), mild cognitive impairment (n = 471), or dementia (n = 132). Total years of education were used as a moderating variable and neuropathology was operationalized as visual ratings of medial temporal lobe atrophy (MTA) on magnetic resonance imaging and computer tomography images. Weighted least squares regression and multiple regression were used to analyze moderation and the effect of education separately by diagnostic group. A composite score of two episodic memory tests constituted the dependent variable.Results: After controlling for age and gender the interaction term between MTA and years of education was significant indicating moderation. In particular, the regression model showed that at low levels of MTA, high education individuals had better episodic memory performance. However, at higher MTA levels, high education individuals had the lowest episodic memory performance. Education had a significant positive effect on episodic memory in SCI and MCI, but not dementia.Conclusion: These results extend the findings of education moderating the effect of MTA on cognition to a naturalistic memory clinic setting. Implications of the findings for theories on CR are discussed.
  •  
48.
  • Hermansson, Leif, et al. (författare)
  • Method for the manufacture of an object of a powdered material by isostatic pressing
  • 1988
  • Patent (populärvet., debatt m.m.)abstract
    • In the manufacture of an object of a powdered material by isostatic pressing of a body (10) preformed from the powdered material with a gaseous pressure medium, the preformed body is provided with a casing (13) of glass which is made gas-impenetrable by heating before carrying out the isostatic...
  •  
49.
  •  
50.
  • Holst, Anna, et al. (författare)
  • Cost-effectiveness of a care manager collaborative care programme for patients with depression in primary care : economic evaluation of a pragmatic randomised controlled study
  • 2018
  • Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 8:11
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To evaluate the cost-effectiveness of a care manager (CM) programme compared with care as usual (CAU) for treatment of depression at primary care centres (PCCs) from a healthcare as well as societal perspective.Design: Cost-effectiveness analysis.Setting: 23 PCCs in two Swedish regions.Participants: Patients with depression (n=342).Main outcome measures: A cost-effectiveness analysis was applied on a cluster randomised trial at PCC level where patients with depression had 3 months of contact with a CM (11 intervention PCCs, n=163) or CAU (12 control PCCs, n=179), with follow-up 3 and 6 months. Effectiveness measures were based on the number of depression-free days (DFDs) calculated from the Montgomery-angstrom sberg Depression Rating Scale-Self and quality-adjusted life years (QALYs).Results were expressed as the incremental cost-effectiveness ratio: Cost/QALY and Cost/DFD. Sampling uncertainty was assessed based on non-parametric bootstrapping.Results: Health benefits were higher in intervention group compared with CAU group: QALYs (0.357 vs 0.333, p<0.001) and DFD reduction of depressive symptom score (79.43 vs 60.14, p<0.001). The mean costs per patient for the 6-month period were Euro368 (healthcare perspective) and Euro6217 (societal perspective) for the intervention patients and Euro246 (healthcare perspective) and Euro7371 (societal perspective) for the control patients (n.s.). The cost per QALY gained was Euro6773 (healthcare perspective) and from a societal perspective the CM programme was dominant.Discussion: The CM programme was associated with a gain in QALYs as well as in DFD, while also being cost saving compared with CAU from a societal perspective. This result is of high relevance for decision-makers on a national level, but it must be observed that a CM programme for depression implies increased costs at the primary care level.
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