| 1. |
- Avelin, Pernilla
(författare)
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Stillbirth : a loss for the whole family
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Stillbirth loss is a profound experience affecting around 450 families every year in Sweden. Method: Two questionnaires, one postal with three measurements over a two-year period with 55 parents (I), and a web questionnaire answered by 411 parents (III), five focus groups with a total of 25 parents (II), and individual face-to-face interviews with 13 bereaved adolescent siblings of a stillborn baby (IV) constitute the data collection. The qualitative data were analysed with a content analysis, descriptive statistics were used for the quantitative data. The overall aim of the thesis was to study the loss of a stillborn baby from the perspective of parents and siblings. Results: The parents strived to create an environment in which siblings are confidently allowed and invited to participate in processes surrounding the stillbirth. They promoted an understanding of the new and unexpected family situation. Some parents expressed difficulty in focusing on the needs of siblings during the acute grief after the loss. Most of the siblings met their stillborn sister or brother. The meeting was described as natural, enriching and self-evident and as an important component to create understanding; it attributed identity and personality to the stillborn baby. When the siblings created memories the baby was acknowledged and took on a tangible form. Furthermore, parents and siblings expressed feelings of broken expectations of becoming a larger family. Additionally, being a sister or brother of a stillborn baby brought up thoughts about the sibling relationship, and whether they could still identify themselves as big sisters or brothers. Many parents reported the loss had strengthened their relationship. Some parents and adolescent siblings expressed that they were grieving alone as well as together with other members of the family. They developed an inner strength and a trust in each other. For others, expectations of their own and other family members ́ way of grieving could pose a threat to their close relationship; a lack of understanding for each other ́s way to express grief or their needs could create an emotional distance. Some adolescents expressed feelings of being part of a common grief in the family, but simultaneously being outside. The loss of their baby sibling implied a temporary loss of their parents ́ parenthood. Conclusions: This thesis gives new information on the thoughts and feelings in a family after they have experienced a stillbirth. Clinically the information can be used to help health-care professionals communicate with parents and siblings after this event. For parents seeking advice, it may help to know that the parents in this study, who actively involved the stillborn baby ́s siblings in the meeting and farewell afterwards, by and large reported encouraging experiences only.
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| 2. |
- Capilla, R., et al.
(författare)
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The new era of software reuse
- 2019
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Ingår i: Journal of Software. - : John Wiley and Sons Ltd. - 2047-7473 .- 2047-7481. ; 31:8
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 3. |
- Capilla, R., et al.
(författare)
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The Promise and Challenge of Runtime Variability
- 2011
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Ingår i: Computer. - 0018-9162 .- 1558-0814. ; 44:12, s. 93-95
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Runtime variability offers a good choice for many systems that experience dynamic changes in their quality and context.
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| 7. |
- de Brun, Maryam, 1991-
(författare)
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Hyperglycaemia during pregnancy : The challenge of screening and deciding diagnostic criteria for gestational diabetes in Sweden
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Hyperglycaemia during pregnancy is one of the most common complicationsof pregnancy. In 2013, the World Health Organisation recommended diagnostic criteria (WHO-2013) for gestational diabetes mellitus (GDM), whichremains controversial due to an expected increase in prevalence, and the uncertainty as to the clinical relevance of treating these additional women or its cost-effectiveness.Paper I involves a cross-sectional study of 4 918 pregnant women using riskfactor screening, which was poorly predictive of the WHO-2013 criteria, with an area under the curve of 40% (95% CI 24–32). In Paper II, a systematic review and meta-analysis of the prevalence of GDM according to the WHO2013 criteria in 136 705 women showed a 75% (RR 1.75, 95% CI 1.53-2.01) increased prevalence compared to the other GDM criteria. In Papers III-IV, a national stepped wedge cluster randomised controlled trial of 26 160 pregnancies before and 28 509 after the implementation of the WHO-2013 criteria across eight clusters during 2018 led to a 2.90 fold increase in GDM prevalence. No significant decrease was seen in the primary outcome, large for gestational age (LGA). There were, however, health benefits in secondary outcomes for the mother and neonate. There was a significant decrease in LGA dependent on the definition used, including the clinically used in Sweden (>2SD) with adjusted OR of 0.89 (95% CI 0.82-0.97). In Paper IV, the WHO2013 criteria led to increased resource use and incremental costs (€341.1 (195.9)) per pregnancy. The cost-effectiveness needs to be related to health benefits for the mother and/or neonate.In conclusion, the current screening methods for GDM are in need of revision considering their poor predictive characteristics in finding GDM according to the WHO-2013 criteria. Implementing the WHO-2013 criteria in Sweden resulted in higher GDM prevalence with short-term increased resource use with uncertainty in costs savings and considerable healthcare benefits for the mother and neonate. This thesis provides evidence regarding the consequences of implementing the WHO-2013 criteria compared to former Swedish GDM criteria and may assist future decision-making.
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| 10. |
- Grönroos, Gösta, 1968-
(författare)
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Plato on perceptual cognition
- 2001
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of the study is to spell out and consider Plato' s views on perceptual cognition. It is argued that Plato is cornrnitted to the view that perceptual cognition can be rational, and that beliefs about the sensible world need not be confused or ill-founded. Plato' s interest in the matter arises from worries over the way in which his forerunners and contemporaries conceived of perceptual cognition. They conceived of cognitive processes in terms of corporeal changes and attempted to explain perceptual cognition in causal terms. The problem with such accounts, according to Plato, is that they make perceptual cognition an entirely passive process, and seem incapable of accommodating the freedom of reason. Plato's main target is Protagoras' view on cognition and he accuses him of conflating different cognitive phenomena that ought to be kept apart. More particularly, he suggests that Protagoras' 'man the measure' thesis is based on the conflation of sen se perception (aisthesis), belief (doxa) and appearing (phantasia), and that Protagoras is cornmitted to the view that beliefs are arrived at in a non-rational way. It is shown how Plato takes issue with Protagoras by disentangling these three cognitive phenomena. It is argued that Plato' s way of understanding these notions leaves room for the possibility that reason plays apart in perceptual cognition and that we arrive at beliefs in a rational way. In the course of spelling out the argument, Plato' s views on a number of topics are scrutinised: the perceptual mechanism; the objects of sense perception; perceptual content; the nature of belief; the eon trast between belief and appearing; the nation of reason.
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| 11. |
- Lundblad, Linda, et al.
(författare)
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Sympathetic Nerve Activity in Monozygotic Twins Identical at Rest but Not During Arousal
- 2017
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Ingår i: Hypertension. - : Ovid Technologies (Wolters Kluwer Health). - 0194-911X .- 1524-4563. ; 69:5, s. 964-969
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Tidskriftsartikel (refereegranskat)abstract
- Microneurographic recordings of human muscle sympathetic nerve activity responses to sudden sensory stimuli (ie, arousal) have revealed 2 intraindividually reproducible response profiles in healthy young males that predict different neural and blood pressure responses to more sustained stress. Approximately 50% of subjects inhibit muscle sympathetic nerve activity during arousal, whereas the remaining 50% do not, and the latter group displays a markedly greater blood pressure increase in response to arousal, as well as during and after 3 minutes of mental arithmetic. Studying a group of monozygotic twins (10 pairs, 2 excluded from analysis), the aim of the present study was to evaluate the degree of genetic determination of these sympathetic response profiles. Muscle sympathetic burst incidence at rest was similar in twins, with a within-pair burst incidence ratio of 0.87 +/- 0.02 (SEM) compared with 0.73 +/- 0.07 found in unrelated pairs (P= 0.002), confirming a previous study from our laboratory. In contrast, the sympathetic responses to arousal showed large twin within-pair variance (arousal inhibition ratio 0.56 +/- 0.11), which did not significantly differ (P= 0.939) from the variance in pairs of unrelated subjects (0.46 +/- 0.11). The finding that human muscle sympathetic nerve responses to arousal are less determined by genotype than the resting level of corresponding sympathetic nerve activity suggests that the arousal response pattern is more prone to be altered by environmental factors. This raises the possibility that these intraindividually reproducible sympathetic neural response profiles can be modified in a positive direction from a cardiovascular risk perspective.
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| 12. |
- Lundblad, Linda, et al.
(författare)
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Tactile direction discrimination in humans after stroke
- 2020
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Ingår i: Brain Communications. - : Oxford University Press (OUP). - 2632-1297. ; 2:2
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Tidskriftsartikel (refereegranskat)abstract
- Sensing movements across the skin surface is a complex task for the tactile sensory system, relying on sophisticated cortical processing. Functional MRI has shown that judgements of the direction of tactile stimuli moving across the skin are processed in distributed cortical areas in healthy humans. To further study which brain areas are important for tactile direction discrimination, we performed a lesion study, examining a group of patients with first-time stroke. We measured tactile direction discrimination in 44 patients, bilaterally on the dorsum of the hands and feet, within 2 weeks (acute), and again in 28 patients 3 months after stroke. The 3-month follow-up also included a structural MRI scan for lesion delineation. Fifty-nine healthy participants were examined for normative direction discrimination values. We found abnormal tactile direction discrimination in 29/44 patients in the acute phase, and in 21/28 3 months after stroke. Lesions that included the opercular parietal area 1 of the secondary somatosensory cortex, the dorsolateral prefrontal cortex or the insular cortex were always associated with abnormal tactile direction discrimination, consistent with previous functional MRI results. Abnormal tactile direction discrimination was also present with lesions including white matter and subcortical regions. We have thus delineated cortical, subcortical and white matter areas important for tactile direction discrimination function. The findings also suggest that tactile dysfunction is common following stroke.
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| 13. |
- Lundblad, Lennart, et al.
(författare)
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Thoracic gas volume measurements in paralyzed mice
- 2004
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Ingår i: Annals of Biomedical Engineering. - 1573-9686. ; 32:10, s. 1420-1427
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Tidskriftsartikel (refereegranskat)abstract
- We have previously measured thoracic gas volume (V-TG) in spontaneously breathing mice using a whole body plethysmograph and have now extended our technique to allow for V-TG measurements during paralysis. BALB/c mice were anesthetized and placed in a body-box and ventilated via a tracheostomy cannula through the box wall. Box pressure (P-b) and tracheal pressure (P-ao) were measured during spontaneous breathing, and again after paralysis while mechanically compressing the chest. V-TG was much larger after paralysis (0.49+/-0.06 ml, positive end-expiratory pressure=2 cmH(2)O) when compared with spontaneous breathing (0.31+/-0.01 ml). External chest compression produced looping in the plots of P-b versus P-ao that was attributable to gradual changes in P-b upon release of the mechanical chest compression and had the character of thermal transients. Under the assumption that the rate of heating of the air in the chamber was proportional to the pressure applied to the animal's chest, and that any increase in air temperature was dissipated by heat absorption by the chamber walls, we developed an algorithm that corrected for the thermal events. This yielded similar results for V-TG (0.30+/-0.02 ml) as obtained during spontaneous efforts. Our method may prove particularly useful when paralysis is required for the precise measurement of lung mechanics.
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| 14. |
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| 15. |
- Xiong, Ning
(författare)
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A new case-based reasoning method based on dissimilar relations
- 2014
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Ingår i: WSEAS Transactions on Systems. - 1109-2777. ; 13, s. 263-271
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Tidskriftsartikel (refereegranskat)abstract
- Learning relations of objects has recently emerged as a new promising trend for supervised machine learning. Case-based reasoning (CBR) is a subfield of machine learning, which attempts to solve new problems by reusing previous experiences. There is a close link between learning of relations and case-based reasoning in the sense that relation analysis between cases is a core task in a CBR procedure. Traditional CBR systems built upon similar relations can only use local information, and they are restricted by the similarity requirement, i.e., the availability of similar cases to new problems. This paper proposes a new CBR approach that exploits the information about dissimilar relations for solving new problems. A fuzzy dissimilarity model consisting of fuzzy rules has been developed for assessing dissimilarity between cases. Identifying dissimilar cases enables global utilization of more information from the case library and thereby contributes to the avoidance of the similarity constraint with a conventional CBR method. Empirical studies have demonstrated that fuzzy dissimilarity models can be built upon a small case library while still yielding competent performance of the CBR system.
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| 16. |
- Xiong, Ning, et al.
(författare)
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A novel framework for case-based decision analysis
- 2008
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Ingår i: TENTH SCANDINAVIAN CONFERENCE ON ARTIFICIAL INTELLIGENCE. ; , s. 141-148
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Konferensbidrag (refereegranskat)abstract
- Case-based reasoning (CBR) and decision analysis have been two separate research areas aiming to solve problems from different perspectives. CBR is powerful to offer solutions to problems by reusing previous experiences, while decision theory exhibits its strength in dealing with uncertain, nondeterministic situations subject to likelihoods, risks, and probable consequences. In this paper, we present a novel framework of integrating CBR and decision analysis for the purpose of case-based decision analysis. CBR is employed as a methodology to reason from previous cases for building a decision model given the current situation, while decision theory is applied to the decision model learnt from previous cases to identify the most promising, Secured, and rational choices. In such a way, we take advantage of both the ability of CBR to learn without domain knowledge and the strength of decision theory to analyze under uncertainty.
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| 17. |
- Xiong, Ning, et al.
(författare)
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A Walk into Metaheuristics for Engineering Optimization : Principles, Methods and Recent Trends
- 2015
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Ingår i: INTERNATIONAL JOURNAL OF COMPUTATIONAL INTELLIGENCE SYSTEMS. - : Springer Science and Business Media LLC. - 1875-6891 .- 1875-6883. ; 8:4, s. 606-636
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Tidskriftsartikel (refereegranskat)abstract
- Metaheuristics has attained increasing interest for solving complex real-world problems. This paper studies the principles and the state-of-the-art of metaheuristic methods for engineering optimization. Both the classic and emerging approaches to optimization using metaheuristics are reviewed and analyzed. All the methods are discussed in three basic types: trajectory-based, in which in each step a new solution is created from the previous one; multi-trajectory-based, in which a multi-start mechanism is used; and population-based, where multiple new solutions are created considering a population of approximate solutions. We further discuss algorithms and strategies to handle multi-modal and multi-objective optimization tasks as well as methods for parallel implementation of metaheuristic algorithms. Then, different software frameworks for metaheuristics are introduced. Finally, several interesting directions are pointed out as future research trends.
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| 18. |
- Xiong, Ning, et al.
(författare)
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CBR supports decision analysis with uncertainty
- 2009
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Ingår i: CASE-BASED REASONING RESEARCH AND DEVELOPMENT, PROCEEDINGS. - Berlin, Heidelberg : Springer. - 9783642029974 ; , s. 358-373
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Bokkapitel (refereegranskat)abstract
- This paper proposes a novel approach to case-based decision analysis supported by case-based reasoning (CBR). The strength of CBR is utilized for building a situation dependent decision model without complete domain knowledge. This is achieved by deriving states probabilities and general utility estimates from the case library and the subset of cases retrieved in a situation described in query. In particular, the derivation of state probabilities is realized through an information fusion process which comprises evidence (case) combination using the Dempster-Shafer theory and Bayesian probabilistic reasoning. Subsequently decision theory is applied to the decision model learnt from previous cases to identify the most promising, secured, and rational choices. In such a way we take advantage of both the strength of CBR to learn without domain knowledge and the ability of decision theory to analyze under uncertainty. We have also studied the issue of imprecise representations of utility in individual cases and explained how fuzzy decision analysis can be conducted when case specific utilities are assigned with fuzzy data.
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| 19. |
- Zhao, Sen, et al.
(författare)
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Expanding the mutation and phenotype spectrum of MYH3-associated skeletal disorders
- 2022
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Ingår i: NPJ genomic medicine. - : Nature Publishing Group. - 2056-7944. ; 7:1
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Tidskriftsartikel (refereegranskat)abstract
- Pathogenic variants in MYH3 cause distal arthrogryposis type 2A and type 2B3 as well as contractures, pterygia and spondylocarpotarsal fusion syndromes types 1A and 1B. These disorders are ultra-rare and their natural course and phenotypic variability are not well described. In this study, we summarize the clinical features and genetic findings of 17 patients from 10 unrelated families with vertebral malformations caused by dominant or recessive pathogenic variants in MYH3. Twelve novel pathogenic variants in MYH3 (NM_002470.4) were identified: three of them were de novo or inherited in autosomal dominant way and nine were inherited in autosomal recessive way. The patients had vertebral segmentation anomalies accompanied with variable joint contractures, short stature and dysmorphic facial features. There was a significant phenotypic overlap between dominant and recessive MYH3-associated conditions regarding the degree of short stature as well as the number of vertebral fusions. All monoallelic variants caused significantly decreased SMAD3 phosphorylation, which is consistent with the previously proposed pathogenic mechanism of impaired canonical TGF-β signaling. Most of the biallelic variants were predicted to be protein-truncating, while one missense variant c.4244T>G,p.(Leu1415Arg), which was inherited in an autosomal recessive way, was found to alter the phosphorylation level of p38, suggesting an inhibition of the non-canonical pathway of TGF-β signaling. In conclusion, the identification of 12 novel pathogenic variants and overlapping phenotypes in 17 affected individuals from 10 unrelated families expands the mutation and phenotype spectrum of MYH3-associated skeletal disorders. We show that disturbances of canonical or non-canonical TGF-β signaling pathways are involved in pathogenesis of MYH3-associated skeletal fusion (MASF) syndrome.
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