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1.
  • Aeddula, Omsri, 1993- (author)
  • Navigating Data Challenges: AI-Driven Decision Support for Product-Service System Development
  • 2024
  • Doctoral thesis (other academic/artistic)abstract
    • Solution providers are transitioning from product-centric models to service-oriented solutions. This shift has led to the rise of Product-Service Systems (PSS), which offer a holistic approach by integrating physical products with associated services. However, the inherent complexity and collaborative nature of PSS development present a significant challenge: information gathering, analysis, and knowledge building. This is further amplified in the early stages of PSS development due to data challenges such as uncertainty, ambiguity, and complexity. This complicates informed decision-making, potentially leading to the risk of sub-optimal outcomes and impacting the success of final offerings.This research proposes an AI-powered data analysis approach to address these data challenges and augment the decision-making process of PSS development. The focus is on supporting early-stage decision-making, as decisions made at this stage greatly impact the success of final solutions. The research investigates how data can be utilized and visualized to extract actionable insights, ultimately facilitating informed decision-making.The presented research demonstrates that AI-powered data analysis effectively supports informed decision-making in early-stage PSS development. By extracting actionable insights from complex data, handling data limitations, and enabling informed strategic decisions, knowledge sharing, and collaboration are facilitated among stakeholders. Furthermore, integrating AI with visualization tools fosters knowledge building and a deeper understanding of system behavior, ultimately leading to more successful PSS solutions. The efficacy of AI-powered data analysis for handling diverse data types across application domains is demonstrated, potentially leading to benefits such as a deeper understanding of system behavior and proactive solution strategies. These advancements contribute to developing decision support systems specifically for PSS development.Overall, this research demonstrates the efficacy of AI-powered data analysis in overcoming data challenges and empowering decision-makers in early-stage PSS development. This translates to more informed choices, leading to the creation of successful and efficient PSS solutions.
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2.
  • Flyborg, Johan, et al. (author)
  • Results of objective brushing data recorded from a powered toothbrush used by elderly individuals with mild cognitive impairment related to values for oral health
  • 2024
  • In: Clinical Oral Investigations. - : Springer Nature. - 1432-6981 .- 1436-3771. ; 28:1
  • Journal article (peer-reviewed)abstract
    • Objectives: The study aimed to investigate how the objective use of a powered toothbrush in frequency and duration affects plaque index, bleeding on probing, and periodontal pocket depth ≥ 4 mm in elderly individuals with MCI. A second aim was to compare the objective results with the participants’ self-estimated brush use.Materials and methods: Objective brush usage data was extracted from the participants’ powered toothbrushes and related to the oral health variables plaque index, bleeding on probing, and periodontal pocket depth ≥ 4 mm. Furthermore, the objective usage data was compared with the participants’ self-reported brush usage reported in a questionnaire at baseline and 6- and 12-month examination.Results: Out of a screened sample of 213 individuals, 170 fulfilled the 12-month visit. The principal findings are that despite the objective values registered for frequency and duration being lower than the recommended and less than the instructed, using powered toothbrushes after instruction and information led to improved values for PI, BOP, and PPD ≥ 4 mm in the group of elderly with MIC.Conclusions: Despite lower brush frequency and duration than the generally recommended, using a powered toothbrush improved oral health. The objective brush data recorded from the powered toothbrush correlates poorly with the self-estimated brush use.Clinical relevance: Using objective brush data can become one of the factors in the collaboration to preserve and improve oral health in older people with mild cognitive impairment. Trial registration: ClinicalTrials.gov Identifier: NCT05941611, retrospectively registered 11/07/2023. 
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3.
  • Abbadi, Ahmad, et al. (author)
  • Validation of the Health Assessment Tool (HAT) based on four aging cohorts from the Swedish National study on Aging and Care
  • 2024
  • In: BMC Medicine. - : BioMed Central (BMC). - 1741-7015. ; 22:1
  • Journal article (peer-reviewed)abstract
    • Background: As global aging accelerates, routinely assessing the functional status and morbidity burden of older patients becomes paramount. The aim of this study is to assess the validity of the comprehensive clinical and functional Health Assessment Tool (HAT) based on four cohorts of older adults (60 + years) from the Swedish National study on Aging and Care (SNAC) spanning urban, suburban, and rural areas.Methods: The HAT integrates five health indicators (gait speed, global cognition, number of chronic diseases, and basic and instrumental activities of daily living), providing an individual-level score between 0 and 10. The tool was constructed using nominal response models, first separately for each cohort and then in a harmonized dataset. Outcomes included all-cause mortality over a maximum follow-up of 16 years and unplanned hospital admissions over a maximum of 3 years of follow-up. The predictive capacity was assessed through the area under the curve (AUC) using logistic regressions. For time to death, Cox regressions were performed, and Harrell’s C-indices were reported. Results from the four cohorts were pooled using individual participant data meta-analysis and compared with those from the harmonized dataset.Results: The HAT demonstrated high predictive capacity across all cohorts as well as in the harmonized dataset. In the harmonized dataset, the AUC was 0.84 (95% CI 0.81–0.87) for 1-year mortality, 0.81 (95% CI 0.80–0.83) for 3-year mortality, 0.80 (95% CI 0.79–0.82) for 5-year mortality, 0.69 (95% CI 0.67–0.70) for 1-year unplanned admissions, and 0.69 (95% CI 0.68–0.70) for 3-year unplanned admissions. The Harrell’s C for time-to-death throughout 16 years of follow-up was 0.75 (95% CI 0.74–0.75).Conclusions: The HAT is a highly predictive, clinically intuitive, and externally valid instrument with potential for better addressing older adults’ health needs and optimizing risk stratification at the population level. © The Author(s) 2024.
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4.
  • Ferguson, Murdo, et al. (author)
  • Lot-to-lot immunogenicity consistency of the respiratory syncytial virus prefusion F protein vaccine in older adults
  • 2024
  • In: Vaccine: X. - 2590-1362. ; 18
  • Journal article (peer-reviewed)abstract
    • Background: Previous phase 3 studies showed that the AS01E-adjuvanted respiratory syncytial virus (RSV) prefusion F protein-based vaccine for older adults (RSVPreF3 OA) is well tolerated and efficacious in preventing RSV-associated lower respiratory tract disease in adults ≥ 60 years of age. This study evaluated lot-to-lot immunogenicity consistency, reactogenicity, and safety of three RSVPreF3 OA lots. Methods: This phase 3, multicenter, double-blind study randomized (1:1:1) participants ≥ 60 years of age to receive one of three RSVPreF3 OA lots. Serum RSVPreF3-binding immunoglobulin G (IgG) concentration was assessed at baseline and 30 days post-vaccination. Lot-to-lot consistency was demonstrated if the two-sided 95 % confidence intervals (CIs) of the RSVPreF3-binding IgG geometric mean concentration (GMC) ratios between each lot pair at 30 days post-vaccination were within 0.67 and 1.50. Solicited adverse events (AEs) within four days, unsolicited AEs within 30 days, and serious AEs (SAEs) and potential immune-mediated diseases within six months post-vaccination were recorded. Results: A total of 757 participants received RSVPreF3 OA, of whom 708 were included in the per-protocol set (234, 237, and 237 participants for each lot). Lot-to-lot consistency was demonstrated: GMC ratios were 1.06 (95 % CI: 0.94–1.21), 0.92 (0.81–1.04), and 0.87 (0.77–0.99) between the lot pairs (lot 1/2; 1/3; 2/3). For the three lots, the RSVPreF3-binding IgG concentration increased 11.84-, 11.29-, and 12.46-fold post-vaccination compared to baseline. The reporting rates of solicited and unsolicited AEs, SAEs, and potential immune-mediated diseases were balanced between lots. Twenty-one participants reported SAEs; one of these–a case of atrial fibrillation–was considered by the investigator as vaccine-related. SAEs with a fatal outcome were reported for four participants, none of which were considered by the investigator as vaccine-related. Conclusion: This study demonstrated lot-to-lot immunogenicity consistency of three RSVPreF3 OA vaccine lots and indicated that the vaccine had an acceptable safety profile. ClinicalTrials.gov: NCT05059301.
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5.
  • Ferguson, Murdo, et al. (author)
  • Lot-to-lot immunogenicity consistency of the respiratory syncytial virus prefusion F protein vaccine in older adults
  • 2024
  • In: Vaccine: X. - : Elsevier. - 2590-1362. ; 18
  • Journal article (peer-reviewed)abstract
    • Background: Previous phase 3 studies showed that the AS01E-adjuvanted respiratory syncytial virus (RSV) prefusion F protein-based vaccine for older adults (RSVPreF3 OA) is well tolerated and efficacious in preventing RSV-associated lower respiratory tract disease in adults ≥ 60 years of age. This study evaluated lot-to-lot immunogenicity consistency, reactogenicity, and safety of three RSVPreF3 OA lots. Methods: This phase 3, multicenter, double-blind study randomized (1:1:1) participants ≥ 60 years of age to receive one of three RSVPreF3 OA lots. Serum RSVPreF3-binding immunoglobulin G (IgG) concentration was assessed at baseline and 30 days post-vaccination. Lot-to-lot consistency was demonstrated if the two-sided 95 % confidence intervals (CIs) of the RSVPreF3-binding IgG geometric mean concentration (GMC) ratios between each lot pair at 30 days post-vaccination were within 0.67 and 1.50. Solicited adverse events (AEs) within four days, unsolicited AEs within 30 days, and serious AEs (SAEs) and potential immune-mediated diseases within six months post-vaccination were recorded. Results: A total of 757 participants received RSVPreF3 OA, of whom 708 were included in the per-protocol set (234, 237, and 237 participants for each lot). Lot-to-lot consistency was demonstrated: GMC ratios were 1.06 (95 % CI: 0.94–1.21), 0.92 (0.81–1.04), and 0.87 (0.77–0.99) between the lot pairs (lot 1/2; 1/3; 2/3). For the three lots, the RSVPreF3-binding IgG concentration increased 11.84-, 11.29-, and 12.46-fold post-vaccination compared to baseline. The reporting rates of solicited and unsolicited AEs, SAEs, and potential immune-mediated diseases were balanced between lots. Twenty-one participants reported SAEs; one of these–a case of atrial fibrillation–was considered by the investigator as vaccine-related. SAEs with a fatal outcome were reported for four participants, none of which were considered by the investigator as vaccine-related. Conclusion: This study demonstrated lot-to-lot immunogenicity consistency of three RSVPreF3 OA vaccine lots and indicated that the vaccine had an acceptable safety profile. ClinicalTrials.gov: NCT05059301. © 2024 GSK
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6.
  • Henricsson, Sara, et al. (author)
  • Self-perceived oral health and orofacial appearance in older adults - an 18-year follow-up study in Karlskrona, Sweden
  • 2024
  • In: Acta Odontologica Scandinavica. - : MJS publishing. - 0001-6357 .- 1502-3850. ; 83, s. 255-263
  • Journal article (peer-reviewed)abstract
    • OBJECTIVES: To analyze whether self-perceived oral health and orofacial appearance change with increasing age. METHODS: This longitudinal study is based on data from a questionnaire used in the Swedish National Study of Aging and Care. The sample comprises 160 participants 60 years of age at baseline 2001-2003. The same participants were re-examined at 66-, 72-, and 78 years of age. To analyze whether perceptions of oral health and orofacial appearance changed with increasing age, Cochran's Q test was conducted. Statistical significance was considered at p  ≤  0.05, and the calculated value Q must be equal to or greater than the critical chi-square value (Q ≥ 7.82). Significance values have been adjusted for the Bonferroni correction for multiple tests. RESULTS: Self-perceived mouth dryness, both day (Q = 7.94) and night (Q = 23.41), increased over the 18-year follow-up. When divided by gender, significant differences were only seen for mouth dryness at nighttime. A decrease in sensitive teeth was perceived with increasing age, and an increase in self-perceived satisfaction with dental appearance, and a decrease in self-perceived problems with dental gaps between the ages of 60 and 78. These changes were, however, not statistically significant. Men experienced a higher proportion of discomfort with discolored teeth at age 78 than at 60 (Q = 9.09). CONCLUSIONS: Self-perceived oral health and orofacial appearance were relatively stable, with few changes over an 18-year follow-up.
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7.
  • Idrisoglu, Alper (author)
  • Voice for Decision Support in Healthcare Applied to Chronic Obstructive Pulmonary Disease Classification : A Machine Learning Approach
  • 2024
  • Licentiate thesis (other academic/artistic)abstract
    • Background: Advancements in machine learning (ML) techniques and voice technology offer the potential to harness voice as a new tool for developing decision-support tools in healthcare for the benefit of both healthcare providers and patients. Motivated by technological breakthroughs and the increasing integration of Artificial Intelligence (AI) and Machine Learning (ML) in healthcare, numerous studies aim to investigate the diagnostic potential of ML algorithms in the context of voice-affecting disorders. This thesis focuses on respiratory diseases such as Chronic Obstructive Pulmonary Disease (COPD) and explores the potential of a decision support tool that utilizes voice and ML. This exploration exemplifies the intricate relationship between voice and overall health through the lens of applied health technology (AHT. This interdisciplinary nature of research recognizes the need for accurate and efficient diagnostic tools.Objective: The objectives of this licentiate thesis are twofold. Firstly, a Systematic Literature Review (SLR) thoroughly investigates the current state of ML algorithms in detecting voice-affecting disorders, pinpointing existing gaps and suggesting directions for future research. Secondly, the study focuses on respiratory health, specifically COPD, employing ML techniques with a distinct emphasis on the vowel "A". The aim is to explore hidden information that could potentially be utilized for the binary classification of COPD vs no COPD. The creation of a new Swedish COPD voice classification dataset is anticipated to enhance the experimental and exploratory dimensions of the research.Methods: In order to have a holistic view of a research field, one of the commonly utilized methods is to scan and analyze the literature. Therefore, Paper I followed the methodology of an SLR where existing journal publications were scanned and synthesized to create a holistic view in the realm of ML techniques employed to experiment on voice-affecting disorders. Based on the results from the SLR, Paper II focused on the data collection and experimentation for the binary classification of COPD, which was one of the gaps identified in the first study. Three distinct ML algorithms were investigated on the collected datasets through voice features, which consisted of recordings collected through a mobile application from participants 18 years old and above, and the most utilized performance measures were computed for the best outcome. Results: The summary of findings from Paper I reveals the dominance of Support Vector Machine (SVM) classifiers in voice disorder research, with Parkinson's Disease and Alzheimer's Disease as the most studied disorders. Gaps in research include underrepresented disorders, limited datasets in terms of number of participants, and a lack of interest in longitudinal studies. Paper II demonstrates promising results in COPD classification using ML and a newly developed dataset, offering insights into potential decision support tools for COPD diagnosis.Conclusion: The studies covered in this dissertation provide a comprehensive literature summary of ML techniques used to support decision-making on voice-affecting disorders for clinical outcomes. The findings contribute to understanding the diagnostic potential of using ML on vocal features and highlight avenues for future research and technology development. Nonetheless, the experiment reveals the potential of employing voice as a digital biomarker for COPD diagnosis using ML.
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8.
  • Javeed, Ashir, 1989-, et al. (author)
  • Optimizing Depression Prediction in Older Adults : A Comparative Study of Feature Extraction and Machine Learning Models
  • 2024
  • Conference paper (peer-reviewed)abstract
    • Depression emerged as a major public health concern in older adults, and timely prediction of depression has become a difficult problem in medical informatics. The latest studies have attentiveed on feature transformation and selection for better depression prediction. In this study, we assess the performance of various feature extraction algorithms, including principal component analysis (PCA), independent component analysis (ICA), locally linear Embedding (LLE), and t-distributed stochastic neighbor embedding (TSNE). These algorithms are combined with machine learning (ML) classifier algorithms such as Gaussian Naive Bayes (GNB), Logistic Regression (LR), K- nearest-neighbor (KNN), and Decision Tree (DT) to enhance depression prediction. In total, sixteen automated integrated systems are constructed based on the above-mentioned feature extraction methods and ML classifiers. The performance of all of these integrated models is assessed using data from the Swedish National Study on Aging and Care (SNAC). According to the experimental results, the PCA algorithm combined with the Logistic Regression (LR) model provides 89.04% depression classification accuracy. As a result, it is demonstrated that the PCA is a more suitable feature extraction method for depression data than ICA, LLE, and TSNE.
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9.
  • Nyholm, Joel, et al. (author)
  • Prediction of dementia based on older adults’ sleep disturbances using machine learning
  • 2024
  • In: Computers in Biology and Medicine. - : Elsevier. - 0010-4825 .- 1879-0534. ; 171
  • Journal article (peer-reviewed)abstract
    • Background: The most common degenerative condition in older adults is dementia, which can be predicted using a number of indicators and whose progression can be slowed down. One of the indicators of an increased risk of dementia is sleep disturbances. This study aims to examine if machine learning can predict dementia and which sleep disturbance factors impact dementia.Methods: This study uses five machine learning algorithms (gradient boosting, logistic regression, gaussian naive Bayes, random forest and support vector machine) and data on the older population (60+) in Sweden from the Swedish National Study on Ageing and Care — Blekinge (). Each algorithm uses 10-fold stratified cross-validation to obtain the results, which consist of the Brier score for checking accuracy and the feature importance for examining the factors which impact dementia. The algorithms use 16 features which are on personal and sleep disturbance factors.Results: Logistic regression found an association between dementia and sleep disturbances. However, it is slight for the features in the study. Gradient boosting was the most accurate algorithm with 92.9% accuracy, 0.926 f1-score, 0.974 ROC AUC and 0.056 Brier score. The significant factors were different in each machine learning algorithm. If the person sleeps more than two hours during the day, their sex, education level, age, waking up during the night and if the person snores are the variables that most consistently have the highest feature importance in all algorithms.Conclusion: There is an association between sleep disturbances and dementia, which machine learning algorithms can predict. Furthermore, the risk factors for dementia are different across the algorithms, but sleep disturbances can predict dementia.
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10.
  • Svensson, Markus, et al. (author)
  • Association of systemic anticholinergic medication use and accelerated decrease in lung function in older adults
  • 2024
  • In: Scientific Reports. - : Springer Nature. - 2045-2322. ; 14:1
  • Journal article (peer-reviewed)abstract
    • Older adults are frequently exposed to medicines with systemic anticholinergic properties, which are linked to increased risk of negative health outcomes. The association between systemic anticholinergics and lung function has not been reported. The aim of this study was to investigate if exposure to systemic anticholinergics influences lung function in older adults. Participants of the southernmost centres of the Swedish National study on Aging and Care (SNAC) were followed from 2001 to 2021. In total, 2936 subjects (2253 from Good Aging in Skåne and 683 from SNAC-B) were included. An extensive medical examination including spirometry assessments was performed during the study visits. The systemic anticholinergic burden was described using the anticholinergic cognitive burden scale. The effect of new use of systemic anticholinergics on the annual change in forced expiratory volume (FEV1s) was estimated using mixed models. During follow-up, 802 (27.3%) participants were exposed to at least one systemic anticholinergic medicine. On average, the FEV1s of participants without systemic anticholinergic exposure decreased 37.2 ml/year (95% CI [33.8; 40.6]) while participants with low and high exposure lose 47.2 ml/year (95% CI [42.4; 52.0]) and 43.7 ml/year (95% CI [25.4; 62.0]). A novel association between new use of medicines with systemic anticholinergic properties and accelerated decrease in lung function in older adults was found. The accelerated decrease is comparable to that observed in smokers. Studies are needed to further explore this potential side effect of systemic anticholinergics. © The Author(s) 2024.
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