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Sökning: AMNE:(MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Geriatrik) > Kungliga Tekniska Högskolan

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1.
  • Falk Erhag, Hanna, et al. (författare)
  • Concluding Remarks
  • 2022
  • Ingår i: A Multidisciplinary Approach to Capability in Age and Ageing. - Chem : Springer. - 9783030780654 ; 18:2, s. 143-144
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)
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2.
  • Åberg, Anna Cristina, et al. (författare)
  • Medio-lateral stability of sit-to-walk performance in older individuals with and without fear of falling
  • 2010
  • Ingår i: Gait & Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 31:4, s. 438-443
  • Tidskriftsartikel (refereegranskat)abstract
    • Most falls in older people are due to loss of balance during everyday locomotion, e.g., when initiating walking from sitting; sit-to-walk (STW). It has been considered that the broader stride width in walking that is seen in many people with fear of falling (FoF) does not increase stability, but could be predictive of future falls because of increased medio-lateral (ML) velocity of the body centre of mass (CoM). This study was aimed to examine step-, velocity- and stability-related parameters, focusing on ML stability, in STW performance of people with and without FoF. Ten subjects with FoF and 10 matched controls, aged >= 70 years, were included. Kinematic and kinetic data were collected in a laboratory. Stability parameters were calculated from a formula implying that the vertical projection of the CoM extrapolated by adding its velocity times a factor root l/g (height of inverted pendulum divided by gravity) should fall within the base of support (BoS). A related spatial margin of stability (SMoS), defined as the minimum distance from the extrapolated CoM (XCoM) to the boundaries of the BoS, was also calculated. In the phase 'seat-off-second-toe-off, the FoF group had significantly (p < 0.05) shorter and broader steps, lower forward but similar ML CoM velocity, and broader CoM and XCoM widths. The FoF group therefore exhibited a disproportionately large sideways velocity compared to the controls. This indicates that STW may be a hazardous transfer for older people with FoF, which should be relevant in assessment and training aimed at preventing falls.
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3.
  • Fletcher-Sandersjoo, Alexander, et al. (författare)
  • Stockholm score of lesion detection on computed tomography following mild traumatic brain injury (SELECT-TBI) : study protocol for a multicentre, retrospective, observational cohort study
  • 2022
  • Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 12:9
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction Mild traumatic brain injury (mTBI) is one of the most common reasons for emergency department (ED) visits. A portion of patients with mTBI will develop an intracranial lesion that might require medical or surgical intervention. In these patients, swift diagnosis and management is paramount. Several guidelines have been developed to help direct patients with mTBI for head CT scanning, but they lack specificity, do not consider the interactions between risk factors and do not provide an individualised estimate of intracranial lesion risk. The aim of this study is to create a model that estimates individualised intracranial lesion risks in patients with mTBI who present to the ED. Methods and analysis This will be a retrospective cohort study conducted at ED hospitals in Stockholm, Sweden. Eligible patients are adults (>= 15 years) with mTBI who presented to the ED within 24 hours of injury and performed a CT scan. The primary outcome will be a traumatic lesion on head CT. The secondary outcomes will be any clinically significant lesion, defined as an intracranial finding that led to neurosurgical intervention, hospital admission >= 48 hours due to TBI or death due to TBI. Machine-learning models will be applied to create scores predicting the primary and secondary outcomes. An estimated 20 000 patients will be included. Ethics and dissemination The study has been approved by the Swedish Ethical Review Authority (Dnr: 2020-05728). The research findings will be disseminated through peer-reviewed scientific publications and presentations at international conferences.
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4.
  • Winger, Anette, et al. (författare)
  • Health related quality of life in adolescents with chronic fatigue syndrome : a cross-sectional study
  • 2015
  • Ingår i: Health and Quality of Life Outcomes. - : Springer Science and Business Media LLC. - 1477-7525 .- 1477-7525. ; 13
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: To study health related quality of life (HRQOL) and depressive symptoms in adolescents with chronic fatigue syndrome (CFS) and to investigate in which domains their HRQOL and depressive symptoms differ from those of healthy adolescents.Background and objective: Several symptoms such as disabling fatigue, pain and depressive symptoms affect different life domains of adolescents with CFS. Compared to adolescents with other chronic diseases, young people with CFS are reported to be severely impaired, both physiologically and mentally. Despite this, few have investigated the HRQOL in this group.Method: This is a cross-sectional study on HRQOL including 120 adolescents with CFS and 39 healthy controls (HC), between 12 and 18 years. The Pediatric Quality of Life Inventory (TM), 4.0 (PedsQL) was used to assess HRQOL. The Mood and Feelings Questionnaire assessed depressive symptoms. Data were collected between March 2010 and October 2012 as part of the NorCAPITAL project (Norwegian Study of Chronic Fatigue Syndrome in Adolescents: Pathophysiology and Intervention Trial). Linear and logistic regression models were used in analysis, and all tests were two-sided.Results: Adolescents with CFS reported significantly lower overall HRQOL compared to HCs. When controlling for gender differences, CFS patients scored 44 points lower overall HRQOL on a scale from 0-100 compared to HCs. The domains with the largest differences were interference with physical health (B = -59, 95 % CI -54 to -65) and school functioning (B = -52, 95 % CI -45 to -58). Both depressive symptoms and being a patient were independently associated with lower levels of HRQOLConclusion: The difference in HRQOL between CFS patients and healthy adolescents was even larger than we expected. The large sample of adolescents with CFS in our study confirms previous findings from smaller studies, and emphasizes that CFS is a seriously disabling condition that has a strong impact on their HRQOL. Even though depressive symptoms were found in the group of patients, they could not statistically explain the poor HRQOL.
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5.
  • Lundin, J., et al. (författare)
  • Using 360-degree videos for virtual reality exposure in CBT for panic disorder with agoraphobia : A feasibility study
  • 2022
  • Ingår i: Behavioural and Cognitive Psychotherapy. - : Cambridge University Press (CUP). - 1352-4658 .- 1469-1833. ; 50:2, s. 158-170
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Cognitive behavioural therapy (CBT) is an effective treatment for panic disorder with agoraphobia (PDA). However, implementation of some of the procedures involved, particularly in vivo exposure, can be time consuming and taxing for routine health care services. CBT with exposure taking place in virtual reality (VR-CBT) is a more time-efficient option and has shown promising results in the treatment of PDA. However, VR-CBT requires expensive equipment and appropriate virtual environments, which historically has been costly and cumbersome to produce. Thus, access to VR-CBT has been sparse in regular care environments. Aims: The aim of this study was to investigate whether VR-CBT using filmed virtual environments produced with a low-cost 360-degree film camera can be a feasible and acceptable treatment for PDA when implemented in a primary care context. Method: This was an open feasibility trial with a within-group design, with assessments conducted at pre-test, post-test, and 6-month follow-up. Participants (n = 12) received a 10-12 week treatment programme of VR-CBT and PDA-related symptoms were assessed by the primary outcome measure The Mobility Inventory for Agoraphobia (MIA) and the Panic-Disorder Severity Scale-Self Rated (PDSS-SR). Results: The results showed that treatment satisfaction was high and participants were significantly improved on PDA-related measures at post-treatment and at 6-month follow-up with large effect sizes (Cohen's d range = 1.46-2.82). All 12 participants completed the treatment. Conclusions: These findings suggest that VR-CBT with 360-degree video virtual environments delivered to primary care patients with PDA is feasible, acceptable, and potentially efficacious. 
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6.
  • Eftring, H., et al. (författare)
  • Designing a social and assistive robot for seniors
  • 2016
  • Ingår i: Zeitschrift fur Gerontologie und Geriatrie. - : Springer Science and Business Media LLC. - 0948-6704 .- 1435-1269. ; 49:4, s. 274-281
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The development of social assistive robots is an approach with the intention of preventing and detecting falls among seniors. There is a need for a relatively low-cost mobile robot with an arm and a gripper which is small enough to navigate through private homes. Material and methods: User requirements of a social assistive robot were collected using workshops, a questionnaire and interviews. Two prototype versions of a robot were designed, developed and tested by senior citizens (n = 49) in laboratory trials for 2 h each and in the private homes of elderly persons (n = 18) for 3 weeks each. Results: The user requirement analysis resulted in a specification of tasks the robot should be able to do to prevent and detect falls. It was a challenge but possible to design and develop a robot where both the senior and the robot arm could reach the necessary interaction points of the robot. The seniors experienced the robot as happy and friendly. They wanted the robot to be narrower so it could pass through narrow passages in the home and they also wanted it to be able to pass over thresholds without using ramps and to drive over carpets. Conclusion: User trials in seniors’ homes are very important to acquire relevant knowledge for developing robots that can handle real life situations in the domestic environment. Very high reliability of a robot is needed to get feedback about how seniors experience the overall behavior of the robot and to find out if the robot could reduce falls and improve the feeling of security for seniors living alone.
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7.
  • Emami Khoonsari, Payam, et al. (författare)
  • Analysis of the Cerebrospinal Fluid Proteome in Alzheimer's Disease
  • 2016
  • Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 11:3
  • Tidskriftsartikel (refereegranskat)abstract
    • Alzheimer's disease is a neurodegenerative disorder accounting for more than 50% of cases of dementia. Diagnosis of Alzheimer's disease relies on cognitive tests and analysis of amyloid beta, protein tau, and hyperphosphorylated tau in cerebrospinal fluid. Although these markers provide relatively high sensitivity and specificity for early disease detection, they are not suitable for monitor of disease progression. In the present study, we used label-free shotgun mass spectrometry to analyse the cerebrospinal fluid proteome of Alzheimer's disease patients and non-demented controls to identify potential biomarkers for Alzheimer's disease. We processed the data using five programs (DecyderMS, Maxquant, OpenMS, PEAKS, and Sieve) and compared their results by means of reproducibility and peptide identification, including three different normalization methods. After depletion of high abundant proteins we found that Alzheimer's disease patients had lower fraction of low-abundance proteins in cerebrospinal fluid compared to healthy controls (p<0.05). Consequently, global normalization was found to be less accurate compared to using spiked-in chicken ovalbumin for normalization. In addition, we determined that Sieve and OpenMS resulted in the highest reproducibility and PEAKS was the programs with the highest identification performance. Finally, we successfully verified significantly lower levels (p<0.05) of eight proteins (A2GL, APOM, C1QB, C1QC, C1S, FBLN3, PTPRZ, and SEZ6) in Alzheimer's disease compared to controls using an antibody-based detection method. These proteins are involved in different biological roles spanning from cell adhesion and migration, to regulation of the synapse and the immune system.
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8.
  • Sravani, Musunuri, 1987-, et al. (författare)
  • Increased Levels of Extracellular Microvesicle Markers and Decreased Levels of Endocytic/Exocytic Proteins in the Alzheimer's Disease Brain
  • 2016
  • Ingår i: Journal of Alzheimer's Disease. - : IOS Press. - 1387-2877 .- 1875-8908. ; 54:4, s. 1671-1686
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Alzheimer's disease (AD) is a chronic neurodegenerative disorder accounting for more than 50% of all dementia cases. AD neuropathology is characterized by the formation of extracellular plaques and intracellular neurofibrillary tangles consisting of aggregated amyloid-beta and tau, respectively. The disease mechanism has only been partially elucidated and is believed to also involve many other proteins. Objective: This study intended to perform a proteomic profiling of post mortem AD brains and compare it with control brains as well as brains from other neurological diseases to gain insight into the disease pathology. Methods: Here we used label-free shotgun mass spectrometry to analyze temporal neocortex samples from AD, other neurological disorders, and non-demented controls, in order to identify additional proteins that are altered in AD. The mass spectrometry results were verified by antibody suspension bead arrays. Results: We found 50 proteins with altered levels between AD and control brains. The majority of these proteins were found at lower levels in AD. Pathway analyses revealed that several of the decreased proteins play a role in exocytic and endocytic pathways, whereas several of the increased proteins are related to extracellular vesicles. Using antibody-based analysis, we verified the mass spectrometry results for five representative proteins from this group of proteins (CD9, HSP72, PI42A, TALDO, and VAMP2) and GFAP, a marker for neuroinflammation. Conclusions: Several proteins involved in exo-endocytic pathways and extracellular vesicle functions display altered levels in the AD brain. We hypothesize that such changes may result in disturbed cellular clearance and a perturbed cell-to-cell communication that may contribute to neuronal dysfunction and cell death in AD.
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9.
  • Emami Khoonsari, Payam, et al. (författare)
  • Improved Differential Diagnosis of Alzheimer's Disease by Integrating ELISA and Mass Spectrometry-Based Cerebrospinal Fluid Biomarkers
  • 2019
  • Ingår i: Journal of Alzheimer's Disease. - : IOS PRESS. - 1387-2877 .- 1875-8908. ; 67:2, s. 639-651
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Alzheimer's disease (AD) is diagnosed based on a clinical evaluation as well as analyses of classical biomarkers: A beta(42), total tau (t-tau), and phosphorylated tau (p-tau) in cerebrospinal fluid (CSF). Although the sensitivities and specificities of the classical biomarkers are fairly good for detection of AD, there is still a need to develop novel biochemical markers for early detection of AD. Objective: We explored if integration of novel proteins with classical biomarkers in CSF can better discriminate AD from non-AD subjects. Methods: We applied ELISA, mass spectrometry, and multivariate modeling to investigate classical biomarkers and the CSF proteome in subjects (n = 206) with 76 AD patients, 74 mild cognitive impairment (MCI) patients, 11 frontotemporal dementia (FTD) patients, and 45 non-dementia controls. The MCI patients were followed for 4-9 years and 21 of these converted to AD, whereas 53 remained stable. Results: By combining classical CSF biomarkers with twelve novel markers, the area of the ROC curves (AUROCS) of distinguishing AD and MCl/AD converters from non-AD were 93% and 96%, respectively. The FTDs and non-dementia controls were identified versus all other groups with AUROCS of 96% and 87%, respectively. Conclusions: Integration of new and classical CSF biomarkers in a model-based approach can improve the identification of AD, FTD, and non-dementia control subjects.
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10.
  • Gasparrini, S., et al. (författare)
  • Proposal and experimental evaluation of fall detection solution based on wearable and depth data fusion
  • 2016
  • Ingår i: ICT Innovations 2015. - Cham : Springer. - 9783319257334 - 9783319257310 ; , s. 99-108
  • Konferensbidrag (refereegranskat)abstract
    • Fall injury issues represent a serious problem for elderly in our society. These people want to live in their home as long as possible and technology can improve their security and independence. In this work we study the joint use of a camera based system and wearable devices, in the so called data fusion approach, to design a fall detection solution. The synchronization issues between the heterogeneous data provided by the devices are properly treated, and three different fall detection algorithms are implemented. Experimental results are also provided, to compare the proposed solutions.
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