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- Boberg, Julia, et al.
(author)
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Swedish multimodal cohort of patients with anxiety or depression treated with internet-delivered psychotherapy (MULTI-PSYCH)
- 2023
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In: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 13:10
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Journal article (peer-reviewed)abstract
- Purpose Depression and anxiety afflict millions worldwide causing considerable disability. MULTI-PSYCH is a longitudinal cohort of genotyped and phenotyped individuals with depression or anxiety disorders who have undergone highly structured internet-based cognitive-behaviour therapy (ICBT). The overarching purpose of MULTI-PSYCH is to improve risk stratification, outcome prediction and secondary preventive interventions. MULTI-PSYCH is a precision medicine initiative that combines clinical, genetic and nationwide register data.Participants MULTI-PSYCH includes 2668 clinically well-characterised adults with major depressive disorder (MDD) (n=1300), social anxiety disorder (n=640) or panic disorder (n=728) assessed before, during and after 12 weeks of ICBT at the internet psychiatry clinic in Stockholm, Sweden. All patients have been blood sampled and genotyped. Clinical and genetic data have been linked to several Swedish registers containing a wide range of variables from patient birth up to 10 years after the end of ICBT. These variable types include perinatal complications, school grades, psychiatric and somatic comorbidity, dispensed medications, medical interventions and diagnoses, healthcare and social benefits, demographics, income and more. Long-term follow-up data will be collected through 2029.Findings to date Initial uses of MULTI-PSYCH include the discovery of an association between PRS for autism spectrum disorder and response to ICBT, the development of a machine learning model for baseline prediction of remission status after ICBT in MDD and data contributions to genome wide association studies for ICBT outcome. Other projects have been launched or are in the planning phase.Future plans The MULTI-PSYCH cohort provides a unique infrastructure to study not only predictors or short-term treatment outcomes, but also longer term medical and socioeconomic outcomes in patients treated with ICBT for depression or anxiety. MULTI-PSYCH is well positioned for research collaboration.
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| 2. |
- Forsell, Erik, et al.
(author)
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Predicting Treatment Failure in Regular Care Internet-Delivered Cognitive Behavior Therapy for Depression and Anxiety Using Only Weekly Symptom Measures
- 2020
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In: Journal of Consulting and Clinical Psychology. - : American Psychological Association (APA). - 0022-006X .- 1939-2117. ; 88:4, s. 311-321
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Journal article (peer-reviewed)abstract
- Objective: Therapist guided Internet-Delivered Cognitive Behavior Therapy (ICBT) is effective, but as in traditional CBT, not all patients improve, and clinicians generally fail to identify them early enough. We predict treatment failure in 12-week regular care ICBT for Depression, Panic disorder and Social anxiety disorder, using only patients' weekly symptom ratings to identify when the accuracy of predictions exceed 2 benchmarks: (a) chance, and (b) empirically derived clinician preferences for actionable predictions. Method: Screening, pretreatment and weekly symptom ratings from 4310 regular care ICBT-patients from the Internet Psychiatry Clinic in Stockholm, Sweden was analyzed in a series of regression models each adding 1 more week of data. Final score was predicted in a holdout test sample, which was then categorized into Success or Failure (failure defined as the absence of both remitter and responder status). Classification analyses with Balanced Accuracy and 95% Confidence intervals was then compared to predefined benchmarks. Results: Benchmark 1 (better than chance) was reached 1 week into all treatments. Social anxiety disorder reached Benchmark 2 (>65%) at week 5, whereas Depression and Panic Disorder reached it at week 6. Conclusions: For depression, social anxiety and panic disorder, prediction with only patient-rated symptom scores can detect treatment failure 6 weeks into ICBT, with enough accuracy for a clinician to take action. Early identification of failing treatment attempts may be a viable way to increase the overall success rate of existing psychological treatments by providing extra clinical resources to at-risk patients, within a so-called Adaptive Treatment Strategy.
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| 6. |
- Boman, Christoffer, et al.
(author)
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Development of innovative small(micro)-scale biomass-based CHP technologies
- 2017
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Reports (other academic/artistic)abstract
- To enhance the overall efficiency of the use of biomass in the energy sector in Europe, the large electricity production potential from small-scale biomass heating systems should be utilised. So far, no technologically sound (in terms of efficiency and reliability) and economically affordable micro- and small-scale biomass CHP technologies are, however, available. Therefore, the present ERA-NET project (MiniBioCHP) aimed at the further development and test of new CHP technologies based on small-scale biomass combustion in the electric capacity range between some W and 100 kW. Within the project, an international consortium consisting of 12 partners from 4 countries, including university institutions, institutes and industry (both engineering and manufacturing), collaborated closely to perform high level R&D on three promising micro/small-scale biomass based CHP technologies which are covering a broad range of applications in the residential heating sector. The Austrian engineering company BIOS, coordinated the international project. The project was based on earlier basic research and development work related to these promising new technologies and aimed at the achievement of a technological level which allows a first (commercial) demonstration after the end of the project. The three CHP concepts included in the MiniBioCHP project were;1. Pellet stoves with a thermoelectric generator (TEG)2. Small-scale biomass boilers (10-30 kWth) with a micro-ORC process3. High temperature heat exchanger (HT-HE) for an externally fired gas turbine (EFGT)The Swedish part of the project was focused on the development of the concept of biomass based EFGT with dedicated R&D activities related to the development of the HT-HE system. The Swedish project consisted of the research partners Umeå University (project leader), Luleå University of Technology, Chalmers University of Technology and RISE Research Institutes of Sweden, together with the industrial partners Enertech AB/Osby Parca and Ecergy. The expertise of the Swedish partners regarding ash related problems, grate boiler combustion and modelling, deposit formation and high temperature corrosion, were combined with the know-how of a Polish partner regarding HT-HE design, construction, testing and optimisation.The HT-HE is the most crucial component in EFGT processes significantly influencing the investment costs, availabilities as well as the efficiencies that can be achieved. With a thermal capacity from several hundred kW up to 2-3 MWth) the CHP technology based on a biomass boiler and an EFGT is suitable for district heating systems, or process heat consumers. The electricity produced by the gas turbine (up to some 100 kWel) can be used to cover the own electricity consumption of a company and/or fed into the grid. Even though the concept of biomass based EFGT has been an interesting alternative for small-scale CHP production for some decades, and R&D activities have been undertaken, tackling both economic and technical aspects, only a few pilot-plants have been in operation and no initiative has so far reached the level of commercial implementation. Thus, the concept of EFGT fed with biomass is still considered to be in a rather early development stage and the main technical challenges are related to alkali deposit induced corrosion and thermal stress of the HT-HE material, turbine design/operation and system integration.Within the present project, a HT-HE prototype aimed for an EFGT system was therefore designed, constructed and successfully tested at flue gas temperatures up to 900°C. Thus, appropriate guidelines for a compact design of the HT-HE and recommendations have been worked out to minimize thermal stresses as well as ash related problems regarding ash deposit formation and high temperature corrosion in a biomass boiler system. Furthermore, different concepts for the overall biomass based EFGT system have been worked out and evaluated. The outcome of the project will hopefully be used in the further development work and form the basis for a first testing and demonstration plant within the coming years.
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| 7. |
- Boman, Fiffi, et al.
(author)
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Comparing parent and teacher assessments of mental health in elementary school children
- 2016
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In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 44:2, s. 168-176
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Journal article (peer-reviewed)abstract
- Background: Screening instruments are often used for detecting mental health problems in children and adolescents. The Strengths and Difficulties Questionnaire (SDQ) is one instrument for screening children's mental health. The SDQ can be used for assessment by different informants, i.e. parents, teachers and by 11-16 year olds for self-reporting. Aims: The aim was to compare the precision and validity of parental and teacher SDQ assessments in elementary school children, and to analyze whether assessments were affected by the child's sex and by socio-demographic factors. Methods: A total of 512 primary school students were included in a cross-sectional study. Exploratory factor analysis, sensitivity/specificity analysis, Cronbach's alphas, and logistic regression were applied. Results: Parents rated 10.9% and teachers 8.8% of the children as high-risk individuals, but the overlap was low (32.1%). Cronbach's alphas were 0.73 and 0.71 for parents and teachers, respectively. However, factor analysis showed that the five-factor solution could be confirmed only for teacher ratings. Moreover, only the parents' ratings were affected by maternal educational level and parental country of birth when rating the same children as the teachers. Conclusions: Construct validity was only confirmed for teacher assessments. However, parental assessments might capture a dimension of a child's mental health that seems to be sensitive to socioeconomic factors, which could be important when addressing equity issues, and for the dialogue between parents and school.
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| 8. |
- Boman, Magnus, et al.
(author)
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Learning machines in Internet-delivered psychological treatment
- 2019
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In: Progress in Artificial Intelligence. - : Springer Verlag. - 2192-6352 .- 2192-6360. ; 8:4, s. 475-485
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Journal article (peer-reviewed)abstract
- A learning machine, in the form of a gating network that governs a finite number of different machine learning methods, is described at the conceptual level with examples of concrete prediction subtasks. A historical data set with data from over 5000 patients in Internet-based psychological treatment will be used to equip healthcare staff with decision support for questions pertaining to ongoing and future cases in clinical care for depression, social anxiety, and panic disorder. The organizational knowledge graph is used to inform the weight adjustment of the gating network and for routing subtasks to the different methods employed locally for prediction. The result is an operational model for assisting therapists in their clinical work, about to be subjected to validation in a clinical trial.
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| 9. |
- Borén, Eleonora, et al.
(author)
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Kaolin as fuel additive in grate combustion of biomass to mitigate ash related problems and particle emissions
- 2022
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In: Proceedings of the 28th International Conference on the Impact of Fuel Quality on Power Production and the Environment. - : Department of Applied Physics and Electronics, Umeå University.
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Conference paper (peer-reviewed)abstract
- Bioenergy is a fundamental part in sustainable development but use of novel fuel feedstocks potentiallymore sustainable may also bring associated ash-related challenges in practical operation that could bemitigated by co-conversion or additives. Kaolin, a clay mineral, is an additive known to be beneficialfor reduction of slagging tendencies and particulate matter formation in combustion of traditionalwoody-type biomass but its impact on thermal conversion of other biomasses still warrantsinvestigation. The aim of the present work is therefore to investigate how thermal conversion of atypical K-Ca-rich woody-type biomass, poplar, and a K-Si-rich annual crop, grass, is affected by kaolinaddition in fixed bed combustion. Additivation levels were calculated according to amount of alkaliintroduced with the two feedstocks, and incorporated by co-pelletization, in the case of poplar, anadditional blending d method was tested, by powder coating of pellets The results show that kaolinaddition improved the bottom ash characteristics, especially for grass, but the main differencesbetween feedstocks were found in particulate matter and flue gas composition. The particulate matterconcentrations were reduced with kaolin addition due to removal of gaseous K compounds which inturn caused higher SOx and HCl concentrations due to the lower amount of gaseous alkali for reaction.Further, initially high CO levels observed for both fuel feedstocks were reduced with the addition ofkaolin where co-pelletization with poplar proved more effective than powder coating the fuel particlesurfaces. This suggests that high concentrations of gaseous K-compounds may impact conversion ofthe carbonaceous matrix negatively.
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| 10. |
- Boström, Dan, et al.
(author)
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Ash transformation chemistry during combustion of biomass
- 2012
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In: Energy & Fuels. - Washington DC : American Chemical Society (ACS). - 0887-0624 .- 1520-5029. ; 26:1, s. 85-93
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Journal article (peer-reviewed)abstract
- There is relatively extensive knowledge available concerning ash transformation reactions during combustion of woody biomass. In recent decades, the use of these energy carriers has increased, from a low-technology residential small-scale level to an industrial scale. Along this evolution, ash chemical-related phenomena for woody biomass have been observed and studied. Therefore, presently the understanding for these are, if not complete, fairly good. However, because the demand for CO2-neutral energy resources has increased recently and will continue to increase in the foreseeable future, other biomasses, such as, for instance, agricultural crops, have become highly interesting. The ash-forming matter in agricultural biomass is rather different in comparison to woody biomass, with a higher content of phosphorus as a distinctive feature. The knowledge about the ash transformation behavior in these systems is far from complete. Here, an attempt to give a schematic but general description of the ash transformation reactions of biomass fuels is presented in terms of a conceptual model, with the intention to provide guidance in the understanding of ash matter behavior in the use of any biomass fuel, primarily from the knowledge of the concentrations of ash-forming elements. The model was organized in primary and secondary reactions. Restrictions on the theoretical model in terms of reactivity limitations and physical conditions of the conversion process were discussed and exemplified, and some principal differences between biomass ashes dominated by Si and P, separately, were outlined and discussed.
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