| 1. |
|
|
| 2. |
- Bäckström, Caroline A., et al.
(author)
-
In the need of a digital cicerone in healthcare? – Guidance for parents
- 2022
-
In: BMC Pregnancy and Childbirth. - : BioMed Central (BMC). - 1471-2393 .- 1471-2393. ; 22:1
-
Journal article (peer-reviewed)abstract
- Objective: To explore parents’ experiences using digital tools in relation to pregnancy, labor and birth, and the child’s first 18 months. Background: Parents find relevant information using digital healthcare tools, material obtained from professionals, as well as personal opinions and experiences that vary in quality. Method: Fifteen parents were interviewed and data were analyzed beginning with content analysis and followed by thematic analysis. Results: The main theme was insecurity and responsibility for own choices and knowledge. Parents use digital tools to take responsibility for their insecurity and need for knowledge when entering parenthood. Conclusion: The parents’ experiences highlighted that (1) insecurity can be both eased and enhanced using digital tools, (2) they took responsibility for feelings of insecurity and the search for knowledge, and (3) they needed knowledge to make the right choices and feel secure that these choices are made in the best interest of their new family.
|
|
| 3. |
|
|
| 4. |
- Maple-Grødem, Jodi, et al.
(author)
-
Lack of Association between GBA Mutations and Motor Complications in European and American Parkinson's Disease Cohorts
- 2021
-
In: Journal of Parkinson's Disease. - : IOS Press. - 1877-7171 .- 1877-718X. ; 11:4, s. 1569-1578
-
Journal article (peer-reviewed)abstract
- Background: Motor complications are a consequence of the chronic dopaminergic treatment of Parkinson's disease (PD) and include levodopa-induced dyskinesia (LIDs) and motor fluctuations (MF). Currently, evidence is on lacking whether patients with GBA-associated PD differ in their risk of developing motor complications compared to the general PD population.Objective: To evaluate the association of GBA carrier status with the development of LIDS and MFs from early PD.Methods: Motor complications were recorded prospectively in 884 patients with PD from four longitudinal cohorts using part IV of the UPDRS or MDS-UPDRS. Subjects were followed for up to 11 years and the associations of GBA mutations with the development of motor complications were assessed using parametric accelerated failure time models.Results: In 439 patients from Europe, GBA mutations were detected in 53 (12.1%) patients and a total of 168 cases of LIDs and 258 cases of MF were observed. GBA carrier status was not associated with the time to develop LIDs (HR 0.78, 95%CI 0.47 to 1.26, p = 0.30) or MF (HR 1.19, 95%CI 0.84 to 1.70, p = 0.33). In the American cohorts, GBA mutations were detected in 36 (8.1%) patients and GBA carrier status was also not associated with the progression to LIDs (HR 1.08, 95%CI 0.55 to 2.14, p = 0.82) or MF (HR 1.22, 95%CI 0.74 to 2.04, p = 0.43).Conclusion: This study does not provide evidence that GBA-carrier status is associated with a higher risk of developing motor complications. Publication of studies with null results is vital to develop an accurate summary of the clinical features that impact patients with GBA-associated PD.
|
|
| 5. |
- af Bjerkén, Sara, et al.
(author)
-
Reliability and validity of visual analysis of [18F]FE-PE2I PET/CT in early Parkinsonian disease
- 2023
-
In: Nuclear medicine communications. - : Wolters Kluwer. - 0143-3636 .- 1473-5628. ; 44:5, s. 397-406
-
Journal article (peer-reviewed)abstract
- Objective: [18F]FE-PE2I (FE-PE2I) is a new radiotracer for dopamine transporter (DAT) imaging with PET. The aim of this study was to evaluate the visual interpretation of FE-PE2I images for the diagnosis of idiopathic Parkinsonian syndrome (IPS). The inter-rater variability, sensitivity, specificity, and diagnostic accuracy for visual interpretation of striatal FE-PE2I compared to [123I]FP-CIT (FP-CIT) single-photon emission computed tomography (SPECT) was evaluated.Methods: Thirty patients with newly onset parkinsonism and 32 healthy controls with both an FE-PE2I and FP-CIT were included in the study. Four patients had normal DAT imaging, of which three did not fulfil the IPS criteria at the clinical reassessment after 2 years. Six raters evaluated the DAT images blinded to the clinical diagnosis, interpreting the image as being ‘normal’ or ‘pathological’, and assessed the degree of DAT-reduction in the caudate and putamen. The inter-rater agreement was assessed with intra-class correlation and Cronbach’s α. For calculation of sensitivity and specificity, DAT images were defined as correctly classified if categorized as normal or pathological by ≥4/6 raters.Results: The overall agreement in visual evaluation of the FE-PE2I- and FP-CIT images was high for the IPS patients (α = 0.960 and 0.898, respectively), but lower in healthy controls (FE-PE2I: α = 0.693, FP-CIT: α = 0.657). Visual interpretation gave high sensitivity (both 0.96) but lower specificity (FE-PE2I: 0.86, FP-CIT: 0.63) with an accuracy of 90% for FE-PE2I and 77% for FP-CIT.Conclusion: Visual evaluation of FE-PE2I PET imaging demonstrates high reliability and diagnostic accuracy for IPS.
|
|
| 6. |
- Botero, Carlos Alberto, et al.
(author)
-
Microstructural and mechanical evaluation of a cr-mo-v cold-work tool steel produced via electron beam melting (Ebm)
- 2021
-
In: Materials. - : MDPI AG. - 1996-1944. ; 14:11
-
Journal article (peer-reviewed)abstract
- In this work, a highly alloyed cold work tool steel, Uddeholm Vanadis 4 Extra, was manufactured via the electron beam melting (EBM) technique. The corresponding material microstructure and carbide precipitation behavior as well as the microstructural changes after heat treatment were characterized, and key mechanical properties were investigated. In the as-built condition, the mi-crostructure consists of a discontinuous network of very fine primary Mo-and V-rich carbides dispersed in an auto-tempered martensite matrix together with ≈15% of retained austenite. Adjusted heat treatment procedures allowed optimizing the microstructure by the elimination of Mo-rich carbides and the precipitation of fine and different sized V-rich carbides, along with a decrease in the retained austenite content below 2%. Hardness response, compressive strength, and abrasive wear properties of the EBM-manufactured material are similar or superior to its as-HIP forged counterparts manufactured using traditional powder metallurgy route. In the material as built by EBM, an impact toughness of 16–17 J was achieved. Hot isostatic pressing (HIP) was applied in order to further increase ductility and to investigate its impact upon the microstructure and properties of the material. After HIPing with optimized protocols, the ductility increased over 20 J.
|
|
| 7. |
- Bäckström, David C, M.D. 1978-, et al.
(author)
-
NfL as a biomarker for neurodegeneration and survival in Parkinson disease
- 2020
-
In: Neurology. - : Wolters Kluwer. - 0028-3878 .- 1526-632X. ; 95:7, s. e827-e838
-
Journal article (peer-reviewed)abstract
- OBJECTIVE: To determine whether neurofilament light chain protein in CSF (cNfL), a sensitive biomarker of neuroaxonal damage, reflects disease severity or can predict survival in Parkinson disease (PD).METHODS: We investigated whether disease severity, phenotype, or survival in patients with new-onset PD correlates with cNfL concentrations around the time of diagnosis in the population-based New Parkinsonism in Umeå (NYPUM) study cohort (n = 99). A second, larger new-onset PD cohort (n = 194) was used for independent validation. Association of brain pathology with the cNfL concentration was examined with striatal dopamine transporter imaging and repeated diffusion tensor imaging at baseline and 1 and 3 years.RESULTS: Higher cNfL in the early phase of PD was associated with greater severity of all cardinal motor symptoms except tremor in both cohorts and with shorter survival and impaired olfaction. cNfL concentrations above the median of 903 ng/L conferred an overall 5.8 times increased hazard of death during follow-up. After adjustment for age and sex, higher cNfL correlated with striatal dopamine transporter uptake deficits and lower fractional anisotropy in diffusion tensor imaging of several axonal tracts.CONCLUSIONS: cNfL shows usefulness as a biomarker of disease severity and to predict survival in PD. The present results indicate that the cNfL concentration reflects the intensity of the neurodegenerative process, which could be important in future clinical trials.CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that in patients with PD, cNfL concentrations are associated with more severe disease and shorter survival.
|
|
| 8. |
- Bäckström, David C, M.D. 1978-, et al.
(author)
-
Prediction and early biomarkers of cognitive decline in Parkinson disease and atypical parkinsonism: a population-based study
- 2022
-
In: Brain Communications. - : Oxford University Press (OUP). - 2632-1297. ; 4:2
-
Journal article (peer-reviewed)abstract
- Backstrom et al. report that, in a population-based cohort of patients with new-onset Parkinson disease, approximately half develop dementia within 10 years. Measurement of CSF biomarkers together with baseline cognitive function, olfaction and motor disease severity has high accuracy for predicting who will develop dementia. The progression of cognitive decline is heterogeneous in the three most common idiopathic parkinsonian diseases: Parkinson disease, multiple system atrophy and progressive supranuclear palsy. The causes for this heterogeneity are not fully understood, and there are no validated biomarkers that can accurately identify patients who will develop dementia and when. In this population-based, prospective study, comprehensive neuropsychological testing was performed repeatedly in new-onset, idiopathic parkinsonism. Dementia was diagnosed until 10 years and participants (N = 210) were deeply phenotyped by multimodal clinical, biochemical, genetic and brain imaging measures. At baseline, before the start of dopaminergic treatment, mild cognitive impairment was prevalent in 43.4% of the patients with Parkinson disease, 23.1% of the patients with multiple system atrophy and 77.8% of the patients with progressive supranuclear palsy. Longitudinally, all three diseases had a higher incidence of cognitive decline compared with healthy controls, but the types and severity of cognitive dysfunctions differed. In Parkinson disease, psychomotor speed and attention showed signs of improvement after dopaminergic treatment, while no such improvement was seen in other diseases. The 10-year cumulative probability of dementia was 54% in Parkinson disease and 71% in progressive supranuclear palsy, while there were no cases of dementia in multiple system atrophy. An easy-to-use, multivariable model that predicts the risk of dementia in Parkinson disease within 10 years with high accuracy (area under the curve: 0.86, P < 0.001) was developed. The optimized model adds CSF biomarkers to four easily measurable clinical features at baseline (mild cognitive impairment, olfactory function, motor disease severity and age). The model demonstrates a highly variable but predictable risk of dementia in Parkinson disease, e.g. a 9% risk within 10 years in a patient with normal cognition and CSF amyloid-beta(42) in the highest tertile, compared with an 85% risk in a patient with mild cognitive impairment and CSF amyloid-beta(42) in the lowest tertile. Only small or no associations with cognitive decline were found for factors that could be easily modifiable (such as thyroid dysfunction). Risk factors for cognitive decline in multiple system atrophy and progressive supranuclear palsy included signs of systemic inflammation and eye movement abnormalities. The predictive model has high accuracy in Parkinson disease and might be used for the selection of patients into clinical trials or as an aid to improve the prevention of dementia.
|
|
| 9. |
- Bäckström, Ingela, 1963-, et al.
(author)
-
Quality in preschools through systematic quality work – a principal’s perspective
- 2024
-
In: Quality Assurance in Education. - : Emerald. - 0968-4883 .- 1758-7662. ; 32:2, s. 257-273
-
Journal article (peer-reviewed)abstract
- Purpose: The purpose of this paper is to explore existing and desired methodologies for systematic quality work to promote quality in preschools from the principal’s perspective. Design/methodology/approach: A collaborative approach was used in this research project, and principals were asked to complete portfolio assignments. Their answers to those portfolio assignments were analysed by the research team and subsequently compared to total quality management values. Findings: Existing and desired methodologies for systematic quality work are presented and sorted into 13 and 17 groups, respectively. The principals desire four times more methodologies than they are presently using to promote systematic quality work, and the results show that they must extend their methodologies to support TQM values. Research limitations/implications: This research is based on answers collected from 18 principals in one municipality in Sweden. Practical implications: The use of the cornerstone model provides a framework to illustrate the application of TQM in preschools. Originality/value: Principals struggle to find time for systemic quality work. The presented results can be used to work systematically with quality in preschools and other organizations.
|
|
| 10. |
- Cea, B., et al.
(author)
-
Development and Evaluation of an Innovative Method Based on Dilution to Sample Solid and Condensable Fractions of Particles Emitted by Residential Wood Combustion
- 2021
-
In: Energy & Fuels. - : American Chemical Society. - 0887-0624 .- 1520-5029. ; 35:23, s. 19705-
-
Journal article (peer-reviewed)abstract
- An innovative and simple method based on dilution, named as the dilution chamber (DC), allowing the measurement of solid and condensable fractions of particulate matter emitted by residential wood combustion appliances has been developed, and its performances have been evaluated. The DC method was then tested by five European institutes (Ineris, ISSI/ENEA, DTI, and RISE) on advanced residential wood log/pellet stoves, under nominal output and low output combustion conditions and using different fuel types. The aim of the study was to evaluate the capability of the DC method to collect the condensable fraction. The DC method was compared with another manual method used to collect the solid and condensable fractions at the same time, the dilution tunnel (DT), on four sampling platforms. A third method, a combining heated filter and impinger filled in with isopropanol collection (SPC-IPA), was also used by Ineris only for comparison with the DC method. PM measurements based on the DC method globally showed a linear correlation with PM measurements based on DT (R2 ranged between 0.81 and 0.99, p < 0.05) specifically for the residential wood stoves under low output conditions when the condensable fraction contributes the most. An analysis and quantification of PAHs related to the total mass of PM of samples taken by the DC method and performed by ENEA/ISSI showed that it produces a condensation effect of semivolatile species comparable or even greater than the DT method. PM emission factors calculated from PM measurements based on the DC method were (i) about 2- to 20-fold higher for the residential wood stoves (EF ranged between 201 to 2420 g GJ-1) compared to those obtained for the residential pellet stoves (EF ranged between 108 to 556 g GJ-1) and (ii) of the same magnitude of PM emission factors from the literature or the EMEP/EEA air pollutant emission inventory guidebook.
|
|
