Publikationer från Linköpings universitet
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The outcomes of a structured bowel management programme on childhood functional constipation: a retrospective pre – post intervention study
No full textAim: The purpose of this study was to describe and evaluate the effectiveness of a six-month structured bowel management programme (SBMP) for children with therapy-resistant functional constipation (FC). Method: A retrospective review of medical records with a pre-post design was conducted at an outpatient paediatric clinic in Sweden. Bowel frequency, stool form, faecal incontinence, and abdominal pain were compared before and after the intervention. Predictive factors for successful discharge and duration of care through long-term follow-up were calculated. Results: Of the 142 children enrolled in the SBMP, 132 completed the programme. Despite previous FC therapy resistance, the SBMP achieved a treatment success rate of 44 % within 6 months, and 58 % after 12 months. The need for additional contacts beyond those scheduled and persistent faecal leakage were significant predictors of non-recovery. Long-term follow-ups indicate that after 2 years of care, approximately 80 % of the children achieved recovery. Conclusion: This study highlights the effectiveness of the SBMP in managing therapy-resistant FC in children at a general outpatient paediatric clinic, while also emphasising the necessity of long-term follow-up for sustainable results. Implications to practice: The results suggest that a structured care programme like the SBMP helps set realistic expectations and ensures consistent quality of care for children with FC, despite the severity and complexities involved. (c) 2025 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/)
Språkmodeller är taktiska-scenario granskare
No full textHigh-level software testing is often complex and highly situational, and there are areas where conventional methods of automation are simply not feasible. One such potential area is the post-mortem analysis of failed tests. This thesis explores the feasibility of using Large Language Models (LLMs) for automating the analysis of simulation-based test-scenarios within Tacsi, a tactical simulation environment developed by Saab AB. A system monickered ScenarioLens was implemented to summarise JSON-encoded recordings of these scenarios and to generate a conclusive briefing. Extensive experiments evaluated model size and prompting strategies, validated through a novel method of measuring accuracy tailored to the LLM-generated conclusions. Results demonstrate that LLMs are able to generalise well to this domain under certain constraints and offer promising avenues for integrating AI into high-level, domain-specific software testing workflows. Additionally, the thesis explores the use of multimodal LLMs for the same task, though this approach showed less potential compared to purely text-based methods
Optimering av lågkoncentrationsraffinör : Byte av en fuzzy regulator till en PI regulator på enlågkoncentrationsraffinör
No full textThe pulp needed to make paper can be done in several ways. At Holmen papermill Braviken pulp is made by thermomechanical pulping (TMP) where the wood chips are ground to pulp by refineries powered by large electric motors. In these processes a low concentration refinery (LC-refinery) is a specific type of refinery. At Braviken, there is a particular LC-refinery called LCS2. The power of the refinery can be changed by running a second, smaller motor which is changing the distance between the two disks where the pulp is going through. The power of the large motor is controlled by a simple strategy, if the power is unsatisfactory, the small motor runs for two seconds. The system has a tendency to overreact and oscillate between low and high power. A new type of controller, a PI (proportional-integral) controller, was proposed which varied the time of the pulses depending on the amplitude of the error. The system together with the new and the old controller was rigorously simulated. The new controller was made sure to be robust, then it was implemented in the real system and the result was analyzed. After LCS2, the pulp can go into three different valves. Because changes in the flow of one valve affect pressure, it can in turn affect the other valves' flows. The two valves which made the pulp proceed to the strainer were not controlled by the controllers, but were instead run manually, to reduce the risk of oscillation. The three valves were viewed as one large system with three inputs and three outputs. This system was analyzed and simulated, enabling autonomous operation without human intervention in the real system. Det finns flera sätt att göra den pappersmassa som behövs till papper. Vid Holmens pappers-bruk Braviken görs det genom en termomekanisk process (TMP). Det innebär att träflis körsigenom en raffinör som separerar träfiber. En lågkoncentrationsraffinör (LC-raffinör), är enviss sorts raffinör som har studerats i detta arbete. I Braviken finns det en specifik raffinörvid namn LCS2. Effekten hos denna raffinör kan ändras genom att en andra, mindre motor,genom två-sekunders pulser ändrar på avståndet mellan diskarna där träflisorna passerar.LCS2 har en tendens att överreagera då den oscillerar fram och tillbaka. En annan regula-tor, en PI-regulator, föreslogs och varierar istället tiden på pulserna beroende på storlekenpå effektfelet. Systemet modellerades och den nya regulatorn tillsammans med den gamlaregulatorn simulerades för att verifiera förbättringar med och robustheten hos den nya reg-ulatorn. Den nya regulatorn implementerades även i det verkliga systemet och resultatetanalyserades.Efter LCS2 kan pappersmassan gå genom tre olika ventiler. Om en ventil öppnas påverkastrycket som i sin tur påverkar flödet ur de andra ventilerna. Det fanns två ventiler somsköttes manuellt och inte styrdes av regulatorer. De tre ventilerna sågs som ett stort systemmed tre in- och tre utsignaler. Detta system analyserades och simulerades och sedan gjordesändringar i det verkliga systemet så att alla tre regulatorer kunde köras automatisk
Directional Sensitivity-Based DOA Estimation Using a Fourier Series Model
No full textDirection of arrival (DOA) estimation is a fundamental problem in signal processing and has applications in various fields such as radar, sonar, and acoustics. In this article, we propose a method for DOA estimation using the received power at each sensor. The method is based on the directional sensitivity of the sensor elements at various frequencies. We model the directional sensitivity using a Fourier series (FS) model, where the parametric model enables Cramér-Rao lower-bound (CRLB) computations. The FS model is estimated from measurements of a wideband noise signal. To estimate the DOA, the measured power profile is compared to the FS model using the least-squares (LS) method. The proposed power-based method offers several advantages over classical time-delay methods, particularly in allowing arbitrarily small arrays and still handling broadband signals. Additionally, it enables low-rate sampling, which simplifies hardware requirements and significantly reduces processor load. In numerical evaluations with a microphone array and natural sound sources, we still benchmark our method against state-of-the-art time-delay methods. Real-world experiments show promising results, performing on par with the best of the other evaluated methods for all natural signals, despite relying on significantly less information. A key benefit is robustness against array size limitations. By utilizing the received signal power instead of time delays or phase information, the method enables small arrays with great DOA resolution. Furthermore, outdoor data collected a year after calibration confirms its robustness, demonstrating consistent performance over time.Funding Agencies|Wallenberg AI, Autonomous Systems and Software Program (WASP) through the Knut and Alice Wallenberg Foundation; Excellence Center at Linkoeping-Lund in Information Technology (ELLIIT); Security Link</p
A cryptic moth species drives major outbreak dynamics on oak without escaping its natural enemies
No full textGlobal forest ecosystems are experiencing increasingly frequent and severe insect outbreaks, driven by complex interactions among climate change, land-use alterations, and shifting species distributions. Species that are morphologically indistinguishable - often referred to as cryptic species - can differ significantly in distribution, host use, and susceptibility to natural enemies and might thereby differ in outbreak dynamics. Yet, the contribution of cryptic species to temporal changes in the frequency and severity of insect outbreak dynamics remains poorly understood. Motivated by recent defoliation events in northern European oak forests, we investigated an emerging leaf-miner outbreak in Sweden. Through targeted surveys, rearing from 22 sites and Malaise trapping at 34 sites (56 sites total), we identified a pronounced spatial clustering of outbreaks at higher latitudes. The newly recognised cryptic species Acrocercops andreneli was strongly associated with these outbreaks, whereas sites with only Acrocercops brongniardella never showed outbreaks. Host-parasitoid networks related to the two cryptic moth species were strikingly similar. Our findings demonstrate the importance of cryptic species for outbreak dynamics and their consequences for host plant health in ways that are easily overlooked by traditional taxonomy. Moreover, such outbreak dynamics cannot always be linked to a lack of top-down control by natural enemies.Funding Agencies|Formas via the Swedish National Research Programme on Climate [2021-02142]</p
Personality traits and perfectionism in female and male soccer players with or without primary anterior cruciate ligament reconstruction: a cross-sectional study
No full textObjective: To investigate differences in personality traits in female and male soccer players with or without primary anterior cruciate ligament reconstruction (ACLR) and between female and male players with ACLR. Design: Cross-sectional. Participants: 188 female and 58 male players two years after ACLR and 119 female and 107 male knee-healthy players. Main outcome measures: The Swedish universities Scales of Personality and the Sport Multidimensional Perfectionism Scale questionnaires. Results: Females with ACLR did not differ from females without ACLR in any personality trait. Males with ACLR scored slightly higher than males without ACLR for stress susceptibility (50.9 +/- 9.0 vs 47.8 +/- 8.0) and lack of assertiveness (50.3 +/- 8.9 vs 46.6 +/- 9.4), and slightly lower in adventure seeking (51.9 +/- 8.3 vs 55.1 +/- 8.0), personal standards (3.3 +/- 0.9 vs 3.7 +/- 0.7), concern over mistakes (2.6 +/- 0.9 vs 2.9 +/- 0.8), and perceived coach pressure (2.0 +/- 0.9 vs 2.4 +/- 0.9) (p &lt;0.05, small-medium effect sizes). Females with ACLR scored higher than males with ACLR for psychic anxiety and social desirability and lower for detachment, physical trait aggression and perceived parental and coach pressure (p &lt; 0.05, small-medium effect sizes). Conclusion: Personality traits do not differ between females and small differences in males with or without ACLR. Sex differences exist in personality in soccer players, but the clinical importance is unclear.Funding Agencies|Futurum-the Academy for Healthcare, Region Jonkoping County [FUTURUM-766791, FUTURUM-767001, FUTURUM-792801]; Medical Research Council of Southeast Sweden [FORSS-936990]; Swedish Research Council for Sport Science [FO2014-0023]</p
Increased Mortality and Morbidity in Patients With Heart Failure With Sarcoidosis Compared With Other Causes: A Propensity-Matched Nationwide Cohort Study
No full textBackground The prognosis of heart failure (HF) from ischemic heart disease (IHD) is generally worse than from dilated cardiomyopathy (DCM). The impact of prior sarcoidosis on HF outcomes is unknown. We evaluated the prognostic impact of sarcoidosis in HF compared with IHD-HF and DCM-HF using SwedeHF (Swedish Heart Failure Registry).Methods We identified patients with sarcoidosis before HF diagnosis (SC-HF) and propensity-matched them to patients with DCM-HF or IHD-HF between 2003 and 2020. The primary outcome was all-cause mortality; secondary outcomes were cardiovascular death and hospital readmission.Results A total of 422 patients with SC-HF, 6913 with DCM-HF, and 47 164 with IHD-HF were eligible. After 1:2 matching, 365 patients with SC-HF (median follow-up 2.9 years) were compared with 730 with DCM-HF (3.6 years), and 418 with SC-HF (2.8 years) with 836 with IHD-HF (3.6 years). Baseline characteristics were well balanced. Patients with SC-HF had more comorbidities than DCM-HF but fewer than IHD-HF. One-year all-cause mortality was higher in patients with SC-HF than DCM-HF (12.9% versus 8.6%; hazard ratio [HR, 1.51] [95% CI, 1.04-2.21]; P=0.031), along with higher readmission rates. Compared patients with IHD-HF, those with SC-HF also showed higher 1-year mortality (14.8% versus 9.7%; HR, 1.58 [95% CI, 1.14-2.20]; P=0.006). Similar relative risks were observed across full follow-up.Conclusions Sarcoidosis-associated HF is linked to significantly higher mortality than both DCM and IHD and to higher morbidity than DCM. These findings underscore the need for heightened clinical attention and may warrant tailored management strategies for this high-risk group.Funding Agencies|Swedish Heart and Lung Foundation [20240797]; Swedish government; Country councils [ALFGBG-981978, ALFGBG-991243]</p
Compressional Behavior of Naphthalene (C10H8) and Anthracene (C14H10) up to 50 GPa
No full textIn this study, we explored the behavior of naphthalene and anthracene under compression to similar to 50 and similar to 42 GPa, respectively, using synchrotron single-crystal X-ray diffraction (SCXRD) in diamond anvil cells. Both compounds demonstrate remarkable structural stability, with no phase transitions being observed. The equations of states were obtained with the following parameters: V 0 = 182.2(2) & Aring;3, K 0 = 8.4(10) GPa, and K ' = 5.5(6) for naphthalene, and V 0 = 238.0(2) & Aring;3, K 0 = 8.4(5) GPa, and K ' = 8.0(4) for anthracene. Theoretical calculations correctly reproduce experimental data and enable accurate localization of hydrogen atoms. The analysis of Hirshfeld surfaces for both naphthalene and anthracene suggests that the herringbone packing motif of the molecules, the limited contribution of stronger C&lt;middle dot&gt;&lt;middle dot&gt;&lt;middle dot&gt;C interactions to intermolecular bonding, and the high flexibility of relatively weak H&lt;middle dot&gt;&lt;middle dot&gt;&lt;middle dot&gt;H interactions allow a gradual compaction of their structures without phase transitions. Our research contributes to the understanding of the compressional mechanisms, bonding evolution, and structural stability of polyaromatic hydrocarbons under compression.Funding Agencies|Deutsche Forschungsgemeinschaft; Bavarian Academy of Sciences and Humanities [LA 4916/1-1, DU 945/15-1]; Deutsche Forschungsgemeinschaft [200900971]; Swedish Government Strategic Research Area in Materials Science on Functional Materials at Linkoping University</p
Laboratory Assessment of Emicizumab Levels in Hemophilia A: Influence of Assay Selection on Reported Results
No full textBackground: Emicizumab has emerged as a promising therapy for hemophilia A (HA), employing a bypassing mechanism to restore hemostasis. However, since the traditional factor assays cannot be used for measuring the effect of emicizumab, treatment monitoring is difficult. Objectives: To assess the impact of emicizumab on global hemostatic potential (OHP), as well as on chromogenic and modified one-stage (mOSA) FVIII assays calibrated for emicizumab in patient samples. Methods: Peripheral blood samples from patients with HA on emicizumab were utilized for a validation (n = 28) and a clinical cohort (n = 9). Emicizumab concentration was measured by chromogenic FVIII and mOSA (Actin FS, Actin FSL, and PTT-LA), while overall haemostatic potential (OHP) was used to assess global hemostasis. Results: Significantly lower emicizumab concentrations were observed using chromogenic FVIII assay compared to mOSA (P &lt; .005, P &lt; .005, and P &lt; .005 for mOSA Actin FSL, mOSA Actin FS, and mOSA PTT-LA respectively) in the validation cohort. In the clinical cohort, emicizumab concentrations were significantly lower with chromogenic FVIII assay compared to mOSA Actin FS (P &lt; .005) and mOSA PTT-LA (P = .009), but not mOSA Actin FSL. In the clinical cohort, no correlation was seen between OHP and emicizumab. Conclusion: Accurate measurement of emicizumab concentration may have the potential to understand assay variability, which is important for informed clinical decision-making in HA patients. Our findings underscore the need for introducing new methods for measuring emicizumab concentration and suggest chromogenic-based methodologies as a viable option for mitigating assay interference.Funding Agencies|Baxalta US Inc; Takeda group of companies [IIR-SWE-BXLT-001972/ IISR-2017-104237]; Arosenius fond and the Karolinska Institute Foundation for Coagulation Research</p
Assessing both early and late EEG patterns improves prediction of outcome after cardiac arrest
No full textObjective: Previously proposed "synchronous EEG patterns" predict poor outcome within 24 h after cardiac arrest (CA). We investigate the prognostic performance of these early EEG predictors in addition to the late EEG predictors (&gt;24 h) recommended in the European post-resuscitation guidelines. Methods: Observational substudy of the TTM2-trial including consecutive comatose resuscitated patients. Continuous EEG-monitoring (cEEG) was blindly assessed using the American Clinical Neurophysiology Societys standardised EEG terminology and categorised into early EEG predictors (burst-suppression with identical or highly epileptiform bursts, or suppression with generalised periodic discharges) and late EEG predictors (heterogenous burst-suppression or suppression). Poor outcome was defined as modified Rankin Scale 4-6 at six months. Results: Of 191 included patients, 53 % had poor outcome. Early EEG predictors had 100 %[CI 96-100] specificity at all time-points and maximal sensitivity 30 %[CI 21-40] before 24 h. Late EEG predictors had 100 %[CI 96-100] specificity beyond 24 h with maximal sensitivity 32 %[CI 21-43]. Using both early and late EEG predictors, and gradually adding cEEG-information from consecutive time-epochs, sensitivity increased to 49 %[CI 39-59] up to 36 h after CA (p = 0.001). A continuous background within 12 h predicted good outcome (sensitivity 61 %[CI 50-71]; specificity 87 %[CI 79-93]). Conclusion: Searching for both early EEG predictors (e.g. identical burst-suppression) and late EEG predictors (e.g. heterogenous burst-suppression &gt; 24 h) significantly improved sensitivity of poor outcome prediction without false positive survivors in this cohort. A self-fulfilling prophecy may have affected our results. cEEG during the first two days after CA identified half of the patients with a long-term poor outcome and half of the patients with a good outcome