Publikationer från Linköpings universitet
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A comparative study of image quality and diagnostic confidence in diagnosis and follow-up of scaphoid fractures using photon-counting detector CT and energy-integrating detector CT
No full textPurpose: Scaphoid fractures in patients and assessment of healing using PCD-CT have, as far as we know, not yet been studied. Therefore, the aim was to compare photon counting detector CT (PCD-CT) with energy integrating detector CT (EID-CT) in terms of fracture visibility and evaluation of fracture healing. Method: Eight patients with scaphoid fracture were examined with EID-CT and PCD-CT within the first week posttrauma, and with additional scans at 4, 6 and 8 weeks. Our clinical protocol for wrist examination with EID-CT was used (CTDIvol 3.1 +/- 0.1 mGy, UHR kernel Ur77). For PCD-CT matched radiation dose, reconstruction kernel Br89. Quantitative analyses of noise, CNR, trabecular and cortical sharpness, and bone volume fraction were conducted. Five radiologists evaluated the images for fracture visibility, fracture gap consolidation and image quality, and rated their confidence in the diagnosis. Results: The trabecular and cortical sharpness were superior in images obtained with PCD-CT compared with EIDCT. A successive reduction in trabecular bone volume fraction during the immobilized periods was found with both systems. Despite higher noise and lower CNR with PCD-CT, radiologists rated the image quality of PCD-CT as superior. The visibility of the fracture line within 1 -week post -trauma was rated higher with PCD-CT as was diagnostic confidence, but the subsequent assessments of fracture gap consolidation during healing process and the confidence in diagnosis were found equivalent between both systems. Conclusion: PCD-CT offers superior visibility of bone microstructure compared with EID-CT. The evaluation of fracture healing and confidence in diagnosis were rated equally with both systems, but the radiologists found primary fracture visibility and overall image quality superior with PCD-CT.Funding Agencies|ALF Grants [RO-965126]</p
The Second Language Adult Learner in a Swedish context : – A qualitative study about adult learners’ contexts and their impact in second language acquisition.
No full textThis thesis explores the factors influencing second language learning, concentrating on social, professional, and political dimensions, through the lens of Educational Productivity Theory and Community of Practice Theory. Applying a qualitative methodology, structured interviews were conducted with six participants who have experience in learning Swedish as a second language at SFI in Sweden. The study aims to identify how these theories help explain the impact of social relationships, professional motivations, and political contexts on language acquisition in a Swedish context. The results reveal that overall social interactions, particularly within communities of practice, considerably improve learner motivation and engagement. Professional factors, such as setting goals for career advancement, were also found to influence language learning efficiency. Moreover, political influences, such as lack of jobs, lack of housing, “social dumping” and low investment in education and integration of immigrants, shape learners’ opportunities and sets pressure on the newly migrated. By using these theoretical frameworks, the study contributes to a deeper perception of the complex factors that influence second language learning and emphasizes the role of broader and more supportive social and professional contexts
Concurrent Associations Between Callous-Unemotional Traits, Moral Disengagement, and Bullying Perpetration in Adolescence
No full textThe aim of the current study was twofold. The first aim was to examine whether callous-unemotional (CU) traits are directly related to moral disengagement and bullying perpetration as well as whether CU traits are indirectly related to bullying perpetration mediated by moral disengagement among adolescents. The second aim was to examine whether the three distinct dimensions of CU-callousness, uncaringness, and unemotionality-are directly related to moral disengagement and bullying perpetration, as well as whether they are indirectly related to bullying perpetration mediated by moral disengagement among adolescents. Self-report survey data from 706 adolescents (Mage = 14.5) from 20 schools in Sweden were gathered and analyzed using structural equation modeling. The findings suggest that CU traits were positively and directly linked to bullying perpetration, but also indirectly mediated by moral disengagement. Similarly, callousness and uncaringness showed direct and indirect associations with bullying perpetration, whereas unemotionality was found to be only indirectly associated with bullying perpetration. Unemotionality had the weakest connection to moral disengagement and was not directly related to bullying perpetration, whereas callousness, in particular, but also uncaringness, had stronger connections to moral disengagement and bullying perpetration. In sum, the findings underscore the importance of explicitly integrating moral considerations into endeavors aimed at preventing school bullying among adolescents.Funding Agencies|Robert Thornberg from The Swedish Research Council [D0775301]</p
Centralisation of extremely preterm births and decreased early postnatal mortality in Sweden, 2004-2007 versus 2014-2016
No full textAim: We evaluated the increased centralisation of extremely preterm (EPT) births in Sweden in relation to the changes in mortality and morbidity. Methods: Population- based data covering Swedish live births from 22 + 0 to 26 + 6 weeks of gestation during 2004-2007 and 2014-2016 were analysed for associations between time- period, birth within (inborn) or outside (outborn) regional centres, and outcomes. Results: Among 1626 liveborn infants, 703 were born in 2004-2007 and 923 in 2014- 2016. Birth outside (vs. within) regional centres was associated with a higher infant mortality even after adjustment for birth cohort, gestational age, birthweight standard deviation score and infant sex (adjusted odds ratio 2.01, 95% confidence interval 1.31-3.07, p = 0.001). The higher 1year mortality in outborn infants was mainly due to more deaths within 24 h after birth. Outborn infants had a higher incidence of intraventricular haemorrhage grade 3-4 than inborn infants (22% vs. 14% in 2004-2007, and 22% vs. 13% in 2014-2016, both p &lt; 0.05). While survival to 1 year without major morbidity increased in inborn infants (33%-40%, p = 0.008), it remained unchanged in outborn infants (29% vs. 30%, p = 0.88). Conclusion: Centralisation of EPT births contributed to a lower 1year mortality in 2014-2016 than that in 2004-2007, attributed to a decrease in deaths before 24 h among inborn infants.Funding Agencies|The Childhood Foundation of Swedish Order of Freemasons</p
Social Avoidance of Mice in Pain in Naturalistic Conditions
No full textPain and social behavior are subject to reciprocal modulation. Social animals show attenuated pain behavior in the presence of conspecifics, while observers are in turn affected by exposure to another individual in pain. Both phenomena have been established in rodents, which in addition to experiencing emotional contagion from afflicted conspecifics may act to relieve their afflicted state. Little has been done to investigate the motivation of such prosocial behavior in naturalistic conditions. Here, using a novel formalin test targeting the nape of the neck, a socially relevant area, we investigated nocifensive behaviors and social interactions in mice group-housed in a seminatural environment (SNE). In the SNE, formalin-injected mice displayed fewer back-scratching occurrences than when housed alone, which was inversely correlated to the social behavior received. These mice also emitted and received fewer social interactions, attesting of social withdrawal. With respect to dyadic exchanges, saline-treated mice initiated fewer allosniffing and anogenital sniffing episodes towards formalin-treated mice than towards other saline-treated ones. These findings are counter to those showing empathy and prosocial approach in mouse pain models. It is possible that in naturalistic conditions that allow the mice to express a wide range of their behavioral repertoire, healthy mice simply avoid individuals in pain and the cost associated with emotional contagion. Interestingly, behaviors involving direct body contact, namely allogrooming and pair-resting, were not different between saline- and formalin-treated mice and thus may carry a prosocial, altruistic component. These findings unveil new patterns of social modulation by pain in a naturalistic laboratory setting holding high translational value.Funding Agencies|Knut and Alice Wallenberg Foundation [2019.0047]; Linkoeping University</p
Waxy- or Putty-Like Materials as a Novel Drug Preparation for Synthetic Cannabinoid Receptor Agonists: Detection in Prisons and In Vitro Cannabinoid Receptor Activity
No full textAfter the Scottish Prison Service (SPS) introduced mail photocopying procedures in December 2021, a shift in smuggling methods was observed for synthetic cannabinoid receptor agonists (SCRAs) and other new psychoactive substances (NPS) from drug-infused papers back to traditional sample matrices (e.g., tablets and powders), although new matrices also emerged. This study reports on waxy- or putty-like materials as a novel drug preparation for SCRAs and other drugs seized from UK prisons. In 2023, 22 of these new preparations were seized from Scottish prisons, with eight found in sealed vape pods. The materials were positive for SCRAs, phytocannabinoids, novel benzodiazepines, and/or gabapentinoids. Additionally, 11 preparations were seized from an English prison, all containing the SCRAs MDMB-4en-PINACA and MDMB-INACA. MDMB-INACA was pharmacologically characterized using in vitro CB1 and CB2 bioassays, revealing moderate efficacy but low potency at CB1. Furthermore, the in vitro CB1 bioassay was also used to evaluate the CB1 activating potential of extracts from eight seized samples. Six of these showed high CB1 activity, whereas the samples lacking SCRAs or containing only MDMB-INACA showed no or only weak CB1 activity, respectively. Lastly, applying the bioassay as an activity-based "untargeted" screening method effectively identified the presence of SCRAs in one waxy preparation, which was initially not detected by gas chromatography-mass spectrometry (GC-MS). This underscores the effectiveness of the bioassay for evaluating these new waxy- or putty-like materials for the presence of SCRAs.Funding Agencies|Scottish Prison Service [01865]; Leverhulme Trust [RC-2015-011]; Bijzonder Onderzoeksfonds (BOF) of Ghent University [BOF21/DOC/248]; Research Foundation Flanders (FWO) [1S54521N]; Engineering and Physical Sciences Research Council (EPSRC) [EP/V026917/1, EP/L016354/1]; Strategic Research Area in Forensic Sciences at Linkoeping University</p
Validation of the European visual field standards for driving: A driving simulator-based study
No full textPurposeTo determine whether we could establish evidence-based pass/fail criteria for perimetry in the context of the European visual field standards for driving.MethodsThis two-centre, cross-sectional study included participants with binocular visual field loss that had led to revocation of a group-1 driving licence. The participants underwent cognitive and binocular visual testing, including the European Driving Test (EDT), a perimetry algorithm that adheres to the European visual field standards. We used a high-fidelity driving simulator to compare the driving ability of these participants with healthy controls. Two driving instructors classified each driving test as passed or failed. Receiver operating characteristic (ROC) analysis and area under the curve (AUC) determined the ability of perimetry to discriminate between passed and failed driving tests.ResultsThe study included 70 participants with visual field loss and 37 controls. A non-significantly higher proportion of controls passed the driving test (75% vs. 63%; p = 0.22). In ROC analysis, contrast sensitivity performed best (AUC of 0.73), followed by NEI VFQ-25 (AUC of 0.64). Peripheral visual field (AUC of 0.56) and central visual field (AUC of 0.47) performed weaker. Combining the central and peripheral visual field, and their interaction, increased AUC to 0.63.ConclusionPerimetry was a poor predictor of simulator-based driving test result, and we could not establish appropriate pass/fail criteria for the European visual field standards. Because perimetry is not an accurate diagnostic tool for fitness to drive, a practical driving assessment should be performed in case of doubt.Funding Agencies|Norwegian Glaucoma Research Foundation; Arthur and Odd Clauson's Legacy; Oslo University Hospital; Norwegian Association of the Blind</p
Effectiveness of JAK Inhibitors Compared With Biologic Disease-Modifying Antirheumatic Drugs on Pain Reduction in Rheumatoid Arthritis: Results From a Nationwide Swedish Cohort Study
No full textObjective. To compare the effectiveness of JAK inhibitors (JAKis) and biologic disease-modifying antirheumatic drugs (bDMARDs) on pain in patients with rheumatoid arthritis. Methods. In this retrospective study, we investigated patients with a diagnosis of rheumatoid arthritis, starting treatment with a JAKi (n = 1,827), a tumor necrosis factor inhibitor (TNFi; n = 6,422), an interleukin-6 inhibitor (n = 887), abatacept (n = 1,102), or rituximab (n = 1,149) in 2017 to 2019, using data from several linked Swedish national registers. Differences in change in pain, assessed with a visual analogue scale (0-100 mm), from baseline to 3 months, as well as proportions of patients remaining on initial treatment with low pain (visual analogue scale pain &lt;20) at 12 months, were compared between treatments. Comparisons of treatment responses between JAKis and bDMARDs were evaluated using multivariable linear regression, adjusted for patient characteristics, comorbidities, current comedication, and previous treatment. Results. JAKi treatment was associated with a greater decrease in pain at 3 months compared with TNFi treatment (adjusted mean additional decrease 4.0 mm; 95% confidence interval 1.6-6.3), with similar trends in comparisons with non-TNFi bDMARDs. More patients achieved low pain at 12 months on JAKis compared with TNFis, in particular among those previously treated with at least two bDMARDs (adjusted change contrast 5.3 percentage points; 95% confidence interval 1.0-9.6). Conclusion. JAKis had a slightly better effect on pain outcomes at 3 and 12 months compared with TNFis, with significantly greater differences in patients previously treated with at least two bDMARDs. The effect of JAKis on pain reduction was at least similar to that of non-TNFi bDMARDs.Funding Agencies|Lund University</p
Homo academicus as Guild, Employment, and Attitude : The Academy in Transition
No full textHomo academicus, who are we, who do we want to be, and how do others view us? There are many alternative answers to these questions. In this chapter, I explore three different conceptions that not only differ in outlook and underlying assumptions, but also on who counts as Homo academicus. The three are Homo academicus as guild, employment, and attitude to knowledge and learning. As during previous information technology revolutions—writing, paper, printing, penny post, telegraph, copier, e.g.—the present digitisation again poses challenges to the established order, power structures, and conceptions of (worthwhile) knowledge, giving cause to look at the assumptions underpinning and shaping these conceptions. Again, the role of the academy is in transition. Entering a road towards Homo academicus-ship may be motivated by a range of desires: the search for truth or justified true belief; a longing for becoming an authority—or merely to be accepted into the circles where those one views as authorities reside and act; making a career in a structure with a seemingly clear hierarchy—or merely making a living; a passion for a topic; a wish for intellectual challenges—or merely intellectual conversations …. These desires can be met to differing degrees and in different forms depending on the conception of Homo academicus. And the surrounding world provides support, funding, admiration, challenges, and disdain partly based on which conception(s) surrounding actors hold. How these three conceptions and their underlying assumptions interact, challenge, and are challenged by each other and by trends in the societies of which they form parts, is the object of this chapter examining current transitions
Skin graft take rate among minor burns : A cohort study to investigate the effect of factors such as burn depth, burn size, and timing of the operation
No full textBackground: It has been known for decades that early excision of burns reduces morbidity and mortality. Early surgical excision and skin grafting has become the most important part of successful healing in burn management, especially in major burns. However, it is not entirely clear whether early excision and skin transplantation has the same advantages in smaller burns and there is no consensus on the timing of skin grafting in this group. The aim was to investigate the effect of timing and other factors for skin graft take rate among minor burns. Methods: This retrospective study included patients with thermal injury, a burn size smaller than 11 % total body surface area (TBSA), and who were treated with a skin graft operation. Take rate at the second dressing change after operation was used as main outcome, a cut-off of 95% take rate was for the multivariable logistic regression. Results: A total of 195 patients were included, median (IQR) age was 42 (9–68) years, 65 % were male, and median (IQR) area of deep burns was 2 (1–4) % of the body surface area (BSA). Multivariable regression showed that smaller area of deep burns and scalds (compared with flame and contact burns) were associated with a take rate of ≥ 95 %. Age, timing of the skin graft transplantation, and plasma C-reactive protein showed no independent effect on take rate. The regression model was significant but weak (ROC AUC 0.71, 95 % CI 0.62–0.79). Conclusion: Our results suggest that the extent and depth of the burn are the most important factors for skin graft take rate among minor burns, while timing of the transplantation is not associated with take rate for the skin graft. The advantageous effect of scalds may be interpreted to mean that scalds in general are more superficial than flame and contact burns, a difference that may not be detected by the use of a Lund and Browder chart. The conclusion is, however, tempered by the retrospective study design and the relatively low discriminatory power in our study.This study was funded by the department of Hand Surgery, Plastic Surgery and Burns, and Linköping University, Linköping, Sweden.</p