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  • 1.
    Ansell, Anna
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Jedlinski, Adam
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Johansson, Ann-Charlotte
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Roberg, Karin
    Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping. Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science.
    Epidermal growth factor is a biomarker for poor cetuximab response in tongue cancer cells2016In: Journal of Oral Pathology & Medicine, ISSN 0904-2512, E-ISSN 1600-0714, Vol. 45, no 1, p. 9-16Article in journal (Refereed)
    Abstract [en]

    Background: Epidermal growth factor receptor (EGFR) is a target for treatment in tongue cancer. Here, EGFR ligands were evaluated for their potential uses as predictive biomarkers of cetuximab treatment response.

    Methods: In three tongue cancer cell lines the influences of epidermal growth factor (EGF), amphiregulin (AR), and epiregulin (EPR) on tumour cell proliferation and cetuximab response were evaluated by the addition of recombinant human (rh) proteins or the siRNA-mediated downregulation of endogenous ligand production.

    Results: EGF or AR downregulation suppressed the proliferation of all investigated cell lines. Furthermore, all cell lines displayed increased cetuximab resistance upon the addition of rhEGF, whereas EGF silencing resulted in an improved cetuximab response in one cell line.

    Conclusions: Our data suggest that EGF and AR are critical components of the EGFR signalling network required for full proliferative potential. Moreover, EGF is a potential predictive biomarker of poor cetuximab response and a possible treatment target.

  • 2.
    Arlinger, Stig
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Speech language pathology, Audiology and Otorhinolaryngology. Linköping University, Faculty of Medicine and Health Sciences.
    Nordqvist, Peter
    Royal Institute Technology, Sweden.
    Öberg, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    International Outcome Inventory for Hearing Aids: Data From a Large Swedish Quality Register Database2017In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 26, no 3, p. 443-450Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this study was to analyze a database of completed International Outcome Inventory for Hearing Aids (IOI-HA) questionnaires obtained from over 100,000 clients fitted with new hearing aids in Sweden during the period of 2012-2016. Mean IOI-HA total scores were correlated with degree of hearing loss, unilateral versus bilateral fitting, first-time versus return clients, gender, and variation among dispensing clinics. The correlations with expectations, service quality, and technical functioning of the hearing aids were also analyzed. Method: Questionnaires containing the 7 IOI-HA items as well as questions concerning some additional issues were mailed to clients 3-6 months after fitting of new hearing aids. The questionnaires were returned to and analyzed by an independent research institute. Results: More than 100 dispensing clinics nationwide take part in this project. A response rate of 52.6% resulted in 106,631 data sets after excluding incomplete questionnaires. Forty-six percent of the responders were women, and 54% were men. The largest difference in mean score (0.66) was found for the IOI-HA item "use" between return clients and first-time users. Women reported significantly higher (better) scores for the item "impact on others" compared with men. The bilaterally fitted subgroup reported significantly higher scores for all 7 items compared with the unilaterally fitted subgroup. Experienced users produced higher scores on benefit and satisfaction items, whereas first-time users gave higher scores for residual problems. No correlation was found between mean IOI-HA total score and average hearing threshold level (pure-tone average [ PTA]). Mean IOI-HA total scores were found to correlate significantly with perceived service quality of the dispensing center and with the technical functionality of the hearing aids. Conclusions: When comparing mean IOI-HA total scores from different studies or between groups, differences with regard to hearing aid experience, gender, and unilateral versus bilateral fitting have to be considered. No correlation was found between mean IOI-HA total score and degree of hearing loss in terms of PTA. Thus, PTA is not a reliable predictor of benefit and satisfaction of hearing aid provision as represented by the IOI-HA items. Identification of a specific lower fence in PTA for hearing aid candidacy is therefore to be avoided. Large differences were found in mean IOI-HA total scores related to different dispensing centers.

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  • 3.
    Asp, Filip
    et al.
    Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Mäki-Torkko, Elina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Karltorp, Eva
    Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Harder, Henrik
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Hergils, Leif
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Eskilsson, Gunnar
    Karolinska University Hospital, Sweden.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    A longitudinal study of the bilateral benefit in children with bilateral cochlear implants2015In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 54, no 2, p. 77-88Article in journal (Refereed)
    Abstract [en]

    Objective: To study the development of the bilateral benefit in children using bilateral cochlear implants by measurements of speech recognition and sound localization. Design: Bilateral and unilateral speech recognition in quiet, in multi-source noise, and horizontal sound localization was measured at three occasions during a two-year period, without controlling for age or implant experience. Longitudinal and cross-sectional analyses were performed. Results were compared to cross-sectional data from children with normal hearing. Study sample: Seventy-eight children aged 5.1-11.9 years, with a mean bilateral cochlear implant experience of 3.3 years and a mean age of 7.8 years, at inclusion in the study. Thirty children with normal hearing aged 4.8-9.0 years provided normative data. Results: For children with cochlear implants, bilateral and unilateral speech recognition in quiet was comparable whereas a bilateral benefit for speech recognition in noise and sound localization was found at all three test occasions. Absolute performance was lower than in children with normal hearing. Early bilateral implantation facilitated sound localization. Conclusions: A bilateral benefit for speech recognition in noise and sound localization continues to exist over time for children with bilateral cochlear implants, but no relative improvement is found after three years of bilateral cochlear implant experience.

  • 4.
    Bernstein, Joshua G. W.
    et al.
    Walter Reed National Mil Medical Centre, MD 20889 USA.
    Danielsson, Henrik
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Hällgren, Mathias
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Rönnberg, Jerker
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Oticon AS, Denmark.
    Spectrotemporal Modulation Sensitivity as a Predictor of Speech-Reception Performance in Noise With Hearing Aids2016In: TRENDS IN HEARING, ISSN 2331-2165, Vol. 20, article id 2331216516670387Article in journal (Refereed)
    Abstract [en]

    The audiogram predicts amp;lt;30% of the variance in speech-reception thresholds (SRTs) for hearing-impaired (HI) listeners fitted with individualized frequency-dependent gain. The remaining variance could reflect suprathreshold distortion in the auditory pathways or nonauditory factors such as cognitive processing. The relationship between a measure of suprathreshold auditory function-spectrotemporal modulation (STM) sensitivity-and SRTs in noise was examined for 154 HI listeners fitted with individualized frequency-specific gain. SRTs were measured for 65-dB SPL sentences presented in speech-weighted noise or four-talker babble to an individually programmed master hearing aid, with the output of an ear-simulating coupler played through insert earphones. Modulation-depth detection thresholds were measured over headphones for STM (2cycles/octave density, 4-Hz rate) applied to an 85-dB SPL, 2-kHz lowpass-filtered pink-noise carrier. SRTs were correlated with both the high-frequency (2-6 kHz) pure-tone average (HFA; R-2 = .31) and STM sensitivity (R-2 = .28). Combined with the HFA, STM sensitivity significantly improved the SRT prediction (Delta R-2 = .13; total R-2 = .44). The remaining unaccounted variance might be attributable to variability in cognitive function and other dimensions of suprathreshold distortion. STM sensitivity was most critical in predicting SRTs for listenersamp;lt;65 years old or with HFA amp;lt;53 dB HL. Results are discussed in the context of previous work suggesting that STM sensitivity for low rates and low-frequency carriers is impaired by a reduced ability to use temporal fine-structure information to detect dynamic spectra. STM detection is a fast test of suprathreshold auditory function for frequencies amp;lt;2 kHz that complements the HFA to predict variability in hearing-aid outcomes for speech perception in noise.

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  • 5.
    Boisvert, Isabelle
    et al.
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences. Macquarie University, Australia; HEARing Cooperat Research Centre, Australia; SCIC Cochlear Implant Program, Australia.
    McMahon, Catherine M.
    Macquarie University, Australia; HEARing Cooperat Research Centre, Australia.
    Dowell, Richard C.
    HEARing Cooperat Research Centre, Australia; University of Melbourne, Australia; Royal Victorian Eye and Ear Hospital, Australia.
    Lyxell, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping. Linköping University, The Swedish Institute for Disability Research.
    Long-Term Asymmetric Hearing Affects Cochlear Implantation Outcomes Differently in Adults with Pre- and Postlingual Hearing Loss2015In: PLOS ONE, E-ISSN 1932-6203, Vol. 10, no 6, article id e0129167Article in journal (Refereed)
    Abstract [en]

    In many countries, a single cochlear implant is offered as a treatment for a bilateral hearing loss. In cases where there is asymmetry in the amount of sound deprivation between the ears, there is a dilemma in choosing which ear should be implanted. In many clinics, the choice of ear has been guided by an assumption that the reorganisation of the auditory pathways caused by longer duration of deafness in one ear is associated with poorer implantation outcomes for that ear. This assumption, however, is mainly derived from studies of early childhood deafness. This study compared outcomes following implantation of the better or poorer ear in cases of long-term hearing asymmetries. Audiological records of 146 adults with bilateral hearing loss using a single hearing aid were reviewed. The unaided ear had 15 to 72 years of unaided severe to profound hearing loss before unilateral cochlear implantation. 98 received the implant in their long-term sound-deprived ear. A multiple regression analysis was conducted to assess the relative contribution of potential predictors to speech recognition performance after implantation. Duration of bilateral significant hearing loss and the presence of a prelingual hearing loss explained the majority of variance in speech recognition performance following cochlear implantation. For participants with post-lingual hearing loss, similar outcomes were obtained by implanting either ear. With prelingual hearing loss, poorer outcomes were obtained when implanting the long-term sound-deprived ear, but the duration of the sound deprivation in the implanted ear did not reliably predict outcomes. Contrary to an apparent clinical consensus, duration of sound deprivation in one ear has limited value in predicting speech recognition outcomes of cochlear implantation in that ear. Outcomes of cochlear implantation are more closely related to the period of time for which the brain is deprived of auditory stimulation from both ears.

  • 6.
    Brännström, Jonas K
    et al.
    Linköping University, Faculty of Arts and Sciences. Dept of clinical science, Section of Logopedics, Phoiatrics and audiology, Lund University, Sweden.
    Öberg, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Ingo, Elisabeth
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Månsson, Kristoffer N. T.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Sweden.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Eriksholm Research Centre, Oticon A/S, Denmark.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Eriksholm Research Centre, Oticon A/S, Denmark.
    The Process of Developing an Internet-Based Support System for Audiologists and First-Time Hearing Aid Clients2015In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 24, no 3, p. 320-324Article in journal (Refereed)
    Abstract [en]

    Background: In audiologic practice, complementary information sources and access to the clinician between appointments improve information retention and facilitate adjustment behaviors. An Internet-based support system is a novel way to support information sharing and clinician access. Purpose: This research forum article describes the process of developing an Internet-based support system for audiologists and their first-time hearing aid clients. Method: The iterative development process, including revisions by 4 research audiologists and 4 clinical audiologists, is described. The final system is exemplified. Conclusion: An Internet-based support system was successfully developed for audiologic practice.

  • 7.
    Farnebo, Lovisa
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Laurell, Göran
    Uppsala University, Sweden.
    Makitie, Antti
    University of Helsinki, Finland; Helsinki University Hospital, Finland; Karolinska Institute, Sweden.
    A Nordic survey on the management of head and neck CUP2016In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 136, no 11, p. 1159-1163Article in journal (Refereed)
    Abstract [en]

    Conclusion: The management of Head and Neck Cancer of Unknown Primary (HNCUP) patients varies both between centres within and also between the Nordic countries. This study contributes to a continuing discussion of how to improve the accuracy of diagnosis and quality of treatment of HNCUP patients.Objectives: The initiative for this study was based on the lack of common guidelines for diagnostic procedures and for treatment of HNCUP patients in the Nordic countries constituting a region having a rather homogeneous population.Method: A structured questionnaire was sent to all university hospitals in the five Nordic countries.Results: Four of the five Nordic countries use either national guidelines or specific protocols when handling HNCUP. The main diagnostic tools are PET-CT, fine needle aspiration, endoscopic evaluation with biopsies, and most often bilateral tonsillectomy. At 21 of 22 university hospitals the treatment decision is made at a multidisciplinary conference. Three of seven Swedish centres use only radiotherapy or chemoradiotherapy to treat N+ HNCUP patients. Robotic surgery for biopsy of the tongue base is beginning to become an alternative to targeted biopsies in Sweden and Finland. Narrow Band Imaging is used only in Finland.

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  • 8.
    Farnebo, Lovisa
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping. Linköping University, Faculty of Medicine and Health Sciences.
    Malila, Nea
    Finnish Cancer Registry, Finland.
    Makitie, Antti
    Karolinska Institute, Sweden; Karolinska Hospital, Sweden; University of Helsinki, Finland; Helsinki University Hospital, Finland.
    Laurell, Goran
    Uppsala University, Sweden.
    Early death among head and neck cancer patients2016In: Current Opinion in Otolaryngology & Head and Neck Surgery, ISSN 1068-9508, E-ISSN 1531-6998, Vol. 24, no 2, p. 115-120Article, review/survey (Refereed)
    Abstract [en]

    Purpose of reviewManagement of advanced head and neck cancer (HNC) is characterized by high mortality. Furthermore, the treatment involves significant burden to patients and high costs to healthcare systems. Recognizing the risks of early death in patients with a high probability of noncurable disease is important for each individual treatment decision-making. It is thus critical to consider the benefits and side-effects of the planned treatment in relation to the expected survival and to discuss these factors with the patient. However, only few studies have documented early death in HNC patients, that is, during the first posttreatment 6 months. We performed a systematic literature review to find the incidence of this phenomenon and to outline the probable cause.Recent findingsEarly mortality in patients with HNC can be explained either by direct effect of malignant disease, may be related to comorbidities, or secondary to the treatment. These factors act together resulting in expected or unexpected early death.SummaryThe present review provides information on the mechanisms leading to early phase mortality (<6 months) after management of HNC. It also reports the incidence of this phenomenon among Finnish and Swedish patient populations.

  • 9.
    Farnebo, Lovisa
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping. Linköping University, Faculty of Medicine and Health Sciences.
    Stjernstrom, Annika
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences.
    Fredrikson, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Ansell, Anna
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Garvin, Stina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Pathology and Clinical Genetics.
    Thunell, Lena
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences.
    DNA repair genes XPC, XPD, XRCC1, and XRCC3 are associated with risk and survival of squamous cell carcinoma of the head and neck2015In: DNA Repair, ISSN 1568-7864, E-ISSN 1568-7856, Vol. 31, p. 64-72Article in journal (Refereed)
    Abstract [en]

    Head and neck squamous cell carcinomas (HNSCC) are a heterogenous group of tumors with a high rate of early recurrences, second primary tumors, and mortality. Despite advances in diagnosis and treatment over the past decades, the overall 5-year survival rate remains around 50%. Since the head-and neck-region is continuously exposed to potentially DNA-damaging exogenous and endogenous factors, it is reasonable to expect that the DNA repair genes play a part in the development, progression, and outcome of HNSCC. The aim of this study was to investigate the SNPs XPC A499V, XPD K751Q XRCC1 R399Q and XRCC3 T241M as potential risk factors and indicators of survival among Caucasian patients. One-hundred-sixty-nine patients as well as 344 healthy controls were included and genotyped with PCR-RFLP. We showed that XPC A499V was associated with increased risk of HNSCC, especially laryngeal carcinoma. Among women, XPD K751Q was associated with increased risk of oral SCC. Furthermore, XPD homozygous mutant individuals had the shortest survival time, a survival time that increased however after full dose radiotherapy. Wild-type individuals of XRCC3 T241M demonstrated an earlier age of onset. HPV-positive never smokers had lower frequencies of p53 mutation. Among HNSCC patients, HPV-positivity was significantly associated with XRCC1 R399Q homozygous mutant genotype. Moreover, combinations of putative risk alleles seemed to act synergistically, increasing the risk of HNSCC. In conclusion, our results suggest that SNPs of the DNA repair genes XPC, XPD, XRCC1, and XRCC3 may affect risk and survival of HNSCC. (C) 2015 Elsevier B.V. All rights reserved.

  • 10.
    Finke, Mareike
    et al.
    Hannover Medical Sch, Germany; Cluster Excellence Hearing4all, Germany; Cluster Excellence Hearing4all, Germany.
    Boenitz, Hanna
    Hannover Medical Sch, Germany.
    Lyxell, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping. Linköping University, The Swedish Institute for Disability Research.
    Illg, Angelika
    Hannover Medical Sch, Germany.
    Cochlear implant effectiveness in postlingual single-sided deaf individuals: whats the point?2017In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 56, no 6, p. 417-423Article in journal (Refereed)
    Abstract [en]

    Objectives: By extending the indication criteria for cochlear implants (CI), the population of CI candidates increased in age, as well as range and type of hearing loss. This qualitative study identified factors that contributed to seek CI treatment in single-sided deaf individuals and gained insights how single-sided deafness (SSD) and hearing with a CI affect their lives. Design: An open-ended questionnaire and a standardised inventory (IOI-HA) were used. Qualitative data reflecting the reasons to seek CI treatment and the individual experiences after CI switch-on were collected. Study sample: A total of 19 postlingually deafened single-sided deaf CI users. Results: Participants use their CI daily and stated that their life satisfaction increased since CI activation. The analysis of the qualitative data revealed four core categories: sound localisation, tinnitus and noise sensitivity, fear to lose the second ear and quality of life. Conclusions: Our results show how strongly and diversely quality of hearing and quality of life is affected by acquired SSD and improved after CI activation. Our data suggest that the fear of hearing loss (HL) on the normal hearing (NH) ear is an important but so far neglected reason to seek treatment with a CI in individuals with postlingual SSD.

  • 11.
    Frodlund, Jonas
    et al.
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Harder, Henrik
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Mäki-Torkko, Elina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Ledin, Torbjörn
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Vestibular Function After Cochlear Implantation: A Comparison of Three Types of Electrodes2016In: Otology and Neurotology, ISSN 1531-7129, E-ISSN 1537-4505, Vol. 37, no 10, p. 1535-1540Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate the vestibular function after cochlear implantation with different types of electrode arrays. Study Design: Retrospective cohort study. Setting: Academic tertiary referral center. Materials and Methods: Forty three adults underwent first cochlear implantation. Three consecutive series of patients: Group 1 (n = 13) implanted with a precurved electrode, Group 2 (n = 15) implanted with a straight electrode, Group 3 (n = 15) implanted with a flexible electrode. Patients vestibular functions were assessed with pre-and postoperative caloric testing using videonystagmography (VNG). The postoperative reduction of the maximum slow phase velocity (MSPV) in the implanted ear was evaluated. Medical charts were reviewed to evaluate the occurrence of late onset of postoperative vestibular symptoms. Results: Mean reduction of MSPV was 7.6/s (standard deviation [SD] 8.0) in Group 1, 23.1/s (SD 16.6) in Group 2, and 0.1/s (SD 18.5) in Group 3. Significant difference was found between Group 1 and 2 (p amp;lt; 0.030) and between Group 2 and 3 (p amp;lt; 0.001). Group 2 showed a higher prevalence of late onset of clinical vertigo (28.6%) than Group 1 (7.7%) and 3 (6.7%). Conclusion: In this prospective study, significantly larger reductions of caloric responses were found in subjects implanted with a straight electrode compared with subjects implanted with a precurved or flexible electrode. These findings seem to correlate to a higher prevalence of postoperative vertigo.

  • 12.
    Garvin, Stina
    et al.
    Östergötlands Läns Landsting, Center for Diagnostics, Department of Clinical Pathology and Clinical Genetics. Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Tiefenböck, Katharina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Farnebo, Lovisa
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Thunell, Lena
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Health Sciences.
    Farnebo, Marianne
    Karolinska Institute, Sweden.
    Roberg, Karin
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Nuclear expression of WRAP53 beta is associated with a positive response to radiotherapy and improved overall survival in patients with head and neck squamous cell carcinoma2015In: Oral Oncology, ISSN 1368-8375, E-ISSN 1879-0593, Vol. 51, no 1, p. 24-30Article in journal (Refereed)
    Abstract [en]

    Objectives: Today there are no reliable predictive markers for radiotherapy response in head and neck squamous cell carcinoma (HNSCC), leading to both under-and over-treatment of patients, personal suffering, and negative socioeconomic effects. Inherited mutation in WRAP53 beta (WD40 encoding RNA Antisense to p53), a protein involved in intracellular trafficking, dramatically increases the risk of developing HNSCC. The purpose of this study was to investigate whether WRAP53 beta can predict response to radiotherapy in patients with HNSCC. Materials and methods: Tumor biopsies from patients with HNSCC classified as responders or non-responders to radiotherapy were examined for the expression of the WRAP53 beta protein and single nucleotide polymorphisms in the corresponding gene employing immunohistochemistry and allelic discrimination, respectively. In addition, the effect of RNAi-mediated downregulation of WRAP53 beta on the intrinsic radiosensitivity of two HNSCC cell lines was assed using crystal violet and clonogenic assays. Results: Nuclear expression of WRAP53 beta was significantly associated with better response to radiotherapy and improved patient survival. Downregulation of WRAP53 beta with siRNA in vitro enhanced cellular resistance to radiation. Conclusions: Our findings suggest that nuclear expression of WRAP53 beta promotes tumor cell death in response to radiotherapy and is a promising predictor of radiotherapy response in patients with HNSCC.

  • 13.
    Gustafsson, Håkan
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Radiology in Norrköping/Finspång. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Kale, Ajay
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Dasu, Alexandru
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. The Skandion Clinic, Uppsala, Sweden.
    Lund, Anders
    Linköping University, Department of Physics, Chemistry and Biology, Chemical Physics. Linköping University, Faculty of Science & Engineering.
    Edqvist, Per-Henrik
    Uppsala University, Uppsala, Sweden.
    Roberg, Karin
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    EPR oximetry of cetuximab-treated head-and-neck tumours in a mouse model2017In: Cell Biochemistry and Biophysics, ISSN 1085-9195, E-ISSN 1559-0283, Vol. 75, no 3-4, p. 299-309Article in journal (Refereed)
    Abstract [en]

    Head and neck squamous cell carcinoma (HNSCC) tumours are associated with high mortality despite advances in therapy. The monoclonal antibody cetuximab (Erbitux®) has been approved for the treatment of advanced HNSCC. However, only a subset of HNSC patients receiving cetuximab actually responds to treatment, underlining the need for a means to tailor treatments of individual patients. The aim of the present study was to investigate the effect of cetuximab treatment on tumour growth, on tumour partial oxygen pressure as measured by LiPc electron paramagnetic resonance oximetry and on the expression of proteins involved in tumour growth, metabolism and hypoxia. Two HNSCC cell lines, UT-SCC-2 and UT-SCC-14, were used to generate xenografts on female BALB/c (nu/nu) nude mice. Mice with xenografts were given three injections of intraperitoneal cetuximab or phosphate-buffered saline, and the tumour volume was recorded continuously. After treatment the tumour partial oxygen pressure was measured by LiPc electron paramagnetic resonance oximetry and the expression of epidermal growth factor receptor (EGFR), phosphorylated EGFR, Ki-67, MCT1, MCT4, GLUT1, CAIX and HIF-1α were investigated by immunohistochemistry. In xenografts from both cell lines (UT-SCC-2 and UT-SCC-14) cetuximab had effect on the tumour volume but the effect was more pronounced on UT-SCC-14 xenografts. A higher tumour oxygenation was measured in cetuximab-treated tumours from both cell lines compared to untreated controls. Immunocytochemical staining after cetuximab treatment shows a significantly decreased expression of EGFR, pEGFR, Ki67, CAIX and nuclear HIF-1α in UT-SCC-14 tumours compared to untreated controls. MCT1 and GLUT1 were significantly decreased in tumours from both cell lines but more pronounced in UT-SCC-14 tumours. Taken together, our results show that cetuximab treatment decreases the tumour growth and increases the tumour partial oxygen pressure of HNSCC xenografts. Furthermore we found a potential connection between the partial oxygen pressure of the tumours and the expression of proteins involved in tumour growth, metabolism and hypoxia.

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  • 14.
    Henricson, Cecilia
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Lidestam, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Lyxell, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping. Linköping University, The Swedish Institute for Disability Research.
    Moller, Claes
    Örebro University Hospital, Sweden.
    Cognitive skills and reading in adults with Usher syndrome type 22015In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 6, no 326Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate working memory (WM), phonological skills, lexical skills, and reading comprehension in adults with Usher syndrome type 2 (USH2). Design: The participants performed tests of phonological processing, lexical access, WM, and reading comprehension. The design of the test situation and tests was specifically considered for use with persons with low vision in combination with hearing impairment. The performance of the group with USH2 on the different cognitive measures was compared to that of a matched control group with normal hearing and vision (NVH). Study Sample: Thirteen participants with USH2 aged 21-60 years and a control group of 10 individuals with NVH, matched on age and level of education. Results: The group with USH2 displayed significantly lower performance on tests of phonological processing, and on measures requiring both fast visual judgment and phonological processing. There was a larger variation in performance among the individuals with USH2 than in the matched control group. Conclusion: The performance of the group with USH2 indicated similar problems with phonological processing skills and phonological WM as in individuals with long-term hearing loss. The group with USH2 also had significantly longer reaction times, indicating that processing of visual stimuli is difficult due to the visual impairment. These findings point toward the difficulties in accessing information that persons with USH2 experience, and could be part of the explanation of why individuals with USH2 report high levels of fatigue and feelings of stress (Wahlqvist et al., 2013).

  • 15.
    Henriksson, Ingrid
    et al.
    Gothenburg Univ, Sweden.
    Hjerten, Andreas
    Gothenburg Univ, Sweden.
    Zackariasson, Jesper
    Gothenburg Univ, Sweden.
    Davidsson, Linda
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Andersson Damberg, Amanda
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Saldert, Charlotta
    Gothenburg Univ, Sweden.
    Ball, Martin J.
    Bangor Univ, Wales.
    Mueller, Nicole
    Univ Coll Cork, Ireland.
    Public awareness of aphasia - results of a Swedish sample2019In: Aphasiology, ISSN 0268-7038, E-ISSN 1464-5041, Vol. 33, no 1, p. 94-104Article in journal (Refereed)
    Abstract [en]

    Background: Public awareness of a condition like aphasia may affect service provision and everyday life communication for people affected by the condition. Nevertheless, studies have shown that the public awareness of aphasia is low in many countries. Aims: This study explores awareness and knowledge of aphasia among the general public in Sweden. Methods amp; Procedures: We describe two surveys on the public awareness of aphasia undertaken using convenience samples in four different cities in southern Sweden. The questionnaire was closely based on those used in previous studies of aphasia awareness around the world. A total of 372 participants were recruited. Results are presented in terms of whether participants had heard of aphasia or not, and in the case that they had heard of it, whether they had a basic knowledge of the condition. Further analyses were undertaken on these three groups of participants: their gender and age distributions, educational background, what they knew about aphasia, and where they had learnt about it. Outcomes amp; Results: The results are discussed in comparison with similar surveys elsewhere, and we note the comparatively high percentage of participants who have heard of aphasia in our survey though, mirroring previous surveys, the amount of knowledge was often limited or incorrect. Unlike in other surveys, no clear relation was found between gender and awareness of aphasia, or education and awareness of aphasia. Age profiles and the source of participants information about aphasia were similar to earlier studies: that is, older people seem to have more aphasia awareness than younger people do. Further, media like TV, radio, newspapers, and magazines were the most often reported source for knowledge of aphasia. Conclusions: There is a need for further work to increase public awareness of aphasia and different forms of public media may play an important role in this endeavour.

  • 16.
    Hessen Soderman, A.-C.
    et al.
    Aleris Sabbatsberg, Sweden; Karolinska Institute, Sweden.
    Odhagen, E.
    Sahlgrens University Hospital, Sweden; University of Gothenburg, Sweden.
    Ericsson, E.
    University of Örebro, Sweden.
    Hemlin, C.
    Sollentuna Specialist Clin, Sweden.
    Hultcrantz, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Sunnergren, O.
    Ryhov County Hospital and Futurum, Sweden.
    Stalfors, J.
    Sahlgrens University Hospital, Sweden; University of Gothenburg, Sweden.
    Post-tonsillectomy haemorrhage rates are related to technique for dissection and for haemostasis. An analysis of 15734 patients in the National Tonsil Surgery Register in Sweden2015In: Clinical Otolaryngology, ISSN 1749-4478, E-ISSN 1365-2273, Vol. 40, no 3, p. 248-254Article in journal (Refereed)
    Abstract [en]

    ObjectivesTo analyse post-tonsillectomy haemorrhage (PTH) rates related to technique for dissection and haemostasis. Study DesignRegister study from the National Tonsil Surgery Register in Sweden (NTSRS). MethodsAll patients, subjected to tonsillectomy (TE) without adenoidectomy from 1 March 2009 to 26 April 2013, were included in the study. The surgeon reports data about technique and early PTH, while late PTH is reported by the patient in a questionnaire 30days after surgery. Results15734 patients with complete data concerning technique for dissection and for haemostasis were identified in the NTSRS. Techniques used were cold steel dissection with uni- or bipolar diathermy haemostasis (65.3%), diathermy scissors (15.7%), coblation (9.1%), cold steel dissection with cold haemostasis (7.4%) and ultrascision (2.5%). Early and late PTH were reported in 3.2% and 9.4% of the cases, respectively, and return to theatre (RTT) in 2.7%. The rates for PTH and RTT related to technique were analysed. Compared with cold dissection+ cold haemostasis, late PTH rate was 2.8 times higher after cold dissection + hot haemostasis, 3.2 times higher after coblation, 4.3 times higher after diathermy scissors and 5.6 times higher after ultrascision. The risk for RTT was higher for all hot techniques except for coblation, while ultrascision resulted in a lower risk for early PTH. ConclusionsAll hot techniques resulted in a higher risk for late PTH compared with cold steel dissection +cold haemostasis. The risk for RTT was higher for all hot techniques except for coblation, while ultrascision resulted in a lower risk for early PTH. An early PTH was associated with an increased risk for late PTH.

  • 17.
    Hua, Håkan
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Anderzen-Carlsson, Agneta
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences. Örebro University Hospital, Sweden.
    Widen, Stephen
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences. University of Örebro, Sweden.
    Moller, Claes
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences. Örebro University, Sweden; Örebro University Hospital, Sweden.
    Lyxell, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping. Linköping University, The Swedish Institute for Disability Research.
    Conceptions of working life among employees with mild-moderate aided hearing impairment: A phenomenographic study2015In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 54, no 11, p. 873-880Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim was to explore the conceptions of working life among employees with mild-moderate aided hearing impairment (HI). Design: This study has a descriptive design, in which data was collected by means of semi-structured interviews. All interviews were audio-recorded and transcribed verbatim. The text was analysed in accordance with the phenomenographic approach. Study sample: Fifteen participants with mild-moderate aided HI were recruited to the current study. Results: The analysis of the interviews resulted in four main categories describing the participants conceptions of working life: (1) diffiiculties in daily work, (2) communication strategies, (3) facilitating factors in work environment, and (4) impact on daily life. The four identified descriptive categories show that the effects of HI on the lives of working adults generate far-reaching psychosocial consequences for the individual. Conclusions: This study demonstrates that difficulties and impact of having a HI interact with strategies used by the individual and contextual facilitators made in the work environment. We argue that there is a need for extensive services in aural rehabilitation for this population. This includes identifying the need of assistive listening devices, teaching the individual with HI about communication strategies and informing stakeholders about the consequence of having a HI.

  • 18.
    Hultcrantz, Elisabeth
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Nosrati Zare Noe, Ramesh
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Corticosteroid treatment of idiopathic sudden sensorineural hearing loss: analysis of an RCT and material drawn from the Swedish national database2015In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 272, no 11, p. 3169-3175Article in journal (Refereed)
    Abstract [en]

    A randomized placebo-controlled study has demonstrated no effect of prednisolone in customary dosage on idiopathic sudden sensorineural hearing loss (ISSNHL). The aim of the present paper is to analyse a larger patient group by meta-analysis of data from the RCT together with a corresponding material drawn from the Swedish national database for ISSNHL. Data from 192 patients, 18-80 years with ISSNHL, were available. All had an acute hearing loss of at least 30 dB measured as PTA in the three most affected contiguous frequencies. All patients had been enrolled within one week after onset and evaluated by audiograms after 3 months. 45/99 (RCT) and 54/99 (the database) had been treated with prednisolone in tapering doses from 60 mg daily and 42/93 with placebo (RCT) or 51/93 with no treatment (the database). Primary outcome was the mean hearing improvement on day 90 for the different groups. A mean difference of greater than 10 dB improvement was required to demonstrate a treatment effect for prednisolone compared to placebo/no treatment. No significant difference was seen between the prednisolone group and placebo/no treatment (p = 0.06). Total recovery was 38 % in prednisolone group, 40 % in the placebo and 14 % in the no treatment group. Vertigo at the onset of hearing loss and age at onset had an equal negative prognostic value in all groups and signs of inflammation had a positive effect. Prednisolone in customary dosage does not influence recovery after ISSNHL.

  • 19.
    Håkan, Hua
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Johansson, Björn
    Department of Audiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Magnusson, Lennart
    Department of Audiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Lyxell, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Ellis, Rachel J.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Speech Recognition and Cognitive Skills in Bimodal Cochlear Implant Users2017In: Journal of Speech, Language and Hearing Research, ISSN 1092-4388, E-ISSN 1558-9102, Vol. 60, no 9, p. 2752-2763Article in journal (Refereed)
    Abstract [en]

    Purpose: To examine the relation between speech recognition and cognitive skills in bimodal cochlear implant (CI) and hearing aid users.

    Method: Seventeen bimodal CI users (28-74 years) were recruited to the study. Speech recognition tests were carried out in quiet and in noise. The cognitive tests employed included the Reading Span Test and the Trail Making Test (Daneman & Carpenter, 1980; Reitan, 1958, 1992), measuring working memory capacity and processing speed and executive functioning, respectively. Data were analyzed using paired-sample t tests, Pearson correlations, and partial correlations controlling for age.

    Results: The results indicate that performance on some cognitive tests predicts speech recognition and that bimodal listening generates a significant improvement in speech in quiet compared to unilateral CI listening. However, the current results also suggest that bimodal listening requires different cognitive skills than does unimodal CI listening. This is likely to relate to the relative difficulty of having to integrate 2 different signals and then map the integrated signal to representations stored in the long-term memory.

    Conclusions: Even though participants obtained speech recognition benefit from bimodal listening, the results suggest that processing bimodal stimuli involves different cognitive skills than does unimodal conditions in quiet. Thus, clinically, it is important to consider this when assessing treatment outcomes.

  • 20.
    Jangamreddy, Jaganmohan Reddy
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Health Sciences.
    Jain, Mayur V.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Health Sciences.
    Hallbeck, Anna-Lotta
    Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Oncology. Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences.
    Roberg, Karin
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Lotfi, Kourosh
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Diagnostics, Department of Clinical Pharmacology.
    Los, Marek Jan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Health Sciences. Pomeranian Medical University, Szczecin, Poland.
    Glucose starvation-mediated inhibition of salinomycin induced autophagy amplifies cancer cell specific cell death2015In: Oncotarget, E-ISSN 1949-2553, Vol. 6, no 12, p. 10134-10145Article in journal (Refereed)
    Abstract [en]

    Salinomycin has been used as treatment for malignant tumors in a small number of humans, causing far less side effects than standard chemotherapy. Several studies show that Salinomycin targets cancer-initiating cells (cancer stem cells, or CSC) resistant to conventional therapies. Numerous studies show that Salinomycin not only reduces tumor volume, but also decreases tumor recurrence when used as an adjuvant to standard treatments. In this study we show that starvation triggered different stress responses in cancer cells and primary normal cells, which further improved the preferential targeting of cancer cells by Salinomycin. Our in vitro studies further demonstrate that the combined use of 2-Fluoro 2-deoxy D-glucose, or 2-deoxy D-glucose with Salinomycin is lethal in cancer cells while the use of Oxamate does not improve cell death-inducing properties of Salinomycin. Furthermore, we show that treatment of cancer cells with Salinomycin under starvation conditions not only increases the apoptotic caspase activity, but also diminishes the protective autophagy normally triggered by the treatment with Salinomycin alone. Thus, this study underlines the potential use of Salinomycin as a cancer treatment, possibly in combination with short-term starvation or starvation-mimicking pharmacologic intervention.

  • 21.
    Jedlinski, Adam
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Divison of Neurobiology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Garvin, Stina
    Linköping University, Department of Clinical and Experimental Medicine, Divison of Neurobiology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Clinical pathology.
    Johansson, Ann-Charlotte
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences.
    Edqvist, Per-Henrik
    Uppsala University, Uppsala, Sweden.
    Pontén, Fredrik
    Uppsala University, Uppsala, Sweden.
    Roberg, Karin
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Cetuximab sensitivity of head and neck squamous cell carcinoma xenografts is associated with treatment-induced reduction of EGFR, pEGFR, and pSrc2017In: Journal of Oral Pathology & Medicine, ISSN 0904-2512, E-ISSN 1600-0714, no 9, p. 717-724Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The aim of this study was to validate in vitro drug sensitivity testing of head and neck squamous cell carcinoma (HNSCC)cell lines in an in vivo xenograft model, and to identify treatment-induced changes in the EGFR signaling pathway that could be used as markersfor cetuximab treatment response.

    METHODS: The in vitro cetuximab sensitivity of two HNSCC cell lines, UT-SCC-14 and UTSCC-45, was assessed using a crystal violet assay. In order to determine the corresponding in vivo sensitivity, UT-SCC-14 and UT-SCC-45 xenografts were generated in female BALB/c (nu/nu) nude mice. Mice were given three injections of intraperitoneal cetuximab or PBS and the tumor volume was recorded continuously. The expression of epidermal growth factor receptor (EGFR), phosphorylated EGFR (pEGFR), phosphorylated Src (pSrc), and Ki67 was investigated by immunohistochemistry.

    RESULTS: The treatment sensitive UT-SCC-14 cells were found to have an intrinsic cetuximab sensitivity (ICmabS) of 0.15 whereas the ICmabS of the insensitive cell line UT-SCC-45 was 0.78. The corresponding size ratio between untreated and cetuximab treated xenografts was 0.22 and 0.83 for UT-SCC-14 and UT-SCC-45, respectively. UT-SCC-14 cells had a higher baseline expression of pEGFR as compared to UT-SCC-45. Furthermore, in UT-SCC-14 xenografts there was a decrease in EGFR, pEGFR and pSrc upon cetuximab treatment. In contrast, a slight cetuximab-induced increase in EGFR, pEGFR and pSrc was observed in treatment-resistant UT-SCC-45 xenografts.

    CONCLUSIONS: The in vitro treatment sensitivity was reproduced in the in vivo model and cetuximab sensitivity was found to associate with a treatment-induced reduction in pEGFR and pSrc.

  • 22.
    Johansson, Ann-Charlotte
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    La Fleur, Linnea
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping. Linköping University, Faculty of Medicine and Health Sciences.
    Melissaridou, Styliani
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Roberg, Karin
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    The relationship between EMT, CD44(high)/EGFR(low) phenotype, and treatment response in head and neck cancer cell lines2016In: Journal of Oral Pathology & Medicine, ISSN 0904-2512, E-ISSN 1600-0714, Vol. 45, no 9, p. 640-646Article in journal (Refereed)
    Abstract [en]

    BackgroundHead and neck squamous cell carcinoma (HNSCC) tumors are often therapy resistant and may originate from cancer stem cells or tumor cells with an epithelial-to-mesenchymal transition (EMT) phenotype. The aim of this study was to characterize HNSCC cell lines with regard to EMT profile and to investigate the influence of EMT on the response to treatment. MethodsmRNA expression of the EMT-associated genes CDH1 (E-cadherin), CDH2 (N-cadherin), FOXC2, TWIST1, VIM (vimentin), and FN1 (fibronectin) was determined using quantitative real-time PCR. Cell morphology and migration were investigated by phase-contrast microscopy and Boyden chamber assay, respectively. The cell surface expression of CD44 and epidermal growth factor receptor (EGFR) was examined by flow cytometry. The response to radiotherapy, cetuximab, and dasatinib was assessed by crystal violet staining. ResultsA total of 25 cell lines investigated differed greatly with regard to EMT phenotype. Cell lines with an EMT expression profile showed a mesenchymal morphology and a high migratory capacity. In addition, they exhibited a high cell surface expression of CD44 and a low expression of EGFR, a pattern previously associated with stemness. When the EMT inducer transforming growth factor- (TGF-) was added to non-EMT cells, changes in treatment responses were observed. Moreover, the expression of TWIST1 was found to correlate with radioresistance. ConclusionsThe data presented in this report suggest that EMT is associated with a CD44(high)/EGFR(low) phenotype and possibly negative impact on radiotherapy response in HNSCC cell lines.

  • 23.
    Kilman, Lisa
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Zekveld, Adriana A.
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. ENT/Audiology and EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, Netherlands.
    Hällgren, Mathias
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Rönnberg, Jerker
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Subjective ratings of masker disturbance during the perception of native and non-native speech2015In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 6, article id 1065Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to address how 43 normal-hearing (NH) and hearing-impaired (HI) listeners subjectively experienced the disturbance generated by four masker conditions (i.e., stationary noise, fluctuating noise, Swedish two-talker babble and English two-talker babble) while listening to speech in two target languages, i.e., Swedish (native) or English (non-native). The participants were asked to evaluate their noise-disturbance experience on a continuous scale from 0 to 10 immediately after having performed each listening condition. The data demonstrated a three-way interaction effect between target language, masker condition, and group (HI versus NH). The HI listeners experienced the Swedish-babble masker as significantly more disturbing for the native target language (Swedish) than for the non-native language (English). Additionally, this masker was significantly more disturbing than each of the other masker types during the perception of Swedish target speech. The NH listeners, on the other hand, indicated that the Swedish speech-masker was more disturbing than the stationary and the fluctuating noise-maskers for the perception of English target speech. The NH listeners perceived more disturbance from the speech maskers than the noise maskers. The HI listeners did not perceive the speech maskers as generally more disturbing than the noise maskers. However, they had particular difficulty with the perception of native speech masked by native babble, a common condition in daily-life listening conditions. These results suggest that the characteristics of the different maskers applied in the current study seem to affect the perceived disturbance differently in HI and NH listeners. There was no general difference in the perceived disturbance across conditions between the HI listeners and the NH listeners.

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  • 24.
    Kilman, Lisa
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, Linnaeus Centre HEAD.
    Zekveld, Adriana
    Linköping University, Department of Behavioural Sciences and Learning. VU University Medical Center, ENT/audiology.
    Hällgren, Mathias
    Linköping University, Department of Clinical and Experimental Medicine, Division of Speech language pathology, Audiology and Otorhinolaryngology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Rönnberg, Jerker
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, Linnaeus Centre HEAD.
    Performance, proficiency and perceived disturbance in native and non-native languages2015Conference paper (Refereed)
    Abstract [en]

    Identifying speech in adverse listening conditions requires both native and non-native listeners to cope with decreased intelligibility. The current study examined in four speech reception threshold (SRT) conditions how speech maskers (two-talker babble Swedish, two-talker babble English) and noise maskers (stationary and fluctuating noise) interfered with target speech in Swedish (native language) and English (non-native language). Listening disturbance for each condition was rated on a continuous scale. The participants also performed standardized tests in English proficiency, nonverbal reasoning and working memory capacity; the latter in both Swedish and English. Normal-hearing (n = 23) and hearing-impaired (n = 23) native Swedish listeners participated, age-range between 28 and 65 years.

    The SRTs were better for native as compared to non-native speech. In both groups, speech perception performance was lower for the speech than the noise maskers, especially for non-native target speech. The level of English proficiency is important for non-native speech intelligibility in noise. A three-way interaction effect on the subjective rating scores indicated that the hearing loss affects the subjective disturbance of Swedish babble in native and non-native language perception.

    Conclusion: Speech perception and subjective disturbance is influenced by a complex interaction between masker types and individual abilities.

  • 25.
    Kim, Jeewon
    et al.
    Stanford University, CA 94305 USA.
    Ho Shin, June
    Stanford University, CA 94305 USA.
    Chen, Che-Hong
    Stanford University, CA 94305 USA.
    Cruz, Leslie
    Stanford University, CA 94305 USA.
    Farnebo, Lovisa
    Linköping University, Department of Clinical and Experimental Medicine, Division of Speech language pathology, Audiology and Otorhinolaryngology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping. Stanford University, CA 94305 USA.
    Yang, Jieying
    Stanford University, CA 94305 USA.
    Borges, Paula
    Stanford University, CA 94305 USA.
    Kang, Gugene
    Stanford University, CA 94305 USA.
    Mochly-Rosen, Daria
    Stanford University, CA 94305 USA.
    Sunwoo, John B.
    Stanford University, CA 94305 USA; Stanford University, CA 94305 USA.
    Targeting aldehyde dehydrogenase activity in head and neck squamous cell carcinoma with a novel small molecule inhibitor2017In: Oncotarget, E-ISSN 1949-2553, Vol. 8, no 32, p. 52345-52356Article in journal (Refereed)
    Abstract [en]

    Chemoresistant cancer cells express high levels of aldehyde dehydrogenases (ALDHs), particularly in head and neck squamous cell carcinoma (HNSCC). The ALDH family of enzymes detoxify both exogenous and endogenous aldehydes. Since many chemotherapeutic agents, such as cisplatin, result in the generation of cytotoxic aldehydes and oxidative stress, we hypothesized that cells expressing high levels of ALDH may be more chemoresistant due to their increased detoxifying capacity and that inhibitors of ALDHs may sensitize them to these drugs. Here, we show that overall ALDH activity is increased with cisplatin treatment of HNSCC and that ALDH3A1 protein expression is particularly enriched in cells treated with cisplatin. Activation of ALDH3A1 by a small molecule activator (Alda-89) increased survival of HNSCC cells treated with cisplatin. Conversely, treatment with a novel small molecule ALDH inhibitor (Aldi-6) resulted in a marked decrease in cell viability, and the combination of Aldi-6 and cisplatin resulted in a more pronounced reduction of cell viability and a greater reduction in tumor burden in vivo than what was observed with cisplatin alone. These data indicate that ALDH3A1 contributes to cisplatin resistance in HNSCC and that the targeting of ALDH, specifically, ALDH3A1, appears to be a promising strategy in this disease.

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  • 26.
    Knipping, Stephan
    et al.
    Stadt Klinikum Dessau, Germany; Martin Luther Univ Halle Wittenberg, Germany.
    Michaelis, Franziska
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Retrospective analysis of risk factors for postoperative bleeding undergoing adenotonsillectomy2019In: Laryngo-, Rhino-, Otologie, ISSN 0935-8943, E-ISSN 1438-8685, Vol. 98, no 2, p. 96-104Article in journal (Refereed)
    Abstract [en]

    Objective Adenotonsillectomy is one of the most common surgical procedures in Germany and the most critical postoperative complication is postoperative hemorrhage, particularly for children. The medical history has been considered superior to laboratory tests. Material and Methods In a retrospective anonymous examination over a 4-year period the data of children and adolescent patients subject to surgery of the Waldeyers tonsillar ring were recorded. Based on the preoperative questionnaire of the blood coagulation history and the laboratory chemical screening, risk factors for hemorrhage as well as for von Willebrand Disease (VWD) were identified. Results Included in the examination were 171 male and 137 female patients. Postoperative hemorrhage occurred in 43 children (14 %) between the 1st and 13th day after surgery. 4.2 % of the hemorrhage occured within 24 hours and 10.4 % after 24 hours. Children with frequent epistaxis had a significant higher risk of postoperative hemorrhage. A preoperatively pathological hemoglobin value was associated with a significantly higher rate of postoperative bleeding in children with VWD, a significantly increased risk of postoperative hemorrhage was observed, particularly in male VWD patients. Conclusions In case of a conspicious family history, especially of the mother in the bleeding questionnaire, a significantly increased risk for VWD could be observed. Here it is advisable to determine the PTT as well as PFA-100 and, to continue with a further VWD step-diagnostics. A suspect preoperative laboratory screening, especially hemoglobin value, is associated with higher risk of postoperative hemorrhage.

  • 27.
    Larsby, Birgitta
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Hällgren, Mathias
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Nilsson, Linda
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. CLINTEC, Division of Speech and Language Pathology, Karolinska Institutet, Stockholm; Speech and Language Pathology Clinic, Karolinska University Hospital, Stockholm, Sweden.
    The influence of female versus malespeakers’ voice on speech recognitionthresholds in noise: Effects of low and high-frequency hearing impairment2015In: Speech, Language and Hearing, ISSN 2050-571X, Vol. 18, no 2, p. 84-90Article in journal (Refereed)
    Abstract [en]

    Purpose: To investigate the effect of female versus male speakers’ voice on the ability to recognize speech innoise in two groups of sensorineural hearing-impaired listeners, one group with impairment at lowfrequencies and the other at high frequencies.Method: Eight participants with high-frequency hearing impairments (Hf-HI) and seven with low-frequencyhearing impairments (Lf-HI) participated. Sixteen normal hearing (NH) participants served as reference.The sentences from the hearing in noise test, read by a female or a male speaker, were presentedmonaurally with a background noise. In an adaptive procedure, the mean speech recognition threshold,for 50% correctly recognized sentences, was calculated for the female and male voice and each test subject.Results: The Hf-HI group had significantly greater difference in signal-to-noise ratio (SNR) results betweenfemale and male voices. Irrespective of hearing impairment, the female voice required 2.1 dB better SNR.In addition, the NH group showed a small but significant difference in favor of the male voice.Conclusions: Results indicate that speaker gender matters for hearing impaired and NH individuals’ ability torecognize speech in noise.

  • 28.
    Levén, Anna
    et al.
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Lyxell, Björn
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Granlund, Mats
    Linköping University, The Swedish Institute for Disability Research.
    Arvidsson, Patrik
    Linköping University, The Swedish Institute for Disability Research.
    Prospective memory in persons with intellectual disability: reduced load on episodic memory due to the link between what to do and when to act.2016Conference paper (Other academic)
    Abstract [en]

    Background:

    Persons with intellectual disability express poor prospective memory. Prospective memory loads on limited capacity resources for instance episodic memory, working memory, and attention. Load occurs both from prospective, retrospective and ongoing tasks. Retrieval is accomplished either by top down attentional control processes or automatic bottom up processes.

    Methods:

    23 persons with intellectual disability and a control group of 25 persons performed a prospective memory game (Levén et al., 2013) with an ongoing episodic memory task and a working memory task. The game included prospective memory tasks with a low and high demand on top down attentional control processes. The groups differed in raven scores.

    Results:

    The intellectual disability group committed frequent omissions and were out performed by the control group on both prospective memory, episodic memory and working memory tasks.

    Both groups performed significantly better on tasks with low demand on top down attentional processes. A link between the intended task and target improved cued recall performance only in the intellectual disability group, likely because of near ceiling performance in the control group. Contrary to previous results (Levén et al., 2008; Levén et al., 2011), working memory correlated with prospective memory with high load on episodic memory only in the control group. On the other hand, as in previous studies, different memory processes were correlated to a higher extent and varied more in the intellectual disability group.

    Conclusions:

    As assumed, persons with intellectual disability can manage prospective memory tasks with a high load on bottom-up processing, however, performance is reduced if more top-down processing is required. High episodic memory performance for persons with intellectual disabilities with a link between targets and prospective memory action to perform, did not correspond with higher prospective memory performance as would be expected due to reduced load on episodic memory.

     

  • 29.
    Lewin, Nongnit
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Ryhov Hospital, Sweden.
    Cederblad, Lena
    University of Uppsala Hospital, Sweden.
    Andersson, Bengt-Åke
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Ryhov Hospital, Sweden.
    Olin, Mattias
    Ryhov Hospital, Sweden.
    Nilsson, Mats
    Ryhov Hospital, Sweden.
    Rutqvist, Lars Erik
    Karolinska University Hospital, Sweden.
    Lundgren, Jan
    Karolinska University Hospital, Sweden.
    Engström, Mats
    University of Uppsala Hospital, Sweden.
    Tytor, Wieslaw
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Löfgren, Sture
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Lewin, Freddi
    Ryhov Hospital, Sweden.
    Single-Nucleotide Polymorphisms and Cancer Risk, Tumor Recurrence, or Survival of Head and Neck Cancer Patients2017In: Oncology, ISSN 0030-2414, E-ISSN 1423-0232, Vol. 92, no 3, p. 161-169Article in journal (Refereed)
    Abstract [en]

    Objective: This paper aims at studying the influence of single-nucleotide polymorphisms (SNPs) on cancer risk, tumor recurrence, and survival in head and neck (Hamp;N) cancer patients. Methods: A total of 45 SNPs in 41 genes were investigated. A total of 174 Caucasian Hamp;N cancer patients and 245 healthy blood donors were enrolled in the study. Results: Ten SNPs were associated with Hamp;N cancer risk, but the identified SNPs differed among males and females. Some of the SNPs were related to immune response genes. The immune response gene SNPs were also related to survival. In particular, we noted that the tumor necrosis factor alpha (TNF alpha) rs1800629 could have an influence on cancer risk; tumor recurrence as well as survival. Conclusion: Genetic variation of the TNFa rs1800629 might be useful as a biomarker in clinical decision-making since it was found to be related to cancer risk, tumor recurrence, and survival of Hamp;N cancer patients. (C) 2016 S. Karger AG, Basel

  • 30.
    Lohi, Venla
    et al.
    University of Oulu, Finland; Oulu University Hospital, Finland.
    Hannula, Samuli
    University of Oulu, Finland; Oulu University Hospital, Finland.
    Ohtonen, Pasi
    Oulu University Hospital, Finland.
    Sorri, Martti
    University of Oulu, Finland; Oulu University Hospital, Finland.
    Mäki-Torkko, Elina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping. University of Oulu, Finland.
    Hearing impairment among adults: The impact of cardiovascular diseases and cardiovascular risk factors2015In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 54, no 4, p. 265-273Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate the influence of cardiovascular diseases on hearing impairment (HI) among adults. Furthermore, to seek other potential risk factors for HI, such as smoking, obesity, and socioeconomic class. Design: A cross-sectional, unscreened, population-based, epidemiological study among adults. Study sample: The subjects (n = 850), aged 54-66 years, were randomly sampled from the population register. A questionnaire survey, an otological examination, and pure-tone audiometry were performed. Results: Cardiovascular diseases did not increase the risk for HI in a propensity-score adjusted logistic regression model: OR 1.24, 95% CI 0.79 to 1.96 for HI defined by better ear hearing level (BEHL), and OR 1.48, 95% CI 0.96 to 2.28 for HI defined by worse ear hearing level (WEHL), in the 0.5-4 kHz frequency range. Heavy smoking is a risk factor for HI among men (BEHL: OR 1.96, WEHL: OR 1.88) and women (WEHL: OR 2.4). Among men, obesity (BEHL, OR 1.85) and lower socioeconomic class (BEHL: OR 2.79, WEHL: OR 2.28) are also risk factors for HI. Conclusion: No significant association between cardiovascular disease and HI was found.

  • 31.
    Makitie, A.
    et al.
    Univ Helsinki, Finland; Helsinki Univ Hosp, Finland; Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
    Ruuskanen, M.
    Turku Univ Hosp, Finland.
    Bentzen, J.
    Herlev Univ Hosp, Denmark.
    Brun, E.
    Lund Univ, Sweden.
    Gebre-Medhin, M.
    Lund Univ, Sweden.
    Friesland, S.
    Karolinska Univ Hosp, Sweden.
    Marsk, E.
    Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
    Hammarstedt-Nordenvall, L.
    Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
    Gille, E.
    Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
    Reizenstein, J.
    Örebro Univ Hosp, Sweden.
    Adell, Gunnar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Oncology.
    Farnebo, Lovisa
    Linköping University, Department of Clinical and Experimental Medicine, Division of Speech language pathology, Audiology and Otorhinolaryngology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Rzepecki, Jan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences.
    Haugen, H.
    Sahlgrens Univ Hosp, Sweden.
    Soderstrom, K.
    Umeå Univ, Sweden.
    Zackrisson, B.
    Umea Univ, Sweden.
    Bergstrom, S.
    Gävle Cent Hosp, Sweden.
    Loden, B.
    Karlstad Hosp, Sweden.
    Cederblad, L.
    Uppsala Univ Hosp, Sweden.
    Laurell, G.
    Uppsala Univ Hosp, Sweden.
    Smeland, E.
    Univ Hosp North Norway, Norway.
    Evensen, J. Folkvard
    Oslo Univ Hosp, Norway.
    Lund, J. A.
    Trondheim Reg and Univ Hosp, Norway.
    Tondel, H.
    Trondheim Reg and Univ Hosp, Norway.
    Karlsdottir, A.
    Haukeland Hosp, Norway.
    Johannsson, J.
    Landspitali Univ Hosp, Iceland.
    Johansen, J.
    Odense Univ Hosp, Denmark.
    Kristensen, C. A.
    Rigshosp, Denmark.
    Jensen, K.
    Aarhus Univ Hosp, Denmark.
    Andersen, L. J.
    Aalborg Hosp, Denmark.
    Koivunen, P.
    Oulu Univ Hosp, Finland.
    Korpela, M.
    Oulu Univ Hosp, Finland.
    Voutilainen, L.
    Kuopio Univ Hosp, Finland.
    Wigren, T.
    Tampere Univ Hosp, Finland.
    Minn, H.
    Turku Univ Hosp, Finland.
    Joensuu, H.
    Helsinki Univ Hosp, Finland; Univ Helsinki, Finland.
    Overgaard, J.
    Aarhus Univ Hosp, Denmark.
    Saarilahti, K.
    Helsinki Univ Hosp, Finland; Univ Helsinki, Finland.
    The management and survival outcomes of nasopharyngeal cancer in the Nordic countries2018In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 57, no 4, p. 557-560Article in journal (Other academic)
    Abstract [en]

    n/a

  • 32.
    Malmberg, Milijana
    et al.
    Hearing Org, Sweden; Univ Gothenburg, Sweden.
    Thoren, Elisabet Sundewall
    Malmo Univ, Sweden.
    Öberg, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping. Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Oticon AS, Denmark.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Inst, Sweden.
    Kahari, Kim
    Univ Gothenburg, Sweden.
    Experiences of an Internet-based aural rehabilitation (IAR) program for hearing aid users: a qualitative study2018In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 57, no 8, p. 570-576Article in journal (Refereed)
    Abstract [en]

    Objective: Internet interventions for hearing aid (HA) users have been shown to be effective in helping persons with hearing problems. As earlier research refers to objective data on these effects, little is known about how participants experience the Internet interventions subjectively. The aim of the present study was to explore participants experiences of an Internet-based aural rehabilitation (IAR) program for HA-users, and to explore the possible subjective benefits of such a program. Design: A qualitative exploratory design was implemented involving semi-structured telephone interviews. The interviews were transcribed and analysed using content analysis. Study sample: Interviews were conducted with 20 participants (9 men and 11 women) who had completed an IAR program for HA-users. The participants were 57-81 years old and had used HAs for 2-25 years. Results: The results are organised in three main categories: general experiences associated with participating in the program, knowledge obtained from the program and perceived impact of taking part in the program. Conclusions: The overall results indicate positive experiences of the IAR program, and an overreaching theme of increased self-esteem was identified. The findings provide some valuable information for developers of future IAR programs.

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  • 33.
    Malmenholt, Ann
    et al.
    Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Lohmander, Anette
    Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Mcallister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping. Linköping University, Faculty of Medicine and Health Sciences. Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Childhood apraxia of speech: A survey of praxis and typical speech characteristics2017In: Logopedics, Phoniatrics, Vocology, ISSN 1401-5439, E-ISSN 1651-2022, Vol. 42, no 2, p. 84-92Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this study was to investigate current knowledge of the diagnosis childhood apraxia of speech (CAS) in Sweden and compare speech characteristics and symptoms to those of earlier survey findings in mainly English-speakers. Method: In a web-based questionnaire 178 Swedish speech-language pathologists (SLPs) anonymously answered questions about their perception of typical speech characteristics for CAS. They graded own assessment skills and estimated clinical occurrence. Results: The seven top speech characteristics reported as typical for children with CAS were: inconsistent speech production (85%), sequencing difficulties (71%), oro-motor deficits (63%), vowel errors (62%), voicing errors (61%), consonant cluster deletions (54%), and prosodic disturbance (53%). Motor-programming deficits described as lack of automatization of speech movements were perceived by 82%. All listed characteristics were consistent with the American Speech-Language-Hearing Association (ASHA) consensus-based features, Strands 10-point checklist, and the diagnostic model proposed by Ozanne. The mode for clinical occurrence was 5%. Number of suspected cases of CAS in the clinical caseload was approximately one new patient/year and SLP. Conclusions: The results support and add to findings from studies of CAS in English-speaking children with similar speech characteristics regarded as typical. Possibly, these findings could contribute to cross-linguistic consensus on CAS characteristics.

  • 34.
    Mattson, Lina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Lentini, Antonio
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Gawel, Danuta
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Badam, Tejaswi
    Linköping University, Department of Physics, Chemistry and Biology, Bioinformatics. Linköping University, Faculty of Science & Engineering.
    Benson, Mikael
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Allergy Center.
    Ledin, Torbjörn
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Nestor, Colm
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Gustafsson, Mika
    Linköping University, Department of Physics, Chemistry and Biology, Bioinformatics. Linköping University, Faculty of Science & Engineering.
    Serra I Musach, Jordi
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Björkander, Janne
    County Council Jonköping, Sweden.
    Xiang, Zou
    Hong Kong Polytech University, Peoples R China.
    Zhang, Huan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Potential Involvement of Type I Interferon Signaling in Immunotherapy in Seasonal Allergic Rhinitis2016In: Journal of Immunology Research, ISSN 2314-8861, E-ISSN 2314-7156, article id 5153184Article in journal (Refereed)
    Abstract [en]

    Specific immunotherapy (SIT) reverses the symptoms of seasonal allergic rhinitis (SAR) in most patients. Recent studies report type I interferons shifting the balance between type I T helper cell (Th1) and type II T helper cells (Th2) towards Th2 dominance by inhibiting the differentiation of naive Tcells into Th1 cells. As SIT is thought to cause a shift towardsTh1 dominance, we hypothesized that SIT would alter interferon type I signaling. To test this, allergen and diluent challenged CD4(+) T cells from healthy controls and patients from different time points were analyzed. The initial experiments focused on signature genes of the pathway and found complex changes following immunotherapy, which were consistent with our hypothesis. As interferon signaling involves multiple genes, expression profiling studies were performed, showing altered expression of the pathway. These findings require validation in a larger group of patients in further studies.

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  • 35.
    Melissaridou, Styliani
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences.
    Wiechec, Emilia
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences.
    Magan, Mustafa
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences.
    Jain, Mayur Vilas
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences. Department of Molecular Medicine and Gene Therapy, Lund Stem Cell Center, Lund University, Lund, Sweden.
    Chung, Man Ki
    Department of Otorhinolaryngology-Head & Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea.
    Farnebo, Lovisa
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology.
    Roberg, Karin
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    The effect of 2D and 3D cell cultures on treatment response, EMT profile and stem cell features in head and neck cancer.2019In: Cancer Cell International, E-ISSN 1475-2867, Vol. 19, no 16Article in journal (Refereed)
    Abstract [en]

    Background

    Head and Neck Squamous Cell Carcinoma (HNSCC) tumors are often resistant to therapies. Therefore searching for predictive markers and new targets for treatment in clinically relevant in vitro tumor models is essential. Five HNSCC-derived cell lines were used to assess the effect of 3D culturing compared to 2D monolayers in terms of cell proliferation, response to anti-cancer therapy as well as expression of EMT and CSC genes.

    Methods

    The viability and proliferation capacity of HNSCC cells as well as induction of apoptosis in tumor spheroids cells after treatment was assessed by MTT assay, crystal violet- and TUNEL assay respectively. Expression of EMT and CSC markers was analyzed on mRNA (RT-qPCR) and protein (Western blot) level.

    Results

    We showed that HNSCC cells from different tumors formed spheroids that differed in size and density in regard to EMT-associated protein expression and culturing time. In all spheroids, an up regulation of CDH1, NANOG and SOX2 was observed in comparison to 2D but changes in the expression of EGFR and EMT markers varied among the cell lines. Moreover, most HNSCC cells grown in 3D showed decreased sensitivity to cisplatin and cetuximab (anti-EGFR) treatment.

    Conclusions

    Taken together, our study points at notable differences between these two cellular systems in terms of EMT-associated gene expression profile and drug response. As the 3D cell cultures imitate the in vivo behaviour of neoplastic cells within the tumor, our study suggest that 3D culture model is superior to 2D monolayers in the search for new therapeutic targets.

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  • 36.
    Miles, Kelly
    et al.
    Linköping University, The Swedish Institute for Disability Research. Macquarie University, Australia; HEARing Cooperat Research Centre, Australia.
    McMahon, Catherine
    Macquarie University, Australia; HEARing Cooperat Research Centre, Australia.
    Boisvert, Isabelle
    Macquarie University, Australia; HEARing Cooperat Research Centre, Australia.
    Ibrahim, Ronny
    Macquarie University, Australia; HEARing Cooperat Research Centre, Australia.
    de Lissa, Peter
    HEARing Cooperat Research Centre, Australia; Macquarie University, Australia.
    Graham, Petra
    Macquarie University, Australia.
    Lyxell, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping. Linköping University, The Swedish Institute for Disability Research.
    Objective Assessment of Listening Effort: Coregistration of Pupillometry and EEG2017In: TRENDS IN HEARING, ISSN 2331-2165, Vol. 21, article id 2331216517706396Article in journal (Refereed)
    Abstract [en]

    Listening to speech in noise is effortful, particularly for people with hearing impairment. While it is known that effort is related to a complex interplay between bottom-up and top-down processes, the cognitive and neurophysiological mechanisms contributing to effortful listening remain unknown. Therefore, a reliable physiological measure to assess effort remains elusive. This study aimed to determine whether pupil dilation and alpha power change, two physiological measures suggested to index listening effort, assess similar processes. Listening effort was manipulated by parametrically varying spectral resolution (16- and 6-channel noise vocoding) and speech reception thresholds (SRT; 50% and 80%) while 19 young, normal-hearing adults performed a speech recognition task in noise. Results of off-line sentence scoring showed discrepancies between the target SRTs and the true performance obtained during the speech recognition task. For example, in the SRT80% condition, participants scored an average of 64.7%. Participants true performance levels were therefore used for subsequent statistical modelling. Results showed that both measures appeared to be sensitive to changes in spectral resolution (channel vocoding), while pupil dilation only was also significantly related to their true performance levels (%) and task accuracy (i.e., whether the response was correctly or partially recalled). The two measures were not correlated, suggesting they each may reflect different cognitive processes involved in listening effort. This combination of findings contributes to a growing body of research aiming to develop an objective measure of listening effort.

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  • 37.
    Moradi, Shahram
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Wahlin, Anna
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Hällgren, Mathias
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Rönnberg, Jerker
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Lidestam, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    The Efficacy of Short-term Gated Audiovisual Speech Training for Improving Auditory Sentence Identification in Noise in Elderly Hearing Aid Users2017In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 8, article id 368Article in journal (Refereed)
    Abstract [en]

    This study aimed to examine the efficacy and maintenance of short-term (one-session) gated audiovisual speech training for improving auditory sentence identification in noise in experienced elderly hearing-aid users. Twenty-five hearing aid users (16 men and 9 women), with an average age of 70.8 years, were randomly divided into an experimental (audiovisual training, n = 14) and a control (auditory training, n = 11) group. Participants underwent gated speech identification tasks comprising Swedish consonants and words presented at 65 dB sound pressure level with a 0 dB signal-to-noise ratio (steady-state broadband noise), in audiovisual or auditory-only training conditions. The Hearing-in-Noise Test was employed to measure participants auditory sentence identification in noise before the training (pre-test), promptly after training (post-test), and 1 month after training (one-month follow-up). The results showed that audiovisual training improved auditory sentence identification in noise promptly after the training (post-test vs. pre-test scores); furthermore, this improvement was maintained 1 month after the training (one-month follow-up vs. pre-test scores). Such improvement was not observed in the control group, neither promptly after the training nor at the one-month follow-up. However, no significant between-groups difference nor an interaction between groups and session was observed. Conclusion: Audiovisual training may be considered in aural rehabilitation of hearing aid users to improve listening capabilities in noisy conditions. However, the lack of a significant between-groups effect (audiovisual vs. auditory) or an interaction between group and session calls for further research.

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  • 38.
    Mäki-Torkko, Elina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Vestergren, Sara
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Harder, Henrik
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Lyxell, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping. Linköping University, The Swedish Institute for Disability Research.
    From isolation and dependence to autonomy - expectations before and experiences after cochlear implantation in adult cochlear implant users and their significant others2015In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, no 6, p. 541-547Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of the study was to examine pre-operative expectations and the postoperative experiences related to cochlear implants (CI) in CI-users and their significant others. Methods: A questionnaire was used and the responses were analysed by means of The Qualitative Content Analysis. All adults implanted between 1992 and 2010, who had had their implants for a minimum of 12 months (n = 120) were contacted. Response rate was high (90.8%), and all-inclusive answers were received from 101 CI-users (84.2%). Results: The overall sense of increased well-being and life satisfaction was described as having lived in two different worlds, one with the auditory stimulation and one without. In the overall sense of increased well-being and satisfaction three interwoven subcategories, alienation - normality, fear - autonomy, and living a social life emerged. When CI-users and their significant others recalled the time prior to receiving the CI, a sense of fear was present with origins in the concern for the respondents (CI-users) ability to cope and care independently in society. Conversely, after the implantation both parties emphasized the notion of a distinct transformation within the CI-user towards autonomy. Communication was highlighted as a large part of living social life. Conclusion: The CI increases well-being and satisfaction for both CI-users and their significant others, which is especially evident regarding enhanced autonomy, normality and living social life.

  • 39.
    Naylor, Graham
    et al.
    Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Öberg, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Wänström, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Exploring the Effects of the Narrative Embodied in the Hearing Aid Fitting Process on Treatment Outcomes2015In: Ear and Hearing, ISSN 0196-0202, E-ISSN 1538-4667, Vol. 36, no 5, p. 517-526Article in journal (Refereed)
    Abstract [en]

    Objectives: There is strong evidence from other fields of health, and growing evidence in audiology, that characteristics of the process of intervention as perceived by the client (embodied narratives) can have significant effects on treatment outcomes, independent of the technical properties of the intervention itself. This phenomenon deserves examination because studies of technical interventions that fail to take account of it may reach erroneous conclusions and because clinical practice can put such effects to therapeutic use. The aim of this study was to test the idea that embodied narratives might affect outcomes in hearing aid fitting. This was achieved by carrying out experiments in which technical (acoustic) differences between alternative hearing aid fittings were absent, while providing test subjects with a strong contrast between the processes apparently applied to derive the fittings being compared. Thus, any effects of contrasting narratives could be observed, free of acoustical confounds. The hypothesis was that narrative effects would be observed. Design: A balanced crossover design was used, in which subjects received and evaluated two bilateral hearing aid fittings in succession. Subjects were deceived as to the true identical content of the hearing aid fittings being compared, but encouraged to believe that one fitting process was interactive and the other was diagnostic in character. Two almost identical experiments were undertaken: one with 24 experienced adult hearing aid users and another with 16 adult first-time users. Each hearing aid fitting was worn at home for 2 weeks, after which self-report outcome measures (Hearing Aid Performance Questionnaire, Hearing Handicap Inventory for the Elderly, and International Outcome Inventory for Hearing Aids) were administered. After the second test period, a short preference questionnaire was also completed. Results: Twenty of the 24 experienced users showed a clear preference for one or the other fitting, and their self-report scores reflected these preferences. Effect sizes were comparable with those typically observed for true acoustical contrasts. No order effect was seen in this group. In contrast, 13 of the 16 first-time users preferred the second fitting. Trends in the self-report measures were similar for this group but weaker than for the experienced users. In both groups, the reasons given for subjects preference were predominantly related to sound, despite there being no acoustical differences. Conclusions: This study suggests that the narrative embodied in a given fitting process can have a substantial effect on the perceived benefit of the treatment, independent of any acoustical differences, at least for experienced users. For first-time users, acclimatization seems to overshadow the purely narrative effect of any fitting process. In the future, research study designs should include steps to avoid narrative effects when technical parameters of hearing aids are the intended object of study. In clinical practice, the narrative is part of the therapeutic context, and one may design it for maximum beneficial effect.

  • 40.
    Novozhilova, E.
    et al.
    Karolinska University Hospital, Sweden; Karolinska University Hospital, Sweden.
    Englund-Johansson, U.
    Lund University, Sweden.
    Kale, A.
    Karolinska University Hospital, Sweden; Karolinska University Hospital, Sweden.
    Jiao, Y.
    Karolinska University Hospital, Sweden; Karolinska University Hospital, Sweden; Capital Medical University, Peoples R China.
    Olivius, Petri
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    EFFECTS OF ROCK INHIBITOR Y27632 AND EGFR INHIBITOR PD168393 ON HUMAN NEURAL PRECURSORS CO-CULTURED WITH RAT AUDITORY BRAINSTEM EXPLANT2015In: Neuroscience, ISSN 0306-4522, E-ISSN 1873-7544, Vol. 287, p. 43-54Article in journal (Refereed)
    Abstract [en]

    Hearing function lost by degeneration of inner ear spiral ganglion neurons (SGNs) in the auditory nervous system could potentially be compensated by cellular replacement using suitable donor cells. Donor cell-derived neuronal development with functional synaptic formation with auditory neurons of the cochlear nucleus (CN) in the brainstem is a prerequisite for a successful transplantation. Here a rat auditory brainstem explant culture system was used as a screening platform for donor cells. The explants were co-cultured with human neural precursor cells (HNPCs) to determine HNPCs developmental potential in the presence of environmental cues characteristic for the auditory brainstem region in vitro. We explored effects of pharmacological inhibition of GTPase Rho with its effector Rho-associated kinase (ROCK) and epidermal growth factor receptor (EGFR) signaling on the co-cultures. Pharmacological agents ROCK inhibitor Y27632 and EGFR blocker PD168393 were tested. Effect of the treatment on explant penetration by green fluorescent protein (GFP)-labeled HNPCs was evaluated based on the following criteria: number of GFP-HNPCs located within the explant; distance migrated by the GFP-HNPCs deep into the explant; length of the GFP+/neuronal class III beta-tubulin (TUJ1)+ processes developed and phenotypes displayed. In a short 2-week co-culture both inhibitors had growth-promoting effects on HNPCs, prominent in neurite extension elongation. Significant enhancement of migration and in-growth of HNPCs into the brain slice tissue was only observed in Y27632-treated co-cultures. Difference between Y27632- and PD168393-treated HNPCs acquiring neuronal fate was significant, though not different from the fates acquired in control co-culture. Our data suggest the presence of inhibitory mechanisms in the graft-host environment of the auditory brainstem slice co-culture system with neurite growth arresting properties which can be modulated by administration of signaling pathways antagonists. Therefore the co-culture system can be utilized for screens of donor cells and compounds regulating neuronal fate determination. (C) 2014 IBRO. Published by Elsevier Ltd. All rights reserved.

  • 41.
    Ostvoll, Eirik
    et al.
    Sahlgrens University Hospital, Sweden.
    Sunnergren, Ola
    Ryhov County Hospital, Sweden.
    Ericsson, Elisabeth
    University of Örebro, Sweden.
    Hemlin, Claes
    Aleris Specialists Care Centre, Sweden.
    Hultcrantz, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Odhagen, Erik
    University of Gothenburg, Sweden.
    Stalfors, Joacim
    Sahlgrens University Hospital, Sweden.
    Mortality after tonsil surgery, a population study, covering eight years and 82,527 operations in Sweden2015In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 272, no 3, p. 737-743Article in journal (Refereed)
    Abstract [en]

    The objective of this retrospective cohort study was to evaluate mortality rate and cause of death after tonsil surgery in Sweden. Two national registries were used, both run by The Swedish National Board of Health and Welfare, an agency of the Ministry of Health and Social Affairs. In the National Patient register all tonsil surgeries performed in Sweden from 2004 through 2011 were identified. The result from this search was matched with the National Cause of Death Register to identify all deaths that occurred within 30 days of tonsil surgery. Personal identity numbers were used to do the matching of registers. Details on the cause of death were obtained from the Swedish National Board of Health and Welfare. Two deaths were identified in 82,527 operations. Both patients were male, otherwise healthy, children under the age of five, operated due to tonsil-related upper airway obstruction/snoring with coblation technique. Cause of death was bleeding-related airway obstruction in both cases and hemodynamic failure caused by blood loss. Both deaths occurred after discharge from the hospital within the first postoperative week. No abnormal levels of analgesics were found in the postmortal investigations. Two deaths related to tonsil surgery (performed on benign indications) were identified in 82,527 operations (2004-2011) in a well-defined national population. Both deaths were due to postoperative bleeding. Based on our findings, the frequency of post-tonsil-surgery mortality in Sweden was 1/41,263, 2004-2011. Level of evidence 2b retrospective cohort study.

  • 42.
    Rönnberg, Jerker
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Oticon AS, Denmark.
    Ng, Elaine Hoi Ning
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Lidestam, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Zekveld, Adriana
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, The Swedish Institute for Disability Research. Linköping University, Faculty of Arts and Sciences. Vrije University of Amsterdam, Netherlands; Vrije University of Amsterdam, Netherlands.
    Sörqvist, Patrik
    Linköping University, Department of Behavioural Sciences, Cognition, Development and Disability. Linköping University, Faculty of Arts and Sciences. University of Gavle, Sweden.
    Lyxell, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Träff, Ulf
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Yumba, Wycliffe
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Classon, Elisabet
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, The Swedish Institute for Disability Research. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine and Geriatrics.
    Hällgren, Mathias
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Larsby, Birgitta
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Signoret, Carine
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Pichora-Fuller, Kathleen
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, The Swedish Institute for Disability Research. Linköping University, Faculty of Arts and Sciences. University of Toronto, Canada; University of Health Network, Canada; Baycrest Hospital, Canada.
    Rudner, Mary
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Danielsson, Henrik
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Hearing impairment, cognition and speech understanding: exploratory factor analyses of a comprehensive test battery for a group of hearing aid users, the n200 study2016In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 55, no 11, p. 623-642Article in journal (Refereed)
    Abstract [en]

    Objective: The aims of the current n200 study were to assess the structural relations between three classes of test variables (i.e. HEARING, COGNITION and aided speech-in-noise OUTCOMES) and to describe the theoretical implications of these relations for the Ease of Language Understanding (ELU) model. Study sample: Participants were 200 hard-of-hearing hearing-aid users, with a mean age of 60.8 years. Forty-three percent were females and the mean hearing threshold in the better ear was 37.4dB HL. Design: LEVEL1 factor analyses extracted one factor per test and/or cognitive function based on a priori conceptualizations. The more abstract LEVEL 2 factor analyses were performed separately for the three classes of test variables. Results: The HEARING test variables resulted in two LEVEL 2 factors, which we labelled SENSITIVITY and TEMPORAL FINE STRUCTURE; the COGNITIVE variables in one COGNITION factor only, and OUTCOMES in two factors, NO CONTEXT and CONTEXT. COGNITION predicted the NO CONTEXT factor to a stronger extent than the CONTEXT outcome factor. TEMPORAL FINE STRUCTURE and SENSITIVITY were associated with COGNITION and all three contributed significantly and independently to especially the NO CONTEXT outcome scores (R-2 = 0.40). Conclusions: All LEVEL 2 factors are important theoretically as well as for clinical assessment.

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  • 43.
    Semb, Gunvor
    et al.
    Division of Dentistry, University of Manchester , Manchester , UK; Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway; Department of Speech and Language Disorders , Statped sørøst , Oslo , Norway..
    Enemark, Hans
    Cleft Palate Center , Aarhus , Denmark.
    Friede, Hans
    Department of Orthodontics , Sahlgrenska Academy, University of Gothenburg , Sweden.
    Paulin, Gunnar
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    Lilja, Jan
    Department of Plastic Surgery , Sahlgrenska Academy, University of Gothenburg , Sweden.
    Rautio, Jorma
    Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland.
    Andersen, Mikael
    Copenhagen Cleft Palate Center, University Hospital of Copenhagen , Denmark.
    Åbyholm, Frank
    Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway.
    Lohmander, Anette
    Division of Speech and Language Pathology , Karolinska Institute, and Karolinska University Hospital , Stockholm , Sweden.
    Shaw, William
    Division of Dentistry, University of Manchester , Manchester , UK.
    Mølsted, Kirsten
    Copenhagen Cleft Palate Center, University Hospital of Copenhagen , Denmark.
    Heliövaara, Arja
    Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland.
    Bolund, Stig
    Copenhagen Cleft Palate Center, University Hospital of Copenhagen , Denmark.
    Hukki, Jyri
    Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland.
    Vindenes, Hallvard
    Centre for Cleft Lip and Palate, Bergen University Hospital Haukeland , Bergen , Norway.
    Davenport, Peter
    Greater Manchester Cleft Lip and Palate Unit , Royal Manchester Childrens' Hospital , Manchester , UK.
    Arctander, Kjartan
    Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway.
    Larson, Ola
    Stockholm Craniofacial Team , Karolinska University Hospital , Stockholm , Sweden.
    Berggren, Anders
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery.
    Whitby, David
    Greater Manchester Cleft Lip and Palate Unit , Royal Manchester Childrens' Hospital , Manchester , UK.
    Leonard, Alan
    The Royal Hospital for Sick Children , Belfast , N. Ireland.
    Neovius, Erik
    Stockholm Craniofacial Team , Karolinska University Hospital , Stockholm , Sweden.
    Elander, Anna
    Department of Plastic Surgery , Sahlgrenska Academy, University of Gothenburg , Sweden.
    Willadsen, Elisabeth
    Department of Nordic Studies and Linguistics , University of Copenhagen , Denmark.
    Bannister, R. Patricia
    Greater Manchester Cleft Lip and Palate Unit , Royal Manchester Childrens' Hospital , Manchester , UK.
    Bradbury, Eileen
    Private Practitioner , Manchester , UK.
    Henningsson, Gunilla
    Stockholm Craniofacial Team , Karolinska University Hospital , Stockholm , Sweden.
    Persson, Christina
    Sahlgrenska Academy, University of Gothenburg, Sweden;Sahlgrenska University Hospital, Gothenburg, Sweden.
    Eyres, Philip
    Division of Dentistry, University of Manchester , Manchester , UK.
    Emborg, Berit
    Cleft Palate Center , Aarhus , Denmark.
    Kisling-Møller, Mia
    Division of Dentistry, University of Manchester , Manchester , UK.
    Küseler, Annelise
    Division of Dentistry, University of Manchester , Manchester , UK.
    Granhof Black, Birthe
    Division of Dentistry, University of Manchester , Manchester , UK.
    Schöps, Antje
    Copenhagen Cleft Palate Center, University Hospital of Copenhagen , Denmark.
    Bau, Anja
    Copenhagen Cleft Palate Center, University Hospital of Copenhagen , Denmark.
    Boers, Maria
    Copenhagen Cleft Palate Center, University Hospital of Copenhagen , Denmark.
    Søgaard Andersen, Helene
    Copenhagen Cleft Palate Center, University Hospital of Copenhagen , Denmark.
    Jeppesen, Karin
    Copenhagen Cleft Palate Center, University Hospital of Copenhagen , Denmark.
    Marxen, Dorte
    Copenhagen Cleft Palate Center, University Hospital of Copenhagen , Denmark.
    Paaso, Marjukka
    Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland.
    Hölttä, Elina
    Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland.
    Alaluusua, Suvi
    Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland.
    Turunen, Leena
    Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland.
    Humerinta, Kirsti
    Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland.
    Elfving-Little, Ulla
    Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland.
    Tørdal, Inger Beate
    Department of Speech and Language Disorders , Statped sørøst , Oslo , Norway.
    Kjøll, Lillian
    Department of Speech and Language Disorders , Statped sørøst , Oslo , Norway.
    Aukner, Ragnhild
    Department of Speech and Language Disorders , Statped sørøst , Oslo , Norway.
    Hide, Øydis
    Department of Speech and Language Disorders , Statped sørøst , Oslo , Norway.
    Feragen, Kristin Billaud
    Department of Speech and Language Disorders , Statped sørøst , Oslo , Norway.
    Rønning, Elisabeth
    Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway.
    Skaare, Pål
    Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway.
    Brinck, Eli
    Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway.
    Semmingsen, Ann-Magritt
    Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway.
    Lindberg, Nina
    Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway.
    Bowden, Melanie
    Greater Manchester Cleft Lip and Palate Unit , Royal Manchester Childrens' Hospital , Manchester , UK.
    Davies, Julie
    Greater Manchester Cleft Lip and Palate Unit , Royal Manchester Childrens' Hospital , Manchester , UK.
    Mooney, Jeanette
    Greater Manchester Cleft Lip and Palate Unit , Royal Manchester Childrens' Hospital , Manchester , UK.
    Bellardie, Haydn
    Greater Manchester Cleft Lip and Palate Unit , Royal Manchester Childrens' Hospital , Manchester , UK.
    Schofield, Nina
    Greater Manchester Cleft Lip and Palate Unit , Royal Manchester Childrens' Hospital , Manchester , UK.
    Nyberg, Jill
    Stockholm Craniofacial Team , Karolinska University Hospital , Stockholm , Sweden.
    Lundberg, Maria
    Stockholm Craniofacial Team , Karolinska University Hospital , Stockholm , Sweden.
    Linder-Aronson Karsten, Agneta
    Stockholm Craniofacial Team, Department of Dental Medicine , Karolinska Institute , Stockholm , Sweden.
    Larson, Margareta
    Eastman Institute, Stockholms Läns Landsting , Stockholm , Sweden.
    Holmefjord, Anders
    Statped vest , Bergen , Norway.
    Reisæter, Sigvor
    Statped vest , Bergen , Norway.
    Pedersen, Nina-Helen
    Statped vest , Bergen , Norway.
    Rasmussen, Therese
    Statped vest , Bergen , Norway.
    Tindlund, Rolf
    Dental School, University of Bergen , Bergen , Norway.
    Sæle, Paul
    Oral Health Center of Expertise/Western Norway , Bergen , Norway.
    Blomhoff, Reidunn
    Centre for Cleft Lip and Palate, Bergen University Hospital Haukeland , Bergen , Norway.
    Jacobsen, Gry
    Centre for Cleft Lip and Palate, Bergen University Hospital Haukeland , Bergen , Norway.
    Havstam, Christina
    Division for Speech and Language Pathology , Sahlgrenska University Hospital , Gothenburg , Sweden.
    Rizell, Sara
    Department of Orthodontics , Sahlgrenska Academy, University of Gothenburg , Sweden.
    Enocson, Lars
    Department of Orthodontics , Sahlgrenska Academy, University of Gothenburg , Sweden.
    Hagberg, Catharina
    Department of Orthodontics , Sahlgrenska Academy, University of Gothenburg , Sweden.
    Najar Chalien, Midia
    Department of Orthodontics , Sahlgrenska Academy, University of Gothenburg , Sweden.
    Paganini, Anna
    Department of Plastic Surgery , Sahlgrenska Academy, University of Gothenburg , Sweden.
    Lundeborg, Inger
    Linköping University, Department of Clinical and Experimental Medicine, Division of Speech language pathology, Audiology and Otorhinolaryngology. Linköping University, Faculty of Medicine and Health Sciences.
    Marcusson, Agneta
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    Mjönes, Anna-Britta
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Gustavsson, Annica
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    Hayden, Christine
    The Royal Hospital for Sick Children , Belfast , N. Ireland.
    McAleer, Eilish
    The Royal Hospital for Sick Children , Belfast , N. Ireland.
    Slevan, Emma
    The Royal Hospital for Sick Children , Belfast , N. Ireland.
    Gregg, Terry
    The Royal Hospital for Sick Children , Belfast , N. Ireland.
    Worthington, Helen
    Division of Dentistry, University of Manchester , Manchester , UK.
    A Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 1. Planning and management.2017In: Journal of Plastic Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 51, no 1, p. 2-13Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND AIMS: Longstanding uncertainty surrounds the selection of surgical protocols for the closure of unilateral cleft lip and palate, and randomised trials have only rarely been performed. This paper is an introduction to three randomised trials of primary surgery for children born with complete unilateral cleft lip and palate (UCLP). It presents the protocol developed for the trials in CONSORT format, and describes the management structure that was developed to achieve the long-term engagement and commitment required to complete the project.

    METHOD: Ten established national or regional cleft centres participated. Lip and soft palate closure at 3-4 months, and hard palate closure at 12 months served as a common method in each trial. Trial 1 compared this with hard palate closure at 36 months. Trial 2 compared it with lip closure at 3-4 months and hard and soft palate closure at 12 months. Trial 3 compared it with lip and hard palate closure at 3-4 months and soft palate closure at 12 months. The primary outcomes were speech and dentofacial development, with a series of perioperative and longer-term secondary outcomes.

    RESULTS: Recruitment of 448 infants took place over a 9-year period, with 99.8% subsequent retention at 5 years.

    CONCLUSION: The series of reports that follow this introductory paper include comparisons at age 5 of surgical outcomes, speech outcomes, measures of dentofacial development and appearance, and parental satisfaction. The outcomes recorded and the numbers analysed for each outcome and time point are described in the series.

    TRIAL REGISTRATION: ISRCTN29932826.

  • 44.
    Sinkvist, David
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Primary Health Care in Central County.
    Theodorsson, Annette
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Neurosurgery.
    Ledin, Torbjörn
    Linköping University, Department of Clinical and Experimental Medicine, Division of Speech language pathology, Audiology and Otorhinolaryngology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Theodorsson, Elvar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry.
    Five Year Data and Results of Continuous Quality Improvement Using SKURT2017In: Educational Research Applications, E-ISSN 2575-7032, Vol. 2017, no 05, article id ERCA-125Article in journal (Refereed)
    Abstract [en]

    Student rating of teaching isessentialfor attaining and maintaining higheducational quality.A quality improvement system, SKURT,based on digital online weekly combined quantitative, ten-graded scale, and qualitative, open-ended free text, group feedback from medical students was developed. Students rated all educational, non-clerkship, items throughout the entire medical program, spanning eleven terms. The results were semi-publicly available for students and faculty at a Swedish university. This study describes datafrom five-year use of the system,focusing on how the use of SKURT influenced educational items found to be in the most substantial need for improvements.

    Statistically but hardly practically significant improvement in average feedback grade was found during the observation period (average 7.07 in 2009 to 7.24 in 2013 (p<0.001)).The medical program was already in 2007recognized ascenter of excellent quality in higher education. When analyzing the 18 lectures with lowest outcome in the spring 2009 compared to the fall 2013, five were discontinued. The remaining 13 lectures improved significantly (p<0.001) 116% from 2.94 (SD 0.92) to 6.34 (SD 2.58). 

    A weekly group feedback system employing the principles used in SKURTis useful forimproving the quality of medical education particularlyby improvingthe items with the lowest ratings.

  • 45.
    Sinkvist, David
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Primary Health Care in Central County.
    Theodorsson, Annette
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Neurosurgery.
    Ledin, Torbjörn
    Linköping University, Department of Clinical and Experimental Medicine, Division of Speech language pathology, Audiology and Otorhinolaryngology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Theodorsson, Elvar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry.
    SKURT: Quality Improvement System with Comprehensive Weekly Digital Student Group Feedback2017In: Educational Research Applications, E-ISSN 2575-7032, Vol. 2017, no 5, article id RCA-124Article in journal (Refereed)
    Abstract [en]

    Students’ role in evaluation and rating of teachers and education has been extensively researched for nearly a century. Applied worldwide, students’ ratings account for the majority of the available data.We created a new quality improvement system, SKURT, using digital online weekly combined quantitative, ten-graded scale, and qualitative, open-ended free text, group feedback from medical students. Students rated all educational, non-clerkship, items throughout the entire medical program, spanning eleven terms. The rating process is since 2008 an integral part of a medical program at a Swedish university. The results are, after a screening process, semi-publicly available on-demand, for students and faculty, creating a feedback loop enabling continuous improvement of quality.A thorough literature search of students rating of teaching found no other corresponding weekly group rating system spanning all educational items. Quality improvement systems based on similar principles as SKURT can uncover problem areas that are difficult to find using other rating systems and has the potential to circumvent several biases, risks and shortcomings of traditional rating systems in current use.

  • 46.
    Stenbäck, Victoria
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Hällgren, Mathias
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Larsby, Birgitta
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Executive functions and working memory capacity in speech communication under adverse conditions2016In: Speech, Language and Hearing, ISSN 2050-571X, Vol. 19, no 4, p. 218-226Article in journal (Refereed)
    Abstract [en]

    Introduction: Working memory is assumed to play a major part in hearing and communication in everyday listening situations. Our working memory stores information, but in suboptimal listening conditions, interfering stimuli can lead to information only being partially stored, or even missed. Research suggests that a high working memory capacity (WMC) might not just be a result of a large store, but in addition good inhibitory control can facilitate working memory, and therefore aid in situations where focus on a target stimulus while ignoring distractors is needed.

    Objective: The aim of the present study was to investigate how individual WMC, cognitive inhibition, and lexical decision relate to listening to speech under adverse conditions in two separate groups: 46 young normally hearing (NH) and 40 elderly hearing-impaired (HI) individuals.

    Results: It showed that lexical access was of little importance for young NH individuals in a speech-in-noise test, but that high lexical decision-making was associated with lower signal-to-noise ratios for the elderly HI individuals. The results also showed that WMC was of importance for word recognition in a speech-in-noise test for elderly participants, when the 80% word recognition criterion was targeted, but not for the young NH individuals. Finally, results suggest that cognitive inhibition, as measured with the Hayling task, was important for young NH individuals when listening conditions are suboptimal.

    Conclusion: In conclusion, hearing loss is a strong contributing factor to declines in the ability to recognize speech in noise, and in order to assess speech-recognition-in-noise performance, individual differences in WMC and cognitive inhibition should be taken into consideration. Future research should include various age groups, with and without hearing loss, as well as measures of WMC, cognitive inhibition, and lexical access when assessing the ability to listen to speech under adverse conditions.

  • 47.
    Stenbäck, Victoria
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Hällgren, Mathias
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Lyxell, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, The Swedish Institute for Disability Research. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Larsby, Birgitta
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Cognitive inhibition, WMC, and speech-recognition-in-noise2015In: 3rd International conference in Cognitive Hearing Science and Communication, Linköping 14-17 June, 2015., 2015Conference paper (Other academic)
    Abstract [en]

    Cognitive abilities are important for a number of human attributes, such as making sense of communication, holding information active in memory, and making decisions. When it is the goal to focus on a single target voice, and resist intrusions from irrelevant information, cognitive inhibition can aid us in our endeavour. Cognitive inhibition is thought to support and co-operate with working memory. Abilities such as cognitive inhibition and working memory are also important for speech processing, even more so when listening to speech under adverse conditions. In order to assess different difficulties that can arise in every day listening situations, it´s of importance to have solid methods for measuring cognitive abilities. In the present study we present a task assessing cognitive inhibition, and how it relates to individual working memory capacity (WMC), and speech-recognition-in-noise. Forty-six young normally-hearing individuals were presented with a cognitive test battery, as well as a speech-in-noise test. Our results suggest that individuals with high WMC, also exhibit good cognitive inhibition. The results also indicate that those who perform well in the cognitive inhibition task need less favourable signal-to-noise-ratios in the speech-recognition task. Our findings indicate that capacity to resist semantic interference can be used to predict performance in speech-recognition tasks when listening under adverse conditions. 

    Download full text (pdf)
    Poster
  • 48.
    Stenbäck, Victoria
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Hällgren, Mathias
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Lyxell, Björn
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Larsby, Birgitta
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    The role of cognitive abilities in younger and older normally hearing adults when listening to speech under adverse conditions2015In: 6th Aging and Speech Communication Research Conference 2015 (“ASC15”) Bloomington, Indiana, USA October 11-14, 2015 / [ed] Larry E Humes, 2015Conference paper (Other academic)
    Abstract [en]

    Cognitive abilities, such as working memory capacity (WMC), lexical decision making, and cognitive inhibition, can help predict performance on speech-recognition-in-noise tasks. Working memory is assumed to play a major part in every day listening situations, storing and actively working with relevant information, while inhibitory control helps to suppress and separate irrelevant information from interfering with the information processing. With increasing age, comes decreasing cognitive abilities, such as declines in WMC, speed of information processing, and inhibitory control, leading to problems when selectively attending to speech while inhibiting interfering distractors. The aim of the present study was to examine age-related declines in WMC, inhibitory control, and lexical decision making, and their respective roles when listening to speech under adverse listening conditions. Twenty-four young normally-hearing (NH), and 24 elderly ( for their age) NH individuals participated in the study. They completing a cognitive test battery assessing WMC, cognitive inhibition, and lexical decision making, as well as a closed-set (Hagerman sentences) and an open-set (HINT) speech-recognition-in-noise task masked with different maskers. We will present results comparing cognitive abilities in younger normally-hearing individuals with elderly normally-hearing individuals, and how age and cognitive abilities relates to performance on speech-recognition-in-noise tasks.

    Download full text (pdf)
    fulltext
  • 49.
    Stenbäck, Victoria
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Medicine and Health Sciences.
    Hällgren, Mathias
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping. Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Lyxell, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Larsby, Birgitta
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Medicine and Health Sciences.
    the Speech recognition under adverse listening conditions in young normally-hearing listeners2015In: Third International Conference on Cognitive Hearing Science for Communication, Linköping, 14-17 June, 2015. Sweden., 2015Conference paper (Refereed)
    Abstract [en]

    In the present study we aimed to investigate individual differences in cognitive inhibition, WMC, and how they relate to performance on a speech-recognition-in-noise task. Sixteen young normally-hearing individuals were presented with a cognitive test battery, as well as a sentence corpus masked by 5 different maskers, targeting 80% speech-recognition. One masker was a slightly modulated (10%) speech-shaped noise (SSN), 2 maskers were constructed by modulating the SSN with the envelopes from a single female talker, and the international speech test signal (ISTS). We also masked the target sentences with the ISTS, and a single female talker reading a passage in a Swedish newspaper. Our results showed that cognitive inhibition is significantly related to performance when maskers with meaningful, semantic information is used. The results further indicate that young normally-hearing individuals can take advantage of temporal and spectral dips to fill in missing information. Our findings suggest that choice of speech material is of importance for the outcome in speech-recognition-in-noise tasks. We further propose that tasks of cognitive inhibition can be used to predict performance in a speech-recognition task.

    Download full text (pdf)
    Poster
  • 50.
    Stenbäck, Victoria
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science.
    Hällgren, Mathias
    Linköping University, Faculty of Health Sciences. Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Lyxell, Björn
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Larsby, Birgitta
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, The Swedish Institute for Disability Research. Linköping University, Faculty of Health Sciences.
    The Swedish Hayling task, and its relation to working memory, verbal ability, and speech-recognition-in-noise2015In: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 56, no 3, p. 264-272Article in journal (Refereed)
    Abstract [en]

    Cognitive functions and speech-recognition-in-noise were evaluated with a cognitive test battery, assessing response inhibition using the Hayling task, working memory capacity (WMC) and verbal information processing, and an auditory test of speech recognition. The cognitive tests were performed in silence whereas the speech recognition task was presented in noise. Thirty young normally-hearing individuals participated in the study. The aim of the study was to investigate one executive function, response inhibition, and whether it is related to individual working memory capacity (WMC), and how speech-recognition-in-noise relates to WMC and inhibitory control. The results showed a significant difference between initiation and response inhibition, suggesting that the Hayling task taps cognitive activity responsible for executive control. Our findings also suggest that high verbal ability was associated with better performance in the Hayling task. We also present findings suggesting that individuals who perform well on tasks involving response inhibition, and WMC, also perform well on a speech-in-noise task. Our findings indicate that capacity to resist semantic interference can be used to predict performance on speech-in-noise tasks.

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