Publications by authors named "Jan Alexandersson"

5 Publications

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Semiquantitative Criteria in the Eye Bank That Correlate with Cornea Guttata in Donor Corneas.

Klin Monbl Augenheilkd 2021 Jun 22;238(6):680-687. Epub 2021 Jun 22.

Department of Ophthalmology, Saarland University Hospital and Saarland University Faculty of Medicine, Homburg, Germany.

Background: Cornea guttata may not be recognized in the eye bank and recent studies have displayed that guttae are transplanted in about 15% of cases in varying severities. The purpose of this study was to establish semiquantitative criteria for the detection of cornea guttata in donor corneas in the eye bank.

Methods: In this retrospective cohort study, preoperative endothelial pictures of donor corneas were collected and classified according to the post-penetrating keratoplasty cornea guttata grade into three distinct groups: group 1 consists of healthy corneas with no guttae (guttata grade 0); group 2 constitutes corneas with mild asymptomatic cornea guttata (guttata grade +); and group 3 comprises corneas with advanced widespread cornea guttata (guttata grade ++/+++/++++). The preoperative pictures of each group were then individually analyzed using the following five semiquantitative criteria: The number and the area of the cell-depleted surfaces, the presence of less than 50% of the cells having a hexagonal or a circular shape, the presence of cell membrane defects and interruptions, the presence of blebs in the cell membrane, and the presence of groups of cells with a distinct whitish color.

Results: In total, 262 patients were included in this study, with a total number of 1582 preoperative donor corneal endothelial pictures. Out of those pictures, groups 1, 2, and 3 encompassed 995 (62.9%), 411 (26.0%), and 176 (11.1%) pictures, respectively. Three out of the five eye bank criteria were found to correlate with postoperative cornea guttata with a highly significant p value of < 0.001. These three criteria are the presence of less than 50% of the cells having a hexagonal or a circular shape, the presence of cell membrane defects and interruptions and, the presence of blebs. The presence of groups of cells with a distinct whitish color was only a weak predictive factor for cornea guttata (p = 0.069). There was no statistically significant correlation between the number and the area of cell-depleted surfaces and postoperative cornea guttata with a p = 0.181.

Conclusion: Three semiquantitative criteria that can be detected in the eye bank using inverted light microscopy seem to correlate with postoperative cornea guttata: The presence of blebs, the presence of cell membrane defects and interruptions, as well as endothelial pictures with less than 50% of the cells having a hexagonal of circular shape. The presence of groups of cells with a distinct whitish color appears to be a weak predictor of cornea guttata.
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June 2021

Detecting Apathy in Older Adults with Cognitive Disorders Using Automatic Speech Analysis.

J Alzheimers Dis 2019 ;69(4):1183-1193

CoBTeK (Cognition-Behaviour-Technology) Lab, Memory Center CHU, Université Côte d'Azur, Nice, France.

Background: Apathy is present in several psychiatric and neurological conditions and has been found to have a severe negative effect on disease progression. In older people, it can be a predictor of increased dementia risk. Current assessment methods lack objectivity and sensitivity, thus new diagnostic tools and broad-scale screening technologies are needed.

Objective: This study is the first of its kind aiming to investigate whether automatic speech analysis could be used for characterization and detection of apathy.

Methods: A group of apathetic and non-apathetic patients (n = 60) with mild to moderate neurocognitive disorder were recorded while performing two short narrative speech tasks. Paralinguistic markers relating to prosodic, formant, source, and temporal qualities of speech were automatically extracted, examined between the groups and compared to baseline assessments. Machine learning experiments were carried out to validate the diagnostic power of extracted markers.

Results: Correlations between apathy sub-scales and features revealed a relation between temporal aspects of speech and the subdomains of reduction in interest and initiative, as well as between prosody features and the affective domain. Group differences were found to vary for males and females, depending on the task. Differences in temporal aspects of speech were found to be the most consistent difference between apathetic and non-apathetic patients. Machine learning models trained on speech features achieved top performances of AUC = 0.88 for males and AUC = 0.77 for females.

Conclusions: These findings reinforce the usability of speech as a reliable biomarker in the detection and assessment of apathy.
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September 2020

Exploitation vs. exploration-computational temporal and semantic analysis explains semantic verbal fluency impairment in Alzheimer's disease.

Neuropsychologia 2019 08 20;131:53-61. Epub 2019 May 20.

Chair for Development of Language, Learning & Action, University of Saarland, Germany.

Impaired Semantic Verbal Fluency (SVF) in dementia due to Alzheimer's Disease (AD) and its precursor Mild Cognitive Impairment (MCI) is well known. Yet, it remains open whether this impairment mirrors the breakdown of semantic memory retrieval processes or executive control processes. Therefore, qualitative analysis of the SVF has been proposed but is limited in terms of methodology and feasibility in clinical practice. Consequently, research draws no conclusive picture which of these afore-mentioned processes drives the SVF impairment in AD and MCI. This study uses a qualitative computational approach-combining temporal and semantic information-to investigate exploitation and exploration patterns as indicators for semantic memory retrieval and executive control processes. Audio SVF recordings of 20 controls (C, 66-81 years), 55 MCI (57-94 years) and 20 AD subjects (66-82 years) were assessed while groups were matched according to age and education. All groups produced, on average, the same amount of semantically related items in rapid succession within word clusters. Conversely, towards AD, there was a clear decline in semantic as well as temporal exploration patterns between clusters. Results strongly point towards preserved exploitation-semantic memory retrieval processes-and hampered exploration-executive control processes-in AD and potentially in MCI.
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August 2019

Fully Automatic Speech-Based Analysis of the Semantic Verbal Fluency Task.

Dement Geriatr Cogn Disord 2018 8;45(3-4):198-209. Epub 2018 Jun 8.

Memory Clinic, Association IA, CoBTek Lab, CHU Université Côte d'Azur, Nice, France.

Background: Semantic verbal fluency (SVF) tests are routinely used in screening for mild cognitive impairment (MCI). In this task, participants name as many items as possible of a semantic category under a time constraint. Clinicians measure task performance manually by summing the number of correct words and errors. More fine-grained variables add valuable information to clinical assessment, but are time-consuming. Therefore, the aim of this study is to investigate whether automatic analysis of the SVF could provide these as accurate as manual and thus, support qualitative screening of neurocognitive impairment.

Methods: SVF data were collected from 95 older people with MCI (n = 47), Alzheimer's or related dementias (ADRD; n = 24), and healthy controls (HC; n = 24). All data were annotated manually and automatically with clusters and switches. The obtained metrics were validated using a classifier to distinguish HC, MCI, and ADRD.

Results: Automatically extracted clusters and switches were highly correlated (r = 0.9) with manually established values, and performed as well on the classification task separating HC from persons with ADRD (area under curve [AUC] = 0.939) and MCI (AUC = 0.758).

Conclusion: The results show that it is possible to automate fine-grained analyses of SVF data for the assessment of cognitive decline.
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November 2018

Connectivity for healthcare and well-being management: examples from six European projects.

Int J Environ Res Public Health 2009 07 6;6(7):1947-71. Epub 2009 Jul 6.

Faculty of Health and Social Work, University of Plymouth, Drake Circus, Plymouth, PL4 8AA, Devon, UK.

Technological advances and societal changes in recent years have contributed to a shift in traditional care models and in the relationship between patients and their doctors/carers, with (in general) an increase in the patient-carer physical distance and corresponding changes in the modes of access to relevant care information by all groups. The objective of this paper is to showcase the research efforts of six projects (that the authors are currently, or have recently been, involved in), CAALYX, eCAALYX, COGKNOW, EasyLine+, I2HOME, and SHARE-it, all funded by the European Commission towards a future where citizens can take an active role into managing their own healthcare. Most importantly, sensitive groups of citizens, such as the elderly, chronically ill and those suffering from various physical and cognitive disabilities, will be able to maintain vital and feature-rich connections with their families, friends and healthcare providers, who can then respond to, and prevent, the development of adverse health conditions in those they care for in a timely manner, wherever the carers and the people cared for happen to be.
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July 2009