| 1. |
- Ademuyiwa, Adesoji O., et al.
(författare)
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Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries
- 2016
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Ingår i: BMJ Global Health. - : BMJ Publishing Group Ltd. - 2059-7908. ; 1:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Child health is a key priority on the global health agenda, yet the provision of essential and emergency surgery in children is patchy in resource-poor regions. This study was aimed to determine the mortality risk for emergency abdominal paediatric surgery in low-income countries globally.Methods: Multicentre, international, prospective, cohort study. Self-selected surgical units performing emergency abdominal surgery submitted prespecified data for consecutive children aged <16 years during a 2-week period between July and December 2014. The United Nation's Human Development Index (HDI) was used to stratify countries. The main outcome measure was 30-day postoperative mortality, analysed by multilevel logistic regression.Results: This study included 1409 patients from 253 centres in 43 countries; 282 children were under 2 years of age. Among them, 265 (18.8%) were from low-HDI, 450 (31.9%) from middle-HDI and 694 (49.3%) from high-HDI countries. The most common operations performed were appendectomy, small bowel resection, pyloromyotomy and correction of intussusception. After adjustment for patient and hospital risk factors, child mortality at 30 days was significantly higher in low-HDI (adjusted OR 7.14 (95% CI 2.52 to 20.23), p<0.001) and middle-HDI (4.42 (1.44 to 13.56), p=0.009) countries compared with high-HDI countries, translating to 40 excess deaths per 1000 procedures performed.Conclusions: Adjusted mortality in children following emergency abdominal surgery may be as high as 7 times greater in low-HDI and middle-HDI countries compared with high-HDI countries. Effective provision of emergency essential surgery should be a key priority for global child health agendas.
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| 2. |
- Berg, Matilda, et al.
(författare)
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The role of knowledge in internet-based cognitive behavioural therapy for adolescent depression : Results from a randomised controlled study
- 2019
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Ingår i: Internet Interventions. - : Elsevier. - 2214-7829. ; 15, s. 10-17
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Tidskriftsartikel (refereegranskat)abstract
- Background and objectivesClients' knowledge about their condition and treatment is considered crucial for general health improvement, and knowledge acquisition is an essential part in internet-based cognitive behavioural therapy (ICBT). Yet, little is known about the role of knowledge and how it influences treatment outcome. This study aimed to examine if explicit knowledgeincreased following ICBT for adolescent depression, if knowledge gainwould be associated with symptom reduction, and if pre-existing knowledge predicted changes in depressive symptoms.MethodsSeventy-one adolescents were randomised to a therapist-supported ICBT or a attention control condition. A measure of depression (BDI-II) and a knowledge test dealing with depression, comorbid anxiety, and its CBT-treatment were administered before and after treatment.ResultsSignificant improvements in knowledge were observed following ICBT compared to the attention control (between-group Cohen's d = 1.25, 95% CI [0.67–1.79]). On average, participants in the treatment group answered 1.4 more questions correctly at post treatment compared to the control group. No relation between change in knowledge and change in depressive symptoms could be observed. Knowledge scores at baseline were high for both groups, with participants answering approximately 75% of the questions correct. A higher level of initial knowledge level predicted poorer treatment response (Parson's r = −0.38, p = .048).ConclusionsThe findings indicate that knowledge about basic concepts and principles about depression, anxiety, and CBT increases following ICBT. This increase in knowledge was not related to change in depressive symptoms, indicating that knowledge is a different construct. The results also suggest that clients who are more knowledgeable prior to treatment might benefit less from ICBT. In sum, the results highlight the need to further examine the role of knowledge in ICBT.
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| 3. |
- Björk, Albin, et al.
(författare)
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Protein and DNA methylation-based scores as surrogate markers for interferon system activation in patients with primary Sjögren's syndrome
- 2020
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Ingår i: RMD Open. - : BMJ PUBLISHING GROUP. - 2056-5933. ; 6:1
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Standard assessment of interferon (IFN) system activity in systemic rheumatic diseases depends on the availability of RNA samples. In this study, we describe and evaluate alternative methods using plasma, serum and DNA samples, exemplified in the IFN-driven disease primary Sjogren's syndrome (pSS).Methods: Patients with pSS seropositive or negative for anti-SSA/SSB and controls were included. Protein-based IFN (pIFN) scores were calculated from levels of PD-1, CXCL9 and CXCL10. DNA methylation-based (DNAm) IFN scores were calculated from DNAm levels at RSAD2, IFIT1 and IFI44L. Scores were compared with mRNA-based IFN scores measured by quantitative PCR (qPCR), Nanostring or RNA sequencing (RNAseq).Results: mRNA-based IFN scores displayed strong correlations between B cells and monocytes (r=0.93 and 0.95, p<0.0001) and between qPCR and Nanostring measurements (r=0.92 and 0.92, p<0.0001). The pIFN score in plasma and serum was higher in patients compared with controls (p<0.0001) and correlated well with mRNA-based IFN scores (r=0.62-0.79, p<0.0001), as well as with each other (r=0.94, p<0.0001). Concordance of classification as 'high' or 'low' IFN signature between the pIFN score and mRNA-based IFN scores ranged from 79.5% to 88.6%, and the pIFN score was effective at classifying patients and controls (area under the curve, AUC=0.89-0.93, p<0.0001). The DNAm IFN score showed strong correlation to the RNAseq IFN score (r=0.84, p<0.0001) and performed well in classifying patients and controls (AUC=0.96, p<0.0001).Conclusions: We describe novel methods of assessing IFN system activity in plasma, serum or DNA samples, which may prove particularly valuable in studies where RNA samples are not available.
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| 4. |
- Carlsson, Ella, et al.
(författare)
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Mass composition of the escaping plasma at Mars
- 2006
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Ingår i: Icarus. - : Elsevier BV. - 0019-1035 .- 1090-2643. ; 182:2, s. 320-328
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Tidskriftsartikel (refereegranskat)abstract
- Data from the Ion Mass Analyzer (IMA) sensor of the ASPERA-3 instrument suite on Mars Express have been analyzed to determine the mass composition of the escaping ion species at Mars. We have examined 77 different ion-beam events and we present the results in terms of flux ratios between the following ion species: CO2+/O+ and O-2(+)/O+. The following ratios averaged over all events and energies were identified: CO2+/O+ = 0.2 and O-2(+)/O+ = 0.9. The values measured are significantly higher, by a factor of 10 for O-2(+)/O+, than a contemporary modeled ratio for the maximum fluxes which the martian ionosphere can supply. The most abundant ion species was found to be O+, followed by O-2(+) and CO2+. We estimate the loss of CO2+ to be 4.0 x 10(24) s(-1) (0.29 kg s(-1)) by using the previous measurements of Phobos-2 in our calculations. The dependence of the ion ratios in relation to their energy ranges we studied, 0.3-3.0 keV, indicated that no clear correlation was found.
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| 5. |
- Forslin, Barbro M, et al.
(författare)
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The Health-promotion perspective in public-health plans in a Swedish region over three decades
- 2013
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Ingår i: Health Promotion International. - : Oxford University Press (OUP). - 0957-4824 .- 1460-2245. ; 28:2, s. 269-280
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Tidskriftsartikel (refereegranskat)abstract
- The trend away from a health and medical care-based policy to a healthy public policy has taken place in Sweden rather later than in other West European countries. One of the first county councils to establish health-promotion plans was Västernorrland. The aims of this study are to describe the contents of and analyze the changes over time in the five public-health plans in the county. The object of study for the policy analysis consists in these plans between 1978 and 2004. A deductive thematic content analysis was performed for each plan on the basis of the central determinants of health promotion. The positioning of the plans was determined using a theoretical framework (Beattie's modified model) founded in the dimensions of power (individual and collective) and governance (local, i.e. the municipalities, and central, i.e. the county council). The results show that the value attributed to good health was consistently high, but the means for attaining this goal have varied over time. The policy focus of the measures in the plans have taken a cyclical path-from individual empowerment to empowerment from a societal perspective, and back prioritizing of actions at an individual level. On the governance dimension, there has been a corresponding positional change over time-from regional to local and then back to regional. Promoting the health of a population requires mutual interaction between the regional and local levels, in which both societal and individually oriented actions are prioritized.
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| 6. |
- Ingemarsdotter, Emilia, et al.
(författare)
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Quantifying the Net Environmental Impact of Using IoT to Support Circular Strategies—The Case of Heavy-Duty Truck Tires in Sweden
- 2021
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Ingår i: Circular Economy and Sustainability, 2021. - : Springer Science and Business Media LLC. - 2730-597X .- 2730-5988. ; 1:2, s. 613-650
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Tidskriftsartikel (refereegranskat)abstract
- The idea of leveraging the Internet of Things (IoT) to support strategies in line with the circular economy (CE) has been gaining traction in literature. However, previous work has predominantly focused on the opportunities that these technologies can bring, and few studies have critically assessed the environmental viability of the proposed strategies. In this study, we assess the net environmental impact of IoT-enabled circular strategies in the specific case of truck tires in the Swedish context, in order to gain insight into when and how it makes environmental sense to embed IoT hardware into products to support circular strategies. We quantify (1) the potential environmental savings in the different life cycle phases made possible through access to sensor data, and (2) the environmental impact from the added technology needed to provide and process the data. Life cycle assessment (LCA) is used to evaluate the difference in impact between the current state and an ‘IoT scenario’. We find that the IoT scenario gives a 4% lower weighted life cycle impact than the current state. Through sensitivity analysis, we show that the conclusions are sensitive to assumptions made about the expected benefits of adding IoT, which depend on the technological context as well as the current and IoT-induced behavior of stakeholders along the product life cycle. The results are also sensitive to assumptions about the environmental impact of the IoT hardware components, implying that design decisions at this level can be important for ensuring a net environmental impact reduction from IoT-enabled circular strategies.
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| 9. |
- Lagsten, Jenny, 1967-, et al.
(författare)
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Mission Impossible? Applying AI Ethical Guidelines for Automation in Social Work
- 2022
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Konferensbidrag (refereegranskat)abstract
- In this research we investigate how ethical guidelines can be applied in the context of a robotic process automation (RPA) that makes decisions on income support in a Swedish social work agency. Our purpose is to identify ethical concerns that might be subject for regulation and governance when new RPA technology has been implemented in the decision-making process.As a first step we apply the assessment list for trustworthy artificial intelligence (ALTAI) as the evaluation framework. The rapid growth of AI techniques has made both the public and private sector call for new ethical and regulatory frameworks (e.g., Stahl et al., 2021; Schneiderman, 2020). As a response, the area of ethical guidelines for AI has been particularly active where a diverse range of organizations, researchers and national bodies work with and debate ethical frameworks and principles to make use of, or control, these new techniques to serve people and society.Our research question is three-folded: i) How is the RPA implemented and how can the implementation be described? ii) What ethical concerns emerge when income support decision-making is handed over to a RPA? iii) Where can ALTAI provide support for identifying ethical concerns in the context of social work RPA decision-making? We contribute with a description of the RPA as an anatomy of the digital infrastructure for automation of income support in the case municipality and an analysis of the RPA in relation to each key requirement of ALTAI summarizing ethical concerns. We end with preliminary conclusions on the applicability of ALTAI to capture ethical considerations in the context of RPA in social work.
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| 10. |
- Olsson, Ella, et al.
(författare)
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Case-based reasoning applied to geometric measurements for decision support in manufacturing
- 2013
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Ingår i: International Journal of Systems Assurance Engineering and Management. - : Springer Science and Business Media LLC. - 0975-6809 .- 0976-4348. ; 4:3, s. 223-230
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Tidskriftsartikel (refereegranskat)abstract
- Measurements from products are continuously collected to allow adjustments in the production line to certify a feasible product quality. Case-based reasoning is a promising methodology for this type of quality assurance. It allows product measurements and its related adjustments to the production line to be stored as cases in a case-based reasoning system. The idea is to describe an event of adjustments based on deviations in geometric measurement points on a product and connect these measurements to their correlated adjustments done to the production line. Experience will implicitly be stored in each case in the form of uniquely weighted measurement points according to their positive influence on adjustments. Methods have been developed in order to find these positive correlations between measurements and adjustments by analysing a set of historical product measurement and their following adjustments. Each case saved in the case base will be "quality assured" according to this methods and only cases containing strong positive correlations will be used by the system. The correlations will be used to supply each case with its own set individual weights.
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