| 1. |
- Jung, Christian, et al.
(författare)
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A comparison of very old patients admitted to intensive care unit after acute versus elective surgery or intervention
- 2019
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Ingår i: Journal of critical care. - : W B SAUNDERS CO-ELSEVIER INC. - 0883-9441 .- 1557-8615. ; 52, s. 141-148
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Tidskriftsartikel (refereegranskat)abstract
- Background: We aimed to evaluate differences in outcome between patients admitted to intensive care unit (ICU) after elective versus acute surgery in a multinational cohort of very old patients (80 years; VIP). Predictors of mortality, with special emphasis on frailty, were assessed.Methods: In total, 5063 VIPs were induded in this analysis, 922 were admitted after elective surgery or intervention, 4141 acutely, with 402 after acute surgery. Differences were calculated using Mann-Whitney-U test and Wilcoxon test. Univariate and multivariable logistic regression were used to assess associations with mortality.Results: Compared patients admitted after acute surgery, patients admitted after elective surgery suffered less often from frailty as defined as CFS (28% vs 46%; p < 0.001), evidenced lower SOFA scores (4 +/- 5 vs 7 +/- 7; p < 0.001). Presence of frailty (CFS >4) was associated with significantly increased mortality both in elective surgery patients (7% vs 12%; p = 0.01), in acute surgery (7% vs 12%; p = 0.02).Conclusions: VIPs admitted to ICU after elective surgery evidenced favorable outcome over patients after acute surgery even after correction for relevant confounders. Frailty might be used to guide clinicians in risk stratification in both patients admitted after elective and acute surgery.
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| 2. |
- Bruno, Raphael Romano, et al.
(författare)
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The Clinical Frailty Scale for mortality prediction of old acutely admitted intensive care patients: a meta-analysis of individual patient-level data
- 2023
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Ingår i: Annals of Intensive Care. - : SPRINGER. - 2110-5820. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- Background This large-scale analysis pools individual data about the Clinical Frailty Scale (CFS) to predict outcome in the intensive care unit (ICU). Methods A systematic search identified all clinical trials that used the CFS in the ICU (PubMed searched until 24th June 2020). All patients who were electively admitted were excluded. The primary outcome was ICU mortality. Regression models were estimated on the complete data set, and for missing data, multiple imputations were utilised. Cox models were adjusted for age, sex, and illness acuity score (SOFA, SAPS II or APACHE II). Results 12 studies from 30 countries with anonymised individualised patient data were included (n = 23,989 patients). In the univariate analysis for all patients, being frail (CFS >= 5) was associated with an increased risk of ICU mortality, but not after adjustment. In older patients (>= 65 years) there was an independent association with ICU mortality both in the complete case analysis (HR 1.34 (95% CI 1.25-1.44), p < 0.0001) and in the multiple imputation analysis (HR 1.35 (95% CI 1.26-1.45), p < 0.0001, adjusted for SOFA). In older patients, being vulnerable (CFS 4) alone did not significantly differ from being frail. After adjustment, a CFS of 4-5, 6, and >= 7 was associated with a significantly worse outcome compared to CFS of 1-3. Conclusions Being frail is associated with a significantly increased risk for ICU mortality in older patients, while being vulnerable alone did not significantly differ. New Frailty categories might reflect its "continuum" better and predict ICU outcome more accurately.
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| 3. |
- Falk, Joel, 1988-
(författare)
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The fate and ash transformations of phosphorus in combustion of biomass and sewage sludge
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The combustion of phosphorus (P)-rich biomass has a significant potential to increase the stock of biomass resources available for renewable heat and power production. In addition, the P-rich ashes have the potential as a fertilizer and could reduce the need for non-renewable P resources in agriculture. However, several technical challenges must be resolved to realize this potential.During combustion, the ash-forming matter in the fuel undergoes numerous chemical transformations, which can result in the formation of ash melts. Excessive melt formation can lead to durable ash deposits in and around the combustion zone and on heat exchangers, which can lower combustion performance and, in severe cases, lead to a complete shutdown of the process. Further, mono-combustion of P-rich residues such as sewage sludge results in the formation of phosphates with poor plant availability, which can significantly limit the value of the ash as a fertilizer. By co-combustion the sludge with K-rich biomass, it may be possible to alter the chemical speciation of P towards more plant-available phases while simultaneously managing the risk of ash-related operational issues. This work investigates the effect of combustion technology, fuel ash composition, and chemical association of P in the fuel on the fate, i.e., distribution and speciation, and ash transformations of P in combustion and co-combustion of biomass and sewage sludge.The basis of the study was experiments performed in three different combustion technologies, including a fluidized bed (5 kW, 730-800 °C), a fixed bed (20 kW, 950-1250 °C), and a powder burner (150 kW, ~1100°C). The fuels and fuel mixtures included P-rich and P-poor woody biomass, agricultural residues, and sewage sludge, which constitute a wide range of ash compositions in terms of K, Ca, Mg, Fe, Al, Si, and P. The residual ashes from the experiments were collected and chemically characterized with the original fuels and fuel mixtures to determine the ash transformation reactions of P. The experiments were complemented by thermodynamic equilibrium calculations (TECs), which aided the interpretation of experimental data and predicted the risk for operational issues related to the melting of coarse ash fractions.The major share of fuel P was found in coarse ash fractions such as bed ash particles, bottom ash, slag, cyclone ash, wind side deposits, and coarse fly ash. A low share of fuel P was found in fine ash fractions such as leeside deposits and PM1. This generally matched the predictions by TEC, which indicated that P was stable in condensed phases at the relevant compositions and conditions during the combustion experiments. The powder burner experiments produced the highest share of fuel P in PM1 (4-14 wt.%), followed by fixed bed combustion (<4 wt.%), with fluidized bed combustion having the lowest share (<0.6 wt.%). In addition, the experiments with sewage sludge indicated a significantly lower P share in PM1 for a given combustion technology than the other biomass fuels, ranging from <0.2 wt.% in the fluidized bed and <1.2 wt.% in the fixed bed.Combustion and co-combustion of woody biomass and agricultural residues resulted in the formation of a wide range of ortho-, pyro-, and metaphosphates associated with K, Ca, and Mg. Combustion of woody biomass generally resulted in a high share of Ca-orthophosphates, whereas agricultural residues had a higher share of K-rich ortho- and pyrophosphates. Irrespective of biomass assortment, the speciation of P in the ash from combustion and co-combustion followed general trends with respect to the fuel ash composition of the biomass mixture. The frequency and share of pyro- and metaphosphates identified in the coarse ash fractions tended to increase with the relative concentration of P to K, Ca, and Mg in the fuel mixture. A similar correlation was found between the share of K-rich phosphates and the relative concentration of K to Ca and Mg.The crystalline phosphate phases identified in the coarse ash fractions from sewage sludge and K-rich biomass experiments were mainly Fe-rich and Ca-rich orthophosphate. The frequency and share of Fe-rich orthophosphates decreased with the relative P to K, Ca, and Mg concentration in the fuel mixture. However, the sewage sludge mixtures were less prone to form K-rich orthophosphates than the biomass mixtures for a given composition in terms of P to K, Ca, and Mg.Based on TECs, it was possible to qualitatively predict ash-related issues related to the melting behavior of coarse ash fractions, such as slag formation, for woody biomass and agricultural residues by considering the K, Ca, Mg, Si, and P content in the fuel. The share of network formers (SiO2, PO2.5) to total ash oxides had the largest overall influence on the melting tendency of the ash mixture, followed by the ratio of K2O to total network modifiers (K2O, CaO, MgO), which had a high impact on ash mixtures with high relative shares of SiO2. The slagging tendency of fuel mixtures with a high share of sewage sludge could not be predicted based on the melting behavior of the K-Ca-Mg-Si-P-O system due to the high relative share of Fe and Al. The experimental results indicated that the slagging tendency of the sewage sludge was significantly improved by co-combustion with moderate amounts of wheat straw or sunflower husk.Based on the combined results, it was possible to establish four fuel ash molar ratios correlated with the speciation of P in the produced coarse ash fractions and the risk of slag formation in fixed-bed combustion. These ratios were used to recommend practical fuel mixing strategies that could enable the production of combustion ashes with high P-plant availability while simultaneously managing the risk of severe slag formation.
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| 4. |
- Grant, Marcus, et al.
(författare)
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Research for City Practice
- 2017
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Ingår i: Cities and Health. - : Informa UK Limited. - 2374-8834 .- 2374-8842. ; 1:2, s. 108-119
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Tidskriftsartikel (refereegranskat)abstract
- CITY KNOW-HOW: Human health and planetary health are both influenced by city lifestyles, city leadership, and city development. For both, worrying trends are leading to increasing concern. It is imperative that both become core foci in urban policy. Changing the trajectory will require concerted action. The journal Cities & Health journal is dedicated to supporting the flow of knowledge, in all directions to help make this happen. We want to support communication between researchers, practitioners, policy-makers, communities and decision-makers in cities. This is the purpose of this City Know-how section of the journal. ‘Research for city practice’ disseminates lessons from research, explaining the key messages for city leaders, communities and the professions involved in city policy and practice. ‘City shorts’ provide glimpses of what is being attempted or achieved. ‘Case studies’ are where you will find evaluations of interventions and ‘Commentary and debate’ helps extend the conversations we are having and develop much needed new thinking. Join in these conversations. In service to strengthening the community of interest, we would like to include many and varied voices, including those from younger practitioners and researchers, connected with supporting health and health equity in everyday urban lives.
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| 5. |
- Marcus, Grant, et al.
(författare)
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Supporting a Healthy Planet, Healthy People and Health Equity through Urban and Territorial Planning
- 2022
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Ingår i: Planning practice + research. - : ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD. - 0269-7459 .- 1360-0583. ; 37:1, s. 111-130
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Tidskriftsartikel (refereegranskat)abstract
- The form of human settlements impacts on planetary health, population health and health equity. Yet goals for urban and territorial planning are only tangentially linked to public health outcomes. The WHO and UN-Habitat support actions to bring health to the fore in planning and design of human settlements, recently publishing Integrating Health in Urban and Territorial Planning: a sourcebook focusing on why action is needed, how to initiate it; and curating several existing resources on what to do. Recommendations for research, policy and practice include calls for rapid development of closer relationships between public health and spatial planning.
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| 6. |
- Mika, Kevin, et al.
(författare)
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VEDLIoT: Next generation accelerated AIoT systems and applications
- 2023
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Ingår i: Proceedings of the 20th ACM International Conference on Computing Frontiers 2023, CF 2023. - 9798400701405
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Konferensbidrag (refereegranskat)abstract
- The VEDLIoT project aims to develop energy-efficient Deep Learning methodologies for distributed Artificial Intelligence of Things (AIoT) applications. During our project, we propose a holistic approach that focuses on optimizing algorithms while addressing safety and security challenges inherent to AIoT systems. The foundation of this approach lies in a modular and scalable cognitive IoT hardware platform, which leverages microserver technology to enable users to configure the hardware to meet the requirements of a diverse array of applications. Heterogeneous computing is used to boost performance and energy efficiency. In addition, the full spectrum of hardware accelerators is integrated, providing specialized ASICs as well as FPGAs for reconfigurable computing. The project's contributions span across trusted computing, remote attestation, and secure execution environments, with the ultimate goal of facilitating the design and deployment of robust and efficient AIoT systems. The overall architecture is validated on use-cases ranging from Smart Home to Automotive and Industrial IoT appliances. Ten additional use cases are integrated via an open call, broadening the range of application areas.
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| 7. |
- Rantakokko, Jouni, et al.
(författare)
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Positioning of emergency personnel in rescue operations :
- 2007
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Summary and recommendations Presently, GPS-equipped mobile phones are launched at a large scale, enabling a variety of positioning based services. Indeed, GPS is expected to be the future killer application for mobile phones and services. The concept of accurate positioning by technical means implies a large number of applications not only for the mass market, but also for rescue services, fire brigades, police forces, and military and so on. For professional and governmental safety-of-life services the current systems are far from usable and large efforts have to be concentrated on research and development. Technologies based on GPS and other satellite-based positioning systems alone are vulnerable and are expected to malfunction in indoor or challenging electromagnetic environments, or due to antagonistic measures. Satellite-based positioning is a key component in a robust communication and positioning system aimed for first responders. Satellite based positioning in combination with local radio-based positioning systems and dead-reckoning or inertial navigation systems are enablers to fulfill the users? requirements on accuracy and availability of the positioning service. Sweden is a competent player within security. Around 300 companies with some 22.000 employees have been identified within the area. Swedish industry, research institutes and universities are expected to take part in international consortiums within EU FP7, as well as being a player within DHS funded research and development within the personal positioning and navigation area. The market potential for professional and safety-of-life personal equipment for robust positioning and communication with suitable means for information presentation is significant. In the US and the EU there are some 2 million incident responders each. On a national level we count some 35.000 fire fighters, police, and military personnel in international operations. A migration of the technology to private end-consumers as implemented in consumer electronics opens up a gigantic market for wireless services within navigation, gaming, and position-awareness services. Within the project positioning of first responders in rescue operations, robust positioning has been studied. From a system perspective, technologies for positioning of personnel are key system components within a platform for positioning, information transfer for command and control, and information processing and presentation for the personnel at all levels. \? Systems for training are needed to introduce the end-user to the technology, and for training and simulation of novel strategies enabled by the technology. Stationary training systems can be implemented with state-of-the art positioning methods. Feedback from the end-user to the R&D community is instrumental in the specification and development of future means for positioning of first responders. A research infrastructure, or test-bed, for implementation and evaluation of robust positioning is an essential tool. \? The functionality of the equipment has to be robust against hostile electromagnetic environments, either due to the actual physical environment (indoor scenario, intersystem interference from nearby electronic equipment, scenario within a large steel constructions, or power plant, etc), or due to electronic warfare antagonistic actions. Research has to be performed in several areas such as channel characterization for radio positioning, quality of satellite signals subjected to interference, and integrity of sensor information due to external influences. \? Contemporary MEMS-technology provides small-size sensors with low energy consumption. The rapid development within sensor technologies enables data fusion from a plurality of sensors by digital signal processing. Fundamental issues within digital signal processing have to be studied in several fields, including methods to enhance sensor performance by incorporating behavioral modeling; fusion of digital information from a plurality of sensors; aspects of hardware implementation to fulfill requirements on size, weight and uptime, and software defined receivers for radio-based positioning, communication and mapping. In summary, future systems for positioning of first responders in rescue operations rely on the development of infra-structure aimed for end-users in a training scenario; and a platform for R&D-purposes. In parallel, fundamental issues have to be studied regarding the electromagnetic environment, as well as methodologies in digital signal processing.
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| 8. |
- Roura-Pascual, Nuria, et al.
(författare)
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A scenario-guided strategy for the future management of biological invasions
- 2024
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Ingår i: Frontiers in Ecology and the Environment. - 1540-9295 .- 1540-9309.
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Forskningsöversikt (refereegranskat)abstract
- Future dynamics of biological invasions are highly uncertain because they depend on multiple social-ecological drivers. We used a scenario-based approach to explore potential management options for invasive species in Europe. During two workshops involving a multidisciplinary team of experts, we developed a management strategy arranged into 19 goals relating to policy, research, public awareness, and biosecurity. We conceived solutions for achieving these goals under different plausible future scenarios, and identified four interrelated recommendations around which any long-term strategy for managing invasive species can be structured: (1) a European biosecurity regime, (2) a dedicated communication strategy, (3) data standardization and management tools, and (4) a monitoring and assessment system. Finally, we assessed the feasibility of the management strategy and found substantial differences among scenarios. Collectively, our results indicate that it is time for a new strategy for managing biological invasions in Europe, one that is based on a more integrative approach across socioeconomic sectors and countries.
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| 9. |
- Schuffny, Franz Marcus, et al.
(författare)
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Zero-Crossing Detector for a Piezoelectric Energy Harvester
- 2017
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Ingår i: 2017 IEEE NORDIC CIRCUITS AND SYSTEMS CONFERENCE (NORCAS): NORCHIP AND INTERNATIONAL SYMPOSIUM OF SYSTEM-ON-CHIP (SOC). - : IEEE. - 9781538628447
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Konferensbidrag (refereegranskat)abstract
- Energy harvesting is a method that extracts electrical energy from the environment. This paper presents an integrated circuit in 0.35-mu m CMOS that harvests energy from mechanical vibration using a piezoelectric transducer. The circuit applies a bias-flip rectifier to improve the efficiency of the energy extraction. The paper focuses on the design of the key element of the bias-flip rectifier, the zero-crossing detector. It detects the zero crossing of the input current from the piezoelectric transducer and generates the control signals for the bias-flip rectifier. Post-layout simulations show a very low power consumption and high efficiency of the harvester.
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| 10. |
- Strelnikov, Boris, et al.
(författare)
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Sounding rocket project PMWE for investigation of polar mesosphere winter echoes
- 2021
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Ingår i: Journal of Atmospheric and Solar-Terrestrial Physics. - : Elsevier BV. - 1364-6826 .- 1879-1824. ; 218
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Tidskriftsartikel (refereegranskat)abstract
- A first sounding rocket campaign dedicated to investigate the creation mechanism of Polar Mesosphere Winter Echoes (PMWE) was conducted in April 2018 from the north Norwegian Andøya Space Center (69 °N, 16 °E). Two instrumented sounding rockets were launched on 13th and 18th of April under PMWE and non-PMWE conditions, respectively. In this paper we give an overview of the PMWE sounding rocket mission. We describe and discuss some results of combined in situ and ground-based measurements which allow to verify existing PMWE theories. Our measurements ultimately show that: a) polar winter mesosphere is abounded with meteor smoke particles (MSP) and intermittent turbulent layers, b) all PMWE observed during this campaign can be explained by neutral air turbulence, c) turbulence creates small-scale structures in all D-region constituents, including free electrons; d) MSP ultimately influence the radar volume reflectivity by distorting the turbulence spectrum of electrons, e) the influence of MSP and of background electron density is just to increase SNR.
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