| 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. |
- Chambers, Josephine M., et al.
(författare)
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Co-productive agility and four collaborative pathways to sustainability transformations
- 2022
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Ingår i: Global Environmental Change. - : Elsevier BV. - 0959-3780 .- 1872-9495. ; 72
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Tidskriftsartikel (refereegranskat)abstract
- Co-production, the collaborative weaving of research and practice by diverse societal actors, is argued to play an important role in sustainability transformations. Yet, there is still poor understanding of how to navigate the tensions that emerge in these processes. Through analyzing 32 initiatives worldwide that co-produced knowledge and action to foster sustainable social-ecological relations, we conceptualize 'co-productive agility' as an emergent feature vital for turning tensions into transformations. Co-productive agility refers to the willingness and ability of diverse actors to iteratively engage in reflexive dialogues to grow shared ideas and actions that would not have been possible from the outset. It relies on embedding knowledge production within processes of change to constantly recognize, reposition, and navigate tensions and opportunities. Co-productive agility opens up multiple pathways to transformation through: (1) elevating marginalized agendas in ways that maintain their integrity and broaden struggles for justice; (2) questioning dominant agendas by engaging with power in ways that challenge assumptions, (3) navigating conflicting agendas to actively transform interlinked paradigms, practices, and structures; (4) exploring diverse agendas to foster learning and mutual respect for a plurality of perspectives. We explore six process considerations that vary by these four pathways and provide a framework to enable agility in sustainability transformations. We argue that research and practice spend too much time closing down debate over different agendas for change - thereby avoiding, suppressing, or polarizing tensions, and call for more efforts to facilitate better interactions among different agendas.
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| 3. |
- Chambers, Josephine M., et al.
(författare)
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Six modes of co-production for sustainability
- 2021
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Ingår i: Nature Sustainability. - : Springer Science and Business Media LLC. - 2398-9629. ; 4, s. 983-996
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Tidskriftsartikel (refereegranskat)abstract
- Co-production includes diverse aims, terminologies and practices. This study explores such diversity by mapping differences in how 32 initiatives from 6 continents co-produce diverse outcomes for the sustainable development of ecosystems at local to global scales. The promise of co-production to address complex sustainability challenges is compelling. Yet, co-production, the collaborative weaving of research and practice, encompasses diverse aims, terminologies and practices, with poor clarity over their implications. To explore this diversity, we systematically mapped differences in how 32 initiatives from 6 continents co-produce diverse outcomes for the sustainable development of ecosystems at local to global scales. We found variation in their purpose for utilizing co-production, understanding of power, approach to politics and pathways to impact. A cluster analysis identified six modes of co-production: (1) researching solutions; (2) empowering voices; (3) brokering power; (4) reframing power; (5) navigating differences and (6) reframing agency. No mode is ideal; each holds unique potential to achieve particular outcomes, but also poses unique challenges and risks. Our analysis provides a heuristic tool for researchers and societal actors to critically explore this diversity and effectively navigate trade-offs when co-producing sustainability.
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| 4. |
- Gatica-Ortega, María Elena, et al.
(författare)
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Contact dermatitis from glucose sensors in Spain : A multicentric approach
- 2021
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 85:5, s. 554-562
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Tidskriftsartikel (refereegranskat)abstract
- Background: Allergic contact dermatitis from glucose sensors may interfere with their ongoing application. Objective: To evaluate a series of Spanish patients with contact dermatitis to glucose sensors regarding former sources of contact allergens, patch test results, and outcomes from the ongoing use of the device. Methods: A series of patients with contact dermatitis from glucose sensors was investigated in eight dermatology departments across Spain (epidemiological features, brands, latency time to develop dermatitis, the ability to continue using the devices as well as the patch test results). Results: Thirty patients were evaluated (mean age 20.9 years). A total of 66.7% were children and 66.7% female. Ninety per cent used Freestyle Libre (FSL). Eight of 26 (30.8%) reacted to isobornyl acrylate (IBOA) and two of 20 (10.0%) to N,N dimethylacrylamide (DMAA). The mean latency time to develop dermatitis was 9 months. Sixteen of 29 (55.2%) patients continued using the same sensor causing the reaction. Thirteen of 29 (44.8%) patients were unable to continue using the sensor because of severe reactions. Of these, five were positive to IBOA, one to IBOA and DMAA, one to DMAA, one to colophony, and one to isopropyl alcohol wipes. In one patient, the outcome was unknown. Conclusion: The frequency of sensitisation to IBOA and DMAA, was lower than in other European series, but similar to a previously published Spanish article. Legislation requiring manufacturers to provide information regarding the composition of medical devices and cooperate with the investigations into contact dermatitis is urgently needed.
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| 5. |
- Pastor, Ada, et al.
(författare)
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Local and regional drivers of headwater streams metabolism : insights from the first AIL collaborative project
- 2017
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Ingår i: LIMNETICA. - : Asociacion Iberica de Limnologia. - 0213-8409 .- 1989-1806. ; 36:1, s. 67-85
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Tidskriftsartikel (refereegranskat)abstract
- Streams play a key role in the global biogeochemical cycles, processing material from adjacent terrestrial systems and transporting it downstream. However, the drivers of stream metabolism, especially those acting at broad spatial scales, are still not well understood. Moreover, stream metabolism can be affected by hydrological changes associated with seasonality, and thus, assessing the temporality of metabolic rates is a key question to understand stream function. This study aims to analyse the geographical and temporal patterns in stream metabolism and to identify the main drivers regulating the whole ecosystem metabolic rates at local and regional scales. Using a coordinated distributed experiment, we studied ten headwaters streams located across five European ecoregions during summer and fall 2014. We characterized the magnitude and variability of gross primary production (GPP) and ecosystem respiration (ER) with the open-channel method. Moreover, we examined several climatic, geographical, hydrological, morphological, and physicochemical variables that can potentially control stream metabolic rates. Daily rates of stream metabolism varied considerately across streams, with GPP and ER ranging from 0.06 to 4.33 g O-2 m(-2) d(-1) and from 0.72 to 14.20 g O-2 m(-2) d(-1), respectively. All streams were highly heterotrophic (P/R < 1), except the southernmost one. We found that the drier climates tended to have the highest GPP, while humid regions presented the highest ER. Between the sampling periods no statistical differences were found. Partial-least squares models (PLS) explained similar to 80% of the variance in GPP and ER rates across headwater streams and included both local and regional variables. Rates of GPP varied primarily in response to the local variables, such as streambed substrate and stream water temperature. In contrast, regional variables, such as the mean annual temperature or the land use of the catchment, had more relevance to explain ER. Overall, our results highlight that stream metabolism depends on both local and regional drivers and show the positive experience of a young network of researchers to assess scientific challenges across large-scale geographic areas.
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| 6. |
- Pinay, Gilles, et al.
(författare)
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Patterns of denitrification rates in European alluvial soils under various hydrological regimes
- 2007
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Ingår i: Freshwater Biology. - 0046-5070 .- 1365-2427. - 0046-5070 ; 52:2, s. 252-266
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Tidskriftsartikel (refereegranskat)abstract
- 1. Denitrification in floodplain soils is one of the main biological processes emitting and reducing nitrous oxide, a greenhouse gas, and the main process responsible for the buffering capacity of riparian zones against diffuse nitrate pollution. 2. The aim of this study was to measure denitrification rates under a wide range of current climatic conditions and hydrological regimes in Europe (from latitude 64 degrees N to latitude 42 degrees N and from longitude 2 degrees W to longitude 25 degrees E), in order to determine the response patterns of this microbial process under different climatic and hydrological conditions, and to identify denitrification proxies robust enough to be used at the European scale. 3. Denitrification activity was significant in all the floodplain soils studied whatever the latitude. However, we found an increase in rates of an order of magnitude from high to mid latitudes. Maximum rates (above 30 g N m(-2) month(-1)) were measured in the maritime conditions of the Trent floodplain. These rates are similar to mineralisation rates measured in alluvial soils and of the same order of magnitude as the amount of N stored in herbaceous plants in alluvial soils. 4. We used Multivariate Adaptative Regression Splines to relate the response variable denitrification with five relevant predictors, namely soil moisture, temperature, silt plus clay, nitrate content and herbaceous plant biomass. 5. Soil moisture, temperature, and nitrate were the three main control variables of microbial denitrification in alluvial soils in decreasing order of importance. 6. The model developed for denitrification with interaction effects outperformed a pure additive model. Soil moisture was involved in all interactions, emphasising its importance in predicting denitrification. 7. These results are discussed in the context of scenarios for future change in European hydrological regimes.
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| 7. |
- Santigosa-Murillo, Elia, et al.
(författare)
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A novel integrated platform enabling simultaneous microextraction and chemical analysis on-chip
- 2023
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Ingår i: Microchemical journal (Print). - 0026-265X .- 1095-9149. ; 193
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Tidskriftsartikel (refereegranskat)abstract
- The nature and size of biological, pharmaceutical or environmental analytes complicates their extraction and detection outside of laboratories and near the site of interest by the current chromatographic methods because they require the combination of bulky extraction and detection methods. In order to solve this inefficient centralized control, a ground-breaking and miniaturized proof of concept platform is developed in this work. The platform integrates for the very first time an electro-membrane extraction process and an accurate analyte quantification method in the same device, by using electrochemical impedance spectroscopy (EIS) as analytical technique. The microfluidic flow cell, including the microfluidic components, is fabricated in polymeric materials by rapid prototyping techniques. It comprises a four-electrode platinum thin-film chip that enables the control of the microextraction and the full characterization of the process, i.e., extraction efficiency determination, at the same time. The microfluidic system has been simulated by using computational tools, enabling an accurate prediction of the effect of the different experimental conditions in the microextraction efficiency. The platform has been validated in the microextraction of the nonsteroidal anti-inflammatory drug ketoprofen in a range from 0.5 ppm to 6 ppm. The predicted microextraction efficiency values obtained by EIS were compared with those calculated from the high-performance liquid chromatography coupled with a diode array detector (HPLC-DAD), showing an excellent agreement. This validates the high potential of this integrated and miniaturized platform for the simultaneous extraction by electro-membrane and also the analysis within the platform, solving one of the of most important limitations of current systems.
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| 8. |
- Alvarez, Maria Teresa, et al.
(författare)
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Lab-scale production of biogenic sulphide for metal precipitation in remote areas
- 2012
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Ingår i: International Journal of Environment and Waste Management. - 1478-9876. ; 9:3-4, s. 313-329
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Tidskriftsartikel (refereegranskat)abstract
- Batch cultures with wheat straw, biomass of Paja Brava (Festuca orthophylla), filter paper, newspaper and beech leaves (Fagus sylvatica) were established to produce sulphide. Sulphide production, sulphate reduction, concentration of Volatile Fatty Acids (VFAs), enzyme activities and Fluorescence in situ hybridisation were determined. Approximately 5 mM of sulphide was produced during anaerobic digestion of wheat straw, while the production with newspaper as carbon source was the lowest (ca.1 mM). The sulphide production (2-5 mM) in the semi-continuous culture of the consortium A10, using wheat straw supported Cu(II), Pb (II) and Zn (II) removal up to 90%.
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| 9. |
- Baumann, Katrine Y., et al.
(författare)
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Skin microdialysis: methods, applications and future opportunities-an EAACI position paper
- 2019
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Ingår i: Clinical and Translational Allergy. - : BMC. - 2045-7022. ; 9
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Forskningsöversikt (refereegranskat)abstract
- Skin microdialysis (SMD) is a versatile sampling technique that can be used to recover soluble endogenous and exogenous molecules from the extracellular compartment of human skin. Due to its minimally invasive character, SMD can be applied in both clinical and preclinical settings. Despite being available since the 1990s, the technique has still not reached its full potential use as a tool to explore pathophysiological mechanisms of allergic and inflammatory reactions in the skin. Therefore, an EAACI Task Force on SMD was formed to disseminate knowledge about the technique and its many applications. This position paper from the task force provides an overview of the current use of SMD in the investigation of the pathogenesis of chronic inflammatory skin diseases, such as atopic dermatitis, chronic urticaria, psoriasis, and in studies of cutaneous events during type 1 hypersensitivity reactions. Furthermore, this paper covers drug hypersensitivity, UVB-induced- and neurogenic inflammation, and drug penetration investigated by SMD. The aim of this paper is to encourage the use of SMD and to make the technique easily accessible by providing an overview of methodology and applications, supported by standardized operating procedures for SMD in vivo and ex vivo.
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| 10. |
- Bima, Paolo, et al.
(författare)
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Chest Pain in Cancer Patients Prevalence of Myocardial Infarction and Performance of High-Sensitivity Cardiac Troponins
- 2023
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Ingår i: JACC: CARDIOONCOLOGY. - : Elsevier. - 2666-0873. ; 5:5, s. 591-609
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND Little is known about patients with cancer presenting with acute chest discomfort to the emergency department (ED).OBJECTIVES The aim of this study was to assess the prevalence of acute myocardial infarction (AMI), outcomes, and the diagnostic utility of recommended diagnostic tools in this population.METHODS Patients presenting with chest pain to the ED were prospectively enrolled in an international multicenter diagnostic study with central adjudication. Cancer status was assessed prospectively and additional cancer details retrospectively. Findings were externally validated in an independent multicenter cohort.RESULTS Among 8,267 patients, 711 (8.6%) had cancer. Patients with cancer had a higher burden of cardiovascular risk factors and pre-existing cardiac disease. Total length of stay in the ED (5.2 hours vs 4.3 hours) and hospitalization rate (49.8% vs 34.3%) were both increased in patients with cancer (P < 0.001 for both). Among 8,093 patients eligible for the AMI analyses, those with cancer more often had final diagnoses of AMI (184 of 686 with cancer [26.8%] vs 1,561 of 7,407 without cancer [21.1%]; P < 0.001). In patients with cancer, high-sensitivity cardiac troponin T (hs-cTnT) but not high sensitivity cardiac troponin I (hs-cTnI) concentration had lower diagnostic accuracy for non-ST-segment elevation myocardial infarction (for hs-cTnT, area under the curve: 0.89 [95% CI: 0.86-0.92] vs 0.94 [95% CI: 0.93-0.94] [P < 0.001]; for hs-cTnI, area under the curve: 0.93 [95% CI: 0.91-0.95] vs 0.95 [95% CI: 0.94-0.95] [P 1/4 0.10]). In patients with cancer, the European Society of Cardiology 0/1-hour hs-cTnT and hs-cTnI algorithms maintained very high safety but had lower efficacy, with twice the number of patients remaining in the observe zone. Similar findings were obtained in the external validation cohort.CONCLUSIONS Patients with cancer have a substantially higher prevalence of AMI as the cause of chest pain. Length of ED stay and hospitalization rates are increased. The diagnostic performance of hs-cTnT and the efficacy of both the European Society of Cardiology 0/1-hour hs-cTnT and hs-cTnI algorithms is reduced. (Advantageous Predictors of Acute Coronary Syndromes Evaluation [APACE] Study; NCT00470587) (J Am Coll Cardiol CardioOnc 2023;5:591-609) (c) 2023 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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