| 1. |
- Frigyesi, Attila, et al.
(författare)
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Plasma proenkephalin A 119-159 on intensive care unit admission is a predictor of organ failure and 30-day mortality
- 2021
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Ingår i: Intensive Care Medicine Experimental. - : Springer Science and Business Media LLC. - 2197-425X. ; 9:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Proenkephalin A 119-159 (penKid) has been suggested as a marker of renal failure and poor outcome. We aimed to investigate the association of penKid on ICU admission with organ dysfunction and mortality in a mixed ICU population. In this retrospective, observational study, admission penKid levels from prospectively collected blood samples of consecutive patients admitted to four Swedish ICUs were analysed. The association of penKid with day-two sequential organ failure assessment (SOFA) scores and 30-day mortality was investigated using (ordinal) logistic regression. The predictive power of penKid for 30-day mortality and dialysis was assessed using the area under the receiver operating characteristic curve (AUC).RESULTS: Of 1978 included patients, 632 fulfilled the sepsis 3-criteria, 190 had a cardiac arrest, and 157 had experienced trauma. Admission penKid was positively associated with 30-day mortality with an odds ratio of 1.95 (95% confidence interval 1.75-2.18, p < 0.001), and predicted 30-day mortality in the entire ICU population with an AUC of 0.71 (95% confidence interval 0.68-0.73) as well as in the sepsis, cardiac arrest and trauma subgroups (AUCs of 0.61-0.84). Correction for admission plasma creatinine revealed that penKid correlated with neurological dysfunction.CONCLUSION: Plasma penKid on ICU admission is associated with day-two organ dysfunction and predictive of 30-day mortality in a mixed ICU-population, as well as in sepsis, cardiac arrest and trauma subgroups. In addition to being a marker of renal dysfunction, plasma penKid is associated with neurologic dysfunction in the entire ICU population, and cardiovascular dysfunction in sepsis.
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| 2. |
- Hindorf, Marie, et al.
(författare)
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Workload of Swedish Special Forces Operators Experienced During Stressful Simulation Training: A Pilot Study
- 2022
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Ingår i: Journal of Special Operations Medicine. - : Breakaway Media, LLC. - 1553-9768. ; 22:3, s. 42-48
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Stress week was included during training of Special Forces (SF) Operators in Sweden to test their ability and limits for handling stress in different unknown situations and environments at a military training facility in Sweden. The aim of the study was to examine the effects of stress and workload experienced in various tasks during firefighting and military medicine simulation training.Methods: This pilot study was performed during the second day of stress week. The National Aeronautics and Space Administration Task Load Index (NASA-TLX) is a validated, subjective, and multidimensional assessment tool for rating perceived workload with six subscales: mental demand, physical demand, temporal demand, performance, effort, and frustration. These subscales were used as an indicator of stress experienced. The different tasks were assessed by the SF Operators by rating the NASA-TLX subscales for each task, which were then analyzed and compared using ANOVA.Results: There was a significant difference between the two simulation exercises assessed by the participants and instructors, and both groups considered firefighting to be more demanding than medical. The participants perceived the mental and physical demands as more demanding in the firefighting exercises, as well as for the level of frustration and effort. However, no differences regarding performance or temporal demands between the simulation exercises were found.Conclusion: The principle "train as you fight" implies difficult and demanding situations. When exposing Swedish SF Operators to challenging situations, assessment of perceived stress and performance are possible.
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| 3. |
- Isoz, Oscar
(författare)
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Interference detection and localization in the GPS L1 frequency band
- 2012
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The usage of Global Navigation Satellite Systems (GNSS) in general and the American GPS in particular increases everyday and so does the number of applications where it is used. The GNSS receivers relies on receiving signals from satellites orbiting the earth at an altitude of about 20 000 km and the signals received by the receiver are signicantly weaker then the background noise. Due to the weak signals it is fairly easy to intentionally or accidentally make it very hard or even impossible for a receiver to detect and track the satellites.With this in mind there is a need to develop cost eective methods to detect and localize interference so that appropriate counter measures can be taken. A number of methods have been proposed to detect and localize these sources. The complexity of these methods ranges from requiring future cellphones to contain software to monitor the GNSS environment to dedicated systems with multiple antennas and complicated hardware. In this thesis, two complementary methods will be presented which can detect and also localize interference in the GNSS bands using minimum amount of equipment. The equipment is based around a type of GNSS "receiver" that only samples the GNSS frequency so that it can be processed using a software dened GNSS eceiver. It will be shown that it is capable of detecting and localizing interference sources while also be cost eective and easily deployable. The rst technique is based on measuring the received power level. Since the GNSS signals are below the noise oor, the number of visible satellites will not aect the received power level. Instead the received power level will be aected by changes in the spectrum and changes in the receiver hardware. The GNSS signal is fairly robust against interference so an interferer usually has to have a signicantly higher signal power than the received power from the satellites in order to cause problems for the receiver. By monitoring the received signal power using multiple receivers it is possible to both detect interference and estimate the position of the transmitter. This method requires very little bandwidth but since the signal is measured in the analog domain it is sensitive to process variations between dierent receivers. Also, the nonlinear behaviour of the analog components in the receiver limits the accuracy of the position estimations. To improve the accuracy of the interference localization, a second method has been evaluated. In this method the GNSS samples recorded by dierent receivers at different locations is compared. When a GNSS receiver calculates a position it is actually calculating the time it takes for the signals to travel from the satellite to the receiver. This made it possible to synchronize data from multiple independent receivers both in time and frequency and then estimate the time dierence of arrival of the interfering signal between the dierent receivers. Both localization methods were evaluated during experiments done with assistance from the Swedish armed forces research agency (FOI). It will be shown that the signal power measurement can be used as a detector for interference and that the GPS signal can be used to synchronize data from independent stations so that the dierence in distance to a wideband transmitter can be estimated. To determine the amount of interference in the GPS L1 band two measurement campaigns were made. The rst campaign, measured where interference might be present in an urban area using a car mounted receiver. The other campaign took place at two airports in the summer and fall of 2011 and measured the interference level from xed antennas over an extended period of time.All research was done using the GPS L1 signal but the methods can easily be applied to other GNSS signals as well.
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| 4. |
- Lengquist, Maria, et al.
(författare)
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Sepsis Is Underreported in Swedish Intensive Care Units: A Retrospective Observational Multicentre Study
- 2020
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Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172 .- 1399-6576. ; , s. 1167-1167
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundSepsis is a common indication for admission to the intensive care unit (ICU). Since definitions vary across studies, comparisons of prevalence and outcomes have been challenging. We aimed to compare sepsis according to ICU discharge codes with sepsis according to Sepsis‐3 criteria and to investigate the epidemiology of sepsis in the ICU. We hypothesized that sepsis using discharge codes is underreported.MethodsAdult ICU admissions to four ICUs in Sweden between 2015 and 2017 were screened for sepsis according to the Sepsis‐3 criteria. Medical records were reviewed and data extracted from the Swedish Intensive Care Registry.ResultsOf 5990 adult ICU patients, 28% fulfilled the Sepsis‐3 criteria on admission, but only 31% of them had sepsis as the registered main diagnosis at ICU discharge. Of the 1654 Sepsis‐3 patients, 38% met the septic shock criteria. The Sepsis‐3 in‐hospital mortality was 26% compared to 33% in patients with septic shock. The incidence rate for ICU‐treated sepsis was 81 cases per 100 000 person‐years. One in four had a positive blood culture, and 44% were culture negative.ConclusionThis large Swedish multicentre study showed that 28% of adult ICU patients fulfilled the Sepsis‐3 criteria, but only one third of them had sepsis according to ICU discharge codes. We could confirm our hypothesis, that sepsis is severely underreported in Swedish ICUs, and we conclude that discharge codes should not be used for quality control or research purposes.
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| 5. |
- Lundberg, Oscar, et al.
(författare)
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Adrenomedullin and endothelin-1 are associated with myocardial injury and death in septic shock patients
- 2016
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Ingår i: Critical Care. - : Springer Science and Business Media LLC. - 1364-8535 .- 1466-609X. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- AbstractBackgroundAdrenomedullin and endothelin-1 are hormones with opposing effects on the cardiovascular system. Adrenomedullin acts as a vasodilator and seems to be important for the initiation and continuation of the hyperdynamic circulatory response in sepsis. Endothelin-1 is a vasoconstrictor and has been linked to decreased cardiac performance. Few studies have studied the relationship between adrenomedullin and endothelin-1, and morbidity and mortality in septic shock patients. High-sensitivity troponin T (hsTNT) is normally used to diagnose acute cardiac injury but is also prognostic for outcome in intensive care. We investigated the relationship between mid-regional pro-adrenomedullin (MR-proADM), C-terminal pro-endothelin-1 (CT-proET-1), and myocardial injury, measured using transthoracic echocardiography and hsTNT in septic shock patients. We were also interested in the development of different biomarkers throughout the ICU stay, and how early measurements were related to mortality. Further, we assessed if a positive biomarker panel, consisting of MR-proADM, CT-proET-1, and hsTNT changed the odds for mortality.MethodsA cohort of 53 consecutive patients with septic shock had their levels of MR-proADM, CT-proET-1, hsTNT, and left ventricular systolic functions prospectively measured over 7 days. The relationship between day 1 levels of MR-proADM/CT-proET-1 and myocardial injury was studied. We also investigated the relationship between biomarkers and early (7-day) and later (28-day) mortality. Likelihood ratios, and pretest and posttest odds for mortality were calculated.ResultsLevels of MR-proADM and CT-proET-1 were significantly higher among patients with myocardial injury and were correlated with left ventricular systolic dysfunction. MR-proADM and hsTNT were significantly higher among 7-day and 28-day non-survivors. CT-proET-1 was also significantly higher among 28-day but not 7-day non-survivors. A positive biomarker panel consisting of the three biomarkers increased the odds for mortality 13-fold to 20-fold.ConclusionsMR-proADM and CT-proET-1 are associated with myocardial injury. A biomarker panel combining MR-proADM, CT-proET-1, and hsTNT increases the odds ratio for death, and may improve currently available scoring systems in critical care.Keywords: Sepsis, Shock, Adrenomedullin, Endothelin-1, High-sensitivity troponin, Echocardiography, Myocardial injury, Mortality, Likelihood ratio
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| 6. |
- Lundberg, Oscar
(författare)
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Adrenomedullin in sepsis
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- AbstractBackgroundSepsis is a syndrome difficult to diagnose and stratify. The epidemiology of sepsis and consistency of criteria fulfillment with diagnosis coding in Swedish intensive care units (ICU) are largely unknown. Biomarkers can be of help to understand pathophysiology, identify clusters within sepsis and to individualize treatment.AimThe overarching aim of this thesis was to explore how adrenomedullin (ADM) relates, alone or in combination with other biomarkers, to sepsis in regard to mortality and illness severity among patients in the ICU and emergency department (ED). Due to the suspected underreporting of sepsis, and in order to relate admission ADM levels with sepsis definitions, the epidemiology of sepsis at ICU admission was described.MethodsThe cohorts included in this thesis, formed by sepsis and non-sepsis patients admitted to the ICU as well as sepsis patient in the ED, had their levels of ADM and other biomarkers measured and related to mortality, organ failure, need for organ support, and, when possible, to ICU admission and ED discharge.ResultsThe levels of ADM, endothelin-1 (ET-1) and high-sensitivity troponin t (hsTNT) were described during the first 7 days of ICU admission in a septic shock cohort and showed a significant association with mortality and myocardial injury. A positive biomarker panel with all three biomarkers increased the odds for mortality 13 to 20-fold.Approximately one third of all ICU admissions fulfilled the sepsis-3 criteria, but the consistency with diagnosis coding was poor, as only 31% of these patients had sepsis as main diagnosis.Among sepsis and non-sepsis ICU patients alike, increasing levels of ADM were associated with mortality and need for organ support. After adjusting for severity of disease an association of ADM with sepsis was seen.ADM measured among ED sepsis patients showed significant association with mortality, severe organ failure, ICU admission and ED discharge. Further, ADM added information to other known demographic predictors and routine biomarkers.ConclusionsADM, alone or in combination with other biomarkers, adds information to known prognostic factors and seems to be of aid in triaging, stratification and prognostication of sepsis patients in the ED and ICU.
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| 7. |
- Lundberg, Oscar, et al.
(författare)
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Bioactive adrenomedullin in sepsis patients in the emergency department is associated with mortality, organ failure and admission to intensive care
- 2022
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 17:4, s. 1-16
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundAdrenomedullin is a vasoactive hormone with potentially prognostic and therapeutic value, which mainly has been investigated in intensive care unit (ICU) settings. The triaging in the emergency department (ED) of patients to the right level of care is crucial for patient outcome.ObjectivesThe primary aim of this study was to investigate the association of bioactive adrenomedullin (bio-ADM) with mortality among sepsis patients in the ED. Secondary aims were to investigate the association of bio-ADM with multiple organ failure (MOF), ICU admission and ED discharge.MethodsIn this prospective observational cohort study, adult sepsis patients in the ED (2013–2015) had blood samples collected for later batch analysis of bio-ADM. Odds ratios (OR) with 95% confidence interval (CI) for bio-ADM were calculated.ResultsBio-ADM in 594 sepsis patients was analyzed of whom 51 died within 28 days (8.6%), 34 developed severe MOF, 27 were ICU admitted and 67 were discharged from the ED. The median (interquartile range) bio-ADM was 36 (26–56) and 63 (42–132) pg/mL among survivors and non-survivors, respectively, 81 (56–156) pg/mL for patients with severe MOF and 77 (42–133) pg/mL for ICU admitted patients. Each log-2 increment of bio-ADM conferred an OR of 2.30 (95% CI 1.74–3.04) for mortality, the adjusted OR was 2.39 (95% CI 1.69–3.39). The area under the receiver operating characteristic curve of a prognostic mortality model based on demographics and biomarkers increased from 0.80 to 0.86 (p = 0.02) when bio-ADM was added. Increasing bio-ADM was associated with severe MOF, ICU admission and ED discharge with adjusted ORs of 3.30 (95% CI 2.13–5.11), 1.75 (95% CI 1.11–2.77) and 0.46 (95% CI 0.32–0.68), respectively.ConclusionBio-ADM in sepsis patients in the ED is associated with mortality, severe MOF, ICU admission and ED discharge, and may be of clinical importance for triage of sepsis patients in the ED.
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| 8. |
- Lundberg, Oscar, et al.
(författare)
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Cycles of innovation and alignment in digital transformation : investigating the dynamics of resource recombination in a construction firm
- 2020
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Ingår i: Proceedings of the 53rd Hawaii International Conference on System Sciences, HICSS 2020. - : IEEE Computer Society. - 9780998133133 ; , s. 4346-4355
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Konferensbidrag (refereegranskat)abstract
- The generative nature of digital technology implies that during digital transformation (DT), organizations traverse multiple cycles of innovation and resource alignment. Still, extant research mainly chronicles DT as linear and contained phenomenon occurring in response to a dramatic environmental change event. How new resources align with previous ones into novel combinations, the work that supports continuous organizational capability building, and the temporal relationships between cycles of change in DT has received scant attention. Drawing on dynamic capability theory, we analyze innovation and resource alignment cycles driving DT at Lundqvist Trävaru AB, a small Swedish construction firm. Our study has at least two contributions. First, the analysis reveals three types of dynamic capabilities that shape resource generation and alignment in DT. Second, we provide a process model outlining the innovation and alignment cycles that fuel DT as they scale in the focal firm.
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| 9. |
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| 10. |
- Lundberg, Oscar H.M., et al.
(författare)
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Circulating bioactive adrenomedullin as a marker of sepsis, septic shock and critical illness
- 2020
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Ingår i: Critical Care. - : Springer Science and Business Media LLC. - 1364-8535. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Biomarkers can be of help to understand critical illness and to identify and stratify sepsis. Adrenomedullin is a vasoactive hormone, with reported prognostic and potentially therapeutic value in sepsis. The primary aim of this study was to investigate the association of circulating bioactive adrenomedullin (bio-ADM) levels at intensive care unit (ICU) admission with mortality in sepsis patients and in a general ICU population. Secondary aims included the association of bio-ADM with organ failure and the ability of bio-ADM to identify sepsis. Methods: In this retrospective observational study, adult patients admitted to one of four ICUs during 2016 had admission bio-ADM levels analysed. Age-adjusted odds ratios (OR) with 95% CI for log-2 transformed bio-ADM, and Youden’s index derived cut-offs were calculated. The primary outcome was 30-day mortality, and secondary outcomes included the need for organ support and the ability to identify sepsis. Results: Bio-ADM in 1867 consecutive patients were analysed; 632 patients fulfilled the sepsis-3 criteria of whom 267 had septic shock. The median bio-ADM in the entire ICU population was 40 pg/mL, 74 pg/mL in sepsis patients, 107 pg/mL in septic shock and 29 pg/mL in non-septic patients. The association of elevated bio-ADM and mortality in sepsis patients and the ICU population resulted in ORs of 1.23 (95% CI 1.07–1.41) and 1.22 (95% CI 1.12–1.32), respectively. The association with mortality remained after additional adjustment for lactate in sepsis patients. Elevated bio-ADM was associated with an increased need for dialysis with ORs of 2.28 (95% CI 2.01–2.59) and 1.97 (95% CI 1.64–2.36) for the ICU population and sepsis patients, respectively, and with increased need of vasopressors, OR 1.33 (95% CI 1.23–1.42) (95% CI 1.17–1.50) for both populations. Sepsis was identified with an OR of 1.78 (95% CI 1.64–1.94) for bio-ADM, after additional adjustment for severity of disease. A bio-ADM cut-off of 70 pg/mL differentiated between survivors and non-survivors in sepsis, but a Youden’s index derived threshold of 108 pg/mL performed better. Conclusions: Admission bio-ADM is associated with 30-day mortality and organ failure in sepsis patients as well as in a general ICU population. Bio-ADM may be a morbidity-independent sepsis biomarker.
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| 11. |
- Lundberg, Oscar, et al.
(författare)
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Unpacking construction site digitalization: the role of incongruence and inconsistency in technological frames
- 2022
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Ingår i: Construction Management and Economics. - : Taylor & Francis Group. - 0144-6193 .- 1466-433X. ; 40:11-12, s. 987-1002
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Tidskriftsartikel (refereegranskat)abstract
- Construction site operations often involve multiple actors with substantial variations in assumptions, expectations, and knowledge about technology. This could impair digitalization, which involves development of socio-cognitive environments that foster use of digital technology in new organizational procedures. Nevertheless, construction industry digitalization research has mainly addressed firm-level transformation of engineering phases and focused on technology, largely ignoring challenges arising from cognitive differences among actors at construction sites. Thus, we report a case study of attempts to spark construction site digitalization through a shared information management system (IMS). Applying technology frame of reference theory, we demonstrate how differences within groups among actors’ frames (inconsistency) shape group-level frame misalignment (incongruence) and thus digitalization outcomes. The IMS was implemented successfully at the focal firm’s headquarter and regional office levels. However, substantial construction site-level frame inconsistency led to misaligned group-level expectations and generated a fragmented socio-cognitive environment that hindered strategic digitalization. In conclusion, socio-cognitive environments at industry, construction site, and group levels recursively shape individual frames, and harmonization of frames is important to realize construction digitalization.
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| 12. |
- Lundberg, Oscar, et al.
(författare)
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Virtual reality as a transformative technology : A literature review and research opportunities
- 2023
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Konferensbidrag (refereegranskat)abstract
- Virtual reality (VR) provides unique visualization capabilities rendering it a potentially transformative digital technology. Rapid consumerization of VR has triggered an interest in organizations to explore diverse value creation opportunities. However, VR scholarship is currently dominated by technical and psychological perspectives. This paper therefore examines the current state of research on VR with a particular focus on organizational aspects to investigate its role in digital transformation (DT). The analysis reveals that it focuses on three key areas: user experience design, e-commerce and retail, and collaboration. Placing these areas in a context of DT, the paper articulates several opportunities for IS research.
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| 13. |
- Robba, Chiara, et al.
(författare)
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Oxygen targets and 6-month outcome after out of hospital cardiac arrest : a pre-planned sub-analysis of the targeted hypothermia versus targeted normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trial
- 2022
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Ingår i: Critical Care. - : Springer Science and Business Media LLC. - 1364-8535 .- 1466-609X. ; 26, s. 1-13
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Tidskriftsartikel (refereegranskat)abstract
- Background: Optimal oxygen targets in patients resuscitated after cardiac arrest are uncertain. The primary aim of this study was to describe the values of partial pressure of oxygen values (PaO2) and the episodes of hypoxemia and hyperoxemia occurring within the first 72 h of mechanical ventilation in out of hospital cardiac arrest (OHCA) patients. The secondary aim was to evaluate the association of PaO2 with patients’ outcome. Methods: Preplanned secondary analysis of the targeted hypothermia versus targeted normothermia after OHCA (TTM2) trial. Arterial blood gases values were collected from randomization every 4 h for the first 32 h, and then, every 8 h until day 3. Hypoxemia was defined as PaO2 < 60 mmHg and severe hyperoxemia as PaO2 > 300 mmHg. Mortality and poor neurological outcome (defined according to modified Rankin scale) were collected at 6 months. Results: 1418 patients were included in the analysis. The mean age was 64 ± 14 years, and 292 patients (20.6%) were female. 24.9% of patients had at least one episode of hypoxemia, and 7.6% of patients had at least one episode of severe hyperoxemia. Both hypoxemia and hyperoxemia were independently associated with 6-month mortality, but not with poor neurological outcome. The best cutoff point associated with 6-month mortality for hypoxemia was 69 mmHg (Risk Ratio, RR = 1.009, 95% CI 0.93–1.09), and for hyperoxemia was 195 mmHg (RR = 1.006, 95% CI 0.95–1.06). The time exposure, i.e., the area under the curve (PaO2-AUC), for hyperoxemia was significantly associated with mortality (p = 0.003). Conclusions: In OHCA patients, both hypoxemia and hyperoxemia are associated with 6-months mortality, with an effect mediated by the timing exposure to high values of oxygen. Precise titration of oxygen levels should be considered in this group of patients. Trial registration: clinicaltrials.gov NCT02908308, Registered September 20, 2016.
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| 14. |
- Robba, Chiara, et al.
(författare)
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Ventilatory settings in the initial 72 h and their association with outcome in out-of-hospital cardiac arrest patients : a preplanned secondary analysis of the targeted hypothermia versus targeted normothermia after out-of-hospital cardiac arrest (TTM2) trial
- 2022
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Ingår i: Intensive Care Medicine. - : Springer Science and Business Media LLC. - 0342-4642 .- 1432-1238. ; 48:8, s. 1024-1038
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The optimal ventilatory settings in patients after cardiac arrest and their association with outcome remain unclear. The aim of this study was to describe the ventilatory settings applied in the first 72 h of mechanical ventilation in patients after out-of-hospital cardiac arrest and their association with 6-month outcomes. Methods: Preplanned sub-analysis of the Target Temperature Management-2 trial. Clinical outcomes were mortality and functional status (assessed by the Modified Rankin Scale) 6 months after randomization. Results: A total of 1848 patients were included (mean age 64 [Standard Deviation, SD = 14] years). At 6 months, 950 (51%) patients were alive and 898 (49%) were dead. Median tidal volume (VT) was 7 (Interquartile range, IQR = 6.2–8.5) mL per Predicted Body Weight (PBW), positive end expiratory pressure (PEEP) was 7 (IQR = 5–9) cmH20, plateau pressure was 20 cmH20 (IQR = 17–23), driving pressure was 12 cmH20 (IQR = 10–15), mechanical power 16.2 J/min (IQR = 12.1–21.8), ventilatory ratio was 1.27 (IQR = 1.04–1.6), and respiratory rate was 17 breaths/minute (IQR = 14–20). Median partial pressure of oxygen was 87 mmHg (IQR = 75–105), and partial pressure of carbon dioxide was 40.5 mmHg (IQR = 36–45.7). Respiratory rate, driving pressure, and mechanical power were independently associated with 6-month mortality (omnibus p-values for their non-linear trajectories: p < 0.0001, p = 0.026, and p = 0.029, respectively). Respiratory rate and driving pressure were also independently associated with poor neurological outcome (odds ratio, OR = 1.035, 95% confidence interval, CI = 1.003–1.068, p = 0.030, and OR = 1.005, 95% CI = 1.001–1.036, p = 0.048). A composite formula calculated as [(4*driving pressure) + respiratory rate] was independently associated with mortality and poor neurological outcome. Conclusions: Protective ventilation strategies are commonly applied in patients after cardiac arrest. Ventilator settings in the first 72 h after hospital admission, in particular driving pressure and respiratory rate, may influence 6-month outcomes.
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| 15. |
- Rönnby, Sara, et al.
(författare)
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mHealth Self-Report Monitoring in Competitive Middle- and Long-Distance Runners : Qualitative Study of Long-Term Use Intentions Using the Technology Acceptance Model
- 2018
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Ingår i: JMIR mHealth and uHealth. - : JMIR Publications Inc.. - 2291-5222. ; 6:8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: International middle- and long-distance running competitions attract millions of spectators in association with city races, world championships, and Olympic Games. It is therefore a major concern that ill health and pain, as a result of sports overuse, lead to numerous hours of lost training and decreased performance in competitive runners. Despite its potential for sustenance of performance, approval of mHealth self-report monitoring (mHSM) in this group of athletes has not been investigated.OBJECTIVE: The objective of our study was to explore individual and situational factors associated with the acceptance of long-term mHSM in competitive runners.METHODS: The study used qualitative research methods with the Technology Acceptance Model as the theoretical foundation. The study population included 20 middle- and long-distance runners competing at national and international levels. Two mHSM apps asking for health and training data from track and marathon runners were created on a platform for web survey development (Briteback AB). Data collection for the technology acceptance analysis was performed via personal interviews before and after a 6-week monitoring period. Preuse interviews investigated experience and knowledge of mHealth monitoring and thoughts on benefits and possible side effects. The postuse interviews addressed usability and usefulness, attitudes toward nonfunctional issues, and intentions to adhere to long-term monitoring. In addition, the runners' trustworthiness when providing mHSM data was discussed. The interview data were investigated using a deductive thematic analysis.RESULTS: The mHSM apps were considered technically easy to use. Although the runners read the instructions and entered data effortlessly, some still perceived mHSM as problematic. Concerns were raised about the selection of items for monitoring (eg, recording training load as running distance or time) and about interpretation of concepts (eg, whether subjective well-being should encompass only the running context or daily living on the whole). Usefulness of specific mHSM apps was consequently not appraised on the same bases in different subcategories of runners. Regarding nonfunctional issues, the runners competing at the international level requested detailed control over who in their sports club and national federation should be allowed access to their data; the less competitive runners had no such issues. Notwithstanding, the runners were willing to adhere to long-term mHSM, provided the technology was adjusted to their personal routines and the output was perceived as contributing to running performance.CONCLUSIONS: Adoption of mHSM by competitive runners requires clear definitions of monitoring purpose and populations, repeated in practice tests of monitoring items and terminology, and meticulousness regarding data-sharing routines. Further naturalistic studies of mHSM use in routine sports practice settings are needed with nonfunctional ethical and legal issues included in the evaluation designs.
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| 16. |
- Silfvergren, Oscar, et al.
(författare)
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Digital twin predicting diet response before and after long-term fasting
- 2022
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Ingår i: PloS Computational Biology. - : Public Library of Science. - 1553-734X .- 1553-7358. ; 18:9
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Tidskriftsartikel (refereegranskat)abstract
- Today, there is great interest in diets proposing new combinations of macronutrient compositions and fasting schedules. Unfortunately, there is little consensus regarding the impact of these different diets, since available studies measure different sets of variables in different populations, thus only providing partial, non-connected insights. We lack an approach for integrating all such partial insights into a useful and interconnected big picture. Herein, we present such an integrating tool. The tool uses a novel mathematical model that describes mechanisms regulating diet response and fasting metabolic fluxes, both for organ-organ crosstalk, and inside the liver. The tool can mechanistically explain and integrate data from several clinical studies, and correctly predict new independent data, including data from a new study. Using this model, we can predict non-measured variables, e.g. hepatic glycogen and gluconeogenesis, in response to fasting and different diets. Furthermore, we exemplify how such metabolic responses can be successfully adapted to a specific individuals sex, weight, height, as well as to the individuals historical data on metabolite dynamics. This tool enables an offline digital twin technology.
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| 17. |
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SPECULATE, COLLABORATE, DEFINE - TEXTILE THINKING FOR FUTURE WAYS OF LIVING
- 2017
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Konstnärligt arbete (refereegranskat)abstract
- About the exhibitionHow can we design for the future? In this avant-garde exhibition architects, interaction, fashion and textile designers show their works in progress when they speculate about, collaborate on, and define how to strengthen the foundations of design for more sustainable forms of living. The exhibition Speculate, collaborate, define – textile thinking for future ways of living, is a work in progress by the PhD students in the ArcInTexETN project. ArcInTexETN is an EU-funded training network of early stage researchers exploring new expressions of living through textile thinking. They collaborate in three scales – building, interior, and body – looking into methods for turning current scientific knowledge into the design of new forms of living.With videos as their main medium, the students present different takes on the subject. In “Ahti”, a speculative short film about the first human being born in space, the story is set in the future. It’s 2076 and there is no water left on our planet Earth. Ahti wears the same suit every day, like a second skin. The skin has different properties that protect him and allow him to walk on any surface, levitate, communicate and store energy.Have you heard about the Wolpertinger? It’s a hybrid animal whose appearance evokes the idea that, however different the parts are, they constitute a whole, functioning organism. With the animal as an analogue, a collection of videos are projections of different pieces of work, showing a patchwork of cooperation, exposing the working process of collaborative design.The film “What is interior?” presents an interior landscape, a shifting view of this paradoxical space, narrated by a linguistic review that argues to define the term interior. The film gives an examination of the definitions that frame the term, as well as creating the fleeting textures that shapes it.In addition to the video projections there are also three individual installations. So, bring your nose and your curiosity! This is not only an audio-visual exhibition.
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| 18. |
- Thurfjell, Magnus, et al.
(författare)
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Narrow Beam Channel Characteristics Measured on an 5G NR Grid-of-Beam Test-Bed
- 2018
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Konferensbidrag (refereegranskat)abstract
- Massive MIMO enabling dynamic beamforming is one key component in 5G New Radio (NR). Narrow beams improve capacity by reduced interference and extend coverage by increased antenna gain. One implementation of dynamic beamforming is Grid-of-Beams (GoB) with fixed narrow beams. In this study, the per beam characteristics are measured in a full-scale micro cell deployment with a mm-wave 5G NR test-bed. It is shown that the channel characteristics are strongly dependent on reflections captured within each beam. Channel conditions such as delay spread, singular value ratio and MIMO rank differ also between adjacent beams. Reflections may even cause significant path length difference which may call for individual synchronization per beam, e.g. meaning that beams at same transmission point may not always be considered quasi co-located (QCL)
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| 19. |
- Vihlborg, Per, 1978-, et al.
(författare)
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Blood biomarkers for occupational hand-arm vibration exposure
- 2024
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Ingår i: Toxicology and industrial health. - : Sage Publications. - 0748-2337 .- 1477-0393.
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Tidskriftsartikel (refereegranskat)abstract
- Hand-arm vibration is a common occupational exposure that causes neurological impairment, myalgia, and vibration-induced Raynaud's phenomena or vibration white fingers (VWF). The pathological mechanism is largely unknown, though several mechanisms have been proposed, involving both immunological vascular damage and defective neural responses. The aim of this study was to test whether the substances interleukin-33 (IL-33), macrophage-derived chemokine (MDC), interleukin-10 (IL-10), endothelin-1 (ET-1), C-C motif chemokine ligand 20 (CCL20), calcitonin, and thromboxane (TXA2) changed before and after occupational hand-arm vibration exposure. 38 full-time shift workers exposed to hand-arm vibration were recruited. All the participants underwent medical examinations regarding symptoms of Raynaud's phenomena. In 29 of the participants, the concentration of IL-33, MDC, IL-10, ET-1, CCL20, calcitonin, and TXA2 was measured before and after a workday. There was a significant increase in ET-1 and calcitonin concentration and a decrease in the CCL20 concentration after the work shift in all participants. In the group suffering from VWF, but not in the non-VWF group, MDC was statistically significantly lower before the work shift (p = .023). The VWF group also showed a significant increase in MDC after the work shift. Exposure to occupational hand-arm vibration is associated with changes in ET-1, calcitonin, and MDC concentration in subjects suffering from vibration white fingers, suggesting a role of these biomarkers in the pathophysiology of this condition.
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| 20. |
- Villo, Piret, et al.
(författare)
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Kinetic Analysis as an Optimization Tool for Catalytic Esterification with a Moisture-Tolerant Zirconium Complex
- 2020
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Ingår i: Journal of Organic Chemistry. - : AMER CHEMICAL SOC. - 0022-3263 .- 1520-6904. ; 85:11, s. 6959-6969
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Tidskriftsartikel (refereegranskat)abstract
- This work describes the use of kinetics as a tool for rational optimization of an esterification process with down to equimolar ratios of reagents using a recyclable commercially available zirconocene complex in catalytic amounts. In contrast to previously reported group IV metal-catalyzed esterification protocols, the work presented herein circumvents the use of water scavengers and perfluorooctane sulfonate (PFOS) ligands. Insights into the operating mechanism are presented.
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| 21. |
- Xu, Bo, et al.
(författare)
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Power Density Measurements at 15 GHz for RF EMF Compliance Assessments of 5G User Equipment
- 2017
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Ingår i: IEEE Transactions on Antennas and Propagation. - : Institute of Electrical and Electronics Engineers (IEEE). - 0018-926X .- 1558-2221. ; 65:12, s. 6584-6595
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Tidskriftsartikel (refereegranskat)abstract
- In this paper, different measurement schemes are studied in order to investigate the possibilities and limitations of scalar-and vector-based measurement systems for radio frequency electromagnetic fields compliance assessments of fifth generation mobile communication user equipment (UE). Two UE antenna array designs, transmitting at 15 GHz and employing patch and notch antenna elements, are considered for different phase excitations. Using free space power density as the exposure metric, the maximum permissible transmitted power of UE, compliant with the maximum permissible exposure limits specified by the U.S. Federal Communications Commission (FCC) and the basic restrictions of the International Commission on Non-Ionizing Radiation Protection, is determined. The accuracy of different measurement schemes is assessed using numerical simulation. Verifying measurements is carried out in a semiane-choic chamber. The results indicate that, for UE employing array antennas and intended to be used in immediate vicinity of the human body, scalar measurement systems used in combination with straightforward field combination techniques will lead to overly conservative results. A more accurate and less conservative approach for these products is to conduct separate measurements for different excitations in order to span the space of possible excitations. This will result in a more complicated measurement setup and increase the measurement time, which points to a need for very fast measurement systems.
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