| 1. |
- Adrian, Maria, et al.
(författare)
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Mechanical complications after central venous catheterisation in the ultrasound-guided era : a prospective multicentre cohort study
- 2022
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Ingår i: British Journal of Anaesthesia. - : Elsevier BV. - 1471-6771 .- 0007-0912. ; 129:6, s. 843-850
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Limited data are available on the incidence of mechanical complications after ultrasound-guided central venous catheterisation. We aimed to determine the incidence of mechanical complications in hospitals where real-time ultrasound guidance is clinical practice for central venous access and to identify variables associated with mechanical complications.METHODS: All central venous catheter insertions in patients ≥16 yr at four emergency care hospitals in Sweden from March 2, 2019 to December 31, 2020 were eligible for inclusion. Every insertion was monitored for complete documentation and occurrence of mechanical complications within 24 h after catheterisation. Multivariable logistic regression analyses were used to determine associations between predefined variables and mechanical complications.RESULTS: In total, 12 667 catheter insertions in 8586 patients were included. The incidence (95% confidence interval [CI]) of mechanical complications was 7.7% (7.3-8.2%), of which 0.4% (0.3-0.5%) were major complications. The multivariable analyses showed that patient BMI <20 kg m -2 (odds ratio 2.69 [95% CI: 1.17-5.62]), male operator gender (3.33 [1.60-7.38]), limited operator experience (3.11 [1.64-5.77]), and increasing number of skin punctures (2.18 [1.59-2.88]) were associated with major mechanical complication. Subclavian vein catheterisation was associated with pneumothorax (5.91 [2.13-17.26]). CONCLUSIONS: The incidence of major mechanical complications is low in hospitals where real-time ultrasound guidance is the standard of care for central venous access. Several variables independently associated with mechanical complications can be used for risk stratification before catheterisation procedures, which might further reduce complication rates.CLINICAL TRIAL REGISTRATION: NCT03782324.
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| 2. |
- Holmström, Anna-Karin, et al.
(författare)
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Effect on orofacial pain in patients with chronic pain participating in a multimodal rehabilitation programme : a pilot study
- 2023
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Ingår i: Scandinavian Journal of Pain. - : Walter de Gruyter. - 1877-8860 .- 1877-8879. ; 23:4, s. 656-661
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Orofacial pain in patients taking part in a multimodal rehabilitation programme (MMRP) due to chronic bodily pain is common but it is not known whether such a rehabilitation programme can also have an effect on the presence of orofacial pain. The first aim of this study was to evaluate the effect of an MMRP on orofacial pain frequency. The second aim was to evaluate differences in the effect on quality of life and on psychosocial factors related to chronic pain.METHODS: MMRP was evaluated through validated questionnaires from the Swedish Quality Registry for Pain Rehabilitation (SQRP). Fifty-nine patients participating in MMRP filled out the two screening questions for orofacial pain in addition to the SQRP questionnaires before and after participation in MMRP during the period August 2016 to March 2018.RESULTS: Pain intensity decreased significantly after the MMRP (p=0.005). Fifty patients (69.4 %) reported orofacial pain before MMRP and no significant decrease after the programme (p=0.228). Among individuals with orofacial pain, the self-reported level of depression decreased after participation in the programme (p=0.004).CONCLUSIONS: Even though orofacial pain is common among patients with chronic bodily pain, participation in a multimodal pain programme was not enough to reduce frequent orofacial pain. This finding implies that specific orofacial pain management including information about jaw physiology could be a justified component of patient assessment prior to a multimodal rehabilitation programme for chronic bodily pain.
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| 3. |
- Holmström, Ulrika, et al.
(författare)
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Cerebrospinal fluid levels of GFAP and pNF-H are elevated in patients with chronic spinal cord injury and neurological deterioration
- 2020
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Ingår i: Acta Neurochirurgica. - : Springer Nature. - 0001-6268 .- 0942-0940. ; 162:9, s. 2075-2086
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Tidskriftsartikel (refereegranskat)abstract
- Background Years after a traumatic spinal cord injury (SCI), a subset of patients may develop progressive clinical deterioration due to intradural scar formation and spinal cord tethering, with or without an associated syringomyelia. Meningitis, intradural hemorrhages, or intradural tumor surgery may also trigger glial scar formation and spinal cord tethering, leading to neurological worsening. Surgery is the treatment of choice in these chronic SCI patients. Objective We hypothesized that cerebrospinal fluid (CSF) and plasma biomarkers could track ongoing neuronal loss and scar formation in patients with spinal cord tethering and are associated with clinical symptoms. Methods We prospectively enrolled 12 patients with spinal cord tethering and measured glial fibrillary acidic protein (GFAP), ubiquitin C-terminal hydrolase L1 (UCH-L1), and phosphorylated Neurofilament-heavy (pNF-H) in CSF and blood. Seven patients with benign lumbar intradural tumors and 7 patients with cervical radiculopathy without spinal cord involvement served as controls. Results All evaluated biomarker levels were markedly higher in CSF than in plasma, without any correlation between the two compartments. When compared with radiculopathy controls, CSF GFAP and pNF-H levels were higher in patients with spinal cord tethering (p <= 0.05). In contrast, CSF UCH-L1 levels were not altered in chronic SCI patients when compared with either control groups. Conclusions The present findings suggest that in patients with spinal cord tethering, CSF GFAP and pNF-H levels might reflect ongoing scar formation and neuronal injury potentially responsible for progressive neurological deterioration.
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| 4. |
- Munappy, Aiswarya Raj, 1990, et al.
(författare)
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Data management for production quality deep learning models: Challenges and solutions
- 2022
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Ingår i: Journal of Systems and Software. - : Elsevier BV. - 0164-1212 .- 1873-1228. ; 191
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Tidskriftsartikel (refereegranskat)abstract
- Deep learning (DL) based software systems are difficult to develop and maintain in industrial settings due to several challenges. Data management is one of the most prominent challenges which complicates DL in industrial deployments. DL models are data-hungry and require high-quality data. Therefore, the volume, variety, velocity, and quality of data cannot be compromised. This study aims to explore the data management challenges encountered by practitioners developing systems with DL components, identify the potential solutions from the literature and validate the solutions through a multiple case study. We identified 20 data management challenges experienced by DL practitioners through a multiple interpretive case study. Further, we identified 48 articles through a systematic literature review that discuss the solutions for the data management challenges. With the second round of multiple case study, we show that many of these solutions have limitations and are not used in practice due to a combination of four factors: high cost, lack of skill-set and infrastructure, inability to solve the problem completely, and incompatibility with certain DL use cases. Thus, data management for data-intensive DL models in production is complicated. Although the DL technology has achieved very promising results, there is still a significant need for further research in the field of data management to build high-quality datasets and streams that can be used for building production-ready DL systems. Furthermore, we have classified the data management challenges into four categories based on the availability of the solutions.(c) 2022 The Authors. Published by Elsevier Inc. 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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| 5. |
- Munappy, Aiswarya Raj, 1990, et al.
(författare)
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On the Impact of ML use cases on Industrial Data Pipelines
- 2021
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Ingår i: Proceedings - Asia-Pacific Software Engineering Conference, APSEC. - : IEEE. - 1530-1362. ; 2021-December, s. 463-472, s. 463-472
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Konferensbidrag (refereegranskat)abstract
- The impact of the Artificial Intelligence revolution is undoubtedly substantial in our society, life, firms, and employment. With data being a critical element, organizations are working towards obtaining high-quality data to train their AI models. Although data, data management, and data pipelines are part of industrial practice even before the introduction of ML models, the significance of data increased further with the advent of ML models, which force data pipeline developers to go beyond the traditional focus on data quality. The objective of this study is to analyze the impact of ML use cases on data pipelines. We assume that the data pipelines that serve ML models are given more importance compared to the conventional data pipelines. We report on a study that we conducted by observing software teams at three companies as they develop both conventional(Non-ML) data pipelines and data pipelines that serve ML-based applications. We study six data pipelines from three companies and categorize them based on their criticality and purpose. Further, we identify the determinants that can be used to compare the development and maintenance of these data pipelines. Finally, we map these factors in a two-dimensional space to illustrate their importance on a scale of low, moderate, and high.
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| 6. |
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| 7. |
- Sjöbom, Ulrika, et al.
(författare)
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Analysis of Brain Injury Biomarker Neurofilament Light and Neurodevelopmental Outcomes and Retinopathy of Prematurity among Preterm Infants
- 2021
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Ingår i: JAMA Network Open. - : American Medical Association (AMA). - 2574-3805. ; 4:4
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Tidskriftsartikel (refereegranskat)abstract
- Importance: Circulating levels of neurofilament light (NfL) and glial fibrillary acidic protein (GFAP) are important in the course of brain injury in adults, but longitudinal postnatal circulating levels in preterm infants have not been investigated. Objectives: To examine postnatal longitudinal serum levels of NfL and GFAP in preterm infants during the first 15 weeks of life and to explore possible associations between these biomarkers, neonatal morbidities, and neurodevelopmental outcomes at 2 years. Design, Setting, and Participants: This cohort study used data from 3 clinical studies, including 221 infants born before 32 weeks gestational age (GA) from 1999 to 2015; neurodevelopmental outcomes were evaluated in 120 infants. Data were collected at tertiary-level neonatal intensive care units in Gothenburg, Lund, and Uppsala, Sweden. Data analysis was conducted from January to October 2020. Exposure: Preterm birth. Main Outcomes and Measures: Serum NfL and GFAP levels, retinopathy of prematurity (ROP), intraventricular hemorrhage, and Bayley Scales of Infant Development II and III at 2 years of age, analyzed by multivariate logistic regression measured by odds ratio (OR), and receiver operating characteristic curve (ROC) analysis. Area under the curve (AUC) was also measured. Results: The 221 included infants (108 [48.9%] girls) had a mean (SD) GA at birth of 26.5 (2.1) weeks and a mean (SD) birth weight of 896 (301) grams. NfL levels increased after birth, remaining high during the first 4 weeks of life before declining to continuously low levels by postnatal age 12 weeks (median [range] NfL level at birth: 58.8 [11.5-1371.3] ng/L; 1 wk: 83.5 [14.1-952.2] ng/L; 4 wk: 24.4 [7.0-306.0] ng/L; 12 wk: 9.1 [3.7-57.0] ng/L). In a binary logistic regression model adjusted for GA at birth, birth weight SD score, Apgar status at 5 minutes, and mode of delivery, the NfL AUC at weeks 2 to 4 was independently associated with any ROP (OR, 4.79; 95% CI, 2.17-10.56; P <.001). In an exploratory analysis adjusted for GA at birth and sex, NfL AUC at weeks 2 to 4 was independently associated with unfavorable neurodevelopmental outcomes at 2 years corrected age (OR per 10-unit NfL increase, 1.07; 95% CI, 1.02-1.13; P =.01). Longitudinal GFAP levels were not significantly associated with neonatal morbidity or neurodevelopmental outcome. Conclusions and Relevance: In this study, high NfL levels during the first weeks of life were associated with ROP and poor neurodevelopmental outcomes at 2 years of age. Associations between NfL and later neurovascular development in infants born prematurely should be investigated further.
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| 8. |
- Stenholm, Åke, et al.
(författare)
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Survival and growth of saprotrophic and mycorrhizal fungi in recalcitrant amine, amide and ammonium containing media
- 2021
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 16:9
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Tidskriftsartikel (refereegranskat)abstract
- The elimination of hazardous compounds in chemical wastes can be a complex and technically demanding task. In the search for environmental-friendly technologies, fungal mediated remediation and removal procedures are of concern. In this study, we investigated whether there are fungal species that can survive and grow on solely amine-containing compounds. One compound containing a primary amine group; 2-diethylaminoethanol, one compound with a primary amide group; 2,6-dichlorobenzamide (BAM), and a third compound containing a quaternary ammonium group; N-3-trimethyl(2-oxiranyl)methanaminium chloride, were selected. The choice of these compounds was motivated by their excessive use in large scale manufacturing of protein separation media (2-diethylaminoethanol and the quaternary amine). 2,6-dichlorobenzamide, the degradation product of the herbicide 2,6-dichlorobenzonitrile (dichlobenil), was chosen since it is an extremely recalcitrant compound. Utilising part of the large fungal diversity in Northern European forests, a screening study using 48 fungal isolates from 42 fungal species, including saprotrophic and mycorrhizal fungi, was performed to test for growth responses to the chosen compounds. The ericoid (ERM) mycorrhizal fungus Rhizoscyphus ericae showed the best overall growth on 2-diethylaminoethanol and BAM in the 1-20 g L-1 concentration range, with a 35-fold and 4.5-fold increase in biomass, respectively. For N-3-trimethyl(2-oxiranyl)methanaminium chloride, the peak growth occurred at 1 g L-1. In a second experiment, including three of the most promising fungi (Laccaria laccata, Hygrophorus camarophyllus and Rhizoscyphus ericae) from the screening experiment, a simulated process water containing 1.9% (w/v) 2-diethylaminoethanol and 0.8% (w/v) N(3-)trimethyl(2-oxiranyl)methanaminium chloride was used. Laccaria laccata showed the best biomass increase (380%) relative to a control, while the accumulation for Rhizoscyphus ericae and Hygrophorus camarophyllus were 292% and 136% respectively, indicating that mycorrhizal fungi can use amine- and amide-containing substrates as nutrients. These results show the potential of certain fungal species to be used in alternative green wastewater treatment procedures.
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| 9. |
- Winka, Katarina, 1970-, et al.
(författare)
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Pedagogiskt mentorskap för hållbart lärarskap
- 2020
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Ingår i: nu2020. ; , s. 207-208
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Konferensbidrag (refereegranskat)abstract
- Mentorskap bygger på att en erfaren yrkesutövare (mentor) hjälper någon annan (adept) att bli mer kompetent i sitt yrke. Den grundläggande idén är att ta vara på och sprida erfarenhetsbaserad kunskap inom organisationen. Genom att bidra till en kollegas professionella utveckling kan mentorn utveckla sina egna kunskaper, förmågor och förhållningssätt. För adepten är det en möjlighet att utveckla sig och sin egen roll som lärare inom akademin (Mathisen, 2009; Eastcott, 2016).Syftet med denna presentation är att delge erfarenheter från ett pedagogiskt mentorskapsprogram som utvecklats, genomförts och utvärderats vid Umeå universitet. Mentorskapsprogrammet är ett komplement till det högskolepedagogiska utbildningsutbudet och samtidigt ett sätt att tillvara ta de pedagogiskt meriterade lärarnas kompetens och vilja att bidra till hållbar pedagogisk utveckling.Umeå universitet har en pedagogisk meriteringsmodell där lärare kan ansöka om prövning mot kriterier för utnämning till meriterad eller excellent lärare. Modellen har haft stort genomslag och det finns över 200 utnämnda lärare. En fråga som uppstått är hur lärosätet kan ta tillvara dessa lärares erfarenhet, engagemang och kompetens. I en undersökning av de utnämnda lärarnas förväntningar och önskemål framkom en stark vilja att dela med sig av sin kunskap och inspirera andra till pedagogisk utveckling. Detta ledde till att ett pedagogiskt mentorsprogram initierades 2019 med syftet att främja erfarenhetsutbyte och kollegial samverkan inom lärosätet.Mentorskapsprogrammet består av en utbildning för mentorerna och ett pedagogiskt mentorstöd för adepterna. Ett intyg motsvarande en veckas högskolepedagogisk kurs utfärdas för de som genomför mentorsutbildningen och agerar mentorer. Vid antagning till mentorsplatserna prioriteras sökande med lång undervisningserfarenhet och ett reflekterande förhållningssätt till lärarrollen. Med andra ord: utnämning i Umeå universitetets pedagogiska meriteringsmodell är meriterande. För adepterna gäller inga speciella urvalskriterier förutom intresse att utveckla sin pedagogiska kompetens.I matchningen av mentorer och adepter lades särskild vikt vid fakultets- och ämnesöverskridande konstellationer. Potentiella ämnesmässiga kopplingar undveks med argumentet att den akademiska lärarrollen och den pedagogiska verksamheten ska vara i fokus. I pilotomgången ingick sju mentor/adeptpar varav sex slutförde programmet.Utvärderingen bekräftade vikten av att programmet är universitetsövergripande och att mentorer och adepter matchas över fakultets- och ämnesgränser. Det utgör även ett exempel på hur de meriterade och excellenta lärarnas engagemang och drivkraft för pedagogisk utveckling kan tas tillvara. Som helhet representerar det pedagogiska mentorskapsprogrammet en win-win-situation, där både adepter och mentorer växer i sin identitet och professionella roll.Målgruppen för presentationen inkluderar alla som är nyfikna på undervisning/utbildning/högskolepedagogik, pedagogiska utvecklare samt personer med pedagogiska ledarskapsuppdrag. ReferenserMathisen, P. 2009. Mentor: i teori och praktik. Studentlitteratur: LundEastcott, D. (2016). Coaching and mentoring in academic development (pp. 86–102). In: Popovic, C., & Baume, D. (2016). Advancing practice in academic development. Taylor and Francis Inc.
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| 10. |
- Zhang, Hongyi, 1996, et al.
(författare)
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Autonomous Navigation and Configuration of Integrated Access Backhauling for UAV Base Station Using Reinforcement Learning
- 2022
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Ingår i: Proceedings - 2022 IEEE Future Networks World Forum, FNWF 2022. - : IEEE. ; , s. 184-189, s. 184-189
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Konferensbidrag (refereegranskat)abstract
- Fast and reliable connectivity is essential to enhance situational awareness and operational efficiency for public safety mission-critical (MC) users. In emergency or disaster circumstances, where existing cellular network coverage and capacity may not be available to meet MC communication demands, deployable-network-based solutions such as cells-on-wheels/wings can be utilized swiftly to ensure reliable connection for MC users. In this paper, we consider a scenario where a macro base station (BS) is destroyed due to a natural disaster and an unmanned aerial vehicle carrying BS (UAV-BS) is set up to provide temporary coverage for users in the disaster area. The UAV-BS is integrated into the mobile network using the 5G integrated access and backhaul (IAB) technology. We propose a framework and signalling procedure for applying machine learning to this use case. A deep reinforcement learning algorithm is designed to jointly optimize the access and backhaul antenna tilt as well as the three-dimensional location of the UAV-BS in order to best serve the on-ground MC users while maintaining a good backhaul connection. Our result shows that the proposed algorithm can autonomously navigate and configure the UAV-BS to improve the throughput and reduce the drop rate of MC users.
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