| 41. |
- Kwon, J. Y., et al.
(författare)
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Seeing the person before the numbers: Personas for understanding patients? life stories when using patient-reported outcome measures in practice settings
- 2023
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Ingår i: International Journal of Medical Informatics. - : Elsevier BV. - 1386-5056. ; 172
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Tidskriftsartikel (refereegranskat)abstract
- Aims: While patient-reported outcome measures (PROMs) are increasingly being integrated into health infor-mation technologies, one challenge has been to assist clinicians in understanding how the responses to PROMs relate to patient stories for identifying and addressing the care needs of individual patients. Personas, hypo-thetical representations of patients, can be used as an innovative strategy to support clinicians' use of PROMs in their practice. These personas embody patients' life stories, making them a valuable tool for understanding the person when using PROMs. The aim of this project focused on cancer-related experiences to develop personas as a knowledge translation strategy to support clinicians' use of PROMs for person-centred cancer care. Methods: Eight older adults participated in online workshops (n = 2-3 participants/workshop; 1.5-hour sessions) to co-develop personas that reflected their collective experiences at a particular stage of their cancer journeys. Participants were asked to identify themes that focused on what the personas were thinking and feeling, what influenced how the personas acted, and the personas' overall goals. Participants subsequently completed an emotional well-being PROM from the perspective of the persona. Personas were further refined based on key themes identified during the workshop discussions. Results: Four personas representing the cumulative experiences of the workshop participants were developed to help clinicians link PROM responses to patient stories. These personas became the basis of four practice sce-narios, which were examples of interactions between a clinician and each persona, to demonstrate the use of PROMs in practice. Conclusion: Personas can be used to illustrate patients' life stories and contextualize PROMs data. As a knowledge translation strategy, personas can foster clinician awareness of how responses to PROMs can be used to initiate conversations to better understand patients' unique life situations.
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| 43. |
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| 44. |
- Moldarev, Dmitrii, et al.
(författare)
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Photochromic properties of yttrium oxyhydride thin films : Surface versus bulk effect
- 2020
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Ingår i: Materialia. - : Elsevier BV. - 2589-1529. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Photochromic yttrium oxyhydride (YHO) films of different thicknesses but similar chemical composition were grown by reactive magnetron sputtering. Photochromie response of the films defined as the relative change in transmittance upon illumination increases almost linearly with thickness for films below 600 nm and saturates (approximate to 50%) for thicker ones. These results suggest that the photochromic effect on YHO films has a bulk nature and might be limited by material transport on the microscale.
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| 45. |
- Pitthan, Eduardo, et al.
(författare)
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In-situ, real-time investigation of the formation of oxygen-containing rare-earth hydrides by combining a quartz crystal microbalance and ion beam analysis
- 2023
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Ingår i: Materialia. - : Elsevier. - 2589-1529. ; 27
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Tidskriftsartikel (refereegranskat)abstract
- We present an in-situ and real-time investigation of the formation of YHO and GdHO thin films grown by reactive e(-)-beam evaporation. Mass changes were continuously monitored during deposition, oxidation, and illumination using a highly sensitive quartz crystal microbalance, while changes in chemical composition and depth profiles were investigated simultaneously by ion beam analysis. Results highlight the strong reactivity of freshly deposited YHx and GdHx films, even under ultra-high vacuum conditions. Oxidation starts at the surfaces of the films and the oxidation rate is strongly dependent on the O-2 pressure. The response of the system under ion beam irradiation and in-situ illumination is also presented and discussed. For the measured mass changes, a quantitative agreement better than 2% was observed between both techniques and demonstrates the consistency and sensitivity of this approach.
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| 46. |
- Wolff, M., et al.
(författare)
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Conceptualizing multidimensional barriers : a framework for assessing constraints in realizing recreational benefits of urban green spaces
- 2022
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Ingår i: Ecology and Society. - : Resilience Alliance, Inc.. - 1708-3087. ; 27:2
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Tidskriftsartikel (refereegranskat)abstract
- Although potential urban green space accessibility is being discussed widely, specific barriers that affect accessibility are often under-estimated. They do not equate to limited or uneven accessibility nor are they exclusively related to physical settings. Rather, the range of barriers and their complex interactions, including people’s perceptions, personal conditions, and institutional frameworks, make this topic less clear cut and difficult to put into practice for planning purposes. Given the importance of barriers when people make decisions, we present a conceptual framework to capture the cumulative and interactive effects of different barriers on realizing recreational benefits of urban green spaces. The framework classifies physical, personal, and institutional barriers and highlights their interactions based on three case studies: Stockholm, Leipzig, and Lodz. We argue that constraints to the accessibility of urban green spaces are not so much the interactions between various physical, personal, and institutional barriers, but more the significance that beneficiaries assign to them as perceived barrier effects. Studying barriers seeks to improve the knowledge about the non-use of urban green spaces and to enable us to draw conclusions about the actual accessibility of recreational benefits. Deduced from the conceptual framework, three pathways are contrasted for improving accessibility to the recreational benefits of urban green spaces: the environment, knowledge, and engagement. We argue that these pathways should not be a diffuse objective, but a sensitive and scale-dependent re-balance of individual, physical, and institutional factors for considering justice in environmental and green space planning and management. Our systematic conceptualization and classification of multidimensional barriers enables a more comprehensive understanding of individuals’ decisions in terms of accessing recreational benefits.
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| 47. |
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| 48. |
- Bendtsen, Katja Maria, et al.
(författare)
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Particle characterization and toxicity in C57BL/6 mice following instillation of five different diesel exhaust particles designed to differ in physicochemical properties
- 2020
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Ingår i: Particle and Fibre Toxicology. - : Springer Science and Business Media LLC. - 1743-8977. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Diesel exhaust is carcinogenic and exposure to diesel particles cause health effects. We investigated the toxicity of diesel exhaust particles designed to have varying physicochemical properties in order to attribute health effects to specific particle characteristics. Particles from three fuel types were compared at 13% engine intake O2 concentration: MK1 ultra low sulfur diesel (DEP13) and the two renewable diesel fuels hydrotreated vegetable oil (HVO13) and rapeseed methyl ester (RME13). Additionally, diesel particles from MK1 ultra low sulfur diesel were generated at 9.7% (DEP9.7) and 17% (DEP17) intake O2 concentration. We evaluated physicochemical properties and histopathological, inflammatory and genotoxic responses on day 1, 28, and 90 after single intratracheal instillation in mice compared to reference diesel particles and carbon black. RESULTS: Moderate variations were seen in physical properties for the five particles: primary particle diameter: 15-22 nm, specific surface area: 152-222 m2/g, and count median mobility diameter: 55-103 nm. Larger differences were found in chemical composition: organic carbon/total carbon ratio (0.12-0.60), polycyclic aromatic hydrocarbon content (1-27 μg/mg) and acid-extractable metal content (0.9-16 μg/mg). Intratracheal exposure to all five particles induced similar toxicological responses, with different potency. Lung particle retention was observed in DEP13 and HVO13 exposed mice on day 28 post-exposure, with less retention for the other fuel types. RME exposure induced limited response whereas the remaining particles induced dose-dependent inflammation and acute phase response on day 1. DEP13 induced acute phase response on day 28 and inflammation on day 90. DNA strand break levels were not increased as compared to vehicle, but were increased in lung and liver compared to blank filter extraction control. Neutrophil influx on day 1 correlated best with estimated deposited surface area, but also with elemental carbon, organic carbon and PAHs. DNA strand break levels in lung on day 28 and in liver on day 90 correlated with acellular particle-induced ROS. CONCLUSIONS: We studied diesel exhaust particles designed to differ in physicochemical properties. Our study highlights specific surface area, elemental carbon content, PAHs and ROS-generating potential as physicochemical predictors of diesel particle toxicity.
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| 49. |
- Bjorvatn Saevik, Åse, et al.
(författare)
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Potential Transcriptional Biomarkers to Guide Glucocorticoid Replacement in Autoimmune Addison's Disease
- 2021
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Ingår i: Journal of the Endocrine Society. - : Endocrine Society. - 2472-1972. ; 5:3
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundNo reliable biomarkers exist to guide glucocorticoid (GC) replacement treatment in autoimmune Addison’s disease (AAD), leading to overtreatment with alarming and persistent side effects or undertreatment, which could be fatal.ObjectiveTo explore changes in gene expression following different GC replacement doses as a means of identifying candidate transcriptional biomarkers to guide GC replacement in AAD.MethodsStep 1: Global microarray expression analysis on RNA from whole blood before and after intravenous infusion of 100 mg hydrocortisone (HC) in 10 patients with AAD. In 3 of the most highly upregulated genes, we performed real-time PCR (rt-PCR) to compare gene expression levels before and 3, 4, and 6 hours after the HC infusion. Step 2: Rt-PCR to compare expression levels of 93 GC-regulated genes in normal versus very low morning cortisol levels in 27 patients with AAD.ResultsStep 1: Two hours after infusion of 100 mg HC, there was a marked increase in FKBP5, MMP9, and DSIPI expression levels. MMP9 and DSIPI expression levels correlated with serum cortisol. Step 2: Expression levels of CEBPB, DDIT4, FKBP5, DSIPI, and VDR were increased and levels of ADARB1, ARIDB5, and POU2F1 decreased in normal versus very low morning cortisol. Normal serum cortisol levels positively correlated with DSIPI, DDIT4, and FKBP5 expression.ConclusionsWe introduce gene expression as a novel approach to guide GC replacement in AAD. We suggest that gene expression of DSIPI, DDIT4, and FKBP5 are particularly promising candidate biomarkers of GC replacement, followed by MMP9, CEBPB, VDR, ADARB1, ARID5B, and POU2F1.
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| 50. |
- 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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