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- Arbring Sjöström, Theresia, 1987-, et al.
(author)
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Design and Operation of Hybrid Microfluidic Iontronic Probes for Regulated Drug Delivery
- 2021
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In: Advanced Materials Technologies. - Hoboken, New Jersey : John Wiley & Sons. - 2365-709X. ; 6:2
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Journal article (peer-reviewed)abstract
- Highly controlled drug delivery devices play an increasingly important role in the development of new neuroengineering tools. Stringent - and sometimes contradicting - demands are placed on such devices, ranging from robustness in freestanding devices, to overall device miniaturization, while maintaining precise spatiotemporal control of delivery with high chemical specificity and high on/off ratio. Here, design principles of a hybrid microfluidic iontronic probe that uses flow for long-range pressure-driven transport in combination with an iontronic tip that provides electronically fine-tuned pressure-free delivery are explored. Employing a computational model, the effects of decoupling the drug reservoir by exchanging a large passive reservoir with a smaller microfluidic system are reported. The transition at the microfluidic-iontronic interface is found to require an expanded ion exchange membrane inlet in combination with a constant fluidic flow, to allow a broad range of device operation, including low source concentrations and high delivery currents. Complementary to these findings, the free-standing hybrid probe monitored in real time by an external sensor is demonstrated. From these computational and experimental results, key design principles for iontronic devices are outlined that seek to use the efficient transport enabled by microfluidics, and further, key observations of hybrid microfluidic iontronic probes are explained.
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- Björnqvist, Anton, 1995-, et al.
(author)
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An Analysis of a Swedish Medical Command and Control System’s Situation Reports from the COVID-19 Pandemic
- 2022
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In: ISCRAM 2022 Conference Proceedings – 19th International Conference on Information Systems for Crisis Response and Management. - 9788284270999 ; , s. 334-348
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Conference paper (peer-reviewed)abstract
- This paper presents an analysis of situation reports used and created by a crisis management team within the Swedish healthcare sector during the early phase of the COVID-19 pandemic. The analysis was conducted through a deductive content analysis, where categories were identified based on the concepts of common operational pictures, sensemaking, and situation awareness. In the analysis, support for all identified categories was found. Based on the analysis and the concepts, future recommendations regarding what type of information that ought to be included in situation reports were created. These recommendations include, amongst others, the categories of consequences, how it is perceived by the public, objectives, status and implications of information, future scenarios, actions, resources, and work procedures.
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- Björnqvist, Anton, 1995-, et al.
(author)
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Identifying Teamwork Processes in a Medical Command and Control Team During the COVID-19 Pandemic
- 2023
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In: Proceedings of the 20th International ISCRAM Conference. - Omaha, USA. ; , s. 711-720
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Conference paper (peer-reviewed)abstract
- This paper presents an ethnographic study consisting of non-participatory observations of a Swedish regional medical command and control team during their crisis response to the COVID-19 pandemic. The field-notes from the observations were analyzed using a deductive content analysis with categories representing teamwork processes. The content analysis showed that the studied regional medical command and control team was engaged in all but one of the predefined teamwork processes. Furthermore, the content analysis also added to the understanding of the regional medical command and control teamÂ’s work procedures by emphasizing how the team was engaged in the different processes. Lastly, the content analysis also made it possible to identify potential developmental needs of the studied regional medical command and control team.
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- Lindhagen, Alva, et al.
(author)
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Supporting Instructors in Conducting Exercises
- 2023
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In: Proceedings of the 20th International ISCRAM Conference. - Omaha, USA. ; , s. 721-731
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Conference paper (peer-reviewed)abstract
- Planning, designing, facilitating, and evaluating are central activities for instructors when conducting exercises.When conducting these activities, instructors usually rely on past experiences since structured educations orguides for instructors do not exist. It is therefore evident that there is a need for such educations or guides.In this study, the contents of a guide for instructors are proposed. The contents are based on seven semi-structuredinterviews with novel and experienced instructors, where they were asked to map their procedures for conductingexercises through a journey map. The interviews resulted in material which was transcribed and analysed using athematic analysis. The thematic analysis emphasized five themes to consider when acting as an instructor, namelyroles, realism, defining purpose and goals, learning, and planning and acting.The results from the interviews, combined with past literature, resulted in proposed contents for an instructor’sguide which is currently being developed.
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- Linhagen, Alva, et al.
(author)
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A Meta-evaluation of Swedish Evaluations of COVID-19 Pandemic Management
- 2022
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In: ISCRAM 2022 Conference Proceedings – 19th International Conference on Information Systems for Crisis Response and Management. - 9788284270999 ; , s. 349-361
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Conference paper (peer-reviewed)abstract
- The COVID-19 pandemic has had a global impact om society. Different countries and organizations have chosen different approaches to manage this crisis. This paper aims to describes how public Swedish actors (county administrative boards, municipalities, and regional councils) evaluated their management of the COVID-19 pandemic. Also, the paper aims to suggest improvements for crisis management strategies. Applying a meta-evaluation approach to open reports from the public organizations means collecting evaluation reports, determining if they fit the inclusion criteria, and if so, include them in the analysis. Included reports were categorized and given points indicating different types of merits. In addition, a thematic analysis of conclusions was conducted. 110 evaluation reports from 98 different organizations are included in the analysis. The importance of evaluating, having a structure for data collection, analysis, and reporting is reflected in the quality of the reports. Four identified themes offer an understanding of areas in need for development among Swedish regional councils, municipalities, and county administrative boards.
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- Munch, Marie W., et al.
(author)
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Effect of 12 mg vs 6 mg of Dexamethasone on the Number of Days Alive Without Life Support in Adults With COVID-19 and Severe Hypoxemia The COVID STEROID 2 Randomized Trial
- 2021
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In: Journal of the American Medical Association (JAMA). - : AMER MEDICAL ASSOC. - 0098-7484 .- 1538-3598. ; 326:18, s. 1807-1817
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Journal article (peer-reviewed)abstract
- Question What is the effect of 12 mg vs 6 mg of dexamethasone on the number of days alive without life support at 28 days in patients with COVID-19 and severe hypoxemia? Findings In this randomized trial that included 1000 patients with COVID-19 and severe hypoxemia, treatment with 12 mg/d of dexamethasone resulted in 22.0 days alive without life support at 28 days compared with 20.5 days in those receiving 6 mg/d of dexamethasone. This difference was not statistically significant. Meaning Compared with 6 mg of dexamethasone, 12 mg of dexamethasone did not statistically significantly reduce the number of days alive without life support at 28 days. This multicenter randomized clinical trial compares the effects of 12 mg/d vs 6 mg/d of dexamethasone in patients with COVID-19 and severe hypoxemia. IMPORTANCE A daily dose with 6 mg of dexamethasone is recommended for up to 10 days in patients with severe and critical COVID-19, but a higher dose may benefit those with more severe disease. OBJECTIVE To assess the effects of 12 mg/d vs 6 mg/d of dexamethasone in patients with COVID-19 and severe hypoxemia. DESIGN, SETTING, AND PARTICIPANTS A multicenter, randomized clinical trial was conducted between August 2020 and May 2021 at 26 hospitals in Europe and India and included 1000 adults with confirmed COVID-19 requiring at least 10 L/min of oxygen or mechanical ventilation. End of 90-day follow-up was on August 19, 2021. INTERVENTIONS Patients were randomized 1:1 to 12 mg/d of intravenous dexamethasone (n = 503) or 6 mg/d of intravenous dexamethasone (n = 497) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was the number of days alive without life support (invasive mechanical ventilation, circulatory support, or kidney replacement therapy) at 28 days and was adjusted for stratification variables. Of the 8 prespecified secondary outcomes, 5 are included in this analysis (the number of days alive without life support at 90 days, the number of days alive out of the hospital at 90 days, mortality at 28 days and at 90 days, and >= 1 serious adverse reactions at 28 days). RESULTS Of the 1000 randomized patients, 982 were included (median age, 65 [IQR, 55-73] years; 305 [31%] women) and primary outcome data were available for 971 (491 in the 12 mg of dexamethasone group and 480 in the 6 mg of dexamethasone group). The median number of days alive without life support was 22.0 days (IQR, 6.0-28.0 days) in the 12 mg of dexamethasone group and 20.5 days (IQR, 4.0-28.0 days) in the 6 mg of dexamethasone group (adjusted mean difference, 1.3 days [95% CI, 0-2.6 days]; P = .07). Mortality at 28 days was 27.1% in the 12 mg of dexamethasone group vs 32.3% in the 6 mg of dexamethasone group (adjusted relative risk, 0.86 [99% CI, 0.68-1.08]). Mortality at 90 days was 32.0% in the 12 mg of dexamethasone group vs 37.7% in the 6 mg of dexamethasone group (adjusted relative risk, 0.87 [99% CI, 0.70-1.07]). Serious adverse reactions, including septic shock and invasive fungal infections, occurred in 11.3% in the 12 mg of dexamethasone group vs 13.4% in the 6 mg of dexamethasone group (adjusted relative risk, 0.83 [99% CI, 0.54-1.29]). CONCLUSIONS AND RELEVANCE Among patients with COVID-19 and severe hypoxemia, 12 mg/d of dexamethasone compared with 6 mg/d of dexamethasone did not result in statistically significantly more days alive without life support at 28 days. However, the trial may have been underpowered to identify a significant difference.
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- Saghaleyni, Rasool, 1987, et al.
(author)
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Enhanced metabolism and negative regulation of ER stress support higher erythropoietin production in HEK293 cells
- 2022
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In: Cell Reports. - : Elsevier BV. - 2211-1247. ; 39:11
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Journal article (peer-reviewed)abstract
- Recombinant protein production can cause severe stress on cellular metabolism, resulting in limited titer and product quality. To investigate cellular and metabolic characteristics associated with these limitations, we compare HEK293 clones producing either erythropoietin (EPO) (secretory) or GFP (non-secretory) protein at different rates. Transcriptomic and functional analyses indicate significantly higher metabolism and oxidative phosphorylation in EPO producers compared with parental and GFP cells. In addition, ribosomal genes exhibit specific expression patterns depending on the recombinant protein and the production rate. In a clone displaying a dramatically increased EPO secretion, we detect higher gene expression related to negative regulation of endoplasmic reticulum (ER) stress, including upregulation of ATF6B, which aids EPO production in a subset of clones by overexpression or small interfering RNA (siRNA) knockdown. Our results offer potential target pathways and genes for further development of the secretory power in mammalian cell factories.
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