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- Bager, Johan-Emil, et al.
(author)
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Vernakalant for Cardioversion of Recent-Onset Atrial Fibrillation in the Emergency Department: The SPECTRUM Study
- 2022
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In: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 147:5-6, s. 566-577
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Journal article (peer-reviewed)abstract
- Introduction: Intravenous vernakalant is a therapeutic option for symptomatic, recent-onset atrial fibrillation (AF). This secondary analysis from the large SPECTRUM study assessed the safety and effectiveness of vernakalant when used in the emergency department setting (ED group) or in an inpatient hospital setting (non-ED group). Methods: This post hoc analysis of the international, observational, post-authorization SPECTRUM study included 1,289 and 720 recent-onset AF episodes in adults in the ED and non-ED groups, respectively. Safety endpoints included the evaluation of pre-defined health outcomes of interest (HOIs) and other serious adverse events (SAEs) during vernakalant treatment and during the first 24 h after the last infusion. Effectiveness endpoints comprised the rate of successful vernakalant cardioversion, the time from the start of the vernakalant infusion to cardioversion, and the length of hospital stay. Data were analysed using descriptive statistics. Results: The safety profile of vernakalant was similar in the ED and non-ED groups. In the ED group, 12 pre-defined HOIs were reported in 11 patients (0.9%); all but one occurred within 2 h after start of the first infusion. These events comprised nine significant bradycardia cases, of which one was associated with transient hypotension and three with sinus arrest, and 2 cases of atrial flutter with 1:1 conduction. Five other SAEs were reported. All patients with vernakalant-related events recovered without sequelae. No Torsade de Pointes, ventricular fibrillation, or deaths occurred. Successful cardioversion was reported in 67.8% (95% confidence interval: 65.2-70.4) and 66.4% (62.5-70.1) of episodes, with a median time to conversion of 11.0 and 10.0 min in the ED and non-ED groups, respectively. Patients had a median length of hospital stay of 7.4 h and 17.1 h in the ED and non-ED groups, respectively. Conclusion: Intravenous vernakalant was well tolerated with similar cardioversion rates in patients treated in the ED or non-ED setting and does not require admission to a coronary care unit or intensive care unit. First-line treatment with vernakalant could allow an early discharge in patients with recent-onset AF treated in the ED.
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2. |
- Bager, Simon L., et al.
(author)
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Blockchain is not a silver bullet for agro-food supply chain sustainability: Insights from a coffee case study
- 2022
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In: Current Research in Environmental Sustainability. - : Elsevier BV. - 2666-0490. ; 4
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Journal article (peer-reviewed)abstract
- Information sharing lies at the core of most governance interventions within agro-food commodity supply-chains, such as certification standards or direct trade relationships. However, actors have little information available to guide sustainable consumption decisions beyond simple labels. Blockchain technology can potentially alleviate the numerous sustainability problems related to agro-food commodity supply-chains by fostering traceability and transparency. Despite significant research on blockchain, there is limited understanding of the concrete barriers and benefits and potential applications of blockchain in real-world settings. Here, we present a case study of blockchain implementation in a coffee supply-chain. Our aim is to assess the potential of blockchain technology to promote sustainability in coffee supply chains through increased traceability and transparency and to identify barriers and opportunities for this. While our pilot implementation clearly illustrates certain benefits of blockchain, it also suggests that blockchain is no silver bullet for delivering agro-food supply chain sustainability. Knowledge on provenance and transparency of information on quality and sustainability can help trigger transformation of consumer behaviour, but the actual value lies in digitising the supply chain to increase efficiency and reduce costs, disputes, and fraud, while providing more insight end-to-end through product provenance and chain-of-custody information. We identify a need to understand and minimize supply chain barriers before we can reap the full benefits of digitalization and decentralization provided by blockchain technology.
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3. |
- Singh, Christina, et al.
(author)
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Coffee producers' perspectives of blockchain technology in the context of sustainable global value chains
- 2022
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In: FRONTIERS IN BLOCKCHAIN. - : Frontiers Media SA. - 2624-7852. ; 5
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Journal article (peer-reviewed)abstract
- Transparency and equitability are key for improved sustainability outcomes in global value chains. Blockchain technology has been touted as a tool for achieving these ends. However, due to the limited empirical evidence, claims on transparency and sustainability benefits are largely theoretical. We lack an understanding of the benefits and drawbacks for upstream actors within global value chains and how this affects technology adoption. Addressing this gap, we conduct an empirical study to identify the drivers and obstacles for coffee producers in Colombia in adopting blockchain. We base our research on an event-driven and permissioned blockchain model, specifically designed for this research. Applying the Participation Capacity Framework and conducting semi-structured interviews with coffee producers and key informants, we analyze adoption attitudes towards the blockchain application. We further identify opportunities and drawbacks from the producers' perspective. We set these findings in the context of the Global Value Chain research, considering the existing power relations in the coffee value chain. The top-down nature of blockchain projects raises distributive concerns, as resource investments, implementation burden, and risks are significantly higher upstream, whereas downstream lead firms will benefit most. We identify data squeeze as an additional channel of sustainable supplier squeeze relevant in the case of blockchain initiatives. Data squeeze implies lead firms turning the data obtained through, likely unpaid, labour of blockchain participants into a monetizable assets and marketable value through branding and advertisement. Based on the findings, we identify potential design dimensions and implementation features that can contribute to materializing producer benefits, thus mitigating the risk of a sustainability-driven supplier squeeze.
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