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- Andersson Granberg, Tobias, 1973-, et al.
(författare)
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Predicting Volunteer Travel Time to Emergencies
- 2022
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Ingår i: ISCRAM 2022 Conference Proceedings – 19th International Conference on Information Systems for Crisis Response and Management. - 9788284270999 ; , s. 44-54
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Konferensbidrag (refereegranskat)abstract
- A model is developed, which can predict the travel time for volunteers that are dispatched as first responders to emergencies. Specifically, the case of lay responders to out of hospital cardiac arrest is studied. Positions from historical responses is used to estimate the real response times, which are used to train and evaluate the new travel time model. The new model considers the road network and the transport mode most likely used by the volunteers. The results for the new model are compared to a model used in an existing volunteer initiative. They show that the new model can make better predictions in 59.7% of the cases. This can be used directly as a base for improving the travel time estimates in existing volunteer initiatives, and to improve the input data to the continuously evolving volunteer resource management systems.
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| 3. |
- Fredman, David
(författare)
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Computational exploration of human genome variation
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In studies of human genome variation, researchers attempt to identify the DNA sequence differences between our genomes that contribute substantially to variation that can be observed on a physical level (phenotype). Genetic variation can also be used to study population dynamics in human history, and how evolutionary forces have shaped the human genome. These endeavors require comprehensive data resources and computational tools to facilitate directed data generation on the scale necessary for detection of biologically relevant signals. Data management systems are also necessary to store, compare and interpret the collective data masses created by researchers in the field. This thesis describes the development of computational resources and algorithms for improving the efficiency of studies into human genome variation with a focus on single nucleotide polymorphism (SNP). Issues addressed are: i) databases emphasizing quality assurance, improved annotation and portable formats, ii) assay design for improved PCR and hybridization reactions through a consideration of DNA secondary structure, iii) SNP selection using a combination of in silico methods for prediction of the functional impact of SNPs and evidence of positive selection to identify sequence differences that may be disruptive to a living cell, and possibly cause disease, iv) genome structure in a comprehensive study into the dynamics of duplicated segments and how they affect SNP genotyping. Building on previous work around a database for human sequence variation within genes (Hgbase), a scalable database and accompanying portable data formats for all human sequence variation was developed (HGVbase). Following the availability of the complete human genome draft, the sequence variations were layered on top of this scaffold and annotation and search capabilities were vastly improved. Going forward, systems were constructed to capture genotypes, haplotypes, phenotypes and the (complex) relations between them. This new information increases our ability to extract and prioritize biologically interesting subsets of data. In conjunction with new genotyping technology, high-throughput genotyping assay design software facilitated studies encompassing large numbers of SNPs. This capacity was leveraged in creating a set of validated SNP markers in coding regions of genes for subsequent use in studies into disease genetics and population genetics. The genotyping technology was developed further to enable a genome-wide study of single base variants in duplicated segments. The study led to the discovery of a form of sequence variation that we termed "Multi-site Variation" (MSV). This explains a large fraction of the observed increase of predicted polymorphism in duplicated sequence and indicates considerable copy number variation in the human genome. MSVs are able to masquerade as SNPs when genotyped with standard methods in population samples. Unfortunately this is not always revealed by Hardy-Weinberg disequilibrium considerations or mendelian inheritance tests.
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| 4. |
- Fredman, David, et al.
(författare)
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Objective classification and comparison of OHCA and AED locations using geographic information systems
- 2015
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Ingår i: Resuscitation. - : Elsevier BV. - 0300-9572 .- 1873-1570. ; 96, s. 21-21
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Tidskriftsartikel (refereegranskat)abstract
- The Utstein registry template stress recording of out-of-hospital cardiac arrest (OHCA) location and suggest eight data options with additional subcategories. The subjectivity in categorization of OHCA locations by emergency medical services (EMS) makes objective regional and international comparisons hard.
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| 5. |
- Fredman, David
(författare)
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Placement of automated external defibrillators and logistics to facilitate early defibrillation in sudden cardiac arrest
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background and aim: Out-of-hospital cardiac arrest (OHCA) is a leading cause of death in many western countries. Much effort is put in to measures to improve survival. Early cardiopulmonary resuscitation (CPR) and the use of an automated external defibrillator (AED) significantly increase the chance of survival. In 2016, 5,312 cases of OHCA were reported to the Swedish Register for Cardiopulmonary Resuscitation (SRCR), but only 577 (11%) survived to 30-days. The bystander CPR rate in Sweden is high (73%), and AEDs are widely spread in all parts of the country; however, the use of public AEDs is low. If the use of AEDs could be increased, more patients could be saved. The aim of this thesis was to investigate, in four separate studies, how logistics and placement of AEDs can help facilitate early defibrillation. Methods and results: Study 1. A prospective study at five emergency dispatch centres in Sweden where dispatchers were given access to the Swedish AED registry and had instructions to refer callers to nearby AEDs in cases of suspected OHCA. Of 3,009 suspected OHCA calls over seven months, only 200 occurred within 100 metres of an AED, and in only two cases did dispatchers referred callers to a nearby AED. AED accessibility (opening hours of the venue) and the fact that the callers often were alone on the scene, were identified as barriers for referral. Study 2. A retrospective analysis of AED installation sites and locations of OHCA in public locations in Stockholm. We used renowned geographic information system (GIS) analyses and a freely available dataset of land use (Urban Atlas). Incidence of OHCA in public locations in “residential areas” was similar to “non-residential” but AED installation was significantly higher in “non-residential areas”. Study 3. An explorative study to investigate the feasibility of using unmanned aerial vehicles (UAV)/Drones to transport AEDs to decrease time to defibrillation. The study included live test flights of a UAV system as well as retrospective GIS analysis of suitable locations for installation of UAVs equipped with AEDs for maximum coverage of OHCA. Study 4. An overview of the Swedish AED registry (SAEDREG) shows a two-fold increase of registered AEDs since 2013 and that the majority (45%) of the n=15,849 AEDs are placed in offices/workplaces. In a select region of Sweden, a survey was directed to the owners of all n=218 AEDs that focused on AED functionality and reasons for not registering the AED in SAEDREG. An additional n=94 AEDs were found through customer registries from AED vendors. AED functionality was high in both groups. Owners of AEDs not registered in SAEDREG was often unaware of the national AED registry or stated difficulties with the registration process as the main cause for not registering AEDs in SAEDREG. Conclusions: Dispatch centres have the potential to refer callers to nearby AEDs at an early stage in OHCA but may need supporting training and software. There is a mismatch between where public OHCA occur and where AEDs are located. Most AEDs are found in offices and workplaces whereas most OHCA occur in residential areas. Drones have the potential to transport AEDs and compensate for prolonged ambulance response time, especially in rural areas. A high quality national AED register is important for increasing general awareness within the community, thus facilitating early defibrillation in OHCA; however, many AEDs are nonregistered or discarded in the validation process.
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| 6. |
- Fredman, David, et al.
(författare)
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Use of a geographic information system to identify differences in automated external defibrillator installation in urban areas with similar incidence of public out-of-hospital cardiac arrest : A retrospective registry-based study
- 2017
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 7:5
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Tidskriftsartikel (refereegranskat)abstract
- Objectives Early defibrillation in out-of-hospital cardiac arrest (OHCA) is of importance to improve survival. In many countries the number of automated external defibrillators (AEDs) is increasing, but the use is low. Guidelines suggest that AEDs should be installed in densely populated areas and in locations with many visitors. Attempts have been made to identify optimal AED locations based on the incidence of OHCA using geographical information systems (GIS), but often on small datasets and the studies are seldom reproduced. The aim of this paper is to investigate if the distribution of public AEDs follows the incident locations of public OHCAs in urban areas of Stockholm County, Sweden. Method OHCA data were obtained from the Swedish Register for Cardiopulmonary Resuscitation and AED data were obtained from the Swedish AED Register. Urban areas in Stockholm County were objectively classified according to the pan-European digital mapping tool, Urban Atlas (UA). Furthermore, we reclassified and divided the UA land cover data into three classes (residential, non-residential and other areas). GIS software was used to spatially join and relate public AED and OHCA data and perform computations on relations and distance. Results Between 1 January 2012 and 31 December 2014 a total of 804 OHCAs occurred in public locations in Stockholm County and by December 2013 there were 1828 AEDs available. The incidence of public OHCAs was similar in residential (47.3%) and non-residential areas (43.4%). Fewer AEDs were present in residential areas than in non-residential areas (29.4% vs 68.8%). In residential areas the median distance between OHCAs and AEDs was significantly greater than in non-residential areas (288 m vs 188 m, p<0.001). Conclusion The majority of public OHCAs occurred in areas classified in UA as 'residential areas' with limited AED accessibility. These areas need to be targeted for AED installation and international guidelines need to take geographical location into account when suggesting locations for AED installation.
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