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Assessing the impact of evaluations of crisis management efforts
No full textTo support learning, evaluations of crisis management efforts must be effective and lead to actionable recommendations that are implemented. However, little is known regarding what approaches are currently employed to evaluate crisis management efforts, the degree of implementation of recommendations, or if certain approaches are associated with a higher degree of implementation. This study explored these areas by analysing 24 evaluation reports from a Swedish regional public healthcare organisation and examining the implementation status of the presented recommendations. The analysis of the evaluation reports showed that evaluations can be improved in terms of methodology and presentation, for example, by providing arguments for methodological choices and more clearly stating the purpose of evaluations. A focus group categorised all 202 recommendations from the analysed evaluation reports to assess their implementation. The results showed that 28 % of the recommendations had been implemented with a clear connection to a specific evaluation, while 45 % were implemented with an unclear connection. Only 12 % were categorised as unimplemented, and 15 % were categorised as unknown. This suggests that evaluations of crisis management efforts have an impact. However, questions regarding their direct impact remain, given that most recommendations were categorised as implemented with unclear connections to specific evaluations. Combining the results from the analysis of the evaluation reports with the categorisations by the focus group showed that including stakeholders in evaluations and providing arguments for why recommendations should be implemented can increase the direct impact of evaluations of crisis management efforts.Funding Agencies|Region Ostergotland's civil preparedness unit</p
Inborn errors of immunity are associated with increased COVID-19–related hospitalization and intensive care compared to the general population
No full textBackground: It is thought that patients with inborn errors of immunity (IEI) are more susceptible to severe coronavirus disease 2019 (COVID-19) than the general population, but a quantification of this potential risk is largely missing. Objective: We assessed the impact of COVID-19 on patients with IEI. Methods: A nationwide cohort study was performed to estimate the relative risk (RR) for hospitalization, intensive care, and death within 30 days after a positive severe acute respiratory syndrome coronavirus 2 test result in an IEI population (n = 2392) compared to the general population (n = 8,270,705) using data from Swedish national registries. Three time periods were studied: the prevaccination period, and the Alpha/Delta and Omicron periods. Adjustment was made for demographics, income, comorbidities, and vaccination status. Results: During the prevaccination period, 25.2% of the IEI population was hospitalized, compared to 17.5% and 5.2% during the Alpha/Delta and Omicron periods, respectively. For the 3 time periods, the adjusted RR [95% confidence interval] for hospitalization in the IEI population compared to the general population was 3.1 [2.1-4.2], 3.5 [2.4-4.8], and 4.3 [2.5-6.7], respectively. The respective values for intensive care after COVID-19 were 5.6 [2.6-10.8], 4.7 [1.7-10.1], and 4.7 [1.7-10.1] for the 3 periods. Five patients (0.6%) in the IEI population died within 30 days of a positive PCR test result compared to 18,773 (0.2%) in the general population during the 3 study periods. Conclusion: Patients with IEI had a 3 to 4 times higher risk for hospitalization and a 5 times higher risk for intensive care during COVID-19 compared to the general population.Funding Agencies|Swedish Research Council [2021-04779]</p
NRF-mediated autophagy and UPR: Exploring new avenues to overcome cancer chemo-resistance
No full textThe development of chemo-resistance remains a significant hurdle in effective cancer therapy. NRF1 and NRF2, key regulators of redox homeostasis, play crucial roles in the cellular response to oxidative stress, with implications for both tumor growth and resistance to chemotherapy. This study delves into the dualistic role of NRF2, exploring its protective functions in normal cells and its paradoxical support of tumor survival and drug resistance in cancerous cells. We investigate the interplay between the PERK/NRF signaling pathway, ER stress, autophagy, and the unfolded protein response, offering a mechanistic perspective on how these processes contribute to chemoresistance. Our findings suggest that targeting NRF signaling pathways may offer new avenues for overcoming resistance to chemotherapeutic agents, highlighting the importance of a nuanced approach to redox regulation in cancer treatment. This research provides a molecular basis for the development of NRFtargeted therapies, potentially enhancing the efficacy of existing cancer treatments and offering hope for more effective management of resistant tumors
Self-Efficacy in Hypertension Management Using e-Health Technology: A Randomized Controlled Trial in Primary Care
No full textSelf-efficacy is tightly intertwined with person-centered care and correlates with engaging in self-care behaviors, an important part of hypertension treatment. Evidence indicates that e-Health-based self-management interventions could increase self-efficacy. The objectives of this study were to investigate whether an intervention with a person-centered approach supported by e-Health technology can impact self-efficacy. Furthermore, to examine the impact of self-efficacy on hypertension management, and assess if self-efficacy can indicate which patients might see the greatest improvement on blood pressure from an e-Health-based self-management intervention for hypertension. This multicenter randomized controlled trial included 949 primary healthcare patients with hypertension. After exclusions, data was analyzed for 862 patients. The intervention group used an e-Health-based self-management system for 8 weeks. Self-efficacy was measured with the general self-efficacy (GSE) scale at inclusion, 8-week follow-up and 1-year follow-up. A significant increase in the mean GSE score in the intervention group was identified (p 0.042). No significant association between self-efficacy and blood pressure control was found. GSE scores did not significantly differ between the patients that had the best effect on blood pressure and those that had none. This study showed a significant increase in self-efficacy after the intervention. Self-management-based e-Health interventions might have a role in clinical practice to increase self-efficacy and improve general health. We found no association between self-efficacy and achieving a blood pressure below 140/90. Furthermore, no support was found to claim that self-efficacy would be an indicator of which patients might have the greatest effect from a self-management-based e-Health intervention for hypertension.Funding Agencies|Kamprad Foundation; Gothenburg University Centre for Person-Centered Care (GPCC)</p
Mpox Virus as a Global Public Health Emergency: A Scoping Review
No full textThe monkeypox (Mpox) virus has emerged as a global public health emergency of international concern recently. The virus that was endemic in West and Central Africa has now been reported with chains of global transmission to several countries. A scoping review was carried out from the relevant literature available from PubMed, Scopus and Web of Science. This comprehensive analysis describes the virus epidemiology, pathogenesis, clinical manifestations, complications including secondary bacterial infections, diagnosis, treatment and vaccination. The article underscores the significance of key viral and immune mediators of infection and discusses updated recommendations on therapeutic strategies and vaccination.Funding Agencies|Office of Research Infrastructure Programs</p
Systematic Coronary Risk Evaluation 2 (SCORE2), arterial stiffness, and subclinical coronary atherosclerosis in a population-based study
No full textAimTo investigate the association between Systematic Coronary Risk Evaluation 2 (SCORE2) and subclinical damage in two vascular beds: atherosclerosis in the coronary arteries and aortic arterial stiffness, in a large population-based cohort without cardiovascular disease or diabetes. MethodsDesign: A cross-sectional study based on Swedish CArdio Pulmonary bioImaging Study (SCAPIS) data. Study population: A population-based cohort of 3087 participants aged 50-64. OutcomePulse Wave Velocity (PWV) was measured, and aortic arterial stiffness was defined as PWV &gt;= 10 m/s. Coronary artery calcium score (CACS) was determined by coronary computed tomography and clinically significant coronary calcification was defined as CACS &gt; 100. ResultsThe prevalence of arterial stiffness was 6.6% in the low-moderate SCORE2 risk group, 31.0% in the high-risk group, and 53.3% in the very high-risk group. The prevalence of coronary calcification was 4.5%, 18.5% 23.0%, respectively. There was a modest overlap between arterial stiffness and coronary calcification in all SCORE2 risk groups. When comparing the high SCORE2 risk group with the low-moderate risk group, the Odds ratio (OR) was 6.4, 95% confidence interval (CI 5.1-8.0) for arterial stiffness and 4.8 (CI 3.7-6.3) for coronary calcification. When comparing the very high SCORE2 risk group to the low-moderate group, the OR was 16.2 (CI 11.3-23.1) for arterial stiffness and 6.4 (CI 4.2-9.7) for coronary calcification. ConclusionOur study shows that high cardiovascular risk according to SCORE2 is associated with increased arterial stiffness and significant coronary calcification in a population without prevalent cardiovascular disease or diabetes. This knowledge can be useful in primary care, where SCORE2 is frequently used as a risk prediction tool. The modest overlap between arterial stiffness and coronary calcification suggests that CACS and PWV describe different types of vascular damage. KEY POINTS center dot What is known? center dot arterial stiffness and coronary calcification are measures of subclinical vascular damage and predictors of poorer cardiovascular outcomes. center dot What is the knowledge gap? center dot there is limited data on the association between scORe2 and subclinical macrovascular damage. center dot What this study shows? center dot this study shows an association between scORe2 risk and arterial stiffness and subclinical coronary atherosclerosis. the higher the scORe2 risk the higher the prevalence of both arterial stiffness and coronary calcification. these two measures overlap, albeit to a small extent.Funding Agencies|Swedish Heart and Lung Foundation [2016-03151]; Knut and Alice Wallenberg Foundation [2014-00471]; Swedish Research Council [822-2013-20001]; VINNOVA (Sweden's Innovation Agency) [2012-044761]; Linkoping University; Linkoping University Hospital; Region Ostergoetland, Sweden</p
Significant room for improvement in the prehospital assessment and treatment of acute abdominal pain: a retrospective observational study
No full textBackgroundAcute abdominal pain (AAP) is a common reason for calling emergency medical services (EMS). Despite the widely acknowledged importance of effective prehospital pain management, described by patients as crucial regardless of any other factor, studies on prehospital pain management in AAP patients are limited and suggest room for improvement. This is particularly relevant given the long-standing controversy surrounding the use of analgesia in AAP patients before a final diagnosis is made, which may still influence the prehospital pain management.MethodsA retrospective cohort study of pain management in EMS patients with AAP in a central Swedish region. The region had a population density of 15.7 inhabitants per square kilometer spread over a mix of small urban and rural settings. Patient records were manually reviewed and scanned for written assessments or numeric ratings of pain. The analysis focused on proportions of assessment, treatment and reassessment of pain as well as median pain intensity, pain reduction and proportion of patients with a low last recording of pain.Results816 patients were included. Pain was assessed in 55% (n = 447) of all cases. The median initial pain intensity was eight units (IQR 6.0-9.0) on the Numerical Rating Scale (NRS), and 90% (n = 403) of the assessed patients experienced moderate or severe pain. Of those, 62% (n = 249) received pharmacological treatment. In 50% (n = 158) of all cases receiving treatment, pain was reassessed afterwards. The median pain reduction was four units (IQR 2.0-5.0) on the NRS scale. Among all cases, 10% (n = 84) had a last recorded pain assessment indicating low pain.ConclusionsSignificant room for improvement in the prehospital management of acute abdominal pain was found. The proportions of pain assessment, treatment and reassessment were low with nine out of ten patients leaving prehospital care with unknown, moderate or severe pain. Among the cases where pain assessment, treatment and reassessment were made and recorded, four out of five patients experienced significant pain relief, indicating the potential of better prehospital pain management.Funding Agencies|Linkping University</p
Towards Visual Analytics for Explainable AI in Industrial Applications
No full textAs the levels of automation and reliance on modern artificial intelligence (AI) approaches increase across multiple industries, the importance of the human-centered perspective becomes more evident. Various actors in such industrial applications, including equipment operators and decision makers, have their needs and preferences that often do not align with the decisions produced by black-box models, potentially leading to mistrust and wasted productivity gain opportunities. In this paper, we examine these issues through the lenses of visual analytics and, more broadly, interactive visualization, and we argue that the methods and techniques from these fields can lead to advances in both academic research and industrial innovations concerning the explainability of AI models. To address the existing gap within and across the research and application fields, we propose a conceptual framework for visual analytics design and evaluation for such scenarios, followed by a preliminary roadmap and call to action for the respective communities.The present study is partially funded by VINNOVA Sweden (2021-04336), Bundesministerium für Bildung und Forschung (BMBF; 01IS22030), and Rijksdienst voor Ondernemend Nederland (AI2212001) under the project Explanatory Artificial Interactive Intelligence for Industry (EXPLAIN).The authors would like to thank Emmanuel Brorsson and Gianluca Manca for providing a new, original figure illustrating the visual interface from the respective paper by Manca et al.EXPLAI
Expression of concern: Electrochemical genosensor based on gold nanostars for the detection of Escherichia coli O157:H7 DNA
No full textA strange breaching behaviour of a beaked whale
No full textAn undescribed breaching behaviour of a beaked whale Mesoplodon sp. was seen west of Brazil in the deep waters off the Abrolhos Bank. Consecutive breaches were performed in a counterclockwise circle, the whale always falling on its left side with its head inwards where two other whales were basking