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Outcome prediction of prostate cancer patients on active surveillance using weakly supervised deep learning
No full textTo avoid over-treatment of prostate cancer patients following screening for elevated prostate-specific antigen (PSA) levels, keeping patients on active surveillance has been suggested as an alternative to radical treatment. This means reoccurring visits for patients with low-grade cancer to monitor progression. The Prostate Cancer Research International Active Surveillance (PRIAS) study was initiated to research the benefits of active surveillance. Usually, the presence and grade of cancer are determined with needle-core biopsies of the prostate. However, the Gleason grading scale has demonstrated intra- and inter-observer variability. This is a limiting factor for novel automated Gleason grading algorithms. To address this, and simultaneously utilizing a cohort collected within the PRIAS program, we have developed a deep learning-based framework for outcome prediction of patients on active surveillance. Our framework does not use explicit Gleason grades and consists of a pre-trained feature extractor, a feature selector, and an attention-based outcome predictor. We evaluate three feature extractors: the foundation model UNI, an ImageNet pre-trained model, and our Gleason grading network. Using UNI as the feature extractor outperformed the other models, with an average area under the receiver operator characteristic curve (AUC) of 0.996 (95% CI: 0.996 – 0.996). To our knowledge, this is the first end-to-end deep learning-based model for patient-level outcome predictions of prostate cancer patients on active surveillance. We believe that our algorithm could assist the pathologists and facilitate the implementation of prostate cancer screening programs, however, more work is needed in terms of validation and generalization. Our code for training and evaluating our models is publicly available*
Enhancing safety performance in UK metal manufacturing : a revised framework to reduce fatal accidents
No full textFatal accidents in UK’s manufacturing sector are expected to remain the same or increase in coming years. This paper has tried to combat this issue by adapting and further developing a previously defined Safety Framework for the Paint Sector, to evaluate the safety performance of a metal manufacturing facility. To achieve this, the original Safety Framework was updated to align with the current British safety legislation outlined by the British Standards Institution. The framework was based on a three-level multi-attribute value theory (MAVT). Upon reviewing BSI 45001, the Safety Framework was founded upon the concept of Deming’s Plan, Do, Check, Act (PDCA) which is the foundation for the original framework, therefore, the first-level attributes remained consistent. The 13 attributes of the second level and 36 attributes of the third level were derived from the literature review and updated to relevant legislation. To develop the Safety Framework, the Delphi method was used. This included interviews that were conducted with employees and managers from either a Safety or Engineering background. The second part of the paper involved the improvement of the Safety Framework, based on the interview feedback. The main findings of the study revealed that the final Safety Framework has been deemed relevant for the Metal Manufacturing Sector by Industry Suitably Qualified and Experienced Personnel (SQEP). The majority of Interviewees deemed the Safety Framework to have a clear layout and easy to understand. The interviews and final Safety Framework suggested the importance of a company’s emphasis on employee welfare and health, in order to reduce accidents in the workplace. The originality of this paper lies in its application and validation of a sector-specific safety framework, contributing to the body of knowledge by offering a replicable methodology for adapting safety frameworks to other manufacturing sectors
Dendrokronologisk analys av mangårdsbyggnaden på Karstorpsgården, Naums socken, Västergötland
No full textDendrokronologisk och vedanatomisk analys av kavelbro på Åsle mosse, Falköping, Västergötland
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Chronic Airflow Limitation, Lower Respiratory Symptoms, COPD and Chronic Rhinosinusitis in a Middle-Aged Population : The Swedish CArdioPulmonary bioImage Study (SCAPIS). A Link Between the Lower and Upper Airways
No full textPurpose: Chronic rhinosinusitis (CRS) is related to asthma and chronic obstructive pulmonary disease (COPD). However, combined data on CRS, pulmonary function, lower airway symptoms, and cigarette smoking from the general population are lacking. The current study investigates the relationships between CRS and chronic airflow limitation (CAL), lower airway symptoms and COPD in a middle-aged population of ever-smokers and never-smokers. Patients and Methods: All subjects from the Swedish CArdioPulmonary bioImage Study (SCAPIS) were included. Subjects underwent spirometry after bronchodilation. Chronic airflow limitation was defined as FEV1/FVC ratio <0.7. Computed tomography imaging of the thorax was performed to detect the presence of emphysema, and the subjects answered a comprehensive questionnaire on CRS, lower airway symptoms, asthma, chronic bronchitis, and cigarette smoking habits. Results: In total, 30,154 adult subjects in the age range of 50–64 years were included. The prevalence of CRS was 5.6%. CRS was more-prevalent among subjects in the following categories: CAL (7.6%), lower airway symptoms (15.7%), current smokers (8.2%), asthma (13.6%), never-smokers and ever-smokers with COPD (17.6% and 15.3%, respectively), emphysema (6.7%), and chronic bronchitis (24.5%). In the adjusted regression model, CRS was significantly associated with CAL (OR 1.40), lower airway symptoms (OR 4.59), chronic bronchitis (OR 6.48), asthma (OR 3.08), and COPD (OR 3.10). Conclusion: In this national, randomly chosen population sample of more than 30,000 middle-aged men and women, CRS is associated with CAL, lower airway symptoms, chronic bronchitis, asthma, and COPD. In patients with CRS and in patients with lower airway inflammation, it is important to consider the inflammatory status of the entire airway system
Improving the effectiveness of climate change adaptation measures
No full textTo a large degree, economic metrics and mechanisms underpin the design of adaptation policies. Such a focus has undesired consequences on the effectiveness of adaptation measures as well as on our ability to prevent incommensurable losses. The article puts forward four strategic changes in adaptation policy that shift the focus away from markets and toward community-level visions of what a liveable future entails. These changes involve accommodating diverse ethical positions, through decision-making processes that are rich in information, include diverse perspectives, and are transparent with respect to the value trade-offs they entail; reflecting social norms in adaptation, through community-led initiatives whereby local priorities and cultural expressions are given centre-stage in the design of adaptation responses; limiting path dependence, through champions within key institutions that are prepared to affect change in times of disruptive climate disasters; and enfranchising marginalised groups, notably by incorporating multiple knowledges and worldviews in adaptation policy, promoting deliberation and negotiation, and subverting exclusionary practices
Editorial: Special-purpose money for sustainability : Special-purpose money for sustainability
No full textThe rationale for this Editorial and the Special Feature Issue (SFI) it introduces is the conviction that money and monetary system design are largely overlooked in debates concerning sustainability. Modern monies (i.e., conventional sovereign fiat currencies) and aspects of them (such as their issuance, functions, and features) tend to be taken for granted as self-evident foundations for the organization of human exchange. The design of conventional money is not so self-evident as generally assumed, however. In its function as a generalized unit of account, modern money makes possible an economic conceptualization of efficiency that now dominates markets and economic thinking. Combined with currency convertibility and capital mobility, this has provided unprecedented levels of commensurability. As a feature of modern markets, this generalized commensurability is rarely questioned or reflected upon despite its significance for sustainability and growing awareness within the humanities and social sciences of the “agency” potential of artifacts (Latour in Reassembling the social: an introduction to actor-network theory, Oxford University Press, Oxford, 2005). From an ontological stance of actant theory, we argue here that money and its design clearly impact on the nature of both social and human–environmental relations. Paradoxically, money—perhaps the most influential artifact of all in modern society with momentous consequences for human society, ecosystems, and the biosphere—has so far largely escaped critical scrutiny. This Editorial and the Special Feature Issue it introduces examine the relation between money design and sustainability, and explore the potentially transformative roles that Special or Limited Purpose complementary currencies might play in sustainability transitions