How people living with HIV experience treatment in health and medical care : A literature review

Bakgrund: Hiv är ett virus som angriper kroppens immunsystem och som obehandlat kan  leda till aids. Idag beräknas omkring 40 miljoner människor världen över leva med hiv. Viruset sprids främst genom oskyddade sexuella kontakter, via blod samt från mödrar med hiv till barn under en graviditet, förlossning eller via amning. Tack vare moderna antiretrovirala mediciner kan personer med hiv idag leva långa och friska liv utan att smitta andra. Trots detta finns dock fortfarande stigma och okunskap kring hiv. Syfte: Syftet med litteraturöversikten var att beskriva hur personer som lever med hiv upplever bemötande i hälso- och sjukvården. Metod: En icke-systematisk litteraturöversikt baserad på 12 vetenskapliga artiklar som genom urval samt avgränsningar sökts fram i databaserna Cinahl och Pubmed. För att kvalitetsgranska samtliga artiklar har Sophiahemmets bedömningsunderlag för vetenskaplig klassificering och kvalitet använts. Via en integrerad dataanalys har resultatet sedan kategoriserats samt sammanställts. Resultat: Resultatet redovisades i två huvudkategorier: Upplevelser av vårdrelationer samt Upplevelser av vårdkvalitet. Resultatet visade att tillit till vårdpersonal var avgörande för en god vårdrelation och öppen kommunikation. Ett personcentrerat förhållningssätt ansågs ge upphov till upplevelser av delaktighet och tillhörighet. Kontinuitet ansågs viktigt för tillit till vårdpersonal och en känsla av säkerhet. Otrygghet upplevdes vid oavsiktligt avslöjande och stigmatiserande beteende från vårdpersonalen. Slutsats: Litteraturöversikten visade på att ett gott bemötande, rätt behandling och minskad stigmatisering har en avgörande roll i att förbättra livsvillkoren för personer som lever med hiv. Hälso- och sjukvårdens roll är att erbjuda evidensbaserad, trygg och respektfull vård som främjar såväl fysisk som psykisk hälsa.Background: Hiv is a virus that attacks the body's immune system and that, if left untreated, can  lead to AIDS. Today, it is estimated that around 40 million people worldwide are living with hiv. The virus is mainly spread through unprotected sexual contact, through blood and from mothers with hiv to children during pregnancy, childbirth or through breastfeeding. Thanks to modern antiretroviral medications, people with hiv today can live long and healthy lives without infecting others. Despite this, however, there is still stigma and ignorance around hiv. Aim: The purpose of the literature review was to describe how people living with hiv experience treatment in health and medical care. Method: A non-systematic literature review based on 12 scientific articles that were searched through selection and limitations in the databases Cinahl and Pubmed. To check the quality of all articles, Sophiahemmet's assessment documents for scientific classification and quality have been used. Through an integrated data analysis, the results have then been categorized and compiled. Results: The results were reported in two main categories: Experiences of caring relationships and Experiences of quality in care. The results showed that trust in health personnel was vital for a good care relationship and open communication. A person-centered approach was considered to cause experiences of participation and belonging. Continuity was deemed important for trust in healthcare personnel and a sense of security. Distrust was experienced in cases of unintentional disclosure and stigmatizing behavior from health care personnel. Conclusions: The literature review showed that a good encounter, appropriate treatment and reduced stigmatization play a crucial role in improving the living conditions of people living with hiv. The role of healthcare is to offer evidence-based, safe and respectful care that promotes both physical and mental health.

Deep Learning based Tool for Optimizing Scrap Feed prior to EAF Operation

Självklart! Här är texten med de saknade mellanslagen tillagda, utan andra ändringar:  The steel industry is a key sector for modern society. Due to the extreme versatility of steel, it finds application in very different sectors. However, the steel industry is also very polluting, accounting for roughly 7-9 % of the yearly global anthropogenic CO2 emissions. Steel is produced either from iron ore, with the Blast Furnace-Basic Oxygen Furnace (BF-BOF) process, or from steel scrap, following the Electric Arc Furnace (EAF) process. With the latter being a more sustainable alternative (roughly half of the energy required and 1.5 tonnes of CO2 emissions), the steel industry looks forward to shifting the production towards the EAF, which today accounts for 29 % of the global production. However, differently from the BF-BOF, the EAF has still not been optimized up to its full potential. In the process of achieving EAF process’ maximum efficiency, the integration of artificial intelligence could represent a significant step forward. The power and computational ability of machine learning models may indeed be used to further analyse the data collected from industry. In this way, it could be possible to improve the understanding of the EAF process and help optimizing it. This thesis focuses on using data clustering algorithms (Gaussian Mixture Model and K-Means) to analyse real industrial data. The objective was to examine the influence of the steel scrap type and its preparation on the EAF energy consumption. The information gathered during the preliminary data analysis and the data clustering were then used to develop and support an optimizer tool used to predict the most energy-efficient configuration of the EAF charging bucket.Självklart! Här är texten med de saknade mellanslagen tillagda, utan några andra ändringar:  Stålindustrin är en nyckelsektor för det moderna samhället. På grund av stålets extrema mångsidighet, finner det användning inom väldigt olika sektorer. Men stålindustrin är också mycket förorenande och står för ungefär 7-9 % av de årliga globala antropogena CO2-utsläppen. Stål framställs antingen från järnmalm, med masugns-Basic Oxygen Furnace (BF-BOF)-processen, eller från stålskrot, enligt den elektriska ljusbågsugnen (EAF)-processen. Eftersom det senare är ett mer hållbart alternativ (ungefär hälften av energin som krävs och 1.5 ton CO2-utsläpp) ser stålindustrin fram emot att flytta produktionen mot EAF, som idag står för 29 % av den globala produktionen. Men till skillnad från BF-BOF har EAF fortfarande inte optimerats till sin fulla potential. I processen att uppnå EAF-processens maximala effektivitet kan integreringen av artificiell intelligens utgöra ett betydande steg framåt. Kraften och beräkningsförmågan hos modeller för maskininlärning kan verkligen användas för att ytterligare analysera data som samlas in från industrin. På så sätt skulle det kunna vara möjligt att förbättra förståelsen av EAF-processen och hjälpa till att optimera den. Denna avhandling fokuserar på att använda dataklustringsalgoritmer (Gaussian Mixture Model och K-Means) för att analysera verklig industriell data. Syftet var att undersöka vilken inverkan stålskrottypen och dess beredning har på energiförbrukningen för EAF. Informationen som samlades in under den preliminära dataanalysen och dataklustringen användes sedan för att utveckla och stödja ett optimeringsverktyg som används för att förutsäga den mest energieffektiva konfigurationen av EAF-laddningsskopan

Detecting Item Misfit in Rasch Models

Psychometrics have long relied on rule-of-thumb critical values for goodness of fit metrics. With powerful personal computers it is both feasible and desirable to use simulation methods to determine appropriate cutoff values. This paper evaluates the use of an R package for Rasch psychometrics that has implemented functions to simplify the process of determining simulation-based cutoff values. Through six simulation studies, comparisons are made between information-weighted conditional item fit (“infit”) and item-restscore correlations using Goodman and Kruskal’s γ. Results indicate the limitations of small samples (n < 500) in correctly detecting item misfit, especially when a larger proportion of items are misfit and/or when misfit items are off-target. Infit with simulation-based cutoffs outperforms item-restscore with sample sizes below 500. Both methods result in problematic rates of false positives with large samples (n >= 1000). Large datasets should be analyzed using nonparametric bootstrap of subsamples with item-restscore to reduce the risk of type-1 errors. Finally, the importance of an iterative analysis process is emphasized, since a situation where several items show underfit will cause other items to show overfit. Underfit items should be removed one at a time, and a re-analysis conducted for each step to avoid erroneously eliminating items

Insect herbivory releases more nutrients in warmer and drier forests

Climate, forest successional stage, and soil substrate age can alter herbivore communities and their effects on biogeochemical cycling, but the size and spatial variability of these effects are poorly quantified. To address this knowledge gap, we established a globally distributed network of 50 broadleaved old-growth forests across six continents, encompassing well-constrained local-scale gradients in mean annual temperature (MAT), mean annual precipitation (MAP), succession, and soil substrate age. We used this network to investigate how these variables impact insect foliar herbivory and the associated carbon, nitrogen, phosphorus, and silica fluxes in forest ecosystems. Over 1 to 2 years, we measured stand-level foliar biomass production, leaf-level herbivory, and foliar element concentrations. At the global scale, insect herbivores liberated higher amounts of elements from the canopies of warmer and drier sites than those of cooler and wetter sites with patterns for phosphorus being most pronounced. MAT exerted a stronger influence over insect-mediated element fluxes than MAP. Foliar biomass production and leaf-level herbivory responses to MAT and MAP were mainly responsible for the observed changes in insect-mediated element fluxes; we also observed minor effects of foliar phosphorus concentration on phosphorus fluxes. Local-scale trends were mixed and successional stage or soil substrate age did not appear to influence insect herbivore-mediated element fluxes. These results demonstrate that climate effects on plant-herbivore interactions are stronger at large than small scales, at which herbivory rates and nutrient fluxes appear to be more strongly affected by a diversity of non-climate factors

Språkteknologi och agenter för AI-assisterad diagnostik av maskinskador

Recent advances in reasoning artificial intelligence (AI) agents powered by language models (LMs) and custom tools open new opportunities for AI-assisted condition monitoring (CM) involving unlabelled but annotated, complex industrial data. Technical language annotations written by domain experts include unstructured information regarding machine condition, maintenance actions, and tacit knowledge. This thesis investigates how LMs and LM agents can improve human-machine interaction and facilitate training of AI models on CM industry data using annotations as surrogate ground-truth labels. The main contribution is the introduction of technical language supervision (TLS) to address the long-standing gap between idealised labelled lab datasets and complex unlabelled field data, and the development of AI agents for condition monitoring including a multimodal vector store with domain specific retrieval and generation modules. Specific contributions are: (1) the introduction and implementation of TLS for CM through contrastive learning with annotated sensor data, including a literature survey and implementations of zero-shot fault diagnosis on unlabelled industry data; (2) the creation of a method to improve technical language processing by augmenting out-of-vocabulary technical words with natural language descriptions and evaluating semantic similarities of technical language representations; (3) the development of a human-centric method for language-based fault classification using visualisation and clustering; (4) the development of an open source chatbot agent which facilitates natural language interaction with industry data and models through a custom CM vector store with data-specific retrieval augmented generation, LM analysis of annotations and hierarchy data, and LM assisted CM; (5) the compilation of a publicly available annotated industry dataset; (6) an investigation of specific CM data processing challenges, such as different data modalities, time-delays between annotations and signal properties, component-specific noise and feature levels, and non-linear fault development over time. The results of the studies indicate that annotations are a viable substitute for labels when processed with regard to the technical language therein, and integrating LM-based agents on annotated CM data facilitates answering queries corresponding to industrial analysis tasks. By augmenting out-of-vocabulary technical words with natural language descriptions, LM performance can be improved, as demonstrated in initial work on classifying technical fault descriptions with the BERT LM improving accuracy from 88.3% to 94.2%, thereby halving the error rate. In the industrial datasets analysed, gathered from kraftliner paper machines over four years, the most common faults and alarms were cable and sensor faults, while bearing faults were the most common causes of follow up analysis and maintenance stops. Clustering CM data based on both signal and language properties indicates that cable and sensor faults can be differentiated from bearing faults with an F1-score of 92.6%. The usefulness of the developed agents was evaluated in typical CM workflows, and the results indicate that AI agents with custom tools are capable of generating historic insight and meaningful fault descriptions. In particular, using a custom multimodal CM retrieval augmented generation approach with a custom CM vector store, the false alarm rate for sensor and cable faults is shown to be lowered from over 80% in current work flows, to under 30% with the proposed method. This suggests that false and redundant alarms which negatively impact maintenance planning by prompting time-consuming human analysis can be reduced. The main takeaways of this thesis are that annotations can facilitate the development of AI models on field industry data, and bring meaningful historic insights. This approach has the potential to augment existing CM practices by reducing false alarm prevalence, providing more meaningful alarms, and improving upskilling

Rectus abdominis muscle atrophy, prophylactic mesh, and stoma placement : retrospective findings from a prospective multicenter trial

Purpose The primary aim of this study was to investigate whether rectus abdominis muscle atrophy is associated with a lower risk of developing parastomal hernia. Secondary objectives were to assess whether the use of prophylactic mesh is a risk factor for rectus abdominis muscle atrophy and whether the position of the stoma within the rectus abdominis muscle affects the risk of parastomal hernia. Methods This retrospective study analysed patients from a prospective, randomised, multicentre trial in which rectal cancer patients were randomised to stoma creation with or without prophylactic mesh. Computed tomography at 12 months was evaluated to identify parastomal hernia, rectus abdominis muscle atrophy and position of stoma in the rectus abdominis muscle. Results Out of 149 patients, rectus abdominis muscle atrophy was observed in 9% and parastomal hernia in 42% of patients. There was no association between rectus abdominis muscle atrophy and parastomal hernia (p = 0.80; RR 1.07; CI 0.62–1.86), nor between prophylactic mesh and rectus abdominis muscle atrophy (p = 0.19; RR 2.00; CI 0.7–5.73). Stoma placement within the rectus abdominis muscle also showed no association with parastomal hernia development (p = 0.69; RR 0.97; CI 0.81–1.15). Conclusion This study found no statistically significant association between rectus abdominis muscle atrophy and parastomal hernia. The use of prophylactic mesh was not a risk factor for rectus abdominis muscle atrophy, and stoma placement within the rectus abdominis muscle was not associated with parastomal hernia. The previously reported association between prophylactic mesh, rectus abdominis muscle atrophy, and parastomal hernia was not confirmed in this cohort

Dehydration-induced AVP stimulates glucagon release and ketogenesis

Gliflozins, such as dapagliflozin, belong to a class of drugs that inhibit the sodium-glucose cotransporter 2. Gliflozins have been found to raise glucagon levels, a hormone secreted from pancreatic islet a-cells, which can trigger ketosis. However, the precise mechanisms through which gliflozins increase glucagon secretion remain poorly understood. In addition, gliflozins induce osmotic diuresis, resulting in increased urine volume and plasma osmolality. In this study, we investigated the hypothesis that a compensatory increase in arginine-vasopressin (AVP) mediates dapagliflozin-induced increases in glucagon in vivo. We show that dapagliflozin does not increase glucagon secretion in the perfused mouse pancreas, neither at clinical nor at supra-clinical doses. In contrast, AVP potently increases glucagon secretion. In vivo, dapagliflozin increased plasma glucagon, osmolality, and AVP. An oral load with hypertonic saline amplified dapagliflozin-induced glucagon secretion. Notably, a similar increase in glucagon could also be elicited by dehydration, evoked by 24-h water restriction. Conversely, blockade of vasopressin 1b receptor signaling, with either pharmacological antagonism or knockout of the receptor, resulted in reduced dapagliflozin-induced glucagon secretion in response to both dapagliflozin and dehydration. Finally, blocking vasopressin 1b receptor signaling in a mouse model of type 1 diabetes diminished the glucagon-promoting and ketogenic effects of dapagliflozin. Collectively, our data suggest that AVP is an important regulator of glucagon release during both drug-induced and physiological dehydration. NEW &amp; NOTEWORTHY Gliflozin-induced ketogenic effects partly result from increased glucagon levels. This study shows that dapagliflozin-triggered glucagon secretion is not directly mediated by the pancreas but rather linked to arginine-vasopressin (AVP). Dehydration, common in diabetic ketoacidosis, elevates AVP, potentially explaining the increased ketoacidosis risk in gliflozin-treated patients. Thus, our results highlight AVP as a potential therapeutic target to mitigate the risk of ketoacidosis associated with gliflozin treatments in patients with diabetes.CC BY 4.0Correspondence: A. Benrick ([email protected]).L.J.B.B. held a Sir Henry Wellcome Postdoctoral Fellowship (Wellcome, 201325/Z/16/Z), JRF from Trinity College, and Health Sciences Bridging Funding (University of Oxford). I.W.A. holds funding from the Swedish Research Council (2020-01463), Diabetes Wellness Sweden, EFSD/European Research Program on “New Targets for Diabetes or Obesity-related Metabolic Diseases” supported by MSD 2022, and the Mary von Sydow Foundation. A.B. holds funding from the Swedish Research Council (2020-02485) and the Mary von Sydow Foundation (4923). T.G.H. is supported by a Novo Nordisk postdoctoral fellowship run in partnership with the University of Oxford. A.K. held an NIH grant (F31 DK109575). P.R. holds funding from the Swedish Research Council (2013-7107). The funding bodies did not have a role in the study design and had no role in the implementation of the study.</p

Wood Modification with Maleic Anhydride and Sodium Hypophosphite

Wood has been a crucial material for construction throughout history. However, due to poor natural durability of wood, it is difficult to use outdoors without any additional treatment. Conventionally, wood has been fully or partially impregnated with preservatives. However, some substances are harmful to mankind and environment, hence, regulated strictly. Therefore, methods for achieving sustainable protection of wood have been required and one method that has been investigated for achieving this has been through chemical modification.  This doctoral thesis aims to develop a new modification system for solid wood in use class 3. The objective was to develop a wood modification system based on maleic anhydride (MA) and sodium hypophosphite (SHP) that enables exterior use without leaching by weathering. To meet this requirement, the modification should involve formation of stable cross-linking, altering the interaction between moisture and wood, consequently enhancing dimensional stability and biological resistance.  To test the possibility of using MA and SHP, Scots pine sapwood (Pinus sylvestris L.) was treated with various ratio of chemical reagents, curing temperatures and durations. The treated wood was subjected to repetitive wet-dry cycle to assess its dimensional stability and leachability of chemical reagents. The result indicated formation of a stable cross-linking between wood constituents.  To further investigate the formation of cross-link, solid-state 13C cross-polarization magic-angle-spinning (CP-MAS) nuclear magnetic resonance (NMR), 31P MAS NMR and X-ray photoelectron spectroscopy (XPS) were employed. The findings indicated that the cross-linking was likely to involve phosphonate (C-P-O) bonds. These results provided a deeper fundamental understanding of the reaction mechanisms between wood, MA and SHP, providing further scope for improved treatment systems in the future. The impact of the modification on wood-water interactions was analyzed using low-field nuclear magnetic resonance (LFNMR) to study water in the wood at a saturated state. Additionally, the hydrophilicity of cell walls was studied via infrared spectroscopy after deuteration using liquid D2O. The results indicated that the modification reduced the affinity of the wood cell wall to water without altering the number of accessible hydroxyl groups.   Finally, the modified wood was evaluated for fungal decay resistance, mechanical strength test (bending), and thermal stability. The modification significantly reduced mass loss caused by wood-decaying fungi by limiting the moisture uptake in wood and altering the chemical structure of wood. On the other hand, the modification did not improve resistance to fungal growth on the wood surface, suggesting that nutrient accessibility on surface was not influenced by the modification. A bending test showed that while the modulus of elasticity (MOE) was not affected, modulus of rupture (MOR) decreased to half that of untreated wood. Thermal resistance was improved due to the presence of phosphonate, which can promote the formation of a protective char layer and radical moieties.  This study demonstrated the potential of modifying wood with MA and SHP to enhance durability, dimensional stability, and fire resistance. The modification formed stable cross-link within the wood components, reducing water interaction and improving resistance to biological degradation. However, the reduction in MOR limits its suitability for load-bearing applications. Despite this, the results suggest that the modified wood could be a viable alternative for non-load bearing exterior applications. Future research should focus on optimising the modification process by reducing temperature, duration, and solvent use while maintaining performance. Investigating catalysts for the reaction may help address these challenges. Additionally, long-term field testing under real environmental conditions is needed to evaluate the durability and stability of the modified wood. Environmental impact assessments and life cycle analysis will also be crucial for ensuring commercial feasibility and sustainability

A discourse analysis of the representation of personal assistance in the Flashback thread : "All personal assistance is being discontinued by politicians due to uncontrollable fraud?"

Efter införandet av Lag 1993:387 om stöd och service till vissa funktionshindrade, LSS, har insatsen personlig assistans setts som en viktig del av det svenska välfärdssystemet. Under de senaste åren har dock kritik riktats mot systemet, med fokus på påstått bidragsfusk och höga kostnader. Samtidigt har det funnits en debatt om hur nedskärningar och förändringar i lagar påverkar livskvaliteten för de som är beroende av assistans, vilket har lett till starka känslor och delade åsikter i både politiska och offentliga diskurser. I den här uppsatsen undersöker jag diskurser kring personlig assistans och hur dessa framställs i de offentliga diskussionerna på det svenska internetforumet Flashback. Genom att använda diskursanalys som teori och metodologisk ansats analyseras inlägg från en specifik tråd som fokuserar på nedläggningen av personlig assistans och påstått bidragsfusk. Jag kommer också att belysa de teman och argument som användarna på forumet framhäver, samt att identifiera hur negativa stereotyper och maktrelationer påverkar uppfattningen av personer med funktionsnedsättning. I analysen framkommer att diskussionerna präglas av starka känslor och en polariserad syn på personlig assistans, där ekonomiska argument mot politiska beslut, funkofobi och främlingsfientlighet dominerar. After the introduction of the Act concerning Support and Service for Persons with Certain Functional Impairments, LSS, personal assistance has been seen as an important part of the Swedish welfare system. However, in recent years, criticism has been directed at the system, focusing on alleged benefit fraud and high costs. At the same time, there has been a debate about how cutbacks and changes in laws affect the quality of life for those who depend on assistance, leading to strong emotions and divided opinions in both political and public discourses.  This thesis examines the discourses surrounding personal assistance and how these are presented in public discussions on the Swedish internet forum Flashback. By using discourse analysis as a theoretical and methodological approach, posts from a specific thread that focuses on the discontinuation of personal assistance and alleged benefit fraud are analyzed. The thesis aims to highlight the themes and arguments emphasized by users on the forum, as well as to identify how negative stereotypes and power relations influence perceptions of persons with disabilities. The analysis reveals that the discussions are characterized by strong emotions and a polarized view of personal assistance, where economic arguments against political decisions, ableism, and xenophobia dominate.

An alternative open science framework

Purpose – The article uses the Marxist base/superstructure model to frame the current dominant form of open science (OS), presenting a critical analysis drawing on policy documents, empirical examples, and mainstream and critical research. The argument focuses on how the project understands its relation to openness, society, science and information and communication technologies (ICTs). Theoretical concepts as openness ideology, cognitive and academic capitalism, and agonistic pluralism, are used for the analysis and development of an alternative OS framework. Design/methodology/approach – A conceptual analysis and ideology critique of OS is conducted within a general Marxist framework. In a subsequent step an alternative form of OS is developed with the help of Chantal Mouffe’s theoretical concept agonistic pluralism. The article’s argument is structured by 4 propositions and 2 proposals. Findings – The current dominant OS framework naturalises commercial enclosures in relation to applied science/open innovation and displays a socially fragmented character in relation to citizen science (CS). This aligns with the openness ideology that downplays the social effect of enclosures related to data, information and knowledge. OS’s focus on standardised applied science accommodates social sciences and humanities under natural sciences’ umbrella. The critique of which, leads to the argument for a political OS, connected to social movements. This alternative is developed around Mouffe’s concept of agonistic pluralism and could counteract the commodification of academia and reinvigorate it with diverse forms of applied research. Originality/value – The article delivers a critical and systematic analysis founded in the Marxist base/superstructure model that frames and combines conceptual elements rarely combined in Library and Information Science’s STS-oriented literature. It problematises the conditions for scholarly research under capitalism’s current cognitive phase and identifies positive potentialities that hitherto have eluded the attention from the wider international Library and Information Science community. Through this, the article contributes to a discussion about what kind of (open) science society needs