The complexity of kidney disease and diagnosing it – cystatin C, selective glomerular hypofiltration syndromes and proteome regulation

Estimation of kidney function is often part of daily clinical practice, mostly done by using the endogenous glomerular filtration rate (GFR)-markers creatinine or cystatin C. A recommendation to use both markers in parallel in 2010 has resulted in new knowledge concerning the pathophysiology of kidney disorders by the identification of a new set of kidney disorders, selective glomerular hypofiltration syndromes. These syndromes, connected to strong increases in mortality and morbidity, are characterized by a selective reduction in the glomerular filtration of 5–30 kDa molecules, such as cystatin C, compared to the filtration of small molecules <1 kDa dominating the glomerular filtrate, for example water, urea and creatinine. At least two types of such disorders, shrunken or elongated pore syndrome, are possible according to the pore model for glomerular filtration. Selective glomerular hypofiltration syndromes are prevalent in investigated populations, and patients with these syndromes often display normal measured GFR or creatinine-based GFR-estimates. The syndromes are characterized by proteomic changes promoting the development of atherosclerosis, indicating antibodies and specific receptor-blocking substances as possible new treatment modalities. Presently, the KDIGO guidelines for diagnosing kidney disorders do not recommend cystatin C as a general marker of kidney function and will therefore not allow the identification of a considerable number of patients with selective glomerular hypofiltration syndromes. Furthermore, as cystatin C is uninfluenced by muscle mass, diet or variations in tubular secretion and cystatin C-based GFR-estimation equations do not require controversial race or sex terms, it is obvious that cystatin C should be a part of future KDIGO guidelines.publishedVersio

Framework For Enabling Structured Communication of Security Vulnerabilities in the Production Domain in Industry 4.0

As industries are increasingly adapting to new technological trends for data collection and production efficiency, they are fulfilling the description of being part of the industry 4.0 (I4.0) paradigm. This swift development has led to unforeseen consequences concerning managerial and strategic aspects of security. In addition, threats and sophisticated attacks have increased, emphasizing a greater demand for information security management in the industrial setting. For smaller industrial manufacturers, information security management is not always available due the cost of resources, placing them in a challenging position. In addition, I4.0 introduces the area of OT/IT (Operational Technology and Information Technology) convergence, which is often heavily complex, creating the need for cross-competence. Furthermore, consequences from cyber attacks in the production domain can be catastrophic as they may endanger the safety and health of personnel. Thus, smaller manufacturing industries need to utilize existing resources to enable the prerequisites of managing security issues that may come with I4.0. Structuring and effectivizing the communication of security issues is needed to ensure that suitable competence can address security issues in a timely manner. The aspects of communication and competence are not addressed by current security standards and frameworks in the industrial context, nor are they equally applicable for smaller industrial organizations.  This study aims to contribute to the research field of information security in I4.0 by investigating how security vulnerabilities should be communicated at a smaller manufacturing industry that does not have an information security management system. The framework is based on a traditional incident response information flow and was designed at a Swedish manufacturing industry through the narrative of OT or production personnel.

Design principles for intuitivity in complex systems

Det kan vara svårt att uppnå intuitivitet i komplexa system. Denna studie syftar till att identifieravilka designprinciper som främjar intuitivitet i komplexa system samt rekommendationer om hursystemutvecklare bör arbeta i utvecklingsprocessen för att göra systemen intuitiva. Teori somrelaterar till komplexa system, användbarhet och intuition har undersökts. Etableradedesignprinciper för gränssnittsdesign har utvärderats för att identifiera vilka designprinciper somblir centrala för komplexa system. En kvalitativ studie har använts för att utforska och identifieraförbättringsområden i utvecklingsprocessen av ett intuitivt system. De identifieradedesignprinciperna för intuitivitet i komplexa system presenteras och användes för att gerekommendationer. Detta baserades på de förbättringsområden som upptäcktes under desemistrukturerade intervjuer med ett utvalt företaget. Resultatet jämförs med teorikapitlet omintuition. Slutligen presenteras studiens slutsatser och förslag till vidare studier.It can be difficult to achieve intuitiveness in complex systems. This study aims to identify whichdesign principles promotes intuitiveness in complex systems as well as recommendations ofhow developers can work in developing these systems. Literature of complex systems, usabilityand intuition have been surveyed. Established principles of design have been evaluated toidentify which principles relates to complex systems. A qualitative study was used to exploreand identify areas of improvement in the development of an intuitive system. The identifiedprinciples for intuitiveness in complex systems are presented and then used to providerecommendations for the areas of improvement identified in interviews. The results arecompared with theory on intuition. Lastly, the concluding remarks and suggestions for furtherstudies are presented

The complexity of kidney disease and diagnosing it - Cystatin C, selective glomerular hypofiltration syndromes and proteome regulation.

Estimation of kidney function is often part of daily clinical practice, mostly done by using the endogenous GFR-markers creatinine or cystatin C. A recommendation to use both markers in parallel in 2010 has resulted in new knowledge concerning the pathophysiology of kidney disorders by identification of a new set of kidney disorders, selective glomerular hypofiltration syndromes. These syndromes, connected to strong increases in mortality and morbidity, are characterised by a selective reduction in the glomerular filtration of 5-30 kDa molecules, such as cystatin C, compared to the filtration of small molecules < 1kDa dominating the glomerular filtrate e.g., water, urea, creatinine. At least two types of such disorders, shrunken or elongated pore syndrome, are possible according to the pore model for glomerular filtration. Selective glomerular hypofiltration syndromes are prevalent in investigated populations, and patients with these syndromes often display normal measured GFR or creatinine-based GFR-estimates. The syndromes are characterised by proteomic changes promoting the development of atherosclerosis, indicating antibodies and specific receptor-blocking substances as possible new treatment modalities. Presently, the KDIGO guidelines for diagnosing kidney disorders do not recommend cystatin C as a general marker of kidney function and will therefore not allow the identification of a considerable number of patients with selective glomerular hypofiltration syndromes. Furthermore, as cystatin C is uninfluenced by muscle mass, diet or variations in tubular secretion and cystatin C-based GFR-estimation equations do not require controversial race or sex terms, it is obvious that cystatin C should be a part of future KDIGO guidelines. This article is protected by copyright. All rights reserved