Innovation in Healthcare, An analysis of the regional preconditions in Skåne for innovation in digital healthcare.

The upcoming changes in the demographic structure will put pressure on the healthcare system in Skåne. Tax financed hospitals with more beds, doctors, nurses and other personnel will not be the solution to cope with the upcoming demands. Increasing healthcare productivity is one way, where digital healthcare is a potential part of the solution. One of the major limitations of the digital healthcare market is not the shortage of technology but rather the innovation-uptake is slow in healthcare compared to other sectors. The problem is to understand why the technology uptake is slow, which barriers prevents uptake and what decelerate continued innovation in the healthcare sector. Purpose: The main purpose aim to describe and analyze the regional preconditions in Skåne for innovation in digital healthcare. The goal has been to identify strengths, opportunities and various barriers that prevents or delay innovation in the region. Identifying and proposing innovative health strategies with the TOWS-framework. Sub purposes are to identify upcoming global trends in healthcare and gather a list of digital healthcare projects in the region. Methodology: The methodology for gathering data for this master thesis consists of a combination of primary and secondary data. Collected from secondary research, explorative quantitative survey study, semi structured interviews with key actors, attending and observing national and local eHealth events. Conclusions: The region of Skåne in the south of Sweden got the possibilities for a good climate for innovation in healthcare. There is a possibility to gather ideas and projects for incremental innovation in the region. Both the healthcare professionals and patients are sitting with valuable expertise and knowledge, which at this time is not fully utilized. To get a more radical change in the healthcare sector some barriers need to be broken down. These changes need a more strategic and political approach, many of them need to be brought up on a national level. Today security laws regulation the use of information need to be modified to allow the use of unidentified healthcare data. Making it easier for the academia and companies to use this information would allow them to pursue new research areas and possible innovations. For new entrepreneurs and businesses there is need to learn how to use the reimbursement model to support their business plans. It is also important that the way into the healthcare sector, procurements, is built to handle and promote these new ventures. Skåne has a gap in expertise regarding semantic interoperability, both in the business and academic sector. This is not a unique problem for Skåne and can be seen in other regions as well. Collaborations with other regions and worldwide expertise is needed to fill this gap and promote advances in this field. Comparing to other countries, Sweden are ranked 3rd on the list of innovation uptake in healthcare just beaten by Denmark and Estonia. Third place in digital healthcare solution implementation is good but we can’t sit down and be satisfied with the result. Even if you are in first place you need to constantly revaluate your position and look for areas to improve. The region have most of the building blocks to get a good climate for innovation in digital healthcare. Region Skåne have to join the blocks together, here is a unique opportunity to facilitate cross-border meetings, be a collaborate voice, and put digital healthcare on the agenda. There is a need for a link into healthcare to get providers, doctors and nurses to share their ideas and needs to business, entrepreneurs, and the academia. Lobbying to politicians and policymakers should be done to raise the awareness and try to change some regulations and laws that acts as barriers for innovation today

Metallföroreningar i Landskrona - miljöövervakning med blåmussla

Environmental monitoring using bioindicators is a valuable tool in quantifying and assessing metal pollution in the aquatic environment. In this study, I have analyzed monitoring data on metals in blue mussels (Mytilus Edulis) from the Öresund in Landskrona, Sweden. Comparisons with previous monitoring studies from the area show elevated concentrations of several metals, including copper (Cu), lead (Pb) and zinc (Zn), suggesting a local source of pollution in Landskrona. Deviations from guideline values calculated by the swedish EPA, representing baseline values, are shown to be Large or Very Large for copper, lead, nickel (Ni) and tin (Sn). In addition, lead and cadmium (Cd) concentrations in mussels exceed limit values for foodstuff determined by the European Commission, rendering the mussels unsuitable for human consumption. Multivariate principal component analysis (PCA) of the data show covariance between copper, lead, zinc and tin, suggesting a common source of pollution. GIS-analysis of the data show that the highest concentrations of copper, lead, zinc and tin are found in the area of Varvsudden, an industrial area with several metal industries, a large shipyard and a marina for recreational boating. Combined, these analyses suggest multiple pollution sources including industrial effluents and anti-fouling paint. With the approach used in this study, continued environmental monitoring expanded with the quantification of abiotic factors can give more detailed insight on the metal pollution sources, providing a solid knowledge base for remediation and prevention of future pollution

Prevalence of Giardia intestinalis in Swedish beef cattle

Giardia är encelliga parasiter, så kallade protozoer. Släktet Giardia omfattar flera arter varav en, Giardia intestinalis (synonymer: Giardia duodenalis och Giardia lamblia), infekterar magtarmkanalen och kan orsaka sjukdom hos djur och människor. Många infektioner förlöper helt symtomfritt både hos djur och människor men dessa individer kan ändå sprida smittan vidare. Vanliga symtom vid infektioner hos människa är diarré, buksmärta, magkramper, trötthet och viktminskning. Hos vuxna nötkreatur och kalvar har endast lös avföring kunnat kopplas till giardiasis men det finns även undersökningar som inte hittat några samband mellan lös avföring och infektion. Parasiten smittar fekalt-oralt via cystor som utsöndras med avföringen. Vanliga smittvägar är direktsmitta, vatten och när det gäller människor till en mindre del livsmedel. Syftet med studien var att undersöka prevalensen av G. intestinalis hos kalvar i svenska dikobesättningar samt att undersöka om det fanns något samband mellan andelen smittade djur och deras ålder. 277 avföringsprover samlades in från 24 dikobesättningar i 2 områden i Sverige. Alla djur i undersökningen var under 3 månader vid provtagningen. En översiktlig klinisk undersökning gjordes av varje individ. Proverna koncentrerades, kylförvarades och undersöktes sedan med flourescensmikroskopering. Den yngsta positiva individen var bara 1 dygn gammal. Prevalensen var 38,3 % (CI 95 % 32,6 – 43,9 %) och det fanns ett samband mellan ålder och andelen infekterade djur. Störst andel infekterade djur fanns i den 7e till 9e levnadsveckan. Det fanns också ett samband mellan kalvens kön och infektion. Fler tjurkalvar var infekterade än kvigkalvar. Kvantifiering av antalet utsöndrade cystor tyder på förekomst av ”superspridare”.Giardia intestinalis (synonyms: Giardia duodenalis and Giardia lamblia) is a microscopic, single cell, intestinal parasite that infects humans and animals. Common clinical signs in humans include diarrhea, abdominal pain, abdominal cramps, fatigue and weight loss. In cattle, the only symptom associated with infection is loose stool but there are also publications that contradict those findings. However, it is quite common for both humans and animals to be infected and have no signs of illness. These individuals can still transmit the parasite to others and contaminate the environment. The parasite is transmitted as cysts via the fecal-oral route, either by individual-toindividual contact or by ingestion of contaminated food or water. Animals also contract the infection from their environment and their herd/pack-members through oral contact with fur, soil, plants, beddings, fecal matter stuck to tools and stable interior etc. A study was conducted to investigate the prevalence of Giardia intestinalis in beef calves in Swedish suckler herds. I further aimed to investigate if any significant correlation could be found between the age of the infected animal and the percentage of infected animals. 277 faecal samples were collected from 24 beef suckler herds in two different regions in Sweden. The animals were all under 3 months old at the time of sample collection. A brief, clinical examination was performed on every individual. The samples were concentrated, stored and later examined with fluorescence microscopy. The youngest positive calf sampled was only 1 day old. The prevalence was 38,3 %, (CI 95% 32,6 – 43,9%) and there was a correlation between age and percentage of positive animals. The animals between 7 and 9 weeks of age had the highest infection rate. There was also a correlation between gender and infection by Giardia intestinalis. The bull calves were more frequently infected than the heifers. Quantification of excreted cysts per gram of faecal matter implies the existence of super shedder

Inhibitory Receptors Alter Natural Killer Cell Interactions with Target Cells Yet Allow Simultaneous Killing of Susceptible Targets

Inhibitory receptors expressed on natural killer (NK) cells abrogate positive signals upon binding corresponding major histocompatibility complex (MHC) class I molecules on various target cells. By directly micromanipulating the effector–target cell encounter using an optical tweezers system which allowed temporal and spatial control, we demonstrate that Ly49–MHC class I interactions prevent characteristic cellular responses in NK cells upon binding to target cells. Furthermore, using this system, we directly demonstrate that an NK cell already bound to a resistant target cell may simultaneously bind and kill a susceptible target cell. Thus, although Ly49-mediated inhibitory signals can prevent many types of effector responses, they do not globally inhibit cellular function, but rather the inhibitory signal is spatially restricted towards resistant targets

Intensity of Oestrus Signalling Is the Most Relevant Indicator for Animal Well-Being in High-Producing Dairy Cows

Full signalling of oestrous behaviour is vital for proper timing of AI and good reproductive performance, currently jeopardized by shorter observations of oestrus behaviour. Alternative indicators including progesterone (P4) recordings on-farm are tested. Oestrous intensity of 37 heifers (H) and 30 1st-parity dairy cows (C1) either Swedish Red (32) or Swedish Holstein (35) with high genetic potential for milk production, was studied in relation to AI. P4-levels in blood or milk were monitored on-farm at 0, 7, and 20 d post-AI with a portable ELISA reader (eProCheck800). Avoidance distance and body condition were scored at day 7, and pregnancy diagnosed by P4 (day 20) and trans-rectal palpation (day 50). More heifers (46%) than C1-cows (10%) showed standing oestrus (strongest intensity, P < 0.05), leading to higher pregnancy rate at d50 (72% versus 37% for C1, P < 0.01) and calving rate (H: 64%, C1: 33%, P < 0.05). Avoidance distances were short (<1 m), reflecting good human-animal interaction. Visually-recorded standing oestrus yielded 4.8 fold higher odds of pregnancy, respectively 4.6-fold higher odds of calving. On-farm P4-recordings had complementary value yet less accuracy. Intensity of oestrus signalling relates to animal well-being, reflected in pregnancy-to-term being a good indicator for optimal welfare in high-producing dairy cattle

RNA atlas of human bacterial pathogens uncovers stress dynamics linked to infection

Bacterial processes necessary for adaption to stressful host environments are potential targets for new antimicrobials. Here, we report large-scale transcriptomic analyses of 32 human bacterial pathogens grown under 11 stress conditions mimicking human host environments. The potential relevance of the in vitro stress conditions and responses is supported by comparisons with available in vivo transcriptomes of clinically important pathogens. Calculation of a probability score enables comparative cross-microbial analyses of the stress responses, revealing common and unique regulatory responses to different stresses, as well as overlapping processes participating in different stress responses. We identify conserved and species-specific 'universal stress responders', that is, genes showing altered expression in multiple stress conditions. Non-coding RNAs are involved in a substantial proportion of the responses. The data are collected in a freely available, interactive online resource (PATHOgenex). Bacterial stress responses are potential targets for new antimicrobials. Here, Avican et al. present global transcriptomes for 32 bacterial pathogens grown under 11 stress conditions, and identify common and unique regulatory responses, as well as processes participating in different stress responses.Peer reviewe

Optical trap stiffness in the presence and absence of spherical aberrations

Optical traps are commonly constructed with high-numerical-aperture objectives. Oil-immersion objectives suffer from spherical aberrations when used for imaging in aqueous solutions. The effect of spherical aberrations on trapping strength has been modeled by approximation, and only a few experimental results are available in the case of micrometer-sized particles. We present an experimental study of the dependence of lateral and axial optical-trap stiffness on focusing depth for polystyrene and silica beads of 2 μm diameter by using oil- and water-immersion objectives. We demonstrate a strong depth dependence of trap stiffness with the oil-immersion objective, whereas no depth dependence was observed with the water-immersion objective. © 2006 Optical Society of America

Access to Research Veterinary Medicine International Volume

Full signalling of oestrous behaviour is vital for proper timing of AI and good reproductive performance, currently jeopardized by shorter observations of oestrus behaviour. Alternative indicators including progesterone (P 4 ) recordings on-farm are tested. Oestrous intensity of 37 heifers (H) and 30 1st-parity dairy cows (C 1 ) either Swedish Red (32) or Swedish Holstein (35) with high genetic potential for milk production, was studied in relation to AI. P 4 -levels in blood or milk were monitored on-farm at 0, 7, and 20 d post-AI with a portable ELISA reader (eProCheck 800 ). Avoidance distance and body condition were scored at day 7, and pregnancy diagnosed by P 4 (day 20) and trans-rectal palpation (day 50). More heifers (46%) than C 1 -cows (10%) showed standing oestrus (strongest intensity, P &lt; 0.05), leading to higher pregnancy rate at d50 (72% versus 37% for C1, P &lt; 0.01) and calving rate (H: 64%, C1: 33%, P &lt; 0.05). Avoidance distances were short (&lt;1 m), reflecting good human-animal interaction. Visually-recorded standing oestrus yielded 4.8 fold higher odds of pregnancy, respectively 4.6-fold higher odds of calving. On-farm P4-recordings had complementary value yet less accuracy. Intensity of oestrus signalling relates to animal well-being, reflected in pregnancy-to-term being a good indicator for optimal welfare in high-producing dairy cattle