Development of a sedation protocol for dogs undergoing optical coherence tomography (OCT)

Under 90-talet utvecklades en ny teknik för ögonundersökning, kallad optisk koherenstomografi (OCT). Tekniken kan åskådliggöra delar av ögat vilka tidigare enbart kunnat ses histologiskt. OCTtekniken har inom humanvården etablerats som en rutinmässig undersökning som utförs av oftalmologer i diagnostiskt syfte. Tekniken är till exempel väl adapterad för att diagnosticera morfologiska förändringar i retina. Förändringar i retina upptäckts inom veterinärvården idag med hjälp av oftalmoskop, förutsatt att förändringen är stor nog, eller indirekt via elektroretinogram (ERG). OCT-tekniken kräver dock ett fixerat och centrerat öga, samt en stilla och lugn hund. Detta innebär i de flesta fall att sedering eller anestesi krävs. I dagsläget finns inget sederingsprotokoll framtaget som medger ett centrerat och stilla öga, vilket innebär att spekulum, hållsuturer eller dylikt krävs för att genomföra undersökningen. Sedering enligt fyra olika protokoll har använts och analyserats avseende ögats position och fysiologiska parametrar. Sederingsprotokollen innehöll olika kombinationer av läkemedlen medetomidin, butorfanol, ketamin och Zoletil (1:1 tiletamin: zolazepam). Sedering enligt protokoll 2 (konstant infusion av medetomidin + ketamin) och 3 (Zoletil + medetomidin + butorfanol) gav otillfredsställande resultat avseende fysiologiska parametrar respektive ögats position och läkemedelsbiverkningar i form av katalepsi och kramper. Protokoll 1 (Medetomidin + ketamin + butorfanol) och protokoll 4 (medetomidin + ketamin) resulterade i stabila värden avseende de fysiologiska parametrarna och goda resultat avseende ögats position. Användning av protokoll 4 visades med samtliga parametrar inräknade åstadkomma bäst resultat av de prövade protokollen.A novel technology for examination of the eyes was developed during the 90´s. The technology is called optical coherence tomography (OCT). By using light, the OCT technology makes it possible to visualize parts of the eye that were previously only possible to see by histology. OCT is already well established in human medicine. The technology is used routinely by ophthalmologists for examination of an array of diseases of the eye. OCT is more than capable of diagnosing morphological changes of the retina. Changes in the morphology of the retina is by date mostly diagnosed using ophthalmoscopes or indirectly using electroretinogram (ERG) in veterinary medicine. Use of the OCT-technology in veterinary medicine is accompanied with the demand of sedation, or anesthesia. To date there is to our knowledge no suitable sedation protocol for dogs during OCT examination published. Sedation used today for canine patients undergoing OCT examination is not chosen specifically to generate an immobilized and centrally located eye. Problems regarding the eyes position during sedation is therefore present and the use of aids for maintaining an ideal eye is necessary (e.g. speculums, stay suture). Sedation with four different protocols containing different combinations of medetomidine, ketamine, butorphanol and Zoletil (1:1 tiletamine: zolazepam) was used and analyzed in this study. Protocols 2 (Constant rate infusion with medetomine + ketamine) and 3 (Zoletil + medetomidine + butorphanol) produced poor results regarding positioning of the eyes and physiological parameters. Protocols 1 (medetomidine + ketamine + butorphanol) and 4 (medetomidine + ketamine) produced stable and sound results both regarding the position of the eyes during sedation and the physiological aspects. Sedation according to protocol 4 produced the best results in this study and was therefore chosen to be further developed for clinical eye examinations with OCT

Metabol inflammation vid övervikt

Kroniskt överintag av näringsämnen kan leda till övervikt och förändring av fettvävnadens metabola och endokrina funktion. Detta kan resultera i en ökad frisättning av fettsyror, hormoner och proinflammatoriska molekyler och uppkomsten av metabolt aktiverad inflammation. När fettvävnaden expanderar skadas adipocyterna och dess kringliggande stroma. Expansionen kan leda till att vävnaden blir syrefattig och att adipocyter skadas eller går i nekros. Vid sådana tillfällen sänds stressignaler ut vilket resulterar i en ökad proinflammatorisk miljö och rekrytering av immunceller. I inflammationens tidiga skede rekryteras T-lymfocyter som efter exponering för proinflammatoriska signaler från bland annat adipocyter i fettvävnaden utvecklar ett Th-1 svar. Th-1 cellerna driver inflammationen vidare genom rekrytering av monocyter som tillsammans med de fettvävnadsmakrofager som redan finns i fettvävnaden differentieras mot proinflammatoriska M1 fenotypen. Vid en fullt utvecklad metabol inflammation, meta-inflammation, ses en närvaro av nära på alla typer av immunceller i fettvävnaden där makrofagerna dominerar i antal. Rekrytering och differentiering av immunceller till fettvävnaden medieras till stor del av signaler från adipocyter i form av adipokiner och cytokiner från innate lymphoid cells. Framförallt adipokinernas inverkan på det adaptiva immunförsvaret genom utsöndring av proinflammatoriska signaler visar på en nära koppling mellan det metabola systemet och immunsystemet. En ökad insulinresistens ses jämsides med en ökad inflammationsgrad då flera av de signaler som driver inflammation även påverkar insulinregleringen.Chronic obesity changes the metabolic and endocrine function of the adipose tissue. This can lead to an increased release of fatty acids, hormones, and proinflammatory molecules resulting in a metabolic inflammation. With the expansion of adipose tissue during obesity the adipocytes and stromal cells take damage. The expansion may lead to hypoxi and necrosis of adipocytes. In such cases the release of stress-signals is initiated in the adipose tissue wich results in an increasingly proinflammatory milieu and recruitment of immune cells. In the early stages of inflammation T-lymphocytes are recruited and are exposed to proinflammatory signals in the adipose tissue that primes the cells towards a Th-1 response. The now proinflammatory Th-1 cell is a potent mediator that drives the inflammation forward. Later on macrophages are recruited and together with adipose tissue macrophages already on site they are primed towards the proinflammatory M1 phenotype. In the fully developed metainflammation nearly all types of immune cells may be present in the adipose tissue with macrophages as the dominant celltype. The recruitment and differentiation of immune cells are largely mediated by signals from adipocytes in form of adipokines and cytokines from the innate lymphoid cells. Chiefly the effect that adipokines have on the adaptive immune system will differentiate cells towards a proinflammatory response illustrating the close relation between the metabolic system and the immunesystem. Alongside with the increasing inflammation an increased insulin resistance will occur due to the inhibitory effect on the insulin signaling that many of the proinflammatory signals exert

Jämställdhet i skogssektorn kommer att hända - men när?

The Swedish forest sector have under a long time been characterized of a masculine culture but are changing toward a more equal forest sector. With the perspective of composition of board members and board work, methods and actions can be discussed to improve changes toward a more equal board and organisation. To investigate how equality work can be implemented in an organisation and its company board can be affected, six board members representing different organisations in the forest sector have been interviewed. Their experiences as board members as well as their many years of work experiences contribute in the analysis of expected competence in a board as well as how equality and equality work can be discussed and implemented in board work. The analysis also include how they view quota and how it can affect the desired competence when implemented in the board. The results showed that the board members are positive toward a change toward equality, but actions on implementing equality work is not included in the board work except discussions about it. Many respondents remark that equality and equality work is an operative discussion and that it will be fulfilled with time. In the analysis it appeared that quota is a sensitive word. When implementing actions to achieve equality, quota need to be developed so the concept is clearer before it can be implemented.Den svenska skogssektorn har länge präglats av en mansdominerad kultur, men håller på att förändras mot en mer jämställd skogssektor. Med utgångspunkt ur sammansättningen av styrelsemedlemmar och styrelsearbete kan metoder och åtgärder diskuteras för att förbättra arbetet mot en mer jämställd styrelse och organisation. För att undersöka hur jämställdhetsarbetet inom styrelsen såväl som i organisationen kan påverkas har sex styrelsemedlemmar som representerar olika organisationer i skogsbranschen intervjuats. Deras erfarenheter som styrelseledamot samt många års arbetslivserfarenhet bidrar till analysen om hur förväntad kompetens i en styrelse samt hur jämställdhet och jämställdhetsarbete kan diskuteras och implementeras i deras styrelsearbete. Analysen innehåller deras syn på kvotering samt hur det kan påverka efterfrågad kompetens i styrelsen. Resultatet visade att styrelsemedlemmarna är positiva till en jämställd förändring, men att åtgärder för att arbeta med jämställdhet inte implementerats i styrelsearbetet annat än i form av diskussioner. Många respondenter påpekar att frågan är mer av en operativ fråga och att den kommer lösas med tiden. I analysen såg vi att kvotering är ett känsligt ordval. Vid implementering av åtgärder för att uppnå jämställdhet bör begreppet utvecklas för en bättre förståelse innan vidare genomförande

Negative predictive value and potential cost savings of acute nuclear myocardial perfusion imaging in low risk patients with suspected acute coronary syndrome: A prospective single blinded study

<p>Abstract</p> <p>Background</p> <p>Previous studies from the USA have shown that acute nuclear myocardial perfusion imaging (MPI) in low risk emergency department (ED) patients with suspected acute coronary syndrome (ACS) can be of clinical value. The aim of this study was to evaluate the utility and hospital economics of acute MPI in Swedish ED patients with suspected ACS.</p> <p>Methods</p> <p>We included 40 patients (mean age 55 ± 2 years, 50% women) who were admitted from the ED at Lund University Hospital for chest pain suspicious of ACS, and who had a normal or non-ischemic ECG and no previous myocardial infarction. All patients underwent MPI from the ED, and the results were analyzed only after patient discharge. The current diagnostic practice of admitting the included patients for observation and further evaluation was compared to a theoretical "MPI strategy", where patients with a normal MPI test would have been discharged home from the ED.</p> <p>Results</p> <p>Twenty-seven patients had normal MPI results, and none of them had ACS. MPI thus had a negative predictive value for ACS of 100%. With the MPI strategy, 2/3 of the patients would thus have been discharged from the ED, resulting in a reduction of total hospital cost by some 270 EUR and of bed occupancy by 0.8 days per investigated patient.</p> <p>Conclusion</p> <p>Our findings in a Swedish ED support the results of larger American trials that acute MPI has the potential to safely reduce the number of admissions and decrease overall costs for low-risk ED patients with suspected ACS.</p

Impact by pancreatic stellate cells on epithelial-mesenchymal transition and pancreatic cancer cell invasion:adding a third dimension in vitro

Pancreatic cancer is associated with a highly abundant stroma and low-grade inflammation. In the local tumour microenvironment, elevated glucose levels, the presence of tumour-associated stellate cells and macrophages are hypothesised to promote the tumour progression and invasion. The present study investigated the influence by the microenvironment on pancreatic cancer cell invasion in vitro. After co-culture with tumour-associated pancreatic stellate cells (TPSCs), pancreatic cancer cells displayed up to 8-fold reduction in levels of epithelial-mesenchymal transition (EMT) markers E-cadherin and ZO-1, while β-catenin and vimentin levels were increased. A 3D organotypic model showed that TPSCs stimulated pancreatic cancer cell invasion, both as single cell (PANC-1) and cohort (MIAPaCa-2) invasion. The combined presence of TPSCs and M2-like macrophages induced invasion of the non-invasive BxPC-3 cells. High glucose conditions further enhanced changes in EMT markers as well as the cancer cell invasion. In summary, co-culture with TPSCs induced molecular changes associated with EMT in pancreatic cancer cells, regardless of differentiation status, and the organotypic model demonstrated the influence of microenvironmental factors, such as glucose, stellate cells and macrophages, on pancreatic cancer cell invasion

Design space exploration of shell structures using quality diversity algorithms

Computer-aided optimization algorithms in structural engineering have historically focused on the structural performance of generated forms, often resulting in the selection of a single ‘optimal’ solution. However, diversity of generated solutions is desirable when those solutions are shown to a human user to choose from. Quality-Diversity (QD) search is an emerging field of Evolutionary Computation which can automate the exploration of the solution space in engineering problems. QD algorithms, such as MAP-Elites, operate by maintaining and expanding an archive of diverse solutions, optimising for quality in local niches of a multidimensional design space. The generated archive of solutions can help engineers gain a better overview of the solution space, illuminating which designs are possible and their trade-offs. In this paper we apply Quality Diversity search to the problem of designing shell structures. Since the design of shell structures comes with physical constraints, we leverage a constrained optimization variant of the MAP-Elites algorithm, FI-MAP-Elites. We implement our proposed methodology within the Rhino/Grasshopper environment and use the Karamba Finite Element Analysis solver for all structural engineering calculations. We test our method on case studies of parametric models of shell structures that feature varying complexity. Our experiments investigate the algorithm’s ability to illuminate the solution space and generate feasible and high-quality solutions.peer-reviewe

Acceleration and Deceleration in the Internationalization Process of the Firm

By adopting a processual and dynamic view on internationalization, we develop the concepts of acceleration and deceleration, providing analytical tools to enhance our understanding of the non-linearity and multidimensionality of internationalization. We argue that acceleration and deceleration are embedded in the internationalization process and are a consequence of the firm’s capability to absorb and integrate acquired knowledge, and to find and exploit opportunities. In addition, we advance the idea that changes in speed are further influenced by how the firm integrates and coordinates the resources it has deployed within and across various internationalization dimensions. Thus, it emerges that the overall evolution of commitment to internationalization is more complex than received theories tend to present; therefore, empirical studies should aim to include a wide set of international activities and processes embedded in time

Nurturing Business Ecosystems for Growth in a Foreign Market: Incubating, Identifying and Integrating Stakeholders

This paper explores the process of nurturing a business ecosystem to facilitate corporate growth in an unfamiliar foreign market with high product uncertainty and no network resources. The authors conducted a qualitative, longitudinal study by examining a successful business case — ARM (a leader in microprocessor intellectual property) — to demonstrate how firms nurture their business ecosystems to develop in the Chinese market and to stimulate demand even with- out the advantages of resources and stabilized products. Based on the road map method, this paper develops a framework of creating a business ecosystem in three sequential stages namely, incubating complementary partners, identifying leader partners, and integrating ecosystem part- ners. The findings enrich classic international business and demand chain theories by highlighting different roles stakeholders adopt to cope with uncertain products in a foreign market. In practical terms, these findings also provide Mode 2 knowledge with application context (Gibbons et al., 1997) on entering new markets by building up an ecosystem

Internationalisation speed and MNE performance: A study of the market-seeking expansion of retail MNEs

Existing research is divided on whether firms that rapidly expand their overseas operations perform better than firms that internationalize slowly. Drawing on Penrose’s theory of the growth of the firm we argue that the positive effects of rapid internationalization give way to negative effects with increasing internationalization speed, leading to an inverted U-shaped association between internationalization speed and firm performance. We analyse the market-seeking expansion of 110 retailers over a 10-year period (2003–2012) and find support for a curvilinear relationship between internationalization speed and firm performance that is moderated by the geographic scope of firms’ internationalization path and firms’ international experience. Our study contributes to resolving conflicting views on the link between internationalization speed and firm performance

Simple word of mouth or complex resource orchestration for overcoming liabilities of outsidership

Drawing on the resource orchestration literature, we explore the processes by which transnational entrepreneurs offset the liabilities of outsidership they face in their host country. We show how these entrepreneurs’ outsidership with respect to domestic business networks of the host country is compensated by their involvement in diaspora networks. Our second contribution lies in an extension of the resource orchestration framework, as we show that sequencing of resource orchestration processes is important for the implementation of the entrepreneurs’ strategy for using their embeddedness within the diaspora network for enhancing their competitiveness, and can lead to lead to groupings of activities that differ from the groupings found in the original version of the framework