Making touch-based kiosks accessible to blind users through simple gestures

Touch-based interaction is becoming increasingly popular and is commonly used as the main interaction paradigm for self-service kiosks in public spaces. Touch-based interaction is known to be visually intensive, and current non-haptic touch-display technologies are often criticized as excluding blind users. This study set out to demonstrate that touch-based kiosks can be designed to include blind users without compromising the user experience for non-blind users. Most touch-based kiosks are based on absolute positioned virtual buttons which are difficult to locate without any tactile, audible or visual cues. However, simple stroke gestures rely on relative movements and the user does not need to hit a target at a specific location on the display. In this study, a touch-based train ticket sales kiosk based on simple stroke gestures was developed and tested on a panel of blind and visually impaired users, a panel of blindfolded non-visually impaired users and a control group of non-visually impaired users. The tests demonstrate that all the participants managed to discover, learn and use the touch-based self-service terminal and complete a ticket purchasing task. The majority of the participants completed the task in less than 4 min on the first attempt

Liver Elastography in Primary Sclerosing Cholangitis Patients Using Three Different Scanner Systems

The aim of the study described here was to characterize three different liver elastography methods in primary sclerosing cholangitis (PSC) patients, for the first time exploring 2-D shear wave elastography (2-D-SWE) in PSC patients and its putative advantages over point shear wave elastography (pSWE). Sixty-six adult PSC patients (51 males, 77%) underwent liver elastography: Transient elastography (TE), pSWE and 2-D-SWE were applied head-to-head after B-mode ultrasonography and blood tests. Liver stiffness measurements (LSMs) by pSWE yielded lower values than those by TE; 2-D-SWE had less steep slope but was overall not significantly different from TE. Correlation between LSMs by pSWE and TE was excellent (intraclass correlation coefficient = 0.92); correlation for 2-D-SWE with either pSWE or TE was moderate but improved with exclusion of overweight individuals. LSMs correlated with the Enhanced Liver Fibrosis test (ELF) across all scanner systems. Our study indicates that LSM by different systems is feasible in PSC patients and that 2-D-SWE tends to underestimate stiffness compared with TE.publishedVersio

Point Shear Wave Elastography and the Effect of Physical Exercise, Alcohol Consumption, and Respiration in Healthy Adults

Purpose Ultrasound elastography is a noninvasive method for liver stiffness measurement (LSM) with the aim of reflecting approximate liver fibrosis load. Despite minimal evidence, current guidelines recommend 10 min of rest and breath hold prior to measurements and offer no advice concerning recent alcohol consumption, leading to challenges in clinical practice. We aimed to investigate how LSM in healthy adults is influenced by physical exercise, recent alcohol consumption, and respiration. Materials and Methods 42 healthy subjects aged 21–36 years were included. LSM using point shear wave elastography (pSWE) was performed in five stages: baseline, after physical activity, after registration of alcohol consumption, and during breath hold compared to free breathing. Results LSM values were significantly increased following physical exercise compared to baseline values (4.1±0.8 vs. 3.8±0.8 kPa, p=0.01). Alcohol consumption during the last 72 h (0–27 alcohol units) did not significantly affect LSM. There was no significant difference between LSM during breath hold and free breathing. Conclusion In healthy subjects, LSM increased after recent physical exercise, while alcohol consumption 24–72 h prior to examination did not have a significant impact. There was no clinically significant effect of breath hold on LSM. Our study supports present guidelines recommending rest prior to LSM, while indicating that breath hold may not be mandatory. Recent moderate alcohol exposure may affect LSM to a lesser extent than commonly believed.publishedVersio

Controlled Attenuation Parameter in Healthy Individuals Aged 8–70 Years

Purpose Controlled attenuation parameter (CAP) is a non-invasive method to assess the presence of liver steatosis. It has been evaluated in children and adults, mainly in either the obese or in subjects with suspected liver disease. Our aim was to describe CAP in healthy non-obese subjects without suspected liver steatosis and to suggest cutoff levels for steatosis. Materials and Methods We prospectively recruited 187 individuals aged 8–70 years. All underwent clinical examination, including height and weight measurement. Body mass index (BMI) was calculated and converted into z-scores. To exclude liver pathology, B-mode ultrasound and liver stiffness measurements were performed in all prior to CAP measurement. Blood was drawn for liver biochemistry in adults. Results CAP was associated with BMI z-score across all ages. CAP started to rise alongside BMI z-score already in subjects with a BMI below average. CAP values were higher in adults than in children (p<0.001), and higher in adult males than adult females (p=0.014). CAP did not correlate with age within the adult or pediatric cohorts. CAP was highly correlated with the fatty liver index. 18 and 23% of subjects showed CAP above the suggested cutoff value for children and adults, respectively. Conclusion CAP was correlated with BMI z-score, even in individuals with a below-average BMI . We found CAP above published cutoff values in a substantial proportion of presumably healthy, non-obese children and adults, warranting further research to clarify whether this represents non-obese non-alcoholic fatty liver disease or if reference values need adjustment.publishedVersio

The introduction of a regional Norwegian HEMS coordinator: an assessment of the effects on response times, geographical service areas and severity scores

Background Due to unwanted delays and suboptimal resource control of helicopter emergency medical services (HEMS), regional HEMS coordinators have recently been introduced in Norway. This may represent an unnecessary link in the alarm chain, which could cause delays in HEMS dispatch. Systematic evaluations of this intervention are lacking. We wanted to conduct this study to assess possible changes in HEMS response times, mission distribution patterns and patient characteristics within our region following this intervention. Methods We retrospectively collected timeline parameters, patient characteristics and GPS positions from HEMS missions executed by three regional HEMS bases in Mid-Norway during 2017–2018 (preintervention) and 2019 (postintervention). The mean regional response time in HEMS missions was assessed by an interrupted time series analysis (ITS). The geographical mission distribution between regional HEMS resources was assessed by a before-after study with a convex hull-based method. Results There was no significant change in the level (-0.13 min/month, p = 0.88) or slope (-0.13 min/month, p = 0.30) of the mean regional response time trend line pre- and postintervention. For one HEMS base, the service area was increased, and the median mission distance was significantly longer. For the two other bases, the service areas were reduced. Both the mean NACA score (4.13 ± SD 0.027 vs 3.98 ± SD 0.04, p < 0.01) and the proportion of patients with severe illness or injury (NACA 4–7, 68.2% vs 61.5%, p < 0.001) were higher in the postintervention group. Conclusion The introduction of a regional HEMS coordinator in Mid-Norway did not cause prolonged response times in acute HEMS missions during the first year after implementation. Higher NACA scores in the patients treated postintervention suggest better selection of HEMS use.publishedVersio

Lovgivning, innhold og organisering av tannhelsebehandling for sosialt svake grupper i befolkningen

Source https://www.tannlegetidende.no/journal/2021/2/m-938/Lovgivning,_innhold_og_organisering_av_tannhelsebehandling_for_sosialt_svake_grupper_i_befolkningen.Formålet med denne artikkelen er å beskrive behandlingssystemene for tannhelse i fire nordiske land, både på generell basis, men først og fremst blant sosialt vanskeligstilte grupper. Alle disse landene tilbyr gratis tannbehandling for barn og ungdom, men tilbudet varierer når det gjelder voksne. Voksne i Norge må betale fra egen lomme. I Danmark blir de grunnleggende utgiftene dekket, skjønt bare delvis. I Finland blir kostnadene subsidiert av offentlige tannhelsetjenester, men tilgangen til dette er begrenset. I Sverige må voksne selv betale inntil et visst terskelbeløp, mens høyere behandlingskostnader blir subsidiert. I tillegg har alle nordiske land flere andre støttesystemer for tannbehandling for sosialt vanskeligstilte grupper. I alle land har disse systemene opp gjennom årene utviklet seg til et lappeteppe av ulike typer subsidier. Disse systemene er i ferd med å bli, eller er allerede blitt revidert med større eller mindre endringer

Showrooming - lavprofitt vs. høyprofitt

Bacheloroppgave i Markedsføringsledelse fra Handelshøyskolen BI, 2021Showrooming er et fenomen som går ut på at kunder finner et produkt i en fysisk butikk, men gjennomfører kjøpet billigere på nett. Som følge av økt digitalisering og endring i folks handlevaner ønsket vi å finne ut nærmere hvordan dette har påvirket fysiske butikker, og vi kom dermed frem til problemstillingen; “Hvordan påvirker fysiske butikkers profittmarginer folks moralske evaluering av showrooming?” Studien ble gjennomført som et eksperiment hvor våre 272 deltakere ble delt inn i to grupper. Begge gruppene ble presentert for et hypotetisk scenario hvor showrooming ble gjennomført. Den ene gruppen ble presentert for en case hvor Petter showroomet i en butikk med høye profittmarginer, mens den andre gruppen ble presentert for en case hvor butikken Petter showroomet i hadde lave profittmarginer. Formålet var å undersøke om det var forskjell på respondentenes moralske evaluering på bakgrunn av dette. For å belyse problemstillingen ble det fremsatt seks hypoteser. Vi utførte en korrelasjonsmatrise og t-test av mellomgruppeforskjeller. Resultatene viser en generell enighet blant respondentene, hvor fem av seks hypoteser blir støttet. Respondentene opplever showrooming som mer umoralsk om det blir utført i en butikk med lave profittmarginer. Dette kan være en indikasjon på at befolkningen generelt mener det er mer umoralsk å showroome dersom butikker sliter

Whole blood RNA sequencing identifies transcriptional differences between primary sclerosing cholangitis and ulcerative colitis

Background & Aims: Genetic and microbiome studies across patients with primary sclerosing cholangitis (PSC) and ulcerative colitis (UC) have indicated that UC in PSC is a separate disease entity to primary UC, but expression studies for PSC are lacking. Methods: We conducted whole blood RNA sequencing experiments for 495 patients with UC, 220 patients with PSC (including 177 with UC), and 320 healthy controls from Germany and Norway. Differential expression analyses, gene ontology and coexpression analyses and random forest machine learning were performed to identify genes, ontologies and transcriptional features that discriminate diagnoses. Results: The blood transcriptome in UC and PSC is dominated by neutrophil activation genes (e.g. S100A12). In UC, but not in PSC (neither PSC alone nor patients with an additional diagnosis of UC [PSC/UC]), ribosomal, mitochondrial, and energy metabolism genes are upregulated in conjunction with antibody transcript expression (MZB1, IGJ). In PSC, there is an increase in modules related to apoptosis and expression of genes of interferon-I-related ontologies. Random forest analysis could poorly discriminate PSC alone from PSC/UC (AUROC 0.56), but could discriminate PSC, UC, and controls with high accuracy (AUROC UC vs. controls 0.95, PSC vs. controls 0.88, UC vs. PSC 0.986). The main coexpression modules relevant for distinguishing PSC, UC, and controls are enriched in neutrophil degranulation and antibody production genes. Conclusions: Supported by machine learning results, PSC and UC appear to be separate entities on a molecular level, while PSC/UC and PSC are indistinguishable. Impact and implications: Clinical and genetic studies suggest that the colitis-like symptoms in primary sclerosing cholangitis (PSC) represent a different disease entity from primary ulcerative colitis (UC). The present study supports this assumption with transcriptomic data from whole blood and describes notable differences in gene expression between primary UC and PSC, providing insights into the still unclear pathophysiology of both diseases. These findings are of interest to scientists seeking to decipher the molecular pathophysiology of both diseases and provide evidence that a redefinition of the PSC-UC phenotype should be considered. The study practically supports future molecular research by providing a large transcriptomic whole blood reference cohort.publishedVersio

Fluctuating biomarkers in primary sclerosing cholangitis: A longitudinal comparison of alkaline phosphatase, liver stiffness, and ELF

Background & Aims Primary sclerosing cholangitis (PSC) is a progressive liver disease characterised by fluctuating liver biochemistries and highly variable disease progression. The Enhanced Liver Fibrosis (ELF®) test and liver stiffness measurements (LSMs) reflect fibrosis and predict clinical outcomes in PSC; however, longitudinal assessments are missing. We aimed to characterise the systematic change in ELF and LSM over time in a prospective cohort of patients with PSC, along with their longitudinal relationship to alkaline phosphatase (ALP) and bilirubin. Methods We included 113 non-transplant PSC patients (86 males [76.1%]; mean age 43.3 ± 15.7 years) with annual study visits between 2013 and 2019 at 2 Norwegian centres. ELF test, LSM, clinical data, liver biochemistries, and revised Mayo risk score were measured. We used linear mixed-effects models to estimate change over time, intraclass correlations (ICCs), and their relationship with ALP and bilirubin. Results At baseline, the median (range) ELF test was 9.3 (7.5–12.9) and median LSM 1.26 m/s (0.66–3.04 m/s). ELF and LSM increased over time (0.09 point/year, 95% CI [0.03, 0.15], p = 0.005, vs. 0.12 point/year, 95% CI [0.03, 0.21], p = 0.009). Between-patient effects explained 78% of ELF variation (ICC 0.78) and 56% of LSM variation (ICC 0.56). ALP also increased and showed the highest ICC (0.86). Conclusions ELF and LSM increased over a 5-year period. Longitudinal analyses demonstrated differences regarding within- and between-patient effects, suggesting that the ELF test may have superior reliability for risk stratification compared with LSM in PSC.publishedVersio