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Patrik Hummel,Abha Saxena,Corinna Klingler 한국역학회 2018 Epidemiology and Health Vol.40 No.-
This article describes, categorizes, and discusses the results of a rapid literature review aiming to provide an overview of the ethical issues and corresponding solutions surrounding pregnancies in epidemic outbreaks. The review was commissioned by the World Health Organization to inform responses to the Zika outbreak that began in 2015. Due to the urgency of the response efforts that needed to be informed by the literature search, a rapid qualitative review of the literature published in PubMed was conducted. The search and analysis were based on the operationalization of 3 key concepts: ethics, pregnancy, and epidemic outbreak. Ethical issues and solutions were interpreted within a principlist framework. The data were analyzed using qualitative content analysis. The search identified 259 publications, of which the full text of 23 papers was read. Of those, 20 papers contained a substantive part devoted to the topic of interest and were therefore analyzed further. We clustered the ethical issues and solutions around 4 themes: uncertainty, harms, autonomy/liberty, and effectiveness. Recognition of the identified ethical issues and corresponding solutions can inform and improve response efforts, public health planning, policies, and decision-making, as well as the activities of medical staff and counselors who practice before, during, or after an epidemic outbreak that affects pregnant women or those of reproductive age. The rapid review format proved to be useful despite its limited data basis and expedited review process.
Patrik Kristhope Meyer,Achmad Nurmandi,Agustiyara Agustiyara 서울대학교행정대학원 2019 Asian Journal of Political Science Vol.27 No.1
AfterbeinganeutralactorfordecadesinthecomplexSouthChinaSea (SCS) territorial disputes, Indonesia has seen itself compelled by China’s assertiveness to become firmer about protecting its territorial sovereignty around the Natuna Islands (NI). Jakarta is alarmed by China’s claims that it has undeniable historical fishing rights in the NI territorial waters because they undermine Indonesia’s territorial sovereignty. Our analysis loosely adopts the securitization conceptual framework proposed by the Copenhagen School to reveal that Jakarta swiftly securitized the NI issue between 2014 and 2016. Using a combination of quantitative and qualitative methods, this paper unpacks how the Indonesian printed mainstream media discussed the NI in recent years. By the end of 2016, the Indonesian media portrayed China’s claims that it has historical fishing rights in the NI territorial waters as the most urgent national security threat to Indonesia, i.e. the NI issue was securitized. This analysis shows that the Indonesian people accepted Jakarta’s security discourse, i.e. Jakarta had successfully securitized China’s claims over the NI territorial waters. This paper makes a new contribution to the securitization literature by simultaneously analysing the Indonesian news and social media outlets.
Magnusson, Patrik K. E.,Lee, Donghwan,Chen, Xu,Szatkiewicz, Jin,Pramana, Setia,Teo, Shumei,Sullivan, Patrick F.,Feuk, Lars,Pawitan, Yudi Cambridge University Press 2016 TWIN RESEARCH AND HUMAN GENETICS - Vol.19 No.2
<P>Monozygotic (MZ) twins stem from the same single fertilized egg and therefore share all their <I>inherited</I> genetic variation. This is one of the unequivocal facts on which genetic epidemiology and twin studies are based. To what extent this also implies that MZ twins share genotypes in adult tissues is not precisely established, but a common pragmatic assumption is that MZ twins are 100% genetically identical also in adult tissues. During the past decade, this view has been challenged by several reports, with observations of differences in post-zygotic copy number variations (CNVs) between members of the same MZ pair. In this study, we performed a systematic search for differences of CNVs within 38 adult MZ pairs who had been misclassified as dizygotic (DZ) twins by questionnaire-based assessment. Initial scoring by PennCNV suggested a total of 967 CNV discordances. The within-pair correlation in number of CNVs detected was strongly dependent on confidence score filtering and reached a plateau of <I>r</I> = 0.8 when restricting to CNVs detected with confidence score larger than 50. The top-ranked discordances were subsequently selected for validation by quantitative polymerase chain reaction (qPCR), from which one single ~120kb deletion in <I>NRXN1</I> on chromosome 2 (bp 51017111-51136802) was validated. Despite involving an exon, no sign of cognitive/mental consequences was apparent in the affected twin pair, potentially reflecting limited or lack of expression of the transcripts containing this exon in nerve/brain.</P>
Mechanical Thrombectomy in Acute Stroke Patients with Moderate to Severe Pre-Stroke Disability
Marek Sykora,Patrik Michel,Davide Strambo,Stefan Krebs,Julia Ferrari,Alexandra Posekany,Dominika Mikšová,Konstantin Hermann,Thomas Gattringer,Elke Gizewski,Hannes Deutschmann,Christian Neumann,Wilfrie 대한뇌졸중학회 2022 Journal of stroke Vol.24 No.3
Background and Purpose Studies on mechanical thrombectomy (MT) in acute ischemic stroke (AIS) patients with preexisting disability are limited. We aimed to compare the outcomes of MT versus best medical treatment (BMT) in these patients. Methods In the nationwide Austrian registry and Swiss monocentric registry, we identified 462 AIS patients with pre-stroke disability (modified Rankin Scale [mRS] score ≥3) and acute large vessel occlusion. The primary outcome was returning to pre-stroke mRS or better at 3 months. Secondary outcomes were early neurological improvement (National Institutes of Health Stroke Scale score improvement ≥8 at 24 to 48 hours), 3-month mortality, and symptomatic intracerebral hemorrhage (sICH). Multivariable regression models and propensity score matching (PSM) were used for statistical analyses. Results Compared with the BMT group (n=175), the MT group (n=175) had younger age, more severe strokes, and lower pre-stroke mRS, but similar proportion of receiving intravenous thrombolysis. MT was associated with higher odds of returning to baseline mRS or better at 3 months (adjusted odds ratio [aOR], 2.5; 95% confidence interval [CI], 1.39 to 4.47), early neurological improvement (aOR, 2.62; 95% CI, 1.41 to 4.88), and lower risk of 3-month mortality (aOR, 0.29; 95% CI, 0.18 to 0.49). PSM analysis showed similar findings. MT was not associated with an increased risk of sICH (4.0% vs. 2.1% in all patients; 4.2% vs. 2.4% in the PSM cohort). Conclusions MT in patients with pre-stroke mRS ≥3 might improve the 3-month outcomes and short-term neurological impairment, suggesting that pre-stroke disability alone should not be a reason to withhold MT, but that individual case-by-case decisions may be more appropriate.
Kare J. Karlsson,Patrik H. Niemela,Anders R. Jonsson,Carl-Johan A. Tornhage 한국산업안전보건공단 산업안전보건연구원 2016 Safety and health at work Vol.7 No.1
Background: Previous research has shown that paramedics are exposed to risks in the form of injuries to the musculoskeletal system. In addition, there are studies showing that they are also at increased risk of cardiovascular disease, cancer, and psychiatric diseases, which can partly be explained by their constant exposure to stress. The aim of this study is to evaluate whether the use of shoulder straps decreases physical effort in the form of decreased heart rate and cortisol concentration. Methods: A stretcher with a dummy was carried by 20 participants for 400 m on two occasions, one with and one without the shoulder straps. Heart rate was monitored continuously and cortisol samples were taken at intervals of 0 minutes, 15 minutes, 30 minutes, 45 minutes, and 60 minutes. Each participant was her or his own control. Results: A significant decrease in heart rate and cortisol concentration was seen when shoulder straps were used. The median values for men (with shoulder straps) at 0 minutes was 78 bpm/21.1 nmol/L (heart rate/cortisol concentration), at 15 minutes was 85 bpm/16.9 nmol/L, and at 60 minutes was 76 bpm/15.7 nmol/L; for men without shoulder straps, these values were 78 bpm/21.9 nmol/L, 93 bpm/ 21.9 nmol/L, and 73 bpm/20.5 nmol/L. For women, the values were 85 bpm/23.3 nmol/L, 92 bpm/ 20.8 nmol/L, and 70 bpm/18.4 nmol/L and 84 bpm/32.4 nmol/L, 100 bpm/32.5 nmol/L, and 75 bpm/ 25.2 nmol/L, respectively. Conclusion: The use of shoulder straps decreases measurable physical stress and should therefore be implemented when heavy equipment or a stretcher needs to be carried. An easy way to ensure that staff use these or similar lifting aids is to provide them with personalized, well-adapted shoulder straps. Another better option would be to routinely sewn these straps into the staff’s personal alarm jackets so they are always in place and ready to be used.
Fredrik Ejserholm,John Stegmayr,Patrik Bauer,Fredrik Johansson,Lars Wallman,Martin Bengtsson,Stina Oredsson 한국생체재료학회 2015 생체재료학회지 Vol.19 No.3
Background: The flexibility of implantable neural probes has increased during the last 10 years, starting with stiff materials such as silicone to more flexible materials like polyimide. We have developed a novel polymer based on Off-Stoichiometry Thiol-Enes + Epoxy (OSTE+, consisting of a thiol, two allyls, an epoxy resin and two initiators), which is up to 100 times more flexible than polyimide. Since a flexible neural probe should be more biocompatible than a stiff probe, an OSTE+ probe should be more biocompatible than one composed of a more rigid material. We have investigated the toxicity of OSTE+ as well as of OSTE+ that had been incubated in water for a week (OSTE+H2O) using MTT assays with mouse L929 fibroblasts. We found that OSTE+ showed cytotoxicity, but OSTE+H2O did not. Extracts were analyzed using LC-MS and GC-MS in order to identify leaked chemicals. Results: Most constituents were found in extracts of OSTE+, whereas only initiators were found in OSTE+H2O extracts. The detected levels of each chemical found in the LC-MS and the GC-MS analysis were below the toxicity level when compared to MTT assays of all the individual chemicals, except for one of the initiators that had an IC50 value close to the detected levels. Conclusion: Our notion is that the toxicity of OSTE+ was caused by one of the initiators, by impurities in the constituents or by synergistic effects of low doses of leaked chemicals. However, our conclusion is that if OSTE+ is incubated for one week in water, OSTE+ is not cytotoxic and suitable for further in vivo studies.