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Abstract Somatic copy number variations (CNVs), including abnormal chromosome numbers and structural changes leading to gain or loss of genetic material, play a crucial role in initiation and progression of cancer. CNVs are believed to cause gene dosage imbalances and modify cis-regulatory elements, leading to allelic expression imbalances in genes that influence cell division and thereby contribute to cancer development. However, the impact of CNVs on allelic gene expression in cancer remains unclear. Allele-specific expression (ASE) analysis, a potent method for investigating genome-wide allelic imbalance profiles in tumors, assesses the relative expression of two alleles using high-throughput sequencing data. However, many existing methods for gene-level ASE detection rely on only RNA sequencing data, which present challenges in interpreting the genetic mechanisms underlying ASE in cancer. To address this issue, we developed a robust framework that integrates allele-specific copy number calls into ASE calling algorithms by leveraging paired genome and transcriptome data from the same sample. This integration enhances the interpretability of the genetic mechanisms driving ASE, thereby facilitating the identification of driver events triggered by CNVs in cancer. In this study, we utilized BASE to conduct a comprehensive analysis of ASE in high hyperdiploid acute lymphoblastic leukemia (HeH ALL), a prevalent childhood malignancy characterized by gains of chromosomes X, 4, 6, 10, 14, 17, 18, and 21. Our analysis unveiled the comprehensive ASE landscape in HeH ALL. Through a multi-perspective examination of HeH ASEs, we offer a systematic understanding of how CNVs impact ASE in HeH, providing valuable insights to guide ASE studies in cancer.

Abstract Dose management systems (DMS) are an essential tool for quality assurance and optimising patient radiation exposure. For radiologists and medical physicists, they are important for managing many radiation protection tasks. In addition, they help fulfil the requirements of Directive 2013/59/EURATOM regarding the electronic transmission of dosimetric data and the detection of unintended patient exposures. The EuroSafe Imaging Clinical Dosimetry and Dose Management Working Group launched a questionnaire on the use of DMS in European member states and analysed the results in terms of modalities, frequency of radiological procedures, involvement of medical physics experts (MPEs), legal requirements, and local issues (support by information technology (IT), modality interfaces, protocol mapping, clinical workflow, and associated costs). Critical relevance statement Despite the great advantages of dose management systems for optimising radiation protection, distribution remains insufficient. This questionnaire shows that reasons include: a lack of DICOM interfaces, insufficient harmonisation of procedure names, lack of medical physicist and IT support, and costs. Key Points Quantitative radiation dose information is essential for justification and optimisation in medical imaging. Guidelines are required to ensure radiation dose management systems quality and for acceptance testing. Verifying dose data management is crucial before dose management systems clinical implementation. Medical physics experts are professionals who have important responsibilities for the proper management of dose monitoring. Graphical Abstract

Background Coronary atherosclerosis detected by imaging is a marker of elevated cardiovascular risk. However, imaging involves large resources and exposure to radiation. The aim was, therefore, to test whether nonimaging data, specifically data that can be self‐reported, could be used to identify individuals with moderate to severe coronary atherosclerosis. Methods and Results We used data from the population‐based SCAPIS (Swedish CardioPulmonary BioImage Study) in individuals with coronary computed tomography angiography (n=25 182) and coronary artery calcification score (n=28 701), aged 50 to 64 years without previous ischemic heart disease. We developed a risk prediction tool using variables that could be assessed from home (self‐report tool). For comparison, we also developed a tool using variables from laboratory tests, physical examinations, and self‐report (clinical tool) and evaluated both models using receiver operating characteristic curve analysis, external validation, and benchmarked against factors in the pooled cohort equation. The self‐report tool (n=14 variables) and the clinical tool (n=23 variables) showed high‐to‐excellent discriminative ability to identify a segment involvement score ≥4 (area under the curve 0.79 and 0.80, respectively) and significantly better than the pooled cohort equation (area under the curve 0.76, P

Background Dual antiplatelet therapy (DAPT) reduces ischemic events but increases bleeding risk, especially in patients with high bleeding risk (HBR). This study aimed to compare outcomes of abbreviated versus standard DAPT strategies in patients with HBR with acute coronary syndrome undergoing percutaneous coronary intervention. Methods and Results Patients from the SWEDEHEART (Swedish Web‐system for Enhancement and Development of Evidence‐Based Bare in Heart Disease Evaluated According to Recommended Therapies) registry with at least 1 HBR criterion who underwent percutaneous coronary intervention for acute coronary syndrome were identified and included. Patients were divided into 2 groups based on their planned DAPT time at discharge: 12‐month DAPT or an abbreviated DAPT strategy and matched according to their prescribed P2Y12 inhibitor at discharge. The primary outcome assessed was time to net adverse clinical events at 1 year, which encompassed cardiac death, myocardial infarction, ischemic stroke, or clinically significant bleeding. Time to major adverse cardiovascular events and the individual components of net adverse clinical events were considered secondary end points. A total of 4583 patients were included in each group. The most frequently met HBR criteria was age older than 75 years (65.6%) and Predicting Bleeding Complications in Patients Undergoing Stent Implantation and Subsequent Dual Antiplatelet Therapy score ≥25 (44.6%) in the standard DAPT group and oral anticoagulant therapy (79.6%) and age 75 years and older (55.2%) in the abbreviated DAPT group. There was no statistically significant difference in net adverse clinical events (12.9% versus 13.1%; hazard ratio [HR], 0.99 [95% CI, 0.88–1.11], P=0.83), major adverse cardiovascular events (8.6% versus 7.9%; HR, 1.08 [95% CI, 0.94–1.25]), or their components between groups. The results were consistent among all of the investigated subgroups. Conclusions In patients with HBR undergoing percutaneous coronary intervention due to acute coronary syndrome, abbreviated DAPT was associated with comparable rates of net adverse clinical events and major adverse cardiovascular events to a DAPT duration of 12 months.

Abstract Background Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancers with limited treatment options, illustrating an urgent need to identify new drugable targets in PDACs. Objective Using the similarities between tumor development and normal embryonic development, which is accompanied by rapid cell expansion, we aimed to identify and characterize embryonic signaling pathways that were reinitiated during tumor formation and expansion. Methods and Results Here, we report that the transcription factors E2F1 and E2F8 are potential key regulators in PDAC. E2F1 and E2F8 RNA expression is mainly localized in proliferating cells in the developing pancreas and in malignant ductal cells in PDAC. Silencing of E2F1 and E2F8 in PANC‐1 pancreatic tumor cells inhibited cell proliferation and impaired cell spreading and migration. Moreover, loss of E2F1 also affected cell viability and apoptosis with E2F expression in PDAC tissues correlating with expression of apoptosis and mitosis pathway genes, suggesting that E2F factors promote cell cycle regulation and tumorigenesis in PDAC cells. Conclusion Our findings illustrate that E2F1 and E2F8 transcription factors are expressed in pancreatic progenitor and PDAC cells, where they contribute to tumor cell expansion by regulation of cell proliferation, viability, and cell migration making these genes attractive therapeutic targets and potential prognostic markers for pancreatic cancer.

Key points 1. European health professionals reveal different RP E&T experiences. 2. Around 12% of the respondents report the absence of undergraduate RP topics. 3. The radiation protection problems perception varies across Europe. 4. The results revealed a heterogeneity of compliance with the EU recommendations.

Background and purpose: In proton therapy, a 3.5% margin is often used to account for proton range uncertainties, of which computed tomography (CT) image noise is assumed to contribute 0.5%. This work evaluates the noise-sensitivity of three dual-energy computed tomography (DECT)-based methods for mapping proton stopping power relative to water (SPR): Näsmark & Andersson (N&A), Landry-Saito (L-S), and the commercial application DirectSPR. Methods and materials: DECT image data of a CIRS-062M phantom was acquired with CT scanners from two different vendors. Acquisitions were repeated 30 times to account for intra- and inter-scan variations. SPR maps were generated with the three DECT-based methods and range simulated in a commercial treatment planning system. Results: Noise in input data was amplified in L-S SPR maps, kept level with DirectSPR, while N&A compressed noise overall but displayed sensitivity to the choice of input data, potentially leading to increased noise levels. In our simulations, only N&A improved upon the assumed 0.5% noise contribution to range uncertainty on one scanner. On the other scanner, uncertainties exceeded 0.5% for all three methods. Mitigation of this issue was demonstrated by using a method employing virtual mono-energetic images as input. Increasing imaging radiation dose, as expected, alleviates the problem, while applying noise reduction only helped to a lesser extent. Conclusions: While range uncertainty due to noise is small compared to other contributions, it becomes more important as we move towards smaller treatment margins and the noise-sensitivity of SPR mapping methods should be carefully estimated and considered before clinical implementation.

BackgroundArtificial intelligence (AI) applications in health care are expected to provide value for health care organizations, professionals, and patients. However, the implementation of such systems should be carefully planned and organized in order to ensure quality, safety, and acceptance. The gathered view of different stakeholders is a great source of information to understand the barriers and enablers for implementation in a specific context. ObjectiveThis study aimed to understand the context and stakeholder perspectives related to the future implementation of a clinical decision support system for predicting readmissions of patients with heart failure. The study was part of a larger project involving model development, interface design, and implementation planning of the system. MethodsInterviews were held with 12 stakeholders from the regional and municipal health care organizations to gather their views on the potential effects implementation of such a decision support system could have as well as barriers and enablers for implementation. Data were analyzed based on the categories defined in the nonadoption, abandonment, scale-up, spread, sustainability (NASSS) framework. ResultsStakeholders had in general a positive attitude and curiosity toward AI-based decision support systems, and mentioned several barriers and enablers based on the experiences of previous implementations of information technology systems. Central aspects to consider for the proposed clinical decision support system were design aspects, access to information throughout the care process, and integration into the clinical workflow. The implementation of such a system could lead to a number of effects related to both clinical outcomes as well as resource allocation, which are all important to address in the planning of implementation. Stakeholders saw, however, value in several aspects of implementing such system, emphasizing the increased quality of life for those patients who can avoid being hospitalized. ConclusionsSeveral ideas were put forward on how the proposed AI system would potentially affect and provide value for patients, professionals, and the organization, and implementation aspects were important parts of that. A successful system can help clinicians to prioritize the need for different types of treatments but also be used for planning purposes within the hospital. However, the system needs not only technological and clinical precision but also a carefully planned implementation process. Such a process should take into consideration the aspects related to all the categories in the NASSS framework. This study further highlighted the importance to study stakeholder needs early in the process of development, design, and implementation of decision support systems, as the data revealed new information on the potential use of the system and the placement of the application in the care process.

Abstract Background A Strengths, weaknesses, opportunities and threats analysis was performed to understand the status quo of education and training in radiation protection (RP) and to develop a coordinated European approach to RP training needs based on stakeholder consensus and existing activities in the field. Fourteen team members represented six European professional societies, one European voluntary organisation, two international healthcare organisations and five professions, namely: Medical Physicists; Nuclear Medicine Physicians; Radiologists; Radiation Oncologists and Radiographers. Four subgroups analysed the “Strengths”, “Weaknesses”, “Opportunities” and “Threats” related to E&T in RP developed under previous European Union (EU) programmes and on the Guidelines on Radiation Protection Education and Training of Medical Professionals in the EU. Results Consensus agreement identified four themes for strengths and opportunities, namely: (1) existing structures and training recommendations; (2) RP training needs assessment and education & training (E&T) model(s) development; (3) E&T dissemination, harmonisation, and accreditation; (4) financial supports. Weaknesses and Threats analysis identified two themes: (1) awareness and prioritisation at a national/global level and (2) awareness and prioritisation by healthcare professional groups and researchers. Conclusions A lack of effective implementation of RP principles in daily practice was identified. EuRnR strategic planning needs to consider processes at European, national and local levels. Success is dependent upon efficient governance structures and expert leadership. Financial support is required to allow the stakeholder professional agencies to have sufficient resources to achieve a pan European radiation protection training network which is sustainable and accredited across multiple national domains.

Abstract Using time-of-flight multiple electron and ion coincidence techniques in combination with a helium gas discharge lamp and synchrotron radiation, the double ionisation spectrum of disulfur (S $$_2$$ 2 ) and the subsequent fragmentation dynamics of its dication are investigated. The S $$_2$$ 2 sample was produced by heating mercury sulfide (HgS), whose vapour at a suitably chosen temperature consists primarily of two constituents: S $$_2$$ 2 and atomic Hg. A multi-particle-coincidence technique is thus particularly useful for retrieving spectra of S $$_2$$ 2 from ionisation of the mixed vapour. The results obtained are compared with detailed calculations of the electronic structure and potential energy curves of S $$_2^{2+}$$ 2 2 + which are also presented. These computations are carried out using configuration interaction methodology. The experimental results are interpreted with and strongly supported by the computational results.

BackgroundDiabetes and its cardiovascular complications are a growing concern worldwide. Recently, some studies have demonstrated that relative risk of heart failure (HF) is higher in women with type 1 diabetes (T1DM) than in men. This study aims to validate these findings in cohorts representing five countries across Europe.MethodsThis study includes 88,559 (51.8% women) participants, 3,281 (46.3% women) of whom had diabetes at baseline. Survival analysis was performed with the outcomes of interest being death and HF with a follow-up time of 12 years. Sub-group analysis according to sex and type of diabetes was also performed for the HF outcome.Results6,460 deaths were recorded, of which 567 were amongst those with diabetes. Additionally, HF was diagnosed in 2,772 individuals (446 with diabetes). A multivariable Cox proportional hazard analysis showed that there was an increased risk of death and HF (hazard ratio (HR) of 1.73 [1.58–1.89] and 2.12 [1.91–2.36], respectively) when comparing those with diabetes and those without. The HR for HF was 6.72 [2.75–16.41] for women with T1DM vs. 5.80 [2.72–12.37] for men with T1DM, but the interaction term for sex differences was insignificant (p for interaction 0.45). There was no significant difference in the relative risk of HF between men and women when both types of diabetes were combined (HR 2.22 [1.93–2.54] vs. 1.99 [1.67–2.38] respectively, p for interaction 0.80).ConclusionDiabetes is associated with increased risks of death and heart failure, and there was no difference in relative risk according to sex.

Autonomous vehicles are becoming a reality with great potential. However, persons with blindness, deafblindness, and deafness, who usually receive information and guidance from the driver, could miss information when travelling in an autonomous car. In this case study, 15 people with hearing and vision impairments explore and compare trips with and without vibrotactile guidance (using Ready-Ride or Ready-Move) in a simulated autonomous vehicle in real traffic (using a Wizard-of-Oz method). The study investigated if vibrotactile aid could enable persons with blindness, deafblindness, and deafness to use autonomous vehicles. Different phases of a trip (before, during, and after) were analysed. The study shows that people with functional impairments such as blindness, deafblindness, and deafness can perform trips independently if given information adapted to their needs through auditory, tactile, or visual information channels. It would be difficult for the target groups to travel without any additional communication aid, such as a vibrotactile guidance aid for all phases of the trip, especially for those with blindness. In all rides with the simulated autonomous car (Wizard-of-Oz set up) without vibrotactile guidance, the driver or assistant (in at least one phase of the trip) had to intervene for the research participants with blindness to complete the trip and continue the study. The study also highlights the usability of the vibrotactile guidance aid and identifies areas in need of improvement.

Abstract This review presents basic information on the dosimetric quantities used in medical imaging for reporting patient doses and establishing diagnostic reference levels. The proper use of the radiation protection quantity “effective dose” to compare doses delivered by different radiological procedures and different imaging modalities with its uncertainties and limitations, is summarised. The estimates of population doses required by the European Directive on Basic Safety Standards is commented on. Referrers and radiologists should be familiar with the dose quantities to inform patients about radiation risks and benefits. The application of effective dose on the cumulative doses from recurrent imaging procedures is also discussed. Patient summary: Basic information on the measurement units (dosimetric quantities) used in medical imaging for reporting radiation doses should be understandable to patients. The Working Group on “Dosimetry for imaging in clinical practice” recommended that a brief explanation on the used dosimetric quantities and units included in the examination imaging report, should be available for patients. The use of the quantity “effective dose” to compare doses to which patients are exposed to from different radiological procedures and its uncertainties and limitations, should also be explained in plain language. This is also relevant for the dialog on to the cumulative doses from recurrent imaging procedures. The paper summarises these concepts, including the need to estimate the population doses required by the European Directive on Basic Safety Standards. Referrers and radiologists should be familiar with the dose quantities to inform patients about radiation risks and benefits.

This study investigates interactive behaviors and communication cues of heavy goods vehicles (HGVs) and vulnerable road users (VRUs) such as pedestrians and cyclists as a means of informing the interactive capabilities of highly automated HGVs. Following a general framing of road traffic interaction, we conducted a systematic literature review of empirical HGV-VRU studies found through the databases Scopus, ScienceDirect and TRID. We extracted reports of interactive road user behaviors and communication cues from 19 eligible studies and categorized these into two groups: 1) the associated communication channel/mechanism (e.g., nonverbal behavior), and 2) the type of communication cue (implicit/explicit). We found the following interactive behaviors and communication cues: 1) vehicle-centric (e.g., HGV as a larger vehicle, adapting trajectory, position relative to the VRU, timing of acceleration to pass the VRU, displaying information via human-machine interface), 2) driver-centric (e.g., professional driver, present inside/outside the cabin, eye-gaze behavior), and 3) VRU-centric (e.g., racer cyclist, adapting trajectory, position relative to the HGV, proximity to other VRUs, eye-gaze behavior). These cues are predominantly based on road user trajectories and movements (i.e., kinesics/proxemics nonverbal behavior) forming implicit communication, which indicates that this is the primary mechanism for HGV-VRU interactions. However, there are also reports of more explicit cues such as cyclists waving to say thanks, the use of turning indicators, or new types of external human-machine interfaces (eHMI). Compared to corresponding scenarios with light vehicles, HGV-VRU interaction patterns are to a high extent formed by the HGV’s size, shape and weight. For example, this can cause VRUs to feel less safe, drivers to seek to avoid unnecessary decelerations and accelerations, or lead to strategic behaviors due to larger blind-spots. Based on these findings, it is likely that road user trajectories and kinematic behaviors will form the basis for communication also for highly automated HGV-VRU interaction. However, it might also be beneficial to use additional eHMI to compensate for the loss of more social driver-centric cues or to signal other types of information. While controlled experiments can be used to gather such initial insights, deeper understanding of highly automated HGV-VRU interactions will also require naturalistic studies.

Engaging in non-driving related tasks (NDRTs) while driving can be considered distracting and safety detrimental. However, with the introduction of highly automated driving systems that relieve drivers from driving, more NDRTs will be feasible. In fact, many car manufacturers emphasize that one of the main advantages with automated cars is that it “frees up time” for other activities while on the move. This paper investigates how well drivers are able to engage in an NDRT while in automated driving mode (i.e., SAE Level 4) in real traffic, via a Wizard of Oz platform. The NDRT was designed to be visually and cognitively demanding and require manual interaction. The results show that the drivers' attention to a great extent shifted from the road ahead towards the NDRT. Participants could perform the NDRT equally well as when in an office (e.g. correct answers, time to completion), showing that the performance did not deteriorate when in the automated vehicle. Yet, many participants indicated that they noted and reacted to environmental changes and sudden changes in vehicle motion. Participants were also surprised by their own ability to, with ease, disconnect from driving. The presented study extends previous research by identifying that drivers to a high extent are able to engage in a NDRT while in automated mode in real traffic. This is promising for future of automated cars ability to “free up time” and enable drivers to engage in non-driving related activities.

Background There is little research on high frequency emergency department users (HEDU) in Sweden. We aim to determine the prevalence and costs of HEDU compared to non-HEDU at Örebro University Hospital (ÖUH). Additionally, we will determine the factors and outcomes associated with being a HEDU. Methods This was a retrospective, observational cohort study of ED patients presenting to ÖUH, Sweden between 2018–19. Analyses used electronic registry, ambulance, and cost data. The definition for HEDU was ≥4 visits/year. HEDUs were categorized further into Repeat, High and Super HEDU with 4–7, 8–18 and ≥19 visits/year, respectively. We used multivariable logistic regression to determine the adjusted odds ratios for factors and outcomes between HEDU and non-HEDU. Findings Of all ÖUH ED patients, 6.1% were HEDU and accounted for 22.4% of ED visits and associated costs. Compared to the mean cost of non-HEDU, the Repeat, High and Super HEDU were more costly by factors of 4, 8 and 27, respectively. The HEDUs were more likely to be male, self-referred, present with abdominal pain, arrive by ambulance, at night and from the Örebro municipal region. Super HEDU were more likely to be of adult age and assigned lower acuity scores. HEDU were more likely to be directed to the surgical zone, less likely to receive radiologic imaging or achieve a 4-hr time target. In contrast to the Repeat and High HEDU, Super HEDU were less likely to be admitted, but more likely to leave without being seen. Conclusion ÖUH has a HEDU population with associated factors and outcomes. They account for a substantial proportion of ED costs compared to non-HEDU.

Beyond the influence of lifestyle-related risk factors for myocardial infarction (MI), the mechanisms of genetic predispositions for MI remain unclear. We sought to identify and characterize differentially expressed genes in early-onset MI in a translational approach. In an observational case–control study, transcriptomes from 112 early-onset MI individuals showed upregulated G protein-coupled receptor 15 (GPR15) expression in peripheral blood mononuclear cells compared to controls (fold change = 1.4, p = 1.87 × 10−7). GPR15 expression correlated with intima-media thickness (β = 0.8498, p = 0.111), C-reactive protein (β = 0.2238, p = 0.0052), ejection fraction (β = −0.9991, p = 0.0281) and smoking (β = 0.7259, p = 2.79 × 10−10). The relation between smoking and MI was diminished after the inclusion of GPR15 expression as mediator in mediation analysis (from 1.27 (p = 1.9 × 10−5) to 0.46 (p = 0.21)). The DNA methylation of two GPR15 sites was 1%/5% lower in early-onset MI individuals versus controls (p = 2.37 × 10−6/p = 0.0123), with site CpG3.98251219 significantly predicting risk for incident MI (hazard ratio = 0.992, p = 0.0177). The nucleotide polymorphism rs2230344 (C/T) within GPR15 was associated with early-onset MI (odds ratio = 3.61, p = 0.044). Experimental validation showed 6.3-fold increased Gpr15 expression in an ischemic mouse model (p < 0.05) and 4-fold increased Gpr15 expression in cardiomyocytes under ischemic stress (p < 0.001). After the induction of MI, Gpr15gfp/gfp mice showed lower survival (p = 0.042) and deregulated gene expression for response to hypoxia and signaling pathways. Using a translational approach, our data provide evidence that GPR15 is linked to cardiovascular diseases, mediating the adverse effects of smoking.

Patients at a high risk for sudden cardiac death (SCD) without previous history of cardiovascular disease remain a challenge to identify. Atherosclerosis and prothrombotic states involve inflammation and non-cardiac tissue damage that may play active roles in SCD development. Therefore, we hypothesized that circulating proteins implicated in inflammation and tissue damage are linked to the future risk of SCD. We conducted a prospective nested case–control study of SCD cases with verified myocardial infarction (N = 224) and matched controls without myocardial infarction (N = 224), aged 60 ± 10 years time and median time to event was 8 years. Protein concentrations (N = 122) were measured using a proximity extension immunoassay. The analyses revealed 14 proteins significantly associated with an increased risk of SCD, from which two remained significant after adjusting for smoking status, systolic blood pressure, BMI, cholesterol, and glucose levels. We identified leukotriene A4 hydrolase (LTA4H, odds ratio 1.80, corrected confidence interval (CIcorr) 1.02–3.17) and hepatocyte growth factor (HGF; odds ratio 1.81, CIcorr 1.06–3.11) as independent risk markers of SCD. Elevated LTA4H may reflect increased systemic and pulmonary neutrophilic inflammatory processes that can contribute to atherosclerotic plaque instability. Increased HGF levels are linked to obesity-related metabolic disturbances that are more prevalent in SCD cases than the controls.

Abstract Background Chronic, low-grade inflammation is an established risk factor for cardiovascular disease. The inflammatory impact of diet can be reflected by concentrations of inflammatory markers in the bloodstream and the inflammatory potential of diet can be estimated by the dietary inflammatory index (DIITM), which has been associated with cardiovascular disease risk in some previous studies. We aimed to examine the association between the DII and the risk of first myocardial infarction (MI) in a population-based study with long follow-up. Method We conducted a prospective case–control study of 1389 verified cases of first MI and 5555 matched controls nested within the population-based cohorts of the Northern Sweden Health and Disease Study (NSHDS), of which the largest is the ongoing Västerbotten Intervention Programme (VIP) with nearly 100 000 participants during the study period. Median follow-up from recruitment to MI diagnosis was 6.4 years (6.2 for men and 7.2 for women). DII scores were derived from a validated food frequency questionnaire (FFQ) administered in 1986–2006. Multivariable conditional logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI), using quartile 1 (most anti-inflammatory diet) as the reference category. For validation, general linear models were used to estimate the association between the DII scores and two inflammatory markers, high-sensitivity C-reactive protein (hsCRP) and interleukin 6 (IL-6) in a subset (n = 605) of the study population. Results Male participants with the most pro-inflammatory DII scores had an increased risk of MI [ORQ4vsQ1 = 1.57 (95% CI 1.21–2.02) P trend = 0.02], which was essentially unchanged after adjustment for potential confounders, including cardiovascular risk factors [ORQ4vsQ1 = 1.50 (95% CI 1.14–1.99), P trend = 0.10]. No association was found between DII and MI in women. An increase of one DII score unit was associated with 9% higher hsCRP (95% CI 0.03–0.14) and 6% higher IL-6 (95% CI 0.02–0.11) in 605 controls with biomarker data available. Conclusion A pro-inflammatory diet was associated with an elevated risk of first myocardial infarction in men; whereas for women the relationship was null. Consideration of the inflammatory impact of diet could improve prevention of cardiovascular disease.

Background The accumulation of myocardial triglycerides and remodeling of the left ventricle are common features in type 2 diabetes mellitus and represent potential risk factors for the development of diastolic and systolic dysfunction. A few studies have investigated the separate effects of diet and exercise training on cardiac function, but none have investigated myocardial changes in response to a combined diet and exercise intervention. This 12‐week randomized study assessed the effects of a Paleolithic diet, with and without additional supervised exercise training, on cardiac fat, structure, and function. Methods and Results Twenty‐two overweight and obese subjects with type 2 diabetes mellitus were randomized to either a Paleolithic diet and standard‐care exercise recommendations (PD) or to a Paleolithic diet plus supervised exercise training 3 hours per week (PD‐EX). This study includes secondary end points related to cardiac structure and function, ie, myocardial triglycerides levels, cardiac morphology, and strain were measured using cardiovascular magnetic resonance, including proton spectroscopy, at baseline and after 12 weeks. Both groups showed major favorable metabolic changes. The PD‐EX group showed significant decreases in myocardial triglycerides levels (−45%, P=0.038) and left ventricle mass to end‐diastolic volume ratio (−13%, P=0.008) while the left ventricle end‐diastolic volume and stroke volume increased significantly (+14%, P=0.004 and +17%, P=0.008, respectively). These variables were unchanged in the PD group. Conclusions Exercise training plus a Paleolithic diet reduced myocardial triglycerides levels and improved left ventricle remodeling in overweight/obese subjects with type 2 diabetes mellitus. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT01513798.

While traffic signals, signs, and road markings provide explicit guidelines for those operating in and around the roadways, some decisions, such as determinations of “who will go first,” are made by implicit negotiations between road users. In such situations, pedestrians are today often dependent on cues in drivers’ behavior such as eye contact, postures, and gestures. With the introduction of more automated functions and the transfer of control from the driver to the vehicle, pedestrians cannot rely on such non-verbal cues anymore. To study how the interaction between pedestrians and automated vehicles (AVs) might look like in the future, and how this might be affected if AVs were to communicate their intent to pedestrians, we designed an external vehicle interface called automated vehicle interaction principle (AVIP) that communicates vehicles’ mode and intent to pedestrians. The interaction was explored in two experiments using a Wizard of Oz approach to simulate automated driving. The first experiment was carried out at a zebra crossing and involved nine pedestrians. While it focused mainly on assessing the usability of the interface, it also revealed initial indications related to pedestrians’ emotions and perceived safety when encountering an AV with/without the interface. The second experiment was carried out in a parking lot and involved 24 pedestrians, which enabled a more detailed assessment of pedestrians’ perceived safety when encountering an AV, both with and without the interface. For comparison purposes, these pedestrians also encountered a conventional vehicle. After a short training course, the interface was deemed easy for the pedestrians to interpret. The pedestrians stated that they felt significantly less safe when they encountered the AV without the interface, compared to the conventional vehicle and the AV with the interface. This suggests that the interface could contribute to a positive experience and improved perceived safety in pedestrian encounters with AVs – something that might be important for general acceptance of AVs. As such, this topic should be further investigated in future studies involving a larger sample and more dynamic conditions.

The introduction of autonomous vehicles (autonomous vehicles) will reshape the many social interactions that are part of traffic today. In order for autonomous vehicles to become successfully integrated, the social interactions surrounding them need to be purposefully designed. To ensure success and save development efforts, design methods that explore social aspects in early design phases are needed to provide conceptual directions before committing to concrete solutions. This paper contributes an exploration of methods for addressing the social aspects of autonomous vehicles in three key areas: the vehicle as a social entity in traffic, co-experience within the vehicle and the user–vehicle relationship. The methods explored include Wizard of Oz, small-scale scenarios, design metaphors, enactment and peer-to-peer interviews. These were applied in a workshop setting with 18 participants from academia and industry. The methods provided interesting design seeds, however with differing effectiveness. The most promising methods enabled flexible idea exploration, but in a contextualized and concrete manner through tangible objects and enactment to stage future use situations. Further, combinations of methods that enable a shift between social perspectives were preferred. Wizard of Oz and small-scale scenarios were found fruitful as collaboration basis for multidisciplinary teams, by establishing a united understanding of the problem at hand.

Intelligence on mass media audiences was founded on representative statistical samples, analysed by statisticians at the market departments of media corporations. The techniques for aggregating user data in the age of pervasive and ubiquitous personal media (e.g. laptops, smartphones, credit cards/swipe cards and radio-frequency identification) build on large aggregates of information (Big Data) analysed by algorithms that transform data into commodities. While the former technologies were built on socio-economic variables such as age, gender, ethnicity, education, media preferences (i.e. categories recognisable to media users and industry representatives alike), Big Data technologies register consumer choice, geographical position, web movement, and behavioural information in technologically complex ways that for most lay people are too abstract to appreciate the full consequences of. The data mined for pattern recognition privileges relational rather than demographic qualities. We argue that the agency of interpretation at the bottom of market decisions within media companies nevertheless introduces a ‘heuristics of the algorithm’, where the data inevitably becomes translated into social categories. In the paper we argue that although the promise of algorithmically generated data is often implemented in automated systems where human agency gets increasingly distanced from the data collected (it is our technological gadgets that are being surveyed, rather than us as social beings), one can observe a felt need among media users and among industry actors to ‘translate back’ the algorithmically produced relational statistics into ‘traditional’ social parameters. The tenacious social structures within the advertising industries work against the techno-economically driven tendencies within the Big Data economy.

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) or Bland-White-Garland syndrome is a rare congenital coronary malformation, accounting for 1 of 300.000 live births and 90% mortality if untreated in infancy. However, in recent years, with the availability of newer, better imaging methods, an increasing number of cases in an older cohort have been identified.