Background
Several studies have recently addressed factors associated with severe Coronavirus disease 2019 (COVID‐19); however, some medications and comorbidities have yet to be evaluated in a large ...matched cohort. We therefore explored the role of relevant comorbidities and medications in relation to the risk of intensive care unit (ICU) admission and mortality.
Methods
All ICU COVID‐19 patients in Sweden until 27 May 2020 were matched to population controls on age and gender to assess the risk of ICU admission. Cases were identified, comorbidities and medications were retrieved from high‐quality registries. Three conditional logistic regression models were used for risk of ICU admission and three Cox proportional hazards models for risk of ICU mortality, one with comorbidities, one with medications and finally with both models combined, respectively.
Results
We included 1981 patients and 7924 controls. Hypertension, type 2 diabetes mellitus, chronic renal failure, asthma, obesity, being a solid organ transplant recipient and immunosuppressant medications were independent risk factors of ICU admission and oral anticoagulants were protective. Stroke, asthma, chronic obstructive pulmonary disease and treatment with renin‐angiotensin‐aldosterone inhibitors (RAASi) were independent risk factors of ICU mortality in the pre‐specified primary analyses; treatment with statins was protective. However, after adjusting for the use of continuous renal replacement therapy, RAASi were no longer an independent risk factor.
Conclusion
In our cohort oral anticoagulants were protective of ICU admission and statins was protective of ICU death. Several comorbidities and ongoing RAASi treatment were independent risk factors of ICU admission and ICU mortality.
Background
During the pandemic, increased numbers of patients requiring intensive care unit (ICU) admission required an increase in ICU capacity, including ICU staffing with competence to care for ...critically ill patients. Consequently, nurses from acute care areas were called in to staff the ICU along with experienced intensive care nurses.
Aims and objectives
To describe Swedish registered nurses' experiences of caring for patients with COVID‐19 in ICUs during the pandemic.
Design
Mixed method survey design.
Methods
An online questionnaire was distributed through social media to registered nurses who had been working in the ICU during the COVID‐19 outbreak. Data were collected for 1 week (May 2020) and analysed using content analysis and descriptive statistics.
Results
Of the 282 nurses who participated, the majority were ICU nurses (n = 151; 54%). Half of the nurses specialized in ICU reported that they were responsible for the ICU care of three or more patients during the pandemic (n = 75; 50%). Among non‐intensive care nurses, only 19% received introduction to the COVID‐19 ICU (n = 26). The analysis of data regarding nurses' experiences resulted in three categories: tumbling into chaos, diminished nursing care, and transition into pandemic ICU care. Participants described how patient safety and care quality were compromised, and that nursing care was severely deprioritized during the pandemic. The situation of not being able to provide nursing care resulted in ethical stress. Furthermore, an increased workload and worsened work environment affected nurses' health and well‐being.
Conclusions
The findings from the present study indicate that nurses perceived that patient safety and quality of care were compromised during the pandemic. This resulted in ethical stress among nurses, which may have affected their physical and psychosocial well‐being.
Relevance to clinical practice
The COVID‐19 pandemic had a severe impact on nurses' work environment, which could result in burnout and staff turnover.
We report three experiments investigating the boundaries of the Foreign Language effect in decision making (examining both risk aversion and moral dilemmas), when the foreign language is culturally ...influential, or when there is high linguistic similarity between the native language and the foreign language. Specifically, we found no Foreign Language effect in the Asian disease problem (Experiment 1a) or the footbridge moral dilemma (Experiment 2a) in Swedish-English bilinguals, but did find a Foreign Language effect for both these tasks in Swedish-French bilinguals (Experiments 1b and 2b). Additionally, we found no Foreign Language effect for moral dilemmas when the language pair was linguistically similar by testing Swedish-Norwegian and Norwegian-Swedish bilinguals (Experiment 3). These results indicate possible boundaries to the Foreign Language effect in decision making and propose that factors such as cultural influence and linguistic similarity diminish the Foreign Language effect.
Background
The remaining symptoms in patients with coronavirus disease 2019 (COVID‐19) treated in intensive care unit are limited described. Therefore, we assessed patient's perception of their ...COVID‐19 disease, stay in intensive care, and remaining symptoms three to six months after intensive care.
Methods
Prospective cohort study was performed in one intensive care unit of a university hospital in Sweden during the first wave. A questionnaire with open‐ended questions and closed‐ended questions was used. Data were analyzed using qualitative and quantitative content analysis and descriptive statistics.
Results
Out of 123 patients treated for COVID‐19, 64 answered the questionnaire 3–6 months after discharge from intensive care. Memories from illness and hospital stay revealed in three categories; awareness of the illness, losing anchor to reality and being cared for in a dynamic environment. Information was perceived as spare by 48% and they wanted the information to be more personal. The diary was perceived as personal and was received by 33% patients. The relationship with family was affected among 39% and 13% of the patients indicated that they had not resumed their daily life. A large amount, 84%, indicated that they had remaining symptoms from COVID‐19. The dominated symptoms were impaired strength and energy both physically and mentally.
Conclusion
Patients reported a variety of physical and mental symptoms, and revealed memories from the ICU, and specific awareness of other patients’ health. It illustrates the need for screening patients for remaining symptoms after COVID‐19 disease and ICU care and may affect resuming patients’ daily life.
Learning new information constitutes a fundamental part of children's school years. Reently, studies have found beneficial effects of emotion on learning and memory. Here, we specifically examined ...the effect of positive emotional prosody on content learning in two groups of Swedish school children (ages 8–10 and 11–13 years). The participants listened to auditory information spoken in a positive or neutral tone of voice and were asked content‐based questions about the information. For the younger children, no difference was found between the number of correct answers to the questions for the positive compared to the neutral tone of voice. The older children, however, had significantly more correct answers in the positive compared to the neutral condition, suggesting that positive emotional prosody can have beneficial effects on content learning, at least in older children. These results may have implications for educational psychology, and the development of Information and Communication Technology.
There were no other statistical differences between patients who showed CKD progression compared to those that did not with regards to basic demographics, comorbid disease or ICU admission ...characteristics (Table 1). ...critical COVID-19 goes with progression of chronic kidney disease in a substantial number of patients. The study was funded by the SciLifeLab/KAW national COVID-19 research program Project Grant to MH (KAW 2020.0182), Swedish Society of Medicine to MH (SLS-938101), and the Swedish Research Council to RF (2014-02569 and 2014-07606). Rights and permissions Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.
Memories become labile when recalled. In humans and rodents alike, reactivated fear memories can be attenuated by disrupting reconsolidation with extinction training. Using functional brain imaging, ...we found that, after a conditioned fear memory was formed, reactivation and reconsolidation left a memory trace in the basolateral amygdala that predicted subsequent fear expression and was tightly coupled to activity in the fear circuit of the brain. In contrast, reactivation followed by disrupted reconsolidation suppressed fear, abolished the memory trace, and attenuated fear-circuit connectivity. Thus, as previously demonstrated in rodents, fear memory suppression resulting from behavioral disruption of reconsolidation is amygdala-dependent also in humans, which supports an evolutionarily conserved memory-update mechanism.
Background Asthma is characterized by increased airway narrowing in response to nonspecific stimuli. The disorder is influenced by both environmental and genetic factors. Exosomes are nanosized ...vesicles of endosomal origin released from inflammatory and epithelial cells that have been implicated in asthma. In this study we characterized the microRNA (miRNA) content of exosomes in healthy control subjects and patients with mild intermittent asthma both at unprovoked baseline and in response to environmental challenge. Objective To investigate alterations in bronchoalveolar lavage fluid (BALF) exosomal miRNA profiles due to asthma, and following subway air exposure. Methods Exosomes were isolated from BALF from healthy control subjects (n = 10) and patients with mild intermittent asthma (n = 10) after subway and control exposures. Exosomal RNA was analyzed by using microarrays containing probes for 894 human miRNAs, and selected findings were validated with quantitative RT-PCR. Results were analyzed by using multivariate modeling. Results The presence of miRNAs was confirmed in exosomes from BALF of both asthmatic patients and healthy control subjects. Significant differences in BALF exosomal miRNA was detected for 24 miRNAs with a subset of 16 miRNAs, including members of the let-7 and miRNA-200 families, providing robust classification of patients with mild nonsymptomatic asthma from healthy subjects with 72% cross-validated predictive power (Q2 = 0.72). In contrast, subway exposure did not cause any significant alterations in miRNA profiles. Conclusion These studies demonstrate substantial differences in exosomal miRNA profiles between healthy subjects and patients with unprovoked, mild, stable asthma. These changes might be important in the inflammatory response leading to bronchial hyperresponsiveness and asthma.
•The ILF is an important occipital-temporal pathway, but its organisation is poorly understood.•The ILF subcomponents were determined based on a white matter dissection of 14 human hemispheres.•ILF ...connectivity was investigated in 24 healthy volunteers using DTT.•Three segments compose the main ILF stem via a specific pattern of connectivity.•The ILF may play a central role within the networks that consolidate visual memory.
The inferior longitudinal fascicle (ILF) is one of the major occipital-temporal association pathways. Several studies have mapped its hierarchical segmentation to specific functions. There is, however, no consensus regarding a detailed description of ILF fibre organisation. The aim of this study was to establish whether the ILF has a constant number of subcomponents. A secondary aim was to determine the quantitative diffusion proprieties of each subcomponent and assess their anatomical trajectories and connectivity patterns.
A white matter dissection of 14 post-mortem normal human hemispheres was conducted to define the course of the ILF and its subcomponents. These anatomical results were then investigated in 24 right-handed, healthy volunteers using in vivo diffusion tensor imaging (DTI) and streamline tractography. Fractional anisotropy (FA), volume, fibre length and the symmetry coefficient of each fibre group were analysed. In order to show the connectivity pattern of the ILF, we also conducted an analysis of the cortical terminations of each segment. We confirmed that the main structure of the ILF is composed of three constant components reflecting the occipital terminations: the fusiform, the lingual and the dorsolateral-occipital. ILF volume was significantly lateralised to the right. The examined indices of ILF subcomponents did not show any significant difference in lateralisation.
The connectivity pattern and the quantitative distribution of ILF subcomponents suggest a pivotal role for this bundle in integrating information from highly specialised modular visual areas with activity in anterior temporal territory, which has been previously shown to be important for memory and emotions.
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