SARS-CoV-2 uses ACE2, an inhibitor of the Renin-Angiotensin-Aldosterone System (RAAS), for cellular entry. Studies indicate that RAAS imbalance worsens the prognosis in COVID-19. We present a ...consecutive retrospective COVID-19 cohort with findings of frequent pulmonary thromboembolism (17%), high pulmonary artery pressure (60%) and lung MRI perfusion disturbances. We demonstrate, in swine, that infusing angiotensin II or blocking ACE2 induces increased pulmonary artery pressure, reduces blood oxygenation, increases coagulation, disturbs lung perfusion, induces diffuse alveolar damage, and acute tubular necrosis compared to control animals. We further demonstrate that this imbalanced state can be ameliorated by infusion of an angiotensin receptor blocker and low-molecular-weight heparin. In this work, we show that a pathophysiological state in swine induced by RAAS imbalance shares several features with the clinical COVID-19 presentation. Therefore, we propose that severe COVID-19 could partially be driven by a RAAS imbalance.
The use of 3D city models is changing from visualization to complex use cases where they act as 3D base maps. This requires links to registers and continuous updating of the city models. Still, most ...models never change or are recreated instead of updated. This study identifies obstacles to version management of 3D city models and proposes recommendations to overcome them, with a main focus on the municipality perspective, foremost in the planning and building processes. As part of this study, we investigate whether national building registers can control the version management of 3D city models. A case study based on investigations of standards, interviews and a review of tools is presented. The study uses an architectural model divided into four layers: data collection, building theme, city model and application. All layers require changes when implementing a new versioning method: the data collection layer requires restructuring of technical solutions and work processes, storage of the national building register requires restructuring, versioning capabilities must be propagated to the city model layer, and tools at the application layer must handle temporal information better. Strong incentives for including versioning in 3D city models are essential, as substantial investment is required to implement versioning in all the layers. Only capabilities required by applications should be implemented, as the complexity grows with the number of versioning functionalities. One outcome of the study is a recommendation to link 3D city models more closely to building registers. This enables more complex use in, e.g., building permits and 3D cadastres, and authorities can fetch required (versioning) information directly from the city model layer.
The integration of 3D city models with Building Information Models (BIM), coined as GeoBIM, facilitates improved data support to several applications, e.g., 3D map updates, building permits issuing, ...detailed city analysis, infrastructure design, context-based building design, to name a few. To solve the integration, several issues need to be tackled and solved, i.e., harmonization of features, interoperability, format conversions, integration of procedures. The GeoBIM benchmark 2019, funded by ISPRS and EuroSDR, evaluated the state of implementation of tools addressing some of those issues. In particular, in the part of the benchmark described in this paper, the application of georeferencing to Industry Foundation Classes (IFC) models and making consistent conversions between 3D city models and BIM are investigated, considering the OGC CityGML and buildingSMART IFC as reference standards. In the benchmark, sample datasets in the two reference standards were provided. External volunteers were asked to describe and test georeferencing procedures for IFC models and conversion tools between CityGML and IFC. From the analysis of the delivered answers and processed datasets, it was possible to notice that while there are tools and procedures available to support georeferencing and data conversion, comprehensive definition of the requirements, clear rules to perform such two tasks, as well as solid technological solutions implementing them, are still lacking in functionalities. Those specific issues can be a sensible starting point for planning the next GeoBIM integration agendas.
This study investigates two concurrent trends across Europe and North America: the increasing instability of parental unions and men’s rising contributions to household work. Because children have ...almost universally resided with their mothers and it is difficult for non-residential fathers to maintain any levels of care work, union dissolutions have potentially slowed societal increases in gender equality. A new family form—50/50 living arrangements—has begun to challenge our understanding of the consequences of union dissolution. Since 50/50 residence requires fathers to take full care responsibility for the child half of the time—something few partnered fathers do—it may even push parents into a more egalitarian division of care work. We have studied care work using Swedish administrative data on parents’ leave from work to care for a sick child. We have created a panel of leave-sharing for children aged 2–11, and use an event-study design to estimate the causal effect of dissolution on the sharing of sick-child leave. The results show that in parental unions dissolving today, the dissolution leads to an increase in fathers’ share of sick-child leave. Whereas union dissolutions have for decades been slowing the gender revolution in Sweden, they are now accelerating it.
The aim of this paper is to present a proposal for a national building standard in Sweden. We define requirements for the proposed standard, e.g., it should support development of 3D city models, ...connect to building information models (BIM) and national registers and be based on a national classification system for the urban environment. Based on these requirements we develop an Application Domain Extension (ADE) of the building model in the proposed CityGML 3.0 standard denoted CityGML Sve-Test. CityGML 3.0 includes several new features of interest, e.g., the space concept, enhanced possibilities to convert data, and to link to other standards. In our study we create test data according to CityGML Sve-Test and evaluate it against the requirements. It is shown that BIM models (in Industry Foundation Classes, IFC, format) can be converted to CityGML Sve-Test and that a classification system facilitates this conversion. The CityGML Sve-Test dataset can be used to increase the automation level in building permissions checking and a related study shows that CityGML 3.0 has capabilities to link to legal information and be a base for 3D cadastral index maps. Based on our experience, we suggest that the national building standard should conform to international standards and, if possible, include a classification system. The exchange format (GML, JSON etc.) might change, but to be based on a standardized data model ensures harmonized structures and concepts.
Interview and observational studies document that dual-caring is characterized by temporality. Two 'ideal-typical' trajectories are identified: 'halving it all' in which couples divide care equally ...on a daily or weekly basis and 'taking turns' in which parents take month- or year-long turns in serving as primary care-givers to the child. This study utilizes a new source of couple-level longitudinal information on parental leave to investigate dual-caring trajectories in contemporary Sweden. Results show that while care trajectories in which only one parent serves as the primary caregiver can be captured without longitudinal information, the dominant dual-caring trajectory cannot. In fact, despite a uniquely flexible parental leave system that allows egalitarian couples to share care on a daily basis, most couples do not share care in every point in time, but 'take turns' in serving as the primary caregiver to the child, with the mother's 'turn' preceding the father's. The results demonstrate that cross-sectional and aggregate measures of child care may fail to detect emerging trends in dual-caring.
Subspecialisation within general surgery has today reached further than ever. However, on-call time, an unchanged need for broad surgical skills are required to meet the demands of acute surgical ...disease and trauma. The introduction of a new subspecialty in North America that deals solely with acute care surgery and trauma is an attempt to offer properly trained surgeons also during on-call time. To find out whether such a subspecialty could be helpful in Sweden we analyzed our workload for emergency surgery and trauma.
Linköping University Hospital serves a population of 257 000. Data from 2010 for all patients, diagnoses, times and types of operations, surgeons involved, duration of stay, types of injury and deaths regarding emergency procedures were extracted from a prospectively-collected database and analyzed.
There were 2362 admissions, 1559 emergency interventions; 835 were mainly abdominal operations, and 724 diagnostic or therapeutic endoscopies. Of the 1559 emergency interventions, 641 (41.1%) were made outside office hours, and of 453 minor or intermediate procedures (including appendicectomy, cholecystectomy, or proctological procedures) 276 (60.9%) were done during the evenings or at night. Two hundred and fifty-four patients were admitted with trauma and 29 (11.4%) required operation, of whom general surgeons operated on eight (3.1%). Thirteen consultants and 11 senior registrars were involved in 138 bowel resections and 164 cholecystectomies chosen as index operations for standard emergency surgery. The median (range) number of such operations done by each consultant was 6 (3-17) and 6 (1-22). Corresponding figures for senior registrars were 7 (0-11) and 8 (1-39).
There was an uneven distribution of exposure to acute surgical problems and trauma among general surgeons. Some were exposed to only a few standard emergency interventions and most surgeons did not operate on a single patient with trauma. Further centralization of trauma care, long-term positions at units for emergency surgery and trauma, and subspecialisation in the fields of emergency surgery and trauma, might be options to solve problems of low volumes.
Tyrosine hydroxylase is the rate-limiting enzyme of catecholamine biosynthesis that catalyzes the conversion of L-tyrosine to L-3,4-dihydroxyphenylalanine. The tyrosine hydroxylase gene is regulated ...by extracellular signaling molecules such as epidermal growth factor, nerve growth factor and steroids. Here, we investigated whether the activity of the tyrosine hydroxylase gene promoter is upregulated by activation of G protein-coupled receptors, the largest group of plasma membrane receptors. We used catecholaminergic neuroblastoma cells as a cellular model and chromatin-integrated tyrosine hydroxylase promoter-luciferase reporter genes. The results show that stimulation of Rαq, a Gαq-coupled designer receptor, triggered transcription of a reporter gene driven by the tyrosine hydroxylase promoter. Transcription was attenuated by overexpression of regulator of G-protein signaling-2, which activates the GTPase activity of the G protein α-subunit, and by a truncated, dominant-negative mutant of phospholipase Cβ3. Extracellular signal-regulated protein kinase was identified as the signal transducer. At the transcriptional level, tyrosine hydroxylase promoter activity was found to be controlled by the transcription factor CREB. Expression experiments with the adenoviral regulator protein E1A, an inhibitor of CBP/p300 histone acetyltransferases, showed that transcription of the reporter gene controlled by the tyrosine hydroxylase is under epigenetic control. We identified the protein phosphatases MAP kinase phosphatase-1 and calcineurin as part of a shutdown device of the signaling cascade linking Rαq designer receptor activation to tyrosine hydroxylase gene transcription. We conclude that tyrosine hydroxylase promoter activity is controlled by Gαq-coupled receptors.
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•Stimulation of a Gαq-coupled designer receptor activates the tyrosine hydroxylase promoter.•Gαq, PLCβ, and ERK1/2 connect receptor stimulation with the tyrosine hydroxylase gene promoter.•MKP-1 and calcineurin function as a negative feedback loop.•The transcription factor CREB is required for activating the tyrosine hydroxylase gene promoter.•E1A blocks tyrosine hydroxylase promoter activation after stimulation of Gαq-coupled receptors.
Educational gradients in parental leave length are opposite for women and men: highly educated women return to work faster than those with low education while highly educated men are absent longer ...than less educated men. Explanations for the opposite gradients are typically made at the individual- or couple-level. To date, no quantitative study has documented whether the opposite educational gradients hold also within workplaces. In this study, we use employer–employee matched Swedish register data with fixed-effects models to examine whether the educational gradient applies also among co-workers in the same workplace. The results show that three-quarters of the educational effect typically attributed to the individual father disappeared when comparing fathers within workplaces. The educational gradient of mothers remained largely unchanged. These findings provide the first population-level evidence for the primacy of the workplace in determining fathers’ care choices.
Version management is a prerequisite for digital information flow between phases in the planning and building processes. Information evolves over time and many parties retrieve information from the ...various phases. The aim of this article is to evaluate versioning methods, focusing on geodata buildings in the 3D cadastre process. The main attention in the evaluation is on the comprehensive ISO standard Product Lifecycle Support (PLCS). PLCS is evaluated against two simpler versioning methods, the versioning in CityGML 3.0 and a modified Git versioning method implemented in CityJSON. CityGML 3.0 fulfils all but one requirement and PLCS meets all. The methods vary in complexity; the Git proposal is a simple solution, easy to implement and maintain, while PLCS includes all functionalities and is complex to implement. There is a trade‐off between number of functionalities and complexity, it is therefore important that the intended purpose determines the choice of versioning method.
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