Search

Vocational Rehabilitation (VR) is a multidisciplinary health and social services process where patients are supported to permanently enter or re-enter the workforce. The aim of this retrospective cohort study spanning the last two decades was to investigate prolonged success after personalised VR and to identify aspects of VR that could be influenced to improve prolonged success. Former patients of an interdisciplinary VR centre in Iceland were surveyed and, using logistic regression, their responses were modelled with respect to socioeconomic information and descriptions of their progression and experience during the VR obtained by rigorous scientific methodology. Several aspects were found that could be influenced to increase the probability of prolonged success. These relate to three main areas; financial security, social skills and mental status as well as the importance of time and support during the transition from VR to work or education. This was independent of age and gender. Personalised VR is a cornerstone of successful VR.

BACKGROUND Every year, millions of children undergo medical procedures that require anesthesia. Fear and anxiety are common among young children undergoing such procedures and can interfere with the child’s recovery and well-being. Relaxation, distraction, and education are methods that can be used to prepare children and help them cope with fear and anxiety, and serious games may be a suitable medium for these purposes. User-centered design emphasizes the involvement of end users during the development and testing of products, but involving young, preschool children may be challenging. OBJECTIVE One objective of this study was to describe the development and usability of a computer-based educational health game intended for preschool children to prepare them for upcoming anesthesia. A further objective was to describe the lessons learned from using a child-centered approach with the young target group. METHODS A formative mixed methods child (user)-centered study design was used to develop and test the usability of the game. Preschool children (4-6 years old) informed the game design through playful workshops (n=26), and usability testing was conducted through game-playing and interviews (n=16). Data were collected in Iceland and Finland with video-recorded direct observation and interviews, as well as children’s drawings, and analyzed with content analysis and descriptive statistics. RESULTS The children shared their knowledge and ideas about hospitals, different emotions, and their preferences concerning game elements. Testing revealed the high usability of the game and provided important information that was used to modify the game before publishing and that will be used in its further development. CONCLUSIONS Preschool children can inform game design through playful workshops about health-related subjects that they are not necessarily familiar with but that are relevant for them. The game’s usability was improved with the participation of the target group, and the game is now ready for clinical testing.

Demand for Vocational Rehabilitation in Iceland has been steadily rising in recent years where the presence of young patients has increased proportionally the most. It is essential that public spending is efficient without compromising the treatment quality. It is worth exploring if a solution for increasing the efficiency in this healthcare section is to use Artificial Intelligence (AI). An innovative project on developing, testing, and implementing specialised AI software in its services is being performed in Janus Rehabilitation. The software, named Volvan in Icelandic, can identify latent areas of possible interest in patient's circumstances which might affect the outcome of their treatment, and assist specialists in providing timely and appropriate interventions. The accuracy, precision, and recall of its predictions have been verified in two recent publications. Volvan seems to be a promising tool for individualised rehabilitation, where patients are dealing with difficult and complex problems. Janus Rehabilitation is in the process of launching Volvan as an unbiased member of the interdisciplinary teams of specialists. The aim of this report is to introduce Volvan and the associated research.

Regular bathing in the Blue Lagoon has beneficial effects on psoriasis. Previously, we showed that exopolysaccharides (EPS-Ca) secreted by Cyanobacterium aponinum, a dominating organism in the Blue Lagoon, increased IL-10 secretion by human dendritic cells (DCs). In addition, co-culturing allogeneic CD4+ T cells with DCs matured in the presence of EPS-Ca increased differentiation of T cells into T regulatory cells at the cost of the disease inducing Th17 cells. In the present study, EPS-Ca increased the proportion of DCs expressing CD141, a surface molecule linked to regulatory DCs, and the CD141+ cells secreted more IL-10 than the CD141- cells. EPS-Ca decreased T cell secretion of IL-17, IL-13 and IL-10 and the proportion of T cells expressing the activation marker CD69 that has also been linked to lymphocyte retention. In addition, EPS-Ca reduced keratinocyte secretion of CCL20 and CXCL10, chemokines implicated in recruitment of inflammatory cells. EPS-Ca decreased DC expression of Dectin-1/CLEC7A and SYK, keratinocyte expression of CLEC7A, SYK and CAMP (the gene for LL37), and T cell expression of phosphorylated Zap70. These results indicate that EPS-Ca may induce a regulatory phenotype of DCs, T cells that are less active/inflammatory and less prone to being retained in the skin, and keratinocytes that induce less recruitment of inflammatory cells to the skin and that these effects may be mediated by the effects of EPS-Ca on CLEC7A and SYK. Overall the results indicate that EPS-Ca may be involved in the beneficial effects psoriasis patients experience when bathing in the Blue Lagoon.

Southern Westfjords of Iceland is a sparsely populated, remote area with rather high proportion of older residents. This study´s aim was to investigate activities and participation in this population, using a descriptive cross-sectional population-based design. The participants were 129 community-dwelling residents, 65–91 years old. The Late Life Function and Disability Instrument was used to measure participants’ activities and participation. It provides interval scale scores where a higher score means less difficulties in activities, more frequent participation, and fewer participation restrictions. Participants had most difficulties in Advanced Lower Extremity functioning and least in Upper Extremity functioning and scored lower on participation frequency than participation restriction. Overall, men reported fewer difficulties in activities than women and the 65–74 years group fewer difficulties than the 75–91 years group. Frequency of participation was higher for women than men and higher for the younger group than the older one who also experienced their participation to be more limited, but men and women did not differ. The participants described barriers limiting their participation in self-care and social life. The results provide valuable information on activities and participation of older residents living rurally and have practical implications for community services in remote arctic areas.

The Blue Lagoon is a geothermal aquifer with a diverse ecosystem located within the Reykjanes UNESCO Global Geopark on Iceland's Reykjanes Peninsula. Blue Lagoon Ltd., which exploits the aquifer, isolated a strain of coccoid cyanobacteria Cyanobacterium aponinum (C. aponinum) from the geothermal fluid of the Blue Lagoon more than two decades ago. Since then Blue Lagoon Ltd. has cultivated it in a photobioreactor, for use as an active ingredient in its skin care products. Until recently, the cultivation of C. aponinum was achieved by feeding it on 99.99% (4N) bottled carbon dioxide (CO2). In this investigation, C. aponinum was cultivated using unmodified, non-condensable geothermal gas (geogas) emitted from a nearby geothermal powerplant as the feed-gas instead of the 4N-gas. The geogas contains roughly 90% vol CO2 and 2% vol hydrogen sulfide (H2S). A comparison of both CO2 sources was made. It was observed that the use of geogas did enhance the conversion efficiency. A 13 weeks' average CO2 conversion efficiency of C. aponinum was 43% and 31% when fed on geogas and 4N-gas, respectively. Despite the high H2S concentration in the geogas, sulfur accumulation in the cultivated biomass was similar for both gas sources. Our results provide a model of a CO2 sequestration by photosynthetic conversion of otherwise unused geothermal emission gas into biomass.

Demand for Vocational Rehabilitation in Iceland has been steadily rising in recent years where the presence of young patients has increased proportionally the most. It is essential that public spending is efficient without compromising the treatment quality. It is worth exploring if a solution for increasing the efficiency in this healthcare section is to use Artificial Intelligence (AI). An innovative project on developing, testing, and implementing specialised AI software in its services is being performed in Janus Rehabilitation. The software, named Völvan in Icelandic, can identify latent areas of possible interest in patient's circumstances which might affect the outcome of their treatment, and assist specialists in providing timely and appropriate interventions. The accuracy, precision, and recall of its predictions have been verified in two recent publications. Völvan seems to be a promising tool for individualised rehabilitation, where patients are dealing with difficult and complex problems. Janus Rehabilitation is in the process of launching Völvan as an unbiased member of the interdisciplinary teams of specialists. The aim of this report is to introduce Völvan and the associated research.

BACKGROUND Information regarding the determinants of successful vocational rehabilitation (VR) is scarce. OBJECTIVE Investigate whether sex, duration, quality of life and financial circumstances influence the success of VR. METHODS The study group consisted of 519 participants (293 women, 56%), who finished VR in the period 2000-2014. The group was divided into the following subgroups: dropouts, unsuccessful and successful VR. Data were collected by questionnaire. RESULTS Income had the most impact on whether the outcome was successful. Having supplemental income when entering the VR program increased the likelihood of a successful conclusion, odds ratio (OR) 5.60 (95% CI; 2.43-13.59) (p

Adaptive systems will become increasingly important for health care in coming years as costs and workload grow. The need for efficient rehabilitation will expand which will be fulfilled by information technologies. This paper presents a novel implementation and application of a dynamic prediction software in vocational rehabilitation. The software is made adaptable with a Genetic Improvement of software methodology and utilised to predict fluctuations in patient's perceived quality of life. Results of accuracy, recall and precision were better than 90% for the classification of the shifts and the mean absolute error in predictions of the quantity of the shifts was low. The findings of the present study support that it is possible to predict fluctuations in quality of life on average based on the status six months prior. Professionals could therefore intervene accordingly and increase the possibility of successful rehabilitation. The significant long term effect on health care from applying the prediction tool might be reduced cost and overall improved quality of life.

With the expanding load on healthcare and consequent strain on budget, the demand for tools to increase efficiency in treatments is rising. The use of prediction models throughout the treatment to identify risk factors might be a solution. In this paper we present a novel implementation of a prediction tool and the first use of a dynamic predictor in vocational rehabilitation practice. The tool is periodically updated and improved with Genetic Improvement of software. The predictor has been in use for 10 months and is evaluated on predictions made during that time by comparing them with actual treatment outcome. The results show that the predictions have been consistently accurate throughout the patients' treatment. After approximately 3 week learning phase, the predictor classified patients with 100% accuracy and precision on previously unseen data. The predictor is currently being successfully used in a complex live system where specialists have used it to make informed decisions.

Silica, precipitated out of geothermal fluid discharged from a geothermal powerplant in Svartsengi on the Reykjanes peninsula in Iceland, was used as a chromatographic adsorbent to extract blue colored protein, C-phycocyanin, from coccoid blue-green algae. The only supplement used was salt obtained by evaporating the geothermal fluid. Analysis of the silica, using scanning electron microscopy, X-ray diffractometry and Brunauer–Emmett–Teller (BET) adsorption confirmed it has a high specific surface area and is amorphous. Upon adsorption and subsequent elution the purity of the extracted protein, measured as the ratio of the light absorbance of 620 and 280 nm, increased from 0.5 to above 2.0. Our results could facilitate utilization of a mostly unused byproduct of geothermal powerplants as chromatographic material.

Publisher's version (útgefin grein). Supplementary information accompanies this paper at https://doi.org/10.1038/s41598-018-37522-6., The MITF transcription factor is a master regulator of melanocyte development and a critical factor in melanomagenesis. The related transcription factors TFEB and TFE3 regulate lysosomal activity and autophagy processes known to be important in melanoma. Here we show that MITF binds the CLEARbox element in the promoters of lysosomal and autophagosomal genes in melanocytes and melanoma cells. The crystal structure of MITF bound to the CLEAR-box reveals how the palindromic nature of this motif induces symmetric MITF homodimer binding. In metastatic melanoma tumors and cell lines, MITF positively correlates with the expression of lysosomal and autophagosomal genes, which, interestingly, are diferent from the lysosomal and autophagosomal genes correlated with TFEB and TFE3. Depletion of MITF in melanoma cells and melanocytes attenuates the response to starvation-induced autophagy, whereas the overexpression of MITF in melanoma cells increases the number of autophagosomes but is not sufcient to induce autophagic fux. Our results suggest that MITF and the related factors TFEB and TFE3 have separate roles in regulating a starvation-induced autophagy response in melanoma. Understanding the normal and pathophysiological roles of MITF and related transcription factors may provide important clinical insights into melanoma therapy., Tis work was supported by a grant of excellence from the Research Fund of Iceland (no 152715) to E.S., M.H.O. and V.T., a Rannís/Marie Curie START Postdoctoral grant to M.H.O. (no 120457041), grant from Eggertssjodur to M.H.O., PhD student grant from the University of Iceland Eimskip Fund to R.D., a United States National Institutes of Health grant (no U24CA143835) to V.T. We acknowledge the European Synchrotron Radiation Facility, Grenoble, France, for provision of synchrotron radiation facilities and we would like to thank Matthew Bowler for assistance in using beamline MASSIF-1. We thank the Sample Preparation and Characterization (SPC) facility at the EMBL Hamburg Unit, Hamburg, Germany, for technical support. We thank Jan Perthold for technical assistance. We acknowledge Melissa Harris for critical reading of a previous version of the manuscript and the Nordic Autophagy Society for supporting collaboration with A.S. and C.B.

Bathing in the Blue Lagoon, a specific geothermal biotope in Iceland has been known for many years to be beneficial for human skin in general and for patients with psoriasis and atopic dermatitis in particular. The scientific rationale for this empirical observation, however has remained elusive. We now report that extracts prepared from silica mud and two different microalgae species derived from the Blue Lagoon are capable of inducing involucrin, loricrin, transglutaminase-1 and filaggrin gene expression in primary human epidermal keratinocytes. The same extracts also affects primary human dermal fibroblasts, because extracts from silica mud and one type of algae inhibited UVA radiation-induced upregulation of matrix metalloproteinase-1 expression and both algae, as well as silica mud extracts induced collagen 1A1 and 1A2 gene expression in this cell type. These effects were not restricted to the in vitro situation because topical treatment of healthy human skin (n = 20) with a galenic formulation containing all three extracts induced identical gene regulatory effects in vivo, which were associated with a significant reduction of transepidermal water loss. In aggregate, these results suggest that the bioactives in Blue Lagoon have the capacity to improve skin barrier function and to prevent premature skin ageing. These observations explain at least some of the beneficial effects of bathing in the Blue Lagoon and provide a scientific basis for the use of Blue Lagoon extracts in cosmetic and/or medical products.

Regular bathing in the Blue Lagoon in Iceland has beneficial effects on psoriasis. Cyanobacterium aponinum is a dominating member of the Blue Lagoon's microbial ecosystem. The aim of the study was to determine whether exopolysaccharides (EPSs) secreted by C. aponinum (EPS-Ca) had immunomodulatory effects in vitro. Human monocyte-derived dendritic cells (DCs) were matured in the absence or presence of EPS-Ca and the effects were determined by measuring the secretion of cytokines by ELISA and the expression of surface molecules by flow cytometry. DCs matured with EPS-Ca at 100 μg/ml secreted higher levels of IL-10 than untreated DCs. Subsequently, DCs matured in the presence or absence of EPS-Ca were co-cultured with allogeneic CD4(+) T cells and their effects on T cell activation analysed by measuring expression of intracellular and surface molecules and cytokine secretion. Supernatant from allogeneic T cells co-cultured with EPS-Ca-exposed DCs had raised levels of IL-10 compared with control. A reduced frequency of IL-17(+)RORγt(+) T cells was observed when co-cultured with EPS-Ca-exposed DCs and a tendency towards increased frequency of FoxP3(+)IL-10(+) T cells, resulting in a lower IL-17(+)RORγt(+)/FoxP3(+)IL-10(+) ratio. The study shows that EPSs secreted by C. aponinum stimulate DCs to produce vast amounts of the immunosuppressive cytokine IL-10. These DCs induce differentiation of allogeneic CD4(+) T cells with an increased Treg but decreased Th17 phenotype. These data suggest that EPSs from C. aponinum may play a role in the beneficial clinical effect on psoriasis following bathing in the Blue Lagoon.

Autophagy is considered a therapeutic target in various cancer types, including melanoma. The transcription factors TFEB and TFE3 have been shown to play a key role in autophagy regulation in various cell types by affecting gene expression required for this process. A close relative to these factors is the transcription factor MITF; often termed the master regulator of melanocyte development and function. MITF activity has also been shown to be important for various stages of melanoma formation and progression. Analysis of The Cancer Genome Atlas expression data from melanoma tumors reveals that MITF expression correlates with lysosomal and autophagy gene expression in metastatic tumors. Furthermore, analysis of expression data from 23 melanoma cell lines shows that MITF expression correlates with lysosomal and autophagy gene expression, and the analysis of available MITF ChIP sequencing data shows that MITF binds the promoters of lysosomal and autophagy genes. This binding was experimentally verified by ChIP experiments in 501Mel melanoma cells. MITF over-expression and knock down experiments show effects of MITF on lysosomal and autophagy gene expression, as well as an effect on the autophagy activity. Autophagy is high in melanoma and has been linked to tolerance against cancer treatment. We have found that MITF regulates autophagy genes and activity in melanoma cell lines. In light of both MITF and autophagy being considered a therapeutic target in melanoma, this relationship needs to be taken into consideration. Citation Format: Katrin Moller, Sara Sigurbjornsdottir, Remina Dilixiati, Solveig H. Brynjolfsdottir, Lionel Larue, Vesteinn Thorsson, Eirikur Steingrimsson, Margret H. Ogmundsdottir. The role of the microphthalmia associated transcription factor in autophagy regulation in melanoma. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 224.

Den här uppsatsen handlar om hur ett litet telekomföretag ska kunna nå långsiktig överlevnad på en konkurrensutsatt marknad. I bakgrunden framgår att det är svårt för små företag att klara sig på en konkurrensutsatt marknad då de inte har samma förutsättningar som stora företag att konkurrera med exempelvis pris. De små operatörerna måste därför erbjuda någonting annat som är värdeskapande för att långsiktigt kunna överleva på marknaden. Uppsatsens syfte är att genom en enkätstudie hos 26 företagskunder analysera och utvärdera telekomföretagens behov av värdeskapande på den mobila bredbandsmarknaden. De teorier som uppsatsen behandlar är involveringsteorin, värdekedja respektive värdestjärna, mervärdeskapande samt nätverkssynsättet. I analysen och resultatet har författarna kommit fram till att utrymmet för nya operatörer på den mogna marknaden inte är speciellt stort och för att den lilla operatören ska överleva måste denne först och främst satsa på värdeskapande i form av produktkvalitet och rikta sig mot höginvolverade mellanstora företagskunder. Den nya operatören bör även erbjuda anpassade företagslösningar och närmare samarbete för att möta kundens önskemål och nå långsiktig överlevnad.

With reference to the traditional use of Cetraria islandica (Iceland moss) for relief of gastric and duodenal ulcer, plant extracts were screened for in vitro activity against Helicobacter pylori. (+)-Protolichesterinic acid, an aliphatic alpha-methylene-gamma-lactone, was identified as an active component. The MIC range of protolichesterinic acid, in free as well as salt form, was 16 to 64 micrograms/ml.