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Leif Pagrotsky on the Swedish Economy

Question: What makes the Swedish economy unique?

Pagrotsky:    Sweden is a small, very open economy.  We have about 9 million inhabitants and we have a tradition of very open borders, sharing world trade with others and pursuing very open trade policies.  We’re members of the European Union and we use our membership to promote open borders and free trade, whereas sometimes there are strong protectionist pressures also in the European Union.  We have been able to cope with globalization in spite of our open borders or perhaps because of it, because we have policies that are designed to make change easier, to promote flexibility, and that means that we have been able to combine the past decades of rapid explosion of international trade with strong employment, rising [real] wages and growing surpluses on the current [account]. 

Question: Which schools of thought inspired the Swedish model?

Pagrotsky:    Well, you can see it two ways.  One is it was gradually developed since the early ‘30s, when Keynesianism was adopted in my country even before Keynes published his General Theory.  The Finance Minister and the top economists in the Stockholm School, Gunnar Myrdal, Bertil Ohlin, [IB] and a few others were highly involved in the international economic policy debate, and they applied Keynesianism before he published General Theory.  And then, gradually, that was expanded through social benefits and all kinds of things, but you can also trace the roots further.  There is a very strong tradition in Sweden of solidarity, of individuals not being left alone, of priority given to taking care of each other, if you wish, and that meant that those policies were well imbedded in temperament, in culture and traditions, and we built upon something that was normally natural in the Swedish sentiment.  It was not something alien that was planted into the country, so I think that is part of the explanation why parties that advocated more American style policies never succeeded in getting any votes, getting many votes in my country.  And now, when we had a change of government two years ago, on a platform that actually meant lower taxes, lower benefits, a retreat in government ambitions, that could only be elected by using a vocabulary and a rhetoric that had the opposite element saying this is a way to improve the public sector.  This is a way to expand.  This is a way to produce more security and more jobs.  It was not a way to use the American model as an argument.

Leif Pagrotsky and the lure of a Scandinavian welfare state.

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A new hydrogel might be strong enough for knee replacements

Duke University researchers might have solved a half-century old problem.

Photo by Alexander Hassenstein/Getty Images
Technology & Innovation
  • Duke University researchers created a hydrogel that appears to be as strong and flexible as human cartilage.
  • The blend of three polymers provides enough flexibility and durability to mimic the knee.
  • The next step is to test this hydrogel in sheep; human use can take at least three years.
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Physicists have understood at least theoretically, that there may be higher dimensions, besides our normal three. The first clue came in 1905 when Einstein developed his theory of special relativity. Of course, by dimensions we’re talking about length, width, and height. Generally speaking, when we talk about a fourth dimension, it’s considered space-time. But here, physicists mean a spatial dimension beyond the normal three, not a parallel universe, as such dimensions are mistaken for in popular sci-fi shows.

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Predicting PTSD symptoms becomes possible with a new test

An algorithm may allow doctors to assess PTSD candidates for early intervention after traumatic ER visits.

Image source: camillo jimenez/Unsplash
Technology & Innovation
  • 10-15% of people visiting emergency rooms eventually develop symptoms of long-lasting PTSD.
  • Early treatment is available but there's been no way to tell who needs it.
  • Using clinical data already being collected, machine learning can identify who's at risk.

The psychological scars a traumatic experience can leave behind may have a more profound effect on a person than the original traumatic experience. Long after an acute emergency is resolved, victims of post-traumatic stress disorder (PTSD) continue to suffer its consequences.

In the U.S. some 30 million patients are annually treated in emergency departments (EDs) for a range of traumatic injuries. Add to that urgent admissions to the ED with the onset of COVID-19 symptoms. Health experts predict that some 10 percent to 15 percent of these people will develop long-lasting PTSD within a year of the initial incident. While there are interventions that can help individuals avoid PTSD, there's been no reliable way to identify those most likely to need it.

That may now have changed. A multi-disciplinary team of researchers has developed a method for predicting who is most likely to develop PTSD after a traumatic emergency-room experience. Their study is published in the journal Nature Medicine.

70 data points and machine learning

nurse wrapping patient's arm

Image source: Creators Collective/Unsplash

Study lead author Katharina Schultebraucks of Columbia University's Department Vagelos College of Physicians and Surgeons says:

"For many trauma patients, the ED visit is often their sole contact with the health care system. The time immediately after a traumatic injury is a critical window for identifying people at risk for PTSD and arranging appropriate follow-up treatment. The earlier we can treat those at risk, the better the likely outcomes."

The new PTSD test uses machine learning and 70 clinical data points plus a clinical stress-level assessment to develop a PTSD score for an individual that identifies their risk of acquiring the condition.

Among the 70 data points are stress hormone levels, inflammatory signals, high blood pressure, and an anxiety-level assessment. Says Schultebraucks, "We selected measures that are routinely collected in the ED and logged in the electronic medical record, plus answers to a few short questions about the psychological stress response. The idea was to create a tool that would be universally available and would add little burden to ED personnel."

Researchers used data from adult trauma survivors in Atlanta, Georgia (377 individuals) and New York City (221 individuals) to test their system.

Of this cohort, 90 percent of those predicted to be at high risk developed long-lasting PTSD symptoms within a year of the initial traumatic event — just 5 percent of people who never developed PTSD symptoms had been erroneously identified as being at risk.

On the other side of the coin, 29 percent of individuals were 'false negatives," tagged by the algorithm as not being at risk of PTSD, but then developing symptoms.

Going forward

person leaning their head on another's shoulder

Image source: Külli Kittus/Unsplash

Schultebraucks looks forward to more testing as the researchers continue to refine their algorithm and to instill confidence in the approach among ED clinicians: "Because previous models for predicting PTSD risk have not been validated in independent samples like our model, they haven't been adopted in clinical practice." She expects that, "Testing and validation of our model in larger samples will be necessary for the algorithm to be ready-to-use in the general population."

"Currently only 7% of level-1 trauma centers routinely screen for PTSD," notes Schultebraucks. "We hope that the algorithm will provide ED clinicians with a rapid, automatic readout that they could use for discharge planning and the prevention of PTSD." She envisions the algorithm being implemented in the future as a feature of electronic medical records.

The researchers also plan to test their algorithm at predicting PTSD in people whose traumatic experiences come in the form of health events such as heart attacks and strokes, as opposed to visits to the emergency department.

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