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Introduction: Hip arthroplasty is a common orthopaedic procedure worldwide. There is an ongoing debate related to the fixation and anaesthesia impact on the 30-day mortality, particularly in the aging population with higher American Society of Anaesthesiology (ASA) Physical-Status. Aim: To study the 30-day all-cause mortality in patients undergoing primary hip arthroplasty, with regards to the impact of age, ASA-class, anaesthesia techniques, indication for surgery and fixation techniques. Materials and methods: Perioperative data for primary hip arthroplasty procedures for osteoarthritis and hip fractures registered in the Swedish Perioperative Registry (SPOR) between 2013 and June 2022 were collected. Binary logistic regressions were performed to assess the impact of age, ASA-class, anaesthetic technique, indication for surgery and fixation on odds ratio for 30-day mortality in Sweden. Results: In total, 79,114 patients, 49,565 with osteoarthritis and 29,549 with hip fractures were included in the main study cohort. Mortality was significantly higher among hip fracture patients compared with osteoarthritis, cumulative 8.2% versus 0.1% at 30-days respectively (p < 0.001). Age above 80 years (OR3.7), ASA 3–5 (OR3.3) and surgery for hip fracture (OR 21.5) were associated with significantly higher odds ratio, while hybrid fixation was associated with a significantly lower odds ratio (OR0.4) of 30-day mortality. In the same model, for the subgroups of osteoarthritis and hip fracture, only age (OR 3.7) and ASA-class (OR 3.3) had significant impact, increasing the odds ratio for 30-day mortality. Hemi arthroplasty was commonly used among the hip fracture patients 20.453 (69.2%), and associated with a significantly higher odds ratio for all-cause 30-day mortality as compared to total hip arthroplasty when adjusting for age and ASA-class and fixation 2.3 (95%CI 1.9–2.3, p < 0.001). Conclusions: All-cause 30-day mortality associated with arthroplasty differed significantly between the two cohorts, hip fracture, and osteoarthritis (8.2% and 0.1% respectively) and mortality expectedly increased with age and higher ASA-class. Anaesthetic method and cement-fixation did not impact the odds ratio for all-cause 30-day mortality after adjustment for age and ASA-class. [ABSTRACT FROM AUTHOR]

Current estimates of carbon dioxide (CO2) evasion from Arctic lakes are highly uncertain because few studies integrate seasonal variability, specifically evasion during spring ice‐melt. We quantified annual CO2 evasion for 14 clear‐water Arctic lakes in Northern Sweden through mass balance (ice‐melt period) and high‐frequency loggers (open‐water period). On average, 80% (SD: ± 18) of annual CO2 evasion occurred within 10 d following ice‐melt. The contribution of the ice‐melt period to annual CO2 evasion was high compared to earlier studies of Arctic lakes (47% ± 32%). Across all lakes, the proportion of ice‐melt : annual CO2 evasion was negatively related to the dissolved organic carbon concentration and positively related to the mean depth of the lakes. The results emphasize the need for measurements of CO2 exchange at ice‐melt to accurately quantify CO2 evasion from Arctic lakes. [ABSTRACT FROM AUTHOR]

Airway, complications, COVID-19, paediatric anaesthesia Other viruses The results of the current study also raise another important question: is the incidence of airway complications related to COVID-19 different from the ones associated with other airway viruses'? Keywords: airway; complications; COVID-19; paediatric anaesthesia EN airway complications COVID-19 paediatric anaesthesia 956 958 3 08/04/22 20220901 NES 220901 I "Has the whole world gone crazy?". [Extracted from the article]

Background: The Michigan Hand Outcomes Questionnaire—MHQ—is a well-known self-assessment questionnaire, where patients' own perception in terms of recovery, pain and the ability to return to activities of daily living is assessed. The purpose of the study was to translate and culturally adapt the Michigan Hand Outcomes Questionnaire to Swedish and to test the validity and reliability in patients with surgically treated distal radius fractures. Methods: The cross-cultural adaptation and the translation process were conducted according to predefined guidelines. Seventy-eight patients with surgically treated distal radius fractures completed the translated version of the questionnaire on their six-week follow-up visit. Results: The translation and cross-cultural adaptation process revealed no major linguistic or cultural issues. The internal consistency of the MHQ-Swe ranged from 0.77 to 0.94 at test 1 and from 0.81 to 0.96 at test 2 for all subscales, which indicates good internal consistency in the subscales. The hand function subscale revealed the lowest results and work performance the highest. The ICCs showed excellent test-retest reliability, ranging from 0.77 to 0.90 on all MHQ subscales and 0.92 on total score. The highest results for the ICC were seen in the satisfaction subscale (ICC = 0.90), while the lowest were seen in the aesthetic subscale (ICC = 0.77). The correlation analysis between the MHQ-Swe, PRWE and VAS showed a generally moderate to high correlation for all the subscales. Conclusions: The Swedish version of the MHQ, the MHQ-Swe, showed good validity and reliability and it is therefore an appropriate and relevant questionnaire for use in patients with surgically treated distal radius fractures. Trial registration: FoU i VGR, Projectnumber: 208491, registered December 9, 2015. [ABSTRACT FROM AUTHOR]

Background: Effective pulmonary blood flow (COEPBF) has recently been validated for its ability to measure cardiac output (CO) in children and animals. This study compared COEPBF with the Fick method (COFick) and CO measurements using an invasive pulmonary artery flow probe (COTS). The aim of the study was to validate COEPBF against these reference methods in a porcine model of hypoxia-induced selective pulmonary hypertension.Methods: Ten anaesthetised mechanically ventilated piglets (median weight 23.9 kg) were exposed to a hypoxic gas mixture inducing selective pulmonary hypertension. Pulmonary hypertension was subsequently reversed with inhaled nitric oxide. Simultaneous recordings of COEPBF, COFick, and COTS were performed throughout the protocol and examined for agreement and trending ability.Results: Overall bias (Bland-Altman) between COEPBF and COTS was 0.2 L min-1 (limits of agreement -0.5 and +0.9 L min-1) with a mean percentage error of 25%. Overall bias between COEPBF and COFick was -0.1 L min-1 (limits of agreement -0.9 and +0.6 L min-1) and a mean percentage error of 25%. The concordance rate was 86% for COEPBF when compared with COTS using a 10% exclusion zone.Conclusions: Estimation of CO with COEPBF results in values very close to the gold standard reference methods COFick and COTS. COEPBF appears to be an accurate tool for monitoring absolute values and changes in CO during hypoxia-induced pulmonary hypertension and inhaled nitric oxide treatment. [ABSTRACT FROM AUTHOR]

Presents information on a study which developed a theoretical model for predicting the kinetics of ice crystallization inside cells during cryopreservation. Basis of the model; Methodology of the study; Results and discussion.

The authors explore ankle pathology and arthroscopic procedures for ankle injuries. Topics discussed include ankle sprain as the most common problem most individuals may suffer, the possible causes of chronic ankle pain, and secondary intra-articular ankle injuries as the most common finding in patients with ankle instability.

Background: Effective pulmonary blood flow (COEPBF) has recently been validated as a technique for determining cardiac output (CO) in animals of varying sizes. The primary aim of our study was to investigate this new technique in paediatric surgical patients, compared with suprasternal two-dimensional Doppler (COSSD).Methods: A total of 15 children undergoing cleft lip/palate surgery were investigated. Before the start of surgery, manoeuvres that were anticipated to reduce (increase in PEEP from 3 to 10 cm H2O) and increase (atropine) CO were undertaken. A study in mechanically ventilated piglets was also undertaken under general anaesthesia, measuring COEPBF and pulmonary artery (COTS) flow by ultrasonic probe as the comparator. Bias (Bland-Altman plots) and limits of agreement were assessed for effective pulmonary blood flow and COSSD or COTS.Results: In paediatric patients (median age 8.5 months), overall bias was -8.1 (limits of agreement -82 to +66) ml kg-1 min-1, with a mean percentage error of 48% and a concordance rate of 64%. In the piglet model, overall bias was -1 (-36 to +38) ml kg-1 min-1, with a mean percentage error of 31% and a concordance rate of 95%.Conclusions: Under controlled experimental conditions, COEPBF is associated with excellent agreement and good trending ability when compared with the gold standard COTS. In the paediatric clinical setting, COEPBF performs well; by contrast, COSSD, an operator- and anatomy-dependent technology, appears less reliable than COEPBF. [ABSTRACT FROM AUTHOR]

A modified burst test (MBT) was used in an extensive test program to characterize fuel cladding failure behavior under rapid loading conditions. The MBT differs from a normal burst test with the use of a driver tube to simulate the expansion of a fuel pellet, thereby producing a partial strain driven deformation condition similar to that of a fuel pellet expansion in a reactivity insertion accident (RIA). A piston/cylinder assembly was used to pressurize the driver tube. By controlling the speed and distance the piston travels the loading rate and degree of sample deformation could be controlled. The use of a driver tube with a machined gauge section localizes deformation and allows for continuous monitoring of the test sample diameter change at the location of maximum hoop strain, during each test. Cladding samples from five irradiated fuel rods were tested between 296 and 553 K and loading rates from 1.5 to 3.5/s. The test rods included variations of Zircaloy-2 with different liners and ZIRLO, ranging in burn-up from 41 to 74 GWd/MTU. The test results show cladding ductility is strongly temperature and loading rate dependent. Zircaloy-2 cladding ductility degradation due to operational hydrogen pickup started to recover at approximately 358 K for test condition used in the study. This recovery temperature is strongly loading rate dependent. At 373 K, ductility recovery was small for loading rates less than 8 ms equivalent RIA pulse width, but longer than 8 ms the ductility recovery increased exponentially with increasing pulse width, consistent with literature observations of loading rate dependent brittle-to-ductile (BTD) transition temperature. The cladding ductility was also observed to be strongly loading rate/pulse width dependent for BWR cladding below the BTD temperature and Pressurized Water Reactor (PWR) cladding at both 296 and 553 K. [ABSTRACT FROM AUTHOR]

In this work we perform a high-resolution spectroscopic investigation of Eu 3+ –Ce 3+ and Pr 3+ –Ce 3+ codoped Y 2 SiO 5 crystals. Satellite line spectra were recorded at low temperatures around the Eu 3+ : 7 F 0 → 5 D 0 and the Pr 3+ : 3 H 4 → 1 D 2 transitions. It is observed that the incorporation of Ce 3+ as a codopant notably changes the Eu 3+ and Pr 3+ satellite line patterns. Satellite lines measured in singly doped Eu 3+ :Y 2 SiO 5 were found at the same spectral positions in Eu 3+ –Ce 3+ codoped crystals. These coincident lines were concluded to be due to pairs of Eu 3+ ions. Extra satellite lines appeared in the codoped crystals, which were assigned to Ce 3+ related structures such as Ce 3+ –Eu 3+ pairs. The analysis of the Pr 3+ satellite line spectra presents further challenges. Satellite lines associated to Pr 3+ pairs show weaker intensity, presumably due to the efficient quenching of the Pr 3+ 1 D 2 emission through cross-relaxation paths ( 1 D 2 → 1 G 4 ; 3 H 4 → 3 F 4 ). The investigation of the Eu 3+ and Pr 3+ satellite line patterns in Y 2 SiO 5 is particularly interesting for their exploitation in rare-earth based quantum computation schemes. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate whether manganese dipyridoxyl diphosphate (MnDPDP) or its metabolite manganese dipyridoxyl ethyldiamine (MnPLED) reduces post-ischemic myocardial injury.Material and Methods: Left anterior descending artery (LAD) in anesthetized pigs was occluded (30 min) followed by reperfusion (120 min) during hemodynamic monitoring and infarct assessment. Three micromol/kg MnDPDP, 1 micromol/kg MnPLED (or a mixture of both) or saline was injected i.v. 10 min before reperfusion followed by infusion of either 3 micromol/kg/h MnDPDP, 1 micromol/kg/h MnPLED (or a mixture of both) or saline. The plasma concentrations of MnDPDP, MnPLED and other metabolites (e.g., ZnDPDP and ZnPLED) were analyzed.Results: Femoral blood flow was reduced by 60% during early reperfusion in controls, whereas only 23 and 31% reductions were seen in animals treated with MnDPDP and MnPLED. During that time, +LV/dP and -LV/dP (maximum rate of left ventricular isovolumic contraction and relaxation, respectively), systolic pressure and diastolic pressure fell significantly less in animals treated with MnDPDP or MnPLED. Three out of 5 control animals experienced ventricular fibrillation (VF) during reperfusion, whereas VF was not seen in any of the pigs treated with MnPLED or/and MnDPDP. The infarct sizes in saline- and MnPLED-treated animals were 39+/-6 and 16+/-5%, respectively, of the occluded areas. MnDPDP did not reduce the infarct size. A mixture of MnDPDP and MnPLED significantly reduced infarct size (10+/-4%). When reperfusion started and throughout reperfusion, almost all injected MnDPDP was present as Zn-metabolites.Conclusion: MnPLED seems to reduce reperfusion-induced cardiac dysfunction and infarct size in pigs. MnDPDP does not reduce infarct size in the pig, probably because of the rapid exchange of Mn2+ for Zn2+ taking place in the pig. [ABSTRACT FROM AUTHOR]

The article focuses on a study on the safety and effectiveness of buprenorphine transdermal patch (BTP) in younger and elderly patients with osteoarthritis (OA) pain. Topics include recommendations on the use of non-steroidal anti-inflammatory drugs (NSAIDs) for the treatment of OA pain, comparison of non-inferiority of (BTP) in elderly patients and younger patients and conduction of the study in accordance with the International Conference on Harmonization Good Clinical Practice guideline.

This study evaluated the short-term recovery of function after an acute Achilles tendon rupture, measured by a single-legged heel-rise test, with main emphasis on the relation to the patient-reported outcomes and fear of physical activity and movement (kinesiophobia). Eighty-one patients treated surgically or non-surgically with early active rehabilitation after Achilles tendon rupture were included in the study. Patient's ability to perform a single-legged heel-rise, physical activity level, patient-reported symptoms, general health, and kinesiophobia was evaluated 12 weeks after the injury. The heel-rise test showed that 40 out of 81 (49%) patients were unable to perform a single heel-rise 12 weeks after the injury. We found that patients who were able to perform a heel-rise were significantly younger, more often of male gender, reported a lesser degree of symptoms, and also had a higher degree of physical activity at 12 weeks. There was also a significant negative correlation between kinesiophobia and all the patient-reported outcomes and the physical activity level. The heel-rise ability appears to be an important early achievement and reflects the general level of healing, which influences patient-reported outcome and physical activity. Future treatment protocols focusing on regaining strength early after the injury therefore seem to be of great importance. Kinesiophobia needs to be addressed early during the rehabilitation process. [ABSTRACT FROM AUTHOR]

We present a method for efficient air bubble removal in microfluidic applications. Air bubbles are extracted from a liquid chamber into a vacuum chamber through a semipermeable membrane, consisting of PDMS coated with amorphous Teflon® AF 1600. Whereas air is efficiently extracted through the membrane, water loss is greatly reduced by the Teflon even at elevated temperatures. We present the water loss and permeability change with the amount of added Teflon AF to the membrane. Also, we demonstrate bubble-free, multiplex DNA amplification using PCR in a PDMS microfluidic device. [ABSTRACT FROM AUTHOR]

Purpose: Quality photographs are essential for clinical documentation, research, and publication in scientific journals and teaching. Oftentimes, non-ideal lighting and a sterile environment restrict the medical photographer, resulting in lower-quality photographs. This article aims to provide a clear and comprehensible guideline for medical photography in an orthopaedic setting. Methods: This article is based on extensive photographic involvement in operating and laboratory settings, in close collaboration with medical professionals from the Steadman Clinic (Vail, Colorado, USA), Gothenburg University (Göteborg, Sweden) and Erasmus MC (Rotterdam, the Netherlands). Background literature was searched through Google Scholar and PubMed. Results: Three relevant journal articles, and one book on medical photography, were used to write this paper. Seventeen Internet articles were used for background information. Conclusion: A relevant, up-to-date and comprehensive guideline to medical photography for medical professionals, with or without photographic experience, is provided. Level of evidence: Expert opinion, Level V. [ABSTRACT FROM AUTHOR]

Distal radius fracture (DRF) is a common injury, affecting both function and activity performance. Postoperative rehabilitation is an essential part of the treatment of a surgically treated DRF. The study aims were to assess pain, hand function, activity performance and apprehensiveness and their association, during the first three months after a surgically treated DRF. Eighty-eight patients with a DRF were assessed for pain, hand function, activity performance and apprehensiveness three days and two, six and 12 weeks after surgery. The results indicated that pain, range of motion (ROM), grip strength, apprehensiveness, and activity performance (PRWE) improved significantly between follow-ups (p <.001–.01). Apprehensiveness correlated moderately with activity performance on all visits (0.40–0.47, p <.01), which implies a correlation between the variables, but the regression model showed that the differences in the PRWE at twelve weeks cannot be explained by the differences in apprehensiveness or range of motion at cast removal. At 12 weeks, the study participants had regained almost 70% of their grip strength and 74–96% of the ROM of the uninjured hand. The study shows that, during the study period, the participants improved in both pain, hand function and activity performance, and indicates that a simple question on apprehensiveness in terms of using the injured hand in daily life could be an important factor in distal radius fracture rehabilitation. [ABSTRACT FROM AUTHOR]

We present a method for PDMS microfabrication of fragile membranes and 3D fluidic networks, using a surface modified water-dissolvable release material, poly(vinyl alcohol), as a tool for handling, transfer and release of fragile polymer microstructures. The method is well suited for the fabrication of complex multilayer microfluidic devices, here shown for a PDMS device with a thin gas permeable membrane and closely spaced holes for vertical interlayer connections fabricated in a single layer. To the authors' knowledge, this constitutes the most advanced PDMS fabrication method for the combination of thin, fragile structures and 3D fluidics networks, and hence a considerable step in the direction of making PDMS fabrication of complex microfluidic devices a routine endeavour. [ABSTRACT FROM AUTHOR]

Abstract: Two-dimensional elastic–plastic finite element analyses was carried out on a laser welded box beam in order to study the impact of the geometrical aspects of the joint type and weld root on the fatigue stress behaviour. Different experimental and hypothetical weld geometries were studied. Characteristic root shapes, measured by the plastic replica method, and critical geometrical aspects were classified and then studied by FE-analysis with respect to their impact on the maximum stress. The simulation of hypothetical transition geometries facilitated the identification of trends and the explanation of part of the phenomena. However, quantitative geometry criteria were only partially suitable to describe the relations. The results have shown that the combination of throat depth, local surface radius and its opening angle determines the peak stress value and its location. Beside extended throat depths, particularly larger toe radii and the avoidance of small opening angles and of surface ripples reduces the peak stress. The explanations were developed in a generalising manner, accompanied by illustrative and flow chart description. [Copyright &y& Elsevier]

Abstract: For fibre laser welding of an eccentric corner joint, the quality of the resulting weld cross section was studied with respect to the dependence on process parameters like lateral laser beam alignment, beam inclination, focal plane position or welding speed. The complex load situation of the support beamer was simplified to bending of one corner. Due to fatigue load, the weld properties causing the peak stress are essential, in particular the top and root shape of the weld cross section. For the parameters varied, the resulting shapes were categorized into different top and root classes, determined by certain key dimensions, considering also welding defects like undercuts. The shapes are boundary conditions for Finite Element Analysis of the joint under load for quantitative comparative analysis of the maximum stress. As two high strength steel grades were joined, the hardness transition across the weld was of interest, too. High speed imaging of the weld pool surface shape provided additional information on the relation between the parameter input and quality output. The different trends identified were discussed and guidelines were derived. As the systematic documentation of results is unsatisfactory in welding, a new method was developed and applied for the first time, called the Matrix Flow Chart. It enables an illustrative view on the resulting welding trends in a combined manner and is extendable by other researchers. [ABSTRACT FROM AUTHOR]

The aim of the present study was to compare isokinetic muscle performance of the knee extensors including surface EMG during repetitive maximum contractions between children with hemiplegic CP and healthy controls. A group of children with hemiplegic cerebral palsy (CP) (16 boys and eight girls; mean age 11 years with SD 2; range 7 to 15 years) and a control group (14 boys and eight girls; mean age 10 years with SD 2; range 7 to 15 years) participated. The relationships between maximum peak torque and the surface electromyography (EMG) variable root mean square (RMS) were obtained during 100 concentric knee extensions at 90°/s. Surface EMG was recorded from rectus femoris, vastus lateralis, and biceps femoris. The children with CP were also tested using Gross Motor Function Measure (GMFM). There were no differences between the groups in muscle endurance for the younger children. The results indicated that the children with CP had less strength enhancement in the hemiplegic leg during puberty. Peak torque correlated with GMFM and with RMS in rectus femoris and vastus lateralis. Co-activation was found in biceps femoris, but it did not affect muscle strength. [ABSTRACT FROM AUTHOR]

Background: Solutions of iodine contrast media (CM) used for selective coronary arteriography (CA) should have minimal propensity to cause ventricular fibrillation (VF). Commonly used CM for CA are nonionic monomers or dimers. Purpose: To compare VF propensity of ready-to-use solutions of one nonionic dimer, iodixanol, and five nonionic monomers, iobitridol, iopamidol, iomeprol, iopromide, and ioversol. Material and Methods: Twenty milliliters of each CM was injected into the left coronary artery (LCA) through an inflated balloon catheter (0.5 ml/s) in 14 pigs; the longest period of injection was 40 s. If VF occurred before 40 s, the injection was stopped and the heart was defibrillated. After VF, there was a delay of 40 min before the next injection. Hemodynamic parameters and vector electrocardiography (VECG) were monitored. A CM with a lower frequency of VF and a longer period between start of injection and start of VF was considered to have a lower VF propensity. Results: Following 14 injections, each of the five nonionic monomers caused 14 VF, whereas iodixanol caused three VF (P<0.01). When VF occurred after iodixanol, it occurred later than after the other CM (P<0.001). Iodixanol caused less prolongation in QRS time (P<0.01) and QTc time (P<0.05) than the other CM. Prolongations in QRS and QTc times caused by CM parallel the VF propensities of the CM. Conclusion: Ready-to-use solutions of the dimer iodixanol have lower VF propensity than solutions of the five monomeric CM. This is related to the fact that the solutions of the dimer iodixanol have lower osmolality, higher viscosity, and higher concentrations of NaCl and CaCl2 than solutions of the five monomers. [ABSTRACT FROM AUTHOR]

Management of controversial animals, like large carnivores, in multi-use landscapes is highly dependent on human tolerance. Human fear of wolves (Canis lupus L., 1758) is known to be an important variable affecting human attitudes towards wolves. Successful management of wolves thus forces managers to respond to human fear of wolves. In this study, we assess the distance at which radio-collared wolves move away from an approaching human, also called the flight initiation distance (FID), and how FID is affected by wind speed and wind direction. We used silent VHF receivers and walked at normal pace towards radio-collared wolves. When approaching the wolves, we made no attempt to hide or walk in a less noisy manner. In the 34 experimental provocations, wolves moved away when the approaching human was between 17 and 310 m away. The mean FID was 106 m. FID was negatively correlated with wind speed. One hour after having been roused by the approaching human, wolves had moved a median distance of 1.2 km. [ABSTRACT FROM AUTHOR]

Abstract: The anti-inflammatory drug piroxicam has been reported to affect the production of reactive oxygen species in phagocytes. This anti-inflammatory effect is thought to be mediated through inhibition of cyclooxygenase (COX), an enzyme important for prostaglandin synthesis. We have compared the effects of piroxicam on superoxide production mediated by two closely related G-protein coupled receptors expressed on neutrophils, the formyl peptide receptor (FPR) and the formyl peptide receptor like 1 (FPRL1). Neutrophils were stimulated with agonists that bind specifically to FPR (the peptide ligand N-formyl-Met-Leu-Phe, fMLF) or FPRL1 (the peptide ligand Trp-Lys-Tyr-Met-Val-L-Met-NH2, WKYMVM) or both of these receptors (the peptide ligand Trp-Lys-Tyr-Met-Val-D-Met-NH2, WKYMVm). Piroxicam reduced the neutrophil superoxide production induced by the FPR agonist but had no significant effect on the FPRL1 induced response. Neutrophil intracellular calcium changes induced by the agonist WKYMVm (that triggers both FPR and FPRL1) were only inhibited by piroxicam when the drug was combined with the FPRL1 specific antagonist, Trp-Arg-Trp-Trp-Trp-Trp (WRW4), and this was true also for the inhibition of superoxide anion release. Receptor-binding analysis showed that the fluorescently labelled FPR specific ligand N-formyl-Nle-Leu-Phe-Nle-Tyr-Lys (fNLFNYK), was competed for in a dose-dependent manner, by the FPR ligand fMLF and as well as by piroxicam. We show that piroxicam inhibits the neutrophil responses triggered through FPR, but not through FPRL1 and this inhibition is due to a reduced binding of the activating ligand to its cell surface receptor. [Copyright &y& Elsevier]

Arsenic trioxide (As2O3) is toxic to multidrug-resistant neuroblastoma cells in vivo and in vitro. In neuroblastoma, As2O3 does not exert its cell death-promoting effects via a classical apoptotic pathway. A death mechanism involving proteolytic cleavage of Bax to a p18 form seems to be of importance, because inhibition of Bax cleavage coincides with diminished cell death. As existing models of cell death implicate Bax in the intrinsic apoptotic pathway, triggering death after Bax translocation to the mitochondria, we investigated the cellular localization of p18 Bax by subcellular fractionation. After As2O3 treatment, p18 Bax was only present in nuclei-enriched, mitochondria-depleted fractions. Cytoplasmic p21 Bax levels decreased, whereas total (p21 and p18) nuclear Bax increased. Overexpressed p21 Bax localized to the cytoplasm and nuclei, whereas overexpressed p18 Bax localized to extra-nuclear structures only. The inability of overexpressed p18 Bax to locate to the nucleus, and the As2O3-induced reduction of p21 Bax in the cytosol, suggest an As2O3-induced mechanism where p18 Bax gets cleaved and ‘trapped’ in the nucleus. This model is strengthened by the observation that calpain, the protease responsible for p18 Bax generation, is present in the nuclei, and that nuclear calpain is induced by increasing As2O3 and Ca2+ levels.Oncogene (2007) 26, 6150–6159; doi:10.1038/sj.onc.1210439; published online 2 April 2007 [ABSTRACT FROM AUTHOR]

Objective:To examine trends and effects of weight loss treatment on health-related quality of life (HRQL) in the severely obese over 10 years.Design:Swedish obese subjects (SOS) intervention study is a controlled, longitudinal trial of the health effects of weight loss in the severely obese.Subjects:A total of 655 of 851 surgically treated and 621 of 852 conventionally treated obese men (body mass index, BMI34) and women (BMI38) who completed 10 years of the study.Measurements:HRQL was assessed before treatment and after 0.5, 1, 2, 3, 4, 6, 8 and 10 years.Results:HRQL change during the 10-year observation period largely followed phases of weight loss, weight regain and weight stability. Improvements and deteriorations in HRQL were associated with the magnitude of weight loss or regain, except regarding anxiety. Peak improvements in the surgical group were observed during the first year of weight loss, whereas the weight regain phase (mainly between 1- and 6-year follow-up) was accompanied by a gradual decline in HRQL. The period from 6- to 10-year follow-up was characterized by relatively stable observations in both weight and HRQL. At 10 years, net gains were noted in all HRQL domains compared to baseline. Comparisons of treatment effects on HRQL in the surgical vs conventional group after 10 years showed significantly better outcome in the surgical group on current health perceptions, social interaction, psychosocial functioning and depression, whereas no significant differences were found for overall mood and anxiety. Long-term results of the study suggest that a maintained weight loss of about 10% is sufficient for positive long-term effects on HRQL, a limit that was reached in about two-thirds of the surgically treated patients who completed 10 years of the study.Conclusion:Long-lasting weight reduction in the severely obese has a general long-standing positive outcome on HRQL. Bariatric surgery is a favorable option for the treatment of severe obesity, resulting in long-term weight loss and HRQL improvements in a majority of patients. However, difficulties among some surgical patients to control and maintain weight loss over time should not be ignored. Future research should study if the long-term efficacy of bariatric surgery may be further enhanced by implementing lifestyle modification techniques in the postoperative management of patients.International Journal of Obesity (2007) 31, 1248–1261; doi:10.1038/sj.ijo.0803573; published online 13 March 2007 [ABSTRACT FROM AUTHOR]

We used logistic regression to compare a set of habitat features inside known Scandinavian wolf Canis lupus territories with the same habitat features in areas outside known territories, but still close enough to be available for wolf colonization. In addition, we analysed changes in habitat variables over time within wolf territories. Wolf territories had lower densities of roads, built-up areas and open land than areas outside wolf territories, but there was no difference in the density of the wolves' main prey, elk Alces alces. The logistic regression model classified 79% of Scandinavia outside the reindeer husbandry area as suitable wolf habitat, that is with a probability of wolf occurrence >0.5. The proportion of built-up areas within the wolf territory decreased as the ‘borders’ of the wolf territory changed over time. Our model had a reasonably high predictive power, with correct classification in 90% (18 of 20) of the observed wolf territories in the study area. Polygons, randomly distributed outside the observed wolf territories, were correctly classified as not being occupied by wolves in 85% of the cases (17 of 20). This allows a more effective use of resources to, for example, prevent wolf depredation on livestock and dogs. [ABSTRACT FROM AUTHOR]

Aim. This paper reports a study to evaluate the contribution of nursing care within an integrated care pathway for patients with hip fracture. Background. There is growing interest in quality assurance in health care. Integrated care pathways are a method to achieve this goal, and are a multi-professional team approach where the requirement for nurses to work effectively within the team is important. However, the nurses' role and contribution within the team have not been well described. Method. A quasi-experimental, prospective study comparing an intervention group with a comparison group was carried out. One hundred and twelve independently living patients, aged 65 years or older and admitted to a Swedish hospital with a hip fracture, were consecutively selected. Pathological fracture and severe intellectual impairment (Pfeiffer's test <3 points) served as exclusion criteria. The intervention was designed to focus on patients' motivation and their prerequisites for rehabilitation and was based on the concept of transition. The main outcome measure was the number of patients restored to preoperative activities of daily living levels in 2003-2004. Findings. In the intervention group 21% were restored to activities of daily living to level A (independent) at discharge, whereas only 5% in the comparison group were restored to this level. No patients in the intervention group, admitted as independent, remained at activities of daily living level F (dependent), whereas 16% remained at level F in the comparison group (P = 0.003). Conclusion. When admitting older patients with a hip fracture, it is important to acquire good knowledge about each patient and their prerequisites and to offer them accelerated rehabilitation in accordance with their individual ability. By monitoring process indicators during the transition, serious deviations from the care plan can be avoided. [ABSTRACT FROM AUTHOR]

The overall aim was to investigate the fatigue pattern and perceived fatigue during repetitive dynamic contractions in young and older men and women. Sixteen older men and women (mean age 73 ± 3 years) and 22 young men and women (mean age 28 ± 6 years) performed 100 repeated maximum concentric isokinetic knee extension contractions at 90°·s^{-1} (1.57 rad·s^{-1}). Throughout the 100 contractions, peak torque (PT) and surface electromyography (EMG) signals from the rectus femoris muscle and the vastus lateralis muscle were recorded simultaneously, together with perceived fatigue (CR-10 scale of Borg). The mean frequency of the power spectrum (MNF) and the root mean square of the signal amplitude (RMS) of the EMG were affected by age and with a sex related difference but for PT the difference of the fatigue pattern was most evident between the sexes. In addition, the young men rated the highest fatigue. Based on EMG, PT and ratings of perceived fatigue it was concluded that the old men fatigued most, the old women fatigued least and the young men perceived greatest fatigue. [ABSTRACT FROM AUTHOR]

Abstract: Energy demand in the built environment is an important issue. In Sweden, 39% of energy use originates from the building sector, and this figure is increasing. Several attempts have been made to improve the energy use, for example low-energy houses, which are built with the aim of decreasing the use of energy, but still providing a good environment for the occupants. An energy simulation program, ESP-r, was used for simulation of the energy requirement and indoor climate in a well-insulated terraced house in Sweden. The building model was compared to measured values from the real object. A computational fluid dynamics (CFD)-model for one room was used to simulate and visualize the airflow and temperature pattern. Increased set-point temperature increases the power demand by about 200kWh/°C. Thinner insulation increases the heat demand but decreases the demand for passive cooling by airing and deteriorates the indoor climate. Different types of windows affect both the energy demand and the indoor climate significantly. Load management was simulated by restriction on the heating possibilities and an economical comparison was made to investigate the advantage of such an operation. The extra insulation has a payoff time of about 38 years at common Swedish energy prices. [Copyright &y& Elsevier]

Abstract: Thermal management of data centers is an important issue for many high technology companies. The power requirement to provide proper indoor climate in data centers is considerable. Thus, possibilities for energy savings and efficient electricity utilization are quite important. In this paper, the airflow and temperature patterns, as well as the electrical power requirement within a small data center, have been investigated. The power requirement within the data center is considerably high, due to an oversized air conditioning system. An infrared camera was used to visualize the airflow and temperature pattern, showing that cool air does not reach the upper levels of the racks, despite a very high air exchange rate. Point measurements of temperatures in a rack show that recirculation cells are present, causing accumulation of heat and improper cooling of electronic equipments. Thus, the chilled air is not distributed properly and consequently the cooling energy is not used effectively. [Copyright &y& Elsevier]

Identification of genes controlling complex diseases has proven to be difficult; however, animal models may pave the way to determine how low penetrant genes interact to promote disease development. We have dissected the Cia5/Eae3 susceptibility locus on mouse chromosome 3 previously identified to control disease in experimental models of multiple sclerosis and rheumatoid arthritis. Congenic strains showed significant but small effects on severity of both diseases. To improve the penetrance, we have now used a new strategy that defines the genetic interactions. The QTL interacted with another locus on chromosome 15 and a partial advanced intercross breeding of the two congenic strains for eight generations accumulated enough statistical power to identify interactions with several loci on chromosome 15. Thereby, three separate loci within the original QTL could be identified; Cia5 affected the onset of arthritis by an additive interaction with Cia31 on chromosome 15, whereas the Cia21 and Cia22 affected severity during the chronic phase of the disease through an epistatic interaction with Cia32 on chromosome 15. The definition of genetic interactions was a prerequisite to dissect the Cia5 QTL and we suggest the partial advanced intercross strategy to be helpful also for dissecting other QTL controlling complex phenotypes.Genes and Immunity (2005) 6, 175-185. doi:10.1038/sj.gene.6364155 Published online 17 February 2005 [ABSTRACT FROM AUTHOR]

Aims: Prognostication of brain damage after cardiac arrest mainly relies on clinical observations. Recently, it has been shown that biochemical markers of brain damage measured in serum aid in this process. In the present study, we wanted to test the usefulness of CSF determinations of a neuronal protein, the neurofilament protein (NFL). Methods and results: Lumbar punctures were performed during week 2 or 3 in 22 patients surviving cardiac arrests. CSF NFL concentrations were analysed using an ELISA. Levels were increased in cardiac arrest patients. Patients with poor outcome according to the Glasgow outcome scale (GOS), low performance at a mini mental state examination (MMSE) and dependent according to Katz at 1 year follow up had the highest NFL levels. The NFL levels correlated well with anoxia time and coma depth. High positive and negative predictive values, particularly for poor outcome according to GOS were observed. Conclusions: Levels of CSF NFL give a reliable measure of the brain damage following cardiac arrest and the levels are highly predictive of poor outcome. This observation urges the development of sensitive serum assays of this marker to be used in the clinical setting. [Copyright &y& Elsevier]

1. To assess the use of stable nitrogen isotopes (δ15N) for reconstructing trophic relationships in planktonic food webs, crustacean zooplankton species and pelagic dissolved and particulate matter were analysed in 14 subarctic lakes in northern Sweden. The lakes are situated along an altitudinal gradient and show a substantial variation in nutrient content and energy mobilization by bacterioplankton and phytoplankton. 2. The δ15N of dissolved and particulate matter was comparatively low, suggesting efficient N recycling and low losses of depleted N from the pelagic zone of these unproductive lakes. 3. Copepods had a systematically higher δ15N than cladocerans, with an average difference of 3.1-4.9‰ within lakes, implying different trophic positions of the two groups. Comparisons of nitrogen pools and energy fluxes suggest that the low cladoceran δ15N was a result of feeding on bacteria. 4. The difference in δ15N between copepods and cladocerans declined with decreasing bacterioplankton production among lakes, due either to increasing trophic isotope fractionation or decreasing relative importance of bacteria in the diet of cladocerans. [ABSTRACT FROM AUTHOR]

In this paper different window energy rating systems (WERS) are evaluated and compared. The comparisons are made for different European climates, types of buildings and orientations. The purpose of the paper is to evaluate how complex a WERS needs to be in order to be able to provide a reliable energy rating which can be applied to different buildings in different climates and orientations. The results indicate that Europe needs to be separated into several different climate zones. A simple linear heating energy-rating model of the form Ag–BU (where g is the total solar energy transmittance, U is the thermal transmittance of the window, and A and B are empirical coefficients), may be sufficient within certain regulations. For warm locations a linear cooling energy rating, depending only on the g factor may also yield an acceptable rating. More advanced models that take the building type into account and that use hourly climate files showgood fit with building simulation programs. [Copyright &y& Elsevier]

The primary purpose of this study was to evaluate whether a preseason strength training programme for the hamstring muscle group – emphasising eccentric overloading – could affect the occurrence and severity of hamstring injuries during the subsequent competition season in elite male soccer players. Thirty players from two of the best premier-league division teams in Sweden were divided into two groups; one group received additional specific hamstring training, whereas the other did not. The extra training was performed 1–2 times a week for 10 weeks by using a special device aiming at specific eccentric overloading of the hamstrings. Isokinetic hamstring strength and maximal running speed were measured in both groups before and after the training period and all hamstring injuries were registered during the total observational period of 10 months. The results showed that the occurrence of hamstring strain injuries was clearly lower in the training group (3/15) than in the control group (10/15). In addition, there were significant increases in strength and speed in the training group. However, there were no obvious coupling between performance parameters and injury occurrence. These results indicate that addition of specific preseason strength training for the hamstrings – including eccentric overloading – would be beneficial for elite soccer players, both from an injury prevention and from performance enhancement point of view . [ABSTRACT FROM AUTHOR]

OBJECTIVE:: The Obesity-related Problems scale (OP) is a self-assessment module developed to measure the impacts of obesity on psychosocial functioning. Our principal aim was to evaluate the construct validity and responsiveness of the OP scale. Our specific aims were to test: (1) the psychometric performance of OP; (2) if OP scores differed by gender and weight category; (3) if OP scores are inversely related to mental well-being; (4) if weight reduction in the obese is accompanied by improvements in psychosocial functioning (OP). SUBJECTS:: Four samples were used: 6863 subjects in the SOS cross-sectional study; 2128 in the SOS intervention study; 1017 nonobese in the SOS reference study; and 3305 obese subjects in the XENDOS study. MEASUREMENTS:: Psychosocial functioning was measured by OP. Overall mood was measured by MACL. Anxiety and depression symptoms were measured by HAD. RESULTS:: Psychometric testing provided strong support for the construct validity of OP. Factor analysis confirmed the homogeneity of the construct and multitrait/multi-item scaling analysis demonstrated strong item-convergent/discriminant validity. Reliability coefficients were high and floor and ceiling effects were small. Psychometric results were cross-validated and replicated in subgroups by gender, age and body mass index (BMI). As expected, large differences in OP were observed between obese and nonobese (P<0.0001). Obese women reported more weight-related psychosocial problems than obese men (P<0.0001). Psychosocial disturbances (OP) among the obese were significantly related to poor mood (MACL; P<0.0001) and anxiety and depression symptoms (HAD; P<0.0001). Change in OP over time was strongly correlated with weight loss (P<0.0001). A distinct dose-response effect between weight reduction and improvements in OP was demonstrated. Scores on psychosocial functioning (OP) and mental well-being (MACL, HAD) in nonobese (BMI<30) surgical patients at 4-y... [ABSTRACT FROM AUTHOR]

Objective: To describe the clinical picture, pathophysiology, and treatment of concomitant lesions of the peroneus brevis tendon and lateral ligament injuries to the ankle.Background: In some cases, chronic lateral ankle instability is associated with a longitudinal partial tear in the peroneus brevis tendon. Patients who suffer from this lesion usually have atypical posterolateral ankle pain combined with signs of recurrent ligament instability ('giving way'). The tendon injury is often overlooked because it is combined with the ligament injury, and the injury mechanisms are similar.Description: Tears or laxity in the superior peroneal retinaculum allow the anterior part of the injured peroneus brevis tendon to ride over the sharp posterior edge of the fibula, leading to a longitudinal tear in the tendon. This combined injury should be suspected in patients with recurrent giving way of the ankle joint and retromalleolar pain. The diagnosis can be established using either ultrasonography or magnetic resonance imaging.Differential Diagnosis: Ligament injury, tenosynovitis, peroneus longus tendon lesion, os peroneum fracture, distal peroneus brevis tendon tear, or anomalous peroneus tertius tendon.Treatment: The tendon injury and the ligament insufficiency should be repaired at the same time.Conclusions: We recommend reconstruction of the superior peroneal retinaculum, combined with repair of the tendon, using side-to-side sutures and anatomical reconstruction of the lateral ankle ligaments. [ABSTRACT FROM AUTHOR]

BACKGROUND: Injury of the anterior cruciate ligament changes the kinematics of the knee joint. In studies of cadaveric knees, investigators have examined the effect of anterior cruciate ligament reconstruction on knee kinematics, but the effect on dynamic knee motion is not known. HYPOTHESIS: Reconstruction of the anterior cruciate ligament restores knee kinematics to normal. STUDY DESIGN: Prospective cohort study. METHODS: Nine patients were examined preoperatively and 1 year after reconstruction. Continuous radiostereometric exposures were performed at a speed of two to four exposures per second while the patients ascended an 8-cm high platform. Tibial rotation and tibial and femoral translation were measured with radiostereometric analysis. RESULTS: Tibial rotation and tibial and femoral translation were not significantly different after anterior cruciate ligament reconstruction compared with preoperative measurements. A radiostereometric evaluation of anterior knee laxity revealed restoration to within 1 mm of that on the uninjured side. Further evaluation of knee function using the Lysholm score, the Tegner activity level score, the International Knee Documentation Committee evaluation system score, and measurements of laxity using the KT-1000 arthrometer revealed significant improvements after reconstruction. CONCLUSION: Kinematics of the anterior cruciate ligament injured knee did not change significantly after ligament reconstruction, but the functional results were satisfactory and knee laxity was diminished. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate the impact of overweight and obesity on health-related quality-of-life (HRQL) in the general population in western Sweden. DESIGN: Cross-sectional survey. SUBJECTS: A total of 5633 men and women aged 16-64 y born in Sweden. MAIN OUTCOME MEASURES: Scale and summary component scores of the SF-36 Health Survey. RESULTS: Obese men aged 16-34 y rated their HRQL lower than normal-weight men did on all four physical health scales of the SF-36 and on two of the four mental health scales. Obese women in the same age group rated their health worse than normal-weight women on three of the physical health scales. Thus, in younger men and women the analysis indicated a clearer negative association between obesity and physical health than between obesity and mental health. Obese women aged 3564 y rated their health worse on all scales than normal-weight women did, while obese men in this age group rated their health worse on only two SF-36 subscales·physical functioning and general health perception. The massively obese men and women suffered from a poor level of HRQL. CONCLUSION: Not only does the level of obesity affect HRQL, the impact of overweight and obesity also differs by age and sex. The importance of aspects of both physical and mental health should be fully recognised. [ABSTRACT FROM AUTHOR]

Presents a study which discussed the predictions of angle-dependent optical properties of glazings. Possibilities of dividing the glazings into different categories or groups with similar angle dependence based on what kind of coating is applied; Simple model comparisons; Impact of angle dependence; Discussion and conclusion.

OBJECTIVE: To evaluate the construct validity of the Three-Factor Eating Questionnaire (TFEQ) in obese men and women. SUBJECTS: A total of 4377 middle-aged, obese subjects in the Swedish Obese Subjects (SOS) study. METHODS: The total sample was randomly split into two data subsets and psychometric testing was performed separately in each sample. Multitrait/multi-item analysis was conducted to test scaling assumptions and factor analysis was used to test the factor structure. Measures of mental well-being (MACL, HAD) were used for testing criterion-based validity. RESULTS: The Cognitive Restraint factor was consistently reproduced and scaling analysis demonstrated strong itemscale discriminant validity, while the item-scale convergent validity was unsatisfactory. The internal structure of the Disinhibition scale was weak. Most Disinhibition and Hunger items grouped in one global factor labeled Uncontrolled Eating. A third cluster containing items on Emotional Eating was also identified. The obtained three-factor structure was cross-validated and replicated across subgroups by gender, age and BMI. CONCLUSION: The original TFEQ factor structure was not replicated. A short, revised 18-item instrument was constructed, representing the derived factors of Cognitive Restraint, Uncontrolled Eating and Emotional Eating. The most efficient items were used to boost both the convergent and discriminant validity of the scales. [ABSTRACT FROM AUTHOR]

Studies the angle dependence of total solar energy transmittance. How key parameters influence the angular variation of the optical properties of windows; Details on the proposed model for windows; Results and conclusion.

The structure and composition of articular cartilage provides unique mechanical properties which effectively dampen and distribute loads during weight-bearing. Acute traumatic damage to the articular cartilage destroys the original structure and composition of the articular cartilage and impairs its function. Lesions in articular cartilage can cause patients severe disabling symptoms from the affected joint. These symptoms also run the risk of developing into degenerative osteoarthrosis with time. Unfortunately, articular cartilage does not have any real ability to heal itself after injury. Different treatment methods have been developed in an attempt to restore the function of the injured joint and to prevent further deterioration in the articular cartilage. Some of these methods have produced promising results in clinical studies, but further research is necessary to establish their efficacy and indications for treatment. Today, no controlled studies that compare these different methods are available. [ABSTRACT FROM AUTHOR]

Functional outcome, stability at radiographic investigation and ankle joint torque after anatomical reconstruction of the lateral ankle ligaments were evaluated in patients with early postoperative mobilization versus those with cast immobilization. Thirty patients with chronic lateral ligament instability of the ankle underwent anatomical reconstruction of the ligaments. Postoperatively the patients were randomly allocated to two groups: Group A (n=15) were immobilized in a below-knee plaster for 6 weeks and Group B (n=15) underwent early controlled range of motion training using an Air-Cast® ankle brace. The functional results were evaluated using a scoring scale and objective results using standardized stress radiographs. Also eccentric and concentric muscle torque at 60°/s was measured in plantar flexion and dorsiflexion, respectively. The functional results were satisfactory in 12/15 ankles in Group A and 14/15 in Group B(n.s.). All the patients with satisfactory results regained normal range of motion. Patients with unsatisfactory results had either residual pain or recurrent instability. In Group B, the strength measurements revealed significantly higher peak torque values after three months in plantar flexion at 60°/s. Six months postoperatively, the torque values did not differ significantly between the groups. Also, there was no group difference in the laxity of the ankle joint, including both anterior talar translation test and talar tilt test, at the two-year follow-up. One patient had a superficial wound infection. We conclude that after the reconstruction of chronic lateral ligament instability of the ankle the functional and stability results were equally good with early postoperative mobilization and 6-week immobilization. However, using early mobilization plantar flexion strength was regained earlier than with cast immobilization, without any risk of short-or medium-term complications, such as increased ankle laxity. We recommend early [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess the outcome of arthroscopic anterior cruciate ligament reconstruction performed using either the 'one incision' technique or the rear-entry 'two-incision' technique, A series of 221 consecutive patients who underwent anterior cruciate ligament reconstruction was reviewed retrospectively. In the study population, two subgroups were defined. Group A consisted of 118 patients who underwent reconstruction using the one-incision transtibial endoscopic technique arid Group B consisted of 103 patients who underwent reconstruction using the two-recision technique. The groups were comparable in terms of age, sex and activity level. The follow-up was performed after 47 (40681 months in Group A and 55 (40-68) months in Group B. The Lysholm score at the final follow-up was significantly lower in Group A (90, 38-100) than in Group B (94. 34-100) (P=0.002). The median KT-1000 total side-to-side difference was 1.5 (-6 to 7.5) mm in Group A, and 2.0 (-3.5 to 9) mm in Group B (n.s.). No significant difference between the groups was found when the IKDC evaluation system was used. Four intra-operative complications were registered in Group A and none in Group B (P=0.06). No significant difference was found in terms of anterior knee pain, the one-leg-hop quotient or the activity level at the final follow-up. In this study the two methods gave similar and satisfactory results. Serious intraoperative complications were. however, recorded in four cases when the one-incision technique was used. [ABSTRACT FROM AUTHOR]

Discusses trends in the treatment of anterior cruciate ligament (ACL) instability and reconstruction. Information on the need for reconstruction; Patients that must be operated; Factors considered in the decisions concerning surgical technique; Rehabilitation after ACL injuries and ACL reconstruction.

Seventy-eight patients (82 shoulders) with symptomatic, recurrent anterior post-traumatic shoulder instability and Bankart lesions were operated on with bioabsorbable tacks (Suretac® fixators). All the patients were followed by an independent observer, with a median follow-up period of 27(21-63) months. The recurrence rate was 8/82(10%). The median Rowe score was 93(37-100) points. The median Constant score for the index shoulders was 90(34-100) points, compared with 93(80-100) points for 59 non-operated healthy shoulders from the same cohort (P=0.03). The external rotation in abduction was 93(50-135)° compared with 105 (75-145)° for the control shoulders (P=0.0018). Arthroscopic shoulder stabilization using bioabsorbable Suretac® fixators appears to produce reliable results if used in patients with post-traumatic shoulder instability and a Bankart lesion. [ABSTRACT FROM AUTHOR]

The brown alga Sargassum muticum has been found attached in Sweden since 1987. This paper reports the distribution in Swedish waters based on 2 major surveys in 1993 and in 1996. Attached population were found along the entire eastern Skagerrak coast, and as far south as to the middle part of the eastern Kattegat coastline. The number of populations and population size decrease when going south, although the differences had dimished between 1993 and 1996. However, the number of new sites, as well as population numbers still increase. Areas with continuous populations can now be found along the NE Skagerrak coast, and isolated localities may also be found in the inner parts of the archipelagoes. No morphological differences were seen between plants from the more saline Skagerrak and the more brackish Kattegat. The maximum plant length recorded was 4.2 m. Sargassum muticum has definitely become a permanent member of the Swedish algal flora. Although the expansion into the Baltic is slow, it is most likely that, given time, the species will colonize suitable habitats in the entire Kattegat. The possibility of further expansion into the Baltic proper, with its low biodiversity, remains a subject for speculation. [ABSTRACT FROM AUTHOR]

Congestive heart failure (CHF) is a significant health problem for women, particularly elderly women. The risk factors for heart failure appear to be different in women than in men, with hypertension and diabetes playing a greater role in women and ischaemic heart disease a greater role in men. The aim of this study was to describe, from a nurse's perspective, how female patients with CHF conceive their life situation. Interview questions were designed with a focus on five dimensions: biophysical, socio-cultural, emotional, intellectual and spiritual-existential. A qualitative method was used with a phenomenographic approach, as this approach examines aspects of the surroundings as they are conceived. Five categories emerged in the results: feeling content, feeling a sense of support, feeling a sense of limitation, feeling anxiety and feeling powerless. A sense of limitation regarding working capacity and being able to support those in their surroundings causes patients with CHF to experience anxiety due to feeling insecure about themselves and in relation to their surroundings. This may result in feelings of worthlessness in women with CHF, both concerning their own capacity and the fact that they feel they are a burden to those around them. Through nursing intervention, these patients can receive help to break this vicious circle of feeling limited and powerless. This can be done by encouraging them to verbalize their feelings and set realistic goals and expectations, and by increasing their knowledge and that of their families concerning CHF and its symptoms, with a focus on self-care and existing possibilities. These measures will make it easier for women with CHF to maintain a hopeful perspective and a sense of control, competence, and self-esteem. [ABSTRACT FROM AUTHOR]