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Tezepelumab is a human monoclonal antibody that blocks the activity of thymic stromal lymphopoietin. This analysis assessed the suitability of a fixed‐dose regimen of tezepelumab 210 mg every 4 weeks (Q4W) in adults and adolescents with severe, uncontrolled asthma. A population pharmacokinetic model was developed using data from 1368 patients with asthma or healthy participants enrolled in 8 clinical studies (phases 1‐3). Tezepelumab exposure‐efficacy relationships were analyzed in the phase 3 NAVIGATOR study (NCT03347279), using asthma exacerbation rates over 52 weeks and changes in pre‐bronchodilator forced expiratory volume in 1 s at week 52. Tezepelumab pharmacokinetics were well characterized by a 2‐compartment linear disposition model with first‐order absorption and elimination following subcutaneous and intravenous administration at 2.1‐420 and 210‐700 mg, respectively. There were no clinically relevant effects on tezepelumab pharmacokinetics from age (≥12 years), sex, race/ethnicity, renal or hepatic function, disease severity (inhaled corticosteroid dose level), concomitant asthma medication use, smoking history, or anti‐drug antibodies. Body weight was the most influential covariate on tezepelumab exposure, but no meaningful differences in efficacy or safety were observed across body weight quartiles in patients with asthma who received tezepelumab 210 mg subcutaneously Q4W. There was no apparent relationship between tezepelumab exposure and efficacy at this dose regimen, suggesting that it is on the plateau of the exposure‐response curve of tezepelumab. In conclusion, a fixed‐dose regimen of tezepelumab 210 mg subcutaneously Q4W is appropriate for eligible adults and adolescents with severe, uncontrolled asthma. [ABSTRACT FROM AUTHOR]

The first case of African swine fever (ASF) was confirmed in Sweden in September 2023. This article describes the local epidemiology, including the spatiotemporal dynamics of the outbreak and some of the factors that may have contributed to its apparently successful eradication. Upon detection of the outbreak, strict control measures were put in place in a preliminarily defined infected zone. A carcass search, including geo‐localisation, removal, sampling, and destruction of found carcasses, was initiated and a preliminary core area was defined based on the results. Six months after confirmation of the first case, 93 wild boar carcasses had been found in the infected zone, of which 62 tested positive for ASF virus (ASFV). All ASFV‐positive carcasses were found inside the core area. Based on two taphonomy methods, it was assumed that the infection was introduced between early May and late June 2023. The data also indicated that the epidemic curve peaked between mid‐August and mid‐September, with the last death occurring in late September 2023. Based on the average estimated time of death, geo‐localisation of carcasses and two‐dimensional kernel density estimation, clustering in space and time was identified. An online questionnaire with questions about hunting and the wild boar population was sent to all leaders of hunting groups in the infected zone. The results showed that the wild boar population had increased in the last 10 years but with large variations and geographical heterogeneity in space use. Disease introduction through natural wild boar movements was excluded and it was assumed that the long‐distance translocation of the virus had occurred through human activities. A municipal waste collection centre without wild boar‐proof fencing is located close to the epicentre of the outbreak, attracting many wild boar and contributing to the spread of the virus once it had been introduced to the population. [ABSTRACT FROM AUTHOR]

All the Nordic countries offer individuals who claim to have been wrongfully convicted the possibility to apply for post-conviction review. The research on wrongful convictions has however often discussed the risk that those cases that are identified, i.e., those cases of post-conviction review that lead to exoneration, are not representative of wrongful convictions as a whole. Moving from this background, this article provides an overview and comparison of the systems of post-conviction review in the Nordic countries, and problematises this description from an access-to-justice perspective with the aim of examining the obstacles wrongful conviction claimants may face when they attempt to pursue this review remedy. On the basis of the parameters used in this article to study accessibility of the review systems, Finland is emerging as the country with the least accessible system, whereas the Norwegian system is the most accessible, followed by that of Iceland. It is not entirely evident how Sweden and Denmark should be ranked in relation to one another however. The results are discussed from a transparency point of view, since detailed information that allows for an analysis of practice appears to be lacking in at least three of the Nordic countries. [ABSTRACT FROM AUTHOR]

Rationale: Tezepelumab reduced exacerbations in patients with severe, uncontrolled asthma across a range of baseline blood eosinophil counts and fractional exhaled nitric oxide levels, and irrespective of allergy status, in the phase 2b PATHWAY (Study to Evaluate the Efficacy and Safety of MEDI9929 [AMG 157] in Adult Subjects With Inadequately Controlled, Severe Asthma; NCT 02054130) and phase 3 NAVIGATOR (Study to Evaluate Tezepelumab in Adults & Adolescents With Severe Uncontrolled Asthma; NCT 03347279) trials. Objectives: To examine the efficacy and safety of tezepelumab in additional clinically relevant subgroups using pooled data from PATHWAY and NAVIGATOR. Methods: PATHWAY and NAVIGATOR were randomized, double-blind, placebo-controlled trials with similar designs. This pooled analysis included patients with severe, uncontrolled asthma (PATHWAY, 18–75 years old; NAVIGATOR, 12–80 years old) who received tezepelumab 210 mg or placebo subcutaneously every 4 weeks for 52 weeks. The annualized asthma exacerbation rate over 52 weeks and secondary outcomes were calculated in the overall population and in subgroups defined by inflammatory biomarker levels or clinical characteristics. Measurements and Main Results: Overall, 1,334 patients were included (tezepelumab, n = 665; placebo, n = 669). Tezepelumab reduced the annualized asthma exacerbation rate versus placebo by 60% (rate ratio, 0.40 [95% confidence interval, 0.34–0.48]) in the overall population, and clinically meaningful reductions in exacerbations were observed in tezepelumab-treated patients with type 2–high and type 2–low disease by multiple definitions. Tezepelumab reduced exacerbation-related hospitalization or emergency department visits and improved secondary outcomes compared with placebo overall and across subgroups. The incidence of adverse events was similar between treatment groups. Conclusions: Tezepelumab resulted in clinically meaningful reductions in exacerbations and improvements in other outcomes in patients with severe, uncontrolled asthma, across clinically relevant subgroups. [ABSTRACT FROM AUTHOR]

The currant bud moth Euhyponomeutoides albithoracellus is a destructive pest in black currant orchards in Northern Sweden and Finland. The larvae feed on the buds, and at high densities, the species can cause severe yield losses. Sex pheromone components of the bud moth were identified via solvent extraction of excised female pheromone glands, analyses by gas chromatography with electroantennographic detection and gas chromatography–mass spectrometry and field trapping experiments. Antennae of males responded strongly and consistently to two compounds in extracts, identified as (E)‐11‐tetradecenyl acetate and (Z)‐11‐tetradecenyl acetate. Weaker and less consistent responses were observed to the corresponding alcohols, (E)‐11‐tetradecenol and (Z)‐11‐tetradecenol, and tetradecyl acetate. Field tests showed strong attraction of bud moth males to a 1:1 blend of (E)‐11‐tetradecenyl acetate and (Z)‐11‐tetradecenyl acetate. Adding the alcohols to the binary acetate blend reduced trap catches drastically, whereas tetradecyl acetate had no statistically significant impact on male attraction when added to that binary blend. Finally, testing different compositions of the binary acetate blend revealed highest catch in traps baited with a 25:75 or 50:50 ratio of the E:Z acetate isomers. The identification of sex pheromone components of the bud moth contributes to developing sustainable control of this pest via monitoring and mating disruption with sex pheromone. [ABSTRACT FROM AUTHOR]

Background: Allergic asthma is the most common phenotype among patients with severe asthma. In the phase 3 NAVIGATOR study (NCT03347279), tezepelumab significantly reduced the annualized asthma exacerbation rate (AAER) versus placebo in patients with severe, uncontrolled asthma. This exploratory analysis evaluated the efficacy of tezepelumab in NAVIGATOR participants with evidence of severe allergic asthma. Methods: Patients (12–80 years old) receiving medium‐ or high‐dose inhaled corticosteroids and ≥ 1 additional controller medication, with or without oral corticosteroids, were randomized to tezepelumab 210 mg or placebo subcutaneously every 4 weeks for 52 weeks in NAVIGATOR. In this analysis, the AAER, forced expiratory volume in 1 second (FEV1), patient‐reported outcomes (PROs), and type 2 biomarker levels were evaluated in patients grouped by sensitivity to perennial aeroallergens, confirmed symptomatic allergy, and eligibility for omalizumab treatment according to the United States (OMA‐US) and the European Union (OMA‐EU) prescribing information, including subgroups according to baseline blood eosinophil counts and fractional exhaled nitric oxide (FeNO) levels. Results: Of 1059 patients who received treatment in NAVIGATOR, 680 (64%) had perennial aeroallergen sensitivity and 318 (30%) had confirmed symptomatic allergy; 379 (36%) and 359 (34%) patients were OMA‐US‐ and OMA‐EU‐eligible, respectively. Tezepelumab reduced the AAER over 52 weeks versus placebo by 58% (95% confidence interval [CI]: 47–67) to 68% (95% CI: 55–77) across these subgroups. Among omalizumab‐eligible patients, AAERs were reduced in patients across baseline blood eosinophil counts and FeNO levels. Tezepelumab improved FEV1 and PROs, and reduced type 2 biomarkers, versus placebo in patients with and without perennial allergy. Conclusions: Tezepelumab was efficacious in patients with severe, uncontrolled asthma with evidence of allergic inflammation, defined by multiple clinically relevant definitions. These findings further support the benefits of tezepelumab in a broad population of patients with severe asthma, including those with severe allergic asthma. [ABSTRACT FROM AUTHOR]

After decades of growth, the Bangladesh Solar Home Systems (SHS) programme, the world's largest domestic solar off-grid electrification scheme which has frequently been heralded as a model for other developing countries, is in danger of collapsing as end user support and installation levels have plummeted. This paper explores the reasons behind this development, tracing the programme run by the Infrastructure Development Company Limited (IDCOL) from its early expansion employing pioneering partnership and financing models, to its more recent decline. It finds that the government's simultaneous implementation of several competing on- and off-grid energy access projects and lack of regulatory oversight alongside significant subsidy decreases which made SHS uncompetitive, led customers to abandon the programme. This, in turn, is putting at risk Bangladesh's objective of achieving Sustainable Development Goal (SDG) 7 – affordable, reliable, sustainable and modern energy for all – by 2030. KEY POLICY INSIGHTS: The intended maturation of the market for off-grid solar did not occur alongside the gradual reduction of the SHS programme's subsidy scheme. This resulted in a lack of service and technology providers and continued high system prices, unattainable to poor households in rural Bangladesh. The Government of Bangladesh's unexpected grid expansion into SHS areas and introduction of free solar energy systems in 2015 further undermined the programme because it led to: o customer's turning away from SHS and defaulting on their loan payments, leading to financial problems for IDCOL's partner organizations. o entry of unregulated sub-standard panels into the market, resulting in a lack of confidence and distrust in the SHS by end-users. • A key role of the government is to ensure the sound quality of the systems and services from the outset to instil customer confidence in the product. • The creation of successful long-term energy access requires a comprehensive, integrated approach to coordinate stakeholders and oversee market development over time, ensuring that markets for new technologies and services such as SHS have an opportunity to succeed. [ABSTRACT FROM AUTHOR]

Introduction: Borderline personality disorder patients are often subjected to inpatient compulsory care due to suicidal behaviour. However, inpatient care is usually advised against as it can have detrimental effects, including increased suicidality. Aim: To investigate what motives psychiatrists have for treating borderline personality disorder patients under compulsory care. Materials and Methods: A questionnaire survey was distributed to all psychiatrists and registrars in psychiatry working at mental health emergency units or inpatient wards in Sweden. The questionnaire contained questions with fixed response alternatives, with room for comments, about the respondents' motives for practising compulsory care of borderline personality disorder patients. The responses were analysed quantitatively with descriptive statistics, and comments were analysed with qualitative descriptive content analysis. Results: The psychiatrists' views were divided on when it was justified to treat borderline personality disorder patients under compulsory care, as were their views on borderline personality disorder patients' decision competence. When there was an assessed risk of harm, 53% were positive to compulsory care of decision-competent borderline personality disorder patients and another 31% because they considered the patients to be decision incompetent in such situations. Adding the risk of harm caused many respondents to alter their assessment of the patient from decision competent to decision incompetent. Conclusion: The large variations in doctors' opinions indicate that the care of borderline personality disorder patients is arbitrary. Further, the assessed risk of harm increases the use of compulsory care, even though such care is advised against in clinical guidelines, has questionable legal support, and could lead to an increased suicide risk over time. [ABSTRACT FROM AUTHOR]

The purpose of this article is to discuss the significance of Liverpool Football Club's (LFC) anthem 'You'll Never Walk Alone' ('YNWA') for Swedish fans of LFC. The song has been played before home matches at the Anfield stadium since the 1960s, and via the media, it has spread all over the world. We can therefore talk about a kind of satellite supporters who can be involved no matter where in the world they are. Based on a survey conducted with help from Liverpool FC Official Supporters Club Sweden, 378 people (355 men and 23 women) answered questions about their relationship to the city of Liverpool and the Liverpool football team, how long they have been fans and why they chose LFC, and, finally, their connection to 'YNWA'. The results show that the Swedish fans feel a great sense of belonging to both the team and the city of Liverpool and that the song is very important to them even in everyday life. For the fans in the survey, 'YNWA' unites them with the team and fans from all over the world while separating themselves from other fans and football clubs with other anthems. The song thus becomes larger than itself. Identity and performances are important concepts on which the article is based. [ABSTRACT FROM AUTHOR]

Introduction: Treatment-induced peripheral neuropathy (TIPN) is a complication of multiple myeloma (MM) treatment. Objective: This real-world, retrospective study used electronic medical record (EMR) data from 3 Swedish clinics to assess the occurrence and economic burden of TIPN in patients with MM. Methods: Eligible patients had an MM diagnosis in the Swedish Cancer Registry between 2006 and 2015 and initiated treatment during that period. Follow-up was until last EMR visit, death, or study end (April 2017). The current analyses included patients receiving bortezomib, lenalidomide, carfilzomib, or thalidomide at any treatment line. To discern healthcare resource utilization (HCRU) and costs associated with TIPN from other causes, patients with TIPN were matched with those without on baseline characteristics, treatment, and line of therapy. All analyses were descriptive. Results: Overall, 457 patients were included; 102 (22%) experienced TIPN. Patients experiencing TIPN during first-line treatment mostly received bortezomib-based regimens (n = 48/57 [84%]); those with TIPN during second- and third/fourth-line treatment mostly received lenalidomide/thalidomide-based regimens (19/31 [61%], 8/14 [57%], respectively). Patients with TIPN had higher HCRU/costs than those without TIPN (mean differences in hospital outpatient visits: 5.2, p = 0.0031; total costs per patient-year: EUR 17,183, p = 0.0007). Conclusions: Effective MM treatments associated with a reduced incidence of TIPN could result in decreased healthcare expenditure. [ABSTRACT FROM AUTHOR]

Background: Tezepelumab is a human monoclonal antibody that blocks thymic stromal lymphopoietin, an epithelial cytokine implicated in asthma pathogenesis, from binding to its heterodimeric receptor. In the phase 2b PATHWAY study, tezepelumab significantly reduced annualized asthma exacerbation rates (AAERs) versus placebo, irrespective of baseline disease characteristics, and improved lung function and symptom control, in adults with severe, uncontrolled asthma. This post hoc analysis assessed the efficacy of tezepelumab in adults with severe, uncontrolled asthma with and without nasal polyposis (NP). Methods: In this post hoc analysis of the PATHWAY study (NCT02054130), participants (N=550) were randomized 1:1:1:1 to receive subcutaneous tezepelumab 70 mg every 4 weeks (Q4W), 210 mg Q4W or 280 mg every 2 weeks (Q2W), or placebo Q2W, for 52 weeks. The AAER over 52 weeks and the change from baseline to week 52 in blood eosinophil count, fractional exhaled nitric oxide (FeNO) levels and serum levels of interleukin (IL)-5 and IL-13 with tezepelumab 210 mg (the phase 3 dose) and placebo were analyzed in patients grouped by self-reported presence (NP+) or absence (NP−) of NP at screening. Results: At baseline, NP+ patients had higher blood eosinophil counts, higher FeNO levels and higher serum IL-5 and IL-13 levels than NP− patients. Tezepelumab 210 mg reduced the AAER versus placebo to a similar extent in both NP+ and NP− patients (NP+, 75% [95% confidence interval (CI): 15, 93], n=23; NP−, 73% [95% CI: 47, 86], n=112). Patients treated with tezepelumab 210 mg demonstrated greater reductions in blood eosinophil count and levels of FeNO, IL-5 and IL-13 than placebo-treated patients, irrespective of NP status. Discussion: Tezepelumab reduced exacerbations and reduced type 2 inflammatory biomarkers in patients with and those without NP, supporting its efficacy in a broad population of patients with severe asthma. [ABSTRACT FROM AUTHOR]

Introduction: Tezepelumab is a human monoclonal antibody that blocks thymic stromal lymphopoietin (TSLP), an epithelial cytokine implicated in airway inflammation in asthma, from binding to its heterodimeric receptor. In the PATHWAY phase 2b study, tezepelumab significantly reduced exacerbation rates compared with placebo in adults with severe, uncontrolled asthma, irrespective of baseline disease characteristics. Objective: To evaluate the effect of tezepelumab on asthma exacerbations on a seasonal basis. Methods: This was a post hoc analysis of the PATHWAY study (NCT02054130). Adults (N=550) with severe, uncontrolled asthma were randomized 1:1:1:1 to receive subcutaneous tezepelumab 70 mg every 4 weeks (Q4W), 210 mg Q4W or 280 mg every 2 weeks (Q2W), or placebo Q2W, for 52 weeks. The annualized asthma exacerbation rate (AAER), total number of days with an exacerbation, proportion of patients with at least one exacerbation or 0, 1 or ≥ 2 exacerbations, and proportion of patients experiencing an exacerbation per day were evaluated by season and over the year, by treatment in the overall study population and in subgroups according to baseline blood eosinophil count (≥ 300 cells/μL or < 300 cells/μL) or atopic asthma status (fluoro-enzyme immunoassay [FEIA]+ or FEIA−). Results: Seasonal variations in exacerbation rates were found, with peaks observed in fall and winter, and greater variations in patients with high blood eosinophil counts (≥ 300 cells/μL). Tezepelumab treatment consistently reduced exacerbation rates across all seasons compared with placebo. Furthermore, there was a trend, which was not significant, toward a reduction in the total number of days with exacerbations and in the proportion of patients with exacerbations during each season in patients treated with tezepelumab compared with those who received placebo, irrespective of blood eosinophil count or atopic asthma status. Conclusion: Tezepelumab reduced exacerbations across all seasons, irrespective of evaluated baseline disease characteristics. These data support the efficacy of tezepelumab in a broad population of patients with severe, uncontrolled asthma. [ABSTRACT FROM AUTHOR]

Continuous subcutaneous (s.c.) apomorphine infusion is an effective therapy for Parkinson's disease (PD), but a limitation is the formation of troublesome s.c. nodules. Various chemically non-identical apomorphine formulations are available. Anecdotal experiences have suggested that shifting from one of these (Apo-Go PumpFill®; apoGPF) to another (Apomorphine PharmSwed®; apoPS) may influence the occurrence and severity of s.c. nodules. We, therefore, followed 15 people with advanced PD (median PD-duration, 15 years; median "off"-phase Hoehn and Yahr, IV) on apoGPF and with troublesome s.c. nodules who were switched to apoPS. Data were collected at baseline, at the time of switching, and at a median of 1, 2.5, and 7.3 months post-switch. Total nodule numbers (P < 0.001), size (P < 0.001), consistency (P < 0.001), skin changes (P = 0.058), and pain (P ≤ 0.032) improved over the observation period. PD severity and dyskinesias tended to improve and increase, respectively. Apomorphine doses were stable, but levodopa doses increased by 100 mg/day. Patient-reported apomorphine efficacy tended to increase and all participants remained on apoPS throughout the observation period; with the main patient-reported reason being improved nodules. These observations suggest that patients with s.c. nodules caused by apoGPF may benefit from switching to apoPS in terms of s.c. nodule occurrence and severity. Alternatively, observed benefits may have been due to the switch itself. As nodule formation is a limiting factor in apomorphine treatment, a controlled prospective study comparing local tolerance with different formulations is warranted. [ABSTRACT FROM AUTHOR]

Background: Patients with severe, uncontrolled asthma have a significant unmet need for new treatments that have broader effects on airway inflammation, and that provide greater improvements in asthma outcomes than currently approved biologics and standard-of-care therapies. Tezepelumab is a human monoclonal antibody that blocks the activity of the epithelial cytokine thymic stromal lymphopoietin. In the PATHWAY phase 2b study (NCT02054130), tezepelumab significantly reduced exacerbations by up to 71% in adults with severe, uncontrolled asthma, irrespective of baseline disease phenotype. This article reports the design and objectives of the pivotal phase 3 NAVIGATOR study.Methods: NAVIGATOR (NCT03347279) is an ongoing randomized, double-blind, placebo-controlled trial in adults (18-80 years old) and adolescents (12-17 years old) with severe, uncontrolled asthma, who are receiving treatment with medium- or high-dose inhaled corticosteroids plus at least one additional controller medication with or without oral corticosteroids (N = 1061). The study population includes approximately equal proportions of patients with high (≥ 300 cells/μL) and low (< 300 cells/μL) blood eosinophil counts. The study comprises a 5-6-week screening period, a 52-week treatment period and a 12-week post-treatment follow-up period. All patients will receive their prescribed controller medications without change throughout the study. The primary efficacy endpoint is the annualized asthma exacerbation rate during the 52-week treatment period. Key secondary endpoints include the effect of tezepelumab on lung function, asthma control and health-related quality of life.Discussion: NAVIGATOR is evaluating the effect of tezepelumab in patients with a broad range of severe asthma phenotypes at baseline, including those with low blood eosinophil counts. The target sample size for NAVIGATOR (N = 1060) was achieved, and it is the largest clinical study of tezepelumab in severe, uncontrolled asthma to date. NAVIGATOR aims to further investigate the effect of tezepelumab on exacerbations and build on observations from the phase 2b PATHWAY study, and to demonstrate further the potential of tezepelumab to provide patients with severe, uncontrolled asthma with improvements in lung function, asthma control and health-related quality of life.Trial Registration: NCT03347279 (ClinicalTrials.gov). Registered 20 November 2017. [ABSTRACT FROM AUTHOR]

Background: Many patients with severe asthma continue to experience asthma symptoms and exacerbations despite standard-of-care treatment. A substantial proportion of these patients require long-term treatment with oral corticosteroids (OCS), often at high doses, which are associated with considerable multiorgan adverse effects, including metabolic disorders, osteoporosis and adrenal insufficiency. Tezepelumab is a human monoclonal antibody that blocks the activity of the epithelial cytokine thymic stromal lymphopoietin. In the PATHWAY phase 2b study (NCT02054130), tezepelumab significantly reduced exacerbations by up to 71% in adults with severe, uncontrolled asthma. Several ongoing phase 3 trials (SOURCE, NCT03406078; NAVIGATOR, NCT03347279; DESTINATION, NCT03706079) are assessing the efficacy and safety of tezepelumab in patients with severe, uncontrolled asthma. Here, we describe the design and objectives of SOURCE, a phase 3 OCS-sparing study.Methods: SOURCE is an ongoing phase 3, multicentre, randomized, double-blind, placebo-controlled study to evaluate the effect of tezepelumab 210 mg administered subcutaneously every 4 weeks on OCS dose reduction in adults with OCS-dependent asthma. The study comprises a 2-week screening and enrolment period, followed by an OCS optimization phase of up to 8 weeks and a 48-week treatment period, which consists of a 4-week induction phase, followed by a 36-week OCS reduction phase and an 8-week maintenance phase. The primary objective is to assess the effect of tezepelumab compared with placebo in reducing the prescribed OCS maintenance dose. The key secondary objective is to assess the effect of tezepelumab on asthma exacerbation rates. Other secondary objectives include the proportion of patients with a reduction in OCS dose (100% or 50% reduction or those receiving < 5 mg) and the effect of tezepelumab on lung function and patient-reported outcomes.Conclusions: SOURCE is evaluating the OCS-sparing potential of tezepelumab in patients with OCS-dependent asthma. SOURCE also aims to demonstrate that treatment with tezepelumab in patients with severe asthma is associated with reductions in exacerbation rates and improvements in lung function, asthma control and health-related quality of life, while reducing OCS dose.Trial Registration: NCT03406078 ( ClinicalTrials.gov ). Registered 23 January 2018. https://clinicaltrials.gov/ct2/show/NCT03406078. [ABSTRACT FROM AUTHOR]

Persons with Parkinson's disease and their care partners want support from health care to develop the skills to handle everyday life with the long‐term condition. Earlier findings indicate that participants of the self‐management program Swedish National Parkinson School experience several benefits of the program. The purpose of this qualitative observational study was to explore if participants had implemented the strategies of self‐monitoring included in the program and use them to communicate health care status and needs in clinical encounters. Data were collected 3 to 15 months after participation in the program and analyzed using constant comparative analysis. Three categories were evident: "Self‐observation in everyday life," "Self‐care activities to promote health," and "Managing emotional impact of Parkinson's Disease." Categories were linked together in a core category that highlight the use of self‐management strategies described by participants during clinical encounters. Results confirmed that persons with Parkinson's disease and care partners use the techniques of self‐observation in their everyday lives. Observations of effects in clinical care can be a valuable approach to evaluate the outcomes educational interventions and their benefits for individuals and health care. [ABSTRACT FROM AUTHOR]

Although threatened by forestry, our knowledge concerning saproxylic insects is strongly biased towards well-known orders, mainly beetles (Coleoptera). The beetles have, therefore, formed the basis on which conservation measures of other groups have been formulated. Despite being more species-rich, the Diptera have been rather neglected. Moreover, our limited knowledge of the Diptera suggests that their demands on the dead wood substrate differ markedly from that of coleopterans. We tested if this is true by comparing the substrate requirements of dipteran and coleopteran species by analysing the affinities of species assemblages for logging residues differing in age, size, and tree species. Insects were reared out from the same samples of bioenergy wood from clear-cuts in Sweden. 15 species of Brachyceran flies were compared with 56 species of Coleoptera. We found the average level of specialisation to be similar between the two groups, but the dipterans had (contrary to the expectations) a higher proportion of specialists. Affinities for differently aged wood were similar. More dipterans than beetles were associated with the coarsest wood (diameter 9 cm–15 cm). More dipterans than beetles tended to be associated with aspen (Populus tremula), while Coleoptera tended to be more associated than Diptera with oak (Quercus) and spruce (Picea abies). We conclude that most recommendations for conserving the saproxylic beetle fauna also seem to benefit dipterans, but that the dipterans might be even more sensitive to which qualities of the wood that is preserved. The high conservation value of aspen is already recognised and our results for dipterans strengthen this. The high incidence of many dipteran species in logging residues suggests that many dipterans use sun-exposed environments. [ABSTRACT FROM AUTHOR]

Background. Parkinson's disease is a neurodegenerative condition with both physical and mental consequences that affect many aspects of everyday life. Persons with Parkinson's disease and their care partners want guidance from healthcare services in order to develop skills to adjust to life with a long-term condition. The Swedish National Parkinson School is a dyadic self-management programme to support both persons with Parkinson's disease and care partners. Objective. To assess the outcomes of the Swedish National Parkinson School as reported by participants. Design. A quasi-experimental case-control study in clinical care using self-reported questionnaires. Participants. Swedish National Parkinson School was offered by health care professionals working in clinical care. Participants in the programme were also asked to participate in the study. A matched control group was recruited for a comparison of findings. In total, 92 persons with Parkinson's disease and 55 care partners were included. Settings. Five Swedish geriatric and neurologic outpatient clinics. Method. Data were collected during 2015–2017, before and after participation in the National Parkinson School or before and after seven weeks of standard care. Outcomes were assessed using generic and Parkinson's specific questionnaires. Descriptive statistics were used to describe baseline characteristics. Mann–Whitney U and Chi2 tests were used to test for between-group differences and within-group differences were tested by the Wilcoxon signed-ranks test. Results. Improvements regarding health status, constructive attitudes and approaches, and skill and technique acquisition were found after the intervention among persons with Parkinson's disease. No changes were found among care partners. Conclusion. The findings indicate that the Swedish National Parkinson School may improve health status and self-management among persons with Parkinson's disease, but further studies are needed to better understand the effects of the programme. [ABSTRACT FROM AUTHOR]

Despite more than 250 years of taxonomic research, we still have only a vague idea about the true size and composition of the faunas and floras of the planet. Many biodiversity inventories provide limited insight because they focus on a small taxonomic subsample or a tiny geographic area. Here, we report on the size and composition of the Swedish insect fauna, thought to represent roughly half of the diversity of multicellular life in one of the largest European countries. Our results are based on more than a decade of data from the Swedish Taxonomy Initiative and its massive inventory of the country's insect fauna, the Swedish Malaise Trap Project The fauna is considered one of the best known in the world, but the initiative has nevertheless revealed a surprising amount of hidden diversity: more than 3,000 new species (301 new to science) have been documented so far. Here, we use three independent methods to analyze the true size and composition of the fauna at the family or subfamily level: (1) assessments by experts who have been working on the most poorly known groups in the fauna; (2) estimates based on the proportion of new species discovered in the Malaise trap inventory; and (3) extrapolations based on species abundance and incidence data from the inventory. For the last method, we develop a new estimator, the combined non-parametric estimator, which we show is less sensitive to poor coverage of the species pool than other popular estimators. The three methods converge on similar estimates of the size and composition of the fauna, suggesting that it comprises around 33,000 species. Of those, 8,600 (26%) were unknown at the start of the inventory and 5,000 (15%) still await discovery. We analyze the taxonomic and ecological composition of the estimated fauna, and show that most of the new species belong to Hymenoptera and Diptera groups that are decomposers or parasitoids. Thus, current knowledge of the Swedish insect fauna is strongly biased taxonomically and ecologically, and we show that similar but even stronger biases have distorted our understanding of the fauna in the past. We analyze latitudinal gradients in the size and composition of known European insect faunas and show that several of the patterns contradict the Swedish data, presumably due to similar knowledge biases. Addressing these biases is critical in understanding insect biomes and the ecosystem services they provide. Our results emphasize the need to broaden the taxonomic scope of current insect monitoring efforts, a task that is all the more urgent as recent studies indicate a possible worldwide decline in insect faunas. [ABSTRACT FROM AUTHOR]

We present an overview of the local environmental development of the valley of Hjaltadalur, situated in Skagafjörður, northern Iceland. The aim of this study is to increase the knowledge about the valley region before and during human settlement in the ninth century. Four mires were investigated after which the Viðvík peat bog was selected as the main site for evaluating changes in climate and landscape. The master core from Viðvík (V-325) was dated and studied further through sediment analysis, loss-on-ignition (LOI), and pollen analysis. According to the age-depth model, based on three radiocarbon dates and analysis of two tephra layers, the 325 cm long Viðvík core comprises approximately 5500 years. In the pollen percentage record, there is a decrease in birch (Betula) and an increase in grass (Poaceae) in the central part of the core, between Hekla 3 horizon at c. 2800 BP and the next dated level at c. 2000 BP. This change corresponds well with previously outlined environmental fluctuations, showing a transition from warm and dry climate to cool and humid climate at this time. Human activity is mainly reflected by a distinct peak in Lactucae pollen in the uppermost part of the core. This change in vegetation corresponds with earlier studies, showing that the vegetation changed dramatically after the colonization of Iceland in the ninth century (during Landnám period, 870–930 AD). The present study shows that a decline in birch started well before human settlement, although the subsequent Viking Age and later settlements continued the deforestation trend. [ABSTRACT FROM AUTHOR]

Geoscience is relevant to issues in sustainability in many ways, for example through the aspects of earth sciences connected to the environment, climate, geohazards, energy and natural resources. There is also significant support for the use of active fieldwork experience as an effective way to teach sustainability in earth science. Some of the best sites for exploring sustainability issues in geoscience are those designated for special attention, such as geoparks, geosites, nature reserves and World Heritage Sites. Former mining areas are another type of useful locality to teach about sustainability in geosciences, as these sites usually present ample evidence of severe mining impacts on the environment and people through time. Historical mining activities can present typical examples of non-sustainable ways of working alongside modern remediation projects to manage severe environmental problems. Here, the Great Copper Mountain in Falun, central Sweden, is presented as an example of a "suitable field study site" for teaching sustainability in geoscience. This site is a former mining area, today museum and visiting resort and a designated UNESCO World Heritage Site. Mining and human activities have had a severe impact on this landscape for up to 1000 years. As a result, it is an example of a historical non-sustainable activity that is now the site of active and developed remediation work that aims for a sustainable future for both environment and people. The Falun site presents themes useful for teaching both geoscience and sustainability, and it is presented in order to demonstrate the advantages of using a site like this for teaching sustainability in earth science. [ABSTRACT FROM AUTHOR]

When stumps on clear cuts are harvested for bioenergy, retention of a share of them is recommended to mitigate environmental issues. To maximise benefits for the diversity of saproxylic beetles, retention should be done in dry positions. Saproxylic dipterans are usually thought to be associated with wetter wood substrates. We therefore hypothesised that dipterans would benefit from other recommendations. We tested that by rearing out insects from spruce and birch stumps sampled in clear fellings, and received a material of 866 individuals of 24 Diptera taxa. Among six Diptera species tested statistically, one was associated with dry stumps when comparing within spruce, and the total abundance of dipterans was higher in dry spruce stumps than in wet. No parameter (total species number, species number per stump, total abundances and abundances of individual species) showed a higher value for wet stumps than for dry. We conclude that there are several Diptera species that frequently use stumps, of which a large share was earlier regarded as very rare. For those, our hypothesis was falsified, as the affinities to dry stumps seem similar as for beetles and the same recommendations could be used. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate effects of snuff on the oral health status of adolescent males.Materials and Methods: The participants consisted of 80 adolescent males between 16-25 years, 40 snuff users and 40 non-users. The snuff users and non-users were matched with reference to their age. Data were collected using a questionnaire containing questions on general and oral health, daily oral hygiene and tobacco habits. The clinical examination was carried out in a dental office by two experienced dental hygienists. Snuff lesions were clinically classified on a four-point scale and documented on colour slides. The examination also assessed the number of teeth, restored tooth surfaces, plaque index and gingival index, probing pocket depth and gingival recessions.Results: Out of 40 snuff users, 35 showed snuff incluced lesions. The clinical diagnosis of snuff users' mucosa showed snuff lesions of different severity clinically classified as degree 1, 2 and 3. When explaining snuff lesions of degree 2 and 3, hours of daily snuff use and package form (portion-bag snuff versus loose snuff) was statistically significant. There were no statistical differences between snuff users and non-users regarding restored tooth surfaces, presence of plaque, gingival inflammation and probing pocket depth. Seventeen percent of the cases showed loss of periodontal attachment as gingival recessions.Conclusion: In spite of mucosal lesions caused by snuff there were no statistical differences in prevalence in plaque and gingivitis between snuff users and non-users. However, some cases showed loss of periodontal attachment as gingival recessions. [ABSTRACT FROM AUTHOR]

Abstract: Aims and objective: To identify and describe experiences valuable for managing daily life after participation in the NPS self‐management intervention. The second part was to explore the applicability of the Self‐ and family management framework by Grey and colleagues for persons with Parkinson's Disease and their relatives. Background: The impact of PD is evident on the lives of both patients and relatives. The National Parkinson School (NPS) is a Swedish self‐management programme designed for patients and relatives, aiming at teaching strategies helpful for the ability of self‐management, in order to promote life satisfaction. Design: Qualitative explorative with inductive and deductive analysis. Methods: Five group discussions with NPS participants were audio‐recorded. Verbatim transcriptions were analysed inductively with thematic analysis according to Braun and Clarke, and the findings were then applied deductively to the existing model for patients with chronic disease. Results: Through the first step of inductive analysis, three themes capturing the meaning, value and experience of being a participant at the NPS were identified: exchanging experiences and feeling support, adjustment and acceptance of PD for managing daily life and promoting life satisfaction. The deductive analysis applied the inductive findings to the Self‐ and family management framework of chronically ill to explore the fit to persons with PD and relatives attending the NPS programme. Conclusions: The NPS programme is a promising approach for helping persons with PD and their relatives to achieve better self‐management of disease and improved life satisfaction. Further evaluations of programme outcomes in clinical practice are warranted. Relevance of clinical practice: Self‐management programmes like the NPS is a promising approach in facilitating a positive mindset and outlook on life and gain knowledge to understand, adapt and handle chronic disease, such as PD, better. [ABSTRACT FROM AUTHOR]

The article discusses the recognition of same-sex partnerships in the Evangelical Lutheran Church of Finland (ELCF). The main focus is on the experiences of recognition and misrecognition of same-sex couples when the couples have asked for a prayer on behalf of their registered partnership. The findings of this study confirm that the researched experiences of recognition have two dimensions, vertical and horizontal. Vertical recognition deals with institutional recognition and experiences with the sacred. Horizontal recognition entails experiences of interpersonal recognition. Narrated experiences often contained both horizontal and vertical dimensions of (mis)recognition. Recognition is a social phenomenon. Participants of the study had two distinct social contexts for recognition. One is the more loosely defined “rainbow community”, the other the formally authoritative, institutional ELCF. Most of the interviewees had positive experiences of recognition from the informal community but mainly negative experiences of misrecognition from the institutional ELCF. The difficult balancing between the conviction of the equal human dignity of each individual and the understanding of marriage as a social category for heterosexuals only led to same-sex couples’ experience of not being treated as equal members of the church. The study affirmed the importance of experiences and feelings as indicators in identifying a valid struggle for recognition. [ABSTRACT FROM AUTHOR]

Regeneration of northern conifer forests is commonly performed by reforestation with genetically improved materials obtained from long-term breeding programs focused on productivity and timber quality. Sanitary threats can, however, compromise the realization of the expected genetic gain. Including pest resistance traits in the breeding programs may contribute to a sustainable protection. Here we quantified the variation in different components of resistance of Norway spruce to its main pest, the pine weevil Hylobius abietis. We followed insect damage in two large progeny trials (52 open-pollinated families with 100-200 individuals per family and trial) naturally infested by the pine weevil. Pine weevils damaged between 17 and 48% of the planted seedlings depending on the trial and year, and mortality due to weevil damage was up to 11.4%. The results indicate significant genetic variation in resistance to the pine weevil, and importantly, the variation was highly consistent across trials irrespective of contrasting incidence levels. Individual heritability estimates for the different components of seedling resistance were consistently low, but family heritabilities were moderate (0.53 to 0.81). While forward selections and breeding for higher resistance seem not feasible, backwards selections of the best parent trees emerge as a putative alternative to reduce weevil damage. A positive genetic correlation between early growth potential and probability of being attacked by the weevil was also observed, but the relationship was weak and appeared only in one of the trials. Overall, results presented here open the door to a new attractive way for reducing damage caused by this harmful pest. [ABSTRACT FROM AUTHOR]

Replanting at appropriate times after harvesting a coniferous forest stand can help efforts to suppress seedling mortality caused by the pine weevilHylobius abietis, but optimal times are uncertain. We hypothesized that planting in June rather than May in the third season after harvest would reduce feeding damage by the pine weevil and increase seedling survival rates in central Sweden, where new-generation weevils mainly fly away from their development sites in May/early June. An experimental test of the hypothesis in eight clear-cuts confirmed that planting in June instead of May reduced proportions of seedlings attacked by pine weevil, bark removal from seedlings’ stems, and proportions of seedlings killed by feeding damage. These differences between seedlings planted in May and June declined to some extent with time but still remained significant after two growing seasons. The total seedling mortality after two seasons did, however, not differ significantly between seedlings planted in May and June. Overall, 29% of all seedlings were killed by pine weevil, 4.0% byHylastesbark beetles, and 2.3% by drought. The results indicate that replanting in spring during the third season after harvest can advantageously continue until mid-June with respect to damage and mortality. [ABSTRACT FROM AUTHOR]

Objective: The amount of visceral adipose tissue is a risk factor for the metabolic syndrome. It is unclear how BMI changes during childhood and adolescence predict adult fat distribution. We hypothesized that there are critical periods during development for the prediction of adult subcutaneous and visceral fat mass by BMI changes during childhood and adolescence.Research Design and Methods: Detailed growth charts were retrieved for the men participating in the population-based Gothenburg Osteoporosis and Obesity Determinants (GOOD) Study (n = 612). Body composition was analyzed using dual-energy X-ray absorptiometry and adipose tissue areas using abdominal computed tomography at 18 to 20 years of age.Results: The main finding in the present study was that subjects with increases in BMI Z score of more than 1 SD during adolescence had, independent of prepubertal BMI, both larger subcutaneous (+138%; P < 0.001) and visceral adipose tissue areas (+91%; P < 0.001) than subjects with unchanged BMI Z-score. In contrast, subjects with increases in BMI Z score of more than 1 SD during late childhood had a larger amount of adult subcutaneous adipose tissue (+83%; P < 0.001) than subjects with unchanged BMI Z score but an unaffected amount of visceral adipose tissue. BMI changes during adolescence predict both visceral and subcutaneous adipose tissue of the abdomen, whereas BMI changes during late childhood predict only the subcutaneous adipose tissue.Conclusions: The amount of visceral adipose tissue in young adult men was associated with BMI changes specifically during adolescence, whereas the amount of subcutaneous adipose tissue was associated with BMI changes during both late childhood and adolescence. [ABSTRACT FROM AUTHOR]

Quick-clay landslides are a serious geohazard in Canada, Norway and Sweden. Identification and mapping of quick clays are essential endeavours because the damage caused by an individual landslide can be large and costly, with potentially fatal consequences. We collected geophysical borehole and soil core data from an area prone to quick-clay landslides in southwestern Sweden. Methodologies included in situ and laboratory measurements, providing information about natural gamma radiation, sonic velocities, electrical conductivity, pH, physical grain size, elemental and mineral composition, magnetic properties, cation exchange capacity and fossil content. A stratigraphic thickness of almost 60 m enables us to study quick clays and their host environment in Sweden at unusually high resolution. Results identify the origin and location of reflections in nearby seismic lines and assign physico-chemical properties to the geological units present in the area. We show that coarse-grained layers are sandwiched between marine clays (some of which are quick clays). These layers function as a conduit for relatively fresh water that infiltrates the marine clays and chemically destabilizes them by leaching out their salts. The salinity distribution in the boreholes indicate that the groundwater movement is downwards, through the coarse-grained layer and towards the Göta river. The presence of these materials is important for the development of quick clays, although not a prerequisite. With the help of surface geophysical methods, the location of the coarse-grained layers can be known faster and more economically, which could be relevant for studying the potential for quick-clay landslide occurrence over large areas. [ABSTRACT FROM AUTHOR]

This article introduces the main international ecumenical contacts of the Evangelical Lutheran Church of Finland (ELCF). The article shows how the ecumenical contacts shape the unique ecclesiology of the ELCF. According to its own ecumenical strategy, the ELCF wants to be the same church in all directions. Unlike Lutheran churches in other Nordic countries, the ELCF is not a state church, but a folk church. Its status from a majority church in a national state is rapidly changing to a majority religious body in a multicultural society. This requires a new kind of ecclesiology, too. This article claims that there are four inter-related issues that shape the ecclesial self-understanding of the ELCF as an ecumenically active folk church. These issues are emphasis on doctrinal unity, communion within the LWF and Porvoo Communion, the status of a decreasing majority folk church, and internal debates on socio-ethical issues, especially those related to sexuality. [ABSTRACT FROM PUBLISHER]

Summary Tumors are composed of multiple cell types besides the tumor cells themselves, including innate immune cells such as macrophages. Tumor-associated macrophages (TAMs) are a heterogeneous population of myeloid cells present in the tumor microenvironment (TME). Here, they contribute to immunosuppression, enabling the establishment and persistence of solid tumors as well as metastatic dissemination. We have found that the pattern recognition scavenger receptor MARCO defines a subtype of suppressive TAMs and is linked to clinical outcome. An anti-MARCO monoclonal antibody was developed, which induces anti-tumor activity in breast and colon carcinoma, as well as in melanoma models through reprogramming TAM populations to a pro-inflammatory phenotype and increasing tumor immunogenicity. This anti-tumor activity is dependent on the inhibitory Fc-receptor, FcγRIIB, and also enhances the efficacy of checkpoint therapy. These results demonstrate that immunotherapies using antibodies designed to modify myeloid cells of the TME represent a promising mode of cancer treatment. [ABSTRACT FROM AUTHOR]

The article discusses the travel behavior changes in the older people, depending on the incidents related to the public transport. It reports on the study of the negative and positive incidents in the public transport environment, conducted with participants from the Stockholm and its capital Sweden. The most negative incidents were found in the areas of station, ticketing and on-board, whereas maintenance of elevators, escalators and driving behavior were found as facilitating factors.

Formative research suggests that a human embryonic stem cell-specific alternative splicing gene regulatory network, which is repressed by Muscleblind-like (MBNL) RNA binding proteins, is involved in cell reprogramming. In this study, RNA sequencing, splice isoform-specific quantitative RT-PCR, lentiviral transduction, and in vivo humanized mouse model studies demonstrated that malignant reprogramming of progenitors into self-renewing blast crisis chronic myeloid leukemia stem cells (BC LSCs) was partially driven by decreased MBNL3. Lentiviral knockdown of MBNL3 resulted in reversion to an embryonic alternative splice isoform program typified by overexpression of CD44 transcript variant 3, containing variant exons 8-10, and BC LSC proliferation. Although isoform-specific lentiviral CD44v3 overexpression enhanced chronic phase chronic myeloid leukemia (CML) progenitor replating capacity, lentiviral shRNA knockdown abrogated these effects. Combined treatment with a humanized pan-CD44 monoclonal antibody and a breakpoint cluster region - ABL proto-oncogene 1, nonreceptor tyrosine kinase (BCR-ABL1) antagonist inhibited LSC maintenance in a niche-dependent manner. In summary, MBNL3 down-regulation-related reversion to an embryonic alternative splicing program, typified by CD44v3 overexpression, represents a previously unidentified mechanism governing malignant progenitor reprogramming in malignant microenvironments and provides a pivotal opportunity for selective BC LSC detection and therapeutic elimination. [ABSTRACT FROM AUTHOR]

A new model is presented that can be used to screen for bioactivation of drugs. The evaluation of toxicity is an important step in the development of new drugs. One way to detect possible toxic metabolites is to use trapping agents such as glutathione. Often human liver microsomes are used as a metabolic model in initial studies. However, there is a need for alternatives that are easy to handle, cheap, and can produce large amounts of metabolites. In the presented study, paracetamol, mefenamic acid, and diclofenac, all known to form reactive metabolites in humans, were incubated with the fungus Cunninghamella elegans and the metabolites formed were characterized with ultra high performance liquid chromatography coupled to a quadrupole time of flight mass spectrometer. Interestingly, glutathione conjugates formed by the fungus were observed for all three drugs and their retention times and MS/MS spectra matched those obtained in a comparative experiment with human liver microsomes. These findings clearly demonstrated that the fungus is a suitable trapping model for toxic biotransformation products. Cysteine conjugates of all three test drugs were also observed with high signal intensities in the fungal incubates, giving the model a further indicator of drug bioactivation. To our knowledge, this is the first demonstration of the use of a fungal model for the formation and trapping of reactive drug metabolites. The investigated model is cheap, easy to handle, it does not involve experimental animals and it can be scaled up to produce large amounts of metabolites. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The article discusses a study which evaluates if individual factors of the deadlift exercise and training could predict low back pain patients' activity, disability, and intensity. Topics include collecting the measures of pain-related fear of muscle endurance and movement, conducting the Biering-Sørensen test to examine hip and back extensor muscles' endurance, and a randomized controlled trial on the efficacy of deadlift training in reducing pain.

The task of the current paper is to compare two important, ecclesiological documents to each other, namely, the document The Church of Jesus Christ (CJC, 1994) of the Leuenberg Church Fellowship to the Faith and Order document The Church: Towards a Common Vision (CTCV, 2012). The first one, CJC, outlines an ecclesiology of one, specific confessional church family and church fellowship, in a geographical area. CTCV, on the other hand, reflects the global situation, and seeks to express convergence between churches living in very different societies and cultural spheres. By comparing the two documents, this paper explores themes such as church as a community of Saints, the Leuenberg methodology of unity, legitimate diversity, apostolic succession and requirements for unity. The paper argues that the Leuenberg model of 'reconciled diversity' could be understood as a step and a practical tool on the way to the full, visible unity, which, according to CTCV, is the ultimate goal of the ecumenical movement. [ABSTRACT FROM AUTHOR]