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Background: Migration has increased the number of immigrant women in western countries, which has led to a need to adapt sexual and reproductive health (SRH) care to a larger variety of experiences. Examples of problems are poor access/utilization of SRH services among migrants and a comparatively higher rate of mortality and morbidity in relation to pregnancy, especially among those from low- and middle-income settings. Attempts to improve SHR care must consider the complexity of both the problem and the system. A national program to improve women's health in Sweden provided opportunities to study interventions aimed at immigrant women, using a complexity theory lens. The purpose was to explore the characteristics and complexity of regional interventions aiming to improve care and health of immigrant women before, during and after childbirth, and provide knowledge on how regional healthcare actors perceive and address problems in these areas.Methods: This archival research study is based on qualitative data from detailed yearly reports of all regional program interventions (n = 21 regions) performed between January 2017 and January 2019. The archival data consists of the regional actors' answers to an extensive questionnaire-like template, where the same questions were to be filled in for each reported intervention. Data analyses were performed in several steps, combining classic and directive content analysis.Results: Six problem categories were addressed by 54 regional interventions, 26 directed at immigrant women and their families, 11 at healthcare staff, and 17 at the organizational system. The simple level interventions (n = 23) were more unilateral and contained information campaigns, information material and translation, education, mapping e.g., of genital mutilation, and providing staff and/or financial resources. The complicated interventions (n = 10) concerned increasing communication diversity e.g., by adding iPads and out-reach visits. The complex interventions (n = 21), e.g., health schools, integration of care, contained development, adaptions, and flexibility with regards to the immigrant women's situation, and more interaction among a diversity of actors, also from the wider welfare system.Conclusions: It is important that complex problems, such as ensuring equal care and health among a diverse population, are addressed with a mix of simple, complicated, and complex interventions. To enhance intended change, we suggest that pre-requisites e.g., communication channels and knowledge on behalf of immigrant women and staff, are ensured before the launch of complex interventions. Alternatively, that simple level interventions are embedded in complex interventions. [ABSTRACT FROM AUTHOR]

To ensure a continuous high standard of police units, it is critical to recruit people who perform well in stressful situations. Today, this selection process includes performing a large series of tests, which still may not objectively reveal a person's capacity to handle a life-threatening situation when subjected to high levels of stress. To obtain more systematic and objective data, 12 police officers were exposed to six scenarios with varying levels of threat while their heart rate and pupil size were monitored. The scenarios were filmed and six expert evaluators assessed the performance of the police officers according to seven predefined criteria. Four of the scenarios included addressing a moderate threat level task and the scenarios were executed in a rapid sequence. Two further scenarios included a familiar firearm drill performed during high and low threat situations. The results showed that there was a large agreement between the experts in how they judged the performance of the police officers (p < 0.001). Performance increased significantly over tasks in four of the seven evaluation criteria (p ≤ 0.037). There was also a significant effect of pupil size (p = 0.004), but not heart rate, when comparing the different sequential scenarios. Moreover, a high level of threat considerably impaired the motor performance of the police officers during the firearms drill (p = 0.002). Finally, the pupil seemed to systematically dilate more when a threat appeared immediately than with a delay in the scenarios (p = 0.007). We conclude that systematic and quantitative judgments from experts provide valuable and reliable information about the performance of participants in realistic and stressful policing scenarios. Furthermore, objective physiological measures of heart rate and pupil size may help to explain and understand why performance sometimes deteriorates. [ABSTRACT FROM AUTHOR]

Older people in Sweden are increasingly being cared for in the own home, where professional caregivers play an important role. This study aimed to describe perceptions of caring responsibility in the context of older people's homes from the perspective of professional caregivers from caring professions. Fourteen interviews were conducted with professional caregivers from different professions. The result show how professional caregivers perceive responsibility as limitless, constrained by time, moral, overseeing, meaningful and lonesome. Responsibility seems to affect caregivers to a large extent when the burden is high. Professional caregivers' perceptions of responsibility, and the potential consequences of a perceived strained work situation therefore need to be addressed. The findings also indicate a need for professional support and guidance when it is difficult to distinguish between professional and personal responsibility. [ABSTRACT FROM AUTHOR]

AIMS: To assess the prevalence of subjective symptoms of pain and/or temporomandibular disorder (TMD) dysfunction and their association with psychosomatic (PS) symptoms in a longitudinal follow-up study of Finnish young adults over an 8-year period. METHODS: One hundred twenty-eight Finnish young adults (60 men and 68 women) were assessed longitudinally at the ages of 15, 18, and 23 years using routine stomatognathic methods and a standardized questionnaire. RESULTS: The prevalence of reported TMD symptoms ranged from 6% to 12% for pain symptoms, from 12% to 28% for dysfunctional symptoms, and from 4% to 7% for a combination of these 2 types of symptoms. The prevalence of PS symptoms, which were constantly present in many of the patients who reported them, ranged from 7% to 11%. A significant correlation (P < .05) was found between TMD pain and PS symptoms at the ages of 15 and 18 years. PS symptoms were not significantly correlated to TMD dysfunction symptoms or to experiencing no symptoms at any age. The majority of subjects in all age groups with both TMD and PS symptoms were female, in a ratio of approximately 2 to 1. CONCLUSION: The prevalence of TMD and PS symptoms was low in adolescence and young adulthood, and there was a significant association, although relatively weak, between PS symptoms and reports of either TMD pain or a combination of TMD pain and dysfunction symptoms. [ABSTRACT FROM AUTHOR]

Much of the Earth's biosphere has been appropriated for the production of harvestable biomass in the form of food, fuel and fibre. Here we show that the simplification and intensification of these systems and their growing connection to international markets has yielded a global production ecosystem that is homogenous, highly connected and characterized by weakened internal feedbacks. We argue that these features converge to yield high and predictable supplies of biomass in the short term, but create conditions for novel and pervasive risks to emerge and interact in the longer term. Steering the global production ecosystem towards a sustainable trajectory will require the redirection of finance, increased transparency and traceability in supply chains, and the participation of a multitude of players, including integrated 'keystone actors' such as multinational corporations. This Perspective examines the global production ecosystem through the lenses of connectivity, diversity and feedback, and proposes measures that will increase its stability and sustainability. [ABSTRACT FROM AUTHOR]

A system was developed for automatic estimations of tree positions and stem diameters. The sensor trajectory was first estimated using a positioning system that consists of a low precision inertial measurement unit supported by image matching with data from a stereo-camera. The initial estimation of the sensor trajectory was then calibrated by adjustments of the sensor pose using the laser scanner data. Special features suitable for forest environments were used to solve the correspondence and matching problems. Tree stem diameters were estimated for stem sections using laser data from individual scanner rotations and were then used for calibration of the sensor pose. A segmentation algorithm was used to associate stem sections to individual tree stems. The stem diameter estimates of all stem sections associated to the same tree stem were then combined for estimation of stem diameter at breast height (DBH). The system was validated on four 20 m radius circular plots and manual measured trees were automatically linked to trees detected in laser data. The DBH could be estimated with a RMSE of 19 mm (6%) and a bias of 8 mm (3%). The calibrated sensor trajectory and the combined use of circle fits from individual scanner rotations made it possible to obtain reliable DBH estimates also with a low precision positioning system. [ABSTRACT FROM AUTHOR]

In this paper an experimental method for extensional measurements on medium viscosity fluids in contraction flow is evaluated through numerical simulations and experimental measurements. This measuring technique measures the pressure drop over a hyperbolic contraction, caused by fluid extension and fluid shear, where the extensional component is assumed to dominate. The present evaluative work advances our previous studies on this experimental method by introducing several contraction ratios and addressing different constitutive models of varying shear and extensional response. The constitutive models included are those of the constant viscosity Oldroyd-B and FENE-CR models, and the shear-thinning LPTT model. Examining the results, the impact of shear and first normal stress difference on the measured pressure drop are studied through numerical pressure drop predictions. In addition, stream function patterns are investigated to detect vortex development and influence of contraction ratio. The numerical predictions are further related to experimental measurements for the flow through a 15:1 contraction ratio with three different test fluids. The measured pressure drops are observed to exhibit the same trends as predicted in the numerical simulations, offering close correlation and tight predictive windows for experimental data capture. This result has demonstrated that the hyperbolic contraction flow is well able to detect such elastic fluid properties and that this is matched by numerical predictions in evaluation of their flow response. The hyperbolical contraction flow technique is commended for its distinct benefits: it is straightforward and simple to perform, the Hencky strain can be set by changing contraction ratio, non-homogeneous fluids can be tested, and one can directly determine the degree of elastic fluid behaviour. Based on matching of viscometric extensional viscosity response for FENE-CR and LPTT models, a decline is predicted in pressure drop for the shear-thinning LPTT model. This would indicate a modest impact of shear in the flow since such a pressure drop decline is relatively small. It is particularly noteworthy that the increase in pressure drop gathered from the experimental measurements is relatively high despite the low Deborah number range explored. [ABSTRACT FROM AUTHOR]

Background: The target substrates of DNA mismatch recognising factors MutSalpha (MSH2+MSH6) and MutSbeta (MSH2+MSH3) have already been widely researched. However, the extent of their functional redundancy and clinical substance remains unclear. Mismatch repair (MMR)-deficient tumours are strongly associated with microsatellite instability (MSI) and the degree and type of MSI seem to be dependent on the MMR gene affected, and is linked to its substrate specificities. Deficiency in MSH2 and MSH6 is associated with both mononucleotide and dinucleotide repeat instability. Although no pathogenic MSH3 mutations have been reported, its deficiency is also suggested to cause low dinucleotide repeat instability.Methods: To assess the substrate specificities and functionality of MutSalpha and MutSbeta we performed an in vitro MMR assay using three substrate constructs, GT mismatch, 1 and 2 nucleotide insertion/deletion loops (IDLs) in three different cell lines.Results: Our results show that though MutSalpha alone seems to be responsible for GT and IDL1 repair, MutSalpha and MutSbeta indeed have functional redundancy in IDL2 repair and in contrast with earlier studies, MutSbeta seems to exceed MutSalpha.Conclusion: The finding is clinically relevant because the strong role of MutSbeta in IDL2 repair indicates MSH3 deficiency in tumours with low dinucleotide and no mononucleotide repeat instability. [ABSTRACT FROM AUTHOR]

Background: Evidence has come to play a central role in health policymaking. However, policymakers tend to use other types of information besides research evidence. Most prior studies on evidence-informed policy have focused on the policy formulation phase without a systematic analysis of its implementation. It has been suggested that in order to fully understand the policy process, the analysis should include both policy formulation and implementation. The purpose of the study was to explore and compare two policies aiming to improve health and social care in Sweden and to empirically test a new conceptual model for evidence-informed policy formulation and implementation.Methods: Two concurrent national policies were studied during the entire policy process using a longitudinal, comparative case study approach. Data was collected through interviews, observations, and documents. A Conceptual Model for Evidence-Informed Policy Formulation and Implementation was developed based on prior frameworks for evidence-informed policymaking and policy dissemination and implementation. The conceptual model was used to organize and analyze the data.Results: The policies differed regarding the use of evidence in the policy formulation and the extent to which the policy formulation and implementation phases overlapped. Similarities between the cases were an emphasis on capacity assessment, modified activities based on the assessment, and a highly active implementation approach relying on networks of stakeholders. The Conceptual Model for Evidence-Informed Policy Formulation and Implementation was empirically useful to organize the data.Conclusions: The policy actors' roles and functions were found to have a great influence on the choices of strategies and collaborators in all policy phases. The Conceptual Model for Evidence-Informed Policy Formulation and Implementation was found to be useful. However, it provided insufficient guidance for analyzing actors involved in the policy process, capacity-building strategies, and overlapping policy phases. A revised version of the model that includes these aspects is suggested. [ABSTRACT FROM AUTHOR]

Background: Epidemiological data suggest a role for common viruses in the pathogenesis of multiple sclerosis (MS), andrecent data showed a negative association of past cytomegalovirus (CMV) infection on pediatric MS risk.Objective: Our aim was to analyze the association of CMV infection with MS risk in an adult case-control material. Ameta-analysis was performed to validate our findings.Methods: Epidemiological Investigation in MS (EIMS) is a case-control study with incident cases and population-basedcontrols. Anti-CMV antibody titers were measured with ELISA, and HLA-A and DRB1 genotyping was performed withSSP-PCR, in 658 MS cases, who all fulfilled the McDonald criteria for MS, and 786 controls.Results: CMV seropositivity was associated with a decreased MS risk, OR = 0.73 (0.58–0.92 95% CI), p = 0.005,adjusted for index age, gender, smoking, sun exposure, EBNA1 IgG titer and HLA-A*02 and DRB1*15. When we removedall cases and controls younger than 18 years at index, the protective effect was still apparent.Conclusions: CMV is negatively associated with adult-onset MS pathology, consistent with results from a study onpediatric MS cases. It remains to be shown whether this negative association is due to a true protective effect of CMVinfection on MS risk. [ABSTRACT FROM AUTHOR]

Background. Fiducials can be used as surrogate for target position during radiotherapy. However, fiducial motion could lead to potential position errors when using fiducials in four-dimensional computed tomography (4DCT) treatment planning and for gated image guided radiotherapy (IGRT). Material and methods. One gold marker (GM) and 5, 10 and 15 mm nickel-titanium (NiTi) stents were inserted in a moving phantom for the purpose of fiducial detection in 4DCT and gated IGRT. Fiducial position errors in 4DCT and BrainLAB's gated IGRT were defined as residuals between fiducial detection and the actual physical position at the instance of image acquisition. Results. Fiducials position errors correlate to speed, fiducial type and orientation during 4DCT acquisition. Lower detection accuracy was measured for the 5 mm NiTi-stent relative to the 10 and 15 mm NiTi stents and GM. Fiducials with orientation 45° relative to the scan direction showed a lower detection accuracy relative to parallel and perpendicular orientations. The standard deviation of position errors in 4DCT were up to 2.2 mm with a maximum deviation of 4.0 mm. Using BrainLAB's gated IGRT the fiducials were detected with a standard deviation of 0.6 mm and a maximum deviation of 1.9 mm. For gated IGRT no correlation to fiducial speed was found. Conclusions. Clinical use of fiducials in combination with treatment planning on mid-ventilation CT phase for moving target should include margins up to 5.5 mm due to potential systematic position errors. [ABSTRACT FROM AUTHOR]

This paper reports the flow behaviour of Newtonian and Boger fluids through various axisymmetric contraction configurations by means of numerical predictions. A principal aim has been to evaluate the geometrical design choice of the hyperbolic contraction flow. The FENE-CR model has been used to reflect the behaviour of Boger fluids, with constant shear viscosity, finite (yet large) extensional viscosity and less than quadratic first normal stress difference. Numerical calculations have been performed on six different contraction configurations to evaluate an optimized geometry for measuring extensional viscosity in uniaxial extensional flow. The influence of a sharp or rounded recess-corner on the nozzle has also been investigated. Few commercial measuring systems are currently available for measurement of the extensional rheology of medium-viscosity fluids, such as foods and other biological systems. In this context, a technique based on the hyperbolic contraction flow would be a suitable alternative. The pressure drop, the velocity field, the first normal stress difference and the strain rate across the geometry have each been evaluated for Newtonian and Boger fluids. This numerical study has shown that the hyperbolic configuration is superior to the other geometry choices in achieving a constant extension rate. In this hyperbolic configuration, no vortices are formed, the measuring range is broader and the strain rate is constant throughout the geometric domain, unlike in the alternative configurations tested. The difference between sharp and rounded recess-corner configurations proved to be negligible and a rise in excess pressure drop (epd) for increasing deformation rates has been observed. [ABSTRACT FROM AUTHOR]

A review on pulp and paper industrial membrane processes using a variety of modules and processes is presented. Membranes are mostly used today to purify process waters and to recover coating colours. Ultrafiltration using tubular membrane modules or cross-rotational (CR) filtration has been widely applied for the purification of process waters. The reuse of UF membrane permeate has decreased the fresh water consumption to lower than 6m3/t of paper in some paper machines. Some industrial membrane processes also recover valuable products from different streams (e.g lignosulphonates). Membranes are also combined with biological degradation processes in some paper mills. Nanofiltration has been used to purify the effluents discharged from the activated sludge process. At least two reverse osmosis plants purify river water to be used as raw water in the mill. Furthermore, advantages of different membrane modules and the current ways to treat membrane concentrate are discussed. [ABSTRACT FROM AUTHOR]

Background Primary care (PC) in Sweden provides ambulatory and home health care outside hospitals. Within the County Council of Stockholm, coding of diagnoses in PC is mandatory and is done by general practitioners (GPs) using a Swedish primary care version of the International Statistical Classification of Diseases, version 10 (ICD-10). ICD-10 has amono-hierarchical structure. SNOMED CT is poly-hierarchical and belongs to a new generation of terminology systems with attributes (characteristics) that connect concepts in SNOMED CT and build relationships. Mapping terminologies and classifications has been pointed out as a way to attain additional advantages in describing and documenting healthcare data. A poly-hierarchical system supports the representation and aggregation of healthcare data on the basis of specific medical aspects and various levels of clinical detail. Objective To describe and compare diagnoses and health problems in KSH97-P/ICD-10 and SNOMED CT using primary care diagnostic data, and to explore and exemplify complementary aggregations of diagnoses and health problems generated from a mapping to SNOMED CT. Methods We used diagnostic data collected throughout 2006 and coded in electronic patient records (EPRs), and a mapping from KSH97-P/ ICD-10 to SNOMED CT, to aggregate the diagnostic data with SNOMED CT defining hierarchical relationship Is a and selected attribute relationships. Results The chapter level comparison between ICD-10 and SNOMED CT showed minor differences except for infectious and digestive system disorders. The relationships chosen aggregated the diagnostic data to 2861 concepts, showing a multidimensional view on different medical and specific levels and also including clinically relevant characteristics through attribute relationships. Conclusions SNOMED CT provides a different view of diagnoses and health problems on a chapter level, and adds significant new views of the clinical data with aggregations generated from SNOMED CT Is a and attribute relationships. A broader use of SNOMED CT is therefore of importance when describing and developing primary care. [ABSTRACT FROM AUTHOR]

Lynch syndrome is an inherited cancer syndrome caused by germline mutations in mismatch repair (MMR) genes MLH1, MSH2, MSH6 and PMS2. LS predisposes to high risk of early-onset colorectal, endometrial and other tumors. Patients with Lynch syndrome have also been shown to have an elevated risk for pancreatic cancer (PC). In this study, we aimed to estimate the frequency of suspected Lynch syndrome among a series of 135 PC patients. Further, we wanted to determine the frequency of MMR gene mutations in the suspected Lynch syndrome cases. We also aimed to verify the pathogenicity of any novel non-truncating variants we might detect with a functional assay. Based on personal and/or familial cancer history, 19 patients were classified as suspected Lynch syndrome cases. DNA material for mutation analysis was available for eleven of them. Four patients were found to carry a total of five MLH1 or MSH2 variants. Of these, MSH2-Q402X, MSH2-G322D, and MLH1-K618A had been previously reported, while the MSH2-E205Q and MSH2-V367I variants were novel. MSH2-Q402X is a known stop mutation and reported here for the first time here in association with PC. MLH1-K618A was found in the unaffected branch of a kindred, suggesting that it may be a polymorphism or a low penetrance variant. MSH2-G322D likely does not cause a MMR defect, although this variant has also been associated with breast cancer as indeed seen in our patient. The novel variants MSH2-E205Q and MSH2-V367I were found in the same patient. Both novel variants were however functional in the applied MMR assay. Our findings suggest that only a small subset of pancreatic cancer patients carry pathogenic MMR mutations. [ABSTRACT FROM AUTHOR]

It is over a decade since the concept of critical flux was introduced. From that time intensive research has been done to find the functionality and dependency of critical flux for different feeds and membranes. The studies focussed on critical flux in the field of oily water filtration are scarce, however, there are numerous membrane units which have been applied to treat waste-water contaminated with oil. It might be due to the fact that in this kind of filtration the oil drops form a gel layer on the surface of the membranes and this gel layer formation is not the case with feeds where the concept of critical flux has been studied (suspended solids forming a cake layer). In membrane filtration of oily water, knowledge on the existence of critical flux and the influence of different parameters on it may enhance a better operation of the membrane units. In order to find the critical flux, a set of experiments was carried out in constant pressure mode using varying pressures from 0.5 to 4 bars. A cycling pressure approach (increasing and decreasing pressure) was applied to find the possible critical flux in a system consisting of emulsified oil and salts. It was found that a weak form of critical flux in some cases might exist close to the lowest pressure. No strong form of critical flux was observed from comparison between pure water and permeate flux since the permeate flux differed significantly from the initial pure water flux even at the lowest pressure. The existence of a limiting flux and its dependency on operating conditions was proven in some cases. The limiting flux was established under different operating conditions, including oil concentration, pH, temperature, salts and flow velocity. The results showed that this flux was significantly influenced by variations in flow velocity and temperature. [ABSTRACT FROM AUTHOR]

Parrotfishes are a group of herbivores that play an important functional role in structuring benthic communities on coral reefs. Increasingly, these fish are being targeted by fishermen, and resultant declines in biomass and abundance may have severe consequences for the dynamics and regeneration of coral reefs. However, the impact of overfishing extends beyond declining fish stocks. It can also lead to demographic changes within species populations where mean body size is reduced. The eVect of reduced mean body size on population dynamics is well described in literature but virtually no information exists on how this may influence important ecological functions. The study investigated how one important function, scraping (i.e., the capacity to remove algae and open up bare substratum for coral larval settlement), by three common species of parrotfishes (Scarus niger, Chlorurus sordidus, and Chlorurus strongylocephalus) on coral reefs at Zanzibar (Tanzania) was influenced by the size of individual fishes. There was a non-linear relationship between body size and scraping function for all species examined, and impact through scraping was also found to increase markedly when fish reached a size of 15-20 cm. Thus, coral reefs which have a high abundance and biomass of parrotfish may nonetheless be functionally impaired if dominated by small-sized individuals. Reductions in mean body size within parrotfish populations could, therefore, have functional impacts on coral reefs that previously have been overlooked. [ABSTRACT FROM AUTHOR]

Coral reefs can undergo unexpected and dramatic changes in community composition, so called phase shifts. This can have profound consequences for ecosystem services upon which human welfare depends. Understanding of this behavior is in many aspects still in its infancy. Resilience has been argued to provide insurance against unforeseen ecosystem responses in the face of environmental change, and has become a prime goal for the management of coral reefs. However, diverse definitions of resilience can be found in the literature, making its meaning ambiguous. Several studies have used the term as a theoretical framework and concern regarding its practical applicability has been raised. Consequently, operationalizing theory to make resilience observable is an important task, particularly for policy makers and managers dealing with pressing environmental problems. Ultimately this requires some type of empirical assessments, something that has proven difficult due to the multidimensional nature of the concept. Biodiversity, spatial heterogeneity, and connectivity have been proposed as cornerstones of resilience as they may provide insurance against ecological uncertainty. The aim of this article is to provide an overview of the divergent uses of the concept and to propose empirical indicators of the cornerstones of coral reef resilience. These indicators include functional group approaches, the ratios of ''good'' and ''bad'' colonizers of space, measurements of spatial heterogeneity, and estimates of potential space availability against grazing capacity. The essence of these operational indicators of resilience is to use them as predictive tools to recognize vulnerability before disturbance occurs that may lead to abrupt phase shifts. Moving toward operationalizing resilience theory is imperative to the successful management of coral reefs in an increasingly disturbed and human-dominated environment. [ABSTRACT FROM AUTHOR]

The benefits of early orthodontic treatment are continuously discussed, but studies are few. We examined whether definite need for orthodontic treatment could be eliminated in public health care by systematically focusing on early intervention. One age cohort living in a rural Finnish municipality (N = 85) was regularly followed from ages 8 to 15 years, and persons with malocclusions were treated according to a preplanned protocol. Treatment need was assessed according to the Dental Health Component (DHC) of the Index of Orthodontic Treatment Need, and treatment outcome by the Peer Assessment Rating Index (PAR). Fifty-two percent of the cohort received treatment, and definite treatment need decreased from 33% to 9%. In the treated group, the mean PAR score reduction was 63%, and 51% showed more than 70% improvement. The results suggest that an early treatment strategy may considerably reduce the need for orthodontic treatment in public health care with limited specialist resources. [ABSTRACT FROM AUTHOR]

The hydrophilicity of regenerated cellulose (RC) ultrafiltration (UF) membranes could be utilized in industrial processes even more than today if there was more information on their thermal stability. Therefore, in this study two different RC UF membranes were used in a temperature range from 15 to 70°C in order to evaluate their performance stability at high temperature. The experiments were performed in neutral, alkaline, and acidic conditions. The influence of temperature on pure water permeability, observed Dextran retention, and membrane structure were used as evaluation criteria. According to the results the tested membranes could be used at 70°C in the tested conditions for several days. The results, however, indicated also that the use in acidic and alkaline conditions at 70°C might shorten the operational life of the membranes. [ABSTRACT FROM AUTHOR]

This study examines the abundances of three morphological categories of juvenile corals (massive, branching and encrusting) on two different types of natural substratum, dead massive and dead branching corals. The overall results show that the morphological characteristics of dead coral substratum have a significant influence on the coral recruitment patterns with respect to the morphology of the recruits: juvenile corals of massive and branching types were more abundant on substrates of corresponding morphology. The results obtained from this study suggest that dead coral might attract coral larvae that are morphologically similar. On the other hand, it may be the result of post-settlement mortality. Whatever the mechanism shaping the patterns is, it seems that the physical morphology of the dead coral substrate has a significant influence on the coral recruit assemblage. Hence, we suggest that substrate morphology can be an important qualitative factor for coral settlement and a possible determinant of community structure. [ABSTRACT FROM AUTHOR]

Discharge waters from activated sludge processes in the pulp and paper industry and from a municipal wastewater treatment plant were filtered with various nanofiltration (NF) and low pressure reverse osmosis (RO) membranes. The purpose was to study flux, retention, and permeate quality after membrane filtration by using a high shear (CR-250/2) filter. The suitability of the achieved permeates for reuse at the industrial site is also discussed. The NF permeate was practically free from colour and organic compounds but contained significant amount of inorganic compounds e.g. chloride ions, especially when a high amount of sulphate containing discharge waters were filtered, in which case a low pressure RO membrane was needed to successfully remove monovalent anions. Organic compounds were almost completely retained by NF and RO membranes and organic carbon in the permeate was less than 10 rag/dm³ on average. The achieved permeate can easily be reused in paper production. Nanofiltration has a significantly higher flux and also a lower fouling tendency than reverse osmosis but it passes through monovalent ions when there is a high sulphate concentration in the water. Therefore, RO might be needed in such cases to produce excellent process water. [ABSTRACT FROM AUTHOR]

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Integrins are a family of heterodimeric cell surface receptors, which are expressed on most cells where they mediate cell-cell and cell-extracellular matrix (ECM) interactions. The αvβ6 integrin is epithelial-specific and binds to the ECM proteins fibronectin, vitronectin and tenascin, and also to the latency associated peptide of TGF-β. Unlike most epithelial integrins, αvβ6 is not expressed constitutively by healthy oral epithelia, but is up-regulated during tissue remodelling, including that accompanying wound healing and carcinogenesis. Although, the data at present have been generated principally from in vitro studies, there is increasing evidence to suggest that αvβ6 may promote carcinoma progression: αvβ6 has been shown to modulate invasion, inhibit apoptosis, regulate protease expression and activate TGF-β1. This review examines the current literature, and discusses the possible role of αvβ6 in wound healing, and in the development and progression of oral squamous cell carcinoma. [ABSTRACT FROM AUTHOR]

An unfavourable root-crown (R/C) ratio caused by short dental roots may result from a developmental deficiency, root resorption after orthodontic treatment, or dental trauma. In the assessment of root shortening, subjective grading has often been used. For objective tooth measurements, varying materials and methods may make the results impossible to compare. This study used a simple, objective method to assess the R/C ratio (relative root length) of mature permanent teeth from panoramic radiographs (PRGs), tested its reproducibility and calculated the mean values of R/C ratios and their variations in a healthy Caucasian (Finnish) population. Two thousand seven hundred and seventy-nine teeth were measured on 108 PRIGS. The intra and inter-examiner reproducibility of the assessment method was good (Pearson correlation coefficients 0.87 and 0.83, respectively; P < 0.001) and the mean R/C ratios did not differ between the repeated measurements (P> 0.05). The biological variance in all cases exceeded the error variance for each tooth. These facts suggest that the method reported in this study can be used in the assessment of the relative root length of 'normal' teeth and its alterations in teeth with developmental or acquired aberrations of dental roots. Males, overall, tended to have higher R/C ratios than females; P-values varied from non significant to less than 0.01. With the exception of the permanent lateral incisors in males and the permanent second molars in both genders, the ratios of the antagonist teeth were significantly greater in the mandible than in the maxilla (P < 0.05 for the lateral incisors of females; P < 0.001 for all other teeth). Consequently, in quantifying root shortening in developmentally short-rooted teeth, tooth and gender-specific reference values should be employed. The Finnish R/C data reported here for all teeth except third molars could be used for comparison with other populations, patient groups or individuals where crown-root aberrations are suspected. [ABSTRACT FROM AUTHOR]

Ultra- and nanofiltration with high shear CR-filters have been utilized for cleaning of clear filtrates and effluents from the pulp and paper industry. The aim was to find out how different nanofiltration membranes operate at high shear conditions. The filtration efficiency of the membranes was evaluated by measuring flux, retention and fouling at various recovery and pH conditions. High fluxes (∼100 L/(m²h)) for nanofiltration membranes were measured when circulation waters from the paper machine were filtered at neutral conditions. In the filtration of discharge of external activated sludge treatment plants we measured fluxes around 150 L/(m²h) even at a concentration factor of 12. The best NF membranes removed over 80% of the organic carbon and of the conductivity and almost completely eliminated the color. With acidic waters fluxes and retentions were significantly lower. The NF270 membrane from Dow and the Desal-5 membranes from Osmonics had the highest flux and retention properties. However, the Desal-5 membrane lost its retention properties slowly, which restricts its use in the high shear CR-filter. CR-nanofiltration can be used in the pulp and paper industry without feed pre-treatment by ultrafiltration. This increases the attractiveness of high shear CR-nanofiltration. [ABSTRACT FROM AUTHOR]

In this study, membrane filtration as an internal purification method, "the kidney", in the pulp and paper industry is discussed. Membrane filtration is economically competitive and a very versatile process. It can be used to remove the enriched organic and/or inorganic loads either partially or totally from, for example, the mechanical pulping and paper making water circuits and it can be applied to various points within the process. With the so-called shear enhanced membrane modules very high fluxes, in ultrafiltration about 400 L/(m²h) and in nanofiltration fluxes almost 200 L/(m²h), have been obtained. Depending on the membrane, suspended solids (microfiltration), polysaccharides, extractives and high molar mass lignous substances (ultrafiltration) and multivalent salts (nanofiltration) can be removed. Ultrafiltration permeate can well be used in paper machine showers to replace fresh water. The quality of the nanofiltration permeate is significantly higher than that of ultrafiltration. The membrane processes can be enhanced by various pre-treatment techniques to produce higher permeate fluxes and to eliminate membrane fouling. Such pre-treatment methods are, e.g., chemical treatment, ozonation and biological treatment. The most cost-effective processes were chemical flocculation, pH adjustment and thermophilic aerobic biological treatment. [ABSTRACT FROM AUTHOR]

The worldwide decline of coral reefs calls for an urgent reassessment of current management practices. Confronting large-scale crises requires a major scaling-up of management efforts based on an improved understanding of the ecological processes that underlie reef resilience. Managing for improved resilience, incorporating the role of human activity in shaping ecosystems, provides a basis for coping with uncertainty, future changes and ecological surprises. Here we review the ecological roles of critical functional groups (for both corals and reef fishes) that are fundamental to understanding resilience and avoiding phase shifts from coral dominance to less desirable, degraded ecosystems. We identify striking biogeographic differences in the species richness and composition of functional groups, which highlight the vulnerability of Caribbean reef ecosystems. These findings have profound implications for restoration of degraded reefs, management of fisheries, and the focus on marine protected areas and biodiversity hotspots as priorities for conservation. [ABSTRACT FROM AUTHOR]

Finnish surface waters are abundant in natural organic matter. Natural organic matter can be removed from drinking water in a water treatment process by coagulation and filtration. The standard treatment operations are not able to remove the smallest molar mass fraction of organic matter and the intermediate molar mass matter is only partly removed. The removal of residual natural organic matter from drinking water by nanofiltration was evalueted in this study. Three different nanofiltration membranes were compared in filtering six pre-treated surface waters. The total organic carbon content of the feed waters varied from 2.0 to 4.2 mg 1-1. Other water quality parameters measured were conductivity, alkalinity, hardness, UV-absorbance, SUVA, E2/E3 value and molecular size distribution by high-performance size-exclusion chromatography. The natural organic matter removal efficiencies of the membranes were good and varied between 100% and 49%, and between 85% and 47% according to molecular size distribution and total organic carbon measurements, respectively. Removal of different molecular size fractions varied from 100% to 56%, 100% to 54% and 88% to 19%, regarding high molar mass, intermediate molar mass and low molar mass organic matter, respectively. The Desal-5 DL membrane produced the highest natural organic matter removals. [ABSTRACT FROM AUTHOR]

Compounded disturbances are becoming increasingly common on coral reefs. Impacts of global warming, which is generally perceived as the most serious threat to coral reefs today, often coincide with various common anthropogenic disturbances, such as pollution and overharvesting. To better evaluate the impact of global warming, interactions between elevated temperature and background disturbance should be investigated. In this study, the physiological response of the reef-building coral Porites cylindrica was investigated, when exposed to enrichment of dissolved inorganic nitrate (+15 μM for 14 days) and elevated seawater temperature (+2ºC for 48 h), in the absence of particulate food. It was shown that P. cylindrica was able to tolerate the temperature exposure without losing symbiotic microalgae or chlorophyll pigments, although the photosynthetic capacity was affected. Nitrate enrichment significantly reduced primary production rate, although zooxanthella population density and chlorophyll concentrations were not affected. The combination of elevated temperature and nitrate enrichment produced an even more pronounced reduction of the production rate. Since coral respiration rate remained unaffected by the treatments, this implies that the corals were unable to acclimate to impaired photosynthesis. However, there was no indication of subsequently reduced tissue growth or increased host catabolism based on tissue biomass measurements. On the other hand, all corals, including controls, lost tissue biomass during the exposure, suggesting a dependence on particulate food. Our results imply that corals on nutrient-exposed reefs may be more stressed during periods of elevated temperature, compared to corals in more pristine areas. [ABSTRACT FROM AUTHOR]

* Little attention is paid in Emergency Care Units (ECUs) in Sweden to the special needs of older people.* The aim of this study was thus to analyse older people's basic needs in the emergency care environment.* The study was carried out with a life-world interpretative approach, and the theoretical framework for interpretation was Abraham Maslow's theory of motivation and personality.* Seven informants aged between 65 and 88 years, with various experiences of being patients with urgent as well as non-urgent health-related problems, were interviewed about their experiences of ECU care.* Their basic needs at the lower levels of Maslow's hierarchy were well-represented in the data. Higher needs, such as desire to know and understand, appeared to be totally neglected. Safety needs dominated the whole situation.* Our conclusion is that standards of care must be developed in Sweden to make older patients feel safer and more secure in ECUs. Furthermore, the principles of nursing care for older patients need to be defined in order to encourage them to take an active part in their own health process. [ABSTRACT FROM AUTHOR]

The aim of this case study has been to analyze factors that hinder the provision of adequate nursing care in one emergency care unit (ECU). The research question was, What are the conditions that explain the provision of inadequate nursing care in an ECU with reported problems concerning caring attitudes? The design of the study was exploratory and interpretive within a hermeneutic tradition. Nurses were interviewed, and field notes were made from participant observations of routine work and staff meetings. An interpreted whole revealed a lack of a holistic perspective. The difficulty of these nurses in accomplishing a holistic perspective seemed to be due to overvaluation of measurable tasks, such as medical interventions, and undervaluation of nonmeasurable tasks, such as caring. As a consequence, caring interventions failed to strengthen the nurses' self-esteem in the same high degree as medical tasks. [ABSTRACT FROM AUTHOR]

The aim of this study was to gain in-depth knowledge of how persons with long-term mental illness experience their everyday situation, in order to identify potential psychosocial obstacles to a meaningful existence. The focus was on psychosocial aspects, such as contact with others and the quality of these contacts. An ethnographic design was used, in order to provide an inside perspective. Four persons with long-term mental illness participated in the study. Three open-ended interviews, at 1-week intervals, were conducted with each informant. Analysis of transcribed material consisted of naive reading and content analysis guided by the investigators' understanding of the psychiatric context. Three themes were generated: feeling lonely but being unable to establish friendships; knowledge of what to do but lacking initiative; and awareness of the need for support but not wanting to be subject to control. These themes reflect contradictions between thoughts, feelings and actions, which seem to contribute to a psychosocial disadvantage in the life of persons with long-term mental illness. [ABSTRACT FROM AUTHOR]

This study focuses on the views of professional health care providers within a geographical district in Sweden. A total of 52 interviews with persons representing different professional levels within psychiatry and the social services were conducted. The purpose was to compare their understanding of what their responsibility entailed as well as their perceptions of goals and required competence. A content analysis, supplemented with interpretations within a hermeneutic tradition, showed that there are both similarities and differences within and between the two organizations. A common finding is that professionals with the least education are to a great extent responsible for the practical care of persons with long-term mental illness. The implication of this finding is that it is important to be aware of this division of responsibility when developing psychiatric nursing and the home care services according to the needs of long-term mentally ill patients. [ABSTRACT FROM AUTHOR]

Biopsy samples of head and neck carcinomas were investigated with regard to elafin, secretory leukocyte protease inhibitor (SLPI), interleukin 1-receptor antagonist [(IL)1-RA] and soluble tumour necrosis factor α receptor antagonist (STNFα RI). SLPI and elafin are serine protease inhibitors produced in the serous cells of the upper respiratory airways and in the keratinocytes, respectively. We have now found the presence of elafin and SLPI in squamous cell carcinomas of the upper respiratory tract (tonsillar, hypopharyngeal, tongue, mouth floor, gingival and laryngeal cancer). Significantly higher amounts of SLPI and elafin are present in well-differentiated and moderately differentiated tumours than in poorly differentiated tumours (p < 0.0001 and p < 0.0015). Tumour necrosis factor-α and IL-1β have been shown to stimulate the production of SLPI and elafin. Since these cytokines can both be difficult to detect, we chose to study their inhibitors, STNFα RI and IL1-RA, instead. IL1-RA was expressed in highly differentiated tumours as well as in poorly differentiated ones. No significant difference was seen between the groups. STNF α RI was only found in very small amounts, sparsely distributed in the tumours, and was not related to the degree of differentiation. [ABSTRACT FROM AUTHOR]

The surfaces of three commercial urea formaldehyde polysulfone membranes from Dow Denmark[sup TM] (GR51, GR61 and GR81) are characterised both topographically and chemically. Their topography is studied by scanning force microscopy to obtain the corresponding pore-size distributions, which are in fair agreement with nominal molecular weight cut-offs.The composition of the surfaces of the membranes is analysed by X-ray photoelectron spectroscopy. The resulting percentage content of nitrogen, which could be attributed probably to an additive used in the manufacturing process, is shown to correlate with the portion of the total surface with different viscoelastic properties as investigated by using phase-contrast scanning force microscopy. Both parameters are increasing for membranes with decreasing molecular weight cut-off. Also, the additive seems to be more sparsely distributed for the membranes with bigger pores, according to fractal analysis. Finally, all the membranes are very similarly wettable. [ABSTRACT FROM AUTHOR]

The emergence of permanent teeth was studied in 187 Finnish children who had longitudinal records of the emergence of all permanent teeth except third molars. Exact emergence dates were known for about one third of the teeth. Emergence ages of the remaining teeth were based on their presence and absence at clinical examinations. We calculated ages at clinical eruption of permanent teeth and tooth counts at half year intervals. Ages corresponding to counts of permanent teeth from 1 to 27 are also given. The schedules presented, which slow means, standard deviations, and percentage distributions, are expected to serve as useful references in clinical dentistry, pediatrics, forensics, and research. The mandibular central incisor emerged before the first molar of the same jaw in 68% of the children. A change in the emergence order of these teeth in Finns seems to have occurred in the 1960s. A visual comparison of dental maturity curves based on tooth counts with curves based on tooth mineralization in a previous Finnish radiographic study showed that the mean curves had roughly the same form, whereas the forms of standard deviation curves differed distinctly. It appears that the two methods to assess dental maturity are not interchangeable in practice. Tooth counts can be used in maturity estimations up to about 13 years of age, whereas the radiographic method works best to about 11 years. [ABSTRACT FROM AUTHOR]

Development of teeth was studied from 2483 dental panoramic tomograms of 1651 healthy Finns ranging in age from 2 to 25 years. Dental maturity was assessed using a method based on developmental stages of 7 left mandibular teeth. We give sex-specific tables of maturity scores as a function of ages and of ages as a function of maturity scores. Also generated are percentile graphs for visual evaluations of dental maturity in children and adolescents. Since maturity scales do not tolerate any missing data, a great limitation for their use, we have developed linear regression models for predicting the formation stages of each of the 7 mandibular teeth. It was easiest to predict the formation stage of the mandibular first molars (correct in 87% within the study material) and most difficult to predict second molars and second premolars (correct in 69% and 70%, respectively). We expect the data and formulae presented in this study to prove useful in research and in clinical and forensic dentistry. [ABSTRACT FROM AUTHOR]

Our earlier studies have shown that some radiographic structural findings in the mandibular condyles are more common in orthodontically treated populations than in normal populations. To test the hypothesis that these findings are stable, we studied condylar findings in panoramic radiographs longitudinally in 39 subjects and in 39 sex- and age-matched controls. The subjects had condylar findings at the end of orthodontic treatment at about 15 years of age; no such findings were seen in the controls. The subjects and controls were re-examined radiographically about 12 years after the post-treatment radiographic examination. We also tested the hypothesis that radiographic condylar findings are associated with temporomandibular disorders (TMD). No statistically significant differences were found between subjects and controls in terms of reported subjective TMD symptoms. Clinically, the subjects had temporomandibular joint (TMJ) crepitation significantly more frequently (27%) than controls (8%) (p < 0.05). Crepitation correlated with some reported symptoms and clinical signs, suggesting that osteoarthrosis might have been an important etiological factor for TMD in the present subjects. At the follow-up examination, radiographic condylar findings were seen in 25 subjects and in four controls (p < 0.001). The condylar findings varied greatly between the time of orthodontic treatment and follow-up in the subjects. The findings had become more severe in 49% of the subjects, more often in females than in males (p < 0.05), whereas in 28% of the subjects the condylar findings had disappeared. Although the radiographic findings after orthodontic treatment fluctuated with age, in most adolescents with changes in their condyles, these findings remained constant or became more severe. It should be emphasized, however, that although there were certain associations between radiographic findings and TMD, the subjective symptoms and clinical signs seemed to cause the subjects no or only minor problems. [ABSTRACT FROM AUTHOR]