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Cancer pain is a common symptom in patients with cancer and can largely affect their quality of life. Pain management is important to minimize the impact of pain on daily activities. Cancer nurses are significantly involved in all steps of pain management and contribute to the success of therapy through their knowledge and expertise. While they generally play an important role in the screening, assessment, diagnosis, treatment and follow-up of patients and their (pain) symptoms, this varies from country to country in Europe. An important aspect is their role in educating patients and their families about what pain is, what impact it can have, how it can be treated pharmacologically or non-pharmacologically and what effects or problems can occur during treatment. While there is a great discrepancy between education and training opportunities for cancer nurses in different European countries, there is a continued need for education and training in pain management. Cancer is increasingly becoming a chronic disease, and the management of pain in cancer survivors will be crucial to maintain an adequate quality of life. With this, the crucial role of cancer nurses is becoming even more important. [ABSTRACT FROM AUTHOR]

Background: Plasma biomarkers reflecting the pathology of frontotemporal dementia would add significant value to clinical practice, to the design and implementation of treatment trials as well as our understanding of disease mechanisms. The aim of this study was to explore the levels of multiple plasma proteins in individuals from families with genetic frontotemporal dementia. Methods: Blood samples from 693 participants in the GENetic Frontotemporal Dementia Initiative study were analysed using a multiplexed antibody array targeting 158 proteins. Results: We found 13 elevated proteins in symptomatic mutation carriers, when comparing plasma levels from people diagnosed with genetic FTD to healthy non-mutation controls and 10 proteins that were elevated compared to presymptomatic mutation carriers. Conclusion: We identified plasma proteins with altered levels in symptomatic mutation carriers compared to non-carrier controls as well as to presymptomatic mutation carriers. Further investigations are needed to elucidate their potential as fluid biomarkers of the disease process. [ABSTRACT FROM AUTHOR]

Plankton distributions are remarkably 'patchy' in the ocean. In this study, we investigated the contrasting phytoplankton-zooplankton distributions in relation to wind mixing events in waters around a biodiversity-rich island (Runde) located off the western coast of Norway. We used adaptive sampling from AUV and shipboard profiles of in-situ phytoplankton photo-physiology and particle identification (copepods, fecal pellets and the dinoflagellate Tripos spp.) and quantification using optical and imaging sensors. Additionally, traditional seawater and net sampling were collected for nutrient and in-vitro chlorophyll a concentrations and phytoplankton and meso-zooplankton abundances. Persistent strong wind conditions (~5 days) disrupted the stratification in offshore regions, while stratification and a subsurface chlorophyll maximum (SCM) were observed above the base of the mixed layer depth (MLD ~30 m) in inshore waters. Contrasting phytoplankton and zooplankton abundances were observed between inshore (with the presence of a SCM) and offshore waters (without the presence of a SCM). At the SCM, phytoplankton abundances (Tripos spp., the diatom Proboscia alata and other flagellates) were half (average of 200 cell L-1) of those observed offshore. On the contrary, meso-zooplankton counts were ~6× higher (732 ind m-3 for Calanus spp.) inshore (where a SCM was observed) compared to offshore areas. In parallel, fecal pellets and ammonium concentrations were high (>1000 ind m-3 for the upper 20 m) at the SCM, suggesting that the shallow mixed layer might have increased encounter rates and promoted strong grazing pressure. Low nutrient concentrations (< 1μM for nitrate) were found below the MLD (60 m) in offshore waters, suggesting that mixing and nutrient availability likely boosted phytoplankton abundances. The size of the absorption cross-section (σPII') and yield of photosystem II photochemistry under ambient light (φPII') changed according to depth, while the depth-related electron flow (JPII) was similar between regions, suggesting a high degree of community plasticity to changes in the light regime. Our results emphasize the importance of using multiple instrumentation, in addition to traditional seawater and net sampling for a holistic understanding of plankton distributions. [ABSTRACT FROM AUTHOR]

Background: Frontotemporal dementia (FTD) is a neurodegenerative disease, resulting in progressive problems in language and/or behaviour and is often diagnosed before 65 years of age. Ubiquitin positive protein aggregates in the brain are among the key pathologic hallmarks of frontotemporal lobar degeneration (FTLD) postmortem. The TANK-binding kinase 1 gene (TBK1) is on the list of genes that can contribute to the development of FTD as well as the related neurodegenerative disease amyotrophic lateral sclerosis (ALS). Methods: In this study, using an array of clinical and neuropathological data combined with biochemical and proteomics assays, we analyze the TBK1 splice-mutation (c.1340 + 1G > A) in a Swedish family with a history of FTD and ALS. We also explore the K63 ubiquitination landscape in post-mortem brain tissue and fibroblast cultures. Results: The intronic (c.1340 + 1G > A) mutation in TBK1 results in haploinsufficiency and affects the activity of the protein in symptomatic and pre-symptomatic mutation carriers. Conclusion: Our results suggest that the mutation leads to a significant reduction of TBK1 activity and induce alterations in K63 ubiquitination profile of the cell already in the presymptomatic stages. [ABSTRACT FROM AUTHOR]

Background: A detailed understanding of the pathological processes involved in genetic frontotemporal dementia is critical in order to provide the patients with an optimal future treatment. Protein levels in CSF have the potential to reflect different pathophysiological processes in the brain. We aimed to identify and evaluate panels of CSF proteins with potential to separate symptomatic individuals from individuals without clinical symptoms (unaffected), as well as presymptomatic individuals from mutation non-carriers. Methods: A multiplexed antibody-based suspension bead array was used to analyse levels of 111 proteins in CSF samples from 221 individuals from families with genetic frontotemporal dementia. The data was explored using LASSO and Random forest. Results: When comparing affected individuals with unaffected individuals, 14 proteins were identified as potentially important for the separation. Among these, four were identified as most important, namely neurofilament medium polypeptide (NEFM), neuronal pentraxin 2 (NPTX2), neurosecretory protein VGF (VGF) and aquaporin 4 (AQP4). The combined profile of these four proteins successfully separated the two groups, with higher levels of NEFM and AQP4 and lower levels of NPTX2 in affected compared to unaffected individuals. VGF contributed to the models, but the levels were not significantly lower in affected individuals. Next, when comparing presymptomatic GRN and C9orf72 mutation carriers in proximity to symptom onset with mutation non-carriers, six proteins were identified with a potential to contribute to a separation, including progranulin (GRN). Conclusion: In conclusion, we have identified several proteins with the combined potential to separate affected individuals from unaffected individuals, as well as proteins with potential to contribute to the separation between presymptomatic individuals and mutation non-carriers. Further studies are needed to continue the investigation of these proteins and their potential association to the pathophysiological mechanisms in genetic FTD. [ABSTRACT FROM AUTHOR]

Cancer patients are considered to have a higher risk of dying and developing severe Coronavirus Disease 2019 (COVID-19). To date, there are few studies including co-morbidities and sociodemographic factors when investigating the outcome of COVID-19 in a cohort of cancer patients. In this study, we analyzed cancer patients that have been hospitalized due to COVID-19 during the first wave of the pandemic in Sweden to investigate the impact of COVID-19 on mortality and morbidity. We retrospectively collected data on all patients with cancer that were hospitalized due to COVID-19-related symptoms at Uppsala University Hospital and Karolinska University Hospital between 1 March and 31 August 2020. The primary endpoint was COVID-19-related death and the secondary endpoint was to describe COVID-19 severity, defined as symptom severity (grades 0–4) and length of stay (LOS) at the university hospitals. In total, 193 patients were included among which 31% died due to COVID-19 and 8% died of other causes. In a multivariable analysis, older age >70 (OR 3.6; 95% CI [1.8–7.3], p < 0.001) and male gender (OR 2.8 [1.4–5.8], p = 0.005) were factors associated with higher likelihood of COVID-19-related death. Several comorbidities ≥2 (OR 5.4 [2.0–14.3], p = 0.001) was independently associated with COVID-19 severity. Treatment with chemotherapy within 90 days prior to COVID-19 diagnosis were not associated with COVID-19-related death or severity. Factors associated with higher likelihood of COVID-19-related death were older age and male gender. More severe COVID-19 symptoms were seen in patients with multiple comorbidities. We did not see any associations between COVID-19-related death or severity and recent treatment including chemotherapy. In summary, this supports a thorough assessment regarding potential risks with COVID-19 infection in patients with cancer, with a combination of individual risk factors in addition to cancer treatments. [ABSTRACT FROM AUTHOR]

Objectives: The purpose was to analyze trends in intensity of care at End-of-life (EOL), in two cohorts of patients with lung or pancreatic cancer. Setting: We used population-based registry data on health care utilization to describe proportions and intensity of care at EOL comparing the two cohorts (deceased in the years of 2010 and 2017 respectively) in the region of Stockholm, Sweden. Primary and secondary outcomes: Main outcomes were intensity of care during the last 30 days of life; systemic anticancer treatment (SACT), emergency department (ED) visits, length of stay (LOS) > 14 days, intensive care (ICU), death at acute care hospital and lack of referral to specialized palliative care (SPC) at home. The secondary outcomes were outpatient visits, place of death and hospitalizations, as well as radiotherapy and major surgery. A multivariable logistic regression analysis was used for associations. A moderation variable was added to assess for the effect of SPC at home between the cohorts. Results: Intensity of care at EOL increased over time between the cohorts, especially use of SACT, increased with 10%, p<0.001, (n = 102/754 = 14% to n = 236/972 = 24%), ED visits with 7%, p<0.001, (n = 25/754 = 3% to n = 100/972 = 10%) and ICU care, 2%, p = 0.04, (n = 12/754 = 2% to n = 38/972 = 4%). High intensity of care at EOL were more likely among patients with lung cancer. The difference in use of SACT between the years, was moderated by SPC, with an increase of SACT, unstandardized coefficient β; 0.87, SE = 0.27, p = 0.001, as well as the difference between the years in death at acute care hospitals, that decreased (β = 0.69, SE = 0.26, p = 0.007). Conclusion: These findings underscore an increase of several aspects regarding intensity of care at EOL, and a need for further exploration of the optimal organization of EOL care. Our results indicate fragmentation of care and a need to better organize and coordinate care for vulnerable patients. [ABSTRACT FROM AUTHOR]

Background and Objective: PSEN1‐H163Y carriers, at the presymptomatic stage, have reduced 18FDG‐PET binding in the cerebrum of the brain (Scholl et al., Neurobiol Aging 32:1388–1399, 2011). This could imply dysfunctional energy metabolism in the brain. In this study, plasma of presymptomatic PSEN1 mutation carriers was analyzed to understand associated metabolic changes. Methods: We analyzed plasma from noncarriers (NC, n = 8) and presymptomatic PSEN1‐H163Y mutation carriers (MC, n = 6) via untargeted metabolomics using gas and liquid chromatography coupled with mass spectrometry, which identified 1199 metabolites. All the metabolites were compared between MC and NC using univariate analysis, as well as correlated with the ratio of Aβ1–42/Aβ1–40, using Spearman's correlation. Altered metabolites were subjected to Ingenuity Pathway Analysis (IPA). Results: Based on principal component analysis the plasma metabolite profiles were divided into dataset A and dataset B. In dataset A, when comparing between presymptomatic MC and NC, the levels of 79 different metabolites were altered. Out of 79, only 14 were annotated metabolites. In dataset B, 37 metabolites were significantly altered between presymptomatic MC and NC and nine metabolites were annotated. In both datasets, annotated metabolites represent amino acids, fatty acyls, bile acids, hexoses, purine nucleosides, carboxylic acids, and glycerophosphatidylcholine species. 1‐docosapentaenoyl‐GPC was positively correlated, uric acid and glucose were negatively correlated with the ratio of plasma Aβ1–42/Aβ1–40 (P < 0.05). Interpretation: This study finds dysregulated metabolite classes, which are changed before the disease symptom onset. Also, it provides an opportunity to compare with sporadic Alzheimer's Disease. Observed findings in this study need to be validated in a larger and independent Familial Alzheimer's Disease (FAD) cohort. [ABSTRACT FROM AUTHOR]

Background: Improved cancer treatments and models of care (such as early palliative care) has developed during recent years. Aspects of healthcare utilisation—unplanned care have been used for evaluation of coordination and quality. The aim was to explore factors associated with cancer healthcare utilisation, during the first year after a cancer diagnosis. Methods: Population‐based registry and patient‐reported data, (The European Organisation of Research and Treatment of Cancer (EORTC), QLQ‐ C30 questionnaire and study‐specific questions) were collected. Descriptive statistics and multivariate regression models were performed. Results: The sample consists of 1718 patients (haematological, gynaecological, upper gastrointestinal and head and neck cancers). Living alone were associated with unplanned hospital admissions (OR 1.35; 95% CI [1.15, 1.59], p < 0.001). Patients with specialised palliative home care had a higher likelihood of unplanned hospital admissions, (OR 4.35; 95% CI [3.22‐5.91], p < 0.001) and re‐admissions within 30 days, (OR, 5.8; 95% CI [4.12‐8.19], p < 0.001). Conclusions: Sociodemographic and clinical factors, such as living alone and disease stage, is associated with healthcare utilisation. Patients with specialised palliative home care report lower levels of HRQoL and higher levels of unplanned care, and our findings stresses the importance of a holistic view when planning care. [ABSTRACT FROM AUTHOR]

Background: The clinical presentations of frontotemporal dementia (FTD) are diverse and overlap with other neurological disorders. There are, as of today, no biomarkers in clinical practice for diagnosing the disorders. Here, we aimed to find protein markers in cerebrospinal fluid (CSF) from patients with FTD, presymptomatic mutation carriers and non-carriers. Methods: Antibody suspension bead arrays were used to analyse 328 proteins in CSF from patients with behavioural variant FTD (bvFTD, n = 16) and progressive primary aphasia (PPA, n = 13), as well as presymptomatic mutation carriers (PMC, n = 16) and non-carriers (NC, n = 8). A total of 492 antibodies were used to measure protein levels by direct labelling of the CSF samples. The findings were further examined in an independent cohort including 13 FTD patients, 79 patients with Alzheimer's disease and 18 healthy controls. Results: We found significantly altered protein levels in CSF from FTD patients compared to unaffected individuals (PMC and NC) for 26 proteins. The analysis show patterns of separation between unaffected individuals and FTD patients, especially for those with a clinical diagnosis of bvFTD. The most statistically significant differences in protein levels were found for VGF, TN-R, NPTXR, TMEM132D, PDYN and NF-M. Patients with FTD were found to have higher levels of TN-R and NF-M, and lower levels of VGF, NPTXR, TMEM132D and PDYN, compared to unaffected individuals. The main findings were reproduced in the independent cohort. Conclusion: In this pilot study, we show a separation of FTD patients from unaffected individuals based on protein levels in CSF. Further investigation is required to explore the CSF profiles in larger cohorts, but the results presented here has the potential to enable future clinical utilization of these potential biomarkers within FTD. [ABSTRACT FROM AUTHOR]

In this study we analyzed sediment trap time series from five tropical sites to assess seasonal variations in concentrations and fluxes of long-chain diols (LCDs) and associated proxies with emphasis on the long-chain diol index (LDI) temperature proxy. For the tropical Atlantic, we observe that generally less than 2 % of LCDs settling from the water column are preserved in the sediment. The Atlantic and Mozambique Channel traps reveal minimal seasonal variations in the LDI, similar to the two other lipid-based temperature proxies TEX 86 and U37K′. In addition, annual mean LDI-derived temperatures are in good agreement with the annual mean satellite-derived sea surface temperatures (SSTs). In contrast, the LDI in the Cariaco Basin shows larger seasonal variation, as do the TEX 86 and U37K′. Here, the LDI underestimates SST during the warmest months, which is possibly due to summer stratification and the habitat depth of the diol producers deepening to around 20–30 m. Surface sediment LDI temperatures in the Atlantic and Mozambique Channel compare well with the average LDI-derived temperatures from the overlying sediment traps, as well as with decadal annual mean SST. Lastly, we observed large seasonal variations in the diol index, as an indicator of upwelling conditions, at three sites: in the eastern Atlantic, potentially linked to Guinea Dome upwelling; in the Cariaco Basin, likely caused by seasonal upwelling; and in the Mozambique Channel, where diol index variations may be driven by upwelling from favorable winds and/or eddy migration. [ABSTRACT FROM AUTHOR]

Currents, wind, bathymetry, and freshwater runoff are some of the factors that make coastal waters heterogeneous, patchy, and scientifically interesting—where it is challenging to resolve the spatiotemporal variation within the water column. We present methods and results from field experiments using an autonomous underwater vehicle (AUV) with embedded algorithms that focus sampling on features in three dimensions. This was achieved by combining Gaussian process (GP) modeling with onboard robotic autonomy, allowing volumetric measurements to be made at fine scales. Special focus was given to the patchiness of phytoplankton biomass, measured as chlorophyll a (Chla), an important factor for understanding biogeochemical processes, such as primary productivity, in the coastal ocean. During multiple field tests in Runde, Norway, the method was successfully used to identify, map, and track the subsurface chlorophyll a maxima (SCM). Results show that the algorithm was able to estimate the SCM volumetrically, enabling the AUV to track the maximum concentration depth within the volume. These data were subsequently verified and supplemented with remote sensing, time series from a buoy and ship-based measurements from a fast repetition rate fluorometer (FRRf), particle imaging systems, as well as discrete water samples, covering both the large and small scales of the microbial community shaped by coastal dynamics. By bringing together diverse methods from statistics, autonomous control, imaging, and oceanography, the work offers an interdisciplinary perspective in robotic observation of our changing oceans. [ABSTRACT FROM AUTHOR]

In this study we have analyzed sediment trap time series from five tropical sites to assess seasonal variations in concentrations and fluxes of long-chain diols (LCDs) and associated proxies with emphasis on the Long chain Diol Index (LDI). For the tropical Atlantic, we observe that generally less than 2 % of LCDs settling from the water column are preserved in the sediment. The Atlantic and Mozambique Channel traps reveal minimal seasonal variations in the LDI, similar to the TEX86 and UK´37. However, annual mean LDI-derived temperatures are in good agreement with the annual mean satellite-derived sea surface temperatures (SSTs). In the Cariaco Basin the LDI shows larger seasonal variation, as do the TEX86 and UK´37. Here, the LDI underestimates SST during the warmest months, which is likely due to summer stratification and the habitat depth of the diol producers deepening to around 20 to 30 m. Surface sediment LDI temperatures in the Atlantic and Mozambique Channel compare well with the average LDI-derived temperatures from the overlying sediment traps, as well as with decadal annual mean SST. Lastly, we observed large seasonal variations in the Diol Index, as indicator of upwelling conditions, at three sites, potentially linked to Guinea Dome upwelling (Eastern Atlantic), seasonal upwelling (Cariaco Basin) and seasonal upwelling and/or eddy migration (Mozambique Channel). [ABSTRACT FROM AUTHOR]

One-year long time series of current velocity and temperature from eight moorings deployed in the Faroe Bank Channel (FBC) are analysed to describe the structure and variability of the dense overflow plume on daily to seasonal timescales. Mooring arrays were deployed in two sections: located 25 km downstream of the main sill, in the channel that geographically confines the overflow plume at both edges (section C), and 60 km further downstream, over the slope (section S). At section C, the average volume transport of overflow waters (< 3 °C) from the Nordic Seas towards the Iceland Basin was 1.3 ± 0.3 Sv; at section S, transport of modified overflow water (< 6 °C) was 1:7 ± 0.7 Sv. The volume transport through the slope section was dominated by mesoscale variability at 3-5-day timescales. A simplified view of along-path entrainment of a gravity current may not be accurate for the FBC overflow. As the plume proceeds into the stratified ambient water, there is substantial detrainment from the deeper layer (bounded by the 3 °C isotherm), of comparable magnitude to the entrainment into the interfacial layer (between the 3 and 6 °C isotherms). A time series of gradient Richardson numbers suggests a quiescent plume core capped by turbulent near bottom and interfacial layers in the channel. At section S, in contrast, the entire overflow plume is turbulent. Based on a two-layer heat budget constructed for the overflow, time mean vertical diffusivities across the top of the bottom layer and across the interfacial layer were (30 ± 15)×10-4 and (120 ± 43) × 10-4 m2 s-1, respectively. [ABSTRACT FROM AUTHOR]

One-year long time series of current velocity and temperature from ten moorings deployed in the Faroe Bank Channel (FBC) are analysed to describe the structure and variability of the dense overflow plume on daily to seasonal time scales. Mooring arrays are deployed in two sections: located 25 km downstream of the main sill, in the channel that geographically confines the overflow plume at both edges (section C), and 60 km further downstream, over the slope (section S). At section C, the average volume transport of overflow waters (< 3 °C) from the Nordic Seas towards the Iceland Basin is 1.3 ± 0.3 Sv; at Section S, transport of modified overflow water (< 6 °C) is 1.8 ± 0.7 Sv. The volume transport through the slope section is dominated by mesoscale variability at 3-5 day time scale. A simplified view of along-path entrainment of a gravity current is not accurate for the FBC overflow. As the plume proceeds into the stratified ambient water, there is substantial detrainment from the deeper layer (bounded by the 3 °C isotherm), of comparable magnitude to the entrainment into the interfacial layer (between the 3 and 6 °C isotherms). Time series of gradient Richardson number suggests a quiescent plume core capped by turbulent near bottom and interfacial layers in the channel. At section S, in contrast, the entire overflow plume is turbulent. Based on a two-layer heat budget constructed for the overflow, mean diffusivities across the top of the bottom layer, and across the interfacial layer are (30 ± 15) × 10-4 m2 s-1 and (119 ± 43) × 10-4 m2 s-1, respectively. [ABSTRACT FROM AUTHOR]

Measurements of ocean microstructure are made in the turbulent Faroe Bank Channel overflow using a turbulence instrument attached to an underwater glider. Dissipation rate of turbulent kinetic energy ε is measured using airfoil shear probes. A comparison is made between 152 profiles from dive and climb cycles of the glider during a 1-week mission in June 2012 and 90 profiles collected from the ship using a vertical microstructure profiler (VMP). Approximately one-half of the profiles are collocated. For 96% of the dataset, measurements are of high quality with no systematic differences between dives and climbs. The noise level is less than 5 × 10−11 W kg−1, comparable to the best microstructure profilers. The shear probe data are contaminated and unreliable at the turning depth of the glider and for U/ u t < 20, where U is the flow past the sensor, u t = ( ε/ N)1/2 is an estimate of the turbulent velocity scale, and N is the buoyancy frequency. Averaged profiles of ε from the VMP and the glider agree to better than a factor of 2 in the turbulent bottom layer of the overflow plume, and beneath the stratified and sheared plume-ambient interface. The glider average values are approximately a factor of 3 and 9 times larger than the VMP values in the layers defined by the isotherms 3°-6° and 6°-9°C, respectively, corresponding to the upper part of the interface and above. The discrepancy is attributed to a different sampling scheme and the intermittency of turbulence. The glider offers a noise-free platform suitable for ocean microstructure measurements. [ABSTRACT FROM AUTHOR]

Observations of hydrography, currents, and microstructure are presented together with sea surface height (SSH) patterns from concurrent satellite tracks to describe the subinertial oscillations in the region downstream of the Faroe Bank Channel overflow. Energetic oscillations with a dominant 3-5-day period have previously been observed in the dense bottom layer and found to be consistent with topographic Rossby waves. Here, the authors present evidence that the oscillations extend over the whole water column and are connected to a wave-like pattern in SSH along the continental slope. The waves are observed in two satellite tracks running parallel to the slope and indicate a wavelength of 50-75 km, an amplitude of about 5 cm, and a phase speed of 15-20cm s-1. The pattern extends at least 450km along the slope. Repeat occupations of a section through a 4-day period show a barotropic velocity anomaly that is associated with an increase in plume transport [from 0.5 to 2.5 Sv (1Sv = 106m3s-1)] and interface height (from 100 to 200 m) as well as changes in dissipation rates and mixing. Estimates of entrainment velocity wE vary with a factor of 102 over the oscillation period, and there is an inverse relation between wE and plume thickness, that is, mixing is most intense when the dense bottom layer is thin. High values of wE coincide with a large percentage of critical Richardson numbers in the interfacial layer. The rotational motion, or the horizontal "stirring," is observed to bring water from the south, traceable because of its low oxygen concentrations, into the plume. [ABSTRACT FROM AUTHOR]