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Abstract Engineered biological neural networks are indispensable models for investigation of neural function and dysfunction from the subcellular to the network level. Notably, advanced neuroengineering approaches are of significant interest for their potential to replicate the topological and functional organization of brain networks. In this study, we reverse engineered feedforward neural networks of primary cortical and hippocampal neurons, using a custom-designed multinodal microfluidic device with Tesla valve inspired microtunnels. By interfacing this device with nanoporous microelectrodes, we show that the reverse engineered multinodal neural networks exhibit capacity for both segregated and integrated functional activity, mimicking brain network dynamics. To advocate the broader applicability of our model system, we induced localized perturbations with amyloid beta to study the impact of pathology on network functionality. Additionally, we demonstrate long-term culturing of subregion- and layer specific neurons extracted from the entorhinal cortex and hippocampus of adult Alzheimer’s-model mice and rats. Our results thus highlight the potential of our approach for reverse engineering of anatomically relevant multinodal neural networks to study dynamic structure-function relationships in both healthy and pathological conditions.

Youth in the US experience high rates of sexual violence. Historically, adults design and deliver preventive initiatives, with youth limited to participants and recipients. The use of community-based participatory research and other participatory approaches can expand the reach and impact of adolescent sexual violence prevention initiatives by positioning youth as leaders and co-researchers. This systematic review explores both adolescent violence prevention programs and research projects that take a participatory, youth-engaged, or youth-led approach. This review aims to understand what activities youth are involved in and how they are equipped for their roles. Following PRISMA guidelines, the review located eight eligible articles that involved high school youth or younger as more than data, focused on adolescent sexual or dating violence prevention, and whose programs or studies were conducted in the United States. I reviewed each article for programmatic and study specifics, with special attention to which stages youth participated in and how capacity-building was incorporated. The results revealed that youth can participate in a variety of activities, though they are involved in certain stages more than others, and that capacity-building ranged in breadth and frequency. I call researchers to detail youth activities and training, and explain clearly their participatory approach and decisions.

Abstract Background Multimorbidity is increasingly acknowledged as a significant health concern, particularly among older individuals. It is associated with a decline in quality of life and psychosocial well-being as well as an increased risk of being referred to multiple healthcare providers, including more frequent admissions to emergency departments. Person-centered care interventions tailored to individuals with multimorbidity have shown promising results in improving patient outcomes. Research is needed to explore how work practices within integrated care models are experienced from Registered Nurse Case Managers’ (RNCMs) perspective to identify areas of improvement. Therefore, the aim of this study was to describe RNCMs’ work experience with a person-centered collaborative healthcare model (PCCHCM). Methods This study used an inductive design. The data were collected through individual interviews with 11 RNCMs and analyzed using qualitative content analysis. Results Data analysis resulted in four generic categories: ‘Being a detective, ‘Being a mediator’, ‘Being a partner’, and ‘Being a facilitator of development’ which formed the basis of the main category ‘Tailoring healthcare, and social services to safeguard the patient’s best.’ The findings showed that RNCMs strive to investigate, identify, and assess older persons’ needs for coordinated care. They worked closely with patients and their relatives to engage them in informed decision-making and to implement those decisions in a personalized agreement that served as the foundation for the care and social services provided. Additionally, the RNCMs acted as facilitators of the development of the PCCHCM, improving collaboration with other healthcare professionals and enhancing the possibility of securing the best care for the patient. Conclusions The results of this study demonstrated that RNCMs tailor healthcare and social services to provide care in various situations, adhering to person-centered care principles and continuity of care. The findings underline the importance of implementing integrated care models that consider the unique characteristics of each care context and adapt different case managers’ roles based on the patient’s individual needs as well as on the specific needs of the local setting. More research is needed from the patients’ and their relatives’ perspectives to deepen the understanding of the PCCHCM concerning its ability to provide involvement, security, and coordination of care.

Abstract Common half-cell measurements deliver oxygen reduction activities linked to the chosen scan rate, limiting their value for fundamental and comparative studies on platinum. Here we show a deconvolution of the intrinsic kinetics from the effect of surface oxygen on platinum. We find an electronic effect of the surface oxygen, substantiate a Tafel slope of ~120 mV/decade, obtain an exchange current density of 13 ± 4 µA/cm2, and an activity of 7 mA/cm2 at 900 mV. Eventually, we broaden the scope of this analysis to the effects of surface rearrangement, alloying, and supported Pt nanoparticles, the latter providing insight into discrepancies between half-cell and fuel cell measurements. We find through computational methods that binding energies of intermediates would be weakened by the presence of highly coordinated oxygen atoms. Finally, we obtain a phenomenological rate equation for the oxygen reduction and evolution reaction, suggesting that both reactions follow a shared mechanism.

Abstract Background Maternal hypothyroidism in pregnancy has been proposed to increase the risk of preeclampsia, but uncertainties persist regarding the underlying causal mechanisms. Thus, it remains unclear if an increased risk of preeclampsia in hypothyroid pregnant women is caused by the lack of thyroid hormones or by the autoimmunity per se. Methods We conducted a retrospective study of two pregnancy cohorts in the Danish population. The nationwide cohort (n = 1,014,775) was register-based and included all singleton pregnancies in Denmark from 1999–2015. The regional cohort (n = 14,573) included the biochemical measurement of thyroid stimulating hormone (TSH), thyroid peroxidase antibodies (TPO-Ab), and thyroglobulin antibodies (Tg-Ab) (ADVIA Centaur XPT, Siemens Healthineers) among pregnant women in The North Denmark Region from 2011–2015 who had a blood sample drawn in early pregnancy as part of routine prenatal screening for chromosomal anomalies. The associations between diagnosed and biochemically assessed hypothyroidism and a diagnosis of preeclampsia were evaluated using logistic regression (adjusted odds ratio (aOR) with 95% confidence interval (CI)) adjusting for potential confounders, such as maternal age, diabetes, and parity. Results In the nationwide cohort, 2.2% of pregnant women with no history of hypothyroidism (reference group (ref.)) were diagnosed with preeclampsia, whereas the prevalence was 3.0% among pregnant women with hypothyroidism (aOR 1.3 (95% CI: 1.2–1.4)) and 4.2% among women with newly diagnosed hypothyroidism in the pregnancy (aOR 1.6 (95% CI: 1.3–2.0)). In the regional cohort, 2.3% of women with early pregnancy TSH 60 U/mL) or Tg-Ab (> 33 U/mL) in early pregnancy (aOR 0.86 (95% CI: 0.6–1.2)). Conclusions In two large cohorts of Danish pregnant women, maternal hypothyroidism was consistently associated with a higher risk of preeclampsia. Biochemical assessment of maternal thyroid function revealed that the severity of hypothyroidism was important. Furthermore, results did not support an association between thyroid autoimmunity per se and preeclampsia.

Abstract Background Social support provided by a family member has been found to have a buffering effect on distress and is associated with better diabetes self-care. This study explores the meaning of social support, as described by close family members of foreign-born people living with type 2 diabetes (PWDM) in Sweden. It also explores the support provided by family members, and the support they need to be able to support the PWDM. Methods Qualitative explorative study, semi-structured interviews for data collection. Qualitative content analysis based on a theoretical framework on social support. Purposive sample of 13 family members, 18–52-years-old, born in countries in the Middle East, Africa, and Russia. Results The meaning of support was described as social and emotional. Most participants described a stressful situation; feelings of sadness/worry about the risk of the PWDM developing complications added to a strained life situation from which one could not opt out. Frequent daily contacts in a family network were evident, particularly by children trained as healthcare professionals. Caring for a family member was considered a filial piety, but it was also a chance to reciprocate. The support provided was mainly informational (e.g., reminders about nutritional intake), but it was also instrumental/practical (administering medicines, helping with economy/logistics, planning/cooking meals, basic care) and emotional (sharing meals, thoughts, and activities). The support the family members needed was getting first-hand information by attending the physician visits, being able to book appointments themselves at suitable times, and preventing the withholding of important information about the PWDM. They also desired an open telephone-line, oral and written information, particularly on diet. Conclusions To family-members, supporting the PWDM was normal and a filial piety. Support provided and needed was not only informational but also instrumental/practical and emotional. In diabetes care, addressing foreign-born individuals, diabetes education needs to be developed, also including family members. Informational material, particularly on diet, and improved access to healthcare and information about the healthcare system have the potential to increase family members’ control over the situation and prevent a negative trajectory in caregiving with perceived demands causing high levels of stress.

Abstract Background The ongoing global migration has led to multicultural societies, with many migrants who do not speak the official language in the host country. This could contribute to communication problems with staff in healthcare and a risk to patient safety. Research on patient safety in medication use in migrants is an under-researched area. The aim was to explore diverse foreign-born people’s experiences and perceptions of self-management of medication and determine if home-based practice patterns have implications on medication safety, and what factors may support safe medication use. Methods A qualitative explorative study, with individual semi-structured interviews and participant observations in the patients’ home. Qualitative content analysis was applied. Results A purposeful sample of 15 foreign-born persons identified by healthcare staff as having language difficulties in Swedish that may pose a safety risk in connection with medication use at home, was selected. Three categories were identified. The first category showed respondents being dependent on another person, having experiences of not receiving information about their medications due to language barriers, having difficulties getting access to the healthcare centre and feeling distrusted/misunderstood. The second category showed respondents being independent and self-motivated Although they struggled, they managed to get access/contact with the healthcare centre themselves and felt understood/listened to by the staff. The last category concerned factors that facilitating medication use; such as having a medication list in the respondents’ own language and offering a choice of language on the answering machine at the healthcare centre. Although they knew it was impossible to get an interpreter at the pharmacy, they felt safe knowing there was always a solution for receiving understandable information. Conclusion The findings highlighted that language barriers can complicate the communication between migrants and the healthcare, which can affect the medication safety. Understanding of this group is essential to improve the cooperation between patients and staff, leading to culturally congruent care. This knowledge should be used in healthcare to understand the gap in communication to increase patient safety. Further research from other angles, e.g. pharmacy/healthcare staff and relatives is needed to identify and evaluate facilitation to improve the outcome of the intended medication treatment.

Background The advent of biosimilars may increase the frequency of dose escalation with biologics in psoriasis.Objective To explore the frequency and outcomes of dose escalation with adalimumab etanercept, and ustekinumab.Methods Data were extracted from DermaReg-Pso, a psoriasis register in Stockholm, Sweden. The main exposure was treatment, and the main outcome was dose escalation. We describe outcomes with dose escalation by estimating drug survival and changes in the Psoriasis Area and Severity Index (PASI).Results 554 patients had 946 treatment episodes with adalimumab, etanercept, or ustekinumab. The cumulative incidence of dose escalation was 4.1 per 100 treatment years. The Hazard Ratios (HRs) for dose escalation with ustekinumab vs adalimumab and ustekinumab vs etanercept were 1.93 (95% CI: 1.25-2.98), and 2.20 (95% CI: 1.42-3.41), respectively. After dose escalation, the HRs for treatment discontinuation with adalimumab and etanercept compared with ustekinumab were 3.10 (95% CI: 1.56-6.18) and 7.15 (95% CI: 3.96-12.94), respectively. PASI was higher after compared to before dose escalation for etanercept (p = 0.036), but not for adalimumab (p = 0.832) or ustekinumab (p = 0.300).Conclusions Dose escalation was comparatively more frequent with ustekinumab than with adalimumab or etanercept; however, treatment discontinuation after dose escalation was more common with adalimumab and etanercept than ustekinumab.

Summary: Aim: To determine the level of knowledge and explore the difference of hand hygiene between nursing students and nurses. Background: Annually, 3.8 million people in Europe acquire healthcare-associated infections, highlighting the importance of hand hygiene. Despite WHO's emphasis on the fact that greater hand hygiene knowledge correlates with improved hand hygiene compliance, several studies have shown knowledge gaps among nurses and nursing students regarding hand hygiene. Design: Descriptive cross-sectional comparative survey. Methods: A version of the WHO “Hand Hygiene Knowledge Questionnaire”, translated into Swedish, was used for data collection among nursing students in the first and last semester, and registered nurses from a university and associated hospital. Data were analyzed by descriptive statistics, and comparison between groups with Fisher's exact test, one-way ANOVA, and post-hoc tests (Pairwise Z-Tests, Tukey HSD). Results: The survey, conducted between December 2020 and January 2021, received responses from 201 participants, including 71 first semester students, 46 last semester students and 84 registered nurses, showing moderate (55.7% [50–74% correct answers]) to good (43.8% [75–100% correct answers]) knowledge levels. First-semester students scored lower (17.0 ± 2.1) than last-semester students (18.8 ± 1.8) and registered nurses (18.3 ± 2.1) out of 25 questions. Discussion: It is necessary for all groups to receive proper education on hand hygiene knowledge and to have an educational program that does not separate the groups but combines them with continuing education, since the students will someday be influencing future hand hygiene knowledge as a peer, together with the nurse.

Abstract Objective/Background The Consensus Sleep Diary (CSD) is widely used to assess subjective sleep. Psychometric evaluations and focus-groups support its validity and clinical usefulness, but further research into its validity is needed. The aim of the study was to evaluate a Swedish translation of the CSD regarding test content and response processes in patients with insomnia. Patients/Methods In connection with translating the CSD into Swedish, we used cognitive interviewing to evaluate test content and the response process, that is, how people make decisions when responding to survey items. Cognitive interviews were conducted with 13 primary health care patients with insomnia disorder (mean age, 49 years; SD 15.5). Iterative, reparative analysis was used to investigate test content. Descriptive deductive analysis was used to investigate interview transcripts for the themes of the cognitive model: comprehension, retrieval, decision process, and judgement. Together, the themes explain the response process when responding to a patient-reported outcome measure. Results The overall comprehension of the CSD could be affected by poor adherence to the instructions (comprehension). Patients had difficulty with recall if they did not complete the diary immediately in the morning and just before bedtime (retrieval). They could have problems deciding how to respond to certain items because they imbued sleep-related concepts with extra meaning (decision process), and had trouble finding response alternatives nuanced enough to describe their experience of sleep and tiredness (judgement). Conclusions This study contributes knowledge on how the instrument is perceived and used by care-seeking patients with insomnia. In this context, the CSD exhibits known flaws such as memory lapses if the diary is not filled in directly in the morning. To increase the accuracy of patients’ responses, therapists should support patients in reading the instructions.

Abstract Common mitochondrial DNA (mtDNA) deletions are large structural variants in the mitochondrial genome that accumulate in metabolically active tissues with age and have been investigated in various diseases. We applied the Splice-Break2 pipeline (designed for high-throughput quantification of mtDNA deletions) to human RNA-Seq datasets and describe the methodological considerations for evaluating common deletions in bulk, single-cell, and spatial transcriptomics datasets. A robust evaluation of 1570 samples from 14 RNA-Seq studies showed: (i) the abundance of some common deletions detected in PCR-amplified mtDNA correlates with levels observed in RNA-Seq data; (ii) RNA-Seq library preparation method has a strong effect on deletion detection; (iii) deletions had a significant, positive correlation with age in brain and muscle; (iv) deletions were enriched in cortical grey matter, specifically in layers 3 and 5; and (v) brain regions with dopaminergic neurons (i.e., substantia nigra, ventral tegmental area, and caudate nucleus) had remarkable enrichment of common mtDNA deletions.

Objective: The physiological adaptations during a normal pregnancy affect renal and thyroid function and levels of associated biochemical markers. An association between cystatin C (CysC), creatinine, and thyroid function has been considered in nonpregnant individuals but not in pregnant women specifically. Methods: Cohort study within the North Denmark Region Pregnancy Cohort (2011–2015) with assessment of thyroid function and autoantibodies (ADVIA Centaur XPT, Siemens Healthineers) in serum residues from the early pregnancy. Consecutive samples (n = 1112) were selected for measurement of CysC and creatinine (At ellica CH 930, Siemens Healthineers), and results were linked to information in Danish nationwide registers for (i) establishment of pregnancy-specific reference intervals for CysC and creatinine and (ii) evaluation of the prevalence of maternal hypothyroidism in early pregnancy according to levels of CysC and creatinine. Results: The established reference intervals (2.5–97.5 percentiles) di ffered by week of pregnancy (week 4–8, 9–11, 12–15) and were CysC: 0.58–0.92 mg/L ; 0.54–0.91 mg/L; 0.52–0.86 mg/L; creatinine: 46.9–73.0 μmol/L; 42.0–68.4 μmol/L; 38.8–66.4 μmol/L. The prevalence of maternal autoimmune hypothyroidism in early pregn ancy differed by the level of CysC and creatinine (75th percentile) and was for CysC 1.7%, 3.8%, 7.4% and for creatinine 2.5%, 4.1%, 7.1%. Conclusions: Reference intervals for CysC and creatinine were dynamic in early pregnancy and decreased with increasing gestational age. Furthermore, higher levels of CysC and creatinine associated with a higher prevalence of maternal autoimmune hypothyroidism. Results encourage considerations on the underlying mechanisms for the association between markers of renal and thyroid function.

This study is the result of a participatory and collaborative project in which Swedish scholars and representatives of island organizations in Sweden set out to define what Swedish island research is and identify imminent research gaps. The article answers the following questions: 1) Which key research gaps can be identified in Swedish island research? 2) How can we relate Swedish island research to the international field of island research? The study is based on community based participatory research. Data was collected through a participatory process with workshops, webinars, and participatory activities in 2022. The main conclusion is that there is a democracy deficit affecting island development which is caused by the institutional structure in Sweden where island communities are mainly subordinated mainland municipalities, and a lack of island and archipelago policies.

Tree pathogens threaten the survival of many forest foundation tree species worldwide. However, there is limited knowledge of how dieback of foundation tree species may threaten other components of forest ecosystems, such as soil biodiversity and associated ecosystem functions. Kauri (Agathis australis), threatened by the root-borne pathogen Phytophthora agathidicida, are culturally and ecologically significant tree species that exert great influence on soil properties. We aimed to characterise soil mesofauna community structure and energy fluxes in kauri forests and assess the potential threat that tree pathogens such as P. agathidicida pose to belowground ecosystems. We sampled soil mesofauna communities and identified specimens to functional feeding groups at 24 pairs of kauri and adjacent broadleaf trees in sites across the Waitākere Ranges Regional Park, Aotearoa – New Zealand. We attributed kauri canopy health scores, measured tree diameter, slope, forest floor depth, and soil carbon dioxide efflux. We also analysed soil samples for P. agathidicida presence, total carbon, and total nitrogen. We constructed soil mesofauna food webs associated with kauri and broadleaf trees, and assessed the uniqueness of food webs associated with kauri and the impacts of P. agathidicida on density, biomass, mean body mass, and energy fluxes of mesofauna taxonomic and trophic groups. We found omnivores with larger body mass at kauri where P. agathidicida was detected (i.e., P. agathidicida-positive soils). Compared to broadleaf trees, mesofauna density and biomass were lower in soils under kauri, and body masses of Symphyla and omnivores were smaller in soils under kauri. Differences in mesofauna community response variables between tree types were mainly modulated by the soil C:N ratio, which had positive effects under broadleaf and neutral to negative effects under kauri. Energy fluxes to detritivores and fungivores were greater under larger trees, regardless of tree type or P. agathidicida detection status. Our findings suggest that kauri support soil mesofauna food webs that are distinctly different from those found under broadleaf trees in the same habitat. A decreased presence of this foundation species may be linked to future impacts on soil mesofauna in this forest ecosystem with increasingly advanced stages of kauri dieback.

Abstract Aim To systematically analyse and synthesize studies investigating job satisfaction (including turnover and turnover intention) and wellbeing (physical, social and psychological including work stress, acculturation stress and sick leave) among migrant care workers in nursing homes. Design An integrated review was conducted. Methods Joanna Briggs Institute's manual guided the analysis of qualitative data (n = 31). Quantitative data (n = 17) were summarized and integrated with the qualitative findings. Results Migrants described high job demands, limited control and social support, and stress possibly related to acculturation. Although, compared to natives (born in the country), inconsistent results were reported about wellbeing and job satisfaction, migrant care workers reported enjoying the relational aspects of work and feeling pride when providing care. A satisfying work environment for migrant care workers enables them enjoying working in elderly care with pride. Public Contribution Help managers to promote an inclusive working life in line with the United Nations Sustainable Development Goal number 8.

In recent years, deep learning approaches have gained significant attention in predicting brain disorders using neuroimaging data. However, conventional methods often rely on single-modality data and supervised models, which provide only a limited perspective of the intricacies of the highly complex brain. Moreover, the scarcity of accurate diagnostic labels in clinical settings hinders the applicability of the supervised models. To address these limitations, we propose a novel self-supervised framework for extracting multiple representations from multimodal neuroimaging data to enhance group inferences and enable analysis without resorting to labeled data during pre-training. Our approach leverages Deep InfoMax (DIM), a self-supervised methodology renowned for its efficacy in learning representations by estimating mutual information without the need for explicit labels. While DIM has shown promise in predicting brain disorders from single-modality MRI data, its potential for multimodal data remains untapped. This work extends DIM to multimodal neuroimaging data, allowing us to identify disorder-relevant brain regions and explore multimodal links. We present compelling evidence of the efficacy of our multimodal DIM analysis in uncovering disorder-relevant brain regions, including the hippocampus, caudate, insula, - and multimodal links with the thalamus, precuneus, and subthalamus hypothalamus. Our self-supervised representations demonstrate promising capabilities in predicting the presence of brain disorders across a spectrum of Alzheimer’s phenotypes. Comparative evaluations against state-of-the-art unsupervised methods based on autoencoders, canonical correlation analysis, and supervised models highlight the superiority of our proposed method in achieving improved classification performance, capturing joint information, and interpretability capabilities. The computational efficiency of the decoder-free strategy enhances its practical utility, as it saves compute resources without compromising performance. This work offers a significant step forward in addressing the challenge of understanding multimodal links in complex brain disorders, with potential applications in neuroimaging research and clinical diagnosis.

Modern gearing applications, in particular electrification, impose new challenges in many different fields of engineering and research. In specific, new demands are imposed on gears, including higher rotational speed, lower noise acceptance, and increased efficiency, as well as increased resistance against pitting and scuffing. To meet these demands, a better understanding of gear contacts is needed. The Eurostars project Effigears proposes a novel multi-perspective methodology for assessment of gear efficiency and contact analysis. The methodology consists of using a novel surface treatment method, Triboconditioning®, implemented in a streamfinishing process, surface measurements using a scattered light method, experimental testing using the standardized FZG test rig, and contact simulations using a novel thermal elasto-hydrodynamic lubrication tool. It is found, in preliminary tests, that enhanced gear performance may be enhanced due to Triboconditioning® surface treatment. Findings also include better understanding of how surface characteristics and lubricants affect scuffing and pitting, and the effect of load distribution on gearset behavior.

Abstract Background Thyroid disease in pregnant women is a matter of clinical awareness, and current clinical guidelines recommend a risk-based screening strategy. This study aimed to evaluate current clinical practice regarding screening for thyroid disease in pregnancy in Denmark. Methods A cross-sectional study was performed in the North Denmark Region with consecutive inclusion of 150 pregnant women from Aalborg University Hospital each year in 2020 and 2021. Medical records were reviewed according to the recommended risk-based screening criteria for thyroid disease in pregnancy. Any measurement of thyroid-stimulating hormone (TSH) was assessed 3 months prior to and in pregnancy. Results Altogether 292 pregnant women who received no current treatment for thyroid disease were included. A total of 81 (27.7%) had a measurement of TSH before or during the pregnancy, and 30 women (10.3%) in the early pregnancy specifically. One or more of the screening criteria for thyroid disease recommended in the Danish clinical practice guideline were fulfilled in 37 of the 81 women (45.7%) with thyroid function tested and among 41 of the 211 (19.4%) women who did not have thyroid function tested before or during pregnancy. Conclusion In a Danish regional investigation, 1 in 4 women had their thyroid function tested in relation to a pregnancy. However, recommended risk-based screening criteria for thyroid disease in pregnancy were heterogeneously distributed. Results encourage considerations on the current practice for the screening of thyroid function in Danish pregnant women and inform the general debate.

Abstract Cerebral ischemic stroke is a leading cause of morbidity and mortality globally. However, the mechanisms underlying ischemic stroke injury remain poorly understood. Here, it is found that deficiency of the ubiquitin‐specific protease USP25 significantly aggravate ischemic stroke injury in mice. USP25 has no impact on neuronal death under hypoxic conditions, but reduced ischemic stroke‐induced neuronal loss and neurological deficits by inhibiting microglia‐mediated neuroinflammation. Mechanistically, USP25 restricts the activation of NF‐κB and MAPK signaling by regulating TAB2. As a deubiquitinating enzyme, USP25 removeds K63‐specific polyubiquitin chains from TAB2. AAV9‐mediated TAB2 knockdown ameliorates ischemic stroke injury and abolishes the effect of USP25 deletion. In both mouse and human brains, USP25 is markedly upregulated in microglia in the ischemic penumbra, implying a clinical relevance of USP25 in ischemic stroke. Collectively, USP25 is identified as a critical inhibitor of ischemic stroke injury and this data suggest USP25 may serve as a therapeutic target for ischemic stroke.

Adapting to site conditions is a central part of forest regeneration and can be done through selection of different planting positions. Requirements are tree species specific, and the use of soil moisture maps could be a way to support decision making in forest regeneration planning. At two experimental sites with varying soil moisture conditions in southern Sweden Norway spruce (Picea abies (L.) Karst.), Scots pine (Pinus sylvestris L.), and silver birch (Betula pendula Roth) seedlings were planted in four different planting positions following mounding site preparation; Depression, Hinge, Mound and Unscarified. Soil moisture estimates were obtained from a high-resolution depth-to-water raster for each planting spot. The effect of soil moisture, planting position and their interactions on mortality, height and diameter was evaluated for each tree species. In wet conditions mounds proved to be the best option to minimize seedling mortality for conifers, but with decreasing soil moisture, differences between the planting positions decreased. Birch on the other hand had the greatest survival in the hinge. The coniferous species displayed increased height and diameter when planted in mounds independent of the soil moisture conditions, whereas silver birch was less dependent on a specific planting position. Results from this study shows that a soil moisture map can explain mortality, height and diameter and thus can be a useful tool when choosing planting position in different soil moisture conditions.

ObjectiveEighty percent of patients with a diagnosis of tetralogy of Fallot (TOF) do not have a known genetic etiology or syndrome. We sought to identify key molecular pathways and biological processes that are enriched in non-syndromic TOF, the most common form of cyanotic congenital heart disease, rather than single driver genes to elucidate the pathogenesis of this disease.MethodsWe undertook exome sequencing of 362 probands with non-syndromic TOF and their parents within the Pediatric Cardiac Genomics Consortium (PCGC). We identified rare (minor allele frequency

Background: Insomnia symptoms seem to be common in cardiac arrest survivors but their associations with important outcomes such as self-reported health and life satisfaction have not previously been reported during the early post-event period. Therefore, the aim of the study was to investigate whether symptoms of insomnia are associated with self-reported health and life satisfaction in cardiac arrest survivors six months after the event. Methods: This multicentre cross-sectional survey included cardiac arrest survivors ≥18 years. Participants were recruited six months after the event from five hospitals in southern Sweden, and completed a questionnaire including the Minimal Insomnia Symptom Scale, EQ-5D-5L, Health Index, Hospital Anxiety and Depression Scale, and Satisfaction With Life Scale. Data were analysed using the Mann-Whitney U test, linear regression, and ordinal logistic regression. The regression analyses were adjusted for demographic and medical factors. Results: In total, 212 survivors, 76.4% males, with a mean age of 66.6 years (SD = 11.9) were included, and of those, 20% reported clinical insomnia. Insomnia was significantly associated with all aspects of self-reported health (p

Introduction: Thyroid disorders have been linked to abnormalities in the coagulation system, and a hypocoagulant state has been proposed in hypothyroidism. The assessment of thyroid function is, however, not routinely recommended as part of the assessment for coagulation disorders. Case presentation: We present a 32-year-old woman who had no history of thyroid disease and who recently gave birth preterm because of severe preeclampsia and intrauterine growth restriction. Due to severe placental dysfunction, she underwent a routine biochemical assessment of the coagulation system 6 months postpartum, and a prolonged activated partial thromboplastin time (APTT) (43 s) was identified along with a low level of coagulation factor VIII (0.44 IU/mL), and a low level of von Willebrand factor (vWF) antigen (0.35 IU/mL), vWF activity (0.38 IU/mL) as well as reduced generation of thrombin. The assessment of thyroid function in the patient identified autoimmune, overt hypothyroidism with a thyroid-stimulating hormone (TSH) concentration of 139 mIU/L, low levels of the peripheral thyroid hormones (total thyroxine: 43 nmol/L, total triiodothyronine: 0.9 nmol/L), and high levels of thyroid peroxidase antibodies (296 U/mL) as well as thyroglobulin antibodies (927 U/mL). Conclusion: In this case, prolonged APTT provided a diagnostic clue for the assessment of thyroid function in a young woman with a recent history of severe placental dysfunction. The identification of autoimmune, overt hypothyroidism emphasizes that measurement of TSH may be of clinical importance in cases of unexplained prolonged APTT or other biochemical signs of abnormalities in the coagulation system.

Objective: Thyroid disease in women of reproductive age is mainly of autoimmune origin, and thyroid peroxidase antibodies (TPO-Ab) as well as thyroglobulin antibodies (Tg-Ab) are key markers. Adding to this, much focus in pregnancy is on euthyroid women who are thyroid antibody positive. Evidence to substantiate the cut -offs for the definition of thyroid autoantibody positivity in early pregnant women is warranted. Methods: Stored serum samples from 14,030 Danish pregnant women were used for the measurement of TPO-Ab, Tg-Ab, TSH, and free thyroxine (ADVIA Centaur XPT, Siemens Healthineers). Among all women, a reference cohort of 10,905 in dividuals was identified for the establishment of antibody cut-offs. Percentile cut-offs f or TPO-Ab and Tg-Ab were determined using regression on order statistics (the reference cohort). The established cut-offs were then applied (the full cohort), and frequencies of early pregnancy as well as later diagnosis of hypothyroidism were evaluated. Results: The highest established cut-offs (95th, 97.5th, and 99th percen tiles) were 59, 68, and 81 U/mL for TPO-Ab and 33, 41, and 52 U/mL for Tg-Ab. W hen the cut-offs were applied in the full cohort, 11.0, 10.2, and 9.7% were TPO-Ab po sitive, whereas 13.3, 12.3, and 11.2% were Tg-Ab positive. Antibody-positive women (TPO-Ab and/or Tg-Ab) had higher median TSH and were more likely to have hypothyroidism in early pregnancy and to be diagnosed with hypothyroidism during follow-up. Conclusions: This large study established and evaluated pregnancy-specific c ut-offs for TPO-Ab and Tg-Ab. The findings are important regarding the class ification of exposure in pregnancy and assessment of thyroid autoimmunity per se.

Abstract Background The Covid-19 pandemic and associated visiting restrictions have challenged communication with others for older people residing in nursing homes. Aim The aim of this study was to explore residents’ experiences of encounters and communication with staff and relatives and friends during the Covid-19 pandemic. Design An exploratory study with an inductive approach. Methods Semi-structured telephone interviews with 16 Swedish nursing home residents were conducted. Data were analyzed using qualitative content analysis; the study reports according to the COREQ checklist. Results Three main categories emerged: (1) Mixed feelings and experiences of encounters with nursing staff, (2) Adapting to hampered communication and finding strategies to overcome language barriers, and (3) Facing pandemic restrictions and living an adjusted life. Nine subcategories are reported within these categories. Residents mainly reported good encounters with staff and receiving the care they needed, but unhelpful encounters were also reported. To manage communication with staff with limited Swedish language skills, residents developed several strategies. During the visiting ban, residents felt secure but also lonely. Staying connected with the outside world required residents to use the phone and handle other digital aids, such as video calls, but lack of technical skills among staff hindered frequent use of video calls. Conclusion This study highlights how residents can feel safe in extreme situations, but increased competence, including digital literacy and language skills, among staff is required. Care providers should provide relevant information to residents and staff and employ competent staff. Findings indicate that communication plans need to include enabling communication for residents both within and outside nursing homes, taking staff language skills into consideration.

Abstract Background Type 2 diabetes mellitus (T2DM) is a global public health problem with complications related to knowledge guiding self-care. Limited knowledge might result in poor control of blood glucose, but there is no previous investigation measuring diabetes knowledge in people diagnosed with T2DM in Thailand. This study was aimed to investigate level of diabetes knowledge and related factors among people with T2DM in Thailand. Method This cross-sectional study was conducted in a Northeastern province in Thailand among 276 people with T2DM, 195 women and 81 men, using a standardized self-report questionnaire, the Diabetes Knowledge Test. The data were analyzed using Pearson’s chi-square test, one-way analysis of variance, and independent samples t-test. Results The majority of respondents had poor diabetes knowledge in all subscales; total knowledge of diabetes (96.7%), general knowledge of diabetes (71.7%), and insulin use knowledge (92.3%). There was no difference found in knowledge scores between males and females. Having finished secondary school education or higher, being employed, or having diabetes-related complications were related to increased total diabetes knowledge and general diabetes knowledge. Conclusion The people with T2DM had poor diabetes knowledge, and those using insulin also had poor knowledge about the use of insulin.

Summary: Triggering receptor expressed on myeloid cell 2 (TREM2) signaling often drives opposing effects in traumatic versus demyelinating CNS disorders. Here, we identify two distinct phenotypes of microglia and infiltrating myeloid populations dependent on TREM2 expression levels at the acute stage and elucidate how they mediate the opposing effects of TREM2 in spinal cord injury (SCI) versus multiple sclerosis animal models (experimental autoimmune encephalomyelitis [EAE]). High TREM2 levels sustain phagocytic microglia and infiltrating macrophages after SCI. In contrast, moderate TREM2 levels sustain immunomodulatory microglia and infiltrating monocytes in EAE. TREM2-ablated microglia (purine-sensing phenotype in SCI and reduced immunomodulatory phenotype in EAE) drive transient protection at the acute stage of both disorders, whereas reduced phagocytic macrophages and lysosome-activated monocytes lead to contrasting neuroprotective and demyelinating effects in SCI versus EAE, respectively. Our study provides comprehensive insights into the complex roles of TREM2 in myeloid populations across diverse CNS disorders, which has crucial implications in devising TREM2-targeting therapeutics.

In order to support or refute the clinical suspicion of cranial giant cell arteritis (GCA), a supplemental imaging modality is often required. High-resolution black blood Magnetic Resonance Imaging (BB MRI) techniques with contrast enhancement can visualize artery wall inflammation in GCA. We compared findings on BB MRI without contrast enhancement with findings on 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/low-dose computed tomography (2-[18F]FDG PET/CT) in ten patients suspected of having GCA and in five control subjects who had a 2-[18F]FDG PET/CT performed as a routine control for malignant melanoma. BB MRI was consistent with 2-[18F]FDG PET/CT in 10 out of 10 cases in the group with suspected GCA. In four out of five cases in the control group, the BB MRI was consistent with 2-[18F]FDG PET/CT. In this small population, BB MRI without contrast enhancement shows promising performance in the diagnosis of GCA, and might be an applicable imaging modality in patients.

In vitro and animal studies have shown that carrot juice containing bioactive natural products, such as falcarinol (FaOH) and falcarindiol (FaDOH), can affect inflammation. The present study was designed to test whether oral intake of carrot juice containing the bioactive acetylenic oxylipins FaOH and FaDOH affects mediators of acute inflammation or the innate immune response in human blood. Carrot juice (500 mL) was administered orally to healthy volunteers, and blood samples were drawn before and 1 h after juice intake. Next, the blood samples were split in two, and one sample was stimulated ex vivo with lipopolysaccharide (LPS) and incubated at 37 °C for 24 h. The concentrations of 44 inflammatory cytokines and chemokines were examined using multiplex electrochemiluminescence analysis. In blood samples not stimulated with LPS, a significant increase in IL-15 was measured 1 h after carrot juice intake. Cytokines like IFN-ɣ, IL-12/IL-23(p40), IL-23, IL-17A, IL-17B, IL-17D, and IL-22 were significantly increased in LPS-stimulated blood samples after carrot juice intake. The upregulation of the immunostimulating cytokines belonging to the IL-23/IL-17 Th17 axis suggests that carrot juice intake could benefit diseases where inflammation plays a role, like in the early stages of diabetes or cancers.

Abstract Background Relatives of nursing home (NH) residents have experienced national or local restrictions on visiting their elderly family member during the Covid-19 pandemic. Today, many NHs have a multicultural environment, as staff, residents and their relatives speak different languages. Thus far, studies of remote communication with staff with limited language skills during the Covid-19 pandemic are lacking. Aim The aim of the present study was to explore relatives’ experiences of encounters and communication with staff and residents in NHs during the Covid-19 pandemic. Method An explorative qualitative study using semi-structured telephone interviews with 17 relatives of NH residents (12 women and 5 men). Data were analyzed using qualitative content analysis to identify four main categories and nine sub-categories. Results Communicating during visiting restrictions was challenging, and relatives experienced ups and downs when trying to stay in contact with NH residents and staff. Relatives received general information, but desired information about residents’ everyday life without having to ask for it. Moreover, remote communication was difficult for residents with hearing impairment or dementia. Even relatives who understood different languages had to develop strategies to communicate with staff with limited language skills in Swedish and English. Relatives did not mention using translating applications to facilitate communication. Conclusion During visiting restrictions, relatives lacked information about residents’ everyday life and found communication with staff with limited language skills challenging. For this reason, and to enable communication with staff with limited language skills, there is a need to find practical and technical solutions for facilitating remote communication between relatives, residents and staff at NHs.

Abstract Mitochondrial dysfunction is a neurobiological phenomenon implicated in the pathophysiology of schizophrenia and bipolar disorder that can synergistically affect synaptic neurotransmission. We hypothesized that schizophrenia and bipolar disorder share molecular alterations at the mitochondrial and synaptic levels. Mitochondria DNA (mtDNA) copy number (CN), mtDNA common deletion (CD), mtDNA total deletion, complex I activity, synapse number, and synaptic mitochondria number were studied in the postmortem human dorsolateral prefrontal cortex (DLPFC), superior temporal gyrus (STG), primary visual cortex (V1), and nucleus accumbens (NAc) of controls (CON), and subjects with schizophrenia (SZ), and bipolar disorder (BD). The results showed (i) the mtDNA CN is significantly higher in DLPFC of both SZ and BD, decreased in the STG of BD, and unaltered in V1 and NAc of both SZ and BD; (ii) the mtDNA CD is significantly higher in DLPFC of BD while unaltered in STG, V1, and NAc of both SZ and BD; (iii) The total deletion burden is significantly higher in DLPFC in both SZ and BD while unaltered in STG, V1, and NAc of SZ and BD; (iv) Complex I activity is significantly lower in DLPFC of both SZ and BD, which is driven by the presence of medications, with no alteration in STG, V1, and NAc. In addition, complex I protein concentration, by ELISA, was decreased across three cortical regions of SZ and BD subjects; (v) The number of synapses is decreased in DLPFC of both SZ and BD, while the synaptic mitochondria number was significantly lower in female SZ and female BD compared to female controls. Overall, these findings will pave the way to understand better the pathophysiology of schizophrenia and bipolar disorder for therapeutic interventions.

Drag torque in a disc brake is the residual torque when the brake is not activated. This torque can adversely influence the total energy consumption, life of the brake components, and level of airborne wear particles from vehicles. Drag torque is of special interest for long haul trucking since it could have an effect of the total energy consumption. Drag torque performance of a disc brake is usually evaluated with conventional inertia dynamometers. Vibrations induced by the wheel can help to retract the pads from the disc and decrease the drag torque. It is hard to study this phenomenon with conventional inertia dynamometers since there is usually no system to induce a forced vibration on the brake. Therefore, the aim of the paper is to investigate the effect of vibrations on the drag torque for a commercial vehicle disc brake with a novel test setup. This is done by comparing test run with and without pads, forced vibrations, and pad retraction springs. The results indicate that the forced vibrations strongly affect the level of measured drag torque. In addition, the introduction of a retraction spring can reduce drag torque with more than 50% when vibrations are induced.

Abstract Aim To explore nursing students’ experiences of applying problem‐based learning to train the core competence teamwork and collaboration. Design The study used a qualitative descriptive design. Method The data were collected using individual interviews with a purposive sample of 11 students and analysed using inductive qualitative content analysis. Results The students’ experiences of applying problem‐based learning to train the core competence teamwork and collaboration were described in two generic categories: prerequisites to train teamwork and collaboration and abilities practised in the base group. The generic category “prerequisites to train teamwork and collaboration” includes three subcategories: previous experience and education, composition of the base group, and common goals and values in the base group. The generic category “abilities practised in the base group” includes four subcategories: taking personal responsibility, practising role distribution and leadership, developing communication skills and creating togetherness in the base group.

Abstract This article explores how nurses experience tension in a professional collaboration between nursing and work with a diaconal profile in Filadelfia, Denmark. Filadelfia was founded in 1897 as a diaconal institution with a hospital and deaconess house. Today, Filadelfia appears primarily as a highly specialized Epilepsy Hospital unrelated to diakonia. The collaboration this article investigates is called The Human Related Conversation (hereafter THRC). It is a practice developed within a diaconal unit of the institution, Filadelfia Uddannelse, and performed by nurses at Filadelfia Epilepsy Hospital. The article is based on a discourse analysis of five interviews conducted using THRC. The analysis finds that the nurses’ experience of THRC generates different discourses, including a nursing discourse and a legitimacy discourse, and encourages them to work in a more value-conscious way.

Plötsligt hjärtstopp är ett globalt hälsoproblem, som tyvärr har en låg överlevnadsgrad. Ungefär 20 % överlever ett hjärtstopp om det sker inne på ett sjukhus, endast hälften så många (ca 10 %) överlever om det sker utanför sjukhus. I Sverige är statistiken något bättre där ca 37 % överlever vid ett hjärtstopp på sjukhus och 11 % om det sker utanför sjukhus. Trots detta är det ett tillstånd som i de flesta fall leder till döden.

The development of biologics for diseases affecting the central nervous system has been less successful compared to other disease areas, in part due to the challenge of delivering drugs to the brain. The most well-investigated and successful strategy for increasing brain uptake of biological drugs is using receptor-mediated transcytosis over the blood–brain barrier and, in particular, targeting the transferrin receptor-1 (TfR). Here, affibody molecules are selected for TfR using phage display technology. The two most interesting candidates demonstrated binding to human TfR, cross-reactivity to the murine orthologue, non-competitive binding with human transferrin, and binding to TfR-expressing brain endothelial cell lines. Single amino acid mutagenesis of the affibody molecules revealed the binding contribution of individual residues and was used to develop second-generation variants with improved properties. The second-generation variants were further analyzed and showed an ability for transcytosis in an in vitro transwell assay. The new TfR-specific affibody molecules have the potential for the development of small brain shuttles for increasing the uptake of various compounds to the central nervous system and thus warrant further investigations.

Clinical and animal model studies have implicated inflammation and glial and peripheral immune cell responses in the pathophysiology of spinal cord injury (SCI). A key player in the inflammatory response after SCI is the pleiotropic cytokine tumor necrosis factor (TNF), which exists both in both a transmembrane (tmTNF) and a soluble (solTNF) form. In the present study, we extend our previous findings of a therapeutic effect of topically blocking solTNF signaling after SCI for three consecutive days on lesion size and functional outcome to study the effect on spatio-temporal changes in the inflammatory response after SCI in mice treated with the selective solTNF inhibitor XPro1595 and compared to saline-treated mice. We found that despite comparable TNF and TNF receptor levels between XPro1595- and saline-treated mice, XPro1595 transiently decreased pro-inflammatory interleukin (IL)-1β and IL-6 levels and increased pro-regenerative IL-10 levels in the acute phase after SCI. This was complemented by a decrease in the number of infiltrated leukocytes (macrophages and neutrophils) in the lesioned area of the spinal cord and an increase in the number of microglia in the peri-lesion area 14 days after SCI, followed by a decrease in microglial activation in the peri-lesion area 21 days after SCI. This translated into increased myelin preservation and improved functional outcomes in XPro1595-treated mice 35 days after SCI. Collectively, our data suggest that selective targeting of solTNF time-dependently modulates the neuroinflammatory response by favoring a pro-regenerative environment in the lesioned spinal cord, leading to improved functional outcomes.

Abstract Background Migrants face structural, socio-political barriers in their resettlement processes that negatively affect their health. Migration also adversely impacts resources such as social capital and health literacy that are of importance for health and integration into society. Hence, there is a need for health promotion in the early post-migration phase. In Sweden, newly settled refugee migrants who have received a residence permit are offered an Introduction programme including a civic orientation course. The program is intended to facilitate access to the labour market and promote integration. The aim of the study was to explore participants’ perceptions and experiences of a civic orientation course with added health communication. Methods We performed six focus group discussions: two in Arabic, two in Farsi and two in Somali. The discussions were facilitated by native speaking moderators. Participants were 32 men and women recruited from civic orientation classes in the county of Stockholm. We used an interview guide with semi-structured questions. The data were analysed using a method for content analysis for focus group discussions. Results Three main categories were identified: (1) ‘The course gives valuable information but needs adjustments’, which includes that the civic and health orientation is needed earlier, during the asylum phase, and that planning and course content need adjustments. (2) ‘The health communication inspired participants to focus on their health’, which includes that the health communication was useful and inspired uptake of healthier habits. (3) ‘Participation in the course promoted independence and self-confidence’, which includes that the course gave insights into society and values in Sweden, and promoted independence and new social contacts. Conclusion This study adds knowledge about the users’ perspectives on the potential of civic orientation to promote the health and integration of newly settled migrants, describing ways in which civic orientation with added health communication promoted health and empowerment. However, the content and delivery of the course need adjustment to better fit the migrants’ life situations and varying pre-existing knowledge.

Abstract Aim This study aimed to describe nursing students' experiences of what facilitate or impede the achievement of learning outcomes in PBL‐based nursing education. Design A qualitative descriptive design was used. Methods Data were collected from individual semi‐structured interviews with 18 undergraduate nursing students in Sweden and were analysed using Burnard's qualitative content analysis. Results The results were organized into three categories: (a) understanding of the required level of knowledge depth (b) tutor's engagement and (c) student base group interactions. These categories represent essential components of PBL that could either facilitate or impede students' achievement of learning outcomes in nursing education. To improve the students' opportunities to achieve the learning outcomes, proper introduction of and a continuous education on PBL as a pedagogical method provided both to students and tutors should be considered important.

Abstract Background Group processes in inter-professional Problem-Based Learning (iPBL) groups have not yet been studied in the health-care educational context. In this paper we present findings on how group-dynamics, collaboration, and tutor style influence the perception of profession-based stereotypes of students collaborating in iPBL groups. Health-care students are trained in iPBL groups to increase their ability to collaborate with other healthcare professionals. Previous research focusing iPBL in healthcare implies that more systematic studies are desired, especially concerning the interaction between group processes and internalized professional stereotypes. The aim of this study is to investigate whether changes in group processes, collaboration, and tutor style, influence the perception of profession-based stereotypes of physician- and nursing-students. Methods The study is a quasi-experimental pre- post-design. The participants included 30 students from five different healthcare professions, mainly medicine and nursing. Other professions were physiotherapy, occupational therapy and speech therapy. The students were divided into four iPBL groups, each consisting of six to nine students and a tutor. Data were collected through systematic observation using four video-recorded tutorials. SPGR (Systematizing the Person Group Relation), a computer-supported method for direct and structured observation of behavior, was used to collect and analyze the data. Results Traditional stereotypical profession-based behaviors were identified in the first observed group meeting. Although the groups followed different paths of development, the group-dynamics changed in all groups over the 6 weeks of collaboration. Two of the groups became more cohesive, one became more fragmented and one became more polarized. Stereotypical behaviors became less frequent in all groups. Our findings indicate that tutor behavior has a strong influence on the development of the group’s dynamics. Conclusion Our findings strongly suggest iPBL is a means of reducing stereotypical behaviors, and may positively increase members’ ability to engage in inter-professional collaboration. Although the pattern of dynamics took different forms in different groups, we argue that iPBL forces students to see the colleague behind his or her profession, thus breaking professional boundaries. The tutor style significantly influenced the iPBL groups’ development. This study contributes to our field by emphasizing the effect of group-processes in increasing mutual understanding across professions.

Volume flow estimation in the common carotid artery (CCA) can assess the absolute hemodynamic effect of a carotid stenosis. The aim of this study was to compare a commercial vector flow imaging (VFI) setup against the reference method magnetic resonance phase contrast angiography (MRA) for volume flow estimation in the CCA. Ten healthy volunteers were scanned with VFI and MRA over the CCA. VFI had an improved precision of 19.2% compared to MRA of 31.9% (p = 0.061). VFI estimated significantly lower volume flow than MRA (mean difference: 63.2 mL/min, p = 0.017), whilst the correlation between VFI and MRA was strong (R2 = 0.81, p < 0.0001). A Bland–Altman plot indicated a systematic bias. After bias correction, the percentage error was reduced from 41.0% to 25.2%. This study indicated that a VFI setup for volume flow estimation is precise and strongly correlated to MRA volume flow estimation, and after correcting for the systematic bias, VFI and MRA become interchangeable.

Objective The aim was to compare self-reported health between cardiac arrest survivors with good cerebral performance (CPC 1) and survivors with moderate cerebral disability (CPC 2).Methods This comparative register study was based on nationwide data from the Swedish Register of Cardiopulmonary Resuscitation. The study included 2058 in-hospital and out-of-hospital cardiac arrest survivors with good cerebral performance or survivors with moderate cerebral disability, 3–6 months postcardiac arrest. Survivors completed a questionnaire including the Hospital Anxiety and Depression Scale (HADS) and EQ-5D five-levels (EQ-5D-5L). Data were analysed using ordinal and linear regression models.Results For all survivors, the prevalence of anxiety and depression symptoms measured by the HADS was 14% and 13%, respectively. Using the EQ-5D-5L, the cardiac arrest survivors reported most health problems relating to pain/discomfort (57%), followed by anxiety/depression (47%), usual activities (46%), mobility (40%) and self-care (18%). Compared with the survivors with good cerebral performance, survivors with moderate cerebral disability reported significantly higher symptom levels of anxiety and depression measured with HADS, and poorer health in all dimensions of the EQ-5D-5L after adjusting for age, sex, place of cardiac arrest, aetiology and initial rhythm (p

Cotton and oil-based fibre consumption is highly problematic because the growth of these materials often requires fertilisers and toxic pesticides. Less environmentally damaging alternative fibres are urgently required. This study investigates Manila-hemp paper-yarn textile fabrics. Manila-hemp (abacá) is a species of banana grown as a commercial crop in the Philippines, Ecuador, and Costa Rica. Knitted structures of paper, cotton, viscose, and polyester yarns are tested and compared. Tensile strength tests are also performed. Paper yarn shows low shrinkage and no pilling, which are excellent characteristics for use in the textile and clothing industries. However, its poor handleability/knittability, high stiffness, and hard grip must be resolved for the widespread application of paper yarn in the textile industry in the future.

Abstract Background Patients with chronic kidney disease (CKD) and arterial calcification are considered at increased risk of adverse cardiovascular outcomes. However, the optimal site for measurement of arterial calcification has not been determined. The primary aim of this study was to examine the pattern of arterial calcification in different stages of CKD. Methods This was an observational, cross-sectional study that included 580 individuals with CKD stages 1–5 (no dialysis) from the Copenhagen CKD Cohort. Calcification of the carotid, coronary and iliac arteries, thoracic and abdominal aorta was assessed using non-contrast multidetector computed tomography scans and quantified according to the Agatston method. Based on the distribution of Agatston scores in the selected arterial region, the subjects were divided into calcium score categories of 0 (no calcification), 1–100, 101–400 and > 400. Results Participants with CKD stages 3–5 had the highest prevalence of calcification and the highest frequency of calcium scores > 400 in all arterial sites. Calcification in at least one arterial site was present in > 90% of patients with CKD stage 3. In all five CKD stages prevalence of calcification was greatest in both the thoracic and abdominal aorta, and in the iliac arteries. These arterial sites also showed the highest calcium scores. High calcium scores (> 400) in all five arterial regions were independently associated with prevalent cardiovascular disease. In multivariable analyses, after adjusting for cardiovascular risk factors, declining creatinine clearance was associated with increasing calcification of the coronary arteries (p = 0.012) and the thoracic aorta (p = 0.037) only. Conclusions Arterial calcification is highly prevalent throughout all five CKD stages and is most prominent in both the thoracic and abdominal aorta, and in the iliac arteries. Follow-up studies are needed to explore the potential of extracardiac calcification sites in prediction of cardiovascular events in the CKD population.

This feature describes an ongoing research and development project (2019-2022) on remote mother tongue teaching in Sweden. The project is based on the collaboration between the Department of Education, Umeå University, and the Competence Centre for Multilingualism. The feature elaborates on challenges and needs for research and practice emerging from the first phase of the project including (1) Strategies for systematically increasing pupils’ digital competence, (2) Remote didactics for interactive and collaborative learning, (3) Forms and methods for more active teaching, especially for younger ages, and (4) Digital relational competence for pupils, teachers and supervisors.

ObjectiveThe tear miRNAome of the male NOD mouse, a model of ocular symptoms of Sjögren’s syndrome (SS), was analyzed to identify unique miRNAs.MethodsMale NOD mice, aged 12-14 weeks, were used to identify tear miRNAs associated with development of autoimmune dacryoadenitis. Age- and sex-matched male BALB/c mice served as healthy controls while age-matched female NOD mice that do not develop the autoimmune dacryoadenitis characteristic of SS were used as additional controls. Total RNA was isolated from stimulated tears pooled from 5 mice per sample and tear miRNAs were sequenced and analyzed. Putative miRNA hits were validated in additional mouse cohorts as well as in tears of SS patients versus patients with another form of dry eye disease, meibomian gland disease (MGD) using qRT-PCR. The pathways influenced by the validated hits were identified using Ingenuity Pathway Analysis.ResultsIn comparison to tears from both healthy (male BALB/c) and additional control (female NOD) mice, initial analy1sis identified 7 upregulated and 7 downregulated miRNAs in male NOD mouse tears. Of these, 8 were validated by RT-qPCR in tears from additional mouse cohorts. miRNAs previously implicated in SS pathology included mmu-miR-146a/b-5p, which were significantly downregulated, as well as mmu-miR-150-5p and mmu-miR-181a-5p, which were upregulated in male NOD mouse tears. All other validated hits including the upregulated miR-181b-5p and mmu-miR-203-3p, as well as the downregulated mmu-miR-322-5p and mmu-miR-503-5p, represent novel putative indicators of autoimmune dacryoadenitis in SS. When compared to tears from patients with MGD, miRNAs hsa-miR-203a-3p, hsa-miR-181a-5p and hsa-miR-181b-5p were also significantly increased in tears of SS patients.ConclusionsA panel of differentially expressed miRNAs were identified in tears of male NOD mice, with some preliminary validation in SS patients, including some never previously linked to SS. These may have potential utility as indicators of ocular symptoms of SS; evaluation of the pathways influenced by these dysregulated miRNAs may also provide further insights into SS pathogenesis.

Abstract Background Globally there are growing multicultural and multilingual societies. As a result of extensive international migration, the number of elderly migrants has increased and will further increase in the future. This makes it necessary for elderly healthcare services to meet elderly migrants’ healthcare needs concerning language and cultural barriers. To our knowledge, previous research in the area of culturally specific nursing homes for migrant seniors is still limited. Thus, the study aimed to investigate the experiences of planning, starting and organizing a culturally specific nursing home for Finnish-speaking older persons. Methods An explorative qualitative study using both semi-structured individual interviews and focus group interviews as data collection. Thirteen informants were purposively recruited, two from Finnish-speaking association, seven healthcare professionals and two family members. Data were analysed by qualitative content analysis. Results Three categories, each with sub-categories, emerged from the data: 1) Motivation to develop this particular culture-specific nursing home; 2) Organizational issues and 3) Aspirations for the future. The study found that information from policy makers, the localization and activities of the nursing home, having healthcare staff who speak the minority language, organizing the nursing home as a mixture of older members of both the majority and the minority communities, all affected the planning, starting and organization of a culturally specific nursing home. Conclusion This study found that information, localization, activities and language adapted to elderly migrants affected the planning, starting and organization of a culturally specific nursing home for Finnish-speaking older persons. These findings should support the healthcare organization in planning, managing and organizing sustainable nursing home care for older people belonging to a minority in order to attain the aim of person-centered and equal healthcare.