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This article examines a population-based opportunistic screening practice for cognitive impairment that takes place at a hospital in Sweden. At the hospital, there is a routine in place that stipulates that all patients over the age of 65 who are admitted to the ward will be offered testing for cognitive impairment, unless they have been tested within the last six months or have been diagnosed with any form of cognitive impairment. However, our analysis shows that this routine is not universally and mechanically applied. Rather, the health care professionals have developed and use an ethico-political judgment, concerning, for example, whom to test, when to offer the tests, and how to explain and perform them. This article explores the role and practice of this form of judgment, emphasising its political and ethical nature. The analysis is based on qualitative interviews with professionals and patients, and draws on the theories of Aristotle and Hannah Arendt.

Choosing a liquid chromatography (LC) column for a particular application can be a surprisingly challenging task. On one hand, column manufacturers give us many options to choose from, including particle types, pore sizes, particle sizes, and different lengths and diameters. On the other hand, we usually don’t have time to experimentally evaluate many combinations of these parameters, and sometimes we end up picking something similar to the columns that are already in the drawer. The “kinetic plot” is a powerful graphical tool that can help leverage the best available theory to help us understand how different combinations of parameters (that is, particle size and length) will perform in terms of the time needed to get to a particular column efficiency (and thus resolution), and therefore make well-informed decisions when choosing columns.

In micro-densitometry of wood it is standard procedure to extract resin and other soluble compounds before X-ray analysis to eliminate the influence of these extractives on wood-density. Dendrochemical studies using X-ray fluorescence analysis on the other hand are commonly conducted without previous extraction. However, it is well known that translocation processes of elements during heartwood formation in trees or (temporal) differences in sap content of wood samples can influence dendrochemical element profiles. This might bias environmental signals stored in time series of element concentrations in wood proxies. We hypothesize that metals tightly bound to cell walls show a more robust proxy potential for environmental conditions than easily translocated ones. To eliminate the noise of these soluble substances in wood elemental time series, their extraction prior to analysis might be necessary. In our study we tested the effect of different solvents (water, alcohol, and acetone) and different extraction times on elemental time series of three tree species with differing wood structure (Pinus sylvestris; Quercus robur and Populus tremula). Micro-XRF analysis was conducted on nine replicates per species using an ITRAX-Multiscanner. A set of elements commonly detected in wood (S, Cl, K, Ca, Ti, Mn, Fe, and Ni) was analysed at high resolution before and after several extraction runs. Besides lowering their levels, extraction did not significantly change the temporal trends for most elements. However, for some elements, e.g., Potassium, Chlorine or Manganese, especially the water extraction led to significant decreases in concentrations and altered temporal trends. Apparently the dipole effect of water produced the strongest extraction power of all three solvents. In addition we observed a dependency of extraction intensity from wood density which differed between wood types. Our results help in interpreting and evaluating element profiles and mark a step forward in establishing dendrochemistry as a robust proxy in dendro-environmental research.

Funding: This study was partly funded by a Scottish Government Rural and Environment Science and Analytical Service award (PM, JW and TSG). The Scottish Northern Cairngorms reconstruction was finalised through the project NERC project ‘SCOT2K: Reconstructing 2000 years of Scottish climate from tree rings (NE/ K003097/1)’ while the new central and northwest Scottish data were developed as part of a NERC Iapetus PhD project. For ancient types of barley at sites in the Scottish Isles, Faroes, and Iceland, we calculated minimum temperature requirements for grain production (grain production threshold, GPT) as accumulated degree days over the cropping season. Site suitability for barley from AD 1200 to 2000 was investigated by comparing these thresholds with reconstructions of annual cropping season degree days (CSDD) using temperature and tree-ring data. In Iceland, between AD 1200 and 1500, reconstructed CSDD were more favorable in the southwest (Reykjavik), with fewer years below the GPT, than in the North, East and West, but there were two periods (1340–1389 and 1426–1475) with low average CSDD and several years below the GPT which possibly influenced the abandonment of barley cultivation around this time. Reconstructed CSDD for the Faroes (Tórshavn) had only one year below the GPT, but 15 periods of four or more consecutive years with low CSDD which would have challenged barley cultivation, especially in the thirteenth century. Reconstructed CSDD were highest for the Scottish Isles, allowing a more prominent role of barley in the farming system and economy. Nevertheless, years with poor harvests or famines were common and about half were associated with low CSDD, resulting in a significant temperature link but also demonstrating the important contribution of other factors. Despite frequent unfavorable years in both the Faroes and Scottish Isles, resilient production systems, well-adapted barley strains and socio-economic factors allowed barley cultivation to continue, and some ancient types to survive to the present day. Publisher PDF

The Old Wood in a New Light database project focuses on the digitization and accessibility of the results of dendrochronological samples analyzed and archived at four Swedish university-based tree-ring laboratories at Lund University, Stockholm University, University of Gothenburg, and the Swedish University of Agricultural Sciences. Collaboration with the Environmental Archaeology Laboratory and Humlab at Umeå University enables long-term open access to data, raw data, and metadata. In this project, we (1) systematically undertake large-scale entry and open access publication of results from wood samples scientifically analyzed and archived by Swedish laboratories and the associated metadata, into the Strategic Environmental Archaeology Database (SEAD; www.sead.se) research data infrastructure, and (2) actively promote the database as a resource for new and ongoing interdisciplinary research initiatives. Including dendrochronological data in SEAD infrastructure allows interdisciplinary studies that combine major scientific and societal questions. Building on a pilot study of construction timber from southern Sweden and adaptation of SEAD digitization workflows, more than 70 000 samples archived at the four dendrochronological laboratories are now being handled in the project. The broad coverage of research networks, stakeholder interaction, and strategic support from the cultural heritage community is guaranteed owing to the ongoing collaboration between laboratories and an established international and multidisciplinary reference group.

This study investigated if straw racks, which enable larger straw rations, induced a more straw-directed behaviour in pigs, as a mean to facilitate the provision of manipulable material and natural behaviour. It was conducted on a commercial farm (459 pigs, 42 pens, 30–120 kg) where half of the pens received 25 L of straw on the floor (CONTROL) and the other half of the pens received straw in a rack holding 44 L of straw (RACK). The pig behaviour in five randomly assigned pens per treatment were recorded for 24 h, during three periods of production. Pig activity levels, exploratory behaviour, pen utilization and available clean straw were scan sampled. During period 1, no pigs were observed interacting with the straw racks. During this period, CONTROL pigs conducted more straw-directed behaviour and less pen-directed behaviour compared to pigs in the pens with a rack during period 1. The lack of rack interactions may imply an underdeveloped spatial cognition in the pigs. Apart from period 1, there were no significant difference in behaviour between RACK and CONTROL pigs. The racks did not disturb the use of the pen. The absent treatment effect in periods 2 and 3 may reflect that there was a too small difference in straw ration between the treatments. In order to design and implement straw racks that promote straw interaction, future studies should focus on understanding pigs’ spatial cognition.

Erythropoietin (EPO) has neuroprotective effects in central nervous system injury models. In clinical trials EPO has shown beneficial effects in traumatic brain injury (TBI) as well as in ischemic stroke. We have previously shown that EPO has short-term effects on astrocyte glutamatergic signaling in vitro and that administration of EPO after experimental TBI decreases early cytotoxic brain edema and preserves structural and functional properties of the blood-brain barrier. These effects have been attributed to preserved or restored astrocyte function. Here we explored the effects of EPO on astrocytes undergoing oxygen-glucose-deprivation, an in vitro model of ischemia. Measurements of glutamate uptake, intracellular pH, intrinsic NADH fluorescence, Na,K-ATPase activity, and lactate release were performed. We found that EPO within minutes caused a Na,K-ATPase-dependent increase in glutamate uptake, restored intracellular acidification caused by glutamate and increased lactate release. The effects on intracellular pH were dependent on the sodium/hydrogen exchanger NHE. In neuron-astrocyte co-cultures, EPO increased NADH production both in astrocytes and neurons, however the increase was greater in astrocytes. We suggest that EPO preserves astrocyte function under ischemic conditions and thus may contribute to neuroprotection in ischemic stroke and brain ischemia secondary to TBI.

Since 2017, opportunistic screening for cognitive impairment takes place at the geriatric ward of a local hospital in Sweden. Persons above the age of 65 who are admitted to the ward, who have not been tested for cognitive impairment during the last six months nor have a previously known cognitive impairment, are offered the Mini-Mental State Examination and the Clock-Drawing Test. This article analyses what the opportunistic screening practice means for patients and healthcare professionals. It combines a phenomenologically-oriented focus on subjectivity and sense-making with a focus that is inspired by science and technology studies on what the tests become within the specific context in which they are used, which allows a dual focus on subjectivity and performativity. The article shows how the tests become several different, not infrequently seemingly contradictory, things: an offer, an important tool for knowledge-production, something unproblematic yet also emotionally troubling, something one can fail and an indicator that one belongs to a risk group and needs to be tested. Further, the article shows how the practice is shaped by the sociocultural context. It examines the role of the affective responses to the test for subjectivity - particularly patient subjectivity - and offers a set of recommendations, if this practice were to expand to other hospitals. Funding Agencies|Vetenskapsradet (the Swedish Research Council)Swedish Research Council [2016-00784]

While the value of early detection of dementia is largely agreed upon, population-based screening as a means of early detection is controversial. This controversial status means that such screening is not recommended in most national dementia plans. Some current practices, however, resemble screening but are labelled “case-finding” or “detection of cognitive impairment”. Labelled as such, they may avoid the ethical scrutiny that population-based screening may be subject to. This article examines conceptualizations of screening and case-finding. It shows how the definitions and delimitations of the concepts (the what of screening) are drawn into the ethical, political, and practical dimensions that screening assessment criteria or principles are intended to clarify and control (the how of screening, how it is and how it should be performed). As a result, different conceptualizations of screening provide the opportunity to rethink what ethical assessments should take place: the conceptualizations have different ethico-political implications. The article argues that population-based systematic screening, population-based opportunistic screening, and case-finding should be clearly distinguished.

Fragment based drug discovery is a critical part of the lead generation toolbox and relies heavily on a readily available, high quality fragment library. Over years of use, the AstraZeneca fragment set had become partially depleted and instances of compound deterioration had been found. It was recognised that a redevelopment was required. This provided an opportunity to evolve our screening sets strategy, whilst ensuring that the quality of the fragment set met the robust requirements of fragment screening campaigns. In this communication we share the strategy employed, in particular highlighting two aspects of our approach that we believe others in the community would benefit from, namely that; (i) fragments were selected with input from Medicinal Chemists at an early stage, and (ii) the library was arranged in a layered format to ensure maximum flexibility on a per target basis.

Publisher Copyright: Copyright © 2022 Helama, Herva, Arppe, Gunnarson, Frank, Holopainen, Nöjd, Mäkinen, Mielikäinen, Sutinen, Timonen, Uusitalo and Oinonen. Tree-ring records constitute excellent high-resolution data and provide valuable information for climate science and paleoclimatology. Tree-ring reconstructions of past temperature variations agree to show evidence for annual-to-centennial anomalies in past climate and place the industrial-era warming in the context of the late Holocene climate patterns and regimes. Despite their wide use in paleoclimate research, however, tree rings have also been deemed unsuitable as low-frequency indicators of past climate. The arising debate concerns whether the millennia-long tree-ring records show signals of orbital forcing due to the Milankovitch cycles. Here, we produce a summer-temperature reconstruction from tree-ring chronology running through mid- and late-Holocene times (since 5486 BCE) comprising minimum blue channel light intensity (BI). The BI reconstruction correlates with existing and new tree-ring chronologies built from maximum latewood density (MXD) and, unlike the MXD data, shows temperature trends on Milankovitch scales comparable to various types of sedimentary proxy across the circumpolar Arctic. Our results demonstrate an unrevealed potential of novel, unconventional tree-ring variables to contribute to geoscience and climate research by their capability to provide paleoclimate estimates from inter-annual scales up to those relevant to orbital forcing.

Capsule: Black-tailed Godwits Limosa limosashow sexual size dimorphism and size differences between the subspecies. The shape varies slightly between the subspecies, but not between the sexes.Aims: To investigate whether and how the three subspecies of Black-tailed Godwits, and the sexes of these subspecies, differ in size and shape.Methods: We collected body dimensions (lengths of the bill, total head, tarsus, tarsus-toe and wing) of adult Black-tailed Godwits from three locations (Iceland, the Netherlands and northwest Australia) corresponding to the breeding or wintering grounds of three known subspecies (islandica, limosa and melanuroides, respectively). Determining sex by molecular assays, we computed degrees of sexual size dimorphism. Using principal component analysis (PCA), we compared differences in size and shape among the different subspecies.Results: The limosa subspecies was the largest and also showed the most significant sexual size dimorphism. Sexual size dimorphism was smallest for wing length and largest for bill length. The first two axes of the PCA that included all subspecies of both sexes explained 94% of the total variation. Most body dimensions were highly correlated with each other, but wing length varied independently of the other dimensions. Males and females differed only in size (the first axis). However, one of the two small subspecies, islandica, also differed in shape (the second axis) from limosa and melanuroides.Conclusions: In all three subspecies of Black-tailed Godwits, females are larger than males. The fact that subspecies differed in the degree of size dimorphism and slightly in shape hints at sex-related differences in the ecological selection pressures between the different flyways.

Glacial extent and mass balance are sensitive climate proxies providing solid information on past climatic conditions. However, series of annual mass-balance measurements of more than 60 years are scarce. To our knowledge, this is the first time the latewood density data (MXD) of the Swiss stone pine (Pinus cembra L.) have been used to reconstruct the summer mass balance (Bs) of an Alpine glacier. The MXD-based Bs well correlates with a Bs reconstruction based on the May to September temperature. Winter precipitation has been used as an independent proxy to infer the winter mass balance and to obtain an annual mass-balance (Bn) estimate dating back to the glaciological year 1811/12. The reconstructed MXD/precipitation-based Bn well correlates with the data both of the Careser and of other Alpine glaciers measured by the glaciological method. A number of critical issues should be considered in both proxies, including non-linear response of glacial mass balance to temperature, bedrock topography, ice thinning and fragmentation, MXD acquisition and standardization methods, and finally the ‘divergence problem’ responsible for the recently reduced sensitivity of the dendrochronological data. Nevertheless, our results highlight the possibility of performing MXD-based dendroglaciological reconstructions using this stable and reliable proxy.

Choosing a liquid chromatography (LC) column for a particular application can be a surprisingly challenging task. On one hand, column manufacturers give us many options to choose from, including particle types, pore sizes, particle sizes, and different lengths and diameters. On the other hand, we usually don’t have time to experimentally evaluate many combinations of these parameters, and sometimes we end up picking something similar to the columns that are already in the drawer. The “kinetic plot” is a powerful graphical tool that can help leverage the best available theory to help us understand how different combinations of parameters (that is, particle size and length) will perform in terms of the time needed to get to a particular column efficiency (and thus resolution), and therefore make well-informed decisions when choosing columns.

Basaltic fissure eruptions, which are characteristic of Icelandic volcanism, are extremely hazardous due to the large quantities of gases and aerosols they release into the atmosphere. The 1783 --1784 CE Laki eruption was one of the most significant high-latitude eruptions in the last millennium and had substantial environmental and climatic impacts. Contemporary observations recorded the presence of a sulfuric haze over Iceland and Europe, which caused famine from vegetation damage and resulted in a high occurrence of respiratory illnesses and related mortality. Historical records in northern Europe show that the summer of 1783 was anomalously warm, but regional tree-ring maximum latewood density (MXD) data from that year are low and lead to erroneously colder reconstructed summer temperatures. Here we measure wood anatomical characteristics of Scots pine (Pinus sylvestris) from Jämtland, Sweden in order to identify the cause of this discrepancy. We show that the presence of intra-annual density fluctuations in the majority of 1783 growth rings, a sudden reduction in lumen and cell wall area, and the measurement resolution of traditional x-ray densitometry lead to the observed reduced annual MXD value. Multiple independent lines of evidence suggest these anatomical anomalies were most likely the result of direct acidic damage to trees in Northern Europe. The common relationship between summer temperature and MXD can be disrupted by acidic haze damage to trees. Our study also demonstrates that quantitative wood anatomy offers a high resolution approach to identifying anomalous years and extreme events in the tree-ring record.

This study investigated if straw racks, which enable larger straw rations, induced a more straw-directed behaviour in pigs, as a mean to facilitate the provision of manipulable material and natural behaviour. It was conducted on a commercial farm (459 pigs, 42 pens, 30–120 kg) where half of the pens received 25 L of straw on the floor (CONTROL) and the other half of the pens received straw in a rack holding 44 L of straw (RACK). The pig behaviour in five randomly assigned pens per treatment were recorded for 24 h, during three periods of production. Pig activity levels, exploratory behaviour, pen utilization and available clean straw were scan sampled. During period 1, no pigs were observed interacting with the straw racks. During this period, CONTROL pigs conducted more straw-directed behaviour and less pen-directed behaviour compared to pigs in the pens with a rack during period 1. The lack of rack interactions may imply an underdeveloped spatial cognition in the pigs. Apart from period 1, there were no significant difference in behaviour between RACK and CONTROL pigs. The racks did not disturb the use of the pen. The absent treatment effect in periods 2 and 3 may reflect that there was a too small difference in straw ration between the treatments. In order to design and implement straw racks that promote straw interaction, future studies should focus on understanding pigs’ spatial cognition.

Efficient point-to-point navigation in the presence of a background flow field is important for robotic applications such as ocean surveying. In such applications, robots may only have knowledge of their immediate surroundings or be faced with time-varying currents, which limits the use of optimal control techniques. Here, we apply a recently introduced Reinforcement Learning algorithm to discover time-efficient navigation policies to steer a fixed-speed swimmer through unsteady two-dimensional flow fields. The algorithm entails inputting environmental cues into a deep neural network that determines the swimmer’s actions, and deploying Remember and Forget Experience Replay. We find that the resulting swimmers successfully exploit the background flow to reach the target, but that this success depends on the sensed environmental cue. Surprisingly, a velocity sensing approach significantly outperformed a bio-mimetic vorticity sensing approach, and achieved a near 100% success rate in reaching the target locations while approaching the time-efficiency of optimal navigation trajectories., Nature Communications, 12 (1), ISSN:2041-1723

X-ray microdensitometry on annually resolved tree-ring samples has gained an exceptional position in last-millennium paleoclimatology through the maximum latewood density (MXD) parameter, but also increasingly through other density parameters. For 50 years, X-ray based measurement techniques have been the de facto standard. However, studies report offsets in the mean levels for MXD measurements derived from different laboratories, indicating challenges of accuracy and precision. Moreover, reflected visible light-based techniques are becoming increasingly popular, and wood anatomical techniques are emerging as a potentially powerful pathway to extract density information at the highest resolution. Here we review the current understanding and merits of wood density for tree-ring research, associated microdensitometric techniques, and analytical measurement challenges. The review is further complemented with a careful comparison of new measurements derived at 17 laboratories, using several different techniques. The new experiment allowed us to corroborate and refresh "long-standing wisdom" but also provide new insights. Key outcomes include (i) a demonstration of the need for mass/volume-based recalibration to accurately estimate average ring density; (ii) a substantiation of systematic differences in MXD measurements that cautions for great care when combining density data sets for climate reconstructions; and (iii) insights into the relevance of analytical measurement resolution in signals derived from tree-ring density data. Finally, we provide recommendations expected to facilitate futureinter-comparability and interpretations for global change research.

Tree-ring chronologies underpin the majority of annually-resolved reconstructions of Common Era climate. However, they are derived using different datasets and techniques, the ramifications of which have hitherto been little explored. Here, we report the results of a double-blind experiment that yielded 15 Northern Hemisphere summer temperature reconstructions from a common network of regional tree-ring width datasets. Taken together as an ensemble, the Common Era reconstruction mean correlates with instrumental temperatures from 1794–2016 CE at 0.79 (p, Tree rings are a crucial archive for Common Era climate reconstructions, but the degree to which methodological decisions influence outcomes is not well known. Here, the authors show how different approaches taken by 15 different groups influence the ensemble temperature reconstruction from the same data.

Soluble urokinase-type plasminogen activator receptor (suPAR) is a chronic inflammation marker associated with the development of a range of diseases, including cancer and cardiovascular disease. The genetics of suPAR remain unexplored but may shed light on the biology of the marker and its connection to outcomes. We report a heritability estimate of 60% for the variation in suPAR and performed a genome-wide association meta-analysis on suPAR levels measured in Iceland (N = 35,559) and in Denmark (N = 12,177). We identified 13 independently genome-wide significant sequence variants associated with suPAR across 11 distinct loci. Associated variants were found in and around genes encoding uPAR (PLAUR), its ligand uPA (PLAU), the kidney-disease-associated gene PLA2R1 as well as genes with relations to glycosylation, glycoprotein biosynthesis, and the immune response. These findings provide new insight into the causes of variation in suPAR plasma levels, which may clarify suPAR’s potential role in associated diseases, as well as the underlying mechanisms that give suPAR its prognostic value as a unique marker of chronic inflammation., Dowsett and colleagues used a genome-wide association approach to investigate the genetic influence on soluble urokinase-type plasminogen activator receptor presence in the plasma of humans. Their findings indicate a 60% heritability factor in British twins, and using a wide sample of Northern European genome samples they identify eleven genetic loci associated with an increase or decrease of this chronic inflammation marker.

The Arctic is one of the regions where the effect of global change is most evident. Associated with warming are changes in snow, sea ice and hydroclimate, all which have significant impacts on environments and society. However, due to short observational records, it is difficult to set the current climate in a long-term context. Arctic driftwood (DW), available throughout the Holocene, is a paleoclimate resource that may shed information on past sea-ice, ocean current and atmospheric conditions because it is transported by sea ice across the Arctic. Moreover, DW tree-ring data can be used to interpret climate in the boreal forests where the trees grew. Here we present a study of 380 DW samples collected on eastern and south-western Svalbard. Combining species identification and dendrochronology, it was found that the DW mainly consisted of Pinus sylvestris, Picea sp. and Larix sp. (87% of all samples), mainly originating from northern Russia. In total, 60% of the DW could be dated and their provenance determined, and four tree-ring width chronologies representing Yenisei and Dvina-Pechora were constructed, facilitating extension and improvement of the existing chronologies representing those regions. Moreover, DW from relict beaches that can be subjected to dendrochronological analyses, provides possibilities to extend pan-Arctic tree-ring data even further back in time. Because there are several processes governing the temporal patterns of wood deposition in the Arctic, using DW as an indicator of sea-ice variations needs further investigation.

It is common practice in liquid chromatography to split the flow of the effluent exiting the analytical column into two or more parts, either to enable parallel detection (e.g., coupling the separation to two destructive detectors such as light scattering and mass spectrometry (MS)), or to accommodate flow rate limitations of a detector (e.g., electrospray ionization mass spectrometry). In these instances the user must make choices about split ratio and dimensions of connecting tubing that is used between the split point and the detector, however these details are frequently not mentioned in the literature, and rarely justified. In our own work we often split the effluent following the second dimension (2D) column in two-dimensional liquid chromatography systems coupled to MS detection, and we have frequently observed post 2D column peak broadening that is larger than we would expect to result from dispersion in the MS ionization source itself. For the present paper we describe a series of experiments aimed at understanding the impact of the split ratio and post-split connecting tubing dimensions on dispersion of peaks exiting an analytical column. We start with the simple idea – based on the principle of conservation of mass – that analyte peaks entering the split point are split into two parts such that the analyte mass (and thus peak volume) entering and exiting the split point is conserved, and directly related to the ratio of flow rates entering and exiting the split point. Measurements of peak width and variance after the split point show that this simple view of the splitting process – along with estimates of additional dispersion in the post-split tubing - is sufficient to predict peak variances at the detector with accuracy that is sufficient to guide experimental work (median error of about 10% over a wide range of conditions). We feel it is most impactful to recognize that flow splitting impacts apparent post-column dispersion not because anything unexpected happens in the splitting process, but because the split dramatically reduces the volume of the analyte peak, which then is more susceptible to dispersion in connecting tubing that would not cause significant dispersion under conditions where splitting is not implemented. These results will provide practitioners with a solid basis on which rational decisions about split ratios and dimensions of post-split tubing can be made. © 2021 Published by Elsevier B.V.

Importance COVID-19 has been associated with excess mortality among patients not diagnosed with COVID-19, suggesting disruption of acute health care provision may play a role. Objective To determine the degree of declines in emergency department (ED) visits attributable to COVID-19 and determine whether these declines were concentrated among patients with fewer comorbidities and lower severity visits. Design We conducted a differences-in-differences analysis of all commercial health insurance claims for ED visits in the first 20 weeks of 2018, 2019, and 2020. The intervention period began March 9 (week 11) of 2020, following state stay-at-home orders. Setting We analyzed claims from Blue Cross Blue Shield of Louisiana (BCBSLA), located in a state with an early US COVID-19 outbreak. Visit and patient risk was assessed through comorbidities previously described as increasing the risk of COVID-19 decompensation, the hospital location's COVID-19 outbreak status, and the Ambulatory Care Sensitive Condition algorithm. Participants The study population comprised all ED visits from all BCBSLA members, whether admitted or discharged. There were 332,917 ED visits over the study period. The study population spanned member demographics including sex, age, and geography. Uninsured adults were not included due to data limitations. Exposures The COVID-19 outbreak beginning March 9, 2020 in Louisiana. Main outcomes and measures The main outcome of interest for this analysis is the difference (percent change) in all ED visits, categorized as either respiratory or non-respiratory, from week 1-20 in 2019 and week 1-10 in 2020, compared to week 11-20 in 2020. Results In this differences-in-differences study using data from a commercial health insurer, we found that non-respiratory ED visits declined by 39%, whereas respiratory visits did not experience a significant decline. Visits that were potentially deferrable or from lower risk patient populations showed greater declines, but even high-risk patients and non-avoidable visits experienced large declines in non-respiratory ED visits. Non-respiratory ED visits declined by only 18% in areas experiencing COVID outbreak. Conclusions and relevance COVID-19 has resulted in significant avoidance of ED care, comprising a mix of deferrable and high severity care. Hospital and public health pronouncements should emphasize appropriate care seeking.

Background:. Fomites are surfaces that carry contaminants and may cause infection. We wanted to assess the bacterial load on rolls of nonsterile microporous tape in a hospital setting and explore the scientific rationale behind the existing practice of applying unsterile adhesives onto a surgical wound. Methods:. We analyzed the aerobic bacterial contamination in rolls of microporous tape collected from surgical theaters, outpatient clinics, and storage rooms at St. Olav’s University Hospital, Trondheim, Norway between 2018 and 2020. We also reviewed the literature for relevant publications. Results:. A total of 58 rolls were collected; 55 were included for final analysis. Exposed tape surfaces were significantly more contaminated than unexposed surfaces. Tape rolls from outpatient clinics were significantly more contaminated and contained a significantly greater variety of microbes than rolls from operation theaters and storage rooms. Unexposed surfaces from both operation theaters and storage rooms demonstrated very little contamination. Conclusions:. Rolls of tape may act as fomites, but widespread use of adhesives is inevitable in hospital settings. Removing the outer layer of a tape roll before use may significantly reduce bacterial contamination. Given sufficient vigilance to avoid cross-contamination, inner layers of tape may represent a close-to-sterile alternative as surgical dressing. However, the economic savings constitute a negligible fraction of the total costs of the surgery, and the risk of contamination seems apparent. Scientific support of dressing a fresh surgical wound with unsterile microporous tape is lacking, and we therefore do not recommend the practice except in situations with very limited resources.

The feeding behavior of the giant ambush-predator “Bobbit worm” (Eunice aphroditois) is spectacular. They hide in their burrows until they explode upwards grabbing unsuspecting prey with a snap of their powerful jaws. The still living prey are then pulled into the sediment for consumption. Although predatory polychaetes have existed since the early Paleozoic, their bodies comprise mainly soft tissue, resulting in a very incomplete fossil record, and virtually nothing is known about their burrows and behavior beneath the seafloor. Here we use morphological, sedimentological, and geochemical data from Miocene strata in northeast Taiwan to erect a new ichnogenus, Pennichnus. This trace fossil consists of an up to 2 m long, 2–3 cm in diameter, L-shaped burrow with distinct feather-like structures around the upper shaft. A comparison of Pennichnus to biological analogs strongly suggests that this new ichnogenus is associated with ambush-predatory worms that lived about 20 million years ago.

Supplemental material, sj-docx-1-cix-10.1177_11769351211065979 for Computational Identification of Stearic Acid as a Potential PDK1 Inhibitor and In Vitro Validation of Stearic Acid as Colon Cancer Therapeutic in Combination with 5-Fluorouracil by Jonathan Mitchel, Pratima Bajaj, Ketki Patil, Austin Gunnarson, Emilie Pourchet, Yoo Na Kim, Jeffrey Skolnick and S. Balakrishna Pai in Cancer Informatics

The relationship between climate and forest is critical to understanding the influence of future climate change on terrestrial ecosystems. Research on trees at high elevations has uncovered the relationship in the Hengduan Mountains region, a critical biodiversity hotspot area in southwestern China. The relationship for the area at low elevations below 2800 m a.s.l. in the region remains unclear. In this study, we developed tree ring width chronologies of Pinus yunnanensis Franch. at five sites with elevations of 1170&ndash, 1725 m in this area. Monthly precipitation, relative humidity, maximum/mean/minimum air temperature and the standardized precipitation evapotranspiration index (SPEI), a drought indicator with a multi-timescale, were used to investigate the radial growth&mdash, climate relationship. Results show that the growth of P. yunnanensis at different sites has a similar response pattern to climate variation. Relative humidity, precipitation, and air temperature in the dry season, especially in its last month (May), are critical to the radial growth of trees. Supplemental precipitation amounts and reduced mean or maximum air temperature can promote tree growth. The high correlations between chronologies and SPEI indicate that the radial growth of trees at the low elevations of the region is significantly limited by the moisture availability. Precipitation in the last month of the previous wet season determines the drought regime in the following dry seasons. In spite of some differences in the magnitudes of correlations in the low-elevation area of the Hengduan Mountains region, chronologies generally matched well with each other at different elevations, and the differences are not evident with the change in elevation.

Background Patients with severe long-chain fatty acid oxidation disorders (LC-FAODs) experience serious morbidity and mortality despite traditional dietary management including medium-chain triglyceride (MCT)-supplemented, low-fat diets. Triheptanoin is a triglyceride oil that is broken down to acetyl-coenzyme A (CoA) and propionyl-CoA, which replenishes deficient tricarboxylic acid cycle intermediates. We report the complex medical and nutrition management of triheptanoin therapy initiated emergently for 3 patients with LC-FAOD. Methods Triheptanoin (Ultragenyx Pharmaceutical, Inc, Novato, CA, USA) was administered to 3 patients with LC-FAOD on a compassionate-use basis. Triheptanoin was mixed with non-MCT-containing low-fat formula. Patients were closely followed with regular cardiac and laboratory monitoring. Results Cardiac ejection fraction normalized after triheptanoin initiation. Patients experienced fewer hospitalizations related to metabolic crises while on triheptanoin. Patient 1 has tolerated oral administration without difficulty since birth. Patients 2 and 3 experienced increased diarrhea. Recurrent breakdown of the silicone gastrostomy tube occurred in patient 3, whereas the polyurethane nasogastric tube for patient 2 remained intact. Patient 3 experiences recurrent episodes of elevated creatine kinase levels and muscle weakness associated with illness. Patient 3 had chronically elevated C10-acylcarnitines while on MCT supplementation, which normalized after initiation of triheptanoin and discontinuation of MCT oil. Conclusions Triheptanoin can ameliorate acute cardiomyopathy and increase survival in patients with severe LC-FAOD. Substituting triheptanoin for traditional MCT-based treatment improves clinical outcomes. MCT oil might be less effective in carnitine-acylcarnitine translocase deficiency patients compared with other FAODs and needs further investigation.

Maximum latewood density (MXD) chronologies have been widely used to reconstruct summer temperature variations. Precipitation signals inferred from MXD data are, however, rather scarce. In this study, we assess the potential of using MXD data derived from Scots pine (Pinus sylvestris L.) growing in the Stockholm archipelago (Sweden) to reconstruct past precipitation variability. In this area, slow-growing pine trees emerge on flat plateaus of bedrock outcrops with thin or absent soil layers and are, therefore, sensitive to moisture variability. A 268-year-long MXD chronology was produced, and climate&ndash, growth relationships show a significant and robust correlation with May&ndash, July precipitation (PMJJr = 0.64, p &lt, 0.01). The MXD based May&ndash, July precipitation reconstruction covers the period 1750&ndash, 2018 CE and explains 41% of the variance (r2) of the observed precipitation (1985&ndash, 2018). The reconstruction suggests that the region has experienced more pluvial phases than drought conditions since the 1750s. The latter half of the 18th century was the wettest and the first half of the 19th century the driest. Climate analysis of &ldquo, light rings&rdquo, (LR), latewood layers of extreme low-density cells, finds their occurrence often coincides with significantly dry (&lt, 41 mm precipitation) and warmer (1&ndash, 2 &deg, C above average temperature), May&ndash, July conditions. Our analysis suggests that these extremes may be triggered by the summer North Atlantic Oscillation (SNAO).

During the Cassini mission (2004-2017) the Radio and Plasma Wave Science (RPWS) experiment has recorded the lightning radio emissions from multiple thunderstorms in Saturn's atmosphere. Most of the storms were located in the storm alley at a planetocentric latitude of 35°South, and there was one extra-large storm at 35°North called "Great White Spot" (GWS), which emitted millions of SEDs. This is short for "Saturn Electrostatic Discharges", a widely-used synonym for the radio emission from Saturn lightning. Most lightning storms have also been observed by the Cassini cameras or by ground-based amateur astronomers as bright white spots with diameters around 2000 km ("smaller" storms in the storm alley) or as large as 10,000 km (GWS at 35°North).In this presentation we focus on a cyclone at 50°North planetocentric latitude, which was observed by the Cassini cameras from 2007 until the end of 2013. Its average diameter was around 3000 km, and it also exhibited some weak SED activity. The first SED outbreak was in December 2010, at the same time when the GWS was raging further south. Due to the differences in longitude and SED rate of the 50°N cyclone compared to the GWS, it is partly possible to separate the SEDs emitted from the cyclone to those emitted from the GWS. The SED rate of the cyclone is rather low, typically a few SEDs per minute, whereas the GWS showed SED rates up to 10 SEDs per second. The SED activity of the 50°North cyclone was very intermittent, it usually lasted for a few weeks before disappearing again for several months. After the first outbreak in December 2010, there was some more activity in early 2011, autumn 2011, December 2011, spring 2012, July 2012, summer 2013, and finally autumn 2013. By comparing SED data from RPWS with images from the Cassini camera we will show that almost all SEDs taking place after the GWS had their origin in the 50°N cyclone, since the SED sub-spacecraft longitude range is consistent with the longitude of the cyclone. The last SED activity from this cyclone took place in November 2013, and it was also the last SED activity recorded by RPWS during the whole Cassini mission. No more SEDs were found from November 2013 until Cassini burned up in Saturn's upper atmosphere in September 2017.

There is no clear-cut boundary between Free and Open Source Software and Open Scholarship, and the histories, practices, and fundamental principles between the two remain complex. In this study, we critically appraise the intersections and differences between the two movements. Based on our thematic comparison here, we conclude several key things. First, there is substantial scope for new communities of practice to form within scholarly communities that place sharing and collaboration/open participation at their focus. Second, Both the principles and practices of FOSS can be more deeply ingrained within scholarship, asserting a balance between pragmatism and social ideology. Third, at the present, Open Scholarship risks being subverted and compromised by commercial players. Fourth, the shift and acceleration towards a system of Open Scholarship will be greatly enhanced by a concurrent shift in recognising a broader range of practices and outputs beyond traditional peer review and research articles. In order to achieve this, we propose the formulation of a new type of institutional mandate. We believe that there is substantial need for research funders to invest in sustainable open scholarly infrastructure, and the communities that support them, to avoid the capture and enclosure of key research services that would prevent optimal researcher behaviours. Such a shift could ultimately lead to a healthier scientific culture, and a system where competition is replaced by collaboration, resources (including time and people) are shared and acknowledged more efficiently, and the research becomes inherently more rigorous, verified, and reproducible.

This article analyses the validity of the standard question, ‘Generally speaking, would you say that most people can be trusted, or that you can’t be too careful in dealing with people?’. It builds on unique material, including survey responses ( N = 356) and letters ( N = 28) from students aged 18–19 years, collected by the author in seven secondary schools in Stockholm. The results suggest that the standard question is less valid as a measure on generalized trust than is commonly assumed in trust research. Rather than referring to trust in people in general, about a third of the responses expressed themes related to rational trust, that is, trust is domain-specific and person-specific. Systematic variation between different school contexts indicates that the standard question reflects social trust in a limited social sphere rather than trust in ‘most people’. The conclusion is that the standard trust question has a problem with validity among young respondents.

Fennoscandia is one of the most prominent regions in the world for dendroclimatological research. Yet, millennium-long tree-ring chronologies in this region have mainly been developed from Scots pine (Pinus sylvestris L.). To explore the possibility of building long-term chronologies using other dominating tree species in the region, this paper presents the first two millennia-long Norway spruce (Picea abies (L.) Karst.) ring-width chronology from Northern Europe. The chronology is composed of living trees and subfossil wood and covers the period from BCE 115 to 2012 CE. A sufficiently replicated and robust chronology is built for the past 360 years back to 1649 CE. Further back in time, the common growth signal is reduced, and hence the reliability of the earlier section of the chronology is lower. The climate calibration results show that the spruce ring-width correlation with June-July mean temperatures over the period 1901–2012 is positive and significant (r = 0.6, p

Standing dead trees (snags) play important roles in forest ecology by storing carbon as well as providing habitats for many species. Moreover, snags preserved for hundreds of years can provide usef ...

Background: Accidental hypothermia with cardiac arrest represents a challenge for pre-hospital rescuers as well as in-hospital staff. For pre-hospital personnel, the main focus is to get the patient to the correct destination without unnecessary delay. For in-hospital personnel early information is vital to assess the possibility for resuscitation with extracorporeal re-warming. The challenge is augmented when rescuers must cross national borders to reach and/or deliver the patients. We present a case where three adolescent boys suffered severe hypothermia after a canoeing accident in Sweden. Case presentation: Three 14-year-old boys were canoeing a mountain lake close to the Norwegian border when their boat capsized and they all fell into the cold water. The rescue operation was hampered by rough weather conditions, and immersion times spanned from 63 to 125 min. Flight times from the scene of accident to the nearest ECMO center in Norway (Trondheim) and Sweden (Umeå) were about 30 and 90 min respectively. Two of the victims showed no vital signs after retrieval from the water and had extremely low body temperatures. They were brought to Trondheim University Hospital where they were resuscitated successfully with extracorporeal re-warming. Unable to be weaned from ECMO in the initial phase, both patients were retrieved by mobile ECMO teams to Karolinska University Hospital, from where they were discharged to their homes with good outcomes, although with some sequelae. A third victim with moderate to severe hypothermia without cardiac arrest was treated at a local hospital, from where he after a short stay was discharged without physical sequelae. Conclusion: These cases are a reminder of the traditional mantra that «no one is dead until warm and dead». Good communication between pre- and in-hospital staff can be vital for optimizing patient treatment when handling victims of severe hypothermia, and especially when there is multiple victims. Communication between neighboring countries, but even neighboring regions within the same country, can be challenging. We encourage regions similar to ours to review protocols regarding hypothermia management, making them more robust before incidents like this take place © The Author(s). 2017. Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/)

The story-takers. Public pedagogy, transitional justice, and Italy's non-violent protest against the Mafia

Producción Científica, Saturn’s convective storms usually fall in two categories. One consists of mid-sized storms ∼2,000 km wide, appearing as irregular bright cloud systems that evolve rapidly, on scales of a few days. The other includes the Great White Spots, planetary-scale giant storms ten times larger than the mid-sized ones, which disturb a full latitude band, enduring several months, and have been observed only seven times since 1876. Here we report a new intermediate type, observed in 2018 in the north polar region. Four large storms with east–west lengths ∼4,000–8,000 km (the first one lasting longer than 200 days) formed sequentially in close latitudes, experiencing mutual encounters and leading to zonal disturbances affecting a full latitude band ∼8,000 km wide, during at least eight months. Dynamical simulations indicate that each storm required energies around ten times larger than mid-sized storms but ∼100 times smaller than those necessary for a Great White Spot. This event occurred at about the same latitude and season as the Great White Spot in 1960, in close correspondence with the cycle of approximately 60 years hypothesized for equatorial Great White Spots., Ministerio de Economía, Industria y Competitividad - Fondo Europeo de Desarrollo Regional (project AYA2015-65041-P), Gobierno Vasco (project IT-366-19)

The paper addresses, based on a case study comprising six process- and manufacturing industry companies, requirements for change and desired effects from Zero Defect Manufacturing in an Industry 4.0 context. The results outline seven problems and five needs perceived by the companies. Further, the results also outline four desired effects. The results are aligned with existing literature and studies but also bring up new aspects of Zero Defect Manufacturing in terms of problems, needs and desired effects. Noteworthy new desired effects are increased trust for the production process and improved gender equality.

Code review is a commonly used practice in software development. It refers to the process of reviewing new code changes before they are merged with the code base. However, to perform the review, developers are mostly assigned manually to code changes. This may lead to problems such as: a time-consuming selection process, limited pool of known candidates and risk of over-allocation of a few reviewers. To address the above problems, we developed Carrot, a machine learning-based tool to recommend code reviewers. We conducted an improvement case study at Ericsson. We evaluated Carrot using a mixed approach. we evaluated the prediction accuracy using historical data and the metrical Mean Reciprocal Rank (MRR). Furthermore, we deployed the tool in one Ericsson project and evaluated how adequate the recommendations were from the point of view of the tool users and the recommended reviewers.We also asked the opinion of senior developers about the usefulness of the tool. The results show that Carrot can help identify relevant non-obvious reviewers and be of great assistance to new developers. However, there were mixed opinions on Carrot's ability to assist with workload balancing and the decrease code review lead time. © 2020 IEEE Computer Society. All rights reserved. open access

We test the application of parametric, non-parametric, and semi-parametric calibration models for reconstructing summer (June–August) temperature from a set of tree-ring width and density data on the same dendro samples from 40 sites across Europe. By comparing the performance of the three calibration models on pairs” of tree-ring width (TRW) and maximum density (MXD) or maximum blue intensity (MXBI), we test whether a non-linear temperature response is more prevalent in TRW or MXD (MXBI) data, and whether it is associated with the temperature sensitivity and/or autocorrelation structure of the dendro parameters. We note that MXD (MXBI) data have a significantly stronger temperature response than TRW data as well as a lower autocorrelation that is more similar to that of the instrumental temperature data, whereas TRW exhibits a redder” variability continuum. This study shows that the use of non-parametric calibration models is more suitable for TRW data, while parametric calibration is sufficient for both MXD and MXBI data – that is, we show that TRW is by far the more non-linear proxy. publishedVersion