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Aim: To study the association between femoral neck (FN) bone mineral density (BMD) T‐score and fracture risk in individuals with and without type 2 diabetes (T2D). Materials and Methods: We performed a single‐centre retrospective cohort study using the Danish National Health Service. BMD of the FN was measured by dual‐energy X‐ray absorptiometry. Cox proportional hazards regression models were used to study the association between FN BMD T‐score and fractures in individuals with and without T2D separately, adjusted for age, comorbidities and comedication. The results from this analysis were used to estimate the 10‐year absolute fracture risk. Results: In total, there were 35,129 women (2362 with T2D) and 7069 men (758 with T2D). The FN BMD T‐score was significantly associated with risk of any, hip and major osteoporotic fracture in men and women with [adjusted hazard risk ratios (aHR) women, hip: 1.57; 95% confidence interval (CI) 1.24–2.00, incidence rate (IR) 8.7; aHR men, hip: 1.55; 95% CI 1.01–2.36, IR 4.6] and without T2D (aHR women, hip: 1.75; 95% CI 1.64–1.87, IR 7.0; aHR men, hip: 1.97, 95% CI 1.73–2.25, IR 6.3), and its ability to predict fracture risk was similar. Fracture IRs were not significantly different for individuals with or without T2D, nor was the estimated cumulative 10‐year fracture risk. Conclusions: The FN BMD T‐score was significantly associated with hip, non‐spine and major osteoporotic fracture risk in men and women with and without T2D. Fracture risk for a given T‐score and age was equal in individuals with and without T2D, as was the ability of the FN BMD T‐score to predict fracture risk. [ABSTRACT FROM AUTHOR]

In spite of their important roles in many ecosystems, data regarding population structure and biogeographic patterns of leeches are scarce. To begin to address this knowledge gap, we herein perform a phylogeographic analysis of the North American medicinal leech, Macrobdella decora (Say, 1824). A total of 224 M. decora specimens were collected from 35 localities across large swaths of USA and Canada and covering most of the known range of the species. Using four loci (mitochondrial cytochrome c oxidase subunit I [COI] and NADH dehydrogenase I [ND1], as well as nuclear 18S rRNA [18S] and 28S rRNA [28S]), we construct phylogenetic trees using several optimality criteria and superimpose geographic patterns onto the trees in order to tease out any potential structure among the populations. Rather surprisingly, given the large geographic range of the species and abundance of potential geographic barriers to gene flow, the analyses showed a conspicuous lack of structure among the different populations of M. decora. However, an AMOVA did show statistically significant differences between the genetic variation within populations and between populations (COI: FST = 0.65412, p < .00001; ND1: FST = 0.69245, p < .00001), which was largely driven by only 6 out of the 35 populations, and indicated a potential barrier for dispersal across the Appalachian Mountains. Finally, a Mantel test showed a weak, but significant, correlation between geographic distance and genetic distance (COI: r = 0.209, p = .027; ND1: r = 0.1289, p = .030); however, this correlation was primarily driven by a single locality. The overall weak structure suggests that M. decora is panmictic throughout its range, and we discuss this in light of previous population level studies in both bloodfeeding and non‐bloodfeeding species, concluding that the lack of structure in M. decora might be due to its high capacity for dispersal via hosts. [ABSTRACT FROM AUTHOR]

Aim: To investigate what happens to cross‐sectionally identified root‐filled teeth over a 6‐year period, regardless of the time that elapsed since primary root canal treatment, in a cohort of adult patients regularly attending a Public Dental Service. A secondary aim was to investigate how the cumulative events affecting root‐filled teeth over the same time were associated with variables obtained from a baseline examination. Methodology: Adult patients with ≥1 previously root‐filled tooth and regularly attending the Public Dental Service in Örebro County were enrolled for study participation in 2015. General dental practitioners examined all identified root‐filled teeth in this cohort at baseline using a standardized protocol and were also responsible for further decision‐making and treatments. After six years, information on events of the root‐filled teeth was collected from dental records. The highest rating (most invasive treatment) on a 5‐point ordinal scale was used in the analyses. Regression analyses with stepwise selection were performed for associations between patient‐ and tooth‐related factors and events. Results: A total of 445 patients with 1007 root‐filled teeth were followed the entire observation time. Twenty (2.0%) of the root‐filled teeth had endodontic retreatment and 150 (14.9%) were extracted over six years. Among teeth with periapical radiolucency or pain, the majority did not undergo retreatment or extraction; however, the multivariate analysis demonstrated that retreatment or extraction was associated with baseline recordings of teeth with periapical radiolucency (p <.0001), tenderness to percussion (p <.0001), and poor coronal restoration (p <.0001). Conclusions: This study corroborates the notion that in general dentistry, root‐filled teeth with radiological signs of apical disease often remain untreated over time. Furthermore, it also reveals that root‐filled teeth presenting with mild pain do not necessarily receive any intervention. However, teeth with baseline signs of apical periodontitis, pain, or inadequate coronal restoration were more likely to have received intervention during the six‐year period. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the 6‐year outcome of root canal treatment irrigated with 0.5% or 3% sodium hypochlorite (NaOCl). Methodology: The baseline trial was designed as a quasi‐randomized clinical trial. Patients referred for root canal treatment to an endodontic specialist clinic were recruited to the study (n = 298). The concentration of NaOCl was allocated quasi‐randomized to 271 subjects (0.5% [n = 139], 3% [n = 132]). Bacterial sampling was performed immediately before root canal filling. Samples were cultured and evaluated as growth or no growth. Patients were invited to a clinical and radiological follow‐up >5 years postoperatively. The clinical outcome measurements were tooth survival, cumulative incidence of endodontic retreatments, patients' assessment of pain, clinical findings and radiological signs of apical periodontitis (AP). Results: Tooth survival was 85.6% in the 0.5% NaOCl group and 81.1% in the 3% NaOCl group (p =.45). There was no record of retreatment in 94.4% in the 0.5% NaOCl group and in 92.2% in the 3% NaOCl group (p =.76). The percentage of asymptomatic cases were 87.8% in the 0.5% group and 85.3% in the 3% NaOCl group (p =.81). Absence of clinical signs of AP was seen in 86.6% in the 0.5% NaOCl group and in 83.6% in the 3% NaOCl group (p =.80). Absence of radiological signs of AP was seen in 74.0% in the 0.5% NaOCl group and 64.1% in the 3% NaOCl group (p =.20). Subjects with positive culture before root filling reported subjective pain with a significantly higher frequency as compared to negative‐culture subjects (p =.014). Conclusions: The use of 0.5% or 3% NaOCl for irrigation during root canal treatment resulted in similar clinical outcomes 5–7 years postoperatively. Persisting bacteria immediately before root filling may predict future episodes of subjective pain. [ABSTRACT FROM AUTHOR]

Background: Health‐related quality of life (HRQoL) is a multidimensional concept used to examine the impact of patient‐perceived health status on quality of life. Patients' perception of illness affects outcomes in both medical and elective surgical patients; however, not much is known about how HRQoL effects outcomes in the emergency surgical setting. This study aimed to examine if patient‐reported HRQoL was a predictor of unplanned readmission after emergency laparotomy. Methods: This study included 215 patients who underwent emergency laparotomy at the Copenhagen University Hospital, Herlev, between August 1, 2021, and July 31, 2022. Patient‐reported HRQoL was assessed with the EuroQol group EQ5D index (EQ5D5L descriptive system and EQ‐VAS). The population was followed from 0 to 180 days after discharge, and readmissions and days alive and out of hospital were registered. A Cox proportional hazard model was used to examine HRQoL and the risk of readmission within 30 and 180 days. Results: Within 30 days, 28.4% of patients were readmitted; within 180 days, the number accumulated to 45.1%. Low self‐evaluated HRQoL predicted 180‐day readmission and was significantly associated with fewer days out of hospital within both 90 and 180 days. Low HRQoL and discharge with rehabilitation were independent risk factors for short‐ (30‐day) and long‐term (180‐day) emergency readmission. Conclusion: Patient‐perceived quality of life is an independent predictor of 180‐day readmission, and the number of days out of hospital was correlated to self‐reported HRQoL. [ABSTRACT FROM AUTHOR]

Background: Socially marginalised patients face many challenges related to their health condition and often have several contacts with healthcare and social service workers. The Danish social nursing initiative, whose nurses have experience and knowledge about marginalisation, aims to support socially marginalised patients during hospital admission and through hospital transitions. However, there is limited knowledge about the hospital transitions of patients being supported by a social nurse. Objectives: The objectives of this study were to explore (1) the perspectives of socially marginalised patients on the transition from hospital to home and (2) how these patients experience the importance of social nursing on patient trajectories after hospital discharge. Methods: A qualitative study with a phenomenological and hermeneutic approach was performed at a large hospital in southern Denmark. Adult patients who had contact with a social nurse during hospital admission were purposely sampled. Data were collected between January 2023 and March 2023. Initial patient interviews were conducted during hospital admission with a second interview 7–22 days after discharge. Systematic text condensation was used for the analysis, and Nvivo 12 supported data storage and coding. Ethical Approval: The study is registered with the Danish Data Protection Agency (22/47509). Informed consent was given by the participants. Results: Sixteen patients participated in the study. The participants experienced major challenges in their transitions from the hospital, which were generally related to their interactions with many different social and healthcare services. While the social nurses supported the patients and helped facilitate care during hospital admission and after discharge, the participants identified transitional care gaps related to multidisciplinary cooperation and standardised care options. Conclusions: This study identifies challenges related to the hospital transition of socially marginalised patients, which indicates a gap in healthcare services. Future research should focus on improving interprofessional collaboration with socially marginalised patients across healthcare services. [ABSTRACT FROM AUTHOR]

Objective: To examine the feasibility and performance of implementing a standardized fetal cardiac scan at the time of a routine first‐trimester ultrasound scan. Method: A retrospective, single‐center study in an unselected population between March 2021 and July 2022. A standardized cardiac scan protocol consisting of a four‐chamber and 3‐vessel trachea view with color Doppler was implemented as part of the routine first‐trimester scan. Sonographers were asked to categorize the fetal heart anatomy. Data were stratified into two groups based on the possibility of evaluating the fetal heart. The influence of maternal and fetal characteristics and the detection of major congenital heart disease were investigated. Results: A total of 5083 fetuses were included. The fetal heart evaluation was completed in 84.9%. The proportion of successful scans increased throughout the study period from 76% in the first month to 92% in the last month. High maternal body mass index and early gestational age at scan significantly decreased the feasibility. The first‐trimester detection of major congenital heart defects was 7/16, of which four cases were identified by the cardiac scan protocol with no false‐positive cases. Conclusion: First‐trimester evaluation of the fetal heart by a standardized scan protocol is feasible to implement in daily practice. It can contribute to the earlier detection of congenital heart defects at a very low false positive rate. Key points: What is already known about this topic? Early fetal cardiac examination at the time of the routine first‐trimester examination has in recent years become more common as ultrasound equipment and experience have improved. The International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) advises performing a cardiac scan, which has proved to add significant enhancement in the diagnosis of congenital heart defect (CHD). What does this study add? This research contributes with insights into the practical implementation of a standardized scan protocol for screening major congenital heart defects (mCHD) in an unselected population in a daily clinical practice. The study finds implementation of early cardiac scan is feasible with a successful visualization rate in 85% of fetuses and can be a valuable supplement to the prenatal diagnosis of mCHD with a low false positive rate (0%). [ABSTRACT FROM AUTHOR]

Aim: To test the psychometric properties of the Finnish version of the Dempster Practice Behaviour Scale and explore nurses' professional autonomy along with which characteristics are related to it. Design: An instrument validation and a descriptive cross‐sectional study. Methods: The web‐based survey was conducted in September 2021 at two university hospitals in Finland. Exploratory factor analysis (EFA) was used to explore the factor structure of the modified instrument, while Cronbach's α coefficients were calculated to determine the reliability of the scale. Descriptive univariate and multivariate analyses were conducted to examine Registered Nurses' professional autonomy. The study followed STROBE guidelines. Results: During the validation process, the 30 items of the Dempster Practice Behaviour Scale were reduced to 25 items. The S‐CVI/Ave for the translated scale was 0.94. When one additional item was omitted from the EFA, the results supported five factors, which explained 45.9% of the total variance. The mean overall autonomy score was 3.63 out of 5, with readiness and empowerment the subscales with the highest and lowest, respectively, mean values. The linear regression models showed that age, nursing experience, unit type, education, shift, and perceptions of the importance of professional autonomy were related to the subscales describing professional autonomy. Conclusion: The psychometric testing provided evidence that the translated instrument was reliable. Nurses assessed that they are skilled professionals who are accountable for their actions. However, they experienced rather low levels of professional autonomy in empowerment and valuation. Health care organizations should consider this through authentic leadership and, thus, possibly strengthen professional autonomy. [ABSTRACT FROM AUTHOR]

Aim: High‐elevation specialist species are threatened by climate change and habitat loss, and their distributions are becoming increasingly reduced and fragmented. In such a context, dispersal ability is crucial to maintain gene flow among patches of suitable habitat. However, information about dispersal is often lacking for these species, especially for those taxa that are usually considered as good dispersers such as birds. We adopted a landscape genomics approach to investigate dispersal in a climate‐sensitive high‐elevation specialist bird. Our aims were to assess the levels of gene flow within a wide mountain area, and to assess the effects of geographic distance and landscape characteristics on dispersal, by testing the isolation by distance (IBD) hypothesis against the isolation by resistance (IBR) hypothesis. Location: European Alps. Taxon: Montifringilla nivalis. Methods: We sampled individuals from several breeding areas and obtained single nucleotide polymorphism (SNP) data by ddRAD sequencing. We then calculated site‐ and individual level genetic distances and individual inbreeding coefficients. To test IBD versus IBR, we related genetic distances to both geographic distances and different measures of landscape resistance by using maximum likelihood population effects models. Results: Gene flow among breeding areas was partly restricted, and we found support for IBD, indicating that geographic distance limits snowfinch dispersal. Spatial patterns of genetic distances suggested that philopatry strongly contributed to determine the observed IBD. High inbreeding coefficients in several individuals indicated frequent mating among relatives. Main Conclusions: Restricted dispersal and frequent inbreeding within 'sky island' systems can also occur in highly mobile species, because their potential ability to cover very large distances can be counteracted by high philopatry levels that are likely related to high dispersal costs. IBD and philopatry will increasingly hinder snowfinch dispersal among suitable areas within the future more restricted and fragmented breeding range, increasing the risks of local extinctions. [ABSTRACT FROM AUTHOR]

For many aquatic and semiaquatic mammal, amphibian and fish species, environmental DNA (eDNA) methods are employed to detect species distribution and to monitor their presence, but eDNA is much less employed for avian species. Here, we developed primers for the detection of true geese and swan species using eDNA and optimised a PCR protocol for eDNA. We selected taiga bean goose (Anser fabalis fabalis) as our focal (sub)species and sampled water from lakes, from which the presence of taiga bean goose was visually confirmed. To test, if taiga bean goose DNA could be detected among DNA of other goose species, we similarly sampled eDNA from a zoo pond housing several Anatidae species. We were able to detect taiga bean goose DNA in all but one of the tested lakes, including the zoo pond. The primers developed are not species‐specific, but rather specific to the genus Anser, due to the close relatedness of Anser species, which prevented the development of species‐specific primers and the use of, for example, quantitative PCR. We also developed eDNA primers for Branta species and Cygnus species and tested these primers using the same samples. Canada goose (B. canadensis) and barnacle goose (B. leucopsis) DNA were only detected in the zoo pond (in which they were present), as the sampled natural lakes fall outside the range of these species. We detected whooper swan (C. cygnus) DNA in three lakes and the zoo pond (in which the species was present). The eDNA method presented here provides a potential means to monitor elusive goose species and to study the co‐occurrence of large waterfowl. [ABSTRACT FROM AUTHOR]

The article discusses the controversy surrounding whether the locations of National Forest Inventory (NFI) plots should be openly accessible or only accessible in justified exceptions. The authors argue that the exact location of NFI sample plots should remain unknown to the public in order to maintain the representativeness and randomness of the sample. They provide examples of adverse effects that can occur if plot locations are shared, such as tampering with the results of the inventory or breaching data protection regulations. The authors suggest making case-by-case decisions for granting access to plot information, considering the purpose of the study and compliance with data protection regulations. They also acknowledge the different challenges faced by forest inventories in the Global South and the need to consider socioeconomic factors in the discussion. [Extracted from the article]

A method for phase retrieval from magnitude-only data for electrically small antennas intended for use in relation to body-centric wireless communication, is presented. The method utilizes the spherical wave expansion (SWE) description of the electromagnetic field radiated by the antenna under test (AUT). The expansion coefficients of the SWE are optimized such that errors between the reconstructed and provided data magnitudes are as small as possible. The required additional phase information is acquired from additional magnitude-only data sets of the AUT in different orientations. These orientations are defined by rotations of the AUT along the Eulerian angles. The performance of the method is evaluated for a realistic configuration, which consists of an inverted-A antenna in the vicinity of an ear. The sensitivity of the method to the angular resolution of the field data, as well as to the Eulerian rotation accuracy, is investigated. Finally, the reconstruction method is tested on a set of practical antenna measurements conducted in an RF-anechoic chamber. [ABSTRACT FROM AUTHOR]

Aim: This prospective cohort study aimed to (i) evaluate patients' treatment decisions, decisional conflict and knowledge levels before and after use of a video‐based decision aid (DA) on asymptomatic persistent endodontic lesions (APEL) and to (ii) elicit important decision factors for patients in the decision‐making process. Methodology: A video DA modelled after the International Patient Decision Aids Standards (IPDAS) was designed. The video was pilot‐tested, revised and used on 50 patients referred to the graduate endodontic clinic and presenting with an incidental finding of APEL detected on radiographs, with informed consent (DSRB 2020/00133). Recruitment was conducted from June 2020 to November 2021. Patients' treatment decisions and decision‐making process were studied. Patients also completed a questionnaire on knowledge gain, decisional conflict and confidence levels. Results: Forty‐three patients (48 teeth) out of 50 patients chose long‐term monitoring of APEL while 7 patients (7 teeth) decided on endodontic intervention. Median knowledge scores increased from 58.3 (IQR: 41.7, 75.0) to 87.5 (IQR: 75.0, 100.0) (p <.001); median decisional conflict scale (DCS) scores decreased from 25.0 (IQR: 12.5, 34.4) to 3.1 (IQR: 0, 23.8) (p <.001), and 44 (88%) patients were confident or very confident with their treatment decisions. Statistical analyses showed that asymptomatic condition of tooth was the sole decision factor with statistical significance while socioeconomic factors (age, gender, race, education and income levels) showed no significant trend. Conclusions: The majority of patients presenting with APEL in this study chose long‐term monitoring over immediate intervention. Using the video‐based DA in the decision‐making process significantly improved patients' knowledge and decreased their decisional conflict levels. [ABSTRACT FROM AUTHOR]

Background: Socially marginalised people are at a substantially increased risk of diseases and typically have several contacts with the healthcare system. Health professionals at hospitals often lack the knowledge, skills, confidence, and time to provide relevant care for socially marginalised patients. Danish hospitals have implemented a social nursing initiative consisting of social nurses with specialised knowledge about marginalisation to support socially marginalised patients. Limited research into patients' perceptions of social nursing has been undertaken. Objective: To explore patients' experiences with the in‐hospital social nursing initiative. Design: A qualitative study was conducted using a phenomenological hermeneutical approach. Setting: Odense University Hospital, Denmark. Participants: Patients aged 18 years and older who had been in contact with a social nurse during hospital admission were purposely sampled. Data saturation was reached when 15 participants were recruited. Methods: In‐depth patient interviews were conducted from November 2021 to April 2022 using a semi‐structured interview guide. The interviews were transcribed verbatim and analysed using systematic text condensation. NVivo 12 software was employed for the analysis. Patient representatives were involved to validate the analysis and interpretations. Results: Three themes were identified: (1) an equal and trusting relationship, (2) receiving person‐centred care, and (3) coherence in the patient trajectory. The results show that when patients have established a relationship with a social nurse, they are willing to let her into their lives and share personal information. Patients also experience person‐centred care and coherence in their trajectory when a social nurse participated in their treatment and care. Conclusion: The findings indicate that the social nursing initiative bridges the gap between socially marginalised patients and healthcare services. [ABSTRACT FROM AUTHOR]

Background: Musculoskeletal disorders (MSK) are a global burden causing significant suffering and economic impact. Systematic identification and targeting of research questions of highest interest for stakeholders can aid in improving MSK disorder knowledge and management. Objective: To obtain Swedish MSK researchers' opinions and views on a collaborative Swedish MSK network (SweMSK) and identify future research areas of importance for Swedish MSK research. Methods: A web‐based survey was conducted July to September 2021 to collect data from 354 Swedish MSK researchers. The survey focused on the need, objectives, and structure of a SweMSK network and identified prioritised areas for future MSK research. Results: The study included 141 respondents, of which 82 were associate professors or professors. The majority (68%) supported the creation of a new musculoskeletal network. The most supported element was increased collaboration regarding nationwide and multicenter studies. Respondents recommended the creation of a homepage and the establishment of national work groups with different specific interests as the primary elements of a new network. Conclusion: The results demonstrated a need and desire for increased national research collaboration and the creation of a new musculoskeletal network. The high academic experience and active research participation of the respondents suggest the need for MSK disorder knowledge and management improvement in Sweden. Therefore, the SweMSK network may help facilitate effective collaboration and research efforts that can contribute to the advancement of MSK disorder management and care. This study may provide valuable insights for policymakers, clinicians, and researchers to improve MSK disorder care and management in Sweden. [ABSTRACT FROM AUTHOR]

Anthropogenic pressures on nature have been causing population declines for centuries. Intensified persecution of apex predators, like the golden eagle, resulted in population bottlenecks during the 19th and 20th centuries. To study population genetics and demographic history of the golden eagle throughout its distribution, we collected museum samples from previously underrepresented regions, such as Russia and Central Asia. We used 12 microsatellite loci and a fragment of the mitochondrial DNA control region to re‐evaluate phylogeography of Eurasian golden eagles and study the impacts of the population bottleneck. Our results revealed a north–south genetic gradient, expressed by the difference between Mediterranean and Holarctic lineages, as well as genetically distinct Northern Europe and Central Asia and Caucasus regions. Furthermore, Northern Europe exhibited the lowest, whereas Central Asia and Caucasus had the highest genetic diversity. Although golden eagles maintained relatively high genetic diversity, we detected genetic signatures of the recent bottleneck, including reduced genetic diversity and a decline in the effective female population size around the year 1975. Our study improves the knowledge of the genetic composition of Eurasian golden eagles and highlights the importance of understanding their historical population dynamics in the face of ongoing and future conservation efforts. [ABSTRACT FROM AUTHOR]

Aim: This historical prospective cohort study of the adult population of Sweden is based on data from a national registry: the primary aim was to evaluate the long‐term survival of teeth after periradicular surgery. A secondary aim was to identify factors predictive of extraction within 10 years of registration of periradicular surgery. Methodology: The cohort consisted of all individuals who had undergone periradicular surgery to treat apical periodontitis, as reported to the Swedish Social Insurance Agency (SSIA) in 2009. The cohort was followed until 31 December 2020. Subsequent registrations of extractions were collected for Kaplan–Meier survival analyses and survival tables. The patients' sex, age, dental service provider and tooth group were also retrieved from SSIA. Only one tooth per individual was included in the analyses. Multivariable regression analysis was used and p <.05 was considered statistically significant. The reporting guidelines STROBE and PROBE were followed. Results: After data cleaning, and exclusion of 157 teeth, 5622 teeth/individuals remained for analysis. The mean age of the individuals at the time of the periradicular surgery was 60.5 years (range 20–97, standard deviation 13.31); 55% were women. At the end of the follow‐up, that is, up to 12 years, a total of 34.1% of the teeth had been reported as extracted. The multivariate logistic regression analysis, based on follow‐up data at 10 years after registration of the periradicular surgery, included 5548 teeth, of which 1461 (26.3%) had been extracted. Significant associations between the independent variables tooth group and dental care setting (both p <.001) and the dependent variable extraction were found. The highest odds ratio (OR) for extraction applied to tooth group: compared to maxillary incisors and canines, mandibular molars were at greatest risk of extraction (OR 2.429, confidence interval 1.975–2.987, p <.001). Conclusions: After periradicular surgery in predominantly elderly people in Sweden, approximately three‐quarters of the teeth are retained over a 10‐year period. The type of tooth is associated with extraction: mandibular molars are at greater risk of extraction than maxillary incisors and canines. [ABSTRACT FROM AUTHOR]

Introduction: In this register‐based study of pregnancies in Denmark, we assessed the associations between maternal age and the risk of fetal aneuploidies (trisomy 21, trisomy 18, trisomy 13, triploidy, monosomy X and other sex chromosome aberrations). Additionally, we aimed to disentangle the maternal age‐related effect on fetal aneuploidies by cases with translocation trisomies and mosaicisms. Material and methods: We followed a nationwide cohort of 542 375 singleton‐pregnant women attending first trimester screening in Denmark between 2008 and 2017 until delivery, miscarriage or termination of pregnancy. We used six maternal age categories and retrieved information on genetically confirmed aneuploidies of the fetus and infant from the national cytogenetic register. Results: We confirmed the known associations between advanced maternal age and higher risk of trisomy 21, 18, 13 and other sex chromosome aberrations, especially in women aged ≥35 years, whereas we found no age‐related associations with triploidy or monosomy X. Cases with translocation trisomies and mosaicisms did not influence the overall reported association between maternal age and aneuploidies. Conclusion: This study provides insight into the accurate risk of fetal aneuploidies that pregnant women of advanced ages encounter. [ABSTRACT FROM AUTHOR]

Aim: To explore associations between root filled teeth, primary and secondary apical periodontitis, and levels of inflammatory markers in blood from patients with a first myocardial infarction and matched controls. Methodology: Between May 2010 and February 2014, 805 patients with a first myocardial infarction and 805 controls, matched for sex, age, and postal code area, were recruited to the multicentre case–control study PAROKRANK (periodontitis and its relation to coronary artery disease). All participants underwent a physical and oral examination, as well as blood sampling. Using panoramic radiography, root filled teeth, primary apical periodontitis, and secondary apical periodontitis were assessed by three independent observers. Blood samples were analysed with enzyme‐linked immunosorbent assay method for the following inflammatory markers: interleukin‐1β (IL‐1β), IL‐2, IL‐6, IL‐8, IL‐12p70, tumour necrosis factor‐α, and high‐sensitivity C‐reactive protein (hsCRP). Additionally, white blood cell count and plasma‐fibrinogen were analysed. Associations between endodontic variables and the levels of inflammatory markers were statistically analysed with Mann–Whitney U‐test and Spearman correlation, adjusted for confounding effects of baseline factors (sex, age, myocardial infarction, current smoking, diabetes, family history of cardiovascular disease, education, marital status, and periodontal disease). Results: Mean age of the cohort was 62 years, and 81% were males. Root fillings were present in 8.4% of the 39 978 examined teeth and were associated with higher levels of hsCRP, fibrinogen, and leukocyte count, but lower levels of IL‐2 and IL‐12p70. After adjusting for confounders, root filled teeth remained associated with higher levels of fibrinogen, but lower levels of IL‐1β, IL‐2, IL‐6, and IL‐12p70. Primary apical periodontitis was found in 1.2% of non‐root filled teeth and associated with higher levels of IL‐8 (correlation 0.06, p =.025). Secondary apical periodontitis was found in 29.6% of root filled teeth but did not relate to the levels of any of the inflammatory markers. Conclusions: This study supports the notion that inflammation at the periapex is more than a local process and that systemic influences cannot be disregarded. Whether the observed alterations in plasma levels of inflammatory markers have any dismal effects on systemic health is presently unknown but, considering the present results, in demand of further investigation. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this cross‐sectional questionnaire study was to investigate motivation to participate in a possible new screening for preeclampsia in the first trimester of pregnancy among Danish pregnant women through a questionnaire based on Theory of Planned Behavior developed for this specific purpose. The new screening combines maternal characteristics with mean arterial pressure, uterine artery pulsatility index and biochemical markers to predict the risk of preeclampsia, whereas the current Danish screening uses maternal characteristics alone. Material and methods: Participation was offered to a proportion of women attending a first or a second trimester screening scan at two University Hospitals in Copenhagen. The questionnaire was set up in REDCap® and answers were entered directly into the database, which was accessed via a QR‐code. Results: We invited 772 pregnant women to participate in the questionnaire survey between November 2021 and April 2022 at Copenhagen University Hospital Rigshospitalet (study site one) (n = 238) and Copenhagen University Hospital Hvidovre (study site two) (n = 534). The response rate was 71.8% (171/238) at study site one and 33.9% (181/534) at study site two. A total of 352 women were included in the study (total participation rate 45.6%). Most women had a positive attitude towards preeclampsia screening in pregnancy, and 99.4% said they would participate in a risk assessment for preeclampsia if given the opportunity. A total of 97.4% answered "yes" to whether a first trimester preeclampsia screening should be offered to all pregnant women in Denmark. Positive motivation to participate in preeclampsia screening was correlated with having a network with a positive attitude towards preeclampsia screening. Conclusions: The results of this study indicate that Danish pregnant women have a positive attitude towards participation in a first trimester screening for preeclampsia. This observation might be useful in relation to possible future implementation in Denmark. [ABSTRACT FROM AUTHOR]

Objectives: Breastfeeding is an energetically costly and intense form of human parental investment, providing sole‐source nutrition in early infancy and bioactive components, including immune factors. Given the energetic cost of lactation, milk factors may be subject to tradeoffs, and variation in concentrations have been explored utilizing the Trivers‐Willard hypothesis. As human milk immune factors are critical to developing immune system and protect infants against pathogens, we tested whether concentrations of milk immune factors (IgA, IgM, IgG, EGF, TGFβ2, and IL‐10) vary in response to infant sex and maternal condition (proxied by maternal diet diversity [DD] and body mass index [BMI]) as posited in the Trivers‐Willard hypothesis and consider the application of the hypothesis to milk composition. Methods: We analyzed concentrations of immune factors in 358 milk samples collected from women residing in 10 international sites using linear mixed‐effects models to test for an interaction between maternal condition, including population as a random effect and infant age and maternal age as fixed effects. Results: IgG concentrations were significantly lower in milk produced by women consuming diets with low diversity with male infants than those with female infants. No other significant associations were identified. Conclusions: IgG concentrations were related to infant sex and maternal diet diversity, providing minimal support for the hypothesis. Given the lack of associations across other select immune factors, results suggest that the Trivers‐Willard hypothesis may not be broadly applied to human milk immune factors as a measure of maternal investment, which are likely buffered against perturbations in maternal condition. [ABSTRACT FROM AUTHOR]

Aim: We examined the heart failure biomarker mid‐regional pro‐atrial natriuretic peptide during the first trimester of pregnancy in relation to early‐onset preeclampsia <34 weeks. Materials and Methods: This case–control study included 34 women with singleton pregnancies with a preeclampsia diagnosis and delivery before 34 weeks of gestation who had attended the routine first‐trimester ultrasound scan at 11–13+6 weeks of gestation between August 2010 and October 2015 at the Copenhagen University Hospital Rigshospitalet, Denmark, and 91 uncomplicated singleton pregnancies matched by time of the routine first‐trimester blood sampling at 8–13+6 weeks. Descriptive statistical analyses were performed for maternal characteristics and obstetric and medical history for the case versus the control group. Concentrations of mid‐regional pro‐atrial natriuretic peptide, placental growth factor, soluble fms‐like tyrosine kinase‐1, and pregnancy‐associated plasma protein A between early‐onset preeclampsia cases and the control group were compared using Students t‐test and the Mann–Whitney U test. Biochemical marker concentrations were converted into multiples of the expected median values after adjustment for gestational age. Results: Mid‐regional pro‐atrial natriuretic peptide levels were not significantly different between early‐onset preeclampsia cases and the control group in the first trimester of pregnancy. As expected, both placental growth factor and pregnancy‐associated plasma protein A levels were significantly lower in early‐onset preeclampsia, whereas soluble fms‐like tyrosine kinase‐1 levels were not statistically significantly different. Conclusion: The maternal first‐trimester concentration of mid‐regional pro‐atrial natriuretic peptide, a peptide with multiple biological functions including a relation to cardiovascular disease, was not significantly different in women with early‐onset preeclampsia. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the cost‐effectiveness of root canal treatment (RCT) compared with a tooth extraction in a general dental practice setting, with reference to cost per quality‐adjusted life‐year (QALY) gained over 1 year. Material and Methods: This is a prospective controlled cohort study based on patients either starting RCT or undergoing extraction at one of six Public Dental Service clinics in the county of Västra Götaland, Sweden. From a total of 65 patients, 2 comparable groups were formed: 37 started RCT and 28 underwent extraction. A societal perspective was used for the cost calculations. QALYs were estimated, based on the EQ‐5D‐5L given to the patients at their first treatment appointment and then after 1, 6, and 12 months. Results: The total mean cost of RCT ($689.1) was higher than for extraction ($280.1). For those patients whose extracted tooth was replaced, the costs were even higher ($1245.5). There were no significant intergroup differences in QALYs, but a significant improvement in health state values in the tooth‐preserving group. Conclusions: In the short term, extraction was cost‐effective compared with preserving a tooth with RCT. However, the potential need for future replacement of the extracted tooth, by an implant, fixed prosthesis, or removable partial dentures, may change the calculation in favor of RCT. [ABSTRACT FROM AUTHOR]

Peutz–Jeghers syndrome (PJS) is an autosomal dominant hereditary polyposis syndrome causing increased morbidity and mortality due to complications of polyposis and the development of cancer. STK11 is the only gene known to be associated with PJS, although in 10%–15% of patients fulfilling the diagnostic criteria no pathogenic variant (PV) is identified. The primary aim of this study was to identify the genetic etiology in all known PJS patients in Denmark and to estimate the risk of cancer, effect of surveillance and overall survival. We identified 56 patients (2–83 years old) with PJS. The detection rate of PVs was 96%, including three cases of mosaicism (6%). In two patients a variant was not detected. At the age of 40 years, the probabilities of cancer and death were 21% and 16%, respectively; at the age of 70 years these probabilities were 71% and 69%. Most cases of cancer (92%) were identified between the scheduled examinations in the surveillance program. These observations emphasize that PJS should be regarded as a general cancer predisposition syndrome, where improvement of clinical care is needed. [ABSTRACT FROM AUTHOR]

Nordic countries are known for having extensive welfare services, a highly compressed wage structure owing to strong social partners, as well as effective regulation and governance in public administration. Various typologies capture aspects of the institutional features of families of nations across various policy areas, showing that there is a specific Nordic variant of political economy. While there is an extensive literature focusing on socio‐economic outcomes in the Nordic countries, there is less scholarly focus on the linkages between the regulatory processes, and their policy output, in response to various challenges. This volume examines how exogenous challenges (market liberalization promoted by EU integration and the gig economy, as well as the COVID‐19 pandemic) and endogenous challenges in the welfare state (regulation of child‐care quality and retirement ages) are tackled in a selection of Nordic countries. After a bibliometric analysis on the state of the literature, features of the Nordic model are presented. Then, the contributions of the articles to the special issue are summarized, after which lessons for other models of political economy are pinpointed. We find that although there is high variation within the Nordics in the studies of the special issue, there is a trend whereby, over time, a broader range of actors involved in the policy and regulatory process. Although not perfect, challenges are solved incrementally and often at an early stage. In other words, the Nordic regulatory model is highly adaptable to different challenges. Thus, the Nordic model does present crucial lessons for other types of political economy. [ABSTRACT FROM AUTHOR]

The likelihood that longevity will continue to increase has generated a search for regulation that make people work longer as they live longer, and thus not just containing pension expenditure but also enlarging labor supply, economic growth, and tax revenue. In public pension policy, Nordic countries have led the world with three types of approaches aimed at making people retire later. The first came when Sweden, followed by Finland and Norway, installed life expectancy coefficients in benefit calculation formulas. The second followed as Finland introduced age‐related accrual rates and the third when Denmark indexed the pensionable age to developments in life expectancy. Since economic incentive‐based regulations failed to raise exit ages sufficiently, Finland and Sweden subsequently linked pensionable ages to life expectancy like Denmark. While this policy brings out inequalities in health and workability, the fact that countries found it necessary to index the pensionable age to longevity instead of just relying on economic incentives in regulating retirement behavior may hold lessons for other countries. [ABSTRACT FROM AUTHOR]

However, markers of systemic inflammation were numerically lower in patients treated with biologics and these biologics may hold the potential to reduce the risk of CVD in patients with psoriasis. The mean SII (492.7 ± 363.0 vs. 696.2 ± 246.3 [ I p i = 0.017]) and NLR (1.95 ± 1.11 vs. 2.77 ± 0.86 [ I p i = 0.002]) were lower in the patients receiving biologic treatment compared to the untreated patients. Psoriasis is a systemic inflammatory disease that is associated with a disease severity-dependent increased risk of atherosclerotic cardiovascular disease (CVD).[1] Increased burden of systemic inflammation and traditional cardiovascular risk factors are thought to increase the risk of CVD in psoriasis, and shared inflammatory pathways represent a possible link between the two diseases.[1] Biomarkers of systemic inflammation such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and high-sensitivity C-reactive protein (hs-CRP) are increased in patients with psoriasis compared to healthy controls.[[2]] Furthermore, increased NLR is associated with CVD in patients with psoriasis.[[4]] Recently, the systemic immune-inflammation index (SII), which is calculated by the following formula: neutrophils × platelets/lymphocytes and thus combines NLR and PLR in one index, was also shown to be increased in patients with psoriasis.[[6]] It is unknown which biomarker of systemic inflammation best captures both disease activity measured by psoriasis area and severity index (PASI)[[2], [8]] and risk of CVD in patients with psoriasis. [Extracted from the article]

Species living in high mountain areas are currently threatened by climate change and human land use changes. High‐elevation birds frequently inhabit island‐like suitable patches around mountain peaks, and in such conditions the capability to exchange individuals among patches is crucial to maintain gene flow. However, we lack information regarding the dispersal ability of most of these species and the possible influence of landscape features on dispersal. In this study, we used population genomics and landscape resistance modelling to investigate dispersal in a high‐elevation specialist migratory bird, the water pipit Anthus spinoletta. We aimed to assess the levels of gene flow in this species within a wide area of the European Alps, and to assess the effects of environmental characteristics on gene flow, by testing the isolation by distance (IBD) hypothesis against the isolation by resistance (IBR) hypothesis. We found clear support for IBR, indicating that water pipits preferentially disperse across suitable breeding habitat (i.e., high‐elevation grassland). IBR was stronger in the part of the study area with less extended suitable habitat. Landscape resistance was slightly better described by habitat suitability models than landscape connectivity models. Despite the observed IBR, gene flow within the study area was high, probably also because of the still wide and relatively continuous breeding range. The forecasted reduction of range of this species may lead to stronger effects of IBR on gene flow. Other high‐elevation specialist birds may show similar IBR patterns, but with possibly stronger effects on gene flow because of their more reduced and patchy habitats. [ABSTRACT FROM AUTHOR]

Introduction: While functional near‐infrared spectroscopy (fNIRS) can provide insight into motor‐cognitive deficits during ecologically valid gait conditions, the feasibility of using fNIRS during complex walking remains unknown. We tested the process and scientific feasibility of using an fNIRS device to measure cortical activity during complex walking tasks consisting of straight walking and navigated walking under single and dual‐task (DT) conditions. Methods: Nineteen healthy people from 18 to 64 years (mean age: 45.7 years) participated in this study which consisted of three complex walking protocols: (i) straight walking, DT walking (walking while performing an auditory Stroop task) and single‐task auditory Stroop, (ii) straight and navigated walking, and (iii) navigated walking and navigated DT walking. A rest condition (standing still) was also included in each protocol. Process feasibility outcomes included evaluation of the test procedures and participant experience during and after each protocol. Scientific feasibility outcomes included signal quality measures, and the ability to measure changes in concentration of deoxygenated and oxygenated hemoglobin in the prefrontal cortex. Results: All participants were able to complete the three protocols with most agreeing that the equipment was comfortable (57.9%) and that the testing duration was adequate (73.7%). Most participants did not feel tired (94.7%) with some experiencing pain (42.1%) during the protocols. The signal qualities were high for each protocol. Compared to the rest condition, there was an increase in oxygenated hemoglobin in the prefrontal cortex when performing dual‐task walking and navigation. Conclusion: We showed that our experimental setup was feasible for assessing activity in the prefrontal cortex with fNIRS during complex walking. The experimental setup was deemed acceptable and practicable. Signal quality was good during complex walking conditions and findings suggest that the different tasks elicit a differential brain activity, supporting scientific feasibility. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to explore the influence of a framing effect in retreatment decision‐making of a root‐filled tooth with asymptomatic apical periodontitis (AP). Method: Two variants of a questionnaire were created in which the factual information about a root filled with AP was identical. The options in the first variant were framed in favor to wait and see (FW) and those in the other variant were framed in favor of retreatment (FR) Two hundred and forty‐eight volunteers were by chance given one of the two versions and were asked to choose between having retreatment or to wait and see. Results: Of the 125 participants given the FW version, 69 (55.2%) chose to wait and see while out of the 123 participants who were given the FR version, 38 (30.9%) made the alike choice (p =.0002). Conclusion: A framing effect is likely to play an essential role in endodontic retreatment decision‐making of root‐filled teeth with asymptomatic apical periodontitis. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to examine (1) the perceptions on core competencies of healthcare professionals working at clinical settings in Oman and (2) which demographic characteristics explain the overall core competency. Design: A cross‐sectional design. Methods: Healthcare Professional Core Competency Instrument, consisting of 11 sub‐scales with 81 items, was distributed to healthcare professionals (n = 1,543; 826 nurses and 717 physicians) who worked at primary, secondary and tertiary healthcare institutions. Descriptive statistics, t‐test, ANOVA and linear regression were used for data analysis. Results: Altogether 1,078 healthcare professionals (628 nurses and 450 physicians) responded representing 70% overall response rate. Healthcare professionals perceived their overall core competence as excellent, safety being the highest, and research and evidence‐based practice was the lowest. The multiple linear regression analysis revealed that ethnicity, gender and years of working experience were the characters that explained the overall core competence, where expatriate senior professionals reported higher competency levels compared with counterparts. [ABSTRACT FROM AUTHOR]

Root‐filled teeth presenting with signs of post‐treatment disease is a common finding in virtually every dental practice. There is both empirical and experimental evidence that, as long as the condition is asymptomatic, it is often left untreated. Professional judgements and decision making in endodontics as in any medical discipline are based on qualified estimations of the probability and the value of relevant outcomes. In this paper we describe various aspects of clinical decision making in general, from a descriptive as well as a normative point of view, but with a particular focus on the condition of the root‐filled tooth with post‐treatment disease. We review how attention to various types of uncertainties are relevant for the decision‐making process. Additionally, we discuss the nature of value judgements and different concepts of health and disease which are important for understanding the complexity of the clinical decision‐making process. We also refer to a set of principal rules that can guide the clinician's decision making in every‐day practice in front of a case with endodontic post‐treatment disease. Finally, we provide some aspects on the sometime cumbersome decision whether to go for a non‐surgical or surgical method, whenever a decision on retreatment has been made. [ABSTRACT FROM AUTHOR]

Surface melt forces summertime ice‐flow accelerations on glaciers and ice sheets. Here, we show that large meltwater‐forced accelerations also occur during wintertime in Greenland. We document supraglacial lakes (SGLs) draining in cascades at unusually high elevation, causing an expansive flow acceleration over a ∼5,200 km2 region during winter. The three‐component interferometric surface velocity field and decomposition modeling reveal the underlying flood propagation with unprecedented detail as it traveled over 160 km from the drainage site to the margin, providing novel constraints on subglacial water pathways, drainage morphology, and links with basal sliding. The triggering SGLs continuously grew over 40 years and suddenly released decades of stored meltwater, demonstrating surface melting can impact dynamics well beyond melt production. We show these events are likely common and thus their cumulative impact on dynamics should be further evaluated. Plain Language Summary: Understanding factors that influence flow speeds on ice sheets are linked to our ability to predict changes in sea level and prepare coastal communities for the future. On the Greenland Ice Sheet, ice flow‐speed changes have long been linked to surface melting in summer. Meltwater can make it to the bed of the ice sheet via surface cracks causing changes in ice motion. Here, we show that melt that is produced during summer, but stored within lakes on the ice surface, can drain to the bed and cause large flow accelerations during winter. This demonstrates the influence of meltwater on flow speeds needs to be considered beyond when it is produced. Key Points: A cascade of supraglacial lake drainages and an associated ice‐flow acceleration are observed during winter in GreenlandDecomposition of motion into vertical and horizontal components allows for subglacial water pathways and links with sliding to be inferredTracking the history of the supraglacial lakes shows some of the meltwater released was produced decades earlier [ABSTRACT FROM AUTHOR]

Purpose: To assess the ability of MRI‐DTI to evaluate growth plate morphology and activity compared with that of histomorphometry and micro‐CT in rabbits. Methods: The hind limbs of female rabbits aged 16, 20, and 24 wk (n = 4 per age group) were studied using a 9.4T MRI scanner with a multi‐gradient echo 3D sequence and DTI in 14 directions (b‐value = 984 s/mm2). After MRI, the right and left hind limb were processed for histological analysis and micro‐CT, respectively. The Wilcoxon signed‐rank test was used to evaluate the height and volume of the growth plate. Intraclass correlation and Pearson correlation coefficient were used to evaluate the association between DTI metrics and age. Results: The growth plate height and volume were similar for all modalities at each time point and age. Age was correlated with all tractography and DTI metrics in both the femur and tibia. A correlation was also observed between all the metrics at both sites. Tract number and volume declined with age; however, tract length did not show any changes. The fractional anisotropy color map showed lateral diffusion centrally in the growth plate and perpendicular diffusion in the hypertrophic zone, as verified by histology and micro‐CT. Conclusion: MRI‐DTI may be useful for evaluating the growth plates. [ABSTRACT FROM AUTHOR]

Aim: This integrative review aimed to describe the perceptions of the quality of care of older patients (aged 65 and above) living with cancer in acute‐care settings. Methods: We identified relevant research suitable for inclusion criteria through systematic searches of the PubMed®, EBSCOhost Academic Search Premier®, Scopus® and Web of Science® databases. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) framework and the Synthesis Without Meta‐analysis (SWiM) guidelines were used to conduct the research and report the results. The quality of the studies was evaluated using the modified Critical Skills Appraisal Programme (CASP) checklist. Results: A total of 24 studies met the inclusion criteria. The data analysis revealed that care quality could be described through three distinct themes: individuality, a sense of security and respectful encounters. Conclusion: The perceptions of older people living with cancer regarding the quality of acute care have not been extensively covered in the literature. Health‐ and age‐related challenges, patients' overall life situation, clear, realistic information about care and the future and respect during encounters should be given attention. Implications for practice: Patient‐centred and tailored care, considering the heterogeneity of the population and support for independence, is needed. [ABSTRACT FROM AUTHOR]

We used historical DNA samples to examine the history of a native horse breed, the Finnhorse. Samples were collected from private collections, museums, schools and excavations, representing the times prior to, during, and after the foundation of the breed; from the end of the 19th century and throughout the 20th century. We sequenced a fragment of mitochondrial DNA from these historical samples to study the history and evolution of maternal lineages of horses back to the early days of the breed, compared the mitochondrial DNA sequence diversity of different historical periods and modern day Finnhorses, estimated the effective population sizes, and searched for both temporal and geographic population genetic structure. We observed high maternal haplotype and nucleotide diversity at the time during the foundation of the breed, and a decrease in both measures during 1931–1970. In addition, we observed losses of some haplotypes present in the early stages of the breed. There was only slight evidence of geographical or temporal population structure. This study is, to our knowledge, the first to use such temporal sampling to reveal the history of a specific animal breed. [ABSTRACT FROM AUTHOR]

Aim: To study the association between endodontic inflammatory disease and a first myocardial infarction (MI). Methodology: The study comprised 805 patients with recent experience of a first MI, each gender, age and geographically matched with a control. Panoramic radiographs were available for 797 patients and 796 controls. Endodontic inflammatory disease was assessed radiographically. The sum of decayed, missing and filled teeth (DMFT) was calculated, and the number of root filled teeth and teeth with periapical lesions were recorded. The associated risk of a first MI was expressed as odds ratios (OR) with 95% confidence intervals (CI), unadjusted and adjusted for confounders (family history of cardiovascular disease, smoking habits, marital status, education and diabetes). Results: Patients who had suffered a first MI had higher DMFT (mean 22.5 vs. 21.9, p =.013) and more missing teeth (mean 7.5 vs. 6.3; p <.0001) than the healthy controls. The number of missing teeth was associated with an increased risk of a first MI (adjusted OR 1.04; CI 1.02–1.06). Conversely, decay‐free, filled teeth were associated with decreased risk (adjusted OR 0.98; CI 0.96–1.00). Analysis based on age disclosed the following variables to be associated with an increased risk of a first MI: number of decayed teeth (adjusted OR 1.18; CI 1.02–1.37, in patients <60 years), any primary periapical lesion (adjusted OR 1.57; CI 1.08–2.29, in patients <65 years) and the proportion of root filled teeth (adjusted OR 1.18; CI 1.03–1.36, in patients ≥65 years). Conclusions: More missing teeth was independently associated with an increased risk of a first MI. In addition, endodontic inflammatory disease may contribute as an independent risk factor to cardiovascular disease since untreated caries, periapical lesions and root fillings, depending on age, were significantly associated with a first MI. [ABSTRACT FROM AUTHOR]

The morphology of bird wings is subject to a variety of selective pressures, including migration, predation, habitat structure and sexual selection. Variation in wing morphology also occurs at the intraspecific and intrapopulation level, and can be related to sex, age, migration strategy and environmental factors. The relationship between environment and intraspecific variation in wing morphology is still poorly understood. In this work, we studied the relationship between wing morphology and breeding environment in a high‐elevation specialist bird, the water pipit Anthus spinoletta. We calculated wing isometric size, pointedness and convexity of 84 birds mist‐netted at breeding sites in year 2021 in the European Alps. We then searched for associations between these traits and potentially relevant breeding site characteristics (vegetation structure, elevation, latitude). For all wing traits, sex and one or more environmental factors best explained the variation, with environmental factors explaining between 3 and 8% of the variation. Wing size was negatively related to tree cover and wing convexity was negatively related to bush cover. Elevation contributed to explain variation in wing pointedness, but the direction of its effect was unclear. The negative relationship between wing size and tree cover could be due to intraspecific competition, i.e. to the relegation of smaller winged low‐quality individuals in marginal grassland areas. Higher wing convexity could improve predator escape ability in areas with scarce protecting vegetation, with possible effects on habitat choice. These findings represent one of the few demonstrated cases of wing morphology–environment relationships at the intraspecific level. [ABSTRACT FROM AUTHOR]

Background: The etiology of dental fear (DF) is multifactorial and involves other contributing factors than dental traumatic experiences. Aim: To study, among adolescents, associations between DF and exposure to child physical abuse (CPA), intimate partner violence (IPV), and bullying. Design: We extracted data from a population‐based survey of 4977 adolescents who were 15–17 years old in 2017. The questionnaire queried socioeconomic background factors, DF, self‐perceived oral health, general health, and exposure to child abuse. To estimate associations between DF and exposure to child abuse, we used multivariate logistic regression analysis. Results: Overall, 8.2% reported DF, girls (10.5%) reported DF significantly more often than boys (5%), and adolescents not identifying themselves as girl or boy reported the highest prevalence of DF (25.5%; p <.001). 15.3% had been exposed to child physical abuse; 11.1%, to IPV; and 11.2%, to bullying. Experiences of IPV and bullying, but not physical abuse, were statistically significantly associated with DF. The odds of developing DF for adolescents exposed to any type of violence was 1.9 times the odds for adolescents with no exposure to child abuse. Conclusion: Exposure to violence is associated with dental fear in adolescents. [ABSTRACT FROM AUTHOR]

Background: Hypospadias is a common congenital malformation often related to the effect of androgens in utero. While hypogonadism is associated with many potential health risks including metabolic and cardiovascular disease, the risk of clinical hypogonadism and comorbidities in men with hypospadias later in life has not been studied. Objectives: Investigate the risk of hypogonadism and somatic comorbidities in adolescents and men born with hypospadias. Materials and methods: We conducted a population‐based cohort study using Swedish registers. Associations between hypospadias and hypogonadism, delayed puberty, metabolic, and cardiovascular disease respectively were estimated using Cox proportional hazards regression. Body measurements from military conscription were analysed in a subpopulation as indicators of growth and cardiometabolic risk. We used sibling comparison analyses to control for familial confounding. Results: Using register data, a total of 2,165,255 men including 9,714 men born with hypospadias were followed from the age of 10 to a maximum of 60 years. We found an association between hypospadias and hypogonadism (Hazard ratio (HR) 3.27, 95% confidence interval (CI) 2.33–4.59) which was more pronounced in proximal hypospadias. Men with hypospadias had shorter average height than their brothers and the general population. We further found an increased risk of delayed puberty (HR 1.49, 95% CI 1.08–2.07), diabetes mellitus type 2 (HR 1.57, 95% CI 1.18–2.09) and cardiovascular disease (HR 1.47, 95% CI 1.27–1.71). Discussion: We found an increased risk of hypogonadism, metabolic and cardiovascular disease in men born with hypospadias, increasing with severity of phenotype, as well as impacted growth. These results indicate discruptions in androgen function past childhood, although some of the associations may be due to other underlying aetiologies. Conclusion: Hypospadias is associated with an increased risk of androgen‐related comorbidity in adolescence and adulthood. We suggest that this can be considered clinically, while further research is needed, especially in older populations. [ABSTRACT FROM AUTHOR]

Aim: To document treatment outcomes and related resources, in patients undergoing root canal treatment (RCT) in county public dental clinics, by monitoring patient records for 12 months from treatment start. Methodology: The subjects comprised 243 patients starting RCT at 20 public dental clinics in Västra Götaland county, Sweden. Their computerized dental records were monitored prospectively for a year after starting their endodontic treatment. Treatment was completed with either a root filling or extraction. The following treatment‐specific variables were registered: number of appointments and days until treatment was completed, possible complications and prescriptions for antibiotics, and for the root filled teeth: type of coronal restoration and further procedures undertaken within the year. The treatment outcomes were compared with the preoperative variables and in a logistic regression analysis. Results: Complete data were available for 240 patients (98.8%): 128 women and 112 men, with a mean age of 48.5 years (SD = 16.3). Molar teeth predominated (n = 113, 47.1%). Most cases were completed with a root filling (n = 169, 70.4%). The remainder were extracted (n = 32, 13.3%) or were still uncompleted (n = 39, 16.3%). On average, a root filling was completed in 2.4 (SD = 0.9) appointments, or extraction at the third appointment (SD = 1.6). The molars were less often completed and often predominant among the extracted teeth. The indication for extraction was often for endodontic or RCT‐related reasons. Most complications were registered in the molars and antibiotics were prescribed in 20 cases. Most root filled teeth were restored with a direct restoration. Four root filled teeth (2.4%) were extracted within the time period. Conclusions: Patient records, followed from the start of treatment, show that 12 months on, the root filling had not been completed in just under 30% of the teeth. Of these, about half were extracted. Of particular concern is the outcome for endodontic treatment of molar teeth. In the general practice setting, molar endodontics are not only technically challenging but also very demanding in terms of chairside resources. In the present study, a successful outcome was achieved in just over half the cases. [ABSTRACT FROM AUTHOR]

Objectives: To explore the impact of anti‐hypertensive treatment of pregnancy‐induced hypertension on foetal growth and hemodynamics in women with pre‐existing diabetes. Methods: A prospective cohort study of 247 consecutive pregnant women with pre‐existing diabetes (152 type 1 diabetes; 95 type 2 diabetes), where tight anti‐hypertensive treatment was initiated and intensified (mainly with methyldopa) when office blood pressure (BP) ≥135/85 mmHg and home BP ≥130/80 mmHg. Foetal growth was assessed by ultrasound at 27, 33 and 36 weeks and foetal hemodynamics were assessed by ultrasound Doppler before and 1–2 weeks after initiation of anti‐hypertensive treatment. Results: In 215 initially normotensive women, anti‐hypertensive treatment for pregnancy‐induced hypertensive disorders was initiated in 42 (20%), whilst 173 were left untreated. Chronic hypertension was present in 32 (13%). Anti‐hypertensive treatment for pregnancy‐induced hypertensive disorders was not associated with foetal growth deviation (linear mixed model, p = 0.681). At 27 weeks, mainly before initiation of anti‐hypertensive treatment, the prevalence of small foetuses with an estimated foetal weight <10th percentile was 12% in women initiating anti‐hypertensive treatment compared with 4% in untreated women (p = 0.054). These numbers were close to the prevalence of birth weight ≤10th percentile (small for gestational age (SGA)) (17% vs. 4%, p = 0.003). Pulsatility index in the umbilical and middle cerebral artery remained stable after the onset of anti‐hypertensive treatment in a representative subgroup (n = 12, p = 0.941 and p = 0.799, respectively). Conclusion: There is no clear indication that antihypertensive treatment causes harm in this particular at‐high‐risk group of pregnant women with diabetes, such that a larger well‐designed study to determine the value of tight antihypertensive control would be worthwhile. [ABSTRACT FROM AUTHOR]

Aim: To translate and validate the Index of Professional Nursing Governance (IPNG) 2.0 and assess the state of professional nursing governance in Finland. Background: Raising and maintaining quality of care while retaining staff are common problems in healthcare globally. Professional governance is a modern way to tackle them, but a reliable instrument is needed to measure the state of nursing governance in Finland, and elsewhere. Methods: The IPNG that was translated into Finnish by forward‐backward translation, culturally adapted and pilot tested with 20 nurses. A sample of 419 nurses was utilised in a cross‐sectional study to assess the state of professional governance in Finland 2018. Results: Principal component analysis yielded six components with good Cronbach's α values. The results clearly indicate that the IPNG version developed and evaluated in this study has suitable psychometric properties for use in Finnish healthcare settings. The validated IPNG scores indicate that nursing governance in Finland is in the professional governance range. The staff have some input in the governance of Finnish healthcare organisations. However, this perception is strongest among the nurse leaders and experts; other groups do not perceive much change yet. Conclusion: Participants, particularly nurse leaders in Finland, had self‐reported impact in decision‐making. The translated IPNG has acceptable internal consistency and can be used to assess healthcare organisations' governance models in Finland and broader in Nordic countries and Europe. [ABSTRACT FROM AUTHOR]

Leeches play important roles in food webs due to their abundance, diversity and feeding habits. Studies using invertebrate‐derived DNA (iDNA) extracted from leech gut contents to target vertebrate DNA have focused on the Indo‐Pacific region and mainly leveraged the leech family Haemadipsidae, composed of bloodfeeding terrestrial leeches, while predatory, fluid/tissue‐feeding and aquatic bloodfeeding species have been largely disregarded. While there is some general knowledge regarding the taxonomic groups that leeches prefer to feed on, detailed taxonomic resolution is missing and, therefore, their potential use for monitoring animals is unknown. In this study, 116 leeches from 12 species (six families) and spanning the three feeding habits were collected in Mexico and Canada. We used DNA metabarcoding to investigate their diet and assess their potential use for biodiversity monitoring. We detected vertebrates from five orders including fish, turtles and birds in the diet of aquatic bloodfeeding leeches; eight invertebrate orders of annelids, arthropods and molluscs in leeches that feed on body fluids and tissues; and 10 orders of invertebrates belonging to Arthropoda and Annelida, as well as one vertebrate and one parasitic nematode, in predatory leeches. These results show the potential use of iDNA from aquatic bloodfeeding leeches for retrieving vertebrate taxa, and from predatory and fluid‐feeding leeches for invertebrates. Our study provides information about the dietary range of freshwater leeches and one terrestrial leech and contributes proof‐of‐concept for the use of these leeches for animal monitoring, expanding our knowledge of the use of iDNA from leech gut contents to North America. [ABSTRACT FROM AUTHOR]

Introduction: People with type 2 diabetes have increased risk of dementia. Glucagonlike peptide-1 (GLP-1) receptor agonists (RAs) are among the promising therapies for repurposing as a treatment for Alzheimer's disease; a key unanswered question is whether they reduce dementia incidence in people with type 2 diabetes. Methods: We assessed exposure to GLP-1 RAs in patients with type 2 diabetes and subsequent diagnosis of dementia in two large data sources with long-term followup: pooled data from three randomized double-blind placebo-controlled cardiovascular outcome trials (15,820 patients) and a nationwide Danish registry-based cohort (120,054 patients). Results: Dementia rate was lower both in patients randomized to GLP-1 RAs versus placebo (hazard ratio [HR]: 0.47 (95% confidence interval [CI]: 0.25-0.86) and in the nationwide cohort (HR: 0.89; 95% CI: 0.86-0.93 with yearly increased exposure to GLP-1 RAs). Discussion: Treatment with GLP-1 RAs may provide a new opportunity to reduce the incidence of dementia in patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]

The population numbers of taiga bean goose (Anser fabalis fabalis) have halved during recent decades. Since this subspecies is hunted throughout most of its range, the decline is of management concern. Knowledge of the genetic population structure and diversity is important for guiding management and conservation efforts. Genetically unique subpopulations might be hunted to extinction if not managed separately, and any inbreeding depression or lack of genetic diversity may affect the ability to adapt to changing environments and increase extinction risk. We used microsatellite and mitochondrial DNA markers to study the genetic population structure and diversity among taiga bean geese breeding within the Central flyway management unit using non‐invasively collected feathers. We found some genetic structuring with the maternally inherited mitochondrial DNA between four geographic regions (ɸST = 0.11–0.20) but none with the nuclear microsatellite markers (all pairwise FST‐values = 0.002–0.005). These results could be explained by female natal philopatry and male‐biased dispersal, which completely homogenizes the nuclear genome. Therefore, the population could be managed as a single unit. Genetic diversity was still at a moderate level (average HE = 0.69) and there were no signs of past population size reductions, although significantly positive inbreeding coefficients in all sampling sites (FIS = 0.05–0.10) and high relatedness values (r = 0.60–0.86) between some individuals could indicate inbreeding. In addition, there was evidence of either incomplete lineage sorting or introgression from the pink‐footed goose (Anser brachyrhynchus). The current population is not under threat by genetic impoverishment but monitoring in the future is desirable. [ABSTRACT FROM AUTHOR]

Aims: To describe the quality of care for older cancer patients in acute care settings as perceived by the responsible nursing staff. Methods: A cross-sectional study design was used. Data were collected using a questionnaire completed by 90 nursing staff at a university hospital and a city hospital. Quality of care was measured using the Revised Humane Caring Scale. Descriptive statistics, reliability analysis, nonparametric tests and linear regression analysis were used to analyse the data. Findings: Generally, the nursing staff perceived the quality of care as good; however, university hospital nursing staff perceived the quality of care to be better than city hospital nursing staff. Compared with other age groups, nursing staff in the 30- to 40-year age group more frequently indicated that patients' information and participation need improvement. Moreover, supplemental education in cancer care was found to have no significant impact on the quality of care. Altogether, nursing staff disagreed the most about their perceptions of staffing, sufficient time and an unhurried atmosphere. Conclusion: Nursing staff should focus more on patients' personal needs, particularly with regard to patients' provision of information and participation in care. Younger nurses need more support and mentoring about complex care from their experienced colleagues when performing their work. Leaders should guarantee availability of the adequate number of competent staff in hospital wards. [ABSTRACT FROM AUTHOR]

Aim: To document satisfaction with root canal treatment procedures and outcomes among patients treated at Swedish public dental clinics. Method: The original material comprised 243 patients who began root canal treatment (RCT) at 20 public dental clinics in the county of Västra Götaland, Sweden. One to three years later, 236 (97.1%) were posted a questionnaire of eight items, rating patient perceptions of RCT completion, present pain intensity and satisfaction with the RCT. To evaluate the reliability of the original responses, the first 50 respondents were mailed a follow‐up questionnaire. Both descriptive and analytical statistics were used to compare respondents and nonrespondents and tooth groups. Results: One hundred and fifty‐nine patients (67.4%) responded: 86 (54.1%) women and 73 (45.9%) men. The mean age 52.5 years, was higher than for nonrespondents (p <.001). A completed root filling was registered for the majority of the teeth (n = 112, 70.9%), but significantly fewer molars had been completed (n = 46, 59.7%, p =.02). Fifty per cent (n = 59) of the patients reported current pain, mostly mild in intensity (n = 45, 38.1%). One hundred and twenty‐three patients (80.9%) recalled experiencing pain during RCT. The highest satisfaction was registered for the item 'chewing ability' (mean = 1.6, SD = 1.9). The majority of patients (n = 114, 75.0%) stated that in retrospect they would still have chosen RCT. However, these patients belonged to the group which either registered the tooth as still present or had not experienced much discomfort during or after RCT. Forty‐four patients (88.0%) responded to the second questionnaire. The reliability of the responses was good. In summary, one to 3 years after beginning RCT at a public dental clinic, patient satisfaction was high, even though every fourth molar had been extracted or treatment had not been completed and half the patients reported persistent pain. The reliability of the patients' responses was considered to be good. Conclusions: The results indicate a need for further clinical observational studies of RCTs undertaken in general dental practice, with special reference to patient‐centred outcomes. [ABSTRACT FROM AUTHOR]