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Background Aim Method Results Conclusion Effective eating disorder (ED) treatments are drastically needed for patients with experiences of sustained and prolonged emotional, physical and sexual childhood maltreatment (CM) that often results in post‐traumatic sequelae such as severe, complex posttraumatic stress disorder (cPTSD). EDs with comorbid cPTSD (cPTSD‐ED) have protracted treatment courses and poorer prognoses.To summarise the knowledge base on cPTSD‐ED with specific emphasis on disturbances in self‐organisation (DSO) in relation to therapeutic alliance (TA) processes.Expert opinions based on current relevant literature are critically examined.Preliminary insights on change and alliance processes suggest that neglecting to address emotional‐relational processes in the conceptualisation and treatment of cPTSD‐ED impedes treatment progress.We hypothesise that the DSO construct inherent in cPTSD‐ED calls for a focus on TA processes in addition to traditional ED treatment elements such as nutritional rehabilitation and behaviour change, and regardless of ED treatment provided. More process research on a larger scale is urgently called for. [ABSTRACT FROM AUTHOR]

Objective Background Methods Results Conclusion To determine the association between human leukocyte antigen (HLA) alleles and migraine, migraine subtypes, and sex‐specific factors.It has long been hypothesized that inflammation contributes to migraine pathophysiology. This study examined the association between migraine and alleles in the HLA system, a key player in immune response and genetic diversity.We performed a case–control study and included 13,210 individuals with migraine and 86,738 controls. All participants were part of the Danish Blood Donor Study Genomic Cohort. Participants were genotyped and 111 HLA alleles on 15 HLA genes were imputed. We examined the association between HLA alleles and migraine subtypes, considering sex‐specific differences.We found no association between HLA alleles and migraine, neither overall, nor in the sex‐specific analysis. In the migraine subtype analysis, three HLA alleles were associated with migraine without aura; however, these associations could not be replicated in an independent Icelandic cohort (2191 individuals with migraine without aura and 278,858 controls). Furthermore, we found no association between HLA alleles and migraine with aura or chronic migraine.We found no evidence of an association between the HLA system and migraine, suggesting that genetic factors related to the HLA system do not play a significant role in migraine susceptibility. [ABSTRACT FROM AUTHOR]

Objectives: Dravet syndrome is a developmental and epileptic encephalopathy characterized by early onset epilepsy with multiple seizure types often intractable to treatment. Randomized clinical trials have demonstrated how treatment with fenfluramine significantly reduces seizure frequency in patients with Dravet syndrome. The study aims to (1) describe the efficacy and tolerability of fenfluramine in a Danish cohort of patients with Dravet syndrome; and (2) evaluate whether treatment with fenfluramine reduces epilepsy‐related hospital contacts administrated by pediatricians or epilepsy‐trained nurses. Methods: A retrospective registry‐based cohort study at the Danish Epilepsy Centre, Filadelfia, Dianalund, Denmark, enrolled 30 pediatric patients with Dravet syndrome treated with fenfluramine between 2017 and 2023. Results: Thirty patients with Dravet syndrome (aged 3–21 years, 12 females) with a verified pathogenic SCN1A variant were included. They were treated with fenfluramine at a mean duration of 29 months with a mean maintenance dose of 0.5 mg/kg/day. The number of patient‐years on treatment was 75 years. At last follow‐up, 6 patients had discontinued treatment due to lack of efficacy or adverse effects. In the remaining 24 patients, generalized tonic–clonic seizures were reduced by ≥30% in 83%, by ≥50% in 67%, and by 100% in 25%. Additionally, 71% of the patients were reduced in concomitant anti‐seizure medication, and 75% experienced a reduction (mean reduction at 52%, range 11%–94%) in epilepsy‐related hospital contacts from baseline to the end of the treatment period. Significance: Treatment with fenfluramine effectively reduced seizure frequency and concomitant antiseizure medication in patients with Dravet syndrome. Furthermore, a decrease in epilepsy‐related contacts by 80% was observed over 6 years of treatment, which may indicate cost‐effective benefits. Plain Language Summary: Patients with Dravet syndrome suffer from severe epileptic seizures that are difficult to treat with medication. Earlier, treatment with fenfluramine (an anti‐seizure medication) has been documented to decrease the total number of seizures in patients with Dravet syndrome. This publication summarizes the experiences with fenfluramine in children with Dravet syndrome at the Danish Epilepsy Centre, Filadelfia, Dianalund, Denmark. Our publication also illustrates that treatment with fenfluramine may reduce the patients' number of yearly contacts with doctors and nurses specialized in epilepsy treatment, which may indicate cost‐effectiveness. [ABSTRACT FROM AUTHOR]

Objective: This scoping review aimed to summarize current knowledge from twin studies on migraine. Migraine heritability, genetic correlations with migraine comorbid disorders, and the use of discordant twin pairs in migraine research are described. Further, the review considers the unused potential of twin studies in migraine research and reflects on future directions. Background: Twin studies can be used to understand how heritable and environmental factors influence human traits and disorders. The classical twin design compares the resemblance of a trait in monozygotic twins to that in dizygotic twins. The classical twin design can be extended to estimate the genetic correlation between disorders, model causality, and describe differences within discordant twin pairs. Methods: Studies focusing on migraine and using a twin study design were included. The search was performed on the PubMed‐MEDLINE database using the search terms "migraine" AND "twin" OR "twins." It was done in May 2023, rerun in November 2023, and managed with the Covidence software. Results: The search identified 52 twin studies on migraine. In 24 papers, the heritability of migraine was estimated with a classical twin design. Heritability estimates ranged from 0.36 to 0.48 for studies with adults, both men and women, and unspecified migraine. Migraine heritability was predominantly estimated with twin cohorts of North European ancestry, and only two studies examined migraine subtypes. A multilevel classical twin design was used in 11 studies to examine the co‐occurrence between migraine and comorbid disorders. The differences within migraine discordant twin pairs were examined in nine studies. Conclusion: The heritability of migraine was estimated with a classical twin design in twin cohorts from seven different countries, with remarkably similar results across studies. Future studies should include migraine subtypes and twin cohorts of non‐North European ancestry to better reflect the global population. Beyond heritability estimations, the twin method is a valuable tool for understanding causality and describing differences within discordant twin pairs. Despite more than 80 years of twin studies in migraine research, the twin design has a large unused potential to advance our understanding of migraine. Plain Language Summary: This review summarizes what has been learned about the inheritance of migraine from studies with twins. Studies with adults, both men and women, estimated the inheritance of migraine at about 36%–48%. However, most of these studies included twins with North European ancestry, and future studies should include twins from different parts of the world to understand how migraine affects people globally. [ABSTRACT FROM AUTHOR]

Formation of large colonies by phytoplankton is considered a disadvantage during low nutrient and non‐turbulent conditions because of diffusion limitation and competition by neighboring cells. This is assumed by diffusion models and not empirical measurements. Here, we measured cell‐specific dissolved inorganic carbon (DIC) and nitrate (NO3−$$ {\mathrm{NO}}_3^{-} $$) assimilation in two chain‐forming Skeletonema marinoi strains by combining secondary ion mass spectrometry with stable isotopic tracer incubations. The pelagic strains were recently germinated from resting stages and thus not adapted to high nutrient regimes of laboratory cultures. During the exponential phase, the cells assimilated excess NO3−$$ {\mathrm{NO}}_3^{-} $$ relative to DIC. The DIC and NO3−$$ {\mathrm{NO}}_3^{-} $$ assimilation varied with chain length or the position of the cell within chains but did not follow any consistent trend. Solitary cells were rare and did not exceed 6% of all cells. During the nitrogen‐limited stationary phase, NO3−$$ {\mathrm{NO}}_3^{-} $$ assimilation was lower than modeled by mass transfer theory at diffusion limitation. NO3−$$ {\mathrm{NO}}_3^{-} $$ assimilation rates were apparently limited by the biological uptake rate at nitrate concentrations < 0.46 μmol L−1. We conclude that S. marinoi is adapted to high nutrient concentrations and may seldom be diffusion limited in coastal waters with ambient NO3−$$ {\mathrm{NO}}_3^{-} $$ concentrations > 0.46 μmol L−1. These findings contrast those previously reported in larger chain forming diatoms, for example, Chaetoceros, which appear to circumvent diffusion limitation at low ambient NO3−$$ {\mathrm{NO}}_3^{-} $$ concentrations and succeed S. marinoi during spring blooms. [ABSTRACT FROM AUTHOR]

Societal Impact Statement: Efficient mitigation of climate change requires predictive models of forest ecosystems as sinks for atmospheric carbon. Mycorrhizal fungi are drivers of soil carbon storage in boreal forests, yet they are typically excluded from ecosystem models, because of a lack of information about their growth and turnover. Closing this knowledge gap could help us better predict future responses to climate change and guide policy decisions for sustainable management of forest ecosystems. This study provides new estimates of the production and turnover of mycorrhizal mycelial biomass and necromass. This information can facilitate the integration of mycorrhizal fungi into new predictive models of boreal forest soils. Summary: In boreal forests, turnover of biomass and necromass of ectomycorrhizal extraradical mycelia (ERM) are important for mediating long‐term carbon storage. However, ectomycorrhizal fungi are usually not considered in ecosystem models, because data for parameterization of ERM dynamics is lacking.Here, we estimated the production and turnover of ERM biomass and necromass across a hemiboreal Pinus sylvestris chronosequence aged 12 to 100 years. Biomass and necromass were quantified in sequentially harvested in‐growth bags, and incubated in the soil for 1–24 month, and Bayesian calibration of mathematical models was applied to arrive at parametric estimates of ERM production and turnover rates of biomass and necromass.Steady states were predicted to be nearly reached after 160 and 390 growing season days, respectively, for biomass and necromass. The related turnover rates varied with 95% credible intervals of 1.7–6.5 and 0.3–2.5 times yr−1, with mode values of 2.9 and 0.9 times yr−1, corresponding to mean residence times of 62 and 205 growing season days.Our results highlight that turnover of necromass is one‐third of biomass. This together with the variability in the estimates can be used to parameterize ecosystem models, to explicitly include ERM dynamics and its impact on mycorrhizal‐derived soil carbon accumulation in boreal forests. [ABSTRACT FROM AUTHOR]

Introduction: Existential loneliness (EL) is an unavoidable, deeper sense of loneliness. EL has been described as disconnection from life and the universe, experienced even in the presence of family and friends. Meaninglessness, loss of health and significant others seem to trigger older persons EL. Older Arabic‐speaking women are a large migrant group in Sweden and there is a lack in knowledge about their experience of EL. Therefore, this study aimed to describe the phenomenon of EL as experienced by older Arabic‐speaking female migrants. Methods: This study was based on a phenomenological approach known as reflective lifeworld research (RLR). Ten older migrated Arabic‐speaking women were included in the study. Lifeworld interviews were conducted to collect data. The data were analysed in accordance with the phenomenological RLR principles of openness, flexibility and bridling. Results: This study shows that EL is experienced when there is a lack of attachment to place and people. EL is experienced more distinctively in the beginning of the migration process. It was difficult sharing feelings of EL with anyone. Feelings of meaninglessness occurred when entering a new lifeworld and triggered EL. EL was however attenuated when being able to practise their religion. Conclusion: Lack of attachment to place and people as well as feelings of meaninglessness brought existential loneliness to the fore for the older Arabic‐speaking female migrants. There was a collision of lifeworlds not at least by the fact moving as a Muslim woman to one of the most secular countries in the world. Practising their religion attenuated their EL. To promote better health for this group of women, it is of importance to be aware of EL and its mode of expression. Implications for Practice: It is crucial to let the voice of older Arabic‐speaking female migrants be heard and to be aware of their experience of EL and its mode of expression in order to promote better health. Further, educational training for nursing professionals and nursing students needs to be provided to develop skills how to be aware of and address EL. [ABSTRACT FROM AUTHOR]

Objective: Emerging research suggests that rheumatoid arthritis (RA) is associated with intestinal dysbiosis. This prospective pilot study evaluates changes in intestinal microbial composition in patients with RA initiating treatment with either methotrexate (MTX) or a tumor necrosis factor inhibitor (TNFi). Methods: Consecutive patients, fulfilling the 2010 American College of Rheumatology/EULAR classification criteria for RA, who started treatment with either MTX or TNFi delivered a stool sample upon initiation of immunosuppression and 3 months later. A 16S ribosomal RNA gene‐based validated microbiota test (GA‐map Dysbiosis Index Score [DIS], Genetic Analysis, Oslo, Norway) was used to evaluate for the presence and degree of dysbiosis. Fecal levels of Prevotella copri (P. copri) were analyzed by custom‐made quantitative polymerase chain reaction. Changes in microbial composition were analyzed in relation to changes in disease activity, as measured by the disease activity score based on 28‐joint counts, using C‐reactive protein. Results: At baseline, dysbiosis was present in 33 of 50 (66%) participants and more common in participants with more than 2 years of disease duration (P = 0.019). At the 3‐month follow‐up, 27 of 50 (54%) were good treatment responders and the DIS had improved in 14 of 50 (28%). Participants initiating TNFi more often exhibited improvement in the DIS compared with those initiating MTX (P = 0.031). P. copri was identified in 32 of 50 (64%) at baseline. An improvement in disease activity score based on 28‐joint counts, using C‐reactive protein was associated with a simultaneous decrease in P. copri abundance (rs = 0.30, P = 0.036). Conclusion: This study affirms that dysbiosis is a feature of RA. Although patients were not randomized to MTX or TNFi, the findings suggest that specific therapies may differentially modulate the gastrointestinal microbiota in RA. The association between P. copri and treatment response requires further study. [ABSTRACT FROM AUTHOR]

Objective: Standardised person‐reported outcomes (PRO) data can contextualise clinical outcomes enabling precision diabetes monitoring and care. Comprehensive outcome sets can guide this process, but their implementation in routine diabetes care has remained challenging and unsuccessful at international level. We aimed to address this by developing a person‐centred outcome set for Type 1 and Type 2 diabetes, using a methodology with prospects for increased implementability and sustainability in international health settings. Methods: We used a three‐round questionnaire‐based Delphi study to reach consensus on the outcome set. We invited key stakeholders from 19 countries via purposive snowball sampling, namely people with diabetes (N = 94), healthcare professionals (N = 65), industry (N = 22) and health authorities (N = 3), to vote on the relevance and measurement frequency of 64 previously identified clinical and person‐reported outcomes. Subsequent consensus meetings concluded the study. Results: The list of preliminary outcomes was shortlisted via the consensus process to 46 outcomes (27 clinical outcomes and 19 PROs). Two main collection times were recommended: (1) linked to a medical visit (e.g. diabetes‐specific well‐being, symptoms and psychological health) and (2) annually (e.g. clinical data, general well‐being and diabetes self management‐related outcomes). Conclusions: PROs are often considered in a non‐standardised way in routine diabetes care. We propose a person‐centred outcome set for diabetes, specifically considering psychosocial and behavioural aspects, which was agreed by four international key stakeholder groups. It guides standardised collection of meaningful outcomes at scale, supporting individual and population level healthcare decision making. It will be implemented and tested in Europe as part of the H2O project. [ABSTRACT FROM AUTHOR]

Summary: Seasonal dynamics of root growth play an important role in large‐scale ecosystem processes; they are largely governed by growth regulatory compounds and influenced by environmental conditions. Yet, our knowledge about physiological drivers of root growth is mostly limited to laboratory‐based studies on model plant species.We sampled root tips of Eriophorum vaginatum and analyzed their auxin concentrations and meristem lengths biweekly over a growing season in situ in a subarctic peatland, both in surface soil and at the permafrost thawfront.Auxin concentrations were almost five times higher in surface than in thawfront soils and increased over the season, especially at the thawfront. Surprisingly, meristem length showed an opposite pattern and was almost double in thawfront compared with surface soils. Meristem length increased from peak to late season in the surface soils but decreased at the thawfront.Our study of in situ seasonal dynamics in root physiological parameters illustrates the potential for physiological methods to be applied in ecological studies and emphasizes the importance of in situ measurements. The strong effect of root location and the unexpected opposite patterns of meristem length and auxin concentrations likely show that auxin actively governs root growth to ensure a high potential for nutrient uptake at the thawfront. [ABSTRACT FROM AUTHOR]

Human‐mediated dispersal of non‐native earthworms can cause substantial changes to the functioning and composition of ecosystems previously earthworm‐free. Some of these earthworm species have the potential to "geoengineer" soils and increase plant nitrogen (N) uptake. Yet the possible consequences of increased plant N concentrations on rodent grazing remains poorly understood. In this study, we present findings from a common garden experiment with two tundra communities, meadow (forb dominated) and heath (shrub dominated), half of them subjected to 4 years of earthworm presence (Lumbricus spp. and Aporrectodea spp.). Within four summers, our earthworm treatment changed plant community composition by increasing graminoid density by, on average, 94% in the heath vegetation and by 49% in the meadow. Rodent winter grazing was more intense on plants growing in soils with earthworms, an effect that coincided with higher N concentrations in plants, indicating a higher palatability. Even though earthworms reduced soil moisture, plant community productivity, as indicated by vegetation greenness (normalized difference vegetation index), was not negatively impacted. We conclude that earthworm‐induced changes in plant composition and trophic interactions may fundamentally alter the functioning of tundra ecosystems. [ABSTRACT FROM AUTHOR]

Premise: Cultivation and naturalization of plants beyond their natural range can bring previously geographically isolated taxa together, increasing the opportunity for hybridization, the outcomes of which are not predictable. Here, we explored the phenotypic and genomic effects of interspecific gene flow following the widespread cultivation of Mentha spicata (spearmint), M. longifolia, and M. suaveolens. Methods: We morphologically evaluated 155 herbarium specimens of three Mentha species and sequenced the genomes of a subset of 93 specimens. We analyzed the whole genomes in a population and the phylogenetic framework and associated genomic classifications in conjunction with the morphological assessments. Results: The allopolyploid M. spicata, which likely evolved in cultivation, had altered trichome characters, that is possibly a product of human selection for a more palatable plant or a byproduct of selection for essential oils. There were signs of genetic admixture between mints, including allopolyploids, indicating that the reproductive barriers between Mentha species with differences in ploidy are likely incomplete. Still, despite gene flow between species, we found that genetic variants associated with the cultivated trichome morphology continue to segregate. Conclusions: Although hybridization, allopolyploidization, and human selection during cultivation can increase species richness (e.g., by forming hybrid taxa), we showed that unless reproductive barriers are strong, these processes can also result in mixing of genes between species and the potential loss of natural biodiversity. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to monitor changes in Osteoprotegerin (OPG) and receptor activator of nuclear factor‐kappa ligand (RANKL) levels in the saliva during orthodontic tooth movement (OTM). Materials and Methods: Nine healthy females (15–20 y of age) with four pre‐molar extractions and fixed appliance were included. In total, 134 stimulated and 134 unstimulated saliva samples were collected: at baseline and then every 6–8 weeks at follow‐up appointments during the whole orthodontic treatment. Twelve age‐matched females with no active orthodontic treatment served as a control group. Saliva samples were analysed by enzyme‐linked immunosorbent assay (Elisa). The mean levels of OPG and RANKL were calculated according to the different orthodontic treatment stages: alignment, space closure and finishing. A mixed model analysis was used to compare the means of treatment stages. Baseline OPG levels were compared with the control group using an independent t‐test. OPG levels were measured in stimulated saliva due to low levels in unstimulated saliva. Results: No significant difference was observed between baseline OPG values and the control group. OPG increased significantly at all treatment stages: alignment, space closure and finishing compared with baseline (P = 0.002, P = 0.039, P ≤ 0.001, respectively). The salivary levels of OPG increased gradually, except during space closure, reaching peak levels at finishing. RANKL was undetectable in stimulated and unstimulated saliva by sandwich Elisa during OTM. Conclusions: This novel approach shows the changes in the levels of OPG in OTM and indicates how and when to sample saliva during orthodontic treatment to analyse bone remodelling. [ABSTRACT FROM AUTHOR]

The release of extracellular vesicles (EVs) in cell cultures as well as their molecular cargo can be influenced by cell culture conditions such as the presence of foetal bovine serum (FBS). Although several studies have evaluated the effect of removing FBS‐derived EVs by ultracentrifugation (UC), less is known about the influence of FBS heat inactivation (HI) on the cell‐derived EVs. To assess this, three protocols based on different combinations of EV depletion by UC and HI were evaluated, including FBS ultracentrifuged but not heat inactivated (no‐HI FBS), FBS heat inactivated before EV depletion (HI‐before EV‐depl FBS), and FBS heat inactivated after EV depletion (HI‐after EV‐depl FBS). We isolated large (L‐EVs) and small EVs (S‐EVs) from FBS treated in the three different ways, and we found that the S‐EV pellet from HI‐after EV‐depl FBS was larger than the S‐EV pellet from no‐HI FBS and HI‐before EV‐depl FBS. Transmission electron microscopy, protein quantification, and particle number evaluation showed that HI‐after EV‐depl significantly increased the protein amount of S‐EVs but had no significant effect on L‐EVs. Consequently, the protein quantity of S‐EVs isolated from three cell lines cultured in media supplemented with HI‐after EV‐depl FBS was significantly increased. Quantitative mass spectrometry analysis of FBS‐derived S‐EVs showed that the EV protein content was different when FBS was HI after EV depletion compared to EVs isolated from no‐HI FBS and HI‐before EV‐depl FBS. Moreover, we show that several quantified proteins could be ascribed to human origin, thus demonstrating that FBS bovine proteins can mistakenly be attributed to human cell‐derived EVs. We conclude that HI of FBS performed after EV depletion results in changes in the proteome, with molecules that co‐isolate with EVs and can contaminate EVs when used in subsequent cell cultures. Our recommendation is, therefore, to always perform HI of FBS prior to EV depletion. [ABSTRACT FROM AUTHOR]

The on‐going climate warming is promoting shrub abundance in high latitudes, but the effect of this phenomenon on ecosystem functioning is expected to depend on whether deciduous or evergreen species increase in response to warming.To explore effects of long‐term warming on shrubs and further on ecosystem functioning, we analysed vegetation and ecosystem CO2 exchange after 20 years of warming in the forest–tundra ecotone in subarctic Sweden. A previous study conducted 9 years earlier had found increased evergreen Empetrum nigrum ssp. hermaphroditum in the forest and increased deciduous Betula nana in the tundra.Following current understanding, we expected continued increase in shrub abundance that would be stronger in tundra than in forest. We expected warming to increase ecosystem respiration (Re) and gross primary productivity (GPP), with a greater increase in Re in tundra due to increased deciduous shrub abundance, leading to a less negative net ecosystem exchange and reduced ecosystem C sink strength.As predicted, vascular plant abundances were higher in the warmed plots with a stronger response in tundra than in forest. However, whereas B. nana had increased in abundance since the last survey, E. hermaphroditum abundance had declined due to several moth and rodent outbreaks during the past decade. In contrast to predictions, Re was significantly lower in the warmed plots irrespective of habitat, and GPP increased marginally only in the forest. The lower Re and a higher GPP under warming in the forest together led to increased net C sink. Re was negatively associated with the total vascular plant abundance.Our results highlight the importance of disturbance regimes for vegetation responses to warming. Climate warming may promote species with both a high capacity to grow under warmer conditions and a resilience towards herbivore outbreaks. Negative correlation between Re and total vascular plant abundance further indicate that the indirect impacts of increased plants on soil microclimate may become increasingly important for ecosystem CO2 exchange in the long run, which adds to the different mechanisms that link warming and CO2 fluxes in northern ecosystems. Read the free Plain Language Summary for this article on the Journal blog. [ABSTRACT FROM AUTHOR]

Introduction: Hyperemesis gravidarum affects 0.3%–3% of pregnant women each year and is the leading cause of hospitalization in early pregnancy. Previous systematic reviews of available treatments have found a lack of consistent evidence, and few studies of high quality. Since 2016, no systematic review has been conducted and an up‐to date review is requested. In a recent James Lind Alliance collaboration, it was clear that research on effective treatments is a high priority for both patients and clinicians. Material and methods: Searches without time limits were performed in the AMED, CINAHL, Cochrane Library, EMBASE, Medline, PsycINFO, and Scopus databases until June 26, 2023. Studies published before October 1, 2014 were identified from the review by O'Donnell et al., 2016. Selection criteria were randomized clinical trials and non‐randomized studies of interventions comparing treatment of hyperemesis gravidarum with another treatment or placebo. Outcome variables included were: degree of nausea; vomiting; inability to tolerate oral fluids or food; hospital treatment; health‐related quality of life, small‐for‐gestational‐age infant; and preterm birth. Abstracts and full texts were screened, and risk of bias of the studies was assessed independently by two authors. Synthesis without meta‐analysis was performed, and certainty of evidence was assessed using the GRADE approach. PROSPERO (CRD42022303150). Results: Twenty treatments were included in 25 studies with low or moderate risk of bias. The certainty of evidence was very low for all treatments except for acupressure in addition to standard care, which showed a possible moderate decrease in nausea and vomiting, with low certainty of evidence. Conclusions: Several scientific knowledge gaps were identified. Studies on treatments for hyperemesis gravidarum are few, and the certainty of evidence for different treatments is either low or very low. To establish more robust evidence, it is essential to use validated scoring systems, the recently established diagnostic criteria, clear descriptions and measurements of core outcomes and to perform larger studies. [ABSTRACT FROM AUTHOR]

Introduction: It is a shortcoming of traditional cardiotocography (CTG) classification table formats that CTG traces are frequently classified differently by different users, resulting in poor interobserver agreements. A fast‐and‐frugal tree (FFTree) flow chart may help provide better concordance because it is straightforward and has clearly structured binary questions with understandable "yes" or "no" responses. The initial triage to determine whether a fetus is suitable for labor when utilizing fetal ECG ST analysis (STAN) is very important, since a fetus with restricted capacity to respond to hypoxic stress may not generate STAN events and therefore may become falsely negative. This study aimed to compare physiology‐focused FFTree CTG interpretation with FIGO classification for assessing the suitability for STAN monitoring. Material and methods: A retrospective study of 36 CTG traces with a high proportion of adverse outcomes (17/36) selected from a European multicenter study database. Eight experienced European obstetricians evaluated the initial 40 minutes of the CTG recordings and judged whether STAN was a suitable fetal surveillance method and whether intervention was indicated. The experts rated the CTGs using the FFTree and FIGO classifications at least 6 weeks apart. Interobserver agreements were calculated using proportions of agreement and Fleiss' kappa (κ). Results: The proportions of agreement for "not suitable for STAN" were for FIGO 47% (95% confidence interval [CI] 42%–52%) and for FFTree 60% (95% CI 56–64), ie a significant difference; the corresponding figures for "yes, suitable" were 74% (95% CI 71–77) and 70% (95% CI 67–74). For "intervention needed" the figures were 52% (95% CI 47–56) vs 58% (95% CI 54–62) and for "expectant management" 74% (95% CI 71–77) vs 72% (95% CI 69–75). Fleiss' κ agreement on "suitability for STAN" was 0.50 (95% CI 0.44–0.56) for the FIGO classification and 0.57 (95% CI 0.51–0.63) for the FFTree classification; the corresponding figures for "intervention or expectancy" were 0.53 (95% CI 0.47–0.59) and 0.57 (95% CI 0.51–0.63). Conclusions: The proportion of agreement among expert obstetricians using the FFTree physiological approach was significantly higher compared with the traditional FIGO classification system in rejecting cases not suitable for STAN monitoring. That might be of importance to avoid false negative STAN recordings. Other agreement figures were similar. It remains to be shown whether the FFTree simplicity will benefit less experienced users and how it will work in real‐world clinical scenarios. [ABSTRACT FROM AUTHOR]

Extracellular vesicles (EVs) are lipid bilayer nanoparticles involved in cell‐cell communication that are released into the extracellular space by all cell types. The cargo of EVs includes proteins, lipids, nucleic acids, and metabolites reflecting their cell of origin. EVs have recently been isolated directly from solid tissues, and this may provide insights into how EVs mediate communication between cells in vivo. Even though EVs have been isolated from tissues, their point of origin when they are in the interstitial space has been uncertain. In this study, we performed three‐dimensional (3D) reconstruction using transmission electron tomography of metastatic and normal liver tissues with a focus on the presence of EVs in the interstitium. After chemical fixation of the samples and subsequent embedding of tissue pieces in resin, ultrathin slices (300 nm) were cut and imaged on a 120 ekV transmission electron microscopy as a tilt series (a series of subsequent images tilted at different angles). These were then computationally illustrated in a 3D manner to reconstruct the imaged tissue volume. We identified the cells delimiting the interstitial space in both types of tissues, and small distinct spherical structures with a diameter of 30–200 nm were identified between the cells. These round structures appeared to be more abundant in metastatic tissue compared to normal tissue. We suggest that the observed spherical structures in the interstitium of the metastatic and non‐metastatic liver represent EVs. This work thus provides the first 3D visualization of EVs in human tissue. [ABSTRACT FROM AUTHOR]

The diarylation and skeletal diversification of unstrained cyclic amines was exploited to expand and modify the favorable properties of this important substrate class with pivotal roles in drug discovery. Cyclic amines were employed in the synthesis of a novel class of amino‐substituted diaryliodonium salts, which were converted to highly functionalized diarylamines through an atom‐efficient one‐pot N‐arylation/ring opening reaction with external nucleophiles. The reaction proceeds through in situ formation of a diarylammonium intermediate that undergoes a nucleophilic ring opening by cleavage of the strong C−N bond. A wide variety of diarylamines was obtained through introduction of two different aryl groups of varied electronics, and the retained iodo‐substituent enables downfield diversifications of the products. More than 20 nucleophiles, including amines, phenols, carboxylic acids, thiols and halides, were alkylated with high functional group tolerance, and the strategy proved efficient also in in late‐stage functionalization of natural products and pharmaceuticals. [ABSTRACT FROM AUTHOR]

Conservation and restoration planning of extremely rare species relies on an understanding of the genetic diversity and population dynamics within a species to overcome potential inbreeding depression. Nānū or Nāʻū (Gardenia remyi H. Mann.) is an endemic tree native to the Hawaiian Islands and is one of more than 200 endangered plant species in Hawaiʻi with less than 50 individuals remaining in the wild. Efforts to understand the genetic diversity and connectivity between wild populations are foundational to conservation management plans, however little is known of the population structure of the species. In this study we utilize double digest restriction‐site associated sequencing (ddRADSeq) on both historical herbarium specimens and samples from living ex situ collections to: (1) Test the hypothesis that we can capture genetic diversity in herbarium material of G. remyi using ddRADSeq, and (2) test the hypothesis that there are genetically distinct populations or subpopulation units among different Hawaiian islands. Usable sequencing data from thirty‐seven samples of herbarium specimens collected between 1952 and 2017 and twenty wild sourced living collection samples were obtained representing all four islands where G. remyi is known to occur. Phylogenetic and population structure analysis revealed a monophyletic ingroup and a clear division between G. remyi samples of the northern island of Kauaʻi and those from the more southeastern younger islands of Molokaʻi, Maui and Hawaiʻi islands. The Kauaʻi samples were further split into a subpopulation from Southern Kauaʻi and the subpopulations from Northern Kauaʻi. Some admixed samples were detected. Our results are consistent with subpopulations of G. remyi, which needs to be considered in future conservation planning and breeding efforts to minimize inbreeding depression. [ABSTRACT FROM AUTHOR]

This article focuses on migrant labour in Nordic agriculture, wild berry picking and food processing. The starting point is the fear of a food crisis at the beginning of the coronavirus pandemic (2020) because of the absence of migrant workers. The question was raised early in the pandemic if food systems in the Global North are vulnerable due to dependence on precarious migrant workers. In the light of this question, we assess the reactions of farmers and different actors in Denmark, Finland, Norway and Sweden to what looked like an unfolding food crisis. In many ways, the reactions in the Nordic countries were similar to each other, and to broader reactions in the Global North, and we follow these reactions as they relate to migrant workers from an initial panic to a return to business as usual despite the continuation of the pandemic. In the end, 2020 proved to be an excellent year for Nordic food production in part because migrant workers were able to come. We discuss reasons why the Nordic countries did not face disruptions during the pandemic, map out patterns of labour precarity and segmentation for migrant labour in agriculture and food production in the Nordic countries and propose questions for further research. [ABSTRACT FROM AUTHOR]

Our group has reported several one‐pot protocols for the synthesis of diaryliodonium salts, which have been recognized as attractive multi‐purpose reagents in areas ranging from organic synthesis to materials chemistry. Over the years, we have identified limitations in the published protocols concerning synthesis of mixed electron‐rich and electron‐poor, as well as highly electron‐poor diaryliodonium salts, as the corresponding starting materials are either too reactive or too unreactive. In this update, we discuss the underlying limitations concerning the stability and reactivity of the involved reagents and provide strategies to overcome these challenges through updated synthetic protocols. [ABSTRACT FROM AUTHOR]

This article discusses the methodology and potential pitfalls in interobserver agreement studies, specifically in the context of assessing the suitability for fetal ECG ST analysis (STAN) when commencing cardiotocography (CTG). The authors used proportions of agreement and kappa analysis to assess the data, which are commonly used methods in similar studies. They also compared their new physiology-based FFTree CTG interpretation approach with the FIGO classification and found some differences in the proportions of agreement. The authors provided special graphs to visualize the results and presented the data in a transparent manner. [Extracted from the article]

Background: Alpha‐1‐acid glycoprotein is an acute‐phase protein with a high affinity for amide local anesthetics. Compared to adults, neonates have lower concentrations of this glycoprotein in plasma, and are therefore at higher risk of developing local anesthetic toxicity. Alpha‐1‐acid glycoprotein concentrations rise in adults after surgery as a response to stress as well as in inflammatory conditions. Previous studies have shown that concentrations of alpha‐1‐acid‐glycoprotein in neonates vary postpartum, influenced by gestational age and mode of delivery. Aim: This study aims to determine the concentrations of alpha‐1‐acid glycoprotein pre‐ and postoperatively in neonates undergoing major surgery. This information is important for determining safe and effective dosage of local anesthetic in this vulnerable group of patients. Methods: In this prospective observational study, 25 neonates (median 3 days of age) undergoing major surgery were included. Blood sampling was performed preoperatively and at four occasions postoperatively. Alpha‐1‐acid‐glycoprotein plasma concentrations were analyzed using an immunoturbidimetric assay. Mann–Whitney U test, Kruskal–Wallis and Spearman ranking correlation test were used for the statistical analysis. Results: Higher plasma concentrations of alpha‐1‐acid‐glycoprotein were found 48 h postoperatively compared to preoperatively [median (inter‐quartile range) 0.815 g L−1 (0.663–0.983 g L−1) vs. 0.300 g L−1 (0.205–0.480 g L−1p < 0.001)], respectively. It was not possible to detect any influence of sex, postnatal age, gestational age, or delivery mode on alpha‐1‐acid‐glycoprotein concentrations in our data. Conclusions: Alpha‐1‐acid‐glycoprotein concentrations increase in neonates as a response to surgery regardless of gestational age, sex, or mode of delivery. [ABSTRACT FROM AUTHOR]

Summary: Global vegetation regimes vary in belowground carbon (C) and nitrogen (N) dynamics. However, disentangling large‐scale climatic controls from the effects of intrinsic plant–soil–microbial feedbacks on belowground processes is challenging. In local gradients with similar pedo‐climatic conditions, effects of plant–microbial feedbacks may be isolated from large‐scale drivers.Across a subarctic–alpine mosaic of historic grazing fields and surrounding heath and birch forest, we evaluated whether vegetation‐specific plant–microbial feedbacks involved contrasting N cycling characteristics and C and N stocks in the organic topsoil. We sequenced soil fungi, quantified functional genes within the inorganic N cycle, and measured 15N natural abundance.In grassland soils, large N stocks and low C : N ratios associated with fungal saprotrophs, archaeal ammonia oxidizers, and bacteria capable of respiratory ammonification, indicating maintained inorganic N cycling a century after abandoned reindeer grazing. Toward forest and heath, increasing abundance of mycorrhizal fungi co‐occurred with transition to organic N cycling. However, ectomycorrhizal fungal decomposers correlated with small soil N and C stocks in forest, while root‐associated ascomycetes associated with small N but large C stocks in heath, uncoupling C and N storage across vegetation types.We propose that contrasting, positive plant–microbial feedbacks stabilize vegetation trajectories, resulting in diverging soil C : N ratios at the landscape scale. [ABSTRACT FROM AUTHOR]

Background and purpose: Understanding migraine in a sex‐specific manner is crucial for improving clinical care, diagnosis and therapy for both females and males. Here, data on sex differences are provided in the presentation of migraine in a large European‐based population cohort, which is representative of the general population. Methods: A population‐based study of 62,672 Danish blood donors (both present and previous donors), of whom 12,658 had migraine, was performed. All participants completed a 105‐item diagnostic migraine questionnaire sent via an electronic mailing system (e‐Boks) between May 2020 and August 2020. The questionnaire allowed for correct diagnosis of migraine according to the International Classification of Headache Disorders, third edition. Results: The migraine questionnaire was in‐cohort validated and had a positive predictive value of 97% for any migraine, a specificity of 93% and a sensitivity of 93%. There were 9184 females (mean age 45.1 years) and 3434 males (mean age 48.0 years). The 3‐month prevalence of migraine without aura was 11% in females and 3.59% in males. The 3‐month prevalence of migraine with aura was 1.72% in females and 1.58% in males. In females, the age‐related 3‐month prevalence of migraine without aura increased markedly during childbearing age. In males, migraine both with and without aura showed less age variation. Females had a higher frequency of migraine attacks (odds ratio [OR] 1.22) but a lower frequency of non‐migraine headaches (OR = 0.35). Females also had a greater intensity of pain, more unilateral and pulsatile pain, and exacerbation by physical activity (OR = 1.40–1.49) as well as more associated symptoms (OR = 1.26–1.98). Females carried 79% of the total migraine disease burden, which was almost exclusively driven by migraine without aura (77%), whilst there was no sex difference in the disease burden of migraine with aura. Conclusion: Females have more severe disease, resulting in a much higher migraine disease burden than indicated by prevalence alone. [ABSTRACT FROM AUTHOR]

We report an efficient radical‐mediated C−C coupling through photoredox‐catalyzed reactions of 4‐alkyl‐dihydropyridines (DHPs) and vinylbenziodoxol(on)es (VBX, VBO). This transition‐metal‐free and mild photocatalytic method has excellent functional group tolerance and affords vinylated products in good yields, with complete retention of the alkene configuration. The utility of the methodology is demonstrated by the diastereoselective synthesis of C‐vinyl glycosides. Preliminary mechanistic studies suggest that the C−C bond formation is stereospecific and proceeds through a concerted radical coupling transition state. [ABSTRACT FROM AUTHOR]

Infecting the stomach of almost 50 % of people, Helicobacter pylori is a causative agent of gastritis, peptic ulcers and stomach cancers. Interactions between bacterial membrane-bound lectin, Blood group Antigen Binding Adhesin (BabA), and human blood group antigens are key in the initiation of infection. Herein, the synthesis of a B-antigen hexasaccharide (B6) and a B-Lewis b heptasaccharide (BLeb7) and Bovine Serum Albumin glycoconjugates thereof is reported to assess the binding properties and preferences of BabA from different strains. From a previously reported trisaccharide acceptor a versatile key Lacto-N-tetraose tetrasaccharide intermediate was synthesized, which allowed us to explore various routes to the final targets, either via initial introduction of fucosyl residues followed by introduction of the B-determinant or vice versa. The first approach proved unsuccessful, whereas the second afforded the target structures in good yields. Protein conjugation using isothiocyanate methodology allowed us to reach high glycan loadings (up to 23 per protein) to mimic multivalent displays encountered in Nature. Protein glycoconjugate inhibition binding studies were performed with H. pylori strains displaying high or low affinity for Lewis b hexasaccharide structures showing that the binding to the high affinity strain was reduced due to the presence of the B-determinant in the Bleb7-conjugates and further reduced by the absence of the Lewis fucose residue in the B6-conjugate. [ABSTRACT FROM AUTHOR]

Lymph node (LN) lipomatosis is a common but rarely discussed phenomenon associated with aging that involves a gradual exchange of the LN parenchyma into adipose tissue. The mechanisms behind these changes and the effects on the LN are unknown. We show that LN lipomatosis starts in the medullary regions of the human LN and link the initiation of lipomatosis to transdifferentiation of LN fibroblasts into adipocytes. The latter is associated with a downregulation of lymphotoxin beta expression. We also show that isolated medullary and CD34+ fibroblasts, in contrast to the reticular cells of the T‐cell zone, display an inherently higher sensitivity for adipogenesis. Progression of lipomatosis leads to a gradual loss of the medullary lymphatic network, but at later stages, collecting‐like lymphatic vessels are found inside the adipose tissue. The stromal dysregulation includes a dramatic remodeling and dilation of the high endothelial venules associated with reduced density of naïve T‐cells. Abnormal clustering of plasma cells is also observed. Thus, LN lipomatosis causes widespread stromal dysfunction with consequences for the immune contexture of the human LN. Our data warrant an increased awareness of LN lipomatosis as a factor contributing to decreased immune functions in the elderly and in disease. © 2022 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland. [ABSTRACT FROM AUTHOR]

Efficient protocols for accessing iodo‐substituted diaryl and aryl(vinyl) sulfides have been developed using iodonium salts as reactive electrophilic arylation and vinylation reagents. The reactions take place under transition‐metal‐free conditions, employing odorless and convenient sulfur reagents. A wide variety of functional groups are tolerated in the S‐diarylation, enabling the regioselective late‐stage application of several heterocycles and drug molecules under mild reaction conditions. A novel S‐difunctionalization pathway was discovered using vinyliodonium salts, which proceeds under additive‐free reaction conditions and grants excellent stereoselectivity in the synthesis of aryl(vinyl) sulfides. A one‐pot strategy combining transition‐metal‐free diarylation and subsequent reduction provided facile access to electron‐rich thioanilines and a direct synthesis of a potential drug candidate derivative. The retained iodo group allows a wide array of further synthetic transformations. Mechanistic insights were elucidated by isolating the key intermediate, and the relevant energy profile was substantiated by DFT calculations. [ABSTRACT FROM AUTHOR]

Structured triacylglycerols (STAG) with desired properties can be synthesized by transesterification using immobilized lipases. Herein, the effect of immobilization conditions and support material on the immobilization yield, specific activity and regioselectivity of lipases from Rhizomucor miehei (RML) and Rhizopus oryzae (ROL) in the production of STAG, are evaluated. Four different support materials utilizing adsorption and one with covalent binding are investigated. Ammonium sulfate is found to significantly increase the activity‐based immobilization yield (12% and 38% for RML and ROL, respectively) and specific activity on Accurel MP1000 (MP1000) when used as the immobilization buffer. Furthermore, the immobilization principle and support material influenced both the activity and regiospecificity. Immobilization by adsorption is found to result in higher catalytic activity, while covalent binding resulted in lipase inactivation. For RML, the highest specific activity of 43 µmol STAG min−1 g−1 (U) is obtained on MP1000, while ROL, which exhibited higher activities in general, results in a maximum activity of 120 U on Lifetech ECR8806. The obtained specific activites are comparable to the commercial preparations Novozym 40086 (45 U) and Lipase DF "Amano" IM (147 U) while the regiospecificity of the developed preparations is even higher, forming at least 64% less byproduct. Practical applications: There is an increasing need for lipids with specific nutritional and physical properties in health, nutrition, and food applications. In this context, STAG are highly promising products due to the possibility to tailor the composition to obtain the desired properties. Immobilized lipases are the catalyst of choice for the production of STAG, in which activity and regioselectivity are particularly important parameters for the process performance. In this study, it is shown that these parameters can be affected by the immobilization conditions and support material. Immobilized preparations with high activity and excellent regiospecificity are created on commercially available supports. This shows the possibility of STAG synthesis with high purity and beneficial properties. [ABSTRACT FROM AUTHOR]

Policy processes are ongoing phenomena without beginning or end. Accordingly, a major focus of research has been on questions of stability and change. This paper continues in this tradition by examining advocacy coalition stability, belief change, and learning. This paper draws on three waves of policy actor surveys that compare panel and non‐panel samples. The data were collected in 2013, 2015, and 2017 in the context of oil and gas development in Colorado, USA. The findings mostly confirm that coalitions and beliefs tend to be stable and that learning leans toward reinforcement rather than change in beliefs. However, although rare, some instances of belief change, change in coalition membership, and changing policy positions occur. This paper makes theoretical and empirical contributions to the study of stability, change, and reinforcement of advocacy coalitions and their beliefs and charges policy scholars to look more at the exceptions to the evidence rather than the confirmations. [ABSTRACT FROM AUTHOR]

Aims: Unmet needs exist in the diagnosis and treatment of heart failure (HF) in the elderly population. Our aim was to analyse and compare data of diagnostics and management of very elderly patients (aged ≥85 years) compared with younger patients (aged 18–84 years) with HF in Sweden. Methods: Incidence of ≥2 HF diagnosis (ICD‐10) was identified from primary/secondary care in Uppsala and Västerbotten during 2010–2015 via electronic medical records linked to data from national health registers. Analyses investigated the diagnosis, treatment patterns, hospitalizations and outpatient visits, and mortality. Results: Of 8702 patients, 27.7% were ≥85 years old, women (60.2%); most patients (80.7%) had unknown left ventricular ejection fraction; key co‐morbidities comprised anaemia, dementia, and cerebrovascular disease. More very elderly patients received cardiovascular disease (CVD)‐related management after diagnosis in primary care (13.6% vs. 6.5%; P < 0.0001), but fewer patients underwent echocardiography (19.3% vs. 42.9%; P < 0.0001). Within 1 year of diagnosis, very elderly patients were less likely to be hospitalized (all‐cause admissions per patient: 1.9 vs. 2.3; P < 0.0001; CVD‐related admissions per patient: 1.8 vs. 2.1; P = 0.0004) or prescribed an angiotensin‐converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB) plus a β‐blocker (45.2% vs. 56.9%; P < 0.0001) or an ACEI/ARB plus a β‐blocker plus a mineralocorticoid receptor antagonist (15.4% vs. 31.7%; P < 0.0001). One‐year mortality was high in patients ≥85 years old, 30.5% (CI: 28.3‐32.7%) out of 1797 patients. Conclusions: Despite the large number of very elderly patients with newly diagnosed HF in Sweden, poor diagnostic work‐up and subsequent treatment highlight the inequality of care in this vulnerable population. [ABSTRACT FROM AUTHOR]

Two regioselective, high‐yielding one‐pot routes to oxygen‐bridged cyclic diaryliodonium salts and ortho‐aryloxy‐substituted acyclic diaryliodonium salts are presented. Starting from easily available ortho‐iodo diaryl ethers, complete selectivity in formation of either the cyclic or acyclic product could be achieved by varying the reaction conditions. The complimentary reactivities of these novel ortho‐oxygenated iodonium salts were demonstrated through a series of chemoselective arylations under metal‐catalyzed and metal‐free conditions, to deliver a range of novel, ortho‐functionalized diaryl ether derivatives. [ABSTRACT FROM AUTHOR]

Aim: The influence of dietary carbohydrates and fats on weight gain is inconclusively understood. We studied the acute impact of these nutrients on the overall metabolic state utilizing the insulin:glucagon ratio (IGR). Methods: Following in vitro glucose and palmitate treatment, insulin and glucagon secretion from islets isolated from C57Bl/6J mice was measured. Our human in vivo study included 21 normoglycaemia (mean age 51.9 ± 16.5 years, BMI 23.9 ± 3.5 kg/m2, and HbA1c 36.9 ± 3.3 mmol/mol) and 20 type 2 diabetes (T2D) diagnosed individuals (duration 12 ± 7 years, mean age 63.6 ± 4.5 years, BMI 29.1 ± 2.4 kg/m2, and HbA1c 52.3 ± 9.5 mmol/mol). Individuals consumed a carbohydrate‐rich or fat‐rich meal (600 kcal) in a cross‐over design. Plasma insulin and glucagon levels were measured at −30, −5, and 0 min, and every 30 min until 240 min after meal ingestion. Results: The IGR measured from mouse islets was determined solely by glucose levels. The palmitate‐stimulated hormone secretion was largely glucose independent in the analysed mouse islets. The acute meal tolerance test demonstrated that insulin and glucagon secretion is dependent on glycaemic status and meal composition, whereas the IGR was dependent upon meal composition. The relative reduction in IGR elicited by the fat‐rich meal was more pronounced in obese individuals. This effect was blunted in T2D individuals with elevated HbA1c levels. Conclusion: The metabolic state in normoglycaemic individuals and T2D‐diagnosed individuals is regulated by glucose. We demonstrate that consumption of a low carbohydrate diet, eliciting a catabolic state, may be beneficial for weight loss, particularly in obese individuals. [ABSTRACT FROM AUTHOR]

Background: Growing care queues, reduced access to care and cancelled surgery are realities for some patients being treated with total hip or knee replacement surgery in Sweden. Most of the patients on the waiting lists have experienced pain and limited motion for a varying period of time, with a negative effect on their everyday lives. Overbooked surgical schedules are already contributing to the lengthy waiting times, but, with the addition of cancellations, longer waiting times will increase still further and may affect patients' well‐being. Methods: In the present study, we aimed to illuminate the experience of having planned surgery cancelled, based on narratives from 10 participants. The interview transcriptions were analysed using a phenomenological hermeneutic approach. Results: The comprehensive analyses revealed that the participants described the agony of being deselected and the additional impression of being excluded. Metaphors of being damaged and feeling physical pain were used and the interpretations referred to the cancellations as unpleasant. Additionally, the important relationship and the trust between the health workers and the patient were negatively affected by the cancellation. Conclusion: After the cancellation, the participants expressed being vulnerable and from their perspective the cancelled surgery affected them deeply; in fact, much more than the healthcare workers appeared to understand. Therefore, information around the cancellation must be given respectfully and with dignity, in a dialogue between the patient and the healthcare workers. Taken together, to enable an opportunity to be involved in the continued care. The cancellations should be seen as an interruption, in which the patients' chance of living a pain‐free, active life is postponed. [ABSTRACT FROM AUTHOR]

Ecotypes are distinct populations within a species that are adapted to specific environmental conditions. Understanding how these ecotypes become established, and how they interact when reunited, is fundamental to elucidating how ecological adaptations are maintained. This study focuses on Themeda triandra, a dominant grassland species across Asia, Africa and Australia. It is the most widespread plant in Australia, where it has distinct ecotypes that are usually restricted to either wetter and cooler coastal regions or the drier and hotter interior. We generate a reference genome for T. triandra and use whole genome sequencing for over 80 Themeda accessions to reconstruct the evolutionary history of T. triandra and related taxa. Organelle phylogenies confirm that Australia was colonized by T. triandra twice, with the division between ecotypes predating their arrival in Australia. The nuclear genome provides evidence of differences in the dominant ploidal level and gene‐flow among the ecotypes. In northern Queensland there appears to be a hybrid zone between ecotypes with admixed nuclear genomes and shared chloroplast haplotypes. Conversely, in the cracking claypans of Western Australia, there is cytonuclear discordance with individuals possessing the coastal chloroplast and interior clade nuclear genome. This chloroplast capture is potentially a result of adaptive introgression, with selection detected in the rpoC2 gene which is associated with water use efficiency. The reason that T. triandra is the most widespread plant in Australia appears to be a result of distinct ecotypic genetic variation and genome duplication, with the importance of each depending on the geographic scale considered. [ABSTRACT FROM AUTHOR]

The vocabulary for describing odors in English natural language is not well understood, as prior studies of odor descriptions have often relied on preselected descriptors and odor ratings. Here, we present a data‐driven approach that automatically identifies English odor descriptors based on their degree of olfactory association, and derive their semantic organization from their distributions in natural texts, using a distributional‐semantic language model. We identify 243 descriptors that are much more strongly associated with olfaction than English words in general. We then derive the semantic organization of these olfactory descriptors, and find that it is captured by four clusters that we name Offensive, Malodorous, Fragrant, and Edible. The semantic space derived from our model primarily differentiates descriptors in terms of pleasantness and edibility along which our four clusters are positioned, and is similar to a space derived from perceptual data. The semantic organization of odor vocabulary can thus be mapped using natural language data (e.g., online text), without the limitations of odor‐perceptual data and preselected descriptors. Our method may thus facilitate research on olfaction, a sensory system known to often elude verbal description. [ABSTRACT FROM AUTHOR]

Extracellular vesicles (EVs) have been shown to be involved in cell‐cell communication and to take part in both physiological and pathological processes. Thanks to their exclusive cargo, which includes proteins, lipids, and nucleic acids from the originating cells, they are gaining interest as potential biomarkers of disease. In recent years, their appealing features have been fascinating researchers from all over the world, thus increasing the number of in vitro studies focused on EV release, content, and biological activities. Cultured cell lines are the most‐used source of EVs; however, the EVs released in cell cultures are influenced by the cell culture conditions, such as the use of foetal bovine serum (FBS). FBS is the most common supplement for cell culture media, but it is also a source of contaminants, such as exogenous bovine EVs, RNA, and protein aggregates, that can contaminate the cell‐derived EVs and influence their cargo composition. The presence of FBS contaminants in cell‐derived EV samples is a well‐known issue that limits the clinical applications of EVs, thus increasing the need for standardization. In this review, we will discuss the pros and cons of using FBS in cell cultures as a source of EVs, as well as the protocols used to remove contaminants from FBS. [ABSTRACT FROM AUTHOR]

Aim: To explore the role of CRNs in Sweden and differences in competences and tasks, using the Clinical Trial Nursing Questionnaire – Swedish version (CTNQ‐SWE). Design: A cross‐sectional survey. Methods: Participants were identified through strategic sampling. Data were analysed by descriptive and comparative statistics. Results: The respondents were experienced nurses who felt proficient in their role, they felt more acceptance by the principal investigators than by nursing colleagues. A majority of CRNs are involved in all procedures specified in the CTNQ‐SWE. The most often performed tasks, also rated as the most important by the CRNs, concerned informed consent and management of investigational products. The education was often informal: with a lack of job descriptions and professional development plans. Need of formal specialist education was expressed. Conclusions: Knowledge about the role description can be used by clinical research enterprise internationally and healthcare organizations aiming to support CRNs in their role. [ABSTRACT FROM AUTHOR]

Vinylbenziodoxolones have recently been identified as efficient hypervalent iodine(III) reagents for electrophilic vinylations under transition metal‐free conditions. Their unique reactivity allows synthesis of either internal or terminal alkenes, depending on the nucleophile class. This paper constitutes the first mechanistic investigation of VBX vinylations, and makes use of NMR studies, deuterium labelling and computations to rationalize the observed regio‐ and stereochemical outcome. Internal alkene formation in S‐vinylation was found to proceed through the ligand coupling mechanism typical of diaryliodonium salts, whereas terminal alkene formation in P‐vinylations took place via a phosphinous acid‐coordinated VBX complex, which underwent concerted deprotonation and Michael‐type addition. Subsequent base‐assisted protonation and E2 elimination delivered the terminal alkene. The findings can be used to predict the regioselectivity in vinylations of other nucleophile classes. [ABSTRACT FROM AUTHOR]

Microbes of the surface ocean release, consume, and exchange labile metabolites at time scales of minutes to days. The details of this important step in the global carbon cycle remain poorly resolved, largely due to the methodological challenges of studying a diverse pool of metabolites that are produced and consumed nearly simultaneously. In this perspective, a new compilation of published data builds on previous studies to obtain an updated estimate of the fraction of marine net primary production that passes through the labile dissolved organic carbon (DOC) pool. In agreement with previous studies, our data mining and modeling approaches hypothesize that about half of ocean net primary production is processed through the labile DOC pool. The fractional contributions from three major sources are estimated at 0.4 for living phytoplankton, 0.4 for dead and dying phytoplankton, and 0.2 for heterotrophic microbes and mesoplankton. [ABSTRACT FROM AUTHOR]

Background: This cross-sectional study assessed the potential of colored periodontal probes (CPP) to classify gingival phenotype in terms of gingival thickness (GT).Methods: Buccal GT in three anterior teeth in each of 50 patients was measured by transgingival sounding and classified by three different methods by eight examiners. Specifically, the diagnostic potential of visual judgment and transparency of a standard periodontal probe (SPP) to discriminate thin and thick gingiva, and of CPP to discriminate thin, medium, thick, or very thick gingiva was assessed.Results: GT ranged from 0.57 to 2.37 mm. Using CPP resulted in a medium judgment in 87% of the cases, on average, and only between 1-10 cases/examiner were judged as thick or very thick. Considering 1 mm GT as relevant cut-off value, all methods showed a high positive predictive value (≥ 0.82) to identify thick cases, but also a high false omission rate (≥ 0.73) indicating that many cases classified as thin were actually thick. Further, 88% of the cases being ≤ 1 mm, were not classified as thin with CPP; this was inferior to SPP, for which, however, still 64% of the cases being ≤ 1 mm thick were wrongly classified. The highest, yet moderate agreement among examiners was achieved by SPP (κ = 0.427), whereas visual judgment and CPP showed only fair (κ = 0.211) and slight agreement (κ = 0.112), respectively.Conclusion: Using CPP resulted in most of the cases in a medium judgment. It seems that CPP cannot distinctly discriminate between "thick" and "very thick" cases and fails to capture the thin high-risk cases. [ABSTRACT FROM AUTHOR]