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IntroductionCattle slurry used as fertilizer in crop production is a mix of feces, urine, water, and bedding material from the housing system. Previous studies have shown that slurry nitrogen (N) availability to crops is dependent on C/N ratio. As the bedding material can contribute a significant part of total slurry carbon (C), its characteristics may affect the C/N ratio of the slurry. There is increasing interest in using the solid fraction from mechanical slurry separation as bedding material, and therefore this study investigated the potential effect of this fraction on slurry N availability, compared with more commonly used bedding materials such as straw and sawdust.MethodsIn two parallel 28-day laboratory incubations, net mineral N release and C mineralization from slurries applied to sandy loam soil were measured. The slurries comprised a liquid fraction (LF) from mechanical cattle slurry separation with a screw-press and different added bedding materials. Liquid fraction was mixed with two types of bedding material, solid slurry fraction (SF) and chopped straw, in different proportions, resulting in C/N ratios of 10, 12, and 14 in the slurry. In additional treatments, two other bedding materials, ground straw and sawdust, with slurry C/N ratio 12, were used.ResultsFor SF and chopped straw, similar negative linear correlations were seen between slurry C/N ratio and net mineral N release after 28 days. Carbon mineralization, expressed as a percentage of total C added, was higher from the mixture containing SF than that containing straw, while no clear relationship with C/N ratio was found. At slurry C/N ratio 12, net release of mineral N was 28–39% of total N and decreased in the order: sawdust>chopped straw=SF=ground straw. Net C mineralization at the same slurry C/N ratio was 33–46% and decreased in the order: SF=ground straw>chopped straw>sawdust.DiscussionFor bedding materials with similar fiber composition (i.e., SF and straw), differences in C availability due to particle size or degree of degradation by microorganisms did not influence slurry N availability measurably. For sawdust, with high lignin content, the results indicate that limited C availability may lead to lower slurry N immobilization.

Abstract Background In the midst of the COVID-19 coronavirus pandemic, a new disease that affects children has arisen called multisystem inflammatory syndrome in children (MIS-C). Several research articles focusing on its medical aspects have been published, but very few have focused on nursing care. The aim of this study was therefore to describe the nursing status of children suffering from MIS-C and the experiences of registered nurses (RNs) in caring for these children in paediatric hospital inpatient care. Methods The study design includes both quantitative nursing clinical record data and qualitative interview data. Quantitative data from the clinical records were analysed using descriptive statistics. Qualitative data analysis of the interviews was conducted using both deductive and inductive approaches with content analysis. Results In total, 47 clinical records from children with MIS-C were investigated during January–March 2021. The mean age of the children was 8.8 years. Boys were more affected than girls. Challenges in children’s nursing status were related to circulation (fever and swelling), nutrition (great thirst and loss of appetite), pain, and psychosocial situations. When caring for children with MIS-C, nurses experienced “frustration over uncertainty of care”, “children’s illbeing” and “unavoidable procedures”. Conclusion This study contributes knowledge to the ongoing nursing care of children suffering from MIS-C. The results show many different areas of nursing focus, which challenges nurses and other disciplines within paediatric hospital care. One important factor when caring for these children was the use of a central venous line early in the care process, which improved the quality of care. Moreover, the care of children suffering from MIS-C demands resources and time from healthcare professionals, especially RNs, to meet caring needs and reduce illbeing.

Summary: This study investigates the role of survivin in epigenetic control of gene transcription through interaction with the polycomb repressive complex 2 (PRC2). PRC2 is responsible for silencing gene expression by trimethylating lysine 27 on histone 3. We observed differential expression of PRC2 subunits in CD4+ T cells with varying levels of survivin expression, and ChIP-seq results indicated that survivin colocalizes with PRC2 along DNA. Inhibition of survivin resulted in a significant increase in H3K27 trimethylation, implying that survivin prevents PRC2 from functioning. Peptide microarray showed that survivin interacts with peptides from PRC2 subunits, and machine learning revealed that amino acid composition contains relevant information for predicting survivin interaction. NMR and BLI experiments supported the interaction of survivin with PRC2 subunit EZH2. Finally, protein-protein docking revealed that the survivin-EZH2 interaction interface overlaps with catalytic residues of EZH2, potentially inhibiting its H3K27 methylation activity. These findings suggest that survivin inhibits PRC2 function.

Introduction The use of proton therapy increases globally despite a lack of randomised controlled trials demonstrating its efficacy and safety. Proton therapy enables sparing of non-neoplastic tissue from radiation. This is principally beneficial and holds promise of reduced long-term side effects. However, the sparing of seemingly non-cancerous tissue is not necessarily positive for isocitrate dehydrogenase (IDH)-mutated diffuse gliomas grade 2–3, which have a diffuse growth pattern. With their relatively good prognosis, yet incurable nature, therapy needs to be delicately balanced to achieve a maximal survival benefit combined with an optimised quality of life.Methods and analysis PRO-GLIO (PROton versus photon therapy in IDH-mutated diffuse grade 2 and 3 GLIOmas) is an open-label, multicentre, randomised phase III non-inferiority study. 224 patients aged 18–65 years with IDH-mutated diffuse gliomas grade 2–3 from Norway and Sweden will be randomised 1:1 to radiotherapy delivered with protons (experimental arm) or photons (standard arm). First intervention-free survival at 2 years is the primary endpoint. Key secondary endpoints are fatigue and cognitive impairment, both at 2 years. Additional secondary outcomes include several survival measures, health-related quality of life parameters and health economy endpoints.Ethics and dissemination To implement proton therapy as part of standard of care for patients with IDH-mutated diffuse gliomas grade 2–3, it should be deemed safe. With its randomised controlled design testing proton versus photon therapy, PRO-GLIO will provide important information for this patient population concerning safety, cognition, fatigue and other quality of life parameters. As proton therapy is considerably more costly than its photon counterpart, cost-effectiveness will also be evaluated. PRO-GLIO is approved by ethical committees in Norway (Regional Committee for Medical & Health Research Ethics) and Sweden (The Swedish Ethical Review Authority) and patient inclusion has commenced. Trial results will be published in international peer-reviewed journals, relevant conferences, national and international meetings and expert forums.Trial registration number ClinicalTrials.gov Registry (NCT05190172).

The overall aim of this article is to contribute to a critical discussion about aims and goals of outdoor education in schools. The study examines motives for outdoor education in the national curricula in Sweden from the end of 19th century until today. The study relies on a discourse analysis methodology. Aspects of continuity and change connected to the identified motives are also included in the analyses. The results show that a scientific perspective on encounters with nature has dominated during the last hundred years. In recent years, more instrumental motives are expressed in the curricula, while students’ personal experiences and feelings are less focused.

To review the longitudinal trajectories -- and the factors influencing their development -- of mental health problems in children with neurodevelopmental disabilities. Systematic review methods were employed. Searches of six databases used keywords and MeSH terms related to children with neurodevelopmental disabilities, mental health problems, and longitudinal research. After the removal of duplicates, reviewers independently screened records for inclusion, extracted data (outcomes and influencing factors), and evaluated the risk of bias. Findings were tabulated and synthesized using graphs and a narrative. Searches identified 94,662 unique records, from which 49 publications were included. The median publication year was 2015. Children with attention deficit hyperactivity disorder were the most commonly included population in retrieved studies. In almost 50% of studies, trajectories of mental health problems changed by < 10% between the first and last time point. Despite multiple studies reporting longitudinal trajectories of mental health problems, greater conceptual clarity and consideration of the measures included in research is needed, along with the inclusion of a more diverse range of populations of children with neurodevelopmental disabilities.

Abstract. Von Meyenburg complexes, or multiple biliary hamartomas, are often asymptomatic lesions incidentally discovered during abdominal or hepatic imaging. The presentation of clinically significant Von Meyenburg complexes ranges from cholestasis and self-limited episodes of cholangitis to malignant degeneration into cholangiocarcinoma. In cases of persistent or recurrent cholangitis, treatment is a significant challenge. Definitive source control with liver transplantation, as in other cases of cholestatic liver disease, may be necessary.

Research question and purpose: Les Mills is a New Zealand-based fitness distributor with a community consisting of approximately 140.000 instructors worldwide who teach standardized workout routines. This paper aims to explore how the COVID-19 pandemic and related measurements, such as social distancing affect the everyday lives and professions of Les Mills International (LMI) group fitness instructors. The aim was met with the following research questions: RQ1: How are social distancing and social connectedness understood, and how do they condition LMI instructors’ understanding of their profession? RQ2: What do LMI instructors think about the #LesMillsUnited campaign to maintain a strong trainer community in the midst of the pandemic? RQ3: How do LMI instructors think that group fitness will change long term due to social distancing? Research methods: Using qualitative measures and a case-study-based approach, data were gathered through interviews with LMI-certified group fitness instructors. Seven semi-structured focused group discussions with fifteen group fitness instructors from different countries were conducted and audio recorded. The first round of virtual discussions took place in April 2020, and the follow-up talks in September 2020. A thematic analysis was employed to analyze the material. Results and findings: According to the participants, online classes as a means of upholding group fitness in times of social distancing is an insufficient substitute to face-to-face instructing, lacking social connectedness that is normally maintained through successful rituals or social scripts. Navigating “instructorhood” during the pandemic includes emotional labor where not only relationships to clients are challenged, but instructors also experience societal pressure to reinvent themselves as instructors. Implications: With no way of telling how long social distancing needs to be practiced, the group fitness industry is facing unprecedented challenges. Making sense of the group fitness profession currently preoccupies instructors who may now have to redefine to themselves how they can teach, and who for.

In recent years, the International Maritime Organization agreed on aiming to reduce shipping’s greenhouse gas emissions by 50% with respect to 2009 levels. Meanwhile, cruise ship tourism is growing at a fast pace, making the challenge of achieving this goal even harder. The complexity of the energy system of these ships makes them of particular interest from an energy systems perspective. To illustrate this, we analyzed the energy and exergy flow rates of a cruise ship sailing in the Baltic Sea based on measurements from one year of the ship’s operations. The energy analysis allows identifying propulsion as the main energy user (46% of the total) followed by heat (27%) and electric power (27%) generation; the exergy analysis allowed instead identifying the main inefficiencies of the system: while exergy is primarily destroyed in all processes involving combustion (76% of the total), the other main causes of exergy destruction are the turbochargers, the heat recovery steam generators, the steam heaters, the preheater in the accommodation heating systems, the sea water coolers, and the electric generators; the main exergy losses take place in the exhaust gas of the engines not equipped with heat recovery devices. The application of clustering of the ship’s operations based on the concept of typical operational days suggests that the use of five typical days provides a good approximation of the yearly ship’s operations and can hence be used for the design and optimization of the energy systems of the ship.

BACKGROUND: Serum amyloid P component (SAP) is a glycoprotein that is universally found associated with different types of amyloid deposits. It has been suggested that it stabilizes amyloid fibrils and therefore protects them from proteolytic degradation. METHODOLOGY/PRINCIPAL FINDINGS: In this paper, we show that SAP binds not only to mature amyloid fibrils but also to early aggregates of amyloidogenic mutants of the plasma protein transthyretin (TTR). It does not inhibit fibril formation of TTR mutants, which spontaneously form amyloid in vitro at physiological pH. We found that SAP prevents cell death induced by mutant TTR, while several other molecules that are also known to decorate amyloid fibrils do not have such effect. Using a Drosophila model for TTR-associated amyloidosis, we found a new role for SAP as a protective factor in inhibition of TTR-induced toxicity. Overexpression of mutated TTR leads to a neurological phenotype with changes in wing posture. SAP-transgenic flies were crossed with mutated TTR-expressing flies and the results clearly confirmed a protective effect of SAP on TTR-induced phenotype, with an almost complete reduction in abnormal wing posture. Furthermore, we found in vivo that binding of SAP to mutated TTR counteracts the otherwise detrimental effects of aggregation of amyloidogenic TTR on retinal structure. CONCLUSIONS/SIGNIFICANCE: Together, these two approaches firmly establish the protective effect of SAP on TTR-induced cell death and degenerative phenotypes, and suggest a novel role for SAP through which the toxicity of early amyloidogenic aggregates is attenuated.

We investigated the concordance between the Unyvero Hospitalized Pneumonia (HPN) application and quantitative culture for detection of bacterial pathogens from serial lower respiratory tract (LRT) specimens collected from the same subject. Comparison of results from HPN application and culture was evaluated using 69 LRT samples from 27 subjects, using two evaluation approaches. False positive detections by the HPN application was 29% (20/69) in Evaluation I vs 10% (7/68) in Evaluation II. Additional pathogens detected by the HPN application could be confirmed in many instances by culture positivity for the same organism from previous or subsequent samples from the same subject. [ABSTRACT FROM AUTHOR]

BackgroundDifferent barriers may hinder children with developmental disabilities (DD) from having a voice in research and clinical interventions concerning fundamentally subjective phenomena, such as participation. It is not well-investigated if video communication tools have the potential to reduce these barriers.AimThis study investigated the feasibility of administering a self-rating instrument measuring participation, Picture My Participation (PmP), via a video communication tool (Zoom), to children with DD.Materials and methodsPmP was administered to 17 children with DD (mean age 13 years). The pictorial representations of activities and response options in PmP were displayed in a shared PowerPoint presentation, enabling nonverbal responses with the annotate function in Zoom. Child and interviewer perceptions of the interview were measured through questionnaires developed for the purpose.ResultsAll the children completed the interview. Most PmP questions were answered, and no adverse events were registered. Technical issues could generally be solved. No special training or expensive equipment was needed for the interviews.ConclusionInterviewer-guided self-ratings of participation and related constructs through video communication may be a feasible procedure to use with children with DD from age 11.SignificanceOffering video communication may increase children’s chances to contribute subjective experiences in research and clinical practice.