Search

Visual-verbal serial recall is disrupted when task-irrelevant background speech has to be ignored. Contrary to previous suggestion, it has recently been shown that the magnitude of disruption may be accentuated by the semantic properties of the irrelevant speech. Sentences ending with unexpected words that did not match the preceding semantic context were more disruptive than sentences ending with expected words. This particular instantiation of a deviation effect has been termed the semantic mismatch effect. To establish a new phenomenon, it is necessary to show that the effect can be independently replicated and does not depend on specific boundary conditions such as the language of the stimulus material. Here we report a preregistered replication of the semantic mismatch effect in which we examined the effect of unexpected words in 4 different languages (English, French, German, and Swedish) across 4 different laboratories. Participants performed a serial recall task while ignoring sentences with expected or unexpected words that were recorded using text-to-speech software. Independent of language, sentences ending with unexpected words were more disruptive than sentences ending with expected words. In line with previous results, there was no evidence of habituation of the semantic mismatch effect in the form of a decrease in disruption with repeated exposure to the occurrence of unexpected words. The successful replication and extension of the effect to different languages indicates the expression of a general and robust mechanism that reacts to violations of expectancies based on the semantic content of the irrelevant speech.

Social media use is an integrated part of youth's social life, enabling access to knowledge and social exploration, but it also increases the risk of experiencing online child sexual abuse (OCSA). Quantitative reviews of OCSA provide insights into prevalence, risk factors, and mental health outcomes, but we have limited knowledge about how youth experience OCSA. This study aims to synthesize qualitative studies on youth's (12–24 years of age) first‐person experiences of OCSA. We conducted a systematic database search and included 16 studies. The meta‐synthesis resulted in three meta‐themes: (1) "Navigating in a digital world – feeling safe and understood," (2) "Being lured, tricked, and caught up in online child sexual abuse," and (3) "Facing the consequences – feeling powerless and blaming oneself." Although the studies included most females, findings apply to all genders and across ages. The results highlight how online sexual engagement is a way to explore social and sexual relationships and address a basic need to be understood and supported. However, when trust is misused, developmental tasks related to autonomy and agency may be shattered, replaced with shame and self‐blame. These findings point to the need to openly and nonjudgementally address OCSA so that it can be disclosed, and the psychological impact can be addressed. [ABSTRACT FROM AUTHOR]

Background: While equity in health care is the core of the Swedish health system, social inequalities in accessing health care, particularly regarding dental care, exist. There is however no information on how the Sámi population is affected. This study aimed to assess the prevalence and risk factors for refraining from seeking dental care among the Sámi in Sweden. Methods: A Sámi sample was constructed from three pre-existing registers. Among the 9,249 invitations for individuals aged 18–84 years old, 3,779 answered the survey during February–May 2021. We first calculated frequencies and proportions of the independent variables in terms of socio-economic, socio-demographic, and cultural-related factors as well as the outcome, refraining from dental care. Then, we summarized the magnitude of the association between the independent variables and self-reported refrain from dental care with the prevalence difference (PD) using the 95% confidence interval (95% CI) for inferential purposes. Results: Overall, 17.5% of the participants refrained from seeking dental care despite self-reported need in the last three months, with almost the same proportion between men and women. Among the socio-demographic factors, being in the 30–44 years group (PD = 8.0; 95% CI: 3.59, 12.48), in the 45–64 group (PD = 7.3; 95% CI: 2.96, 11.61) and in the 65–84 group (PD = 5.4; 95% CI: 0.92, 9.78) as well as being divorced/widow-er (PD = 6.7; 95% CI: 2.73, 10.70) and unmarried (PD = 3.1; 95% CI: 0.23, 6.04) were statistically significantly associated with refraining from seeking dental care. Among the socio-economic variables, those in the middle-income quintile (PD = 5.3; 95% CI: 1.28, 9.35), in the poor (PD = 8.1; 95% CI: 3.64, 12.51) and poorest (PD = 8.0 95% CI: 3.48, 12.50) quintiles, and especially those experiencing economic stress once (PD = 9.2; 95% CI: 2.93, 15.48) and several times (PD = 26.5; 95% CI: 19.50, 33.43), were strongly associated with refraining. Conclusions: Approximately one in six of the Sámi participating in this study refrained from seeking dental care despite self-reported need in the last three months. Those who experienced economic difficulties were the most affected group. To achieve equity in dental health care in Sweden, policies removing economic barriers to access dental health care should be implemented. [ABSTRACT FROM AUTHOR]

Key Points: Question: Can a blood test based on the ratio of plasma phosphorylated tau 217 (p-tau217) relative to non–p-tau217 (expressed as percentage of p-tau217) combined with the amyloid-β 42 and amyloid-β 40 plasma ratio (the amyloid probability score 2 [APS2]) accurately identify Alzheimer disease in primary care and secondary care when prospectively applying predefined biomarker cutoff values? Findings: There were 1213 patients undergoing cognitive evaluation in primary or secondary care. The APS2 had high diagnostic accuracy (range, 88%-92%) for detecting Alzheimer disease pathology in both primary and secondary care. Dementia specialists identified clinical Alzheimer disease with a diagnostic accuracy of 73% vs 91% using the APS2 and primary care physicians had a diagnostic accuracy of 61% vs 91% using the APS2. Meaning: This blood test (the APS2) had high diagnostic accuracy for identifying Alzheimer disease among individuals with cognitive symptoms in primary and secondary care, providing superior performance compared with the diagnostic accuracy after standard clinical evaluation (not using Alzheimer disease biomarkers). Importance: An accurate blood test for Alzheimer disease (AD) could streamline the diagnostic workup and treatment of AD. Objective: To prospectively evaluate a clinically available AD blood test in primary care and secondary care using predefined biomarker cutoff values. Design, Setting, and Participants: There were 1213 patients undergoing clinical evaluation due to cognitive symptoms who were examined between February 2020 and January 2024 in Sweden. The biomarker cutoff values had been established in an independent cohort and were applied to a primary care cohort (n = 307) and a secondary care cohort (n = 300); 1 plasma sample per patient was analyzed as part of a single batch for each cohort. The blood test was then evaluated prospectively in the primary care cohort (n = 208) and in the secondary care cohort (n = 398); 1 plasma sample per patient was sent for analysis within 2 weeks of collection. Exposure: Blood tests based on plasma analyses by mass spectrometry to determine the ratio of plasma phosphorylated tau 217 (p-tau217) to non–p-tau217 (expressed as percentage of p-tau217) alone and when combined with the amyloid-β 42 and amyloid-β 40 (Aβ42:Aβ40) plasma ratio (the amyloid probability score 2 [APS2]). Main Outcomes and Measures: The primary outcome was AD pathology (determined by abnormal cerebrospinal fluid Aβ42:Aβ40 ratio and p-tau217). The secondary outcome was clinical AD. The positive predictive value (PPV), negative predictive value (NPV), diagnostic accuracy, and area under the curve (AUC) values were calculated. Results: The mean age was 74.2 years (SD, 8.3 years), 48% were women, 23% had subjective cognitive decline, 44% had mild cognitive impairment, and 33% had dementia. In both the primary care and secondary care assessments, 50% of patients had AD pathology. When the plasma samples were analyzed in a single batch in the primary care cohort, the AUC was 0.97 (95% CI, 0.95-0.99) when the APS2 was used, the PPV was 91% (95% CI, 87%-96%), and the NPV was 92% (95% CI, 87%-96%); in the secondary care cohort, the AUC was 0.96 (95% CI, 0.94-0.98) when the APS2 was used, the PPV was 88% (95% CI, 83%-93%), and the NPV was 87% (95% CI, 82%-93%). When the plasma samples were analyzed prospectively (biweekly) in the primary care cohort, the AUC was 0.96 (95% CI, 0.94-0.98) when the APS2 was used, the PPV was 88% (95% CI, 81%-94%), and the NPV was 90% (95% CI, 84%-96%); in the secondary care cohort, the AUC was 0.97 (95% CI, 0.95-0.98) when the APS2 was used, the PPV was 91% (95% CI, 87%-95%), and the NPV was 91% (95% CI, 87%-95%). The diagnostic accuracy was high in the 4 cohorts (range, 88%-92%). Primary care physicians had a diagnostic accuracy of 61% (95% CI, 53%-69%) for identifying clinical AD after clinical examination, cognitive testing, and a computed tomographic scan vs 91% (95% CI, 86%-96%) using the APS2. Dementia specialists had a diagnostic accuracy of 73% (95% CI, 68%-79%) vs 91% (95% CI, 88%-95%) using the APS2. In the overall population, the diagnostic accuracy using the APS2 (90% [95% CI, 88%-92%]) was not different from the diagnostic accuracy using the percentage of p-tau217 alone (90% [95% CI, 88%-91%]). Conclusions and Relevance: The APS2 and percentage of p-tau217 alone had high diagnostic accuracy for identifying AD among individuals with cognitive symptoms in primary and secondary care using predefined cutoff values. Future studies should evaluate how the use of blood tests for these biomarkers influences clinical care. This prospective study evaluates a clinically available Alzheimer disease blood test in primary and secondary care using predefined biomarker cutoff values. [ABSTRACT FROM AUTHOR]

Introduction: Periprosthetic femoral fractures (PFFs) following hip arthroplasty, especially Vancouver B2 and B3 fractures, present a challenge due to the association with a loose femoral stem, necessitating either open reduction and internal fixation or stem revision. This study aims to compare outcomes between uncemented and cemented stem revisions in managing Vancouver B2 and B3 fractures, considering factors such as hip-related complications, reoperations, and clinical outcome. Methods: A retrospective cohort study was conducted at Danderyd Hospital, Sweden, from 2008 to 2022, encompassing operatively treated Vancouver B2 and B3 fractures. Patients were categorized into uncemented and cemented stem revision groups, with data collected on complications, revision surgeries, fracture healing times, and clinical outcomes. Results: A total of 241 patients were identified. Significant differences were observed between the two groups in patient demographics, with the cemented group comprising older patients and more females. Follow up ranged from 1 to 15 years. Average follow up time was 3.9 years for the cemented group and 5.5 years for the uncemented group. The cemented stems demonstrated lower rates of dislocation (8.9% versus 22.5%, P = 0.004) and stem loosening (0.6% versus 9.3%, P = 0.004) than the uncemented method. Moreover, the cemented group exhibited shorter fracture healing times (11.4 weeks versus 16.7 weeks, P = 0.034). There was no difference in clinical outcome between groups. Mortality was higher in the cemented group. Conclusions: This retrospective study indicates that cemented stem revision for Vancouver B2–3 fractures is correlated with lower dislocation and stem loosening rates, necessitating fewer reoperations and shorter fracture healing times compared with the uncemented approach. The cemented group had a notably higher mortality rate, urging caution in its clinical interpretation. Level of evidence III [ABSTRACT FROM AUTHOR]

Hereditary transthyretin amyloidosis (hATTR) with polyneuropathy (formerly known as Familial Amyloid Polyneuropathy (FAP)) is an endemic amyloidosis involving the harmful aggregation of proteins, most commonly transthyretin (TTR) but sometimes also apolipoprotein A-1 or gelsolin. hATTR appears to be transmitted as an autosomal dominant trait. Over 100 point mutations have been identified, with the Val30Met substitution being the most common. Yet, the mechanism of pathogenesis and the overall origin of hATTR remain unclear. Here, we argue that hATTR could be related to harmful metal exposure. hATTR incidence is unevenly distributed globally, and the three largest defined clusters exist in Japan, Portugal, and Sweden. All three disease regions are also ancient mining districts with associated metal contamination of the local environment. There are two main mechanisms for how harmful metals, after uptake into tissues and body fluids, could induce hATTR. First, the metals could directly influence the expression, function, and/or aggregation of the proteins involved in hATTR pathology. Such metal–protein interactions might constitute molecular targets for anti-hATTR drug design. Second, metal exposure could induce hATTR -associated genetic mutations, which may have happened several generations ago. These two mechanisms can occur in parallel. In conclusion, the possibility that hATTR could be related to metal exposure in geochemically defined regions deserves further attention. [ABSTRACT FROM AUTHOR]

Aims: To assess the association between experiences of discrimination and mental health among the Sámi population in Sweden. Methods: Cross-sectional study among the self-identified Sámi population living in Sweden in 2021, registered in the electoral roll of the Sámi Parliament, the reindeer mark register and the 'Labour statistics based on administrative sources'. The analysis was based on a final sample of 3658 respondents aged between 18 and 84 years. Adjusted prevalence ratios aPRs for psychological distress (Kessler scale), self-reported anxiety and depression were estimated for four different forms of discrimination (direct experience of discrimination, offended because of ethnicity, historical trauma, and combined discrimination). Results: Higher aPRs of psychological distress, anxiety and depression were observed in women experiencing direct discrimination because of their ethnicity, having been offended because of their ethnicity, and those with a family history of discrimination. Among men, higher aPRs for psychological distress were observed in those experiencing the four different forms of discrimination, but not for anxiety. Depression was only detected in the case of having been offended. Adding experiences of discrimination was associated with a higher prevalence of negative outcomes for all the indicators in women and for psychological distress in men. Conclusions: The observed association between experiences of discrimination and mental health problems would support a gender approach when considering ethnic discrimination in public health policies concerning the Sámi in Sweden. [ABSTRACT FROM AUTHOR]

This study explored the development of theory of mind (ToM) in 80 Swedish-speaking 3- to 5-year-olds, a previously unstudied language and culture. The ToM scale was translated and tested in a Swedish context. The results show that the ToM abilities improve significantly with age. In addition, a gender difference was observed for the whole sample, girls outperformed boys, but follow-up analyses revealed that the difference only remained significant for the 4-year-olds. No gender differences were observed at 3 and 5 years of age. When conducting a scalability analysis, the overall Wellman and Liu scale showed less than acceptable scalability. However, when removing the last task of the scale (Real-Apparent Emotion), the fit and scalability was good. The reason for this divergent result is discussed in terms of cultural differences, such as parental and pedagogical practices in Sweden, which might especially focus on developing children's socio-emotional understanding.

Background: The Swedish Fracture Register (SFR) is a national quality register for all types of fractures in Sweden. Spine fractures have been included since 2015 and are classified using a modified AOSpine classification. The aim of this study was to determine the accuracy of the classification of thoracolumbar burst fractures in the SFR. Methods: Assessments of medical images were conducted in 277 consecutive patients with a thoracolumbar burst fracture (T10-L3) identified in the SFR. Two independent reviewers classified the fractures according to the AOSpine classification, with a third reviewer resolving disagreement. The combined results of the reviewers were considered the gold standard. The intra- and inter-rater reliability of the reviewers was determined with Cohen's kappa and percent agreement. The SFR classification was compared with the gold standard using positive predictive values (PPV), Cohen's kappa and percent agreement. Results: The reliability between reviewers was high (Cohen's kappa 0.70–0.97). The PPV for correctly classifying burst fractures in the SFR was high irrespective of physician experience (76–89%), treatment (82% non-operative, 95% operative) and hospital type (83% county, 95% university). The inter-rater reliability of B-type injuries and the overall SFR classification compared with the gold standard was low (Cohen's kappa 0.16 and 0.17 respectively). Conclusions: The SFR demonstrates a high PPV for accurately classifying burst fractures, regardless of physician experience, treatment and hospital type. However, the reliability of B-type injuries and overall classification in the SFR was found to be low. Future studies on burst fractures using SFR data where classification is important should include a review of medical images to verify the diagnosis. [ABSTRACT FROM AUTHOR]

This article offers a comparative-historical perspective on the moral economy of land. We reconstruct the moral economy of the popular land reform movement that opposed the illegitimate income streams of rentiers and speculators in the early 20th century, tracing the movement's legacy through a long-run analysis of political party platforms since 1880 in the USA, the UK, Germany and Sweden. We find that the land reformers' conceptualization of land as a moral good was a key topic in early 20th-century party politics. Parties across the political spectrum called for wide-ranging interventions in unregulated land markets. But despite the movement's relative success, the new ideal of the ownership society soon gained ground as an alternative to the more radical politics of land decommodification. We find growing multipartisan support for small property owners over time, culminating in the rise of a new moral conceptualization of land as capital. With the recent comeback of the land question, both rural and urban, we conclude that an understanding of historical land reform debates should inform future research toward a much-needed sociology of land. [ABSTRACT FROM AUTHOR]

Stroke may affect physical functioning, cognition, and mental and social aspects of one's life. Health literacy and self-efficacy are associated with positive health outcomes and are important factors for managing the diverse consequences of a stroke. However, there is very little literature on the association between health literacy and self-efficacy. This study aimed to investigate the association between health literacy and self-efficacy among stroke survivors 1 year after discharge from hospital. Participants in this cross-sectional study were patients diagnosed with a stroke, mainly a mild stroke, who were referred to rehabilitation in primary care after discharge from hospital in Sweden. Data was collected using questionnaires, performance-based tests, and medical records. Ordinal logistic regression was used to analyze the association between general self-efficacy and health literacy in adjusted models. The analysis revealed that higher levels of general self-efficacy and higher levels of performing activities of daily living were associated with higher levels of health literacy. Stroke survivors with higher general self-efficacy also report higher health literacy 1-year post-discharge from hospital. Future studies should focus on the pathways by which health literacy and general self-efficacy work among stroke survivors and in populations with low health literacy, severe stroke or significant cognitive impairments. [ABSTRACT FROM AUTHOR]

Contemporary research on so-called Nordic branding has provided crucial insights into the social power of states and how various actors use and circulate 'progressive' nation brand tropes for political and commercial goals. Hitherto, the literature on Nordic branding has focused on a wide range of substantive issues, among other things, human rights, gender equality, social welfare and foreign aid, but considerably less attention has been paid to the topic of security. The present article adds to a small but established literature on how the security sphere is increasingly entangled with nation branding. In the Nordic region, we argue, the latter is particularly evident in the case of Sweden – one of the world's largest per-capita arms exporters in the post-Cold War era but also a country known and often revered for its peaceful and progressive image. Focusing on the case of Sweden, the article contributes to knowledge of how defence industry-related actors (both public and private) draw on and frame nation branding tropes to sell and legitimise their products and services to both insiders (domestic constituents) and outsiders (the global security market). [ABSTRACT FROM AUTHOR]

Aim: This study addresses the scarcity of longitudinal research on the influence of screen media on children. It aims to explore the longitudinal relationship between children's vocabulary development and their exposure to screen media. Methods: The study, initiated in 2017, included 72 children (37 boys) in Östergötland, Sweden, at three key developmental stages: preverbal (9.7 months), early verbal (25.5 months) and preliterate (5.4 years). Parents completed online surveys at each time point, reporting their child's screen time. At 10 months and 2 years, age‐appropriate vocabulary assessments were conducted online. At age 5, children's vocabulary was laboratory assessed. Results: Correlational analysis revealed a negative relationship between language scores and screen media use across all time points. Furthermore, a cross‐lagged panel model demonstrated that screen media use showed significant continuity over time, with screen use at age 2 predicting language development at ages 2 and 5. Conclusion: This longitudinal study, spanned from 9 months to 5 years of age, established a predictive negative association between children's exposure to screen media and their vocabulary development. These findings underscore the need to consider the impact of screen media on early childhood development and may inform guidelines for screen media use in young children. [ABSTRACT FROM AUTHOR]

Saccade latency is widely used across infant psychology to investigate infants' understanding of events. Interpreting particular latency values requires knowledge of standard saccadic RTs, but there is no consensus as to typical values. This study provides standard estimates of infants' (n = 194, ages 9 to 15 months) saccadic RTs under a range of different spatiotemporal conditions. To investigate the reliability of such standard estimates, data is collected at 4 laboratories in 3 countries. Results indicate that reactions to the appearance of a new object are much faster than reactions to the deflection of a currently fixated moving object; upward saccades are slower than downward or horizontal saccades; reactions to more peripheral stimuli are much slower; and this slowdown is greater for boys than girls. There was little decrease in saccadic RTs between 9 and 15 months, indicating that the period of slow development which is protracted into adolescence begins in late infancy. Except for appearance and deflection differences, infant effects were weak or absent in adults (n = 40). Latency estimates and spatiotemporal effects on latency were generally consistent across laboratories, but a number of lab differences in factors such as individual variation were found. Some but not all differences were attributed to minor procedural differences, highlighting the importance of replication. Confidence intervals (95%) for infants' median reaction latencies for appearance stimuli were 242 to 250 ms and for deflection stimuli 350 to 367 ms.

Despite limited and ambiguous empirical data, substance use-related problems have been assumed to be rare among patients with autism spectrum disorders (ASD). Using Swedish population-based registers we identified 26,986 individuals diagnosed with ASD during 1973-2009, and their 96,557 non-ASD relatives. ASD, without diagnosed comorbidity of attention deficit hyperactivity disorder (ADHD) or intellectual disability, was related to a doubled risk of substance use-related problems. The risk of substance use-related problems was the highest among individuals with ASD and ADHD. Further, risks of substance use-related problems were increased among full siblings of ASD probands, half-siblings and parents. We conclude that ASD is a risk factor for substance use-related problems. The elevated risks among relatives of probands with ASD suggest shared familial (genetic and/or shared environmental) liability.

Background. Using a fluid-filled wire with a pressure sensor outside the patient compared to a conventional pressure wire may avoid the systematic error introduced by the hydrostatic pressure within the coronary circulation. Aims. To assess the safety and effectiveness of the novel fluid-filled wire, Wirecath (Cavis Technologies, Uppsala, Sweden), as well as its ability to avoid the hydrostatic pressure error. Methods and Results. The Wirecath pressure wire was used in 45 eligible patients who underwent invasive coronary angiography and had a clinical indication for invasive coronary pressure measurement at Sahlgrenska University Hospital, Gothenburg, Sweden. In 29 patients, a simultaneous measurement was performed with a conventional coronary pressure wire (PressureWire X, Abbott Medical, Plymouth, MN, USA), and in 19 patients, the vertical height difference between the tip of the guide catheter and the wire measure point was measured in a 90-degree lateral angiographic projection. No adverse events caused by the pressure wires were reported. The mean Pd/Pa and mean FFR using the fluid-filled wire and the sensor-tipped wire differed significantly; however, after correcting for the hydrostatic effect, the sensor-tipped wire pressure correlated well with the fluid-filled wire pressure (R = 0.74 vs. R = 0.89 at rest and R = 0.89 vs. R = 0.98 at hyperemia). Conclusion. Hydrostatic errors in physiologic measurements can be avoided by using the fluid-filled Wirecath wire, which was safe to use in the present study. This trial is registered with NCT04776577 and NCT04802681. [ABSTRACT FROM AUTHOR]

Freshwater lakes and reservoirs cover a small fraction of the Earth, however their emission of the greenhouse gas methane (CH4) from the sediment to the atmosphere is disproportionately high. Currently, there is still a limited understanding of the links between sediment characteristics and CH4 formation. Earlier studies have indicated that sediment age and nitrogen content are related to sediment CH4 formation rates, but it is uncertain such relationships are valid across gradients of sediment characteristics. We therefore measured potential CH4 formation rates in multiple layers of sediment sampled from nine lakes situated in the temperate, boreal and alpine biogeographic regions of Sweden, thus differing in productivity, catchment and climate properties. Potential CH4 formation varied over 3 orders of magnitude, and was broadly related to the quantity and reactivity of organic matter, and generally decreased with sediment depth. Sediment age and total nitrogen content were found to be the key controlling factors of potential CH4 formation rates, together explaining 62% of its variability. Moreover, the model developed from the Swedish lake sediment data was able to successfully predict the potential CH4 formation rates in reservoirs situated in different biogeographic regions of Brazil (R2 = 0.62). Therefore, potential CH4 formation rates in sediments of highly contrasting lakes and reservoirs, from Amazonia to alpine tundra, could be accurately predicted using one common model (RMSE = 1.6 in ln‐units). Our model provides a valuable tool to improve estimates of CH4 emission from lakes and reservoirs, and illustrates the fundamental regulation of microbial CH4 formation by organic matter characteristics. Plain Language Summary: Lakes and reservoirs are important emitters of methane, a strong greenhouse gas, to the atmosphere. Methane is produced in absence of oxygen by specific microbes that degrade the organic matter in the sediment. Currently, it is still uncertain which specific sediment properties control the production of methane, and if such properties are the same across lakes and reservoirs located in different ecosystem. To test this, we collected sediment cores from several lakes across different ecosystems in Sweden, and we measured potential methane formation rates. Methane formation rates varied greatly among lakes and was related to the quality and quantity of organic matter in the sediment. From this experiment, we calculated an empirical model that can predict methane formation rates as a function of sediment age and nitrogen content. Moreover, we found that our model could well predict potential methane formation rates in tropical reservoirs. In conclusion, sediment age and nitrogen content are universal controlling factors of methane formation rates across lakes and reservoirs in different ecosystems, from tropics to arctic tundra. Our findings provide a valuable tool to improve estimates of methane emission from lakes and reservoirs and illustrates how sediment characteristics play a crucial role in regulating methane formation rates. Key Points: Methane (CH4) formation rates in lake sediment varied greatly among nine Swedish lakes located in different biogeographic regionsCH4 formation rates are related to reactivity and quantity of organic matter in the sediment, primarily to sediment age and total nitrogenCH4 formation rates measured in contrasting sediment, spanning from Amazonia to Arctic tundra could be predicted by a common empirical model [ABSTRACT FROM AUTHOR]

In this article, a high-resolution acoustic emission sensor, accelerometer, and broadband seismometer array data set is made available and described in detail from in situ experiments performed at Äspö Hard Rock Laboratory in May and June 2015. The main goal of the hydraulic stimulation tests in a horizontal borehole at 410 m depth in naturally fractured granitic rock mass is to demonstrate the technical feasibility of generating multi-stage heat exchangers in a controlled way superiorly to former massive stimulations applied in enhanced geothermal projects. A set of six, sub-parallel hydraulic fractures is propagated from an injection borehole drilled parallel to minimum horizontal in situ stress and is monitored by an extensive complementary sensor array implemented in three inclined monitoring boreholes and the nearby tunnel system. Three different fluid injection protocols are tested: constant water injection, progressive cyclic injection, and cyclic injection with a hydraulic hammer operating at 5 Hz frequency to stimulate a crystalline rock volume of size 30 m × 30 m × 30 m at depth. We collected geological data from core and borehole logs, fracture inspection data from an impression packer, and acoustic emission hypocenter tracking and tilt data, as well as quantified the permeability enhancement process. The data and interpretation provided through this publication are important steps in both upscaling laboratory tests and downscaling field tests in granitic rock in the framework of enhanced geothermal system research. Data described in this paper can be accessed at GFZ Data Services under 10.5880/GFZ.2.6.2023.004. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to illuminate the lived experiences and the path of recovery for adults sustaining a hip fracture before the age of 60. Methods: Participants were purposively sampled from a prospective multicenter cohort study in Sweden and Denmark, and narrative interviews were conducted with 19 individuals 0.7-3.5 years after the fracture. We used a phenomenological hermeneutic method to describe the participants' expressed essential meaning. Results: The experience of sustaining a hip fracture was expressed as a painful and protracted process of regaining self-confidence, function, and independence. It also implied a sense of growing old from one day to the next. Participants were afraid of new falls and fractures, resulting in an increased wariness. When expressing fears and persisting symptoms, participants described being neglected and marginalized by the healthcare system, which was perceived as non-receptive and routinely driven by a notion that hip fractures affect only the elderly. Rehabilitation targeted towards needs different from those of elderly individuals was requested. Conclusion: The lived experience of sustaining a hip fracture in individuals under 60 includes substantial challenges in everyday life, even up to 3.5 years after the injury. Rehabilitation pathways tailored to the needs of younger patients are requested. [ABSTRACT FROM AUTHOR]

The aim of this population-based cross-sectional study was to assess the prevalence of healthcare avoidance during the COVID-19 pandemic and its associated factors among the Sámi population in Sweden. Data from the "Sámi Health on Equal Terms" (SámiHET) survey conducted in 2021 were used. Overall, 3,658 individuals constituted the analytical sample. Analysis was framed using the social determinants of health framework. The association between healthcare avoidance and several sociodemographic, material, and cultural factors was explored through log-binomial regression analyses. Sampling weights were applied in all analyses. Thirty percent of the Sámi in Sweden avoided healthcare during the COVID-19 pandemic. Sámi women (PR: 1.52, 95% CI: 1.36–1.70), young adults (PR: 1.22, 95% CI:1.05–1.47), Sámi living outside Sápmi (PR: 1.17, 95% CI: 1.03–1.34), and those having low income (PR: 1.42, 95% CI:1.19–1.68) and experiencing economic stress (PR: 1.48, 95% CI: 1.31–1.67) had a higher prevalence of healthcare avoidance. The pattern shown in this study can be useful for planning future pandemic responses, which should address healthcare avoidance, particularly among the identified vulnerable groups, including the active participation of the Sámi themselves. [ABSTRACT FROM AUTHOR]

Background: Gaming is a popular past‐time activity among children and adolescents, but it there is also a possible link to negative consequences such as psychological distress and lowered academic achievement. However, there are fundamental knowledge gaps remaining regarding central characteristics of gaming such as heritability, stability over time, and sex differences. We examined the genetic and environmental contribution to gaming behavior, including sex differences, continuity and change, in a longitudinal cohort of twins. Methods: This is the first longitudinal twin study on gaming, involving 32,006 twins in Sweden. Parents were asked about the twins' gaming at ages 9, 15 and 18. We used univariate and multivariate twin analyses to estimate the relative contribution of genetic and environmental influences at each time‐point as well as across time. Sex‐differences were also explored. Results: The results showed large sex differences, where genetics explained more of the variance for boys (31.3%–62.5% depending on age) than for girls (19.4%–23.4%). Genetic factors explained an increasing amount of the variance for boys (31.3% at age 9, 62.5% at age 15 and 53.9% at age 18). Shared environmental factors explained a larger proportion of the variance among girls, which remained relatively stable over time (70.5% at age 9, 61.8% at age 15 and 60.5% at age 18). The results also indicated that most of the variance came from genetic and environmental sources specific to each age. Conclusions: Compared to many other behavioral phenotypes, such as gambling, gaming was relatively unstable with a large degree of genetic innovation. There were large sex differences in the contribution of genetic and environmental factors. This suggests that excessive gaming could be the result of age‐ and sex‐specific genetic and environmental factors, and should be taken into account when mapping gaming behaviors, since these behaviors might be under continual etiological transformation. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the prevalence of poor self‐reported oral health and to identify socio‐demographic, socio‐economic and cultural‐related risk factors associated with poor oral health among Sámi in Sweden. Methods: A Sámi sample frame was constructed drawing from three pre‐existing registers. All identified persons aged 18–84 were invited to participate in the study during February–May 2021. Among the 9249 invitations, 3779 answered the survey. The frequencies of the independent variables in terms of socio‐economic, socio‐demographic and cultural‐related factors as well as the outcome, self‐reported oral health, were calculated first. Prevalence ratios (PRs) and their 95% confidence interval (95% CI) were estimated to assess the relationship between the independent variables and the outcome. Results: Overall, 32.5% of the participants reported a poor oral health with a higher prevalence among men compared to women. Among the socio‐demographic factors, being old (PR: 1.99; 95% CI: 1.59–2.51), unmarried (PR: 1.17; 95% CI: 1.03–1.33) and divorced or widow‐er (PR: 1.27; 95% CI: 1.09–1.46) were statistically associated to poor self‐reported oral health. Among the socio‐economic factors, a low education level (PR: 1.56; 95% CI: 1.29–1.89), belonging to the poorest quintile (PR: 1.63; 95% CI: 1.35–1.96), and experiencing difficulties to make ends meet several times during the last 12 months (PR: 1.74; 95% CI: 1.51–1.99) were statistically significant related to poor oral health. Conclusions: The self‐reported oral health among Sámi in Sweden appears to be worse than that of the general Swedish population. Several socio‐economic and socio‐demographic factors were found to be strongly associated with poor self‐reported oral health. Targeted interventions addressing these social determinants are needed to reduce inequalities in oral health among the Sámi population. [ABSTRACT FROM AUTHOR]

Aims: COVID-19 increases the risk of cardiovascular disease, especially thrombotic complications. There is less knowledge on the risk of arrhythmias after COVID-19. In this study, we aimed to quantify the risk of arrhythmias following COVID-19. Methods and results: This study was based on national register data on all individuals in Sweden who tested positive for SARS-CoV-2 between 1 February 2020 and 25 May 2021. The outcome was incident cardiac arrhythmias, defined as international classification of diseases (10th revision) codes in the registers as follows: atrial arrhythmias; paroxysmal supraventricular tachycardias; bradyarrhythmias; and ventricular arrhythmias. A self-controlled case series study and a matched cohort study, using conditional Poisson regression, were performed to determine the incidence rate ratio and risk ratio, respectively, for an arrhythmia event following COVID-19.A total of 1 057 174 exposed (COVID-19) individuals were included in the study as well as 4 074 844 matched unexposed individuals. The incidence rate ratio of atrial tachycardias, paroxysmal supraventricular tachycardias, and bradyarrhythmias was significantly increased up to 60, 180, and 14 days after COVID-19, respectively. In the matched cohort study, the risk ratio during Days 1–30 following COVID-19/index date was 12.28 (10.79–13.96), 5.26 (3.74–7.42), and 3.36 (2.42–4.68), respectively, for the three outcomes. The risks were generally higher in older individuals, in unvaccinated individuals, and in individuals with more severe COVID-19. The risk of ventricular arrhythmias was not increased. Conclusion: There is an increased risk of cardiac arrhythmias following COVID-19, and particularly increased in elderly vulnerable individuals, as well as in individuals with severe COVID-19. Graphical Abstract Overview of the study methods and main findings. [ABSTRACT FROM AUTHOR]

Background: Attention‐deficit/hyperactivity disorder (ADHD) is an increasingly commonly diagnosed neurodevelopmental condition. One possibility is that this reflects a genuine increase in the prevalence of ADHD due to secular environmental changes, yet this hypothesis remains untested. We therefore investigated whether the genetic and environmental variance underlying ADHD, and traits of ADHD, has changed over time. Methods: We identified twins born from 1982 to 2008 from the Swedish Twin Registry (STR). We linked the STR with the Swedish National Patient Register and Prescribed Drug Register to identify diagnoses of ADHD and prescriptions of ADHD medication for these twins. We also utilized data collected from participants in the Child and Adolescent Twin Study in Sweden (CATSS), born from 1992 to 2008. Their parents completed a structured ADHD screening tool, which was used to measure traits of ADHD and assign broad screening diagnoses of ADHD. We used the classical twin design to test whether the degree to which variation in these measures was influenced by genetic and environmental variation changed over time. Results: We included 22,678 twin pairs from the STR and 15,036 pairs from CATSS. The heritability of ADHD in the STR ranged from 66% to 86% over time, although these fluctuations were not statistically significant. We observed a modest increase in variance in ADHD traits, from 0.98 to 1.09. This was driven by small increases in the underlying genetic and environmental variance, with heritability estimated as 64%–65%. No statistically significant changes in variance in screening diagnoses were observed. Conclusions: The relative contribution of genetic and environmental factors to ADHD has remained stable over time, despite its increasing prevalence. Thus, changes in the underlying etiology of ADHD over time are unlikely to explain the increase in ADHD diagnoses. [ABSTRACT FROM AUTHOR]

Overall, suicide rates in the Nordic region, Denmark, Finland, Iceland, Norway and Sweden, have declined in the past 40 years. The aim of this study was to determine trends in suicide mortality from 2000 to 2018. Data were obtained from official suicide statistics for men and women, 15 years and older. Gender and age groups in four calendar periods were analyzed using Joinpoint Estimated Regression Coefficient. The crude regional suicide rate was 17.1, 2000–2004, decreased to 14.1 per 100,000 inhabitants in 2015–2018. Age-standardized rates are 13.6–11.3. The crude rate decreased by 19.5% (16.3% age-standardized), 19.3% for males and 20.5% for females. The largest decrease was found in Finland (34.9%), the smallest in Norway (1.4%). In males, the exception was an increased suicide rate among all Icelandic except 15–24-year olds, and in 45–64 year-old Norwegians. Among females, an increase was seen among 15–24-year olds in all countries except Iceland, in all age groups in Norway, and in 25–44-year olds in Sweden. In males, a decline of the suicide rated lower than 10% was noted in 25–44 olds in Norway and in 15–64 year-olds in Sweden. A robust decrease was observed in the overall regional suicide rate in recent years. Exceptions are rising rates in Icelandic males, in Norwegian females, and the youngest female groups in all except Iceland. The small decline among middle-aged males in Norway and Sweden is of concern. [ABSTRACT FROM AUTHOR]

Literature about asthma among Indigenous communities worldwide is scarce. This study aimed to estimate the prevalence of self-reported asthma and to identify the risk factors associated with it among the Sámi population in Sweden. A population-based health study (SámiHET) was conducted among the Sámi population aged 18–84 years in 2021. The asthma outcome was self-reported. Potential risk factors included sociodemographic, socioeconomic, cultural, behavioral and psychosomatic factors. Frequencies and percentages of the independent variables and the outcome were calculated. Then, the magnitude of the association between the independent variables and asthma was summarized with the prevalence ratio (PR) using the 95% confidence interval (95% CI) for inferential purposes. Overall, 20.6% of participants reported having asthma and 13.9% suffering from asthma with symptoms. Women (PR: 1.19; 95% CI: 1.01–1.42), those living in the Västerbotten region (PR: 1.35; 95% CI: 1.11–1.63) and those suffering financial strain (PR: 1.34; 95% CI: 1.07–1.69) had a higher risk of self-reported asthma. Among the psychosomatic factors, self-reported allergy (PR: 6.45; 95% CI: 5.11–8.17), overweight (PR: 1.46; 95% CI: 1.19–1.78) and obesity (PR: 1.75; 95% CI: 1.41–2.17) were statistically significant associated to asthma symptoms. A higher prevalence of asthma was found among the Sámi in Sweden compared to the average Swedish population. The associated risk factors were similar to those described in the literature. To understand the reason behind the higher prevalence of asthma among Sámi, more asthma-specific research, including register data, is needed. [ABSTRACT FROM AUTHOR]

Background: Twin studies have demonstrated shared genetic and environmental effects between eating disorders and alcohol involvement in adults and middle adolescents. However, fewer studies have focused on late adolescents or investigated a wide range of eating disorder dimensions and alcohol involvement subscales in both sexes. We examined genetic and environmental correlations among three eating disorder dimensions and two alcohol involvement subscale scores in late adolescent twins using bivariate twin models. Methods: Participants were 3568 female and 2526 male same‐sex twins aged 18 years old from the Child and Adolescent Twin Study in Sweden. The Eating Disorder Inventory‐2 (EDI) assessed the drive for thinness, bulimia, and body dissatisfaction. Alcohol involvement was assessed with the Alcohol Use Disorder Identification Test consumption (AUDIT‐C) and problem (AUDIT‐P) subscales. Results: Only phenotypic and twin correlations in female twins met our threshold for twin modeling. The proportion of total variance for each trait accounted for by additive genetic factors ranged from 0.50 to 0.64 in female twins, with the rest explained by nonshared environmental factors and measurement error. Shared environmental factors played a minimal role in the variance of each trait. The strongest genetic correlation (ra) emerged between EDI bulimia and AUDIT‐P (ra = 0.46, 95% confidence interval: 0.37, 0.55), indicating that the proportion of genetic variance of one trait that was shared with the other trait was 0.21. Nonshared environmental correlations between eating disorder dimensions and alcohol involvement ranged from 0.03 to 0.13. Conclusions: We observed distinct patterns of genetic and environmental effects for co‐occurring eating disorder dimensions and alcohol involvement in female vs. male twins, supporting sex‐specific treatment strategies for late adolescents with comorbid eating disorders and alcohol use disorder. Our findings emphasize the importance of assessing family history of multiple eating disorder dimensions while treating late adolescents with problematic alcohol use, and vice versa, to improve detection and treatment. [ABSTRACT FROM AUTHOR]

The longitudinal relationship between attention deficit hyperactivity disorder (ADHD) and violent criminality has been extensively documented, while long-term effects of autism spectrum disorders (ASDs), tic disorders (TDs), and obsessive compulsive disorder (OCD) on criminality have been scarcely studied. Using population-based registers of all child and adolescent mental health services in Stockholm, we identified 3,391 children, born 1984-1994, with neurodevelopmental disorders, and compared their risk for subsequent violent criminality with matched controls. Individuals with ADHD or TDs were at elevated risk of committing violent crimes, no such association could be seen for ASDs or OCD. ADHD and TDs are risk factors for subsequent violent criminality, while ASDs and OCD are not associated with violent criminality.

Research on winner-loser effects has demonstrated the consequences voting for a winning or losing party have on evaluations of democracy: Voting for the winners makes voters more positive toward democracy and the electoral process while voting for the losers makes them more negative. However, in the literature, less attention has been devoted to a possible winner-loser effect on confidence in the institutions responsible for the conduct of elections. In the following study, we bridge this gap by exploring how confidence in Sweden’s Election Authority changed among voters of winning and losing parties. The analyses indicated that, despite the high institutional trust and system support in Sweden, voters lost confidence in the Election Authority if their party lost and gained confidence if their party won. This effect was strongest among voters of the Sweden Democrats. Overall, Sweden Democratic voters gained the most confidence after the 2022 election, probably attributable to the Sweden Democrats shedding their pariah status and invited to real government influence in 2022. [ABSTRACT FROM AUTHOR]

Background: Several copy number variations (CNVs) are associated with increased risk for neurodevelopmental and psychiatric disorders. The CNV 15q11.2 (BP1‐BP2) deletion has been associated with learning difficulties, attention deficit hyperactivity disorder (ADHD), epilepsy, and brain morphology; however, many carriers present mild or no symptoms. Carrying the reciprocal duplication does not seem to confer risk for these disorders or traits. Our aim was to examine the impact of carrying either 15q11.2 deletion and reciprocal duplication on neurodevelopmental problems in a population‐based sample of children. Methods: Twins with genotype and phenotype information in the Child and Adolescent Twin Study in Sweden (CATSS) were included (N = 12,040). We included measures of neurodevelopmental problems (NDPs), including learning problems, from the questionnaire Autism–Tics, ADHD, and other Comorbidities inventory (A‐TAC) at age 9/12, ADHD and autism spectrum disorder (ASD) questionnaires at age 18, as well as information about lifetime psychiatric diagnoses and epileptic seizures. We tested the association between these phenotypic measurements and carrying the 15q11.2 deletion, the reciprocal duplication, and other CNVs with previously reported strong associations with neurodevelopmental and psychiatric disorders (i.e., psychiatric CNVs). Results: We identified 57 carriers of the 15q11.2 deletion, 75 carriers of the reciprocal duplication, and 67 carriers of other psychiatric CNVs. We did not find an increased risk for NDPs or psychiatric diagnoses in the 15q11.2 deletion carriers. For 15q11.2 duplication carriers, we found an increased risk for math learning problems and fewer self‐reported ADHD symptoms at age 18 but not for other NDPs. In line with previous studies, we found an increased risk of NDPs and other evaluated phenotypes in carriers of psychiatric CNVs. Conclusions: Our results support previous findings that carrying 15q11.2 deletion does not have a large effect on NDPs in children. [ABSTRACT FROM AUTHOR]

Background: The association between tobacco smoking and the risk of COVID-19 and its adverse outcomes is controversial, as studies reported contrasting findings. Bias due to misclassification of the exposure in the analyses of current versus non-current smoking could be a possible explanation because former smokers may have higher background risks of the disease due to co-morbidity. The aim of the study was to investigate the extent of this potential bias by separating non-, former, and current smokers when assessing the risk or prognosis of diseases. Methods: We analysed data from 43,400 participants in the Stockholm Public Health Cohort, Sweden, with information on smoking obtained prior to the pandemic. We estimated the risk of COVID-19, hospital admissions and death for (a) former and current smokers relative to non-smokers, (b) current smokers relative to non-current smokers, that is, including former smokers; adjusting for potential confounders (aRR). Results: The aRR of a COVID-19 diagnosis was elevated for former smokers compared with non-smokers (1.07; 95% confidence interval (CI) =1.00–1.15); including hospital admission with any COVID-19 diagnosis (aRR= 1.23; 95% CI = 1.03–1.48); or with COVID-19 as the main diagnosis (aRR=1.23, 95% CI= 1.01–1.49); and death within 30 days with COVID-19 as the main or a contributory cause (aRR=1.40; 95% CI=1.00–1.95). Current smoking was negatively associated with risk of COVID-19 (aRR=0.79; 95% CI=0.68–0.91). Conclusions: Separating non-smokers from former smokers when assessing the disease risk or prognosis is essential to avoid bias. However, the negative association between current smoking and the risk of COVID-19 could not be entirely explained by misclassification. [ABSTRACT FROM AUTHOR]

Background: Despite extensive efforts, the causes of autism remain unknown. Advancing paternal age has been associated with various neurodevelopmental disorders. We aim to investigate three unresolved questions: (a) What is the association between paternal age and autism spectrum disorders (ASD)?; (b) Does paternal age moderate the genetic and environmental etiological factors for ASD? (c) Does paternal age affect normal variation in autistic-like traits? Methods: Two nationally representative twin studies from Sweden (n = 11, 122, assessed at age 9 or 12) and the UK (n = 13, 524, assessed at age 9) were used. Categorical and continuous measures of ASD, autistic-like traits and autistic similarity were calculated and compared over paternal age categories. Results: Both cohorts showed a strong association between paternal age and the risk for ASD. A U-shaped risk association could be discerned since the offspring of both the youngest and oldest fathers showed an elevation in the risk for ASD. Autistic similarity increased with advancing paternal age in both monozygotic and dizygotic twins. Both cohorts showed significantly higher autistic-like traits in the offspring of the youngest and oldest fathers. Conclusions: Phenomena associated with paternal age are clearly involved in the trajectories leading to autistic-like traits and ASD. Mechanisms influencing the trajectories might differ between older and younger fathers. Molecular genetic studies are now needed in order to further understand the association between paternal age and ASD, as well as normal variation in social, language, and repetitive behaviors in the general population.

This retrospective cohort study aims to provide a comprehensive account of death in Swedish patients with ALS, including clinical status preceding death, the death setting, as well as symptoms. The study presents detailed information on a cohort of patients with ALS from Stockholm, Sweden, deceased in 2018–2020. In addition, selected information is presented on a larger complementary cohort of ALS patients from all regions of Sweden deceased in 2011–2020. Data were obtained from patient medical records, the Swedish Motor Neuron Disease Quality Registry, and the Swedish Quality Registry of Palliative Care. Ninety-three patients were included in the main cohort and 2224 patients in the complementary cohort. In the main cohort, there was a slow decline in weight and motor function during the 12 months preceding death. Most (93.4%) anticipated/prolonged deaths occurred in a palliative care unit, at home, or in an assisted living facility while 44.8% of precipitous deaths occurred in a hospital ward. Next of kin or health care staff were present at death for most patients (78.7%). In the final week of life, 41.1% experienced at least one symptom (either pain, anxiety, confusion, or dyspnea) that was only partially relieved or not at all. The majority of patients died in their own homes or at a palliative unit in the presence of next of kin and most symptoms were adequately managed. This paper might be used in educating patients, next of kin as well as health professionals, decreasing uncertainty surrounding the end of life. [ABSTRACT FROM AUTHOR]

Background: Autism spectrum condition and attention-deficit/hyperactivity disorder (ADHD) are associated with a range of physical health conditions. The aim of this study was to examine the etiological components contributing to co-occurring physical health conditions in autism and ADHD. Methods: In this nationwide Child and Adolescent Twin Study in Sweden, we analyzed data from 10,347 twin pairs aged 9 and 12. Clinical diagnoses of autism, ADHD, and physical health conditions were identified through the Swedish National Patient Register. Subclinical phenotypes of autism and ADHD were defined by symptom thresholds on a standardized parent-interview, the Autism–Tics, ADHD, and Other Comorbidities inventory. Associations between physical health conditions and autism/ADHD phenotypes were examined using generalized estimating equations. Bivariate twin models were applied to estimate the extent to which genetic and environmental risk factors accounted for physical health comorbidities. Results: Similar patterns of association with physical health conditions were found in clinical and subclinical autism/ADHD, with odds ratios ranging from 1.31 for asthma in subclinical ADHD to 8.03 for epilepsy in clinical autism. The estimated genetic correlation (ra) with epilepsy was 0.50 for clinical autism and 0.35 for subclinical autism. In addition, a modest genetic correlation was estimated between clinical autism and constipation (ra = 0.31), functional diarrhea (ra = 0.27) as well as mixed gastrointestinal disorders (ra = 0.30). Genetic effects contributed 0.86 for mixed gastrointestinal disorders in clinical ADHD (ra = 0.21). Finally, subclinical ADHD shared genetic risk factors with epilepsy, constipation, and mixed gastrointestinal disorders (ra = 0.30, 0.17, and 0.17, respectively). Limitations: Importantly, since medical records from primary care were not included in the registry data used, we probably identified only more severe rather than the full range of physical health conditions. Furthermore, it needs to be considered that the higher prevalence of physical health conditions among autistic children and children with ADHD could be associated with the increased number of medical visits. Conclusions: Shared genetic effects contribute significantly to autism and ADHD phenotypes with the co-occurring physical health conditions across different organ systems, including epilepsy and gastrointestinal disorders. The shared genetic liability with co-occurring physical health conditions was present across different levels of autism and ADHD symptom severity. [ABSTRACT FROM AUTHOR]

Clusters of sea stacks, called rauks, are unique rocky landforms characteristic of Baltic Sea coasts. These limestone stacks raise interest due to their spectacular morphology and yet unexplained origin. This study presents the results of seasonal observations (2019–2020) of rauk coast changes carried out in one of the key rauk fields on Fårö Island, Sweden. The landforms developing within three test sites were examined. At Langhammars 'classic' field of rauks built from homogeneous limestone (1) and a shore platform devoid of rauks, underlain clearly separate limestone slabs were explored (2); and at Gamla Hamn, the analysis covered a non-typical rauk field built of densely laminated limestone (3). We applied terrestrial laser scanning (TLS) to obtain data needed in morphometric analyses and rauk surface change monitoring. We identified and determined contemporary erosional rates and dominant processes responsible for eroding and downwearing of rauk coasts. The observed changes were strongly associated with differences in local lithological and structural conditions—from a nearly complete absence within massive limestone rauks notches, to clear signs of erosion within limestone slabs eroded by waves, almost 1 m2 in size. [ABSTRACT FROM AUTHOR]

Key Points: Question: To what extent do genetic and environmental factors contribute to the liability to avoidant restrictive food intake disorder (ARFID)? Findings: In this nationwide Swedish twin study including 16 951 twin pairs aged 6 to 12 years, using parent-reported and national health register data, a composite score to identify the ARFID phenotype was developed. The heritability of ARFID was high (79%), and nonshared environmental factors played a smaller but significant role (21%). Meaning: In this study, the heritability of ARFID was comparable with the heritability of other eating disorders and similar to heritability of neurodevelopmental disorders. This nationwide twin study evaluates the extent to which genetic and environmental factors contribute to the liability to the broad avoidant restrictive food intake disorder phenotype. Importance: Avoidant restrictive food intake disorder (ARFID) is characterized by an extremely limited range and/or amount of food eaten, resulting in the persistent failure to meet nutritional and/or energy needs. Its etiology is poorly understood, and knowledge of genetic and environmental contributions to ARFID is needed to guide future research. Objective: To estimate the extent to which genetic and environmental factors contribute to the liability to the broad ARFID phenotype. Design, Setting, and Participants: This nationwide Swedish twin study includes 16 951 twin pairs born between 1992 and 2010 whose parents participated in the Child and Adolescent Twin Study in Sweden (CATSS) at twin age 9 or 12 years. CATSS was linked to the National Patient Register (NPR) and the Prescribed Drug Register (PDR). Data were collected from July 2004 to April 2020, and data were analyzed from October 2021 to October 2022. Main Outcomes and Measures: From CATSS, NPR, and PDR, all parent reports, diagnoses, procedures, and prescribed drugs that were relevant to the DSM-5 ARFID criteria were extracted when twin pairs were aged 6 to 12 years and integrated into a composite measure for the ARFID phenotype (ie, avoidant/restrictive eating with clinically significant impact, such as low weight or nutritional deficiency, and with fear of weight gain as an exclusion). In sensitivity analyses, autism and medical conditions that could account for the eating disturbance were controlled for. Univariate liability threshold models were fitted to estimate the relative contribution of genetic and environmental variation to the liability to the ARFID phenotype. Results: Of 33 902 included children, 17 151 (50.6%) were male. A total of 682 children (2.0%) with the ARFID phenotype were identified. The heritability of ARFID was 0.79 (95% CI, 0.70-0.85), with significant contributions from nonshared environmental factors (0.21; 95% CI, 0.15-0.30). Heritability was very similar when excluding children with autism (0.77; 95% CI, 0.67-0.84) or medical illnesses that could account for the eating disturbance (0.79; 95% CI, 0.70-0.86). Conclusions and Relevance: Prevalence and sex distribution of the broad ARFID phenotype were similar to previous studies, supporting the use of existing epidemiological data to identify children with ARFID. This study of the estimated genetic and environmental etiology of ARFID suggests that ARFID is highly heritable, encouraging future twin and molecular genetic studies. [ABSTRACT FROM AUTHOR]

The aim of this article was to use an interpretivist approach to analyse the state–citizen nexus in general and the conflict between civil and social rights imposing restrictions on people's freedom of movement during the COVID-19 pandemic in the Nordic countries: Sweden (restrictions were voluntary and relied on nudging and individual implementation), Norway (restrictions of movement were for everyone and was enforced by authorities), and Finland (restrictions of movement were for the capital region and was enforced by authorities). Sweden focused more on upholding the civil rights vis-à-vis social rights whereas in Norway and Finland social rights have trumped civil rights in the face of the pandemic. Thus, the analysis suggests that the Nordic countries cannot be understood as monoliths in all respects. The article thereby contributes to a greater understanding of how the Nordic governments prioritise civil and social rights differently when they are forced to choose. [ABSTRACT FROM AUTHOR]

A considerable number of lakes in Sweden have high phosphorus internal loading from the sediments which cause cyanobacterial blooms every summer. Due to potential risks with such blooms for human health, drinking water supply, and ecosystem services, measures need to be taken to control the phosphorus content. Measures to control the phosphorus input from the surrounding land has been in focus. However, the measures have not been sufficient. This is because phosphorus deposited at the bottom of the lakes for many years are finally starting to leak to the water phase when the decomposition of sediments leads to anoxic conditions. In order to determine effective and efficient lake restoration measures, methods for lake restoration decision support by a multi-criteria analysis and the application of a decision analysis are developed. The multi-criteria analysis includes the determination of costs, longevity, and efficacy of six common lake restoration measures to reduce internal phosphorous loads in two lakes selected as a case study. The results show that aluminum treatment combines a highest efficacy with a high-cost efficiency being thus the optimal identified measure. The method involves adding an aluminum solution to the lakes' sediment, which binds phosphorus, preventing it to be released to the water column. The multi-criteria model is integrated to a decision analytical model. The decision analytical model is used to identify the monetary socio-economic and environmental boundaries for the implementation of the optimal lake restoration measure. [ABSTRACT FROM AUTHOR]

Background and purpose: Hip fractures should be treated based on the best available evidence and cost-effectively to optimize the outcome for this large group of frail patients. This study examined nationwide variation in surgical methods used for hip fractures. Methods: In this cohort study 46,243 patients ≥65 years with a trochanteric hip fracture (THF) or a femoral neck fracture (FNF) registered in the Swedish Fracture Register (SFR) between 1 January 2016 and 31 December 2020 were included. Fractures were classified according to the AO Foundation/Orthopaedic Trauma Association (AO/OTA) fracture classification system. The choice of surgical methods was assessed for each fracture type to compare national variation. Results: 21,312 THFs and 24,072 FNFs (67% women) with a mean age of 83 years (SD 8) were surgically treated. In the treatment of two-fragment THFs (AO/OTA A1) departments ranged from using 90% short intramedullary nails to 98% sliding hip screws. Treating displaced FNFs (AO/OTA B3), the proportion of hemiarthroplasty ranged from 9 to 90%, and internal fixation between 0.6 to 21%, depending on the department. Interpretation: A mature national fracture register permits the monitoring of treatment provided and thus serves as an important aid in assessing compliance with guidelines. The large inter-departmental variation in the surgical management of hip fractures in Sweden appears unwarranted based on the current evidence, indicating a need for updated national guidelines. Further research will have to clarify the impact of this variation on mortality and re-operation rates. [ABSTRACT FROM AUTHOR]

The Resande are a minority ethnic group in Sweden, who were characterized by an itinerant way of life, and they have been suggested to originate from the mixture between Swedish and Romani populations. Because the population history of the Resande has been scarcely studied, we analyzed genome-wide genotype array data from unrelated Resande individuals in order to shed light on their origins and demographic history for the first time from a genetic perspective. Our results confirm the Romani-related ancestry of this population and suggest an admixture event between a Romani-like population and a general Swedish-like population that occurred approximately between the mid-18th and mid-19th centuries, two centuries after the arrival of the first historically reported Romani families in Sweden. This inferred date suggests that the Romani group involved in the admixture is related to the pre-18th-century arrivals of Romani in Scandinavia. In addition, a reduction in the population size is detected previous to the admixture event, suggesting a subtle signal of isolation. The present work constitutes a step forward toward a better representation of ethnic minorities and underrepresented groups in population genetic analyses. In order to know in more detail the complete history of human populations, it is time to focus on studying populations that have not been previously considered for a general scenario and that can provide valuable information to fill in the gaps that still remain uncovered. [ABSTRACT FROM AUTHOR]

Copyright of Acta Oto-Laryngologica is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The introduction of anti-TNF therapy has revolutionized the management of inflammatory bowel disease (IBD). This study aimed to investigate the impact of anti-TNF therapy on emergency subtotal colectomy rates in patients with IBD (ulcerative colitis, Crohn's disease or indeterminate colitis) during two time periods. IBD patients treated with emergency subtotal colectomy for acute severe colitis at Skåne University Hospital, Sweden, during two six-year windows were included. The two time-windows represented pre- and introductory (2004–2009) versus post-introductory (2012–2017) anti-TNF therapy usage. The two periods were compared in terms of the proportion of patients who received anti-TNF therapy, rates of emergency subtotal colectomy, and local IBD prevalence numbers. In total 91 patients were included, 42 (2004–2009) and 49 (2012–2017) patients, respectively. The proportion of patients that received anti-TNF therapy prior to admission was increased from 29% (2004–2009) to 63% (2012–2017) (p =.001). Despite this no significant difference was found in the emergency subtotal colectomy rates between the time periods considering the population at risk (IBD patients living in Skåne county); 1.44/1000 person years versus 1.37/1000 person years (p =.83). Despite an increased proportion of patients with IBD that received anti-TNF therapy prior to admission, no significant decrease in emergency subtotal colectomy rates was noted. Further research is warranted, and a prospective study design would facilitate a better causal understanding. [ABSTRACT FROM AUTHOR]

In a classic piece, Przeworski and Sprague describe an electoral dilemma of social democratic parties: they need to attract middle-class voters without losing support in the shrinking working-class. With cultural issues (e.g. immigration) becoming more salient, this dilemma has intensified recently as the positions of both classes differ markedly on those issues. Against this background, we analyse the class base of social democratic parties in 13 Western European countries using data from the European Social Survey (2002–2018). Our exploratory study shows that in almost all countries support for social democrats has decreased across all classes. Yet, we still find significant differences in the social democrats' class bases. In Denmark, Sweden or Spain, social democrats still largely base their support on service and particularly production workers, while in France or Switzerland, these groups no longer primarily vote for social democrats. Here middle-class people, particularly socio-cultural professionals, are the strongest supporters of social democrats. Countries such as Germany or Norway exhibit no clear social democratic class base and gaining support from both groups at the same time seems to be most difficult. Only the British Labour Party succeeded to some extent in the balancing act of winning both middle- and working-class voters. [ABSTRACT FROM AUTHOR]

Importance: Psychiatric disorders are common among autistic children and adults. Little is known about sex differences in psychiatric disorders and hospitalization in early adulthood.Objective: To examine sex differences in psychiatric diagnoses and hospitalizations in autistic compared with nonautistic young adults.Design, Setting, and Participants: This population-based cohort study assessed all individuals born in Sweden between 1985 and 1997. A total of 1 335 753 individuals, including 20 841 autistic individuals (7129 [34.2%] female individuals), were followed up from age 16 through 24 years between 2001 and 2013. Analysis took place between June 2021 and August 2022.Exposures: Autism was defined as having received at least 1 clinical diagnosis of autism based on the International Classification of Diseases.Main Outcomes and Measures: The cumulative incidence of 11 psychiatric diagnoses up until age 25 years was estimated, and birth year-standardized risk difference was used to compare autistic female and male individuals directly. Sex-specific birth year-adjusted hazard ratios (HRs) with 95% CIs were calculated using Cox regression. Analyses were repeated for inpatient diagnoses to assess psychiatric hospitalization.Results: Of 1 335 753 individuals included in this study, 650 314 (48.7%) were assigned female at birth. Autism was clinically diagnosed in 20 841 individuals (1.6%; 7129 [34.2%] female) with a mean (SD) age of 16.1 (5.1) years (17.0 [4.8] years in female individuals and 15.7 [5.2] years in male individuals) for the first recorded autism diagnosis. For most disorders, autistic female individuals were at higher risk for psychiatric diagnoses and hospitalizations. By age 25 years, 77 of 100 autistic female individuals and 62 of 100 autistic male individuals received at least 1 psychiatric diagnosis. Statistically significant standardized risk differences were observed between autistic female and male individuals for any psychiatric disorder (-0.18; 95% CI, -0.26 to -0.10) and specifically for anxiety, depressive, and sleep disorders. Risk differences were larger among autistic than nonautistic individuals. Compared with nonautistic same-sex individuals, autistic female individuals (HR range [95% CI], 3.17 [2.50-4.04.]-20.78 [18.48-23.37]) and male individuals (HR range [95% CI], 2.98 [2.75-3.23]-18.52 [17.07-20.08]) were both at increased risk for all psychiatric diagnoses. Any psychiatric hospitalization was statistically significantly more common in autistic female individuals (32 of 100) compared with autistic male individuals (19 of 100). However, both autistic female and male individuals had a higher relative risk for psychiatric hospitalization compared with nonautistic female and male individuals for all disorders (female individuals: HR range [95% CI], 5.55 [4.63-6.66]-26.30 [21.50-32.16]; male individuals: HR range [95% CI], 3.79 [3.22-4.45]-29.36 [24.04-35.87]).Conclusions and Relevance: These findings highlight the need for profound mental health services among autistic young adults. Autistic female individuals, who experience more psychiatric difficulties at different levels of care, require increased clinical surveillance and support. [ABSTRACT FROM AUTHOR]

While people with mental ill-health report unsatisfying experiences and poor treatment in general emergency departments, nursing staff report a lack of adequate knowledge and training. This study describes nursing staff's experiences caring for people with mental ill-health in general emergency departments. A qualitative descriptive design was used and 14 interviews were subjected to qualitative content analysis. Results show that nursing staff are dealing with uncertainty and competing priorities when caring for people with mental ill-health. Nursing staff must both take and be given the opportunity to maintain and develop confidence and independence and need support in promoting mental health recovery. [ABSTRACT FROM AUTHOR]

Background: Basic epidemiological data on patella fractures derived from large nationwide and multicenter studies are scarce. This observational register study describes patient epidemiology, fracture classification and treatment of patella fractures in adults in a Swedish population. Methods: We conducted an observational study on data derived from the Swedish Fracture Register (SFR) on all patella fractures classified as non-periprosthetic and non-pathological, registered between 2014 and 2018 in individuals aged ≥ 18years. Epidemiological data on sex, age, side, seasonal variation, trauma mechanism, fracture classification (according to AO/OTA), and treatment were analyzed. Results: 3194 patella fractures were analyzed, occurring at a median age of 67 (range 19–100) years. 64% of all patients were female. Most fractures were caused by low-energy trauma, with 70% due to falling from a standing height. 1796 (56%) of the fractures were transverse compared to 845 (26%) vertical fractures. Most fractures (N=2148, 67%) were treated non-operatively. Operative treatment consisted mainly of Tension Band Wiring (TBW) performed in 774 (24%) patients. Conclusions: Patella fractures mainly occur in elderly women (> 65 years), commonly caused by low-energy trauma. The main treatment is non-operative (67%), except for transverse (AO/OTA C3) fractures. TBW remains the most used operative treatment of choice. These results may help health care providers, researchers and clinicians better understand the panorama of patella fractures in Sweden. [ABSTRACT FROM AUTHOR]