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Introduction Beyond total mesorectal excision (bTME) offers long-term survival in patients with advanced pelvic malignancy. At Skane University Hospital (SUS) Malmo in Sweden, the vertical rectus abdominis musculocutaneous (VRAM) and gluteal maximus (GM) flap have been used for perineal reconstruction to promote healing and functional outcomes after significant tissue loss. This study aims to examine 90-day overall and flap-specific complications in patients with advanced pelvic cancer treated with bTME and perineal flap reconstruction. Method This retrospective study conducted at SUS included patients undergoing surgery between 01 January 2010 and 01 August 2016. Patients’ data were gathered through medical chart reviews. The Clavien-Dindo (CD) classification system was used to classify surgical and medical postoperative complications. Flap-specific complications were evaluated regardless of CD classification. Results One hundred five patients (51 men, 54 women) underwent bTME surgery with perineal reconstruction, with VRAM flaps used in 27 (26%) patients, GM flaps in 51 (49%) patients and GM flaps with vaginal reconstruction in 27 (26%) patients. The 90-day mortality rate was one (1%), despite surgical CD ≥ III and/or medical CD ≥ II complications affecting 51 (48%) patients. Partial perineal dehiscence was noted in 45 (43%) patients, mostly treated conservatively. At the first outpatient postoperative visit (median, 42 days), flap healing was complete in 47 (45%) patients. Conclusion bTME surgery in pelvic cancer patients with perineal flap reconstruction using VRAM or GM flaps results in high overall and flap complication rates, but low mortality. Most complications can be conservatively treated.

In this study, the early expressive vocabulary development was investigated in a group of children with moderate hearing loss (HL). Size and development of expressive vocabulary from 18 30 months were analyzed and compared to a group of children with normal hearing (NH). For the children with HL, the impact of auditory variables on number of words were examined. The relationship of early consonant production to number of words produced of both groups were examined and the phonological complexity of reported words was compared between the groups. The results showed that children with HL (n = 8) produced a similar number of words as the NH (n = 8) at 18 months, but fewer at 24 and 30 months. Hours of HA use showed significant correlations to number of words. The number of different true consonants at 18 months for the whole group showed a significant relationship to number of words produced at 24 months. No significant differences were found between children with HL and NH children regarding phonological complexity of reported words. The findings indicate that the children born with moderate HL who were fitted with hearing aids (HAs) before 6 months of age are at risk in their development of expressive vocabulary. Full-time use of HAs and monitoring of early consonant use should be encouraged in the early intervention of this target group. Funding Agencies|Wibelfonden; , Tysta skolan; Majblomman; Region Stockholm

We propose a generalized finite element method for the strongly damped wave equation with highly varying coefficients. The proposed method is based on the localized orthogonal decomposition introduced in Målqvist and Peterseim [Math. Comp. 83 (2014) 2583–2603], and is designed to handle independent variations in both the damping and the wave propagation speed respectively. The method does so by automatically correcting for the damping in the transient phase and for the propagation speed in the steady state phase. Convergence of optimal order is proven in L2(H1)-norm, independent of the derivatives of the coefficients. We present numerical examples that confirm the theoretical findings.

While many bumblebee species decline due to climate and land-use changes, others cope well with contemporary conditions. One example is Bombus terrestris, which is common in intensively managed agricultural landscapes. During the 20th century its subgenus, which includes the B. lucorum complex (B. lucorum, B. cryptarum and B. magnus) came to dominate Scandinavian bumblebee communities, but the specific contribution of B. terrestris remains to be understood. Using historical data on males, we assessed how the relative abundances of B. terrestris and the B. lucorum complex changed over the past 150 years in southernmost Sweden. We tested if these changes differed between simplified and mixed landscapes and whether the relative abundance of B. terrestris was related to annual mean temperatures. Because floral availability has advanced as a response to climate change, we also tested if the activity period of males (estimated as catching date) has advanced and whether the advancement differs between taxa. The relative abundance of B. terrestris increased similarly in both landscapes, from 21% to 79% over the period, and this was largely explained by increasing temperature. Male activity period has advanced similarly in the two taxa, with 41 days between 1900 and 2015. Although the dominance of B. terrestris correlates clearly with annual mean temperature, it remains to disentangle why. It also remains to understand whether the success of B. terrestris occurs at the expense of other species or simply reflects that this species copes better with contemporary conditions.

Pollen analysis is an important tool in many fields, including pollination ecology, paleoclimatology, paleoecology, honey quality control, and even medicine and forensics. However, labour‐intensive manual pollen analysis often constrains the number of samples processed or the number of pollen analysed per sample. Thus, there is a desire to develop reliable, high‐throughput, automated systems. We present an automated method for pollen analysis, based on deep learning convolutional neural networks (CNN). We scanned microscope slides with fuchsine stained, fresh pollen and automatically extracted images of all individual pollen grains. CNN models were trained on reference samples (122,000 pollen grains, from 347 flowers of 83 species of 17 families). The models were used to classify images of different pollen grains in a series of experiments. We also propose an adjustment to reduce overestimation of sample diversity in cases where samples are likely to contain few species. Accuracy of a model for 83 species was 0.98 when all samples of each species were first pooled, and then split into a training and a validation set (splitting experiment). However, accuracy was much lower (0.41) when individual reference samples from different flowers were kept separate, and one such sample was used for validation of models trained on remaining samples of the species (leave‐one‐out experiment). We therefore combined species into 28 pollen types where a new leave‐one‐out experiment revealed an overall accuracy of 0.68, and recall rates >0.90 in most pollen types. When validating against 63,650 manually identified pollen grains from 370 bumblebee samples, we obtained an accuracy of 0.79, but our adjustment procedure increased this to 0.85. Validation through splitting experiments may overestimate robustness of CNN pollen analysis in new contexts (samples). Nevertheless, our method has the potential to allow large quantities of real pollen data to be analysed with reasonable accuracy. Although compiling pollen reference libraries is time‐consuming, this is simplified by our method, and can lead to widely accessible and shareable resources for pollen analysis. (Less)

Talkers vary in the phonetic realization of their vowels. One influential hypothesis holds that listeners overcome this inter-talker variability through pre-linguistic auditory mechanisms that normalize the acoustic or phonetic cues that form the input to speech recognition. Dozens of competing normalization accounts exist —including both vowel-specific (e.g., Lobanov, 1971; Nearey, 1978; Syrdal and Gopal, 1986) and general-purpose accounts applicable to any type of phonetic cue (McMurray and Jongman, 2011). We add to the cross-linguistic literature by comparing normalization accounts against a new database of Swedish, a language with a particularly dense vowel inventory of 21 vowels differing in quality and quantity. We train Bayesian ideal observers (IOs) on unnormalized or normalized vowel data under different assumptions about the relevant cues to vowel identity (F0-F3, vowel duration), and evaluate their performance in predicting the category intended by talker. The results indicate that the best-performing normalization accounts centered and/or scaled formants by talker (e.g., Lobanov), replicating previous findings for other languages with less dense vowel spaces. The relative advantage of Lobanov decreased when including additional cues, indicating that simple centering relative to the talker’s mean might be sufficient to achieve robust inter-talker perception (e.g., C-CuRE).

One of the central computational challenges for speech perception is that talkers differ in pronunciation--i.e., how they map linguistic categories and meanings onto the acoustic signal. Yet, listeners typically overcome these difficulties within minutes (Clarke & Garrett, 2004; Xie et al., 2018). The mechanisms that underlie these adaptive abilities remain unclear. One influential hypothesis holds that listeners achieve robust speech perception across talkers through low-level pre-linguistic normalization. We investigate the role of normalization in the perception of L1-US English vowels. We train ideal observers (IOs) on unnormalized or normalized acoustic cues using a phonetic database of 8 /h-VOWEL-d/ words of US English (N = 1240 recordings from 16 talkers, Xie & Jaeger, 2020). All IOs had 0 DFs in predicting perception—i.e., their predictions are completely determined by pronunciation statistics. We compare the IOs’ predictions against L1-US English listeners’ 8-way categorization responses for /h-VOWEL-d/ words in a web-based experiment. We find that (1) pre-linguistic normalization substantially improves the fit to human responses from 74% to 90% of best-possible performance (chance = 12.5%); (2) the best-performing normalization accounts centered and/or scaled formants by talker; and (3) general purpose normalization (C-CuRE, McMurray & Jongman, 2011) performed as well as vowel-specific normalization.

Talkers vary in their vowel pronunciation. One hypothesis holds that listeners achieve robust speech perception through pre-linguistic normalization. In recent work (also submitted to ASA), we modeled listeners’ perception of naturally produced /h-VOWEL-d/ words. The best-performing normalization models accounted for ∼90% of the explainable variance in listeners’ responses. Here, we investigate whether the remaining 10% follow from (1) other mechanisms or whether (2) they reflect listeners’ ability to use more cues than available to models. We constructed a new set of *synthesized* /h-VOWEL-d/ stimuli that varied only in F1 and F2. Unsurprisingly, listeners (N = 24) performed worse on these synthesized stimuli than on the natural stimuli (estimated as inter-listener agreement in categorization). Critically though, we find (1) that the same normalization accounts that best explained listeners’ responses to natural stimuli also perform best explaining responses to synthesized stimuli; (2) the best performing model again accounted for ∼90% of explainable variance. This suggests that the ‘failure’ of normalization accounts to fully explain listeners’ categorization behavior is *not* due to restrictions in the ability to feed our models all available cues. Rather, normalization alone—while critical to perception—seems insufficient to fully explain listeners’ ability to adapt based on recent input.

Objective: To externally validate the Swedish version of the LittlEARS® Auditory Questionnaire (LEAQ) in children with normal hearing followed longitudinally, and to examine to what extent ...

In reply to Marquette and Peiffer's article “Grappling With the ‘Real Politics’ of Systemic Corruption: Theoretical Debates Versus ‘Real-World’ Functions,” this article employs three criticisms: Marquette and Peiffer's call to grapple with the “real politics of corruption” does not bring much new to the table, is conceptually flawed, and risks serving as an excuse for corrupt elites to pursue “business as usual.” In response, we reaffirm three insights gained from collective action-based approaches toward corruption. Although corruption might solve individual-level problems in the short term, it is still a de facto problem at the aggregate level, the tools derived from principal–agent theory will not solve the collective action problem of systemic corruption, and elites will be the least likely to implement reform. We conclude by calling for the continued fight against corruption—a fight informed by empirical and theoretical knowledge. (Less)

Why are some states able to provide public goods and promote broad-based development whereas other states do not have the capacity to do any of these things? In search for an answer to this question, the past few decades have witnessed a radical increase in studies emphasizing a presumed negative role of ethnic fractionalization. Having been referred to as “one of the most powerful hypotheses in political economy,” the negative impact of ethnic fractionalization is now even so widely accepted that it has become a “standard” control in regressions explaining variation in political, social, and economic development. This chapter introduces, revisits, and confronts this so-called “diversity debit hypothesis,” focusing on the role of the Quality of Government. In particular, the chapter emphasizes the need to endogenize the relationship between ethnic fractionalization and public goods provision in a way that brings the state up front of the analysis as a social force in its own right, with the power to shape notions of “us” and “them” and, thus, development outcomes.

Granulation of ferroalloys is an alternative to bed-casting and crushing which has been the traditional method for solidification. The granulated product has many advantages having high yield, homogeneous composition and ideal size and shape for addition into metallurgical processes. The GRANSHOT® granulation process is today used as a standard operation for many ferroalloy producers. Development work for granulation of ferromanganese utilizing the GRANSHOT metal granulation process has been carried out in-house in UHT’s pilot granulation facility. The work consists of both small-scale tests and pilot granulations. Impact on product chemistry, physical properties and mechanical strength have been studied in combination with microscopy studies of the granulated product. This paper presents the results of the studies.

Synen på barns rätt till delaktighet har över tid förändrats i skolans styrdokument. Studiens syfte var att synliggöra hur lärare i grundsärskolan arbetar med elevers delaktighet vid upprättandet av pedagogiska utredningar. Empiriinsamlingen skedde genom sju kvalitativa, semistrukturerade intervjuer av lärare verksamma i grundsärskolan. Respondenterna tillfrågades om deras syn på vad delaktighet innebär samt hur deras arbete med att möjliggöra delaktighet för elever i pedagogiska utredningar kan se ut. Resultatet visade på att innebörden av begreppet delaktighet var ungefär densamma för samtliga respondenter. Några definitioner som kom fram var rätten att ha egna synpunkter, att vara involverad, att delta utifrån sina egna förutsättningar men även den egna upplevelsen av att vara delaktig. Lärarna tyckte att elevers delaktighet är viktigt samtidigt som de ansåg att olika funktionsnedsättningar hos elever i särskolan är en försvårande faktor för att de ska kunna göras delaktiga i arbetet med PUT. Studiens titel ”De har inte förmågan att kunna vara delaktiga” valdes genom att citera en av lärarna då vi tyckte att det är ett citat som sammanfattar innebörden av vad flertalet av lärarna förmedlade. Fem av sju lärare ansåg sig inte göra eleverna delaktiga och hade därav inte mycket att delge gällande olika tillvägagångssätt. Övriga två lärare menade att de försöker hitta vägar att kompensera utifrån elevers olika förmågor och förutsättningar. För elever på en tidig utvecklingsnivå kan det exempelvis handla om lärares eller elevassistenters observationer och föräldrasamtal. Studien visar att om läraren har en positiv inställning och ser möjligheter ökar också elevens delaktighet.

Objectives To provide current estimates of alcohol and drug use among pregnant women attending antenatal care lectures in preparation for childbirth in Stockholm, Sweden. Study design A cross-sectional study. Data was collected anonymously among women attending lectures in preparation for childbirth. Main outcome measures The prevalence of alcohol and illicit and non-medical prescription drug use among pregnant women attending antenatal care lectures in preparation for childbirth. Results Nine hundred and thirty-six pregnant women attending lectures in preparation for childbirth participated. Among those answering all questions about alcohol use during pregnancy, 4.2 percent reported use (95% confidence interval (CI), 3.0–5.7%) and among those answering all questions about illicit or non-medical prescription drug use during pregnancy, 0.5 percent reported such use (95% CI, 0.1–1.3%). The prevalences of binge drinking during pregnancy and alcohol and drug use before pregnancy are presented. Comparisons of anonymously and non-anonymously collected data are included. Conclusions Approximately one in 25 women reported using alcohol and approximately one in 200 reported using illicit or non-medical prescription drugs while pregnant. Alcohol use during pregnancy may have decreased in Stockholm, Sweden.

Loss and fragmentation of semi-natural grasslands have had negative consequences for grassland biodiversity, such as butterflies. Urban parks and other urban green spaces have so far largely been overlooked as suitable butterfly habitats, although they could potentially sustain diverse butterfly populations over time. We analysed the temporal change in butterfly species assemblages in urban green spaces in the city of Malmo, Southern Sweden. We studied changes in species richness and abundance of butterflies between 2006 and 2015 in 20 public urban green spaces, characterized by different management regimes. We sampled butterflies in traditional parks with intense grass cutting regimes, in semi-natural grasslands mowed only a few times per year, and in un-managed or irregularly managed ruderal sites. We found a slight increase in the total number of butterfly species in the study area, but a general decline in local species numbers in urban green spaces. Traditional urban parks had the greatest loss of species over time, and altogether the lowest number of species. In contrast, semi-natural parks and ruderal sites had higher numbers of butterfly species and also lost fewer species over time. Our study shows that intensive management strategies in urban green spaces have a negative impact on butterfly assemblages over time. We suggest that less intensive management strategies can be used to create high-quality areas for flower-visiting insects in urban green spaces, possibly in combination with planting larval host plant species, depending on the park type and design.

The purpose of the present study was to investigate the feasibility of developing a fast non-destructive at-line transmission Raman spectroscopy (TRS) method for core tablet potency and content uniformity (CU) as part of a real-time release testing (RTRt) control strategy. The effects of tablet hardness and weight (thickness), API particle size, and concentration were studied by using a novel experimental design called generalized subset designs (GSDs). A subset of 28 experiments plus three replicate center points were selected for a total of 31 experiments. Matrix effects included tablets with active pharmaceutical ingredient (API) at seven concentration levels (14 to 26%w/w), and API particle size (17 to 71 μm), tablet weight (275 to 328 mg), and tablet hardness (8 to 16 SCU) at two levels. Three calibration models were developed, by using partial least squares (PLS) and different preprocessing conditions (model nos. 1 to 3). In model no. 1, all matrix effects were excluded. This model showed high potency prediction errors (RMSEP of 10.0%). When all matrix variations were included in the multivariate calibration according to the GSD as shown in model nos. 2 and 3, the prediction accuracy was greatly improved (RMSEP 2.56 and 1.74% respectively). The statistical significance of the tablet weight, hardness, and API particle size in the %Recovery (TRS vs. the reference HPLC method) was investigated by using MODDE Pro (Sartorius Stedim Data Analytics). Statistically significant effects were identified if the calculated p value was ≤ 0.05. The main effect hardness, the cross-term hardness×particle size, and the quadratic term cal level×cal level showed to be statistically significant. However, these effects had a very small impact on tablet prediction accuracy (± 1.0%w/w) well within the intermediate precision of the method. A non-destructive TRS method for core tablet potency and CU was fully validated, following ICH Q2 and EMEA NIR guidelines. The applicability of the method to process development batches was demonstrated and compared to a previously developed and validated NIR method.