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The next version of the polar Regional Atmospheric Climate Model (referred to as RACMO2.4p1) is presented in this study. The principal update includes embedding of the package of physical parameterizations of the Integrated Forecast System (IFS) cycle 47r1. This constitutes changes in the precipitation, convection, turbulence, aerosol and surface schemes and includes a new cloud scheme with more prognostic variables and a dedicated lake model. Furthermore, the standalone IFS radiation physics module ecRad is incorporated into RACMO, and a multilayer snow module for non-glaciated regions is introduced. Other updates involve the introduction of a fractional land–ice mask, new and updated climatological data sets (such as aerosol concentrations and leaf area index), and the revision of several parameterizations specific to glaciated regions. As a proof of concept, we show first results for Greenland, Antarctica and a region encompassing the Arctic. By comparing the results with observations and the output from the previous model version (RACMO2.3p3), we show that the model performs well regarding the surface mass balance, surface energy balance, temperature, wind speed, cloud content and snow depth. The advection of snow hydrometeors strongly impacts the ice sheet's local surface mass balance, particularly in high-accumulation regions such as southeast Greenland and the Antarctic Peninsula. We critically assess the model output and identify some processes that would benefit from further model development.

Abstract Background Veterinarians are an occupational group with an increased suicide risk. Euthanasing animals may influence both veterinarians’ views on assisted dying in humans and their suicide risk. We investigated (I) attitudes towards assisted dying, (II) whether the field of work and the frequency of euthanasing animals were associated with positive attitudes towards human euthanasia, and (III) whether frequently euthanasing animals was associated with serious suicidal thoughts. Methods We conducted a nationwide cross-sectional study among veterinarians in Norway (response rate: 75%). Logistic regression models were used to calculate the odds ratios for both positive attitudes towards human euthanasia and serious suicidal thoughts. The analyses were adjusted for socio-demographic and work-related factors. Results Fifty-five percent of the veterinarians agreed that euthanasia should be permitted for humans with a fatal disease and short life expectancy. Working with companion animals was independently associated with positive attitudes towards human euthanasia (OR = 1.66 (95% CI: 1.23–2.23)), while veterinarians’ frequency of euthanasing animals was not. Frequency of euthanasing animals was independently associated with serious suicidal thoughts, OR = 2.56 (95% CI: 1.35–4.87). Conclusions Veterinarians’ attitudes towards assisted dying in humans did not differ from those of the general population. Veterinarians’ frequency of euthanasing animals was not associated with positive attitudes towards euthanasia in humans. However, veterinarians working in companion animal practices were more likely to have positive attitudes towards euthanasia in humans. Moreover, euthanising animals five times or more a week was associated with serious suicidal thoughts. We need more research to infer about causality in these findings.

Summary: Here, we present a protocol for quantifying pyramidal neuron hyperexcitability in a mouse model of STXBP1 neurodevelopmental encephalopathy (Stxbp1hap). We describe steps for preparing brain slices, positioning electrodes, and performing an excitability test to investigate microcircuit failures. This protocol is based on recording layer 2/3 cortical pyramidal neurons in response to stimulation of two independent sets of excitatory axons that recruit feedforward inhibition microcircuits.For complete details on the use and execution of this protocol, please refer to Dos Santos et al.1 : Publisher’s note: Undertaking any experimental protocol requires adherence to local institutional guidelines for laboratory safety and ethics.

Abstract The limited sensitivity of circulating tumor cell (CTC) detection in pancreatic adenocarcinoma (PDAC) stems from their extremely low concentration in the whole circulating blood, necessitating enhanced detection methodologies. This study sought to amplify assay-sensitivity by employing diagnostic leukapheresis (DLA) to screen large blood volumes. Sixty patients were subjected to DLA, with a median processed blood volume of ~ 2.8 L and approximately 5% of the resulting DLA-product analyzed using CellSearch (CS). Notably, DLA significantly increased CS-CTC detection to 44% in M0-patients and 74% in M1-patients, yielding a 60-fold increase in CS-CTC enumeration. DLA also provided sufficient CS-CTCs for genomic profiling, thereby delivering additional genomic information compared to tissue biopsy samples. DLA CS-CTCs exhibited a pronounced negative prognostic impact on overall survival (OS), evidenced by a reduction in OS from 28.6 to 8.5 months (univariate: p = 0.002; multivariable: p = 0.043). Additionally, a marked enhancement in sensitivity was achieved (by around 3-4-times) compared to peripheral blood (PB) samples, with positive predictive values for OS being preserved at around 90%. Prognostic relevance of CS-CTCs in PDAC was further validated in PB-samples from 228 PDAC patients, consolidating the established association between CTC-presence and reduced OS (8.5 vs. 19.0 months, p

Licensure exams play a crucial role in ensuring the competence of individuals entering a profession, thereby safeguarding the public and maintaining the quality and integrity of the profession. In Sweden, dentists educated outside the European Union seeking to practise dentistry must undergoa re-certification process. The re-certification process includes a theoretical examination where pass marks are set using a three-level Angoff method. This study aimed to determine the consistency of the Angoff ratings using independent panels at two Swedish universities. Two cohorts of panellists were included in the study: one reference and one external. The reference panel was responsible for rating the upcoming theoretical examinations in the proficiency test, which were used to set the pass mark. The external panel, recruited from a dental school at a university in another region in Sweden, provided ratings after the examinations. Three examinations during 2019-2020 were included in this study (267 items in total). There was a strong correlation (ρ ≥ 0.70, p < .001) between the ratings of the two independent panels, with no significant differences in item ratings across the full exams, dental disciplines, and professional qualifications analysed. This suggests that the three-level Angoff method reliably produces similar standards for assessing the competence of the minimally qualified dentist across different institutions. The expectations of the minimally qualified but still acceptable dentist were comparable between the two independent panels across the three theoretical examinations explored. The alignment between the panels indicates valid, reliable standards across institutions, despite the independent syllabi of the two study programmes. However, while there is an alignment, differences in ratings remain. Consequently, involving multiple institutions in future standard-setting processes could help ensure that the standards reflect a broader range of educational practices, supporting the credibility of licensure examinations.

Background and aimsAs our understanding of platelet activation in response to infections and/or inflammatory conditions is growing, it is becoming clearer that safe, yet efficacious, platelet-targeted phytochemicals could improve public health beyond the field of cardiovascular diseases. The phytonutrient sulforaphane shows promise for clinical use due to its effect on inflammatory pathways, favorable pharmacokinetic profile, and high bioavailability. The potential of sulforaphane to improve platelet functionality in impaired metabolic processes has however hardly been studied in humans. This study investigated the effects of broccoli sprout consumption, as a source of sulforaphane, on urinary 11-dehydro-thromboxane B2 (TXB2), a stable thromboxane metabolite used to monitor eicosanoid biosynthesis and response to antithrombotic therapy, in healthy participants exposed to caloric overload.MethodsIn this double-blind, placebo-controlled, crossover trial 12 healthy participants were administered 16g of broccoli sprouts, or pea sprouts (placebo) followed by the standardized high-caloric drink PhenFlex given to challenge healthy homeostasis. Urine samples were collected during the study visits and analyzed for 11-dehydro-TXB2, sulforaphane and its metabolites. Genotyping was performed using Illumina GSA v3.0 DTCBooster.ResultsAdministration of broccoli sprouts before the caloric load reduced urinary 11-dehydro-TXB2 levels by 50% (p = 0.018). The amount of sulforaphane excreted in the urine during the study visits correlated negatively with 11-dehydro-TXB2 (rs = −0.377, p = 0.025). Participants carrying the polymorphic variant NAD(P)H dehydrogenase quinone 1 (NQO1*2) showed decreased excretion of sulforaphane (p = 0.035).ConclusionSulforaphane was shown to be effective in targeting platelet responsiveness after a single intake. Our results indicate an inverse causal relationship between sulforaphane and 11-dehydro-TXB2, which is unaffected by the concomitant intake of the metabolic challenge. 11-Dehydro-TXB2 shows promise as a non-invasive, sensitive, and suitable biomarker to investigate the effects of phytonutrients on platelet aggregation within hours.Clinical trial registration[https://clinicaltrials.gov/], identifier [NCT05146804].

Abstract Background Veterinarians have a relatively high prevalence of mental health problems; however, research on professional help-seeking is limited. The main purpose of the present study was to investigate the prevalence of mental health problems and professional help-seeking behaviour for such problems, and the independent factors associated with help-seeking behaviour among veterinarians in Norway. Method This cross-sectional study included all veterinarians in Norway (response rate 75%, 70% women). Logistic regression was used to calculate odds ratios (OR) for professional help-seeking for mental health problems. Analyses were controlled for socio-demographic, individual (personality trait reality weakness, SCL-5, attitudes toward mental illness), and work-related factors (work field, job stress). Results The prevalence of self-reported mental health problems in need of treatment was 30% (746/2494), significantly higher among women than men (36% vs. 15%). Fifty-four percent had sought professional help, women significantly more often (56%) than men (41%). Among veterinarians with serious suicidal thoughts, 50% (69/139) had sought help. Veterinarians most frequently related mental health problems to work problems (47%), women significantly more often (49%) than men (34%). Factors significantly associated with help-seeking were being female, OR = 2.11 (95% CI: 1.24–3.60), working with production animals, OR = 0.35 (0.13–0.98), public administration, OR = 2.27 (1.15–4.45), academia/research, OR = 4.78 (1.99–11.47) or ‘other’ fields, OR = 2.79 (1.23–6.32), and attitudes toward mental illness, OR = 1.32 (1.03–1.68). Conclusions Thirty percent of veterinarians in Norway reported mental health problems in need of treatment, and only half of them had sought professional help. A low degree of help-seeking was also seen among those with serious suicidal thoughts. Being female, positive attitudes toward treatment of mental illness, working in public administration, academia/research and ‘other’ field were associated with more help-seeking, while working in production animal practice was associated with less help-seeking. Interventions to increase help-seeking behaviour for mental health problems among veterinarians are warranted.

Wild Atlantic salmon migrate to sea following completion of a developmental process known as parr‐smolt transformation (PST), which establishes a seawater (SW) tolerant phenotype. Effective imitation of this aspect of anadromous life history is a crucial aspect of commercial salmon production, with current industry practice being marred by significant losses during transition from the freshwater (FW) to SW phase of production. The natural photoperiodic control of PST can be mimicked by exposing farmed juvenile fish to a reduced duration photoperiod for at least 6 weeks before increasing the photoperiod in the last 1–2 months before SW transfer. While it is known that variations in this general protocol affect subsequent SW performance, there is no uniformly accepted industry standard; moreover, reliable prediction of SW performance from fish attributes in the FW phase remains a major challenge. Here we describe an experiment in which we took gill biopsies 1 week prior to SW transfer from 3000 individually tagged fish raised on three different photoperiod regimes during the FW phase. Biopsies were subjected to RNA profiling by Illumina sequencing, while individual fish growth and survival was monitored over 300 days in a SW cage environment, run as a common garden experiment. Using a random forest machine learning algorithm, we developed gene expression‐based predictive models for initial survival and stunted growth in SW. Stunted growth phenotypes could not be predicted based on gill transcriptomes, but survival the first 40 days in SW could be predicted with moderate accuracy. While several previously identified marker genes contribute to this model, a surprisingly low weighting is ascribed to sodium potassium ATPase subunit genes, contradicting advocacy for their use as SW readiness markers. However, genes with photoperiod‐history sensitive regulation were highly enriched among the genes with highest importance in the prediction model. This work opens new avenues for understanding and exploiting developmental changes in gill physiology during smolt development. [ABSTRACT FROM AUTHOR]

Licensure exams play a crucial role in ensuring the competence of individuals entering a profession, thereby safeguarding the public and maintaining the quality and integrity of the profession. In Sweden, dentists educated outside the European Union seeking to practise dentistry must undergoa re-certification process. The re-certification process includes a theoretical examination where pass marks are set using a three-level Angoff method. This study aimed to determine the consistency of the Angoff ratings using independent panels at two Swedish universities. Two cohorts of panellists were included in the study: one reference and one external. The reference panel was responsible for rating the upcoming theoretical examinations in the proficiency test, which were used to set the pass mark. The external panel, recruited from a dental school at a university in another region in Sweden, provided ratings after the examinations. Three examinations during 2019–2020 were included in this study (267 items in total). There was a strong correlation (ρ ≥ 0.70, p <.001) between the ratings of the two independent panels, with no significant differences in item ratings across the full exams, dental disciplines, and professional qualifications analysed. This suggests that the three-level Angoff method reliably produces similar standards for assessing the competence of the minimally qualified dentist across different institutions. The expectations of the minimally qualified but still acceptable dentist were comparable between the two independent panels across the three theoretical examinations explored. The alignment between the panels indicates valid, reliable standards across institutions, despite the independent syllabi of the two study programmes. However, while there is an alignment, differences in ratings remain. Consequently, involving multiple institutions in future standard-setting processes could help ensure that the standards reflect a broader range of educational practices, supporting the credibility of licensure examinations. [ABSTRACT FROM AUTHOR]

Introduction: The increase in the migration of dentists educated outside the EU/EEA calls for the sharing of information and evaluation of recognition processes within countries in the EU. In 2017, the Swedish National Board of Health and Welfare implemented the Proficiency test, a recognition process for dentists who have completed an education programme outside the EU/EEA. The Proficiency test consists of a theoretical and an integrated clinical skills examination, followed by a 6‐month clinical practice. The clinical skills examination is a two‐part examination that includes an OSCE and an operative test on a dental manikin. This paper presents data from proficiency tests between 2018 and 2022, and explores factors related to grade fail, that is, demographics, theoretical exam scores and language comprehension. Materials and Methods: In a cohort study, demographics and factors associated with grade fail were explored using test results from theoretical and clinical skills examinations (n = 181) from 2018 to 2022. Pearson correlation coefficient and linear regression analysis were used for studying correlations and associations between exam results. Univariable linear and logistic regression models were used for background variable associations with clinical skills exam outcomes. Results: Higher age was a significant risk factor for failing the clinical skills examination and the OSCE. Higher scores in the theoretical exam reduced the odds of failing the OSCE but were not associated with results in the operative test or the overall results of the clinical skills examination. Regarding the OSCE there was a statistically significant difference within all professional qualifications explored between participants who passed and participants who failed the OSCE. Conclusions: Four years of data collection reveal that age and previous theoretical exam results influence the odds of failing the clinical examination. The study results also highlight the necessity of multiple assessment formats to assess clinical and communication skills of foreign‐trained dentists. [ABSTRACT FROM AUTHOR]

This study investigates the sensitivity of modeled surface melt and subsurface heating on the Antarctic ice sheet to a new spectral snow albedo and radiative transfer scheme in the Regional Atmospheric Climate Model (RACMO), version 2.3p3 (Rp3). We tune Rp3 to observations by performing several sensitivity experiments and assess the impact on temperature and melt by incrementally changing one parameter at a time. When fully tuned, Rp3 compares well with in situ and remote sensing observations of surface mass and energy balance, melt, near-surface and (sub)surface temperature, albedo and snow grain specific surface area. Near-surface snow temperature is especially sensitive to the prescribed fresh snow specific surface area and fresh dry snow metamorphism. These processes, together with the refreezing water grain size and subsurface heating, are important for melt around the margins of the Antarctic ice sheet. Moreover, small changes in the albedo and the aforementioned processes can lead to an order of magnitude overestimation of melt, locally leading to runoff and a reduced surface mass balance.

Excessive alcohol consumption among young people is an international public health concern, as alcohol is associated with a range of adverse short- and long-term consequences. Furthermore, alcohol consumption has been associated with well-being in young people, but the association depends on the chosen measure of well-being. The objective of this study was to assess how weekly alcohol consumption was associated with poor well-being (poor school enjoyment, social inclusion in school, mental well-being, life satisfaction, self-esteem, and self-efficacy, and experiencing loneliness). Cross-sectional data from the Danish National Youth Study 2019 was used (a total of 25,910 students aged 15–25 years).For most outcomes, there was a U-shaped association between weekly alcohol consumption and poor well-being e.g. students who never drank, students who only drank occasionally, and students who drank a lot (22 units of alcohol or more a week) had higher odds of poor well-being, compared to the reference group (1–7 units a week). This was the case for measures such as low school enjoyment (only females), poor mental well-being, low life satisfaction, low self-esteem (only females) and low self-efficacy (only males). Among females, odds of low self-efficacy was higher with higher weekly alcohol consumption. Higher weekly alcohol consumption was associated with lower odds of low social inclusion in school, experiencing loneliness often, and (among males) low self-esteem.Conclusively, well-being in general was lowest among never-, occasional- and heavy drinking students. Understanding these associations can help to decrease alcohol consumption and promote well-being among young students.

Radiative transfer in snow and ice is often not modeled explicitly in regional climate models. In this study, we evaluate a new englacial radiative transfer scheme and assess the surface mass and energy budget for the Greenland ice sheet in the latest version of the regional climate model RACMO2, version 2.3p3. We also evaluate the modeled (sub)surface temperature and melt, as radiation penetration now enables internal heating. The results are compared to the previous model version and are evaluated against stake measurements and automatic weather station data of the K-transect and PROMICE projects. In addition, subsurface snow temperature profiles are compared at the K-transect, Summit, and southeast Greenland. The surface mass balance is in good agreement with observations, with a mean bias of −31 mm w.e. yr−1 (−2.67 %), and only changes considerably with respect to the previous RACMO2 version around the ice margins and near the percolation zone. Melt and refreezing, on the other hand, are changed more substantially in various regions due to the changed albedo representation, subsurface energy absorption, and meltwater percolation. Internal heating leads to higher snow temperatures in summer, in agreement with observations, and introduces a shallow layer of subsurface melt. Hence, this study shows the consequences and necessity of radiative transfer in snow and ice for regional climate modeling of the Greenland ice sheet.

The next version of the polar Regional Atmospheric Climate Model (referred to as RACMO2.4p1) is presented in this study. The principal update includes embedding of the package of physical parameterizations of the Integrated Forecast System (IFS) cycle 47r1. This constitutes changes in the precipitation, convection, turbulence, aerosol and surface schemes and includes a new cloud scheme with more prognostic variables and a dedicated lake model. Furthermore, the standalone IFS radiation physics module ecRad is incorporated into RACMO, and a multilayer snow module for non-glaciated regions is introduced. Other updates involve the introduction of a fractional land–ice mask, new and updated climatological data sets (such as aerosol concentrations and leaf area index), and the revision of several parameterizations specific to glaciated regions. As a proof of concept, we show first results for Greenland, Antarctica and a region encompassing the Arctic. By comparing the results with observations and the output from the previous model version (RACMO2.3p3), we show that the model performs well regarding the surface mass balance, surface energy balance, temperature, wind speed, cloud content and snow depth. The advection of snow hydrometeors strongly impacts the ice sheet's local surface mass balance, particularly in high-accumulation regions such as southeast Greenland and the Antarctic Peninsula. We critically assess the model output and identify some processes that would benefit from further model development. [ABSTRACT FROM AUTHOR]

Objective: This paper describes the study protocol in an ongoing clinical trial evaluating oral screen training as part of a post‐stroke rehabilitation programme. Baseline data were related to four domains: dysphagia, lip function, masticatory performance and patient‐related outcome measures (PROM). Background: Stroke is one of the most common causes of disability‐adjusted life years, and dysphagia is a common remaining problem after stroke. Rehabilitation using oral screen training has been suggested to improve swallowing, but evidence is still insufficient. Materials and Methods: Patients diagnosed with stroke with persisting objective and/or subjective swallowing dysfunction after primary rehabilitation were assessed for eligibility. In total, 25 patients were included. Objective function was assessed by swallowing capacity test (SCT), lip force and masticatory performance, subjective function by EAT‐10 and NOT‐S and PROM by LiSat‐11 and ESAS. Results: Baseline data presented a heterogeneous pattern with no significant association between objective and subjective dysfunction. Most of the participants (20/25) showed impaired swallowing capacity in SCT, and 23/24 revealed orofacial dysfunction according to NOT‐S. The most common subjective item reported was chewing and swallowing problems (19/24). Conclusion: The heterogenous findings in the included tests and the lack of correlations emphasise the importance of multidisciplinary approaches to identify objective and subjective orofacial post‐stroke dysfunction in clinical practice to be able to offer evidence‐based individualised care. The included participants were representative of stroke patients with dysphagia, which supports proceeding with the planned intervention. [ABSTRACT FROM AUTHOR]

Snow and ice albedo schemes in present-day climate models often lack a sophisticated radiation penetration scheme and do not explicitly include spectral albedo variations. In this study, we evaluate a new snow albedo scheme in the Regional Atmospheric Climate Model (RACMO2) for the Greenland ice sheet, version 2.3p3, that includes these processes. The new albedo scheme uses the Two-streAm Radiative TransfEr in Snow (TARTES) model and the Spectral-to-NarrOWBand ALbedo (SNOWBAL) module, version 1.2. Additionally, the bare-ice albedo parameterization has been updated. The snow and ice broadband and narrowband albedo output of the updated version of RACMO2 is evaluated using the Programme for Monitoring of the Greenland Ice Sheet (PROMICE) and Kangerlussuaq transect (K-transect) in situ data and Moderate Resolution Imaging Spectroradiometer (MODIS) remote-sensing observations. Generally, the modeled narrowband and broadband albedo is in very good agreement with satellite observations, leading to a negligible domain-averaged broadband albedo bias for the interior. Some discrepancies are, however, observed close to the ice margin. Compared to the previous model version, RACMO2.3p2, the broadband albedo is considerably higher in the bare-ice zone during the ablation season, as atmospheric conditions now alter the bare-ice broadband albedo. For most other regions, however, the updated broadband albedo is lower due to spectral effects, radiation penetration or enhanced snow metamorphism.