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Abstract Background Individuals with type 1 diabetes are at increased risk of accelerated atherosclerosis, causing coronary artery disease (CAD). The underlying mechanisms remain unclear, but new theories proposed are damage of gut mucosa causing leakage and translocation of gut microbiota products into the circulation, leading to inflammatory responses and atherosclerosis. We therefore aimed to study the associations between gut related inflammatory biomarkers and coronary atherosclerosis in individuals with long-term type 1 diabetes. Methods In this cross-sectional, controlled study of 102 participants with type 1 diabetes and 63 control subjects, we measured circulating levels of intestinal fatty acid binding protein (I-FABP), soluble cluster of differentiation 14 (sCD14), lipopolysaccharide binding protein (LBP) and interleukin 18 (IL-18) by enzyme-linked immunosorbent assay (ELISA), and further gene expression of CD14 and toll-like receptor 4 (TLR4) by real time PCR in circulating leukocytes and peripheral blood mononuclear cells (PBMCs). The participants had either established coronary heart disease (CHD) or underwent computed tomography coronary angiography (CTCA) to assess for coronary atherosclerosis, including total, calcified and soft/mixed plaque volumes. Results In the diabetes group, the levels of I-FABP were significantly higher in participants with established CHD or significant stenosis on CTCA compared to the participants with normal arteries or non-significant stenosis, with median 1.67 ng/ml (interquartile range [IQR] 1.02–2.32) vs. median 1.09 ng/ml (IQR 0.82–1.58), p = 0.003. I-FABP was associated with significant coronary artery stenosis by CTCA (> 50%) or previously established CHD in the adjusted analysis (odds ratio [OR] = 2.32, 95% confidence interval [CI]: 1.09–4.95; p = 0.029). The levels of I-FABP correlated also to total coronary plaque volume (r = 0.22, p

Abstract Background Being born small for gestational age (SGA) is a risk factor for motor difficulties. Previous reviews exploring this topic are mostly focused on children born preterm. We aimed to review the literature to determine the association between being born SGA at term and motor outcomes. Methods PubMed and Embase were searched for relevant articles without any restrictions on publication year or participants’ age. Inclusion criteria were SGA exposure at term (≥ 37 weeks of gestation), cohort studies or randomized controlled trials with motor outcome assessed by standardized motor tests with results reported as continuous scores (mean/median) compared with a control group. Exclusion criteria were abstracts, editorials and commentaries, articles in non-English language or no full text available. Reviews were screened for relevant articles. Quality of included studies was assessed by the Newcastle-Ottawa Scale. Results In total, 674 records were identified by the literature search and screened by two independent authors. Thirteen original articles were eligible and included in a qualitative synthesis, and five (38%) of these were included in a meta-analysis. Nine (69%) studies were from high-income countries. Most studies were carried out in early childhood, and only one study in adulthood. Seven (54%) articles reported that individuals born SGA at term had poorer scores on standardized motor tests compared with controls, while no differences were reported in five (38%) articles. One article did not report p-values, although the differences were comparable to the other studies. Group differences were of small to moderate effect size (0.19 to 0.65 standard deviation units). The pooled effect size was -0.43 (95% confidence interval: -0.60 to -0.25). Adjustment for covariates were reported in seven (54%) articles and did not change the results. Proportions of motor difficulties, reported in five (38%) articles, ranged from 8.9 to 50% in individuals born SGA from infancy to adolescence. Conclusions This systematic review shows that being born SGA, also at term, may be a risk factor for poorer motor outcomes throughout childhood, confirmed by a meta-analysis in early childhood. Further research is needed to establish the risk of adult motor difficulties in individuals born SGA at term.

Abstract Background Integrating behavioral health services in primary care is challenging; a toolkit approach to practice implementation can help. A recent comparative effectiveness randomized clinical trial examined the impact of a toolkit for improving integration on outcomes for patients with multiple chronic conditions. Some aspects of behavioral health integration improved; patient-reported outcomes did not. This report evaluates the implementation strategy (Toolkit) using Proctor’s (2011) implementation outcomes model. Methods Using data from the 20 practices randomized to the active (toolkit strategy) arm (education, redesign workbooks, online learning community, remote coaching), we identified 23 measures from practice member surveys, coach interviews, reports, and field logs to assess Toolkit acceptability, appropriateness, feasibility, and fidelity. A practice survey score was high (met expectations) if its average was ≥ 4 on a scale 1-5; all other data were coded dichotomously, with high = 1. Results Regarding acceptability, 74% (14) of practices had high scores for willingness of providers and staff to use the Toolkit and 68% (13) for quality improvement teams liking the Toolkit. For appropriateness, 95% (19) of practices had high scores for the structured process being a good match and 63% (12) for the Toolkit being a good match. Feasibility, measured by Toolkit prerequisites, was scored lower by site members at project end (e.g., provider leader available as champion: 53% of practices) compared to remote coaches observing practice teams (74%). For “do-ability,” coaches rated feasibility lower for practices (e.g., completion of workbook activities: 32%) than the practice teams (68%). Fidelity was low as assessed across seven measures, with 50% to 78% of practices having high scores across the seven measures. Conclusions Existing data from large trials can be used to describe implementation outcomes. The Toolkit was not implemented with fidelity in at least one quarter of the sites, despite being acceptable and appropriate, possibly due to low feasibility in the form of unmet prerequisites and Toolkit complexity. Variability in fidelity reflects the importance of implementation strategies that fit each organization, suggesting that further study on contextual factors and use of the Toolkit, as well as the relationship of Toolkit use and study outcomes, is needed. Trial registration ClinicalTrials.gov NCT02868983; date of registration: 08/15/2016.

Multiple randomized controlled trials (RCTs) have examined first-line pharmacological agents such as anticholinergics and β3 agonists for the management of overactive bladder symptoms (OAB). Although earlier systematic reviews and (network) meta-analyses aimed to summarize the evidence, a substantial number of trials were not included, so a comprehensive and methodologically rigorous evaluation of the comparative effectiveness of all first-line pharmacological treatments is lacking. We aim to conduct a series of systematic reviews and network meta-analyses (NMAs) for a comprehensive assessment of the effectiveness and safety of first-line pharmacological treatments for OAB. Eligible studies will include RCTs comparing anticholinergics and β3 agonists to one another or to placebo in adults with OAB or detrusor overactivity. Pairs of reviewers with methodological training will independently evaluate candidate studies to determine eligibility and extract relevant data. We will incorporate patient-important outcomes, including urinary urgency episodes, urgency incontinence episodes, any type of incontinence episodes, urinary frequency, nocturia, and adverse events. We will conduct the NMAs using a frequentist framework and a graph theory model for each outcome. Analysis will follow rigorous methodologies, including handling of missing data and assessment of the risk of bias. We will conduct sensitivity and subgroup analyses and will apply the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to rate evidence certainty. Our approach aims to address the knowledge gap in the treatment of OAB by synthesizing evidence from RCTs worldwide. We will employ robust statistical methods, including frequentist NMA, to general clinically relevant and patient-important insights. Sensitivity and subgroup analyses will enhance the robustness and generalizability of our findings. Our reviews strive to inform evidence-based decisions in the management of OAB, to ultimate improve patient outcomes. Our study results may guide health policy decisions, such as reimbursement policies, and future studies in functional urology.The protocol for the review series is registered on PROSPERO as CRD42023266915.

Abstract Clear-cell renal cell carcinoma (ccRCC) is the most common origin of pancreatic metastases (PM). Distinct genomic aberrations, favorable prognosis, and clinical observations on high angiogenesis, and succeeding tyrosine kinase inhibitor (TKI) sensitivity have been reported in PM-ccRCC. However, no functional or single-cell studies have been conducted thus far. We recruited five PM-ccRCC patients and investigated the genomic, single-cell transcriptomic, and drug sensitivity profiles of their patient-derived cells (PDCs). The PM depicted both expected and novel genomic alterations. Further, the transcriptomics differed from both primary and metastatic ccRCC, with upregulations of the PI3K/mTOR and – supporting the clinical observations – angiogenesis pathways. Data integration at pathway level showed that transcriptomics explained drug sensitivities the best. Accordingly, PM-ccRCC PDCs shared sensitivity to many PI3K/mTOR inhibitors. Altogether, we show distinct genomic and transcriptomic signatures in PM-ccRCC, highlight the superiority of transcriptomics in interpreting drug sensitivities, and encourage the use of TKIs and PI3K/mTOR inhibitors in PM-ccRCC.

Abstract Background Exposure to alcohol and/or other addictive drugs in pregnancy is a documented risk factor for neurological impairment. We aimed to assess neurodevelopmental outcome at two years of age in infants exposed to prenatal alcohol and/or other addictive drugs and to examine the predictive value of early motor assessment. Methods This was a follow-up at two years of age in the prospective cohort study Children Exposed to Alcohol and/or Drugs in Intrauterine Life (CEADIL). The exposed group comprised 73 infants recruited from primary health care and included in a hospital follow-up programme at St. Olavs Hospital, Trondheim University Hospital, Norway. The control group comprised 93 healthy, unexposed infants recruited from the maternity ward at the same hospital. All children had been assessed by physiotherapists using the General Movement Assessment (GMA) at three months of age. Presence of fidgety movements, movement character and the Motor Optimality Score – Revised (MOS-R) were used. At two years of age, the children were assessed by trained examiners using the Bayley Scales of Infant and Toddler Development – Third Edition (BSID-III), Ages & Stages Questionnaires: Social-Emotional (ASQ:SE) and the Hollingshead Two-Factor Index of Social Position (SES). Results The cognitive, language and motor composite scores of BSID-III were considerably lower in the exposed group than in the control group. Mean differences adjusted for age and parental SES ranged from − 13.3 (95% confidence interval, CI: -18.6 to -8.0) to -17.7 (95% CI: -23.3 to -12.2). Suboptimal fidgety movements and monotonous movement character had high sensitivity (0.94 to 0.74), but low specificity (0.10 to 0.32), while sensitivity and specificity of the MOS-R was around 50 and 60%, respectively. Conclusions Neurodevelopmental outcome at two years of age was poorer in a group of children exposed to alcohol and/or drugs in pregnancy compared with a control group of healthy, unexposed children. Sensitivity of suboptimal fidgety movements and monotonous movement character at three months of age for later neurodevelopmental outcome was high to acceptable, but the MOS-R had limited sensitivity.

Abstract Background Patients with chronic pain on opioids frequently experience loneliness, which is associated with poorer health outcomes and higher risk for opioid misuse and opioid use disorder. Given that almost half of opioids are prescribed in primary care, a critical need exists for the development and testing of interventions to reduce loneliness in primary care patients at risk for opioid misuse. Cognitive behavioral therapy and social prescribing have been shown to be efficacious in reducing loneliness and improving outcomes in other populations but have not been tested in patients at risk for substance use disorder. The overall objective of our study is to reduce opioid misuse and opioid use disorder by addressing loneliness in patients on long-term opioid therapy in real-world primary care settings. Methods We will conduct a 3-arm pragmatic, randomized controlled trial to compare the effectiveness of two group-based, telehealth-delivered interventions with treatment as usual: (1) cognitive behavioral therapy to address maladaptive thought patterns and behaviors around social connection and (2) a social prescribing intervention to connect participants with social opportunities and develop supportive social networks. Our primary outcome is loneliness as measured by the UCLA Loneliness Scale and our dependent secondary outcome is opioid misuse as measured by the Common Opioid Misuse Measure. We will recruit 102 patients on long-term opioid therapy who screen positive for loneliness from 2 health care systems in Washington State. Implementation outcomes will be assessed using the RE-AIM framework. Discussion Our study is innovative because we are targeting loneliness, an under-addressed but critical social risk factor that may prevent opioid misuse and use disorder in the setting where most patients are receiving their opioid prescriptions for chronic pain. If successful, the project will have a positive impact in reducing loneliness, reducing opioid misuse, improving function and preventing substance use disorder. Trial Registration NCT06285032, issue date: February 28, 2024, original.

Abstract Astrocytes respond and contribute to neuroinflammation by adopting inflammatory reactive states. Although recent efforts have characterized the gene expression signatures associated with these reactive states, the cell biology underlying inflammatory reactive astrocyte phenotypes remains under-explored. Here, we used CRISPR-based screening in human iPSC-derived astrocytes to identify mTOR activation a driver of cytokine-induced endolysosomal system remodeling, manifesting as alkalinization of endolysosomal compartments, decreased autophagic flux, and increased exocytosis of certain endolysosomal cargos. Through endolysosomal proteomics, we identified and focused on one such cargo–IL-32, a disease-associated pro-inflammatory cytokine not present in rodents, whose secretion mechanism is not well understood. We found that IL-32 was partially secreted in extracellular vesicles likely to be exosomes. Furthermore, we found that IL-32 was involved in the polarization of inflammatory reactive astrocyte states and was upregulated in astrocytes in multiple sclerosis lesions. We believe that our results advance our understanding of cell biological pathways underlying inflammatory reactive astrocyte phenotypes and identify potential therapeutic targets.

Abstract Ongoing Arctic greening can increase productivity and reindeer pasture quality in the tundra. However, greening may also entail proliferation of unpalatable species, with consequences for pastoral social-ecological systems. Here we show extensive greening across 20 reindeer districts in Norway between 2003 and 2020, which has reduced pasture diversity. The allelopathic, evergreen dwarf-shrub crowberry increased its biomass by 60%, with smaller increases of deciduous shrubs and no increase in forbs and graminoids, the most species rich growth forms. There was no evidence for higher reindeer densities promoting crowberry. The current management decision-making process aims at sustainable pasture management but does not explicitly account for pasture changes and reduced diversity. Large-scale shifts towards evergreening and increased allelopathy may thus undermine the resource base for this key Arctic herbivore and the pastoral social-ecological system. Management that is sensitive to changes in pasture diversity could avoid mismanagement of a social-ecological system in transition.

Abstract Background Individuals of South Asian origin have a greater risk of cardiovascular disease after gestational diabetes mellitus (GDM) than European individuals. B-type natriuretic peptide (BNP) and the amino-terminal fragment of its prohormone (NT-proBNP) are commonly used for heart failure screening and diagnosis, but biologically BNP exerts several beneficial cardiovascular effects primarily by counteracting the renin-angiotensin-aldosterone-system. We asked whether ethnic differences in circulating NT-proBNP levels could be explained by the differences in cardiometabolic and inflammatory risk markers? Methods We examined 162 South Asian and 107 Nordic women in Norway 1–3 years after GDM with a clinical examination, fasting blood samples and an oral glucose tolerance test. We measured the levels of NT-proBNP, high-sensitivity cardiac troponin T, high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), leptin, adiponectin and markers of insulin sensitivity, such as the Matsuda insulin sensitivity index (ISI). Finally, we tried to identify which independent covariate best mediated the ethnic differences in NT-proBNP. Results The mean (SD) age was 35.3 (4.5) years, BMI 29.1 (6.0) kg/m2, waist-height ratio 0.60 (0.08) and 164 women (61%) had prediabetes/diabetes. Notably, South Asian women had lower levels of NT-proBNP than Nordic women in both the normoglycemic and prediabetes/diabetes groups (median (IQR) 26 (15–38) vs. 42 (22–66) ng/L, p

We evaluate different methods to detect benzene at a parts-per-billion level regarding their potential to be used in a wearable sensor. Benzene is a carcinogenic molecule, regarded as a major health threat by the World Health Organization. A wearable sensor is necessary to detect leaks immediately, but it is challenging to achieve such low limits of detection and quantification, even with laboratory equipment. A wearable sensor must, in addition to good selectivity and sensitivity, meet stricter requirements of size, weight, temperature, repeatability, and power consumption. We conclude that the most promising techniques for a wearable sensor are either infrared photoacoustic spectroscopy near 14.8 μm, or a photoionization detector combined with one of three selective devices: micro-gas chromatography, cavitands, or catalytic filters (WO3, for example). Ultraviolet photoacoustic spectroscopy may also be a suitable future technique for a wearable benzene sensor when efficient LEDs and lasers become available at many UV-C wavelengths.

The article is a response by Kari Aga Myklebost (UiT The Arctic University of Norway) to a commentary by Arnt Bjarne Aronsen (Vardøhus museumsforening) on her previously published article, 'Minnediplomati i grenseland. De russisk-norske patriotiske minneturene 2011–2019', DOI: https://doi.org/10.23865/noros.v37.5514

BackgroundThere is a growing prevalence of nonhealing wounds and chronic diseases in society, and there is an associated need for wound management solutions that include the use of telemedicine. A broad spectrum of factors influences the planning and execution of interventions within telemedicine in chronic wound management, spanning organizations, technologies, and individuals, including professionals and patients. The Telemedicine and Ambulatory Wound Care Team (TELE-AMBUS) project applies a whole-system research approach to account for this spectrum of factors. ObjectiveThe primary objective of this study was to explore and analyze the implementation and consequences of an outpatient wound management model, comprising 2 interconnected quality improvement interventions (ie, telemedicine and ambulatory wound care team) aimed at older and vulnerable patients with chronic wounds, across the specialist and primary health care sectors. Embedded in this objective is the aim to improve the competence levels of health care providers and, consequently, the service quality of outpatient wound management across specialist and primary health care services. MethodsThis project examines the implementation and consequences of an outpatient wound management model through a combined process and economic evaluation research strategy. A sociotechnical system theory approach and multiple work package design support the examination. The project uses observations, conversations, interviews, and economic assessments to gather rich, in-depth insights and understanding on why and how the new wound management model contributes to a change or not compared with the traditional treatment model. ResultsThe project has been funded from 2021 to 2025. Baseline interviews have been conducted since April 2022 and concluded in January 2024. Fieldwork, including nonparticipant observations, semistructured interviews, and informal conversations, has been conducted since November 2022 and is expected to conclude in March 2025. In parallel and as part of the cost-effectiveness analyses, time usage data on the outpatient and regular clinical models are being gathered during the fieldwork. ConclusionsWe applied a whole-system approach in multiple ways, that is, to design or inform our fieldwork and to explore, evaluate, and translate project findings into practice across services. To our knowledge, this approach has not been undertaken in telemedicine in chronic wound management literature and associated human factors and ergonomics research. Thus, our approach can produce both original and novel research and theoretical results internationally. International Registered Report Identifier (IRRID)DERR1-10.2196/55502

Abstract Male postsmolt maturation (“jacking”) is undesired in Atlantic salmon aquaculture due to economic and welfare impacts. Unfortunately, incidence of jacking has increased linked to intensive rearing conditions. This study subjected 1000 salmon (52.1 ± 5.2 g) to one of two temperatures (15, 12.5°C) and one of two photoperiods (constant light‐LL, a 5‐week LD12:12 winter signal regime‐WS) to assess their effects on spermatogenesis regulation. Indicators included testis histology images, mRNA transcription of gonadotropin receptors for follicle‐stimulating hormone (fshr) and luteinizing hormone (lhr), and of factors regulating spermatogenesis like anti‐Müllerian hormone (amh), gonadal‐soma‐derived factors 1 and 2 (gsdf1 and gsdf2), and insulin‐like growth factor‐3 (igf3). High temperature (15°C) induced early testis development processes irrespective of photoperiod, evidenced by presence of type B spermatogonia before clear increases in testis size or any transcriptional changes. The winter signal at 15°C caused a synchronized onset of spermatogenesis not present under constant light. This was evidenced by a pronounced downregulation of the spermatogenesis‐inhibiting factor amh and a clear upregulation in the stimulating factor igf3. Consequently, combining high temperatures with winter signal regimes pose risk; high temperature can stimulate early cellular/endocrine processes of spermatogenesis, which can later be synchronized in the population by an increase in daylength.

Abstract Background Healthcare costs are rising worldwide. At the same time, a considerable proportion of care does not benefit or may even be harmful to patients. We aimed to explore attitudes towards low-value care and identify the most important barriers to the de-implementation of low-value care use in primary care in high-income countries. Methods Between May and June 2022, we email surveyed primary care physicians in six high-income countries (Austria, Finland, Greece, Italy, Japan, and Sweden). Physician respondents were eligible if they had worked in primary care during the previous 24 months. The survey included four sections with categorized questions on (1) background information, (2) familiarity with Choosing Wisely recommendations, (3) attitudes towards overdiagnosis and overtreatment, and (4) barriers to de-implementation, as well as a section with open-ended questions on interventions and possible facilitators for de-implementation. We used descriptive statistics to present the results. Results Of the 16,935 primary care physicians, 1,731 answered (response rate 10.2%), 1,505 had worked in primary care practice in the last 24 months and were included in the analysis. Of the respondents, 53% had read Choosing Wisely recommendations. Of the respondents, 52% perceived overdiagnosis and 50% overtreatment as at least a problem to some extent in their own practice. Corresponding figures were 85% and 81% when they were asked regarding their country’s healthcare. Respondents considered patient expectations (85% answered either moderate or major importance), patient’s requests for treatments and tests (83%), fear of medical error (81%), workload/lack of time (81%), and fear of underdiagnosis or undertreatment (79%) as the most important barriers for de-implementation. Attitudes and perceptions of barriers differed significantly between countries. Conclusions More than 80% of primary care physicians consider overtreatment and overdiagnosis as a problem in their country’s healthcare but fewer (around 50%) in their own practice. Lack of time, fear of error, and patient pressures are common barriers to de-implementation in high-income countries and should be acknowledged when planning future healthcare. Due to the wide variety of barriers to de-implementation and differences in their importance in different contexts, understanding local barriers is crucial when planning de-implementation strategies.

Abstract Targeted therapy is effective in many tumor types including lung cancer, the leading cause of cancer mortality. Paradigm defining examples are targeted therapies directed against non-small cell lung cancer (NSCLC) subtypes with oncogenic alterations in EGFR, ALK and KRAS. The success of targeted therapy is limited by drug-tolerant persister cells (DTPs) which withstand and adapt to treatment and comprise the residual disease state that is typical during treatment with clinical targeted therapies. Here, we integrate studies in patient-derived and immunocompetent lung cancer models and clinical specimens obtained from patients on targeted therapy to uncover a focal adhesion kinase (FAK)-YAP signaling axis that promotes residual disease during oncogenic EGFR-, ALK-, and KRAS-targeted therapies. FAK-YAP signaling inhibition combined with the primary targeted therapy suppressed residual drug-tolerant cells and enhanced tumor responses. This study unveils a FAK-YAP signaling module that promotes residual disease in lung cancer and mechanism-based therapeutic strategies to improve tumor response.

An oral Controlled Human Infection Model (CHIM) with wild-type S. Typhi was re-established allowing us to explore the development of immunity. In this model, ~55% of volunteers who received the challenge reached typhoid diagnosis criteria (TD), while ~45% did not (NoTD). Intestinal macrophages are one of the first lines of defense against enteric pathogens. Most organs have self-renewing macrophages derived from tissue-resident progenitor cells seeded during the embryonic stage; however, the gut lacks these progenitors, and all intestinal macrophages are derived from circulating monocytes. After infecting gut-associated lymphoid tissues underlying microfold (M) cells, S. Typhi causes a primary bacteremia seeding organs of the reticuloendothelial system. Following days of incubation, a second bacteremia and clinical disease ensue. S. Typhi likely interacts with circulating monocytes or their progenitors in the bone marrow. We assessed changes in circulating monocytes after CHIM. The timepoints studied included 0 hours (pre-challenge) and days 1, 2, 4, 7, 9, 14, 21 and 28 after challenge. TD participants provided extra samples at the time of typhoid diagnosis, and 48-96 hours later (referred as ToD). We report changes in Classical Monocytes -CM-, Intermediate Monocytes -IM- and Non-classical Monocytes -NCM-. Changes in monocyte activation markers were identified only in TD participants and during ToD. CM and IM upregulated molecules related to interaction with bacterial antigens (TLR4, TLR5, CD36 and CD206). Of importance, CM and IM showed enhanced binding of S. Typhi. Upregulation of inflammatory molecules like TNF-α were detected, but mechanisms involved in limiting inflammation were also activated (CD163 and CD354 downregulation). CM upregulated molecules to interact/modulate cells of the adaptive immunity, including T cells (HLA-DR, CD274 and CD86) and B cells (CD257). Both CM and IM showed potential to migrate to the gut as integrin α4β7 was upregulated. Unsupervised analysis revealed 7 dynamic cell clusters. Five of these belonged to CM showing that this is the main population activated during ToD. Overall, we provide new insights into the changes that diverse circulating monocyte subsets undergo after typhoid diagnosis, which might be important to control this disease since these cells will ultimately become intestinal macrophages once they reach the gut.

Abstract Individuals born with very low birth weight (VLBW;

Abstract Background Causes of death other than COVID-19 seem to contribute significantly to the excess mortality observed during the 2020–2022 pandemic. In this study, we explore changes in non-COVID-19 causes of death in Norway during the COVID-19 pandemic from March 2020 to December 2022. Methods We performed a population-based cross-sectional study on data from the Norwegian Cause of Death Registry. All recorded deaths from 1st January 2010 to 31st December 2022 were included. The main outcome measures were the number of deaths and age-standardised death rate (ASMR) per 100000 population from the major cause of death groups in 2020, 2021 and 2022. The predicted number of deaths and ASMRs were forecasted with a 95% prediction interval constructed from a general linear regression model based on the corresponding number of deaths and rates from the preceding ten prepandemic years (2010–2019). We also examined whether there were deviations from expected seasonality in the pandemic period based on prepandemic monthly data from 2010–2019. The cumulative number of deaths and ASMR were estimated based on monthly mortality data. Results There was significant excess mortality (number of deaths) in 2021 and 2022 for all causes (3.7% and 14.5%), for cardiovascular diseases (14.3% and 22.0%), and for malignant tumours in 2022 (3.5%). In terms of ASMR, there was excess mortality in 2021 and 2022 for all causes (2.9% and 13.7%), and for cardiovascular diseases (16.0% and 25,8%). ASMR was higher than predicted in 2022 for malignant tumours (2.3%). There were fewer deaths than predicted from respiratory diseases (except COVID-19) in 2020 and 2021, and from dementia in 2021 and 2022. From March 2020 to December 2022, there were cumulatively 3754 (ASMR 83.8) more non-COVID-19 deaths than predicted, of which 3453 (ASMR: 79.6) were excess deaths from cardiovascular disease, 509 (ASMR 4.0) from malignant tumours. Mortality was lower than predicted for respiratory diseases (-1889 (ASMR: -44.3)), and dementia (-530 (ASMR -18.5)). Conclusions There was considerable excess non-COVID-19 mortality in Norway from March 2020 until December 2022, mainly due to excess cardiovascular deaths. For respiratory diseases and dementia, mortality was lower than predicted.

Objective: Recess contributes meaningfully to physical activity (PA), but recess time has declined. The study’s purpose was to report PA by age, gender, and playground feature to inform potential playground configurations more conducive to PA during recess. Methods: Using the System for Observing Play and Leisure Activity in the Youth, kindergarten through 5th grade recesses were observed on at least four days at four schools in Little Rock, Arkansas, United States during May 2023. Target playground features were ball courts, grass, pavement, play structures, and swings. To provide inferential analysis, a comparison of conditional means across playground features, age, and gender was conducted using linear regression with robust standard errors clustered by school. Results: 3,356 playground scans (intercoder correlation = 0.93) were collected and aggregated by school, day, gender, age (grade), and target feature for a sample size of 292 observations. The gender gap was widest among 4-5th graders, 79 % (95 % CI: 72, 86) for males and 64 % (95 % CI: 58, 70) for females. Among females, PA was highest on swings [82 % (95 % CI: 77, 86)] and lowest on paved areas [56 % (95 % CI: 43, 69)]. Among males, it was highest on both swings [81 % (95 % CI: 75, 86)] and ball courts [83 % (95 % CI: 77, 89)] and lowest on grassy areas [64 % (95 % CI: 60, 67)]. Conclusion: Swings, courts, and play structures were associated with a higher proportion of children being engaged in PA. Research is needed to identify whether physical improvements to facilitate access to these features increase PA.

Rapid apple decline (RAD) is a complex phenomenon affecting cultivated apple trees and particularly dwarf rootstocks on grafted young apple trees. Since its first appearance in the United States, RAD has been reported worldwide, for example in Canada, South America, Africa, and Asia. The phenomenon has also been observed in apple orchards in Korea, and it presented similar symptoms regardless of apple cultivar and cultivation period. Most previous reports have suggested that RAD may be associated with multiple factors, including plant pathogenic infections, abiotic stresses, environmental conditions, and the susceptibility of trees to cold injury during winter. However, RAD was observed to be more severe and affect more frequently apple trees on the Malling series dwarf rootstock. In this study, we reviewed the current status of RAD worldwide and surveyed biotic and abiotic factors that are potentially closely related to it in Korea.

Background: Although hydrocele is one of the most common urologic pathologies, it is seldom studied, and the major urologic associations have no guidelines for the management of adult hydroceles. Objective: To characterize international practice variation in the treatment of adult hydroceles. Design, setting, and participants: An international survey was conducted addressing the management of hydroceles among urologists in Belgium, Denmark, Finland, Iceland, Japan, and the Netherlands from September to December 2020. We invited a random sample of 170 urologists from each country (except Iceland). Outcome measurements and statistical analysis: Urologists’ treatment options, factors relevant for decision-making, expected patient satisfaction, and outcomes after aspiration versus surgery were assessed. Results and limitations: Of the 864 urologists contacted, 437 (51%) participated. Of the respondents, 202 (53%) performed both hydrocelectomies and aspiration, 147 (39%) performed hydrocelectomies only, and 30 (8%) performed aspiration only. In Belgium (83%), the Netherlands (75%), and Denmark (55%), urologists primarily performed hydrocelectomies only, whereas in Finland (84%), Japan (61%), and Iceland (91%), urologists performed both hydrocelectomies and aspiration. Urologists favored hydrocelectomy for large hydroceles (78.8% vs 37.5% for small), younger patients (66.0% for patients

Abstract Background Health systems are often susceptible to corruption risks. Corruption within health systems has been found to negatively affect the efficacy, safety, and, significantly, equitable distribution of health products. Enforcing effective anti-corruption mechanisms is important to reduce the risks of corruption but requires first an understanding of the ways in which corruption manifests. When there are public health crises, such as the COVID-19 pandemic, corruption risks can increase due to the need for accelerated rates of resource deployment that may result in the bypassing of standard operating procedures. Main body A rapid review was conducted to examine factors that increased corruption risks during the COVID-19 pandemic as well as potential anti-corruption, transparency and accountability (ACTA) mechanisms to reduce these risks. A search was conducted including terms related to corruption, COVID-19, and health systems from January 2020 until January 2022. In addition, relevant grey literature websites were hand searched for items. A single reviewer screened the search results removing those that did not meet the inclusion criteria. This reviewer then extracted data relevant to the research objectives from the included articles. 20 academic articles and 17 grey literature pieces were included in this review. Majority of the included articles described cases of substandard and falsified products. Several papers attributed shortages of these products as a major factor for the emergence of falsified versions. Majority of described corruption instances occurred in low- and middle-income countries. The main affected products identified were chloroquine tablets, personal protective equipment, COVID-19 vaccine, and diagnostic tests. Half of the articles were able to offer potential anti-corruption strategies. Conclusion Shortages of health products during the COVID-19 pandemic seemed to be associated with increased corruption risks. We found that low- and middle-income countries are particularly vulnerable to corruption during global emergencies. Lastly, there is a need for additional research on effective anti-corruption mechanisms.

Abstract Little is currently known about how climate modulates the relationship between plant diversity and soil organic carbon and the mechanisms involved. Yet, this knowledge is of crucial importance in times of climate change and biodiversity loss. Here, we show that plant diversity is positively correlated with soil carbon content and soil carbon-to-nitrogen ratio across 84 grasslands on six continents that span wide climate gradients. The relationships between plant diversity and soil carbon as well as plant diversity and soil organic matter quality (carbon-to-nitrogen ratio) are particularly strong in warm and arid climates. While plant biomass is positively correlated with soil carbon, plant biomass is not significantly correlated with plant diversity. Our results indicate that plant diversity influences soil carbon storage not via the quantity of organic matter (plant biomass) inputs to soil, but through the quality of organic matter. The study implies that ecosystem management that restores plant diversity likely enhances soil carbon sequestration, particularly in warm and arid climates.

This systematic review addresses the gap in the literature regarding sibling relationship quality among Latinx families, a topic that has not been comprehensively examined to date. This study aimed to synthesize current research on sibling relationship quality in Latinx families, focusing on the influence of cultural factors, identifying key variables associated with sibling relationship quality, and evaluating the methodological approaches used. This paper is a systematic review based on a recently published evidence and gap map (EGM) that identified and visually presented all published studies investigating sibling relationship quality. Additional inclusion criteria were applied to select articles that specifically examined sibling relationship quality in the United States samples with at least 50% Latinx participants. The review included 12 articles representing 6 distinct studies, revealing significant findings on the roles of familism, simpatía, and gender in shaping sibling dynamics. Results indicated that cultural values such as familism and simpatía positively influence sibling intimacy and warmth, while gender dynamics further moderate these relationships. Methodologically, the articles employed longitudinal and cross-sectional designs, utilizing various quantitative measures. The findings underscore the importance of culturally sensitive approaches in studying sibling relationships and highlight the need for further research to explore these dynamics in diverse Latinx subgroups.

This article traces the development and narrative staging in Russian media of the so-called Russian-Norwegian patriotic memory tours that took place from 2011 to 2019 to celebrate a heroic story of WWII Red Army soldiers and Norwegian partisans in Soviet intelligence service. The article concludes that the tours were initiated by Russian state and state-affiliated actors who exported military-patriotic symbols and perspectives across the border to Norway, and actively promoted several intertwined narratives; about joint Russian-Norwegian heroic war history; about historically peaceful relations in the North between Norway and Russia; and about Norway as a friendly Nato-member neighbor that rightfully honors the memory of the Soviet army and its crucial role in the victory over Nazi Germany. After Russia’s annexation of Crimea in 2014, these narratives were supplemented by Russian claims about a contemporary fascist threat spreading from Ukraine and the Baltics. The statements emphasized the acute importance of the patriotic memory tours to resist allegedly growing neo-fascism in today’s Europe. The article argues that the narrative staging of the tours must be read in the context of the Kremlin’s ongoing memory wars with former Soviet republics and Eastern bloc states and Russia’s military aggression in Ukraine since 2014.

Abstract Background Adults born small for gestational age (SGA) have increased risk of adverse health outcomes. Physical activity (PA) is a key determinant of health and health-related quality of life (HRQoL). We aimed to investigate if being born SGA at term is associated with lower objectively measured and self-reported PA during adulthood. We also examined if objectively measured and self-reported PA were associated with HRQoL. Methods As part of the 32-year follow-up in the NTNU Low Birth Weight in a Lifetime Perspective study, SGA and non-SGA control participants wore two tri-axial accelerometers for seven days (37 SGA, 43 control), and completed the International Physical Activity Questionnaire (IPAQ) (42 SGA, 49 control) and the Short Form 36 Health Survey (SF-36) (55 SGA, 67 control). Group differences in objectively measured daily metabolic equivalent of task (MET) minutes spent sedentary (lying, sitting), on feet (standing, walking, running, cycling), on the move (walking, running, cycling) and running/cycling, and group differences in self-reported daily MET minutes spent walking and in moderate and vigorous PA were examined using linear regression. Associations with SF-36 were explored in a general linear model. Results Mean (SD) daily MET minutes on the move were 218 (127) in the SGA group and 227 (113) in the control group. There were no group differences in objectively measured and self-reported PA or associations with HRQoL. In the SGA group, one MET minute higher objectively measured time on the move was associated with 4.0 (95% CI: 0.6–6.5, p = 0.009) points higher SF-36 physical component summary. Conclusion We found no differences in objectively measured and self-reported PA or associations with HRQoL between term-born SGA and non-SGA control participants in adulthood.

Abstract Background De-implementation of low-value care can increase health care sustainability. We evaluated the reporting of direct costs of de-implementation and subsequent change (increase or decrease) in health care costs in randomized trials of de-implementation research. Methods We searched MEDLINE and Scopus databases without any language restrictions up to May 2021. We conducted study screening and data extraction independently and in duplicate. We extracted information related to study characteristics, types and characteristics of interventions, de-implementation costs, and impacts on health care costs. We assessed risk of bias using a modified Cochrane risk-of-bias tool. Results We screened 10,733 articles, with 227 studies meeting the inclusion criteria, of which 50 included information on direct cost of de-implementation or impact of de-implementation on health care costs. Studies were mostly conducted in North America (36%) or Europe (32%) and in the primary care context (70%). The most common practice of interest was reduction in the use of antibiotics or other medications (74%). Most studies used education strategies (meetings, materials) (64%). Studies used either a single strategy (52%) or were multifaceted (48%). Of the 227 eligible studies, 18 (8%) reported on direct costs of the used de-implementation strategy; of which, 13 reported total costs, and 12 reported per unit costs (7 reported both). The costs of de-implementation strategies varied considerably. Of the 227 eligible studies, 43 (19%) reported on impact of de-implementation on health care costs. Health care costs decreased in 27 studies (63%), increased in 2 (5%), and were unchanged in 14 (33%). Conclusion De-implementation randomized controlled trials typically did not report direct costs of the de-implementation strategies (92%) or the impacts of de-implementation on health care costs (81%). Lack of cost information may limit the value of de-implementation trials to decision-makers. Trial registration OSF (Open Science Framework): https://osf.io/ueq32 .

Abstract Background There are inconsistent findings regarding neurological and motor development in infants born moderate to late preterm and infants born small for gestational age at term. The primary aim of this study was to compare neurological and motor function between preterm, term SGA and term AGA infants aged three to seven months corrected age using several common assessment tools. The secondary aim was to investigate their motor function at two years. Methods In this prospective cohort study, we included 43 infants born moderate to late preterm with gestational age 32–36 + 6 weeks, 39 infants born small for gestational age (SGA) at term with a birthweight ≤ 10th centile for gestational age, and 170 infants born at term with appropriate weight for gestational age (AGA). Neurological and motor function were assessed once in infancy between three to seven months corrected age by using four standardised assessment tools: Hammersmith Infant Neurological Examination (HINE), Test of Infant Motor Performance, General Movements Assessment and Alberta Infant Motor Scale. The Ages and Stages Questionnaire (ASQ-2) was used at two years. Results At three to seven months corrected age, mean age-corrected HINE scores were 61.8 (95% confidence interval (CI): 60.5 to 63.1) in the preterm group compared with 63.3 (95% CI: 62.6 to 63.9) in the term AGA group. Preterm infants had 5.8 (95% CI: 2.4 to 15.4) higher odds for HINE scores

This paper presents a discussion of Radcliffe’s pedagogy-space-technology (PST) framework for the development, implementation, and evaluation of learning spaces in light of Merleau-Ponty’s Phenomenology of Perception. The following research questions have guided the theoretical discussion: In which ways can Merleau-Ponty’s body-subject phenomenology enlighten Radcliffe’s framework? How can Merleau-Ponty’s body-subject paradigm be integrated into the development and implementation of hybrid learning environments? The reference to an exploratory case study within the frame of a larger research project will support the theoretical argumentation. In the study, the genesis of an innovative learning environment linked to a cross-institution master’s program located at two Norwegian universities will serve as an example.

A long-standing problem in the study of mutualism is to understand the effects of non-mutualistic community members that exploit the benefits of mutualism without offering commodities in exchange (i.e., ‘exploiters’). Mutualisms are continually challenged by exploiters and their persistence may depend on the costliness of exploitation or on adaptations that allow mutualists to avoid the negative effects of exploiters. Coevolution could lead to changes in mutualists and exploiters that allow mutualisms to persist. Although coevolution is considered essential for mutualism persistence and resistance to disturbance, we have yet to obtain direct experimental evidence of the role of coevolution in resistance to exploitation. Additionally, resistance to exploitation via coevolutionary processes might vary with the degree of dependency between mutualistic partners, as facultative mutualisms are thought to be under weaker coevolutionary selection than obligate mutualisms. Here, we conducted an experimental evolution study using a synthetic yeast mutualism to test how coevolution in facultative and obligate mutualisms affects their resistance to exploitation. We found that naïve facultative mutualisms were more likely to breakdown under exploitation than naïve obligate mutualisms. After 15 weeks of coevolution, both facultative and obligate evolved mutualists were more likely to survive exploitation than naïve mutualists when we reassembled mutualist communities. Additionally, coevolved exploiters were more likely to survive with mutualists, whereas naïve exploiters frequently went extinct. These results suggest that coevolution between mutualists and exploiters can lead to mutualism persistence, potentially explaining why exploitation is ubiquitous but rarely associated with mutualism breakdown.

Preoperative nasopharyngeal viral screening may reduce clinical uncertainty of upper respiratory infections prior to pediatric cardiac surgery but with unclear benefit. From March 2018 to March 2020, patients aged

While the early effects of the COVID-19 pandemic on the United States labor market are well-established, less is known about the long-term impact of SARS-CoV-2 infection and Long COVID on employment. To address this gap, we analyzed self-reported data from a prospective, national cohort study to estimate the effects of SARS-CoV-2 symptoms at three months post-infection on missed workdays and return to work. The analysis included 2,939 adults in the Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE) study who tested positive for their initial SARS-CoV-2 infection at the time of enrollment, were employed before the pandemic, and completed a baseline and three-month electronic survey. At three months post-infection, 40.8% of participants reported at least one SARS-CoV-2 symptom and 9.6% of participants reported five or more SARS-CoV-2 symptoms. When asked about missed work due to their SARS-CoV-2 infection at three months, 7.2% of participants reported missing ≥10 workdays and 13.9% of participants reported not returning to work since their infection. At three months, participants with ≥5 symptoms had a higher adjusted odds ratio of missing ≥10 workdays (2.96, 95% CI 1.81-4.83) and not returning to work (2.44, 95% CI 1.58-3.76) compared to those with no symptoms. Prolonged SARS-CoV-2 symptoms were common, affecting 4-in-10 participants at three-months post-infection, and were associated with increased odds of work loss, most pronounced among adults with ≥5 symptoms at three months. Despite the end of the federal Public Health Emergency for COVID-19 and efforts to "return to normal", policymakers must consider the clinical and economic implications of the COVID-19 pandemic on people's employment status and work absenteeism, particularly as data characterizing the numerous health and well-being impacts of Long COVID continue to emerge. Improved understanding of risk factors for lost work time may guide efforts to support people in returning to work.

ObjectiveIndividuals born very preterm (Study designCohorts with data on physical activity and cognitive function in adults born very preterm/very low birth weight and term-born controls were recruited from the Research on European Children and Adults Born Preterm, and the Adults Born Preterm International Collaboration Consortia. A systematic literature search was performed in PubMed and Embase.ResultsFive cohorts with 1644 participants aged 22-28 years (595 very preterm/very low birth weight and 1049 controls) were included. Adults born very preterm/very low birth weight reported 1.11 (95% CI: 0.68 to 1.54) hours less moderate to vigorous physical activity per week than controls, adjusted for cohort, age and sex. The difference between individuals born very preterm/very low birth weight and controls was larger among women than among men. Neither intelligence quotient nor self-reported executive function mediated the association between very preterm/very low birth weight and moderate to vigorous physical activity. Results were essentially the same when we excluded individuals with neurosensory impairments.ConclusionAdults born very preterm/very low birth weight, especially women, reported less moderate to vigorous physical activity than their term-born peers. Cognitive function did not mediate this association. Considering the risk of adverse health outcomes among individuals born preterm, physical activity could be a target for intervention.

IntroductionThere is increasing evidence that the in utero environment affects the health and disease risk of offspring throughout their lives. The long-term effect of maternal hyperglycaemia on offspring glucose metabolism is of interest in a public health perspective. The aim of this study was to examine the association between in utero exposure to maternal glycaemia and offspring glucose metabolism.MethodsMother-child pairs were recruited from an RCT to prevent gestational diabetes mellitus where 855 healthy pregnant women were randomised to exercise or standard antenatal care. The original RCT detected no group differences in gestational diabetes mellitus prevalence or insulin resistance. The two groups were analysed as one group in the present study. Maternal glucose levels were assessed after 2-hour 75-gram oral glucose tolerance tests in pregnancy week ~34. Offspring outcomes were evaluated at ~9 years of age and included fasting glucose and homeostatic model assessment of insulin resistance. Multivariable regression models were performed, controlling for potential hereditary and lifestyle confounding factors.ResultsComplete data were available for 105 mother-child pairs. The regression analysis showed a positive association between maternal and offspring fasting glucose that was borderline significant (beta=0.18, 95% CI [-0.00027, 0.37], p=0.050). We did not find significant associations between maternal fasting glucose and offspring insulin resistance (beta=0.080, 95% CI [-0.087, 0.25], p=0.34), or between maternal 2-hour glucose and offspring fasting glucose (beta=0.016, 95% CI [-0.038, 0.070], p=0.56) or insulin resistance (beta=0.017, 95% CI [-0.032, 0.065], p=0.49).ConclusionsAssessing a homogeneous group of healthy mother-child pairs, we found a borderline significant positive association between maternal and offspring fasting glucose, which persisted after adjustment for potential hereditary and lifestyle confounding factors. Our findings support other similar studies and highlight that improving the metabolic health of pregnant women, and women in childbearing age, should remain a key public health priority.Clinical trial registrationClinicalTrials.gov, identifier NCT00476567.

IntroductionData on ethnic and racial differences in symptoms and health-related impacts following SARS-CoV-2 infection are limited. We aimed to estimate the ethnic and racial differences in symptoms and health-related impacts 3 and 6 months after the first SARS-CoV-2 infection.MethodsParticipants included adults with SARS-CoV-2 infection enrolled in a prospective multicenter US study between 12/11/2020 and 7/4/2022 as the primary cohort of interest, as well as a SARS-CoV-2-negative cohort to account for non-SARS-CoV-2-infection impacts, who completed enrollment and 3-month surveys (N = 3,161; 2,402 SARS-CoV-2-positive, 759 SARS-CoV-2-negative). Marginal odds ratios were estimated using GEE logistic regression for individual symptoms, health status, activity level, and missed work 3 and 6 months after COVID-19 illness, comparing each ethnicity or race to the referent group (non-Hispanic or white), adjusting for demographic factors, social determinants of health, substance use, pre-existing health conditions, SARS-CoV-2 infection status, COVID-19 vaccination status, and survey time point, with interactions between ethnicity or race and time point, ethnicity or race and SARS-CoV-2 infection status, and SARS-CoV-2 infection status and time point.ResultsFollowing SARS-CoV-2 infection, the majority of symptoms were similar over time between ethnic and racial groups. At 3 months, Hispanic participants were more likely than non-Hispanic participants to report fair/poor health (OR: 1.94; 95%CI: 1.36–2.78) and reduced activity (somewhat less, OR: 1.47; 95%CI: 1.06–2.02; much less, OR: 2.23; 95%CI: 1.38–3.61). At 6 months, differences by ethnicity were not present. At 3 months, Other/Multiple race participants were more likely than white participants to report fair/poor health (OR: 1.90; 95% CI: 1.25–2.88), reduced activity (somewhat less, OR: 1.72; 95%CI: 1.21–2.46; much less, OR: 2.08; 95%CI: 1.18–3.65). At 6 months, Asian participants were more likely than white participants to report fair/poor health (OR: 1.88; 95%CI: 1.13–3.12); Black participants reported more missed work (OR, 2.83; 95%CI: 1.60–5.00); and Other/Multiple race participants reported more fair/poor health (OR: 1.83; 95%CI: 1.10–3.05), reduced activity (somewhat less, OR: 1.60; 95%CI: 1.02–2.51; much less, OR: 2.49; 95%CI: 1.40–4.44), and more missed work (OR: 2.25; 95%CI: 1.27–3.98).DiscussionAwareness of ethnic and racial differences in outcomes following SARS-CoV-2 infection may inform clinical and public health efforts to advance health equity in long-term outcomes.

Abstract Background Evidence suggests that access to green schoolyards may facilitate vigorous play and lead to increased physical activity, which could lead to improved academic outcomes and reduce excess childhood weight gain. Greener schoolyards can also provide additional outdoor amenities that help the community at large. The Little Rock Green Schoolyard Initiative, a program aiming to promote outdoor learning and play in two of the city’s community schools, provides a natural experiment to evaluate the role of such interventions. This article presents the protocols and study plans that will be used to evaluate this community-led initiative on several outcomes including physical activity, sleep quality, use of schoolgrounds, and perceptions of the school environment. Administrative datasets will be used to assess exposure to green schoolyard improvements on academic achievement, attendance, and disciplinary referrals during elementary school. Methods Data will be gathered in two community schools where the green schoolyard improvements are taking place and in two demographically-matched comparison schools located elsewhere within the Little Rock School District. Data will be collected before, during, and after the green schoolyard improvements go into effect. Physical activity and sleep quality will be measured using actigraphy. Physical activity will also be assessed through direct playground observations during recess and outside of school hours. During the final year of the study, administrative data will be assembled and evaluated using difference-in-differences estimation and synthetic controls, two causal inference methods from the program evaluation literature. Discussion The study is designed to provide new insights into the design, implementation, and evaluation of playgrounds among schoolchildren, especially those who are at risk of developing severe obesity during their elementary school years. The research herein will develop empirical data, elucidate potential mechanisms, and practical experience for future study, policymaking, and health services.

Abstract Objective: To describe national disparities in retail food environments by neighbourhood composition (race/ethnicity and socio-economic status) across time and space. Design: We examined built food environments (retail outlets) between 1990 and 2014 for census tracts in the contiguous USA (n 71 547). We measured retail food environment as counts of all food stores, all unhealthy food sources (including fast food, convenience stores, bakeries and ice cream) and healthy food stores (including supermarkets, fruit and vegetable markets) from National Establishment Time Series business data. Changes in food environment were mapped to display spatial patterns. Multi-level Poisson models, clustered by tract, estimated time trends in counts of food stores with a land area offset and independent variables population density, racial composition (categorised as predominantly one race/ethnicity (>60 %) or mixed), and inflation-adjusted income tertile. Setting: The contiguous USA between 1990 and 2014. Participants: All census tracts (n 71 547). Results: All food stores and unhealthy food sources increased, while the subcategory healthy food remained relatively stable. In models adjusting for population density, predominantly non-Hispanic Black, Hispanic, Asian and mixed tracts had significantly more destinations of all food categories than predominantly non-Hispanic White tracts. This disparity increased over time, predominantly driven by larger increases in unhealthy food sources for tracts which were not predominantly non-Hispanic White. Income and food store access were inversely related, although disparities narrowed over time. Conclusions: Our findings illustrate a national food landscape with both persistent and shifting spatial patterns in the availability of establishments across neighbourhoods with different racial/ethnic and socio-economic compositions.

Abstract Plant biodiversity, which is fundamental for the delivery of ecosystem services, is in decline. Yet, knowledge about how plant biodiversity is perceived and appreciated is scarce. We studied biologists' and laypeople's perception and appreciation for plant communities that differ in plant biodiversity, using ranges of plant biodiversity known to affect ecosystem services. We investigate species richness, species turnover and species evenness. A questionnaire based on photographs displaying artificial plant communities was used. Perceived biodiversity was 12% more often congruent with actual biodiversity for biologists than for laypeople. Species richness was perceived congruently with actual species richness by 77% of all respondents, compared with 27% for species evenness and 29% for species turnover. Appreciation for the displayed communities correlated positively with their actual plant biodiversity, except for species turnover. Appreciation always correlated positively with perceived plant biodiversity and even stronger than with actual plant biodiversity. This was not the case for species richness, for which perceived and actual biodiversity were most often congruent. Our results suggest that plant biodiversity is perceived most accurately when changes in species richness are considered, while changes in species evenness and species turnover are perceived less accurately. The respondents' answers indicate that perceived higher plant biodiversity is appreciated more than perceived lower plant biodiversity, even when perceived and actual plant biodiversity are not congruent. We corroborate findings that people value plant biodiversity per se. But we also find that people largely perceive species evenness and turnover with low accuracy; and that people have low appreciation for these biodiversity dimensions that are lesser known but essential to ecosystem functioning. Our finding that biologists have higher accuracy in perceiving biodiversity suggests that biodiversity literacy is key to increasing people's awareness of changes in plant biodiversity. Read the free Plain Language Summary for this article on the Journal blog.

This article has been retracted. Please see the Retraction Notice for more detail: https://doi.org/10.1186/s12889-024-18629-0.

ABSTRACTAntibody discovery against complex antigens is limited by the availability of a reproducible pure source of concentrated properly folded antigen. We have developed a technology to enable direct incorporation of membrane proteins such as GPCRs and into the membrane of poxvirus. The protein of interest is correctly folded and expressed in the cell-derived viral membrane and does not require any detergents or refolding before downstream use. The poxvirus is selective in which proteins are incorporated into the viral membrane, making the antigen poxvirus an antigenically cleaner target for in vitro panning. Antigen-expressing virus can be readily purified at scale and used for antibody selection using any in vitro display platform.

Bakgrunn: Simulering er en pedagogisk metode som kan benyttes for å tydeliggjøre sammensatte problemstillinger. Utfordringer knyttet til legemiddelhåndtering i ulike helseinstitusjoner inkludert sykehjem er kjent. Vi ønsket å se om simulering kunne være nyttig for å få frem ulike utfordringer som er knyttet til dette området. Hensikten med denne artikkelen er å beskrive sykepleieres og helsefagarbeideres erfaringer med å delta i simulering, og hvilke refleksjoner som oppstår rundt legemiddelhåndtering i sykehjem. Metode: Kvalitativ metode med fokusgruppeintervju. Resultater: Sykepleiere og helsefagarbeidere ble bevisst ulike utfordringer knyttet til legemiddelhåndtering ved hjelp av simulering. De fleste opplevde simuleringen som en nyttig metode i denne bevisstgjøringen. De fleste opplevde at de lærte noe som gav ny innsikt i egen arbeidssituasjon. Det var utfordringer knyttet til distraksjoner og stress, mangel på sykepleiere samt uklar ansvar- og oppgavefordeling. Konklusjon: Simulering som metode kan være bevisstgjørende for å synligjøre ulike utfordringer knyttet til legemiddelhåndtering i sykehjem.

ABSTRACT Toll-like receptor 4 (TLR4) is an innate immune receptor responsive to lipopolysaccharide (LPS). Single nucleotide polymorphisms (SNPs) in human TLR4 that encode an A896G transition at SNP rs4986790 (D299G) and a C1196T transition at SNP rs4986791 (T399I) render individuals hyporesponsive to LPS. In humans, these SNPs are also associated with increased susceptibility to inflammatory bowel diseases (IBDs). Using knock-in mice engineered to express the murine homologs of these human TLR4 mutations (“TLR4-SNP” mice), we have shown that TLR4-SNP mice develop significantly more severe colitis induced by dextran sodium sulfate (DSS) than wild-type (WT) mice, similar to IBD in humans expressing these SNPs. Previous studies have provided indirect evidence for “tissue repair” M2 macrophages (Mφ) in the resolution of colitis. Signaling through the IL-4/IL-13 receptor, IL-4Rα, and the transcription factor, peroxisome proliferator-activated receptor (PPARγ), have been shown to be required for induction of M2a Mφ, and our data provide direct evidence for the involvement of both in the repair of DSS-induced colonic damage. In response to DSS, colons of TLR4-SNP mice produced reduced levels of M2a Mφ marker mRNA and protein, including PPARγ, and therapeutic administration of the PPARγ agonist ligand, rosiglitazone, resolved colitis in TLR4-SNP mice, and increased expression of the M2a protein, Ym1. Together, these data indicate that the failure of TLR4-SNP mice to resolve DSS-induced colitis may be secondary to their failure to induce “tissue repair” M2a Mφ. Importance Inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, impacts millions of individuals worldwide and severely impairs the quality of life for patients. Dysregulation of innate immune signaling pathways reduces barrier function and exacerbates disease progression. Macrophage (Mφ) signaling pathways are potential targets for IBD therapies. While multiple treatments are available for IBD, (i) not all patients respond, (ii) responses may diminish over time, and (iii) treatments often have undesirable side effects. Genetic studies have shown that the inheritance of two co-segregating SNPs expressed in the innate immune receptor, TLR4, is associated with human IBD. Mice expressing homologous SNPs (“TLR4-SNP” mice) exhibited more severe colitis than WT mice in a DSS-induced colonic inflammation/repair model. We identified a critical role for M2a “tissue repair” Mφ in the resolution of colitis. Our findings provide insight into potential development of novel therapies targeting Mφ signaling pathways that aim to alleviate the debilitating symptoms experienced by individuals with IBD.

These past few years have shown the importance of successfully designing cross-campus and multi-campus hybrid and fully digital learning environments to sustain and guarantee continuity in learners’ higher education - an aspect that has become pivotal to ensure the survival of Higher Educational Institutions in an increasingly digitalized world. Such learning environments, and related pedagogical practices, seem to contribute to promoting the development of the learners’ critical skills to meet future work-life challenges and possible new crises. It is therefore increasingly important to include students’ experiences and feedback to help develop and define standards and frameworks that can guide educators and other stakeholders in their work. This article presents the results from an exploratory case study within the frame of a larger research project closely linked to a cross-campus and cross-institution master’s degree program at the Norwegian University of Science and Technology (NTNU). The master’s program is a collaboration between NTNU and the University of Oslo (UiO) and is co-located at both campuses through one shared hybrid, physical and virtual, learning space called the Portal. The genesis of the Portal is informed by Radcliffe’s Pedagogy-Space-Technology framework for the design and evaluation of learning spaces. The scope of our research focuses on the “user experiences”, particularly on how students experience their learning space as an arena for student active learning and collaborations in a cross-campus (and cross-institution) organization. With this article, we hope to contribute to the research field in higher education by bringing in newer insight and, hopefully, a fresh point of view.

Abstract There is lack of research on body composition and physical fitness in individuals born small for gestational age (SGA) at term entering mid-adulthood. We aimed to investigate these outcomes in adults born SGA at term. This population-based cohort study included 46 adults born SGA with birth weight

This paper focuses on the design aspects of the key components for a scalable phased-array system over the 200 GHz frequency range. A high-gain phase shifter chain for 220 to 240 GHz frequency range and a high-gain power amplifier (PA) with a high output power are designed in a 0.13- $\mu \text{m}$ SiGe BiCMOS technology. The phase shifter chain includes a low-noise amplifier (LNA), a vector modulator phase shifter (PS), and a gain-enhancing amplifier. The LNA is a five-stage cascode design. The vector modulator core is realized by two variable gain amplifiers based on the Gilbert cell architecture. A four-stage cascode design is used for the gain-enhancing amplifier. The phase shifter chain shows a measured gain of 18 dB at 230 GHz with a $360 {\mathrm { ^{\circ}}}$ phase tuning range and more than 10 dB of gain control. The chip achieves a minimum measured noise figure of 11.5 dB at 230 GHz and shows a wideband noise characteristic. The complete phase shifter chain chip consumes a dc power of 153 mW and occupies a 1.41 mm2 area. A high-power PA that is critical for a large phased-array system is designed. This paper presents a unique 4-way power combining technique utilizing a differential quadrature coupler. The realized balanced PA occupies an area of 0.67 mm2 and shows a measured peak gain of 21 dB at 244 GHz. The PA consumes 819 mW of dc power and delivers a maximum saturated output power $(P_{sat})$ of 7.1 dBm at 244 GHz and more than 4.3 dBm of $P_{sat}$ from 230 to 255 GHz.

Abstract Based on data collected as part of the contact tracing activity of the City of Helsinki Epidemiological Operations Unit, we evaluated the efficacy and effectiveness of isolating SARS-CoV-2 cases and quarantining their exposed contacts during a mildly growing phase of the COVID-19 epidemic in Finland in autumn 2020. Based on the observed symptom-to-symptom intervals in 1016 pairs of primary and secondary cases, we estimated that without case isolation or quarantine 40 $$\%$$ % (90 $$\%$$ % credible interval, CI 25–59) of transmission would have occurred on the day of or after symptom onset. One third of SARS-CoV-2 cases (N = 1521) had initially been quarantined, with a self-reported time until isolation (quarantine) of 0.8 days before symptom onset. This delay translates into an efficacy of 50 $$\%$$ % (90 $$\%$$ % CI 40–63) of averting secondary infections per quarantined case. Due to later isolation (mean 2.6 days after symptoms), the efficacy was smaller (24 $$\%$$ % ; 90 $$\%$$ % CI 12–41) in those two third of the cases (N = 3101) whose isolation was prompted by their symptoms, i.e. without being previously quarantined. At the population level, we evaluated the effectiveness of case isolation and quarantine on the growth rate of the COVID-19 epidemic in the autumn of 2020. Under a wide range of underlying assumptions, the rate would have been at least 2 times higher without case isolation and quarantine. The numbers needed to isolate or quarantine to prevent one secondary case were 2 and 20, respectively.

PATHMAP (Pathogen And Tree fruit Health MAP) is a smartphone application (app) and interactive dashboard developed specifically for support specialists, extension personnel, and university scientists supporting the tree fruit industry. The PATHMAP app collects detailed information about observed diseases, insect pests, and disorders and provides the option to attach photos. The data are then visualized using a graphical interface dashboard displaying an interactive color-coded map. Prior to the development of PATHMAP, abundant tree fruit disorder data were collected each year, but a central interactive repository for archiving data and facilitating communication of field observations did not exist. PATHMAP has been beta tested by university extension personnel, private consultants, and university scientists to ensure usability and functionality. PATHMAP will be used within the tree fruit industry for monitoring known pest patterns, occurrences, and outbreaks of emerging pathogens. It will augment existing extension diagnosis listservs that have value in visual diagnosis but are cumbersome and have no archiving capabilities. Data obtained through the tool can be used in epidemiological meta-analyses and to develop new predictive models, and can serve as a platform to track emerging pathogens, insects, and disorders for a variety of cropping systems. [Figure: see text] The author(s) have dedicated the work to the public domain under the Creative Commons CC0 “No Rights Reserved” license by waiving all of his or her rights to the work worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law, 2022.