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Abstract Background Previous studies have shown varying results on the validity of the rapid emergency triage and treatment system (RETTS), but have concluded that patient age is not adequately considered as a risk factor for short term mortality. Little is known about the RETTS system’s performance between different chief complaints and on short term mortality. We therefore aimed to evaluate how well a model including both RETTS triage priority and patient age (TP and age model) predicts 3-day mortality compared to a univariate RETTS triage priority model (TP model). Secondarily, we aimed to evaluate the TP model compared to a univariate age model (age model) and whether these three models’ predictive performance regarding 3-day mortality varies between patients with different chief complaints in an unsorted emergency department patient population. Methods This study was a prospective historic observational cohort study, using logistic regression on a cohort of patients seeking emergency department care in Stockholm during 2012–2016. Patient visits were stratified into the 10 chief complaint categories (CCC) with the highest number of deceased patients within 3 days of arrival, and to “other chief complaints”. Patients with priority 1 were excluded. Results The studied cohort contained 1,690,981 visits by 788,046 different individuals. The TP and age model predicted 3-day mortality significantly and substantially better than both univariate models in the total population and in each studied CCC. The age model predicted 3-day mortality significantly and substantially better than the TP model in the total population and for all but three CCCs and was not inferior in any CCC. There were substantial differences between the studied CCCs in the predictive ability of each of the three models. Conclusions Adding patient age to the RETTS triage priority system significantly and substantially improves 3-day mortality prediction compared to RETTS priority alone. Age alone is a non-inferior predictor of 3-day mortality compared to RETTS priority. The impact on 3-day mortality prediction of adding patient age to RETTS priority varies between CCCs but is substantial for all CCCs and for the total population. Including age as a variable in future revisions of RETTS could substantially improve patient safety.

In this five-month Swedish field study, we examined losses of nutrients from horse manure over time, in order to examine how regularly manure should be cleared from paddocks in order to minimise the risk of nutrient leaching. Small heaps of manure (400 g) were placed in open cylinders outdoors and samples (five replicates) were taken on 12 occasions from December 2020 to May 2021. The samples were analysed for weight, dry matter content and concentrations of total nitrogen (N), ammonium N, total phosphorus (P), water-extractable P (WEP), potassium (K) and carbon (C). There was a fast decline in P and K concentrations and a strong correlation between accumulated precipitation and losses from the manure into the soil. The mean reduction in total-P was 11 mg P kg−1 manure dry weight per mm accumulated precipitation. Manure N was retained in the manure over the five-month period. In conclusion, this study demonstrated high mobility of P and K, indicating a need for strategies for rapid removal of manure from paddocks. Daily removal of manure from paddocks used year-round would, approximately, save 1.7 kg P and 5.5 kg K per horse per year, which could be recycled to replace non-renewable mineral fertilisers.

Social media have long been studied from platform‐centric perspectives, which entail sampling messages based on criteria such as keywords and specific accounts. In contrast, user‐centric approaches attempt to reconstruct the personalized information environments users create for themselves. Most user‐centric studies analyze what users have accessed directly through browsers (e.g., through clicks) rather than what they may have seen in their social media feeds. This study introduces a data collection system of our own design called PIEGraph that links survey data with posts collected from participants' personalized X (formerly known as Twitter) timelines. Thus, in contrast with previous research, our data include much more than what users decide to click on. We measure the total amount of data in our participants' respective feeds and conduct descriptive and inferential analyses of three other quantities of interest: political content, ideological skew, and fact quality ratings. Our results are relevant to ongoing debates about digital echo chambers, misinformation, and conspiracy theories; and our general methodological approach could be applied to social media beyond X/Twitter contingent on data availability. [ABSTRACT FROM AUTHOR]

As a result of canopy interception and transpiration, trees are often assumed to have negative effects on the local hydrological budget resulting in reduced soil and groundwater resources. However, it has also been shown that trees can have positive effects through reducing surface run-off and improving soil infiltrability and groundwater recharge, especially in many tropical ecosystems characterized by high rain intensity and degradation-prone soils. In this study, we used isotopic measurements of soil water to better understand the main processes by which trees influence local soil water dynamics within a tropical pasture with scattered tree cover in the Copan River catchment, Honduras. We also determined the stable isotope signature of xylem water in grasses and trees to assess potential competition for water sources during the wet and dry seasons. During the wet season, when soil water availability was not limiting, both grasses and trees primarily utilized soil water near the soil surface (i.e., 0–10 cm). In contrast, during the dry season, we observed niche partitioning for water resources where grasses primarily utilized soil moisture at deeper soil depth (i.e., 90–100 cm) while trees relied heavily on groundwater. Moreover, isotopic data of soil water suggest that trees reduce evaporative water losses from the soil surface, as indicated by the lack of correlation between soil water content and lc-excess (line condition excess) values of surface soil water under trees, and enhance preferential flow as suggested by less negative lc-excess values under trees compared to open areas during the dry season. Taken together, our findings provide further support that trees can have positive effects on the local water balance with implication for landscape management, promoting the inclusion of scattered trees to provide water ecosystem services in silvopastoral systems, adding to other ecosystem services like biodiversity or carbon sequestration.

Abstract Background Triage is widely used in the emergency department (ED) in order to identify the patient’s level of urgency and often based on the patient’s chief complaint and vital signs. Age has been shown to be independently associated with short term mortality following an ED visit. However, the most commonly used ED triage tools do not include age as an independent core variable. The aim of this study was to investigate the relationship between age and 7- and 30-day mortality across the triage priority level groups according to Rapid Emergency Triage and Treatment System – Adult (RETTS-A), the most widely used triage tool in Sweden. Methods In this cohort, we included all adult patients visiting the ED at the Karolinska University Hospital, Sweden, from 1/1/2010 to 1/1/2015, n = 639,387. All patients were triaged according to the RETTS-A and subsequently separated into three age strata: 18–59, 60–79 and ≥ 80 years. Descriptive analyses and logistic regression was used. The primary outcome measures were 7- and 30-day mortality. Results We observed that age was associated with both 7 and 30-day mortality in each triage priority level group. Mortality was higher in older patients across all triage priority levels but the association with age was stronger in the lowest triage group (p-value for interaction =

Abstract Background Emergence of tick-borne diseases is impacting humans and livestock across the Northern Hemisphere. There are, however, large regional variations in number of cases of tick-borne diseases. Some areas have surprisingly few cases of disease compared to other regions. The aim here is to provide a first step towards a better understanding of such contrasting regional patterns of disease emergences at the northern distribution range of Ixodes ricinus in Europe. Methods We compare disease incidence, vector abundance and pathogen prevalence in eastern and western Norway differing in the number of tick-borne disease cases. First, we analysed the incidence of Lyme borreliosis in humans, tick-borne fever (anaplasmosis) in sheep and anaplasmosis and babesiosis in cattle to verify if incidence differed. Secondly, we analysed extensive field data on questing tick density, pathogen prevalence, as well as the broad spatial pattern of human and livestock distribution as it may relate to tick exposure. Results The incidences of all diseases were lower in eastern, compared to western, Norway, but this was most marked for the livestock diseases. While the prevalence of Borrelia burgdorferi (sensu lato) in ticks was similar in the two regions, the prevalence of Anaplasma phagocytophilum was markedly lower in eastern, compared to western, Norway. We found overall a lower abundance of questing nymphs in the east. In the east, there were cases of babesiosis in cattle where anaplasmosis was absent, suggesting absence of the pathogen rather than differences in exposure to ticks as part of the explanation for the much lower incidence of anaplasmosis in eastern Norway. Conclusions Many factors contribute to different disease incidence across ecosystems. We found that regional variation in tick-borne disease incidence may be partly linked to vector abundance and pathogen prevalence, but differently for human and livestock diseases. Further studies are needed to determine if there is also regional variation in specific genospecies and strain frequencies differing in pathogenicity.

Environmental change is thought to have driven the recent emergence of Lyme disease in Europe. Using a decade of human disease incidence data across a large area in Norway, Mysterud et al.show that incidence correlates with deer population, but that deer population plays a limited role in recent disease emergence.

Progressive loss of brain tissue is seen in some patients with schizophrenia and might be caused by increased levels of glutamate and resting cerebral blood flow (rCBF) alterations. Animal studies suggest that the normalisation of glutamate levels decreases rCBF and prevents structural changes in hippocampus. However, the relationship between glutamate and rCBF in anterior cingulate cortex (ACC) of humans has not been studied in the absence of antipsychotics and illness chronicity. Ketamine is a noncompetitive N-methyl-D-aspartate receptor antagonist that transiently induces schizophrenia-like symptoms and neurobiological disturbances in healthy volunteers (HVs). Here, we used S-ketamine challenge to assess if glutamate levels were associated with rCBF in ACC in 25 male HVs. Second, we explored if S-ketamine changed the neural activity as reflected by rCBF alterations in thalamus (Thal) and accumbens that are connected with ACC. Glutamatergic metabolites were measured in ACC with magnetic resonance (MR) spectroscopy and whole-brain rCBF with pseudo-continuous arterial spin labelling on a 3-T MR scanner before, during, and after infusion of S-ketamine (total dose 0.375 mg/kg). In ACC, glutamate levels were associated with rCBF before (p

(1) I explore the hypothesis that the water regime is one of the major determinants of the difference between bog and fen in Sphagnum mires because of its effects on the decay loss and the mass accretion rate. This article deals with the recent mass balance and water regime and the variation in mass accretion rate during the last millennium, studied at two mires in southern Sweden. (2) At one bog site and one fen site in the Åkhult mire the recent litter input to the acrotelm and mass accretion in the catotelm were 210 and 38 g m-2 a-1 at the bog site and 300 and 21 g m-2 a-1 at the fen site, respectively. The difference in productivity reflected the availability of plant nutrients and the pH. The smaller loss of mass at the bog site was a result of smaller water table amplitude and a higher median time water level (MTWL) than at the fen site. Through its effects on hummock formation, the water regime is also a major determinant of the surface structure. (3) Around 1000 cal. BP the precipitation and the supply of mineral soil water to the two sites increased and the bog vegetation of that time was replaced by fen vegetation. Mass accretion first increased to 180 g m-2 a-1 but with the upward growth of the mire surface the rate decreased. The recent conditions at the fen site became established ~800 cal. BP, probably as a result of increased water table amplitudes. At the bog site the water regime changed from geogenous to ombrogenous ~600 cal. BP, contemporary with a decrease in precipitation. This change resulted in a rapid increase in mass accretion by 150 % followed by a slow decrease until recent times with low values. The same development was found to have occurred twice at the Store Mosse mire. Such an initial increase in the peat accretion rate must be important for the formation of permanently ombrotrophic conditions in raised bogs.