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Background Surgical treatment of pituitary lesions causing hormonal overproduction or mass effect is standard procedure. There are few reports on the results and complications related to these surgeries from Northern Europe. Our aim was to evaluate the outcome and complications of a single tertiary surgical center over more than a decade. Methods This was a retrospective study on all patients that underwent pituitary surgery from 1st of January 2005 to 31st of December 2017. The analysis included type of lesion, surgical method, pre- and postoperative need for hormonal substitution, hormonal outcome, complications to surgery, survival, need for revision surgery, or stereotactic radiation. Appropriate statistical analyses were made to evaluate surgical results, complications, and survival. Results Five hundred seventy-eight patients were included in the study. Remission was achieved in 58% of patients with GH-producing and 94% of ACTH-releasing adenomas. Sixty-six percent had no preoperative hormonal substitution compared to 39% postoperatively. Rhinosinusitis (10%) was the most commonly reported postoperative complication followed by leakage of cerebrospinal fluid (8%) and meningitis (4%). Standardized mortality rate for the study population was higher (p = 0.18) when compared to the general population. Conclusion Our results regarding remission rates and complications are in comparison with previous studies. Surgery of pituitary lesion can be considered a safe and efficient surgery. We noted lower rates of CSF leakage in the later part of the study period and believe that this, in part, was an effect by the introduction of a multidisciplinary surgical skull base team and increased surgical experience.

We prove versions of various classical results on specialisation of fundamental groups in the context of log schemes in the sense of Fontaine and Illusie, generalising earlier results of Hoshi, Lepage and Orgogozo. The key technical result relates the category of finite Kummer étale covers of an fs log scheme over a complete Noetherian local ring to the Kummer étale coverings of its reduction.

In this paper, we argue that altered incentives for clubs to develop star players after the Bosman ruling can explain why European football has seen lower competitive balance in the Champions League but more competitive balance at the national level. By having a profound impact on the transfers of players within the European Union (EU), the Bosman ruling led to stiffer bidding competition over football stars. We show that this spurred talent development primarily in EU countries without established top clubs having a positive impact on their junior and senior national teams' performance. However, the stiffer bidding competition also led to a lower competitive balance in the Champions League, as non‐established clubs prefer to sell their star players instead of challenging the top clubs. We provide empirical evidence consistent with these findings.

Objective Rathkes cleft cysts are benign, embryological remnants in the pituitary gland. The majority of them are small and asymptomatic but a few may become large, and cause mass effects, pituitary hormone deficiencies and visual impairment. Recommendations for the follow-up of Rathkes cleft cysts vary since data on the natural history are sparse. Patients and Design Data at diagnosis and at 1, 5 and 10 years for patients with a Rathkes cleft cyst (434 at diagnosis, 317 females) were retrieved from the Swedish Pituitary Registry. Cysts = 10 mm that were not operated (n = 174) decreased in size over the years (p < .01). Pituitary hormone deficiencies and visual impairments were more frequent (18% and 5.7%, respectively) but were stable over time. Transphenoidal surgery was performed in 56 patients of whom 51 underwent surgery before the 1-year follow-up. The mean cyst diameter at diagnosis was 18 mm (range: 930 mm), 36% had pituitary hormone deficiency, 45% had visual field defects and 20% had impaired visual acuity. One year after surgery 60% had no cyst remnants, 50% had a pituitary deficiency, 26% had visual field defects and 12% had impaired visual acuity. No major changes were observed after 5 years. Twelve of the operated patients had a follow-up at 10 years, in eight the cyst remnants or recurrences increased in size over time (p < .05). Conclusions Rathkes cleft cysts with a size less than 10 mm rarely grow and our results indicate that radiological follow-up can be restricted to 5 years. In contrast, progression of postoperative remnants or recurrent cysts is more likely and require long-term follow-up.

To determine the reliability of application of the RETTS© triage scale after an educational intervention using paper-based scenarios in emergency care education.Knowledge about and education in triage are important factors in triagescale implementation. Presenting students with a large number of triage scenarios is a common part of triage education.In this prospective cross-sectional study at two universities students undergoing education in emergency care used RETTS© to assess triage level in 46 paper-based scenarios.57 students in the study made 2590 final triage decisions. Fleiss Kappa for final triage was 0.411 which is in the lower range of moderate agreement. In 25 of 46 (53.4%) scenarios, final triage levels did not agree about whether the case was stable or unstable.Application of the RETTS© triage scale after an educational intervention with paper-based simulation in emergency care education resulted in moderate agreement about the final levels of triage.

We study unipotent fundamental groups for open varieties over [math] -adic fields with base point degenerating to the boundary. In particular, we show that the Galois representations associated to the étale unipotent fundamental group are semistable.

The media often cast foreign private equity firms as villains who gamble with local jobs. We use detailed registry data from Sweden to show that foreign buyouts have not affected workers' labor market outcomes. But domestic buyouts have. They have increased unemployment incidence by a fifth, duration by a third, and lowered labor income by seven percent.

Although more than 45 years have passed since hypocomplementemic urticarial vasculitis (HUVS) was first described by McDuffie and colleagues at the Mayo clinic, data on epidemiology, disease outcomes, prognosis and clinical features are scarce. Recently, we published the first epidemiological study of HUVS including data on incidence, prevalence, disease outcomes, prognosis and clinical features using data from two separate Swedish regions during a period of 16 years. The estimation of incidence and prevalence rates indicates that HUVS is rare but not always benign. Renal and lung manifestations were severe in some cases, highlighting the need for careful screening and monitoring of this potentially serious condition. It is reasonable to suspect HUVS in patients with unexplained systemic inflammation combined with6 months of urticaria. Special attention should be paid to patients with recent-onset dyspnea and proteinuria.

I examine whether employment protection affects the willingness of working parents to provide childcare. Using a reform that made it easier for employers to dismiss workers in small firms, I find that softer employment protection reduces the use of temporary parental leave among directly treated fathers. In addition, I find that households respond to an increase in the dismissal risk by reducing temporary parental leave for the indirectly treated spouse. Spousal labor supply can thus serve as informal insurance against adverse income shocks.

Babesia is a malaria-like, intraerythrocytic parasite with more than 100 different species. It is a zoonosis and some of the species are transmitted to humans by ticks and also as a possible transfusion-transmitted infection. In Sweden the disease has been well known in veterinary medicine for a long time, but only a few but severe cases have been published in humans during the last decades. Common symptoms from human Babesia infections (babesiosis) are fever, chills and myalgia and they vary from subclinical to potentially fatal among those with risk factors such as immunosuppression and splenectomy. In the U.S. more than 2,000 cases of babesiosis are found yearly and it is one of the most frequent fatal infections following blood transfusion. A study from southern Sweden has recently revealed a seroprevalence of 16% of Babesia antibodies among Borrelia-infected persons. These results indicate that there is a need to broaden awareness of Babesia in Sweden.

Multipolar fluorine–amide interactions with backbone and side‐chain amides have been described as important for protein–ligand interactions and have been used to improve the potency of synthetic inhibitors. In this study, fluorine interactions within a well‐defined binding pocket on galectin‐3 were investigated systematically using phenyltriazolyl‐thiogalactosides fluorinated singly or multiply at various positions on the phenyl ring. X‐ray structures of the C‐terminal domain of galectin‐3 in complex with eight of these ligands revealed potential orthogonal fluorine–amide interactions with backbone amides and one with a side‐chain amide. The two interactions involving main‐chain amides seem to have a strong influence on affinity as determined by fluorescence anisotropy. In contrast, the interaction with the side‐chain amide did not influence affinity. Quantum mechanics calculations were used to analyze the relative contributions of these interactions to the binding energies. No clear correlation could be found between the relative energies of the fluorine–main‐chain amide interactions and the overall binding energy. Instead, dispersion and desolvation effects play a larger role. The results confirm that the contribution of fluorine–amide interactions to protein–ligand interactions cannot simply be predicted, on geometrical considerations alone, but require careful consideration of the energetic components.

We infer the role of gender identity norms from the reallocation of childcare across parents, following changes in their relative wages. By exploiting variation from a Swedish tax reform, we estimate the elasticity of substitution in parental childcare for the whole population and for demographic groups potentially adhering to differently binding norms. We find that immigrant, married and male breadwinner couples, as well as couples with a male first-born, react more strongly to tax changes that induce a more traditional allocation of spouses' time, while the respective counterpart couples react more strongly to tax changes that induce a more egalitarian division of labor.

We discuss the equivalence of two constructions of a unipotent group scheme attached to a differential graded algebra over a ℚ-algebra. The first construction is using the bar resolution and the second is using Toen's theory of affine stacks. We use this to establish the equivalence of two approaches to the comparison theorem in p-adic Hodge theory for the unipotent fundamental group of varieties defined over p-adic fields.

Significance The theory of motives is one of the central themes in modern arithmetic geometry and number theory. It provides a theoretical framework for understanding a wide variety of questions in the subject and, in particular, predicts certain “independence of ℓ ” properties of étale cohomology of varieties in positive characteristic. Although still partly conjectural, there have been many recent advances in the development of the foundations of a motivic theory. In this paper, we explain how these recent advances in the theory of motives enable one to prove certain expected independence of ℓ properties for operators acting on étale cohomology.

We have devised a new efficient approach to compute combined quantum mechanical (QM) and molecular mechanical (MM, i.e. QM/MM) ligand-binding relative free energies. Our method employs the reference-potential approach with free-energy perturbation both at the MM level (between the two ligands) and from MM to QM/MM (for each ligand). To ensure that converged results are obtained for the MM → QM/MM perturbations, explicit QM/MM molecular dynamics (MD) simulations are performed with two intermediate mixed states. To speed up the calculations, we utilize the fact that the phase space can be extensively sampled at the MM level. Therefore, we run many short QM/MM MD simulations started from snapshots of the MM simulations, instead of a single long simulation. As a test case, we study the binding of nine cyclic carboxylate ligands to the octa-acid deep cavitand. Only the ligand is in the QM system, treated with the semiempirical PM6-DH+ method. We show that for eight of the ligands, we obtain well converged results with short MD simulations (1-15 ps). However, in one case, the convergence is slower (∼50 ps) owing to a mismatch between the conformational preferences of the MM and QM/MM potentials. We test the effect of initial minimization, the need of equilibration, and how many independent simulations are needed to reach a certain precision. The results show that the present approach is about four times faster than using standard MM → QM/MM free-energy perturbations with the same accuracy and precision.

Using rich administrative data on Swedish firms and workers covering two decades, we study how the privatization of state-owned enterprises affects the careers and welfare of workers. Consistent with the effects of an initial reorganization of the workforce, wage income declines and unemployment increases. These effects are stronger for workers protected by state ownership. We do not find negative spillovers of privatization on family and health outcomes. We also demonstrate that privatization encourages workers to enter entrepreneurship. The firm-level productivity gains from privatization are approximately five times larger than the incumbent worker-level costs due to lost wage income.

Let \({c : C \rightarrow X \times X}\) be a correspondence with C and X quasi-projective schemes over an algebraically closed field k. We show that if \({u_\ell : c_1^*\mathbb{Q}_\ell \rightarrow c_2^!\mathbb{Q}_\ell}\) is an action defined by the localized Chern classes of a c2-perfect complex of vector bundles on C, where l is a prime invertible in k, then the local terms of ul are given by the class of an algebraic cycle independent of l. We also prove some related results for quasi-finite correspondences. The proofs are based on the work of Cisinski and Deglise on triangulated categories of motives.

We develop various properties of etale Borel–Moore homology and study its relationship with intersection theory. Using Gabber's localized cycle classes we define etale homological Gysin morphisms and show that they are compatible with the cycle class map and Gysin morphisms in intersection theory. We also study etale versions of bivariant operations, and establish their compatibility with Riemann–Roch transformations and Fulton–MacPherson bivariant operations. As an application of these techniques we show that in certain situations local terms for correspondences acting on etale cohomology are given by cycle classes.

In an earlier paper the notion of a filtered derived equivalence was introduced, and it was shown that if two K3 surfaces admit such an equivalence, then they are isomorphic. In this paper we study more refined aspects of filtered derived equivalences related to the action on the cohomological realizations of the Mukai motive. It is shown that if a filtered derived equivalence between K3 surfaces also preserves ample cones then one can find an isomorphism that induces the same map as the equivalence on the cohomological realizations.

Let q be a power of a prime p, and let k = Fq be an algebraic closure of Fq. For objects over Fq we use a subscript 0, and unadorned letters denote the base change to k. For example, X0 denotes a scheme (or stack) over Fq and X denotes the fiber product X0 ×Spec(Fq) Spec(k). Let X0 be a separated finite type Fq-scheme. A correspondence on X0 is a diagram of separated finite type Fq-schemes C0 c1 ~~|| || || || c2 !! C C C C C C C C

Evidence is accumulating that repeated mild traumatic brain injury (mTBI) incidents can lead to persistent, long-term debilitating symptoms and in some cases a progressive neurodegenerative condition referred to as chronic traumatic encephalopathy. However, to our knowledge, there are no objective tools to examine to which degree persistent symptoms after mTBI are caused by neuronal injury.To determine whether persistent symptoms after mTBI are associated with brain injury as evaluated by cerebrospinal fluid biochemical markers for axonal damage and other aspects of central nervous system injury.A multicenter cross-sectional study involving professional Swedish ice hockey players who have had repeated mTBI, had postconcussion symptoms for more than 3 months, and fulfilled the criteria for postconcussion syndrome (PCS) according to the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) matched with neurologically healthy control individuals. The participants were enrolled between January 2014 and February 2016. The players were also assessed with Rivermead Post Concussion Symptoms Questionnaire and magnetic resonance imaging.Neurofilament light protein, total tau, glial fibrillary acidic protein, amyloid β, phosphorylated tau, and neurogranin concentrations in cerebrospinal fluid.A total of 31 participants (16 men with PCS; median age, 31 years; range, 22-53 years; and 15 control individuals [11 men and 4 women]; median age, 25 years; range, 21-35 years) were assessed. Of 16 players with PCS, 9 had PCS symptoms for more than 1 year, while the remaining 7 returned to play within a year. Neurofilament light proteins were significantly increased in players with PCS for more than 1 year (median, 410 pg/mL; range, 230-1440 pg/mL) compared with players whose PCS resolved within 1 year (median, 210 pg/mL; range, 140-460 pg/mL) as well as control individuals (median 238 pg/mL, range 128-526 pg/mL; P = .04 and P = .02, respectively). Furthermore, neurofilament light protein concentrations correlated with Rivermead Post Concussion Symptoms Questionnaire scores and lifetime concussion events (ρ = 0.58, P = .02 and ρ = 0.52, P = .04, respectively). Overall, players with PCS had significantly lower cerebrospinal fluid amyloid-β levels compared with control individuals (median, 1094 pg/mL; range, 845-1305 pg/mL; P = .05).Increased cerebrospinal fluid neurofilament light proteins and reduced amyloid β were observed in patients with PCS, suggestive of axonal white matter injury and amyloid deposition. Measurement of these biomarkers may be an objective tool to assess the degree of central nervous system injury in individuals with PCS and to distinguish individuals who are at risk of developing chronic traumatic encephalopathy.