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Objectives: Booster COVID-19 vaccinations are used to protect the elderly, a group vulnerable to severe disease. We compared humoral and cellular immunity in older versus younger adults up to eight months after administering a BNT16b2 booster vaccine dose. Next, we analyzed the plasma levels of soluble T cell activation/exhaustion markers. Methods: Home-dwelling older adults (n = 68, median age 86) and younger healthcare workers (n = 35, median age 39), previously vaccinated with two doses of BNT162b2, were given a booster dose at ten months after the initial dose. Our analysis consisted of spike-specific IgG, neutralizing antibodies, memory B cells, IFN-γ and IL-2 secreting T cells and soluble T cell exhaustion/activation markers. Results: Following the initial two doses, the elderly cohort exhibited lower humoral and IFN-γ responses compared to younger adults. The booster dose increased the humoral responses in both older and younger adults. At two months after the booster dose, older and younger vaccinees had comparable levels of antibodies and the responses were maintained up to 18 months. The younger cohort elicited an increase in the cellular response, while no increase was detected in the elderly. The elderly had higher plasma levels of soluble forms of the T cell activation/exhaustion markers CD25 and TIM-3, which inversely correlated with age and T-cell cytokine responses. This suggests that these markers may be related to the observed dysfunctional cellular cytokine response in older adults. However, both elderly and younger adults who experienced breakthrough infections after booster vaccination, elicited more robust humoral and IFN-γ responses. Conclusions: The booster dose elicited neutralizing and spike-specific antibody responses in the elderly that were comparable with that of the younger cohort. However, the lack of a strong cellular cytokine response to the third dose in the elderly may explain their vulnerability to severe infection and may be a consequence of exhausted or senescent T cell responses. (https://clinicaltrials.gov/study/NCT04706390).

Abstract This study aims to assess in situ the impact of effluents originating from an Atlantic salmon (Salmo salar) farm on a nearby slender sea pen (Virgularia mirabilis) field. We evidenced (1) the presence and persistence of emamectin residues (i.e. a common chemotherapeutants used for treating ectoparasites in salmons) in V. mirabilis tissue 56 days after treatment and (2) lethal and sublethal responses of V. mirabilis to effluents discharged by the salmon farm. Particularly, sea pens near the fish farm exhibited significant overproduction of mucus, contraction of polyps’ tentacles, and disappearance of associated fauna. Furthermore, sea pens located directly underneath the farm showed substantial tissue necrosis and, in the most severe case, complete tissue loss and mortality. Our results suggest that lethal damages on sea pens occur directly below the farm, and that sublethal effects are visible up to 500 m from the farm. However, the presence of V. mirabilis below the studied farm, which has been active for more than twenty years, suggests that V. mirabilis population possesses the capacity to recover from the impacts of the farm, thereby preventing the complete disappearance from the area. In this context, it would be particularly interesting to run a temporal survey following the health state of V. mirabilis during an entire production cycle to have a more precise overview of fish farm impacts on this species, including during and after the post-production fallowing period.

Operational modal analysis (OMA) is essential for long-term health monitoring of offshore wind turbines (OWTs), helping identifying changes in structural dynamic characteristics. OMA has been applied under parked or idle states for OWTs, assuming a linear and time-invariant dynamic system subjected to white noise excitations. The impact of complex operating environmental conditions on structural modal identification therefore requires systematic investigation. This paper studies the applicability of OMA based on covariance-driven stochastic subspace identification (SSI-COV) under various non-white noise excitations, using a DTU 10 MW jacket OWT model as a basis for a case study. Then, a scaled (1:75) 10 MW jacket OWT model test is used for the verification. For pure wave conditions, it is found that accurate identification for the first and second FA/SS modes can be achieved with significant wave energy. Under pure wind excitations, the unsteady servo control behavior leads to significant identification errors. The combined wind and wave actions further complicate the picture, leading to more scattered identification errors. The SSI-COV based modal identification method is suggested to be reliably applied for wind speeds larger than the rated speed and with sufficient wave energy. In addition, this method is found to perform better with larger misalignment of wind and wave directions. This study provides valuable insights in relation to the engineering applications of in situ modal identification techniques under operating conditions in real OWT projects.

Abstract Elucidating the effects of domesticated organisms escaping into the natural environment represents a topic of importance in both evolutionary and conservation biology. However, when excluding the abundant data on salmonids, there is a lack of knowledge on this topic for marine fish aquaculture, which continues to expand globally. In order to bridge this empirical gap, we investigated a suspected escape of sexually mature domesticated Atlantic cod from a commercial marine fish farm in northern Norway. This involved genotyping samples of fish from cages on the farm, putatively identified escapees and wild cod captured in the region and samples of recently spawned eggs collected in the sea. Genetic analyses confirmed a farmed ancestry of the suspected escapees, and significantly, 27% of the sampled cod eggs. Furthermore, statistical analyses revealed a strong reduction in genetic variation in all samples of the farmed cod, including low effective population size and high degree of siblingship. These results thus document the escape of sexually mature adult cod and the release of fertilized domesticated cod eggs into the natural environment. Although it is possible that some of the mature escapees spawned post‐escape, the fact that only a single egg of potential hybrid farmed × wild origin was identified, together with the high number of mature cod in the farm, points to within cage spawning as the primary source of these eggs. This suggestion is supported by oceanic particle‐drift modelling, verifying that transport of eggs between the farm and the egg sampling locations was plausible. This study represents a rare documentation of interaction between domesticated and wild populations for a marine fish, pointing towards potential impacts on the local wild population.

Background: Paediatric fractures are relatively common in dogs, and several treatment options exist, particularly for fractures in the distal extremities. Regardless of choice of treatment, the overall goal is rapid restoration and excellent long-term functional recovery, with minimal discomfort and morbidity during healing. This case series aims to report the long-term outcome after minimally invasive percutaneous elastic plate osteosynthesis (MIPEPO) in the treatment of paediatric tibial fractures in dogs and compare this to other treatment options, where all techniques emphasize on biological osteosynthesis. We especially accentuate surgery time, patient comfort level during osteosynthesis, time to clinical union, complications, including long-term follow-up. Case Description: Medical records of five skeletally immature (juvenile) dogs [Open Vet J 2023; 13(12.000): 1744-1751]

Obesity is a known risk factor for severe respiratory tract infections. In this prospective study, we assessed the impact of being obese or overweight on longitudinal SARS-CoV-2 humoral and cellular responses up to 18 months after infection. 274 patients provided blood samples at regular time intervals up to 18 months including obese (BMI ≥30, n=32), overweight (BMI 25-29.9, n=103) and normal body weight (BMI 18.5-24.9, n=134) SARS-CoV-2 patients. We determined SARS-CoV-2 spike-specific IgG, IgA, IgM levels by ELISA and neutralising antibody titres by neutralisation assay. RBD- and spike-specific memory B cells were investigated by ELISpot, spike- and non-spike-specific IFN-γ, IL-2 and IFN-γ/IL-2 secreting T cells by FluoroSpot and T cell receptor (TCR) sequencing was performed. Higher BMI correlated with increased COVID-19 severity. Humoral and cellular responses were stronger in overweight and obese patients than normal weight patients and associated with higher spike-specific IgG binding titres relative to neutralising antibody titres. Linear regression models demonstrated that BMI, age and COVID-19 severity correlated independently with higher SARS-CoV-2 immune responses. We found an increased proportion of unique SARS-CoV-2 specific T cell clonotypes after infection in overweight and obese patients. COVID-19 vaccination boosted humoral and cellular responses irrespective of BMI, although stronger immune boosting was observed in normal weight patients. Overall, our results highlight more severe disease and an over-reactivity of the immune system in overweight and obese patients after SARS-CoV-2 infection, underscoring the importance of recognizing overweight/obese individuals as a risk group for prioritisation for COVID-19 vaccination.

Abstract Sexual desire is of importance to sexual health, functioning, and well-being. Although an increasing number of studies address disorders related to sexual functioning, there is still a limited understanding of the underlying individual factors affecting sexual desire. The aim of the current study was to investigate the effect of sexual shame, emotion regulation strategies, and gender on sexual desire. In order to investigate this, sexual desire, expressive suppression, cognitive reappraisal, and sexual shame was measured in 218 Norwegian participants using the Emotion Regulation Questionnaire-10, the Sexual Desire Inventory-2, and the Sexual Shame Index-Revised. A multiple regression analysis indicated that cognitive reappraisal predicted sexual desire, β = 0.343, (218) = 5.09, p 0.05. Results from the current study indicates that the inclination toward cognitive reappraisal as a preferred emotion regulation strategy may positively affect the strength of sexual desire.

BackgroundPreventing infection in healthcare workers (HCWs) is crucial for protecting healthcare systems during the COVID-19 pandemic. Here, we investigated the seroepidemiology of SARS-CoV-2 in HCWs in Norway with low-transmission settings.MethodsFrom March 2020, we recruited HCWs at four medical centres. We determined infection by SARS-CoV-2 RT-PCR and serological testing and evaluated the association between infection and exposure variables, comparing our findings with global data in a meta-analysis. Anti-spike IgG antibodies were measured after infection and/or vaccination in a longitudinal cohort until June 2021.ResultsWe identified a prevalence of 10.5% (95% confidence interval, CI: 8.8–12.3) in 2020 and an incidence rate of 15.0 cases per 100 person-years (95% CI: 12.5–17.8) among 1,214 HCWs with 848 person-years of follow-up time. Following infection, HCWs (n = 63) mounted durable anti-spike IgG antibodies with a half-life of 4.3 months since their seropositivity. HCWs infected with SARS-CoV-2 in 2020 (n = 46) had higher anti-spike IgG titres than naive HCWs (n = 186) throughout the 5 months after vaccination with BNT162b2 and/or ChAdOx1-S COVID-19 vaccines in 2021. In a meta-analysis including 20 studies, the odds ratio (OR) for SARS-CoV-2 seropositivity was significantly higher with household contact (OR 12.6; 95% CI: 4.5–35.1) and occupational exposure (OR 2.2; 95% CI: 1.4–3.2).ConclusionWe found high and modest risks of SARS-CoV-2 infection with household and occupational exposure, respectively, in HCWs, suggesting the need to strengthen infection prevention strategies within households and medical centres. Infection generated long-lasting antibodies in most HCWs; therefore, we support delaying COVID-19 vaccination in primed HCWs, prioritising the non-infected high-risk HCWs amid vaccine shortage.

Summary: Background: The burden of COVID-19 in children and adolescents has increased during the delta and omicron waves, necessitating studies of long-term symptoms such as fatigue, dyspnoea and cognitive problems. Furthermore, immune responses in relation to persisting symptoms in younger people have not been well characterised. In this cohort study, we investigated the role of antibodies, vaccination and omicron reinfection upon persisting and long-term symptoms up to 8 months post-delta infection. Methods: SARS-CoV-2 RT-PCR positive participants (n = 276, aged 10–20 years) were prospectively recruited in August 2021. We recorded the major symptoms of post COVID-19 condition and collected serum samples 3- and 8-months post delta infection. Binding antibodies were measured by spike IgG ELISA, and surrogate neutralising antibodies against Wuhan and delta variants by the hemagglutination test (HAT). Findings: After delta infection, persisting symptoms at 3 months were significantly associated with higher delta antibody titres (OR 2.97, 95% CI 1.57–6.04, p = 0.001). Asymptomatic acute infection compared to symptomatic infection lowered the risk of persisting (OR 0.13, 95% CI 0.02–0.55, p = 0.013) and long-term (OR 0.28 95% CI 0.11–0.66, p = 0.005) symptoms at 3 and 8 months, respectively. Adolescents (16–20 years) were more likely to have long-term symptoms compared to children (10–15 years) (OR 2.44, 95% CI 1.37–4.41, p = 0.003). Interpretation: This clinical and serological study compares long-term symptoms after delta infection between children and adolescents. The association between high antibody titres and persisting symptoms suggest the involvement of an immune mechanism. Similarly to adults, the dominant long-term symptoms in children are fatigue, dyspnoea and cognitive problems. Funding: This work was funded by the Ministry of Health and Care Services, Norway, the University of Bergen, Norway and Helse Vest, Norway (F-12621).

Objectives: Elderly are an understudied, high-risk group vulnerable to severe COVID-19. We comprehensively analyzed the durability of humoral and cellular immune responses after BNT162b2 vaccination and SARS-CoV-2 infection in elderly and younger adults. Methods: Home-dwelling old (n = 100, median 86 years) and younger adults (n = 449, median 38 years) were vaccinated with two doses of BNT162b2 vaccine at 3-week intervals and followed for 9-months. Vaccine-induced responses were compared to home-isolated COVID-19 patients (n = 183, median 47 years). Our analysis included neutralizing antibodies, spike-specific IgG, memory B-cells, IFN-γ and IL-2 secreting T-cells and sequencing of the T-cell receptor (TCR) repertoire. Results: Spike-specific breadth and depth of the CD4+ and CD8+ TCR repertoires were significantly lower in the elderly after one and two vaccinations. Both vaccinations boosted IFN-γ and IL-2 secreting spike-specific T-cells responses, with 96 % of the elderly and 100 % of the younger adults responding after the second dose, although responses were not maintained at 9-months. In contrast, T-cell responses persisted up to 12-months in infected patients. Spike-specific memory B-cells were induced after the first dose in 87 % of the younger adults compared to 38 % of the elderly, which increased to 83 % after the second dose. Memory B-cells were maintained at 9-months post-vaccination in both vaccination groups. Neutralizing antibody titers were estimated to last for 1-year in younger adults but only 6-months in the older vaccinees. Interestingly, infected older patients (n = 15, median 75 years) had more durable neutralizing titers estimated to last 14-months, 8-months longer than the older vaccinees. Conclusions: Vaccine-induced spike-specific IgG and neutralizing antibodies were consistently lower in the older than younger vaccinees. Overall, our data provide valuable insights into the kinetics of the humoral and cellular immune response in the elderly after SARS-CoV-2 vaccination or infection, highlighting the need for two doses, which can guide future vaccine design.Clinical trials.gov; NCT04706390.

Ertesvåg, Xiao et al. describe a method to evaluate neutralising antibodies to SARS-CoV-2 infection or vaccination, including variants of concern. A second mRNA-vaccine dose results in a broader antibody repertoire in adults, although with reduced cross-reactivity to beta and gamma compared to alpha and delta, particularly in the elderly.

Abstract Background Acute kidney injury (AKI) is associated with high morbidity and mortality in dogs, but diagnosis may be impaired due the insensitivity of routine renal function biomarkers to detect earlier or milder forms of injury. Snake envenomation is one of several causes of AKI in dogs and humans. Dogs are commonly envenomated by the European adder (Vipera berus) between April and October each year, but few studies exist examining serial serum creatinine (sCr) and symmetric dimethylarginine (SDMA) measurements and AKI biomarkers in these dogs. Novel urinary biomarkers could improve clinical outcome by allowing earlier diagnosis of and intervention in AKI. The aim of this study was to assess the presence of AKI in dogs envenomated by V. berus at 12, 24 and 36 h after bite, as well as 14 days later, using sCr, SDMA and a panel of urinary AKI biomarkers normalised to urine creatinine (uCr), compared to a group of healthy control dogs. Results Thirty-five envenomated dogs and 35 control dogs were included. Serum creatinine did not exceed the upper reference limit at any time point in any dog after envenomation. Serum SDMA did not exceed 0.89 μmol/L in any dog. Compared to controls, urinary albumin/uCr, neutrophil gelatinase-associated lipocalin/uCr and monocyte chemotactic protein-1/uCr were significantly elevated 12 h (P

Gymnadenia og Den brændende busk blir kalla Undsets konversjonsroman. Med tanke på at denne romanen har klare sjølvbiografiske trekk, er det underleg at den i dag er nærast ukjent. Svært få har lese dette verket, som for mitt blikk opnar seg som noko av det aller beste Sigrid Undset har skapt, og det er uutforska. Min tese er at Undsets konversjonsroman gir oss livskoden hennar, og eit livsdesign som på sitt djupaste narrative nivå fungerer som Gudsbildets matrise. Dette genererer også ein heilt særeigen sjanger, som kan kallast sakramental realisme. Vår vitskaplege problemstilling er å utforske denne.

BackgroundPatients with primary adrenal insufficiency (PAI) suffer reduced quality of life (QoL), but comparisons with large-scale normative data are scarce. The clinical characteristics associated with reduced QoL are largely unknown.MethodsCross-sectional data on clinical characteristics and QoL scores from 494 patients were included. QoL was measured using RAND-36 (generic) and AddiQoL (-30 and -8, disease-specific). RAND-36 is reported as subdomain scores as well as physical (PCS) and metal (MCS) summary scores and compared with normative data.ResultsPerception of physical role was consistently decreased across age groups in patients with PAI compared with normative data [75 (0-100) vs. 100 (50-100), p

Background: Comparative data on COVID-19 among health care workers (HCWs) in different health care settings are scarce. This study investigated the rates of previous COVID-19 among HCWs in nursing homes, hospitals and a municipal emergency room (ER). Methods: We prospectively included 747 HCWs: 313 from nursing homes, 394 from hospitals and 40 from the ER. The diagnosis of COVID-19 was based on serological evidence of SARS-CoV-2 antibody positivity and self-reported RT-PCR positivity prior to inclusion. Information regarding age, sex and exposure to SARS-CoV-2 infection was collected. Results: A total of 4% (11/313) of nursing home HCWs and 6% (28/434) of HCWs in hospitals/the ER tested positive by serology and/or RT-PCR (p = 0.095). Fewer HCWs in nursing homes had occupational exposure to SARS-CoV-2 compared to those in hospitals/the ER (16% vs. 48%, p < 0, 001), but nursing homes had a higher proportion of HCWs with occupational exposure using partial/no PPE (56% vs. 19%, p < 0.001). Nevertheless, no significant differences in the risk for COVID-19 were found in relation to the rate of occupational exposure (p = 0.755) or use of inadequate PPE (p = 0.631). Conclusions: Despite a small sample size, the risk for COVID-19 among HCWs did not appear to be related to the type of health care facility, rates of occupational exposure or use of PPE.

The motivation for this study is the fast development of floating offshore wind energy and the immature methodology and engineering practice related to predictions of vortex-induced motions (VIM). Benefiting from the oil and gas industry, in the past several decades, extensive knowledge and experience on vortex-induced vibrations (VIV) on slender marine structures has been gained. As the learnings from these efforts should be transferred and adapted to the renewable energy industry, a state-of-the-art review on influential VIM research has been carried out in this paper, focusing on: (1) engineering practice, (2) model tests, (3) numerical calculation, and (4) field measurement. Engineering gaps and potential research topics are identified as future work.

Background: Households studies reflect the natural spread of SARS-CoV-2 in immunologically naive populations with limited preventive measures to control transmission.We hypothesise that seropositivity provides more accurate household attack rates than RT-PCR. Here, we investigated the importance of age in household transmission dynamics. Methods: We enroled 112 households (291 participants) in a case-ascertained study in Bergen, Norway from 28th February to 4th April 2020, collecting demographic and clinical data from index patients and household members. SARS-CoV-2-specific antibodies were measured in sera collected 6–8 weeks after index patient nasopharyngeal testing to define household attack rates. Findings: The overall attack rate was 45% (95% CI 38–53) assessed by serology, and 47% when also including seronegative RT-PCR positives. Serology identified a higher number of infected household members than RT-PCR. Attack rates were equally high in children (48%) and young adults (42%). The attack rate was 16% in asymptomatic household members and 42% in RT-PCR negative contacts. Older adults had higher antibody titres than younger adults. The risk of household transmission was higher when the index patient had fever (aOR 3.31 [95% CI 1.52–7.24]; p = 0.003) or dyspnoea (aOR 2.25 [95% CI 1.80–4.62]; p = 0.027) during acute illness. Interpretation: Serological assays provide more sensitive and robust estimates of household attack rates than RT-PCR. Children are equally susceptible to infection as young adults. Negative RT-PCR or lack of symptoms are not sufficient to rule out infection in household members. Funding: Helse Vest (F-11628), Trond Mohn Foundation (TMS2020TMT05). Abstrakt: Bakgrunn: Studier av husstander gjenspeiler den naturlige spredningen av SARS-CoV-2 blant ikke-immune populasjoner med begrensede tiltak for å forebygge smittespredning. Vår hypotese er at antistoff-påvisning gir mer nøyaktige angrepsrater i husstander sammenliknet med RT-PCR. Her undersøker vi betydnignenngen betydningen av alder i smittespredningen. Metoder: Vi rekrutterte 112 husstander (291 studiedeltakere) i en indeks kasus-bekreftet studie i Bergen, Norge fra 28.02.2020 til 04.04.2020, og samlet inn demografiske og kliniske data fra indekspasienter og deres husstandsmedlemmer. Angrepsrate i husstander ble beregnet ved å måle SARS-CoV-2-spesifikke antistoffer i sera samlet 6–8 uker etter nasofarynksprøve av indekspasienten. Funn: Den totale angrepsraten var 45% (95% KI 38–53) vurdert ved serologi, og 47% ved å inkludere antistoff negative, RT-PCR positive husstandsmedlemmer. Spesifikke antistoffer identifiserer en høyere andel infiserte husstandsmedlemmer sammenliknet med RT-PCR. Angrepsraten var like høy hos barn (48%) og unge voksne (42%). Angrepsraten var 16% hos personer uten symptomer og 42% hos RT-PCR negative husstandsmedlemmer. Eldre voksne hadde høyere antistoff titre enn yngre voksne. Risiko for smitte i husstander var høyere når indekspasienten hadde feber (aOR 3.31 [95% KI 1.52–7.24]; p = 0.003) eller dyspne (aOR 2.25 [95% KI 1.80–4.62]; p = 0.027) under akuttfasen. Tolkning: Serologiske analyser gir mer sensitive og robuste estimater av angrepsrate i husstander sammenliknet med RT-PCR. Barn er like utsatt for infeksjon som voksne. Negativ RT-PCR eller fravær av symptomer er ikke tilstrekkelige for å utelukke infeksjon blant husstandsmedlemmer. Finansiering: Helse Vest (F-11628), Trond Mohn Stiftelse (TMS2020TMT05).

Introduction The current evidence on the efficacy of antibiotic-loaded bone cement (ALBC) in reducing the risk of periprosthetic joint infections (PJI) after primary joint reconstruction is insufficient. In several European countries, the use of ALBC is routine practice unlike in the USA where ALBC use is not approved in low-risk patients. Therefore, we designed a double-blinded pragmatic multicentre register-based randomised controlled non-inferiority trial to investigate the effects of ALBC compared with plain bone cement in primary total knee arthroplasty (TKA).Methods and analysis A minimum of 9,172 patients undergoing full-cemented primary TKA will be recruited and equally randomised into the ALBC group and the plain bone cement group. This trial will be conducted in Norwegian hospitals that routinely perform cemented primary TKA. The primary outcome will be risk of revision surgery due to PJI at 1-year of follow-up. Secondary outcomes will be: risk of revision due to any reason including aseptic loosening at 1, 6, 10 and 20 years of follow-up; patient-related outcome measures like function, pain, satisfaction and health-related quality of life at 1, 6 and 10 years of follow-up; risk of changes in the microbial pattern and resistance profiles of organisms cultured in subsequent revisions at 1, 6, 10 and 20 years of follow-up; cost-effectiveness of routine ALBC versus plain bone cement use in primary TKA. We will use 1:1 randomisation with random permuted blocks and stratify by participating hospitals to randomise patients to receive ALBC or plain bone cement. Inclusion, randomisation and follow-up will be through the Norwegian Arthroplasty Register.Ethics and dissemination The trial was approved by the Western Norway Regional Committees on Medical and Health Research Ethics (reference number: 2019/751/REK vest) on 21 June 2019. The findings of this trial will be disseminated through peer-reviewed publications and conference presentations.Trial registration number NCT04135170.

Background and purpose — Computer-assisted surgery (CAS) in total knee arthroplasty (TKA) has been used in recent years in the hope of improving the alignment and positioning of the implant, thereby achieving a better functional outcome and durability. However, the role of computer navigation in TKA is still under debate. We used radiostereometric analysis (RSA) in a randomized controlled trial (RCT) to determine whether there are any differences in migration of the tibial component between CAS- and conventionally (CONV-) operated TKA. Patients and methods — 54 patients (CAS, n = 26; CONV, n = 28) with a mean age of 67 (56–78) years and with osteoarthritis or arthritic disease of the knee were recruited from 4 hospitals during the period 2009–2011. To estimate the mechanical stability of the tibial component, the patients were examined with RSA up to 24 months after operation. The following parameters representing tibial component micromotion were measured: 3-D vector of the prosthetic marker that moved the most, representing the magnitude of migration (maximum total point motion, MTPM); the largest negative value for y-translation (subsidence); the largest positive y-translation (lift-off); and prosthetic rotations. The precision of the RSA measurements was evaluated and migration in the 2 groups was compared. Results — Both groups had most migration within the first 3 months, but there was no statistically significant difference in the magnitude of the migration between the CAS group and the CONV group. From 3 to 24 months, the MTPM (in mm) was 0.058 and 0.103 (p = 0.1) for the CAS and CON groups, respectively, and the subsidence (in mm) was 0.005 and 0.011 (p = 0.3). Interpretation — Mean MTPM, subsidence, lift-off, and rotational movement of tibial trays were similar in CAS- and CONV-operated knees.

Trial registrationClinicalTrials.gov ClinicalTrials.gov, Project ID: NCT02870751.

Slender marine structures such as deep-water riser systems are continuously exposed to currents, leading to vortex-induced vibrations (VIV) of the structure. This may result in amplified drag loads and fast accumulation of fatigue damage. Consequently, accurate prediction of VIV responses is of great importance for the safe design and operation of marine risers. Model tests with elastic pipes have shown that VIV responses are influenced by many structural and hydrodynamic parameters, which have not been fully modelled in present frequency domain VIV prediction tools. Traditionally, predictions have been computed using a single set of hydrodynamic parameters, often leading to inconsistent prediction accuracy when compared with observed field measurements and experimental data. Hence, it is necessary to implement a high safety factor of 10–20 in the riser design, which increases development costs and adds extra constraints in the field operation. One way to compensate for the simplifications in the mathematical prediction model is to apply adaptive parameters to describe different riser responses. The objective of this work is to demonstrate a new method to improve the prediction consistency and accuracy by applying adaptive hydrodynamic parameters. In the present work, a four-step approach has been proposed: First, the measured VIV response will be analysed to identify key parameters to represent the response characteristics. These parameters will be grouped by using data clustering algorithms. Secondly, optimal hydrodynamic parameters will be identified for each data group by optimisation against measured data. Thirdly, the VIV response using the obtained parameters will be calculated and the prediction accuracy evaluated. Last but not least, classification algorithms will be applied to determine the correct hydrodynamic parameters to be used for new cases. An iteration of the previous steps may be needed if the prediction accuracy of the new case is not satisfactory. This concept has been demonstrated with examples from experimental data.

Infection with enterotoxigenic Escherichia coli (ETEC) producing the heat-stable enterotoxin (ST) is one of the most important causes of childhood diarrhoea in low- and middle-income countries. Here, we undertook a controlled human infection model (CHIM) study to investigate whether ST-producing ETEC strain TW11681 would be suitable for testing the protective efficacy of new ST-based vaccine candidates in vaccine challenge models. In groups of three, nine volunteers ingested 1 × 106, 1 × 107, or 1 × 108 colony-forming units (CFU) of TW11681. Flow cytometry-based assays were used to measure CD4+ T cell responses and antibody levels targeting virulence factors expressed by the strain. We found that infection with TW11681 elicited few and mild symptoms, including mild diarrhoea in two volunteers, both of whom ingested 1 × 106 CFU. Averaged across all volunteers, the CD4+ T cell responses specific for E. coli YghJ mucinase peaked 10 days after infection (3.2-fold (p = 0.016)), while the CD4+ T cell responses specific for Colonization Factor Antigen I (CFA/I) major fimbrial subunit (CfaB) peaked after 28 days (3.6-fold (p = 0.063)). The serum CfaB-specific anti-IgA and anti-IgG/IgM levels were significantly increased and peaked 3 months after infection. Both remained elevated for the duration of the 12-month follow-up. The corresponding anti-YghJ serological response was strongest after 10 days, although a significant increase was seen only for IgA levels (3.2-fold (p = 0.008)). In conclusion, due to its low diarrhoea attack risk, TW11681 is probably not suitable for testing the efficacy of new vaccines in human challenge studies at doses 1 × 106 to 1 × 108. However, the strain may still be useful in CHIMs for studying ETEC host-pathogen interactions.

Significant expansion in salmon production globally has been partially enabled through the establishment of large-capacity sea-farms in high-energy environments that collectively produce substantial quantities of organic waste with potential to cause regional scale environmental degradation. We analyse results from comprehensive spatial and temporal surveys of water column particulates and seabed environmental indicators for responses to farm production, and residual effects. Results confirmed that while the particles can and do reach a relatively wide area, benthic effects do not necessarily follow suit. There was limited evidence of longer-term environmental degradation at some near-field locations and spatially removed deeper sites. We concluded that evidence for regional biological effects was negligible, suggesting: i) modern waste tracing techniques are more sensitive than traditional effects indicators, and ii) waste fluxes in the far-field were being assimilated without causing environmental perturbation. Monitoring at potential accumulation points, especially for sites with complex bathymetry and hydrodynamics is advised. • Substantive novel investigation of far-field effects from large-scale salmon farming • Waste influence field relatively wide (1.3 km) but effects field spatially constrained • Negligible inter-year benthic degradation, assimilation capacity not exceeded • Spatial patterns of waste influence complex, high resolution modelling important [ABSTRACT FROM AUTHOR]

This paper presents a 3-dimensional finite element formulation for predicting the behaviour of complex umbilical cross-sections exposed to loading from tension, torque, internal and external pressure including bending. Helically wound armours and tubes are treated as thin and slender beams formulated within the framework of small strains but large displacements, applying the principle of virtual displacements to obtain finite element equations. Interaction between structural elements is handled by 2- and 3-noded contact elements based on a penalty parameter formulation. The model takes into account a number of features, such as material nonlinearity, gap and friction between individual bodies, and contact with external structures and with a full 3-dimensional description. Numerical studies are presented to validate the model against another model as well as test data.

Abstract Background Prospective studies to document the occurrence of canine diarrhoea and vomiting are relatively scarce in dogs, and the majority of published studies are based on information from clinical records. This study investigates the incidence risk of diarrhoea and vomiting as well as potential risk factors. Methods A cohort study of 585 privately owned dogs of four breeds: Newfoundland, Labrador retriever, Leonberger, and Irish wolfhound. The owners maintained a continuous log regarding housing, exercise, nutrition, and health of their dogs. Episodes of diarrhoea and vomiting were recorded in a consecutive manner in a booklet. The owners completed the questionnaires and reported information at three, four, six, 12, 18, and 24/25 months of age, called observational ages. Associations with potential risk factors for diarrhoea and vomiting were investigated in separate generalized estimating equation analyses. Results The incidence of both diarrhoea and vomiting was influenced by breed. Both diarrhoea and vomiting were relatively common in young dogs, occurring most frequently during the first months of life. After three months of age, the odds of diarrhoea were significantly lower when compared to the observational period seven weeks to three months (OR ranging from 0.31 to 0.70 depending on the period). More males than females suffered from diarrhoea (OR = 1.42). The occurrence of diarrhoea was more common in dogs that also experienced episode(s) of vomiting during the study period (OR = 5.43) and vice versa (OR = 5.50). In the majority of dogs episodes of diarrhoea and vomiting did not occur at the same time. Dogs in urban areas had higher odds (OR = 1.88) of getting diarrhoea compared to dogs living in rural areas. The occurrence of both diarrhoea and vomiting demonstrated a seasonal variation with higher incidence during the summer months. Conclusion Both diarrhoea and vomiting occurred most frequently during the first months of life. The incidence of diarrhoea and vomiting was significantly different between breeds. Diarrhoea occurred more frequently in males and in dogs living in urban areas. Also, a positive association between the occurrence of diarrhoea and vomiting in the same dog was found.

Abstract Background There is increasing evidence for a latitudinal and altitudinal shift in the distribution range of Ixodes ricinus. The reported incidence of tick-borne disease in humans is on the rise in many European countries and has raised political concern and attracted media attention. It is disputed which factors are responsible for these trends, though many ascribe shifts in distribution range to climate changes. Any possible climate effect would be most easily noticeable close to the tick's geographical distribution limits. In Norway- being the northern limit of this species in Europe- no documentation of changes in range has been published. The objectives of this study were to describe the distribution of I. ricinus in Norway and to evaluate if any range shifts have occurred relative to historical descriptions. Methods Multiple data sources - such as tick-sighting reports from veterinarians, hunters, and the general public - and surveillance of human and animal tick-borne diseases were compared to describe the present distribution of I. ricinus in Norway. Correlation between data sources and visual comparison of maps revealed spatial consistency. In order to identify the main spatial pattern of tick abundance, a principal component analysis (PCA) was used to obtain a weighted mean of four data sources. The weighted mean explained 67% of the variation of the data sources covering Norway's 430 municipalities and was used to depict the present distribution of I. ricinus. To evaluate if any geographical range shift has occurred in recent decades, the present distribution was compared to historical data from 1943 and 1983. Results Tick-borne disease and/or observations of I. ricinus was reported in municipalities up to an altitude of 583 metres above sea level (MASL) and is now present in coastal municipalities north to approximately 69°N. Conclusion I. ricinus is currently found further north and at higher altitudes than described in historical records. The approach used in this study, a multi-source analysis, proved useful to assess alterations in tick distribution.

Background and Aims To improve management of patients with Crohn's disease, objective measurements of disease activity are needed. Ileocolonoscopy is the current reference standard but has limitations that restrict repeated use. Ultrasonography is potentially useful for activity monitoring, but no validated sonographic activity index is currently in widespread use. Thus, we aimed to construct and validate a simple ultrasound score for Crohn's disease. Methods Forty patients were prospectively examined with ultrasound and endoscopy in the development phase. The Simple Endoscopic Score for Crohn's Disease [SES-CD] was used as a reference standard. Seven ultrasound variables [bowel wall thickness, length, colour Doppler, stenosis, fistula, stratification and fatty wrapping] were initially included, and multiple linear regression was used to select the variables that should be included in the final score. Second, the ultrasound data from each patient were re-examined for interobserver assessment using weighted kappa and intraclass correlation. Finally, the activity index was validated in a new cohort of 124 patients. Results Length, fistula and stenosis were excluded. The combination of the remaining variables provided a multiple correlation coefficient of r  = 0.78. Interobserver analysis revealed poor agreement for stratification and fatty wrapping and these were thus excluded. There was excellent interobserver agreement for the remaining score consisting of wall thickness and colour Doppler. In both patient cohorts, the ultrasound score correlated well with SES-CD [Development cohort: rho = 0.83, p  < 0.001, Validation cohort: rho = 0.78, p  < 0.001]. A receiver operating characteristic curve analysis revealed an area under the curve of 0.92 and 0.88 for detecting endoscopic activity and moderate endoscopic activity, respectively. Conclusions A simple ultrasound activity index for Crohn's disease consisting of bowel wall thickness and colour Doppler was constructed and validated and correlated well with endoscopic disease activity. ClinicalTrials. gov ID: NCT03481751 [ABSTRACT FROM AUTHOR]

We demonstrate how topology-based measures of connectivity can be used to improve analytical estimates of effective permeability in 2-D fracture networks, which is one of the key parameters necessary for fluid flow simulations at the reservoir scale. Existing methods in this field usually compute fracture connectivity using the average fracture length. This approach is valid for ideally shaped, randomly distributed fractures, but is not immediately applicable to natural fracture networks. In particular, natural networks tend to be more connected than randomly positioned fractures of comparable lengths, since natural fractures often terminate in each other. The proposed topological connectivity measure is based on the number of intersections and fracture terminations per sampling area, which for statistically stationary networks can be obtained directly from limited outcrop exposures. To evaluate the method, numerical permeability upscaling was performed on a large number of synthetic and natural fracture networks, with varying topology and geometry. The proposed method was seen to provide much more reliable permeability estimates than the length-based approach, across a wide range of fracture patterns. We summarize our results in a single, explicit formula for the effective permeability. [ABSTRACT FROM AUTHOR]

Numerical simulations of a vertical tensioned riser in a sheared flow are performed, where the riser top end oscillates sinusoidally in the vertical direction. The oscillating top-end motion causes tension variations and changes in the natural frequencies of the riser. The flow around the structure causes vortex shedding, oscillating lift forces and vortex-induced vibrations (VIV). It is well-known that the vortex shedding is affected by structure motion, and may lock on to the riser’s natural frequencies. However, the vortex shedding frequency must remain close to the Strouhal frequency, and may therefore excite different modes of vibration as the riser tension changes. With this in mind, the overall aim of this paper is to investigate how tension variations affect the VIV response. The riser dynamics are simulated in time domain using a non-linear finite element structural model combined with an empirical hydrodynamic load model. The latter includes a synchronization model which simulates how the vortex shedding reacts to the structure motion to obtain lock-in. Simulations are run using different amplitudes and frequencies for the top-end motion, and the resulting cross-flow displacements and bending strains are studied. The results show that, when the riser top-end oscillates, the VIV response contains several modes, and the dominating mode may vary with time. The number of active modes are found to be strongly dependent on the period of the riser tension. [ABSTRACT FROM AUTHOR]