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Abstract Background A recent dialogue in the field of play, learn, and teach outdoors (referred to as “PLaTO” hereafter) demonstrated the need for developing harmonized and consensus-based terminology, taxonomy, and ontology for PLaTO. This is important as the field evolves and diversifies in its approaches, contents, and contexts over time and in different countries, cultures, and settings. Within this paper, we report the systematic and iterative processes undertaken to achieve this objective, which has built on the creation of the global PLaTO-Network (PLaTO-Net). Methods This project comprised of four major methodological phases. First, a systematic scoping review was conducted to identify common terms and definitions used pertaining to PLaTO. Second, based on the results of the scoping review, a draft set of key terms, taxonomy, and ontology were developed, and shared with PLaTO members, who provided feedback via four rounds of consultation. Third, PLaTO terminology, taxonomy, and ontology were then finalized based on the feedback received from 50 international PLaTO member participants who responded to ≥ 3 rounds of the consultation survey and dialogue. Finally, efforts to share and disseminate project outcomes were made through different online platforms. Results This paper presents the final definitions and taxonomy of 31 PLaTO terms along with the PLaTO-Net ontology model. The model incorporates other relevant concepts in recognition that all the aspects of the model are interrelated and interconnected. The final terminology, taxonomy, and ontology are intended to be applicable to, and relevant for, all people encompassing various identities (e.g., age, gender, culture, ethnicity, ability). Conclusions This project contributes to advancing PLaTO-based research and facilitating intersectoral and interdisciplinary collaboration, with the long-term goal of fostering and strengthening PLaTO’s synergistic linkages with healthy living, environmental stewardship, climate action, and planetary health agendas. Notably, PLaTO terminology, taxonomy and ontology will continue to evolve, and PLaTO-Net is committed to advancing and periodically updating harmonized knowledge and understanding in the vast and interrelated areas of PLaTO.

Background:The value of natural environments for developing children's self-identity and social skills has been known for some time, and more recently the potential of nature-specific (i.e., excluding built environments) outdoor learning for achieving academic outcomes has been explored. Connecting children with natural spaces has been shown to benefit their physical and mental health; however, the utility of nature-specific outdoor environments as a setting for curricular and non-curricular learning has yet to be clearly established. Our aim was to undertake a narrative synthesis of international evidence of nature-specific outdoor learning and its benefits for personal and social development, wellbeing and academic progress.MethodsThis systematic review searched publications between 2000 and 2020 in nine academic databases for evidence of socio-emotional and academic benefits of nature-specific outdoor learning in school-aged educational settings, using concise search criteria registered with PROSPERO. The total search results of 17,886 records were initially screened by title, and then two reviewers made blind reviews of the title and abstract of 1,019 records.Results147 original research studies meeting the criteria were identified. Learning settings ranged across outdoor adventure education, school gardens, field trips, and traditional school subjects taught in natural environments. Study characteristics were summarized, and risk-of-bias tools assessed quality of research as generally moderate, although with a wide range. The reported benefits of learning in natural outdoor settings include: increased student engagement and ownership of their learning, some evidence of academic improvement, development of social and collaborative skills, and improved self-concept factors.ConclusionsNature-specific outdoor learning has measurable socio-emotional, academic and wellbeing benefits, and should be incorporated into every child's school experience with reference to their local context. Teacher pre-service and in-service education needs to include a focus on how natural settings can be used effectively for learning. Further research is needed to clarify the conditions under which specific forms of outdoor learning are most efficacious for various target outcomes. It is recommended that future studies measuring outdoor learning adopt established methodologies to improve the quality of research in this field.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=153171.

Något som särskiljer yrkesdidaktik från annan ämnesdidaktik är kopplingen till ett yrke och arbetsliv. I den svenska gymnasiala yrkesutbildningen blir denna dimension av yrkesdidaktiken särskilt betydelsefull i relation till elevernas arbetsplatsförlagda lärande (apl). Under apl, liksom i skolan, är de uppgifter elever får tillgång till centrala för den utbildningsverksamhet som tar form. I artikeln undersöks blomsterförmedling under arbetsplatsförlagt lärande (apl) på det skolförlagda hantverksprogrammet med inriktning florist med fokus på de uppgifter elever möter. Syftet är att utveckla kunskap om de aspekter av yrkeskunnandet eleverna har svårt att få tillgång till, sett till såväl skol- som arbetsplatsförlagd utbildning. Vad som karakteriserar de uppgifter som eleverna genomför på sina arbetsplatser, samt vilka krav uppfattar eleverna att uppgifterna på apl-platserna ställer på dem är de frågeställningar som vägleder studien. Studien baseras på intervjuer med elever och handledare. Resultaten visar att ekonomi är en svårtillgänglig aspekt av yrkeskunnandet som till stora delar förblir dolt för eleverna, och att ekonomiska motiv inverkar på handledarnas bedömning av vilka uppgifter elever får göra under apl. Vidare synliggörs att ordersedeln utgör ett viktigt redskap på arbetsplatserna. Baserat i dessa resultat framträder att en central yrkesdidaktisk utmaning är att transformera ett specifikt yrkeskunnande till ett yrkesämnesinnehåll och skapa bryggor mellan två skilda praktiker: skola och arbetsplats.

Abstract Background Novel treatments are needed to control refractory status epilepticus (SE). This study aimed to assess the potential effectiveness of fenfluramine (FFA) as an acute treatment option for SE. We present a summary of clinical cases where oral FFA was used in SE. Methods A case of an adult patient with Lennox–Gastaut syndrome (LGS) who was treated with FFA due to refractory SE is presented in detail. To identify studies that evaluated the use of FFA in SE, we performed a systematic literature search. Results Four case reports on the acute treatment with FFA of SE in children and adults with Dravet syndrome (DS) and LGS were available. We report in detail a 30-year-old woman with LGS of structural etiology, who presented with generalized tonic and dialeptic seizures manifesting at high frequencies without a return to clinical baseline constituting the diagnosis of SE. Treatment with anti-seizure medications up to lacosamide 600 mg/d, brivaracetam 300 mg/d, valproate 1,600 mg/d, and various benzodiazepines did not resolve the SE. Due to ongoing refractory SE and following an unremarkable echocardiography, treatment was initiated with FFA, with an initial dose of 10 mg/d (0.22 mg/kg body weight [bw]) and fast up-titration to 26 mg/d (0.58 mg/kg bw) within 10 days. Subsequently, the patient experienced a resolution of SE within 4 days, accompanied by a notable improvement in clinical presentation and regaining her mobility, walking with the assistance of physiotherapists. In the three cases reported in the literature, DS patients with SE were treated with FFA, and a cessation of SE was observed within a few days. No treatment-emergent adverse events were observed during FFA treatment in any of the four cases. Conclusions Based on the reported cases, FFA might be a promising option for the acute treatment of SE in patients with DS and LGS. Observational data show a decreased SE frequency while on FFA, suggesting a potentially preventive role of FFA in these populations. Key points We summarize four cases of refractory status epilepticus (SE) successfully treated with fenfluramine. Refractory SE resolved after 4–7 days on fenfluramine. Swift fenfluramine up-titration was well-tolerated during SE treatment. Treatment-emergent adverse events on fenfluramine were not observed. Fenfluramine might be a valuable acute treatment option for SE in Dravet and Lennox–Gastaut syndromes.

BackgroundProlactinomas (PRLs) are prevalent pituitary adenomas associated with metabolic changes and increased cardiovascular morbidity. This study examined clinical, endocrine, metabolic, and inflammatory profiles in PRL patients, aiming to identify potential prognostic markers.MethodsThe study comprised data from 59 PRL patients gathered in a registry at the University Hospital of Zurich. Diagnostic criteria included MRI findings and elevated serum prolactin levels. We assessed baseline and follow-up clinical demographics, metabolic markers, serum inflammation-based scores, and endocrine parameters. Treatment outcomes were evaluated based on prolactin normalization, tumor shrinkage, and cabergoline dosage.ResultsThe PRL cohort exhibited a higher prevalence of overweight/obesity, prediabetes/diabetes mellitus, and dyslipidemia compared to the general population. Significant correlations were found between PRL characteristics and BMI, HbA1c, and fT4 levels. Follow-up data indicated decreases in tumor size, tumor volume, prolactin levels, and LDL-cholesterol, alongside increases in fT4 and sex hormones levels. No significant associations were observed between baseline parameters and tumor shrinkage at follow-up. A positive association was noted between PRL size/volume and the time to achieve prolactin normalization, and a negative association with baseline fT4 levels.ConclusionThis study underscores the metabolic significance of PRL, with notable correlations between PRL parameters and metabolic indices. However, inflammatory markers were not significantly correlated with patient stratification or outcome prediction. These findings highlight the necessity for standardized follow-up protocols and further research into the metabolic pathogenesis in PRL patients.

Background: A pivotal objective in crop production and plant protection lies in developing environmentally friendly insecticidal preparations and biostimulants. Methods: We employed Bacillus thuringiensis strains with varied insecticidal spectra and engineered melanogenic mutants. Results: We demonstrated a significant increase in insecticidal activity in the isolated mutants. Meanwhile, there was no observable impact of the enhanced synthesis of water-soluble melanin on the nature and abundance of spore and crystal formation. This heightened efficacy can be attributed to the photoprotective qualities of the synthesized pigment, shielding spores and crystals against the detrimental effects of UV radiation and insolation. We demonstrated the high biological activity of water-soluble bacterial melanin through in vivo experiments involving multiple plant species. Conclusions: Our findings indicate that bacterial melanin is a potent phytostimulant. This preparation accelerates and amplifies plant growth and development processes, leading to a substantial increase in crop yield by 20–40%. The simultaneous synthesis of two biologically active substance, melanin and insecticidal toxins, ensures an elevated level of effectiveness in utilizing melaninogenic strains.

Hepatic steatosis is characterized by intrahepatic lipid accumulation and may lead to irreversible liver damage if untreated. Here, we investigate whether multispectral optoacoustic tomography (MSOT) can offer label-free detection of liver lipid content to enable non-invasive characterization of hepatic steatosis by analyzing the spectral region around 930 nm, where lipids characteristically absorb. In a pilot study, we apply MSOT to measure liver and surrounding tissues in five patients with liver steatosis and five healthy volunteers, revealing significantly higher absorptions at 930 nm in the patients, while no significant difference was observed in the subcutaneous adipose tissue of the two groups. We further corroborated the human observations with corresponding MSOT measurements in high fat diet (HFD) - and regular chow diet (CD)-fed mice. This study introduces MSOT as a potential non-invasive and portable technique for detecting/monitoring hepatic steatosis in clinical settings, providing justification for larger studies.

Background: The optimal time to restart direct oral anticoagulants (DOACs) for nonvalvular atrial fibrillation (NVAF) after traumatic intracranial hemorrhage (tICH) is unknown. Physicians must weigh the risk of recurrent hemorrhage against ischemic stroke. We investigated rates of stroke while holding anticoagulation, hemorrhage after anticoagulation resumption, and factors associated with the decision to restart anticoagulation. Methods: Patients presenting to our level I trauma center for tICH while on a DOAC for NVAF were retrospectively reviewed over 2 years. Age, sex, DOAC use, antiplatelet use, congestive heart failure, hypertension, age, diabetes, previous stroke, vascular disease, sex score for stroke risk in NVAF, injury mechanism, bleeding pattern, Injury Severity Score, use of a reversal agent, Glasgow Coma Scale at 24 hours, hemorrhage expansion, neurosurgical intervention, Morse Fall Risk, DOAC restart date, rebleed events, and ischemic stroke were recorded to study rates of recurrent hemorrhage and stroke, and factors that influenced the decision to restart anticoagulation. Results: Twenty-eight patients sustained tICH while on a DOAC. Fall was the most common mechanism (89.3%), and subdural hematoma was the predominant bleeding pattern (60.7%). Of the 25 surviving patients, 16 patients (64%) restarted a DOAC a median 29.5 days after tICH. One patient had recurrent hemorrhage after resuming anticoagulation. One patient had an embolic stroke after 118 days off anticoagulation. Age >80, Injury Severity Score ≥16, and expansion of tICH influenced the decision to indefinitely hold anticoagulation. Conclusion: The low stroke rate observed in this study suggests that holding DOACs for NVAF for 1 month is sufficient to reduce the risk of stroke after tICH. Additional data are required to determine optimal restart timing.

Objective: The Allan-Herndon-Dudley syndrome (AHDS) is a severe disease caused by dysfunctional central thyroid hormone transport due to functional loss of the monocarboxylate transporter 8 (MCT8). In this study, we assessed whether mice with concomitant deletion of the thyroid hormone transporters Mct8 and the organic anion transporting polypeptide (Oatp1c1) represent a valid preclinical model organism for the AHDS. Methods: We generated and metabolically characterized a new CRISPR/Cas9 generated Mct8/Oatp1c1 double-knockout (dKO) mouse line for the clinical features observed in patients with AHDS. Results: We show that Mct8/Oatp1c1 dKO mice mimic key hallmarks of the AHDS, including decreased life expectancy, central hypothyroidism, peripheral hyperthyroidism, impaired neuronal myelination, impaired motor abilities and enhanced peripheral thyroid hormone action in the liver, adipose tissue, skeletal muscle and bone. Conclusions: We conclude that Mct8/Oatp1c1 dKO mice are a valuable model organism for the preclinical evaluation of drugs designed to treat the AHDS.

Abstract In-stent restenosis (ISR) represents a major complication after stenting of intracranial artery stenosis (ICAS). Biomarkers derived from routine blood sampling including C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and mean platelet volume (MPV) have been associated with progressive atherosclerosis. We investigated the role of CRP, NLR, PLR and MPV on the development of intracranial ISR and recurrent stroke risk. We retrospectively included all patients who had undergone stenting of symptomatic ICAS at our university hospital between 2005 and 2016. ISR (≥ 50% stenosis) was diagnosed by regular Duplex sonography follow-up studies and confirmed by digital subtraction angiography or computed tomography angiography (mean follow-up duration: 5 years). Laboratory parameters were documented before stenting, at the time of restenosis and at last clinical follow-up. Of 115 patients (mean age: 73 ± 13 years; female: 34%), 38 (33%) developed ISR. The assessed laboratory parameters did not differ between patients with ISR and those without (p > 0.1). While ISR was associated with the occurrence of recurrent ischemic stroke (p = 0.003), CRP, NLR, PLR and MPV were not predictive of such events (p > 0.1). Investigated blood biomarkers of progressive atherosclerosis were not predictive for the occurrence of ISR or recurrent ischemic stroke after ICAS stenting during a 5-year follow-up.

Straw is an interesting renewable feedstock for various high-value products, such as textile fibers. However, straw encompass to soils maintains a good soil structure, fertility, and carbon storage. Despite the availability of previous research on this topic, uncertainties remain regarding the climate and soil impacts of straw collection. This study aims to show the carbon footprint (CF) of straw collection compared with that of soil encompass. The goal is to demonstrate uncertainties related to initial data and methodological assumptions on whether straw is regarded as a waste or a coproduct and illustrate where more measured data is needed. Life cycle assessment method was used to conduct this study and the data therein were gotten from literature. The results show that straw removal can lead to reduced greenhouse gas emissions in comparison to soil encompass because of reduced nitrogen fertilizing needs and subsequent N2O emissions. However, there is high uncertainty related to soil organic carbon (SOC) and N2O emission changes because of straw removal. It is also possible that greenhouse gas emissions increase due to straw removal. Straw seems to have a relatively low CF, especially when it is regarded as a waste. Coproduct interpretation significantly increases the emissions allocated for straw. Straw also stores carbon, and its total CF can be negative. The life cycle length of the straw-based end products determines how long carbon can be stored before it is released back into the atmosphere. Total greenhouse gas emission balance at a system level can be defined only when also straw refining and manufacturing of replaced final products are considered. Additional information is needed, especially on soil emissions (N2O and CH4) and impacts on SOC storage, to ensure the sustainability of straw-based products.

BackgroundPatient-reported quality of life (QoL) may help to capture sequela of stroke more comprehensively. We aimed to investigate QoL in working age persons with ischemic stroke regarding impaired domains and identify factors associated with better QoL.MethodsWe invited persons with stroke aged 18–55 years to participate in this prospective observational study. We assessed QoL and self-rated health using the EuroQol 5 Dimension questionnaire (EQ-5D) during hospital stay (baseline) and at 3-months follow-up (FU). Additionally, the National Institute of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), cognition (Montreal Cognitive assessment, MOCA), emotion (Hospital Anxiety and Depression Scale), and return to work were evaluated. We used hierarchical regression to identify predictors of QoL (self-rated health and QoL Index score) at FU.ResultsWe included 138 persons with stroke (mean age = 43.6 ± 10 years; 41% female; median admission NIHSS = 2), of whom 99 participated at FU. QoL Index and self-rated health were correlated with NIHSS, mRS, anxiety, and depression at both timepoints. Although 80% had favorable functional outcome at FU (mRS < 2), high proportions of these persons reported problems in the “Pain and/or Discomfort” (25.3%) and “Anxiety/Depression” (22.8%) dimensions. Only discharge NIHSS and baseline MOCA independently predicted self-rated health at FU. Female sex, higher discharge NIHSS, and higher baseline depression scores predicted worse QoL Index scores at FU.ConclusionsThree months post-stroke, working age persons with stroke frequently reported problems in dimensions not assessed by the routinely used mRS. Despite correlations between clinical scales and QoL, patient-reported outcomes and screening for cognition and emotion ensure a more comprehensive assessment of post-stroke consequences relevant for QoL.

Created Out of Mind is an interdisciplinary project, comprised of individuals from arts, social sciences, music, biomedical sciences, humanities and operational disciplines. Collaboratively we are working to shape perceptions of dementias through the arts and sciences, from a position within the Wellcome Collection. The Collection is a public building, above objects and archives, with a porous relationship between research, museum artefacts, and the public. This pre-planning framework will act as an introduction to Created Out of Mind. The framework explains the rationale and aims of the project, outlines our focus for the project, and explores a number of challenges we have encountered by virtue of working in this way.

The impact of anomalous fall Arctic sea ice concentrations (SICs) on atmospheric patterns in the following winter is revisited by analysing results for two time periods: the most recent, satellite-era period (1979–2010) and a longer time-period (1950–2010). On the basis of September SICs for each time-period, an index was constructed which was used to identify anomalous high/low SIC years for both the original, as well as for the linearly detrended sea ice index. Identified years were then used to derive composites for the following winter's monthly atmospheric variables. Mid-troposphere geopotential height composites for winter months are in general reminiscent of the North Atlantic Oscillation pattern with high latitude maximum shifted towards the Barents Sea. Also, lower troposphere temperatures indicate the presence of cooler conditions over the continents during low SIC years. However, differences in the composite patterns are significant only for areas with limited spatial extent. While suggested pathways in previously published studies seem reasonable, our results show that these findings are not yet robust enough from a statistical significance perspective. More data (e.g. provided by longer, climate-quality reanalysis datasets) are needed before conclusions of impacts and feedbacks can be drawn with certainty.

The adsorption of Trametes hirsuta and Melanocarpus albomyces laccases on cellulose and lignin model substrates was studied by quartz crystal microbalance with dissipation, QCM-D. The laccase-treated surfaces were also analyzed by atomic force microscopy (AFM) and x-ray photoelectron spectroscopy (XPS). The laccases were found to adsorb at acidic and neutral pHs on both surfaces. The adsorbed amounts increased rather linearly with the change in dissipation when the lignin or cellulose was treated with T. hirsuta laccase. Higher adsorbed amounts were obtained using M. albomyces laccase. The adsorption of M. albomyces laccase on lignin was strongly dependent on pH. At low pH thin and rigid laccase layers were formed and the amount adsorbed was high, while at high pH the laccase layers formed were dissipative and loose and the amount adsorbed was low. A good correlation between the adsorbed amount of laccase and the surface nitrogen content was found. The adsorption of laccases made the surface structure of the cellulose and lignin substrates more granular.

This article discusses the phenomenon of running away from children’s residential care in the Finnish context. In the Finnish welfare system, residential care is understood as a last-resort form of alternative care. Its aim is to secure children’s well-being, development, and safety. Our article is based on the findings of a small-scale study launched and administrated by the Central Union for Child Welfare. These findings illustrate the multidimensional nature of the topic. First, the reasons for and the consequences of running away are diverse. Second, we need implementation of more inclusive and consistent practices as well as more explicit cooperation between authorities. Finally, the importance of children’s peer relations should be taken more seriously within residential care services. In this article, these findings are discussed bearing in mind the following critical question: What is the point of child welfare if it fails to serve children and safeguard their well-being and health during the out-of-home placement?