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Åke Tegelberg,1,4,5 Bo Wilhelmsson,2 Nina Erixon-Lindroth,6 Leif H Lindström3,41Department of Stomatognathic Physiology, 2Department of Otorhinolaryngology, 3Department of Psychiatry, Central Hospital, Västerås, Sweden; 4Centre for Clinical Research, Uppsala University, Central Hospital, Västerås, Sweden; 5Faculty of Odontology, Malmö University, Malmö, Sweden; 6Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SwedenObjective: The objective of this study was to evaluate the effect of oral appliance (OA) treatment on cognitive functions in patients with obstructive sleep apnea (OSA).Materials and methods: In a prospective study, 50 male patients with verified moderate-to-severe OSA received an OA with mandibular advancement. The cognitive functions assessed included working memory, vigilance, executive functioning, and mental pace, measured before as well as after 6 months of treatment. Somnography was used to measure physiological treatment effects. Forty-three patients completed the 6-month follow-up study.Results: All domains of cognitive functioning measured improved after 6 months of treatment with an OA (P < 0.001). The apnea/hypopnea- and oxygen desaturation-indices decreased significantly after treatment (P < 0.01). An obvious treatment response was reached in 60% of the patients, and 54% of the patients had recovered ie, had normalized breathing during sleep.Conclusion: OA with mandibular advancement is a treatment modality for the physiological symptoms of OSA, and may have a positive impact on cognitive functions, after only 6 months of treatment.Keywords: clinical trial, cognition, oral appliance, sleep apnea, treatment

The housing market in Dar es Salaam, Tanzania, is expanding and with it a need for increased market transparency to guide investors and other stakeholders. The objective of this paper is to evaluate machine learning (ML) methods to appraise real estate in formal and informal housing markets in this nascent market sector. Various advanced ML models are applied with the aim of improving property value estimates in a market with limited access to information. The dataset used included detailed property characteristics and transaction data from both market types. Regression, decision trees, neural networks, and ensemble methods were employed to refine property appraisals across these settings. The findings indicate significant differences between formal and informal market valuations, demonstrating ML’s effectiveness in handling limited data and complex market dynamics. These results emphasise the potential of ML techniques in emerging markets where traditional valuation methods often fail due to the scarcity of transaction data.

The 6th IUFRO Workshop on Connection between Forest Resources and Wood Quality: Modelling Approaches and Simulation Software.

Information on the potential wood supply is important for the wood industry. In this study, the future development of growing stock, cutting potential and wood properties corresponding to the regional scenario of North Karelian Forest Programme 2006â2010 was analysed. The simulations were performed by employing the Finnish MELA system together with the sample plot and tree data of the 9th Finnish National Forest Inventory (NFI9) as initial data for the simulations. Disc-based models for basic wood density, proportion of latewood and fibre length of Norway spruce and Scots pine in Sweden were calibrated and integrated into the MELA system. The wood properties at breast height of both harvested and standing trees were analysed in different strata (age, site type and cutting method) during the scenario period of 50 years (2002â2052). The average wood properties within the same strata varied only slightly over time. However, the results for different strata differed considerably. In general, wood density, fibre length and proportion of latewood increased, on average, as a function of tree age and along with a decrease in site fertility (excl. wood density and proportion of latewood in harvested Norway spruce in the first case and fibre length in the latter case for both species). For trees less than 80 years, properties in harvested trees were equal to or slightly greater than those of standing trees. The values for clear-cuttings were greater or equal to those of thinnings (excl. wood density and proportion of latewood in Norway spruce). The study demonstrates the value of model-based analyses utilising NFI tree measurements in regions that are considered to be sources of raw material.

Recent reports on children and adolescents’ physical activity indicate that approximately 80% do not meet the World Health Organisation’s recommended levels of physical activity. Childhood is a critical period of development; assuch, it isimportant to prioritize health promotion in this phase of one’s life. Use of gamification in mobile apps has been shown to positively influence physical activity levels in children and adolescents. Inclusion of behaviour change techniques (BCTs) has been noted to increase the effect of health promoting interventions. Previous research highlights that children and adolescents find the BCTs of goal setting/planning, feedback, reward, selfmonitoring, social comparison, and social support to be of interest. The aim of this study was to explore Swedish adolescents’ experience with physical activity and apps with a focus on the influence of BCTs. Three focus group interviews were undertaken with a total of 18 participants (11-15 years of age). The data were explored using reflective thematic analysis. In addition to the BCTs identified in previous research, participants in the present study indicated they were positive about mobile apps providing instruction on how to perform a behaviour, demonstration of the behaviour, and the influence of removal of reward. Other attractive features of physical activities apps included developing a streak, competition, and provision of an adequate level of challenge. The present study contributes to a deeper understanding of how BCTs and other features can be implemented in physical activity apps, where individualization and renewal appear to be more important than the actual content features. These findings are important for future work to create interventions that increase the level of physical activity among adolescents both in Sweden and other countries.

Pig transport drivers’ (TDs’) handling actions are of great importance as these drivers handle a large number of finishing pigs during stressful situations. Poor handling techniques can have negative consequences for working conditions, pig welfare and meat quality. We studied the effects of a training intervention on Swedish TDs’ attitudes towards pigs and their handling actions during loading for transport to slaughter. Twenty TDs working with commercial pig transportation in Sweden were recruited and completed an attitude questionnaire. Ten of them were observed during one loading of pigs before training, and one or two loadings after training (49–265 pigs per loading), and eight of them completed the attitude questionnaire again 50–160 days after training. The cognitive-behavioural training program ProHand Pigs® was adapted and delivered to the ten TDs during a group session, followed by individual meetings. TDs’ handling actions were video recorded and summarised as binary variables per 5-s interval. Factor analysis, principal component analysis and paired t-test were conducted to investigate the effects of the training intervention on TDs’ attitudes, and mixed-effects logistic models were used to examine effects on negative and positive handling actions. Training tended to decrease TDs’ beliefs that it is important to move pigs quickly (P = 0.095). Training decreased the odds of a ‘moderately to strongly negative’ action by 55% (P = 0.0013) and increased the odds of a ‘positive’ action by 97% (P

Abstract The aim of this study was to characterize the gene expression of host immune- and cellular responses to a Norwegian virulent strain of Anaplasma phagocytophilum, the cause of tick-borne fever in sheep. Ten sheep were intravenously inoculated with a live virulent strain of A. phagocytophilum. Clinical-, observational-, hematological data as well as bacterial load, flow cytometric cell count data from peripheral blood mononuclear cells and host’s gene expression post infection was analysed. The transcriptomic data were assessed for pre-set time points over the course of 22 days following the inoculation. Briefly, all inoculated sheep responded with clinical signs of infection 3 days post inoculation and onwards with maximum bacterial load observed on day 6, consistent with tick-borne fever. On days, 3–8, the innate immune responses and effector processes such as IFN1 signaling pathways and cytokine mediated signaling pathways were observed. Several pathways associated with the adaptive immune responses, namely T-cell activation, humoral immune responses, B-cell activation, and T- and B-cell differentiation dominated on the days of 8, 10 and 14. Flow-cytometric analysis of the PBMCs showed a reduction in CD4+CD25+ cells on day 10 and 14 post-inoculation and a skewed CD4:CD8 ratio indicating a reduced activation and proliferation of CD4-T-cells. The genes of important co-stimulatory molecules such as CD28 and CD40LG, important in T- and B-cell activation and proliferation, did not significantly change or experienced downregulation throughout the study. The absence of upregulation of several co-stimulatory molecules might be one possible explanation for the low activation and proliferation of CD4-T-cells during A. phagocytophilum infection, indicating a suboptimal CD4-T-cell response. The upregulation of T-BET, EOMES and IFN-γ on days 8–14 post inoculation, indicates a favoured CD4 Th1- and CD8-response. The dynamics and interaction between CD4+CD25+ and co-stimulatory molecules such as CD28, CD80, CD40 and CD40LG during infection with A. phagocytophilum in sheep needs further investigation in the future.

The transition from germinating seeds to emerging seedlings is one of the most vulnerable plant life cycle stages. Heteromorphic diaspores (seed and fruit dispersal units) are an adaptive bet-hedging strategy to cope with spatiotemporally variable environments. While the roles and mechanisms of seedling traits have been studied in monomorphic species, which produce one type of diaspore, very little is known about seedlings in heteromorphic species. Using the dimorphic diaspore model Aethionema arabicum (Brassicaceae), we identified contrasting mechanisms in the germination responses to different temperatures of the mucilaginous seeds (M+ seed morphs), the dispersed indehiscent fruits (IND fruit morphs), and the bare non-mucilaginous M− seeds obtained from IND fruits by pericarp (fruit coat) removal. What follows the completion of germination is the pre-emergence seedling growth phase, which we investigated by comparative growth assays of early seedlings derived from the M+ seeds, bare M− seeds, and IND fruits. The dimorphic seedlings derived from M+ and M− seeds did not differ in their responses to ambient temperature and water potential. The phenotype of seedlings derived from IND fruits differed in that they had bent hypocotyls and their shoot and root growth was slower, but the biomechanical hypocotyl properties of 15-day-old seedlings did not differ between seedlings derived from germinated M+ seeds, M− seeds, or IND fruits. Comparison of the transcriptomes of the natural dimorphic diaspores, M+ seeds and IND fruits, identified 2,682 differentially expressed genes (DEGs) during late germination. During the subsequent 3 days of seedling pre-emergence growth, the number of DEGs was reduced 10-fold to 277 root DEGs and 16-fold to 164 shoot DEGs. Among the DEGs in early seedlings were hormonal regulators, in particular for auxin, ethylene, and gibberellins. Furthermore, DEGs were identified for water and ion transporters, nitrate transporter and assimilation enzymes, and cell wall remodeling protein genes encoding enzymes targeting xyloglucan and pectin. We conclude that the transcriptomes of seedlings derived from the dimorphic diaspores, M+ seeds and IND fruits, undergo transcriptional resetting during the post-germination pre-emergence growth transition phase from germinated diaspores to growing seedlings.

Abstract Background Interprofessional Education (IPE) is now spreading worldwide and many universities are now including IPE in their curricula. The aim of this study was to investigate whether or not such student characteristics as gender, previous working experience in healthcare, educational progress and features of the learning environment, such as educational programmes and curriculum design, have an impact on their open-mindedness about co-operation with other professions. Methods Medical and nursing students at two Swedish universities were invited to fill in the Readiness for Interprofessional Learning Scale (RIPLS). Totally, 955 students were invited and 70.2% (n = 670) participated in the study. A factor analysis of the RIPLS revealed four item groupings (factors) for our empirical data, but only one had sufficient internal consistency. This factor was labelled "Team Player". Results Regardless of the educational programme, female students were more positive to teamwork than male students. Nursing students in general displayed more positive beliefs about teamwork and collaboration than medical students. Exposure to different interprofessional curricula and previous exposure to interprofessional education were only to a minor extent associated with a positive attitude towards teamwork. Educational progress did not seem to influence these beliefs. Conclusions The establishment of interprofessional teamwork is a major challenge for modern healthcare. This study indicates some directions for more successful interprofessional education. Efforts should be directed at informing particularly male medical students about the need for teamwork in modern healthcare systems. The results also imply that study of other factors, such as the student's personality, is needed for fully understanding readiness for teamwork and interprofessional collaboration in healthcare. We also believe that the RIPL Scale still can be further adjusted.

Abstract Incidence of tick-borne encephalitis (TBE) has increased during the last years in Scandinavia, but the underlying mechanism is not understood. TBE human case data reported between 2010 and 2021 were aggregated into postal codes within Örebro County, south-central Sweden, along with tick abundance and environmental data to analyse spatial patterns and identify drivers of TBE. We identified a substantial and continuing increase of TBE incidence in Örebro County during the study period. Spatial cluster analyses showed significant hotspots (higher number of cases than expected) in the southern and northern parts of Örebro County, whereas a cold spot (lower number of cases than expected) was found in the central part comprising Örebro municipality. Generalised linear models showed that the risk of acquiring TBE increased by 12.5% and 72.3% for every percent increase in relative humidity and proportion of wetland forest, respectively, whereas the risk decreased by 52.8% for every degree Celsius increase in annual temperature range. However, models had relatively low goodness of fit (R2

"English as a lingua franca (ELF)" is a well-known concept for English used as an international contact language among people from diverse linguacultural backgrounds. Using a questionnaire, we explored the attitudes of Spanish and Swedish pre-service primary school teachers towards English and its users after their collaboration on a virtual platform, during which they were "ELF users." The findings showed that the ELF user attitudes of the two European student cohorts tended to be ambivalent, mixed, and self-contradictory. After discussing factors for participants' attitudinal tendencies, we conclude that the ambivalence in their overall attitudes seems to mirror the ambivalence of the 'double' definitions of English in educational policy documents, which may affect the goals of teaching English in the classroom. We suggest that university teaching help pre-service teachers develop critical perspectives towards English and English users, as well as reflecting on why they teach English to their future pupils.

Abstract Background The definition of primary care varies between countries. Swedish primary care has developed from a philosophic viewpoint based on quality, accessibility, continuity, co-operation and a holistic view. The meaning of holism in international literature differs between medicine and nursing. The question is, if the difference is due to different educational traditions. Due to the uncertainties in defining holism and a holistic view we wished to study, in depth, how holism is perceived by doctors and nurses in their clinical work. Thus, the aim was to explore the perceived meaning of a holistic view among general practitioners (GPs) and district nurses (DNs). Methods Seven focus group interviews with a purposive sample of 22 GPs and 20 nurses working in primary care in two Swedish county councils were conducted. The interviews were transcribed verbatim and analysed using qualitative content analysis. Results The analysis resulted in three categories, attitude, knowledge, and circumstances, with two, two and four subcategories respectively. A professional attitude involves recognising the whole person; not only fragments of a person with a disease. Factual knowledge is acquired through special training and long professional experience. Tacit knowledge is about feelings and social competence. Circumstances can either be barriers or facilitators. A holistic view is a strong motivator and as such it is a facilitator. The way primary care is organised can be either a barrier or a facilitator and could influence the use of a holistic approach. Defined geographical districts and care teams facilitate a holistic view with house calls being essential, particularly for nurses. In preventive work and palliative care, a holistic view was stated to be specifically important. Consultations and communication with the patient were seen as important tools. Conclusion 'Holistic view' is multidimensional, well implemented and very much alive among both GPs and DNs. The word holistic should really be spelt 'wholistic' to avoid confusion with complementary and alternative medicine. It was obvious that our participants were able to verbalise the meaning of a 'wholistic' view through narratives about their clinical, every day work. The possibility to implement a 'wholistic' perspective in their work with patients offers a strong motivation for GPs and DNs.

Migratory birds play a dual role as potential reservoirs of tick-borne pathogens, and potential dispersers of pathogen-containing ticks during their migratory journeys. Ixodes ricinus, a prevalent tick species in Northern and Western Europe, serves as a primary vector for Anaplasma phagocytophilum—a bacterium with implications for human and animal health. There is limited information available regarding A. phagocytophilum in birds. Our investigation focused on A. phagocytophilum prevalence in ticks collected from migratory birds in southeastern Sweden. The identification of ticks involved both molecular analyses for species determination and morphological classification to ascertain the developmental stage. The presence of A. phagocytophilum was determined using real-time PCR. Of the 1115 ticks analyzed from 4601 birds, 0.9% (n = 10), including I. ricinus and Ixodes frontalis, tested positive for A. phagocytophilum. Notably, common blackbirds (Turdus merula) yielded the highest number of A. phagocytophilum-infected ticks. The findings suggest that A. phagocytophilum is present in a small proportion of ticks infesting migratory birds in southeastern Sweden. Consequently, the role of birds as hosts for ticks infected with A. phagocytophilum appears to be low, suggesting that birds seem to play a minor indirect role in the geographic dispersal of A. phagocytophilum.

Ixodes ricinus nymphs and adults removed from humans, and larvae and nymphs from birds, have been analysed for infection with Babesia species and Borrelia species previously in separately published studies. Here, we use the same data set to explore the coinfection pattern of Babesia and Borrelia species in the ticks. We also provide an overview of the ecology and potential public health importance in Sweden of I. ricinus infected both with zoonotic Babesia and Borrelia species. Among 1952 nymphs and adult ticks removed from humans, 3.1% were PCR-positive for Babesia spp. Of these Babesia-positive ticks, 43% were simultaneously Borrelia-positive. Among 1046 immatures of I. ricinus removed from birds, 2.5% were Babesia-positive, of which 38% were coinfected with Borrelia species. This study shows that in I. ricinus infesting humans or birds in Sweden, potentially zoonotic Babesia protozoa sometimes co-occur with human-pathogenic Borrelia spp. Diagnostic tests for Babesia spp. infection are rarely performed in Europe, and the medical significance of this pathogen in Europe could be underestimated.

We are analysing Stockholm, Sweden's regulated rental housing market, by analysing the distribution of rental apartments based on a person's position in the housing agency queue. Our objective is to examine queue times and estimate the demand for rent-regulated apartments, as well as the market's income elasticity. Using the hedonic two-step approach, we use empirical data from rental contracts provided by the Stockholm Housing Agency to investigate the relationship between individual waiting times and their characteristics, such as income, age, and family composition. The empirical analysis found a strong willingness to pay for rent-regulated apartments, especially for larger homes in better locations with lower regulated rent. The demand for rental apartments increases with increasing income, but this effect is less pronounced in the current distribution system. The findings will be valuable to real estate developers, property owners, and city planners to improve policies for the rental housing market. [ABSTRACT FROM AUTHOR]

The alpha 7 nicotinic acetylcholine receptor (α7nAChR) regulates inflammation in experimental models and is expressed in human peripheral blood mononuclear cells (PBMCs) and in human atherosclerotic plaques. However, its role in regulating inflammation in patients with cardiovascular disease is unknown. This study aims to investigate whether α7nAChR stimulation can reduce the inflammatory response in PBMCs from patients with newly diagnosed coronary artery disease (CAD). Human PBMCs, extracted from patients with verified CAD (n = 38) and control participants with healthy vessels (n = 38), were challenged in vitro with lipopolysaccharide (LPS) in combination with the α7nAChR agonist PHA 568487. Cytokine levels of the supernatants were analyzed using a multiplex immunoassay. Patients in the CAD group were reexamined after 6 mo. The immune response to LPS did not differ between PBMCs from control and CAD groups. α7nAChR stimulation decreased TNFα in both control and CAD groups. The most pronounced effect of α7nAChR stimulation was observed in patients with CAD at their first visit, where 15 of 17 cytokines were decreased [IL-1β, IL-2, IL-4, IL-5, IL-6, IL-7, IL-10, IL-12 (p70), IL-17A, G-CSF, GM-CSF, IFN-γ, MCP-1, MIP-1β, and TNFα]. In conclusion, stimulation with α7nAChR agonist PHA 568487 dampens the inflammatory response in human PBMCs. This finding suggests that the anti-inflammatory properties of the α7nAChR may have a role in treating CAD. NEW & NOTEWORTHY: The α7nAChR is an important regulator of inflammation; however, its anti-inflammatory function in patients with newly diagnosed coronary artery disease (CAD) remains unclear. We demonstrate that stimulation of α7nAChR with PHA 568487 attenuates the inflammatory response in immune cells extracted from healthy controls and patients with newly diagnosed CAD, with a more pronounced effect observed in patients with CAD. This suggests that the anti-inflammatory properties of α7nAChR may have a role in treating chronic inflammatory diseases. [ABSTRACT FROM AUTHOR]

The housing market in Dar es Salaam, Tanzania, is expanding and with it a need for increased market transparency to guide investors and other stakeholders. The objective of this paper is to evaluate machine learning (ML) methods to appraise real estate in formal and informal housing markets in this nascent market sector. Various advanced ML models are applied with the aim of improving property value estimates in a market with limited access to information. The dataset used included detailed property characteristics and transaction data from both market types. Regression, decision trees, neural networks, and ensemble methods were employed to refine property appraisals across these settings. The findings indicate significant differences between formal and informal market valuations, demonstrating ML's effectiveness in handling limited data and complex market dynamics. These results emphasise the potential of ML techniques in emerging markets where traditional valuation methods often fail due to the scarcity of transaction data. [ABSTRACT FROM AUTHOR]