Molecular quantification of parasitic sea louse larvae depends on species and life stage

Sea lice cause substantial economic and environmental harm to Norway's aquaculture industry and wild salmonid populations. Rapid, accurate quantification of lice larval densities in coastal waters remains the greatest bottleneck for providing empirical data on infestation risk within wild salmon habitats and aquaculture production regions. We evaluated the capability of droplet digital PCR (ddPCR) as an absolute quantification method for the planktonic stages of two parasitic louse species, Lepeophtheirus salmonis (Krøyer) and Caligus elongatus (von Nordman). Results demonstrated linear relationships between the DNA quantity measured and the number of spiked larvae for both species and life stages. However, L. salmonis contained a significantly greater number of DNA copies than C. elongatus individuals and for C. elongatus, nauplii displayed a significantly higher number of DNA copies than copepodids. Our results suggest that ddPCR can effectively enumerate louse larvae, but interpreting ddPCR results differ between the two louse species. Obtaining larval abundance estimates from marine plankton samples will depend on the nauplii to copepodid ratio for C. elongatus, but not for L. salmonis.

Promotion of Water as Solvent in Amination of 4-Chloropyrrolopyrimidines and Related Heterocycles under Acidic Conditions

A switch of reaction medium from organic solvents to water can improve the safety and lower the cost of production processes. Hydrochloric acid-promoted amination of fused pyrimidines has been studied using 4-chloro-7H-pyrrolo[2,3-d]pyrimidine and aniline as model compounds. Higher rate was observed in water than in four alcoholic solvents and DMF. An important aspect is that the amount of acid should be kept low to minimize the competing solvolysis. The substrate scope for the amination in water was evaluated by reacting 4-chloro-7H-pyrrolo[2,3-d]pyrimidine with 20 aniline derivatives with variance in steric and electronic properties. Preparative useful reactions were seen for 14 of the 20 derivatives. Unsuited nucleophiles are ortho-substituted anilines with a pKa below 1. Amination of the corresponding quinazoline, thienopyrimidine, and purine also proceeded well in water. Highly lipophilic and crystalline compounds are more efficiently aminated in 2-propanol. Aliphatic and benzylic amines react poorly under acidic conditions, but these aminations can be done in water without acid.

Beyond the Nucleus: Plastic Chemicals Activate G Protein-Coupled Receptors

G protein-coupled receptors (GPCRs) are central mediators of cell signaling and physiological function. Despite their biological significance, GPCRs have not been widely studied in the field of toxicology. Herein, we investigated these receptors as novel targets of plastic chemicals using a high-throughput drug screening assay with 126 human non-olfactory GPCRs. In a first-pass screen, we tested the activity of triphenol phosphate, bisphenol A, and diethyl phthalate, as well as three real-world mixtures of chemicals extracted from plastic food packaging covering all major polymer types. We found 11 GPCR-chemical interactions, of which the chemical mixtures exhibited the most robust activity at adenosine receptor 1 (ADORA1) and melatonin receptor 1 (MTNR1A). We further confirm that polyvinyl chloride and polyurethane products contain ADORA1 or MTNRA1 agonists using a confirmatory secondary screen and pharmacological knockdown experiments. Finally, an analysis of the associated gene ontology terms suggests that ADORA1 and MTNR1A activation may be linked to downstream effects on circadian and metabolic processes. This work highlights that signaling disruption caused by plastic chemicals is broader than that previously believed and demonstrates the relevance of nongenomic pathways, which have, thus far, remained unexplored.

Metacognitive strategies mediate the association between metacognitive beliefs and perceived quality of life

Quality of life may be understood as a multidimensional evaluation of life circumstances in relation to values, expectations, and perceived well-being. Quality of life is thus dependent on the subjective perception of the current life situation, not only objective circumstances. According to metacognitive theory, metacognition guides the appraisal of inner experiences (i.e., thoughts and feelings) and influences how one relates to external stressors. Hence, dysfunctional metacognitive beliefs and the cognitive attentional syndrome (CAS), which includes perseverative thinking, threat monitoring and ineffective coping strategies, may negatively influence subjective quality of life. Therefore, we aimed to investigate if metacognitive beliefs and CAS strategies were associated with quality of life. A sample of 503 participants (77.1% women, mean age 41.0, SD = 11.5) completed the metacognitions questionnaire 30 (MCQ-30), the CAS-1 and the quality of life scale (QOLS). We used structural equation modelling (SEM) to estimate associations between the variables founded in metacognitive theory. The results of the SEM showed a significant direct relationship between metacognitive beliefs and quality of life. CAS strategies mediated the effect of metacognitive beliefs on quality of life. Higher level of metacognitive beliefs was associated with greater use of CAS strategies, which in turn was associated with lower quality of life. Further, more CAS strategies were associated with lower quality of life. The results support the generic metacognitive model and suggest that stronger endorsement of dysfunctional metacognitive beliefs and corresponding CAS strategies are associated with lower quality of life. This observation held even when controlling for relevant covariates and suggests that modifying metacognitive beliefs may impact on subjective quality of life.

Utility and limitations of EEG in the diagnosis and management of ALDH7A1-related pyridoxine-dependent epilepsy. A retrospective observational study

Purpose

Pyridoxine-dependent epilepsy due to ALDH7A1 variants (PDE-ALDH7A1) is a rare disorder, presenting typically with severe neonatal, epileptic encephalopathy. Early diagnosis is imperative to prevent uncontrolled seizures. We have explored the role of EEG in the diagnosis and management of PDE.

Methods

A total of 13 Norwegian patients with PDE-ALDH7A1 were identified, of whom five had reached adult age. Altogether 163 EEG recordings were assessed, 101 from the 1st year of life.

Results

Median age at seizure onset was 9 h (IQR 41), range 1 h-6 days. Median delay from first seizure to first pyridoxine injection was 2 days (IQR 5.5). An EEG burst suppression pattern was seen in eight patients (62%) during the first 5 days of life. Eleven patients had recordings during pyridoxine injections: in three, immediate EEG improvement correlated with seizure control, whereas in six, no change of epileptiform activity occurred. Of these six, one had prompt clinical effect, one had delayed effect (< 1 day), one had no effect, one had uncertain effect, and another had more seizures. A patient without seizures at time of pyridoxine trial remained seizure free for 6 days. Two patients with prompt clinical effect had increased paroxysmal activity, one as a conversion to burst suppression. Autonomic seizures in the form of apnoea appeared to promote respiratory distress and were documented by EEG in one patient. EEG follow-up in adult age did not show signs of progressing encephalopathy.

Conclusion

A neonatal burst suppression EEG pattern should raise the suspicion of PDE-ALDH7A1. Respiratory distress is common; isolated apnoeic seizures may contribute. EEG responses during pyridoxine trials are diverse, often with poor correlation to immediate clinical effect. Reliance on single trials may lead to under-recognition of this treatable condition. Pyridoxine should be continued until results from biomarkers and genetic testing are available.

Mass-Balance-Consistent Geological Stock Accounting: A New Approach toward Sustainable Management of Mineral Resources

Global resource extraction raises concerns about environmental pressures and the security of mineral supply. Strategies to address these concerns depend on robust information on natural resource endowments, and on suitable methods to monitor and model their changes over time. However, current mineral resources and reserves reporting and accounting workflows are poorly suited for addressing mineral depletion or answering questions about the long-term sustainable supply. Our integrative review finds that the lack of a robust theoretical concept and framework for mass-balance (MB)-consistent geological stock accounting hinders systematic industry-government data integration, resource governance, and strategy development. We evaluate the existing literature on geological stock accounting, identify shortcomings of current monitoring of mine production, and outline a conceptual framework for MB-consistent system integration based on material flow analysis (MFA). Our synthesis shows that recent developments in Earth observation, geoinformation management, and sustainability reporting act as catalysts that make MB-consistent geological stock accounting increasingly feasible. We propose first steps for its implementation and anticipate that our perspective as "resource realists" will facilitate the integration of geological and anthropogenic material systems, help secure future mineral supply, and support the global sustainability transition.

Anthropometrics of neonates born to mothers with PCOS with metformin or placebo exposure in utero

INTRODUCTION

Fetal growth may be affected by both maternal polycystic ovary syndrome (PCOS) and metformin therapy. Here, we explore the effect of intrauterine metformin exposure on birth anthropometrics of infants born to women with PCOS. We also investigated whether the effect of metformin on birth anthropometrics is modified by maternal pre-pregnancy body mass index, PCOS hyperandrogenic phenotype, serum androgen levels, preconception use of metformin and offspring sex. Additionally, we assessed newborn anthropometrics in relation to a national reference population.

MATERIAL AND METHODS

Individual data from three randomized controlled triasl were pooled. The randomized controlled trials investigated the effects of metformin in pregnant women with PCOS. In all, 397 and 403 were randomized to the metformin and placebo groups, respectively. A Scandinavian growth reference was used to calculate sex and gestational age adjusted z-scores. Linear regression models were used to estimate the effect of metformin on offspring z-scores of head circumference, birth length, birthweight, placental weight, body mass index, ponderal index and birthweight:placental weight ratio. S-testosterone, s-androstenedione, and s-sex-hormone binding globulin from four timepoints in pregnancy were analyzed.

RESULTS

Compared with the PCOS-placebo group, newborns in the PCOS-metformin group had larger head circumference (head circumference z-score: mean difference = 0.25, 95% CI = 0.11- 0.40). This effect of metformin on head circumference z-score was particularly observed among offspring of overweight/obese mothers and mothers with hyperandrogenic PCOS-phenotype. We observed no difference in other anthropometric measures between the metformin and placebo groups or any clear interaction between maternal androgen levels and metformin. Newborns in the PCOS-placebo group were shorter than in the reference population (birth length z-score: mean = -0.04, 95% CI = -0.05 to -0.03), but head circumference and birthweight were similar.

CONCLUSIONS

Larger head circumference was observed at birth in metformin-exposed offspring of mothers with PCOS. PCOS-offspring were also shorter, with a similar birthweight to the reference population, indirectly indicating higher weight-to-height ratio at birth.

Material and Carbon Footprints of Machinery Capital

Machinery and equipment, integral as technology-specific capital goods, play a dual role in climate change: it acts as both a mitigator and an exacerbator due to its carbon-intensive life cycle. Despite their importance, current climate mitigation analyses often overlook these items, leaving a gap in comprehensive analyses of their material stock and environmental impacts. To address this, our research integrates input-output analysis (IOA) with dynamic material flow analysis (d-MFA) to assess the carbon and material footprints of machinery. It finds that in 2019, machinery production required 30% of global metal production and 8% of global carbon emissions. Between 2000 and 2019, the metal footprint of the stock of machinery grew twice as fast as the economy. To illustrate the global implications and scale, we spotlight key countries. China's rise in machinery material stock is noteworthy, surpassing the United States in 2008 in total amount and achieving half of the US per capita level by 2019. Our study also contrasts economic depreciation─a value-centric metric─with the tangible lifespan of machinery, revealing how much the physical size of the capital stock exceeds its book values. As physical machinery stocks saturate, new machinery can increasingly be built from metals recycled from retired machinery.

Treadmill running intensity and post-exercise increase in plasma cardiac troponin I and T-A pilot study in healthy volunteers

BACKGROUND

Plasma concentrations of cardiac troponins increase in healthy individuals after strenuous training, but the response to lower exercise intensities has not been characterized.

AIM

To determine whether exercise at moderate intensity significantly increases plasma cardiac troponins measured with different assays in healthy recreational athletes.

METHODS

Twenty-four self-reported healthy volunteers were instructed to complete three 60-min bouts of treadmill running at variable intensities: High-intensity training (HIT) including a maximal exercise test and an anaerobic threshold test followed by training at 80%-95% of maximum heart rate (HRmax ), Moderate-intensity training (MIT) at 60%-75% of HRmax , and Low-intensity training (LIT) at 45%-55% of HRmax . Blood samples were collected before and at 2, 4, and 6 h after HIT and 4 h after MIT and LIT. Troponin I and T were measured in plasma samples with assays from Abbot, Siemens, and Roche.

RESULTS

Plasma troponins measured with all assays were significantly increased compared to baseline after HIT but not after LIT. After HIT, the fraction of all participants with one or more values above the assay-specific 99th percentiles ranged from 13% to 61%. The biomarker criteria for acute myocardial injury were met after HIT for troponin T in 75% of female participants having no clinical evidence of coronary artery disease.

CONCLUSION

High-intensity, but not moderate- or low-intensity, training for 60 min induced a potentially clinically significant increase in plasma cardiac troponins in healthy volunteers. Results exceeding the population 99th percentiles were most frequent with the troponin T assay.

Association between patient-reported cognitive function and location of glioblastoma

Objective cognitive function in patients with glioblastoma may depend on tumor location. Less is known about the potential impact of tumor location on cognitive function from the patients' perspective. This study aimed to investigate the association between patient-reported cognitive function and the location of glioblastoma using voxel-based lesion-symptom mapping. Patient-reported cognitive function was assessed with the European Organisation for Research and Treatment (EORTC) QLQ-C30 cognitive function subscale preoperatively and 1 month postoperatively. Semi-automatic tumor segmentations from preoperative MRI images with the corresponding EORTC QLQ-C30 cognitive function score were registered to a standardized brain template. Student's pooled-variance t-test was used to compare mean patient-reported cognitive function scores between those with and without tumors in each voxel. Both preoperative brain maps (n = 162) and postoperative maps of changes (n = 99) were developed. Glioblastomas around the superior part of the left lateral ventricle, the left lateral part of the thalamus, the left caudate nucleus, and a portion of the left internal capsule were significantly associated with reduced preoperative patient-reported cognitive function. However, no voxels were significantly associated with postoperative change in patient-reported cognitive function assessed 1 month postoperatively. There seems to be an anatomical relation between tumor location and patient-reported cognitive function before surgery, with the left hemisphere being the dominant from the patients' perspective.

Optimized synthesis of polyacrylic acid-coated magnetic nanoparticles for high-efficiency DNA isolation and size selection

Solid-phase reversible immobilization (SPRI) bead technology is widely used in molecular biology for convenient DNA manipulation. However, commercial SPRI bead kits lack cost advantages and flexibility. It is, therefore, necessary to develop new and alternative cost-effective methods of on-par or better quality. Herein, an easy and cost-effective method is proposed for synthesizing polyacrylic acid-coated iron oxide nanoparticles (PAA-IONPs) through in situ polymerization at lab scale for high-efficiency nucleic acid extraction and size selection. A design of experiment (DoE) approach was used to investigate the influence of iron oxide nanoparticles (IONPs), acrylic acid (AA) monomer, and sodium dodecyl sulfate (SDS) surfactant amounts on the sizes and carboxyl group densities of PAA-IONPs. Thorough characterization by thermogravimetric analysis (TGA), attenuated total reflection Fourier-transform infrared spectroscopy (ATR-FTIR) and vibrating sample magnetometry (VSM) highlights the importance of a low starting pH achieved by a high ratio of AA/IONPs, to yield the largest sizes (554 nm) and highest carboxyl group densities (2.13 mmol g-1) obtained in this study. An efficient DNA purification strategy is then presented using homemade beads-suspension buffer and optimized bead concentrations (17% PEG 8000, 2.5 M NaCl, and 3 mg mL-1 PAA-IONPs). This method shows comparable performance to the control (AMPure XP beads) for DNA recovery. An adjustable PAA-IONPs DNA purification system was also developed to be used for DNA-size selection at low DNA amounts (50-100 ng) with a high degree of resolution and recovery. In conclusion, this work offers an optimized PAA-IONPs synthesis protocol and a flexible DNA purification approach that will enable researchers to manipulate DNA under various conditions, holding the significant potential to benefit future molecular biology research and diagnostics.

CLET: Computation of Latencies in Event-related potential Triggers using photodiode on virtual reality apparatuses

To investigate event-related activity in human brain dynamics as measured with EEG, triggers must be incorporated to indicate the onset of events in the experimental protocol. Such triggers allow for the extraction of ERP, i.e., systematic electrophysiological responses to internal or external stimuli that must be extracted from the ongoing oscillatory activity by averaging several trials containing similar events. Due to the technical setup with separate hardware sending and recording triggers, the recorded data commonly involves latency differences between the transmitted and received triggers. The computation of these latencies is critical for shifting the epochs with respect to the triggers sent. Otherwise, timing differences can lead to a misinterpretation of the resulting ERPs. This study presents a methodical approach for the CLET using a photodiode on a non-immersive VR (i.e., LED screen) and an immersive VR (i.e., HMD). Two sets of algorithms are proposed to analyze the photodiode data. The experiment designed for this study involved the synchronization of EEG, EMG, PPG, photodiode sensors, and ten 3D MoCap cameras with a VR presentation platform (Unity). The average latency computed for LED screen data for a set of white and black stimuli was 121.98 ± 8.71 ms and 121.66 ± 8.80 ms, respectively. In contrast, the average latency computed for HMD data for the white and black stimuli sets was 82.80 ± 7.63 ms and 69.82 ± 5.52 ms. The codes for CLET and analysis, along with datasets, tables, and a tutorial video for using the codes, have been made publicly available.

Association between Johns Hopkins Adjusted Clinical Groups risk scores and self-reported outcome measures: an observational study among individuals with complex or long-term conditions in Norway

OBJECTIVE

Investigate the association between Johns Hopkins Adjusted Clinical Groups (ACG) risk scores and low scores in self-reported outcome measures (SROMs) among individuals with complex or long-term conditions.

DESIGN

Longitudinal study using five ACG risk scores based on diagnoses from general practitioner (GP) visits in 1 year and responses to a survey including three SROMs 4 months later.

SETTING

Four adjacent municipalities in Central Norway.

PARTICIPANTS

Non-institutionalised individuals ≥18 years with ≥1 diagnosis code indicating a complex or long-term condition, ≥1 visit to a GP, and who participated in the survey (n=2944).

MEASURES

Dependent variables were low scores in the three SROMs (threshold for being defined as a low score in parentheses): Patient Activation Measure (level 1-2), EQ-5D (<0.4) or self-rated health ('Poor'). Independent variables were five ACG variables.

RESULTS

The individuals with the lowest scores in the three SROMs were mostly three separate groups. The lowest Patient Activation Measure scores were associated with high scores in the ACG variables unscaled total cost predicted risk (adjusted odds ratio (adjOR) 1.80) and positive frailty flag (adjOR 1.76). The lowest EQ-5D scores were associated with high scores in the ACG variables unscaled concurrent risk (adjOR 1.60) and probability persistent high user scores (adjOR 2.83). The lowest self-rated health scores were associated with high scores in the ACG variable unscaled concurrent risk scores (adjOR 1.77), unscaled total cost predicted risk scores (adjOR 2.14) and receiving a positive frailty flag (adjOR 1.82).

CONCLUSIONS

There were associations between ACG risk scores and subsequent low SROM scores. This suggests a potential to use diagnosis-based risk stratification systems as a proxy for SROMs to identify individuals with complex or long-term conditions for person-centred healthcare intervention.

The Role of Chloride ion in the Silicate Condensation Reaction from ab Initio Molecular Dynamics Simulations

The comprehension of silicate oligomer formation during the initial stage of zeolite synthesis is of significant importance. In this study, we investigated the effect of chloride ions (Cl-) on silicate oligomerization using ab initio molecular dynamics simulations with explicit water molecules. The results show that the presence of Cl- increases the free energy barriers of all reactions compared to the case without the anion. The formation of the 4-ring structure has the lowest free energy barrier (73 kJ/mol), while the formation of the 3-ring structure has the highest barrier (98 kJ/mol) in the presence of Cl-. These findings suggest that Cl- suppresses the formation of 3-rings and favors the formation of larger oligomers in the process of zeolite synthesis. Our study provides important insights into the directing role of Cl- in silicate oligomerization by regulating thermodynamic and kinetic parameters. An important point to consider is the impact of the anion on aqueous reactions, particularly in altering the hydrogen bond network around reactive species. These results also provide a basis for further studies of the formations of larger silicate oligomers in solution.

Oxidation Kinetics of Nanocrystalline Hexagonal RMn1-xTixO3 (R = Ho, Dy)

Hexagonal manganites, RMnO3 (R = Sc, Y, Ho-Lu), are potential oxygen storage materials for air separation due to their reversible oxygen storage and release properties. Their outstanding ability to absorb and release oxygen at relatively low temperatures of 250-400 °C holds promise of saving energy compared to current industrial methods. Unfortunately, the low temperature of operation also implies slow kinetics of oxygen exchange in these materials, which would make them inefficient in applications such as chemical looping air separation. Here, we show that the oxidation kinetics of RMnO3 can be improved through Ti4+-doping as well as by increasing the rare earth cation size. The rate of oxygen absorption of nanocrystalline RMn1-xTixO3 (R = Ho, Dy; x = 0, 0.15) was investigated by thermogravimetric analysis, X-ray absorption near-edge structure, and high-temperature X-ray diffraction (HT-XRD) with in situ switching of atmosphere from N2 to O2. The kinetics of oxidation increases for larger R and even more with Ti4+ donor doping, as both induce expansion of the ab-plane, which reduces the electrostatic repulsion between oxygen in the lattice upon oxygen ion migration. Surface exchange rates and activation energies of oxidation were determined from changes in lattice parameters observed through HT-XRD upon in situ switching of atmosphere.

Exploiting individual differences to assess the role of place and phase locking cues in auditory frequency discrimination at 2 kHz

The relative role of place and temporal mechanisms in auditory frequency discrimination was assessed for a centre frequency of 2 kHz. Four measures of frequency discrimination were obtained for 63 normal-hearing participants: detection of frequency modulation using modulation rates of 2 Hz (FM2) and 20 Hz (FM20); detection of a change in frequency across successive pure tones (difference limen for frequency, DLF); and detection of changes in the temporal fine structure of bandpass filtered complex tones centred at 2 kHz (TFS). Previous work has suggested that: FM2 depends on the use of both temporal and place cues; FM20 depends primarily on the use of place cues because the temporal mechanism cannot track rapid changes in frequency; DLF depends primarily on temporal cues; TFS depends exclusively on temporal cues. This led to the following predicted patterns of the correlations of scores across participants: DLF and TFS should be highly correlated; FM2 should be correlated with DLF and TFS; FM20 should not be correlated with DLF or TFS. The results were broadly consistent with these predictions and with the idea that frequency discrimination at 2 kHz depends partly or primarily on temporal cues except for frequency modulation detection at a high rate.

Pressure Control of Nonferroelastic Ferroelectric Domains in ErMnO3

Mechanical pressure controls the structural, electric, and magnetic order in solid-state systems, allowing tailoring of their physical properties. A well-established example is ferroelastic ferroelectrics, where the coupling between pressure and the primary symmetry-breaking order parameter enables hysteretic switching of the strain state and ferroelectric domain engineering. Here, we study the pressure-driven response in a nonferroelastic ferroelectric, ErMnO3, where the classical stress-strain coupling is absent and the domain formation is governed by creation-annihilation processes of topological defects. By annealing ErMnO3 polycrystals under variable pressures in the MPa regime, we transform nonferroelastic vortex-like domains into stripe-like domains. The width of the stripe-like domains is determined by the applied pressure as we confirm by three-dimensional phase field simulations, showing that pressure leads to oriented layer-like periodic domains. Our work demonstrates the possibility to utilize mechanical pressure for domain engineering in nonferroelastic ferroelectrics, providing a lever to control their dielectric and piezoelectric responses.

Mercury Exposure in Birds of Prey from Norway: Relation to Stable Carbon and Nitrogen Isotope Signatures in Body Feathers

Mercury (Hg) and stable carbon and nitrogen isotope ratios were analysed in body feathers from nestlings of white-tailed eagles (Haliaeetus albicilla) (WTE; n = 13) and Northern goshawks (Accipiter gentilis) (NG; n = 8) and in red blood cells (RBC) from NG (n = 11) from Norway. According to linear mixed model, species factor was significant in explaining the Hg concentration in feathers (LMM; p < 0.001, estimate (WTE) = 2.51, 95% CI = 1.26, 3.76), with concentrations higher in WTE (3.01 ± 1.34 µg g^-1 dry weight) than in NG (0.51 ± 0.34 µg g^-1 dry weight). This difference and the isotopic patterns for each species, likely reflect their diet, as WTE predominantly feed on a marine and higher trophic-chain diet compared to the terrestrial NG. In addition, Hg concentrations in RBCs of NG nestlings were positively correlated with feather Hg concentrations (Rho = 0.77, p = 0.03), supporting the potential usefulness of nestling body feathers to biomonitor and estimate Hg exposure. Hg levels in both species were generally below the commonly applied toxicity threshold of 5 µg g^-1 in feathers, although exceeded in two WTE (6.08 and 5.19 µg g^-1 dry weight).

Promoting mental health and wellbeing in schools: the impact of yoga on young people's relaxation and stress levels

This study aimed to examine students' experiences with yoga interventions in school. The findings revealed that practicing yoga made young people more aware of their need to relax and positively impacted their mental health and wellbeing. We explored the emphasis on relaxation among our study participants and how relaxation is related to other aspects, such as their experience of stress and sleep habits. This article is based on qualitative data gathered from teenagers in Norway who participated in the Norwegian part of the European research project "Hippocampus: Promoting Mental Health and Wellbeing among Young People through Yoga." The project introduced yoga to young people in schools with an emphasis on those who were disadvantaged, including those with mental health issues and other challenges related to their background. Data were collected from nine individual, semi-structured interviews and 133 logs collected in the spring of 2019. The major themes identified through the interviews and log material included becoming more relaxed and aware of the need to unwind. Thus, the focus on relaxation is based on the importance of the participants assigned to this theme. The study results suggest that yoga enhanced the students' awareness and skills and empowered them to make healthier lifestyle choices. We viewed the importance of relaxation from a salutogenic perspective, focusing on the factors that contribute to good health in contrast to a pathogenic perspective, where curing diseases is the goal.

Bachelor of nursing students' experiences of a longitudinal team training intervention and the use of teamwork skills in clinical practice-A qualitative descriptive study

AIMS

To describe nursing students' experiences of a TeamSTEPPS® longitudinal team training program and the application of teamwork skills in clinical practice.

DESIGN

A descriptive qualitative design.

METHODS

Overall, 22 nursing students participated in six online focus group interviews after attending a TeamSTEPPS® team training program from their first semester. The data were audio-recorded, transcribed and analysed using inductive content analysis and reported following the COREQ guidelines. The focus group interviews took place in the students' fifth's semester.

RESULTS

The main category "Learning teamwork is not an event; it's a journey" emerged from 3 generic categories and 12 subcategories. The participants reported that grasping the relevance of team training and the use of teamwork skills takes time. Utilizing these skills improved their awareness of being a team member and facilitated learning.

CONCLUSION

Team training raised the participants' awareness of teamwork as an essential component of being a professional nurse. Additionally, understanding the complexity of teamwork takes time.

In Situ Sonoactivation of Polycrystalline Ni for the Hydrogen Evolution Reaction in Alkaline Media

In this investigation, we report on the development of a method for activating polycrystalline metallic nickel (Ni(poly)) surfaces toward the hydrogen evolution reaction (HER) in N₂-saturated 1.0 M KOH aqueous electrolyte through continuous and pulsed ultrasonication (24 kHz, 44 ± 1.40 W, 60% acoustic amplitude, ultrasonic horn). It is found that ultrasonically activated Ni shows an improved HER activity with a much lower overpotential of -275 mV vs RHE at -10.0 mA cm^-2 when compared to nonultrasonically activated Ni. It was observed that the ultrasonic pretreatment is a time-dependent process that gradually changes the oxidation state of Ni and longer ultrasonication times result in higher HER activity as compared to untreated Ni. This study highlights a straightforward strategy for activating nickel-based materials by ultrasonic treatment for the electrochemical water splitting reaction.

Physicochemical characterization and quantification of nanoplastics: applicability, limitations and complementarity of batch and fractionation methods

A comprehensive physicochemical characterization of heterogeneous nanoplastic (NPL) samples remains an analytical challenge requiring a combination of orthogonal measurement techniques to improve the accuracy and robustness of the results. Here, batch methods, including dynamic light scattering (DLS), nanoparticle tracking analysis (NTA), tunable resistive pulse sensing (TRPS), transmission electron microscopy (TEM), and scanning electron microscopy (SEM), as well as separation/fractionation methods such as centrifugal liquid sedimentation (CLS) and field-flow fractionation (FFF)-multi-angle light scattering (MALS) combined with pyrolysis gas chromatography mass spectrometry (pyGC-MS) or Raman microspectroscopy (RM) were evaluated for NPL size, shape, and chemical composition measurements and for quantification. A set of representative/test particles of different chemical natures, including (i) polydisperse polyethylene (PE), (ii) (doped) polystyrene (PS) NPLs, (iii) titanium dioxide, and (iv) iron oxide nanoparticles (spherical and elongated), was used to assess the applicability and limitations of the selected methodologies. Particle sizes and number-based concentrations obtained by orthogonal batch methods (DLS, NTA, TRPS) were comparable for monodisperse spherical samples, while higher deviations were observed for polydisperse, agglomerated samples and for non-spherical particles, especially for light scattering methods. CLS and TRPS offer further insight with increased size resolution, while detailed morphological information can be derived by electron microscopy (EM)-based approaches. Combined techniques such as FFF coupled to MALS and RM can provide complementary information on physical and chemical properties by online measurements, while pyGC-MS analysis of FFF fractions can be used for the identification of polymer particles (vs. inorganic particles) and for their offline (semi)quantification. However, NPL analysis in complex samples will continue to present a serious challenge for the evaluated techniques without significant improvements in sample preparation.

Intercalation of CO2 Selected by Type of Interlayer Cation in Dried Synthetic Hectorite

Clay minerals are abundant in caprock formations for anthropogenic storage sites for CO₂, and they are potential capture materials for CO₂ postcombustion sequestration. We investigate the response to CO₂ exposure of dried fluorohectorite clay intercalated with Li⁺, Na⁺, Cs⁺, Ca²⁺, and Ba²⁺. By in situ powder X-ray diffraction, we demonstrate that fluorohectorite with Na⁺, Cs⁺, Ca²⁺, or Ba²⁺ does not swell in response to CO₂ and that Li-fluorohectorite does swell. A linear uptake response is observed for Li-fluorohectorite by gravimetric adsorption, and we relate the adsorption to tightly bound residual water, which exposes adsorption sites within the interlayer. The experimental results are supported by DFT calculations.

Towards a sense of urgency for innovation realization: a case study on complacency asymmetries in interorganizational relations

This paper seeks to explore the concept of complacency as a barrier to the sense of urgency within product innovation, by investigating the concept on behalf of interfirm project partners. More specifically, the study aims to understand complacency within the context of an industrial research project in Norway subject to material substitution of an energy transmission tower. As such, the study seeks to give a contextual understanding of complacency for innovation realization (e.g., innovation speed) from a single case study. The study identified different complacency mechanism asymmetries on behalf of the actors, as well as the varying reasons (drivers) to why urgency gaps may occur among actors. The urgency gaps were found to impact a sense of urgency and thus innovation speed negatively. The asymmetries are presented from the drivers: role understanding, competence, project intent, risk and trust. Moreover, the urgency gaps' implications for interorganizational project collaboration, and how they contribute to theory on industrial product innovation, are explained. The findings contribute with new insights on important mechanisms for how a sense of urgency may be enhanced in research projects subject to interorganizational innovation. Theoretical contributions thus relate to enhanced understanding of complacency asymmetry in product innovation collaboration, and how trust is an important dimension for urgency creation.

Team training program's impact on medication administration, teamwork and patient safety culture in an ambulance service (TEAM-AMB): a longitudinal multimethod study protocol

INTRODUCTION

Medication administration errors (MAEs) have the potential for significant patient harm, and the frequency of MAEs in the ambulance services is not well known. Effective teamwork is paramount for providing safe and effective patient care, especially in a time-sensitive, high-risk environment such as the ambulance services. Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) is an evidence-based team training programme that, to our knowledge, has not been studied in the ambulance services previously. TeamSTEPPS is based on the five principles: team structure, communication, leadership, situation monitoring and mutual support. This study aims to advance the knowledge of the medication administration process in the ambulance services and study the impact of a team training programme on the frequency of MAEs, and the perception of teamwork, and patient safety culture.

METHODS AND ANALYSIS

This study uses a longitudinal multimethod design to evaluate medication administration and the implementation of the team training programme TeamSTEPPS in an ambulance service. A review of electronic patient journals 6 months prior to the intervention, and 12 months after the intervention will provide data on the frequency of MAEs. Focus group interviews and questionnaires will be carried out before and after the intervention to describe the perception of teamwork and patient safety culture among ambulance professionals. Observations, individual interviews and a review of guidelines will be conducted in the first and second quarters of 2022 to study the medication administration process in ambulance services.

ETHICS AND DISSEMINATION

The study protocol was reviewed by the Regional Committees for Medical and Health Research Ethics Central Norway and approved by the Hospital Trust data protection officer, and the head of the Prehospital Division at the Hospital Trust. The data material will be managed confidentially and stored according to regulations. The results will be disseminated through scientific papers, reports, conference presentations, popular press, and social media.

TRIAL REGISTRATION NUMBER

NCT05244928.

Smoking, use of smokeless tobacco, HLA genotypes and incidence of latent autoimmune diabetes in adults

AIMS/HYPOTHESES

Smoking and use of smokeless tobacco (snus) are associated with an increased risk of type 2 diabetes. We investigated whether smoking and snus use increase the risk of latent autoimmune diabetes in adults (LADA) and elucidated potential interaction with HLA high-risk genotypes.

METHODS

Analyses were based on Swedish case-control data (collected 2010-2019) with incident cases of LADA (n=593) and type 2 diabetes (n=2038), and 3036 controls, and Norwegian prospective data (collected 1984-2019) with incident cases of LADA (n=245) and type 2 diabetes (n=3726) during 1,696,503 person-years of follow-up. Pooled RRs with 95% CIs were estimated for smoking, and ORs for snus use (case-control data only). The interaction was assessed by attributable proportion (AP) due to interaction. A two-sample Mendelian randomisation (MR) study on smoking and LADA/type 2 diabetes was conducted based on summary statistics from genome-wide association studies.

RESULTS

Smoking (RR_pooled 1.30 [95% CI 1.06, 1.59] for current vs never) and snus use (OR 1.97 [95% CI 1.20, 3.24] for ≥15 box-years vs never use) were associated with an increased risk of LADA. Corresponding estimates for type 2 diabetes were 1.38 (95% CI 1.28, 1.49) and 1.92 (95% CI 1.27, 2.90), respectively. There was interaction between smoking and HLA high-risk genotypes (AP 0.27 [95% CI 0.01, 0.53]) in relation to LADA. The positive association between smoking and LADA/type 2 diabetes was confirmed by the MR study.

CONCLUSIONS/INTERPRETATION

Our findings suggest that tobacco use increases the risk of LADA and that smoking acts synergistically with genetic susceptibility in the promotion of LADA.

DATA AVAILABILITY

Analysis codes are shared through GitHub ( https://github.com/jeseds/Smoking-use-of-smokeless-tobacco-HLA-genotypes-and-incidence-of-LADA ).

Material Stock and Embodied Greenhouse Gas Emissions of Global and Urban Road Pavement

Roads play a key role in movements of goods and people but require large amounts of materials emitting greenhouse gases to be produced. This study assesses the global road material stock and the emissions associated with materials' production. Our bottom-up approach combines georeferenced paved road segments with road length statistics and archetypical geometric characteristics of roads. We estimate road material stock to be of 254 Gt. If we were to build these roads anew, raw material production would emit 8.4 GtCO₂-eq. Per capita stocks range from 0.2 t/cap in Chad to 283 t/cap in Iceland, with a median of 20.6 t/cap. If the average per capita stock in Africa was to reach the current European level, 166 Gt of road materials, equivalent to the road material stock in North America and in East and South Asia, would be consumed. At the urban scale, road material stock increases with the urban area, population density, and GDP per capita, emphasizing the need for containing urban expansion. Our study highlights the challenges in estimating road material stock and serves as a basis for further research into infrastructure resource management.

How Can Material Stock Studies Assist the Implementation of the Circular Economy in Cities?

City and regional planners have recently started exploring a circular approach to urban development. Meanwhile, industrial ecologists have been designing and refining methodologies to quantify and locate material flows and stocks within systems. This Perspective explores to which extent material stock studies can contribute to urban circularity, focusing on the built environment. We conducted a critical literature review of material stock studies that claim they contribute to circular cities. We classified each article according to a matrix we developed leveraging existing circular built environment frameworks of urban planning, architecture, and civil engineering and included the terminology of material stock studies. We found that, out of 271 studies, only 132 provided information that could be relevant to the implementation of circular cities, albeit to vastly different degrees of effectiveness. Of these 132, only 26 reported their results in a spatially explicit manner, which is fundamental to the effective actuation of circular city strategies. We argue that future research should strive to provide spatial data, avoid being siloed, and increase engagement with other sociopolitical fields to address the different needs of the relevant stakeholders for urban circularity.

Diagnostic pathways for breast cancer in 10 International Cancer Benchmarking Partnership (ICBP) jurisdictions: an international comparative cohort study based on questionnaire and registry data

OBJECTIVES

A growing body of evidence suggests longer time between symptom onset and start of treatment affects breast cancer prognosis. To explore this association, the International Cancer Benchmarking Partnership Module 4 examined differences in breast cancer diagnostic pathways in 10 jurisdictions across Australia, Canada, Denmark, Norway, Sweden and the UK.

SETTING

Primary care in 10 jurisdictions.

PARTICIPANT

Data were collated from 3471 women aged >40 diagnosed for the first time with breast cancer and surveyed between 2013 and 2015. Data were supplemented by feedback from their primary care physicians (PCPs), cancer treatment specialists and available registry data.

PRIMARY AND SECONDARY OUTCOME MEASURES

Patient, primary care, diagnostic and treatment intervals.

RESULTS

Overall, 56% of women reported symptoms to primary care, with 66% first noticing lumps or breast changes. PCPs reported 77% presented with symptoms, of whom 81% were urgently referred with suspicion of cancer (ranging from 62% to 92%; Norway and Victoria). Ranges for median patient, primary care and diagnostic intervals (days) for symptomatic patients were 3-29 (Denmark and Sweden), 0-20 (seven jurisdictions and Ontario) and 8-29 (Denmark and Wales). Ranges for median treatment and total intervals (days) for all patients were 15-39 (Norway, Victoria and Manitoba) and 4-78 days (Sweden, Victoria and Ontario). The 10% longest waits ranged between 101 and 209 days (Sweden and Ontario).

CONCLUSIONS

Large international differences in breast cancer diagnostic pathways exist, suggesting some jurisdictions develop more effective strategies to optimise pathways and reduce time intervals. Targeted awareness interventions could also facilitate more timely diagnosis of breast cancer.

Exercise Self-Efficacy and patient global assessment were associated with 6-min walk test distance in persons with rheumatoid arthritis

INTRODUCTION

Low functional capacity is related to future loss of daily function and cardiovascular events. The present study explored the associations of patient-reported outcome measures (PROMs) and disease-specific measures with functional capacity as measured by the 6-min walk test (6MWT) in persons with rheumatoid arthritis (RA).

METHODS

Seventy-nine participants from rheumatology outpatient clinics were included. The distance walked during the 6MWT (6MWD) was the dependent variable in multivariable regression analyses. Model 1 included the independent variables sex, age (in tertiles to improve model fit), and body mass index (BMI). Building on Model 1, Model 2 added smoking, patient global assessment (PGA), Exercise Self-Efficacy, Hospital Anxiety and Depression Scale's Depression score, and Cohen's Perceived Stress Scale score, whereas Model 3 added smoking, disease duration, present use of glucocorticosteroids, seropositivity, Disease Activity Score 28-C-Reactive Protein (DAS28-CRP), and a comorbidity variable.

RESULTS

Median age was 65 years, 76% were female, and median 6MWD was 493 m. In Model 1, BMI and age were significantly associated with the 6MWD (R2 = 0.42). In Model 2, PGA and Exercise Self-Efficacy were also significantly associated with the 6MWD, with standardized regression coefficients of - 0.21 (p = 0.03) and 0.26 (p = 0.004) respectively (R2 = 0.54). The RA-specific variables in Model 3 were not significantly associated with the 6MWD (R2 = 0.49).

CONCLUSION

The PROMs PGA and Exercise Self-Efficacy were significantly associated with functional capacity as measured by the 6MWT in persons with RA, whereas disease-specific measures such as DAS28-CRP and disease duration were not. Key Points • Functional capacity measured with the 6-minute walk test was significantly associated with body mass index, age, patient global assessment, and Exercise Self-Efficacy in persons with RA. • Patient-reported outcome measures explained more of the variation in functional capacity than objective or composite measures of disease and are relevant measures in clinical follow-up. • Techniques that enhance self-efficacy for exercise should be incorporated into clinical practice to promote physical activity.

A social VR-based collaborative exergame for rehabilitation: codesign, development and user study

Immersive virtual reality (VR)-based exercise video games (exergames) are increasingly being employed as a supportive intervention in rehabilitation programs to promote engagement in physical activity, especially for elderly users. A multifaceted and iterative codesign process is essential to develop sustainable exergaming solutions. The social aspect is considered one of the key motivating factors in exergames; however, research on the social aspect of VR exergames has been limited. Previous studies have relied on competitiveness in exergames, but research has shown that competition can lead to adverse effects on users. With the aim of motivating elderly individuals to participate in physical exercise and improving social connectedness during rehabilitation, this work presents a social VR-based collaborative exergame codesigned with elderly participants and therapists. This exergame stimulates full-body exercise and supports social collaboration among users through a collaborative game task. Furthermore, this article presents a user study based on a mixed-methods approach to gather user feedback on exergame design and the effect of social collaboration versus playing alone in a VR exergame in terms of physical exertion and motivation. This study spanned five weeks (99 exergaming sessions) with 14 elderly participants divided into two groups, one playing collaboratively and the other playing individually. Between-group comparisons were performed at baseline (first week) and in the fourth week, and within-group comparisons were performed in the fifth week, when the participants played the exergame in counterbalanced order. In contrast to the first week, the participants exergaming collaboratively in the fourth week reported significantly higher intrinsic motivation on all subscales (enjoyment: p < 0.02, effort: p < 0.002, usefulness: p < 0.01) and physical exertion (p < 0.001) than those playing alone. Thereafter, exergaming in counterbalanced order during the fifth week resulted in significant differences (medium to large effect size) within groups. The participants found the social VR gameplay enjoyable and agreed that collaboration played a vital role in their motivation. They reported various health benefits, a minimal increase in symptoms of simulator sickness, and excellent usability scores (83.75±13.3). In this work, we also identify various key design principles to support healthcare professionals, researchers and industrial experts in developing ergonomic and sustainable VR-based exergames for senior citizens.

FunHoP analysis reveals upregulation of mitochondrial genes in prostate cancer

Mitochondrial activity in cancer cells has been central to cancer research since Otto Warburg first published his thesis on the topic in 1956. Although Warburg proposed that oxidative phosphorylation in the tricarboxylic acid (TCA) cycle was perturbed in cancer, later research has shown that oxidative phosphorylation is activated in most cancers, including prostate cancer (PCa). However, more detailed knowledge on mitochondrial metabolism and metabolic pathways in cancers is still lacking. In this study we expand our previously developed method for analyzing functional homologous proteins (FunHoP), which can provide a more detailed view of metabolic pathways. FunHoP uses results from differential expression analysis of RNA-Seq data to improve pathway analysis. By adding information on subcellular localization based on experimental data and computational predictions we can use FunHoP to differentiate between mitochondrial and non-mitochondrial processes in cancerous and normal prostate cell lines. Our results show that mitochondrial pathways are upregulated in PCa and that splitting metabolic pathways into mitochondrial and non-mitochondrial counterparts using FunHoP adds to the interpretation of the metabolic properties of PCa cells.

PREvalence Study on Surgical COnditions (PRESSCO) 2020: A Population-Based Cross-Sectional Countrywide Survey on Surgical Conditions in Post-Ebola Outbreak Sierra Leone

Background

Understanding the burden of diseases requiring surgical care at national levels is essential to advance universal health coverage. The PREvalence Study on Surgical COnditions (PRESSCO) 2020 is a cross-sectional household survey to estimate the prevalence of physical conditions needing surgical consultation, to investigate healthcare-seeking behavior, and to assess changes from before the West African Ebola epidemic.

Methods

This study (ISRCTN: 12353489) was built upon the Surgeons Overseas Surgical Needs Assessment (SOSAS) tool, including expansions. Seventy-five enumeration areas from 9671 nationwide clusters were sampled proportional to population size. In each cluster, 25 households were randomly assigned and visited. Need for surgical consultations was based on verbal responses and physical examination of selected household members.

Results

A total of 3,618 individuals from 1,854 households were surveyed. Compared to 2012, the prevalence of individuals reporting one or more relevant physical conditions was reduced from 25 to 6.2% (95% CI 5.4–7.0%) of the population. One-in-five conditions rendered respondents unemployed, disabled, or stigmatized. Adult males were predominantly prone to untreated surgical conditions (9.7 vs. 5.9% women; p < 0.001). Financial constraints were the predominant reason for not seeking care. Among those seeking professional health care, 86.7% underwent surgery.

Conclusion

PRESSCO 2020 is the first surgical needs household survey which compares against earlier study data. Despite the 2013–2016 Ebola outbreak, which profoundly disrupted the national healthcare system, a substantial reduction in reported surgical conditions was observed. Compared to one-time measurements, repeated household surveys yield finer granular data on the characteristics and situations of populations in need of surgical treatment.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00268-022-06695-7.

Resilience and Its Association With Activities of Daily Living 3 Months After Stroke

Independence in basic activities of daily living (ADL) is an important outcome after stroke. Identifying factors associated with independence can contribute to improve post-stroke rehabilitation. Resilience, which is the ability of coping with a serious event, might be such a factor. Still, the impact of resilience and its role in rehabilitation after stroke is poorly investigated. Hence, the purpose of this study was to assess whether resilience assessed early after stroke can be associated with independence in basic ADL 3 months later. Hospitalized patients with a diagnosed acute stroke and a modified Rankin Scale score ≤ 4 were included. Bivariate and multivariate linear regression were applied to assess whether resilience as measured by the Brief Resilience Scale within the first 2 weeks after stroke was associated with basic ADL measured by Barthel Index at 3-month follow-up. Age, sex, fatigue, stroke severity at admission and pre-stroke disability were added as covariates. Sixty-four participants (35 (54.7%) male), aged 75.9 (SD 8.6) years were included 4.3 (SD 2.8) days after stroke. There was no significant change in resilience from baseline 3.1 (SD 0.3) to 3 months later 3.2 (SD 0.5). Resilience was not associated with basic ADL in neither the bivariate (b = 2.01, 95% CI −5.21, 9.23, p = 0.580) nor in the multivariate regression models (b = 0.50, 95% CI −4.87, 6.88, p = 0.853). Our results showed that resilience remained stable during follow-up. Early measurement of resilience was not associated with independence in basic activities of daily living 3 months after stroke. These results, indicate that resilience is a personal trait not associated with the outcome of physical adversity. However, future research should investigate whether resilience is related to the outcomes of psychosocial adversity after a stroke.

'Old wine in a new bottle': conceptualization of biodiversity offsets among environmental practitioners in Uganda

Biodiversity offsets are increasingly adopted to mitigate the negative impacts of development activities on biodiversity. However, in practice, there are inconsistencies in how biodiversity offsets are understood and implemented. Based on interviews with environmental practitioners, the study sought to explore the conceptual understanding of biodiversity offsets among personnel involved in the design and implementation of offset schemes in Uganda. The study employed a 'technical use analysis' to seek personal interpretation and operationalization of the concept of biodiversity offsets. The results revealed that the concept tends to be simplified and adjusted to individual, project, and country contexts. The respondents had varied perceptions of biodiversity offsets in practice as compared to the theoretical concept. Biodiversity offsets were classified under five terms: trade-offs, payments, substitutes, compensations, and mitigation measures. The terms were derived from perceived inability of the measure to attain no net loss, and similarities of biodiversity components and services across impact and offset sites. Biodiversity offsets were thus considered no different from ordinary environmental conservation measures, contributing nothing unique to the conservation agenda. The study concludes that widespread implementation of biodiversity offsets under prevailing perceptions will escalate biodiversity loss. The study recommends emphasis on attaining no net loss through implementing outcome-based offsets as opposed to purpose-based offsets, that require delivering of 'no net loss' gains prior to projects being considered biodiversity offsets.

High-Throughput Fabrication of Triangular Nanogap Arrays for Surface-Enhanced Raman Spectroscopy

Squeezing light into nanometer-sized metallic nanogaps can generate extremely high near-field intensities, resulting in dramatically enhanced absorption, emission, and Raman scattering of target molecules embedded within the gaps. However, the scarcity of low-cost, high-throughput, and reproducible nanogap fabrication methods offering precise control over the gap size is a continuing obstacle to practical applications. Using a combination of molecular self-assembly, colloidal nanosphere lithography, and physical peeling, we report here a high-throughput method for fabricating large-area arrays of triangular nanogaps that allow the gap width to be tuned from ∼10 to ∼3 nm. The nanogap arrays function as high-performance substrates for surface-enhanced Raman spectroscopy (SERS), with measured enhancement factors as high as 10⁸ relative to a thin gold film. Using the nanogap arrays, methylene blue dye molecules can be detected at concentrations as low as 1 pM, while adenine biomolecules can be detected down to 100 pM. We further show that it is possible to achieve sensitive SERS detection on binary-metal nanogap arrays containing gold and platinum, potentially extending SERS detection to the investigation of reactive species at platinum-based catalytic and electrochemical surfaces.

Pretreatment patient-reported cognitive function in patients with diffuse glioma

Purpose

Cognitive function is frequently assessed with objective neuropsychological tests, but patient-reported cognitive function is less explored. We aimed to investigate the preoperative prevalence of patient-reported cognitive impairment in patients with diffuse glioma compared to a matched reference group and explore associated factors.

Methods

We included 237 patients with diffuse glioma and 474 age- and gender-matched controls from the general population. Patient-reported cognitive function was measured using the cognitive function subscale in the European Organisation for Research and Treatment of Cancer QLQ-C30 questionnaire. The transformed scale score (0–100) was dichotomized, with a score of ≤ 75 indicating clinically important patient-reported cognitive impairment. Factors associated with preoperative patient-reported cognitive impairment were explored in a multivariable regression analysis.

Results

Cognitive impairment was reported by 49.8% of the diffuse glioma patients and by 23.4% in the age- and gender-matched reference group (p < 0.001). Patients with diffuse glioma had 3.2 times higher odds (95% CI 2.29, 4.58, p < 0.001) for patient-reported cognitive impairment compared to the matched reference group. In the multivariable analysis, large tumor volume, left tumor lateralization, and low Karnofsky Performance Status score were found to be independent predictors for preoperative patient-reported cognitive impairment.

Conclusions

Our findings demonstrate that patient-reported cognitive impairment is a common symptom in patients with diffuse glioma pretreatment, especially in patients with large tumor volumes, left tumor lateralization, and low functional levels. Patient-reported cognitive function may provide important information about patients’ subjective cognitive health and disease status and may serve as a complement to or as a screening variable for subsequent objective testing.

Adipogenic Activity of Chemicals Used in Plastic Consumer Products

Bisphenols and phthalates, chemicals frequently used in plastic products, promote obesity in cell and animal models. However, these well-known metabolism-disrupting chemicals (MDCs) represent only a minute fraction of all compounds found in plastics. To gain a comprehensive understanding of plastics as a source of exposure to MDCs, we characterized the chemicals present in 34 everyday products using nontarget high-resolution mass spectrometry and analyzed their joint adipogenic activities by high-content imaging. We detected 55,300 chemical features and tentatively identified 629 unique compounds, including 11 known MDCs. Importantly, the chemicals extracted from one-third of the products caused murine 3T3-L1 preadipocytes to proliferate, and differentiate into adipocytes, which were larger and contained more triglycerides than those treated with the reference compound rosiglitazone. Because the majority of plastic extracts did not activate the peroxisome proliferator-activated receptor γ and the glucocorticoid receptor, the adipogenic effects are mediated via other mechanisms and, thus, likely to be caused by unknown MDCs. Our study demonstrates that daily-use plastics contain potent mixtures of MDCs and can, therefore, be a relevant yet underestimated environmental factor contributing to obesity.

In vitro cell composition identification of wood decay fungi by Fourier transform infrared spectroscopy

Decay pathogens follow dissimilar metabolic mechanisms to cause irreversible damage to woody tissues. The objective of this study is to perform inter- and intra-species microbial cell structural comparison using attenuated total reflectance Fourier transform infrared spectroscopy. Representative fungi species, causing brown rot and white rot, namely, Postia placenta and Trametes versicolor, respectively, were cultured in laboratory conditions. In vitro spectral measurements were performed at periodic two week intervals of fungal growth. The study shows structural differences for both species of fungi. The prominent presence of protein amide, carbohydrate and carboxyl bands was of interest. Spectral deconvolution of the infrared broadband around approximately 3300 cm-1 produced peaks at four different wavenumbers. The hydrogen bond energy obtained at the four wavenumbers, from deconvolution, varied from approximately 41 kJ mol-1 to approximately 7 kJ mol-1, indicating the presence of strong and weak forces in microbial cell structure. The hydrogen bond distance, obtained at the deconvoluted wavenumbers, varied between 2.7 Å-2.8 Å, indicating the presence of short and long-distance forces within microbial cells. Microscopic observation showed mycelium colonization, hyphal tip and lateral branching.

Experimental determination of Escherichia coli biomass composition for constraint-based metabolic modeling

Genome-scale metabolic models (GEMs) are mathematical representations of metabolism that allow for in silico simulation of metabolic phenotypes and capabilities. A prerequisite for these predictions is an accurate representation of the biomolecular composition of the cell necessary for replication and growth, implemented in GEMs as the so-called biomass objective function (BOF). The BOF contains the metabolic precursors required for synthesis of the cellular macro- and micromolecular constituents (e.g. protein, RNA, DNA), and its composition is highly dependent on the particular organism, strain, and growth condition. Despite its critical role, the BOF is rarely constructed using specific measurements of the modeled organism, drawing the validity of this approach into question. Thus, there is a need to establish robust and reliable protocols for experimental condition-specific biomass determination. Here, we address this challenge by presenting a general pipeline for biomass quantification, evaluating its performance on Escherichia coli K-12 MG1655 sampled during balanced exponential growth under controlled conditions in a batch-fermentor set-up. We significantly improve both the coverage and molecular resolution compared to previously published workflows, quantifying 91.6% of the biomass. Our measurements display great correspondence with previously reported measurements, and we were also able to detect subtle characteristics specific to the particular E. coli strain. Using the modified E. coli GEM iML1515a, we compare the feasible flux ranges of our experimentally determined BOF with the original BOF, finding that the changes in BOF coefficients considerably affect the attainable fluxes at the genome-scale.

What do they TEL(L)? A systematic analysis of master programs in technology-enhanced learning

This article contributes to the debate on the growing number of interdisciplinary study programs in learning and technology, and aims to understand the diversity of programs as well as curricula structure in an international landscape. Scientific fields share their knowledge and recruit young researchers by offering discipline-specific study programs. Thus, study programs are a reflection of the fields they represent. As technology-enhanced learning is considered to be particularly interdisciplinary and heterogenous, it is important to better understand the landscape of study programs that represents the field. This article presents an analysis of master programs in technology-enhanced learning. A systematic review and analysis of master programs offered in English has been conducted and further used as input for hierarchical cluster analysis. The study identified general characteristics, curricula structure, and organization of topics of these programs. Hierarchical cluster analysis and qualitative content analysis helped us to identify the major types of curricular structures and typical topics covered by the courses. Results show that most study programs rely on interdisciplinary subjects in technology-enhanced learning with a considerable number of subjects from education, learning and psychology. Subjects related to technology, information and computer science appear in such programs less frequently.

OUP accepted manuscript

A rapid and cost-efficient tissue preparation protocol for laser ablation-inductively coupled plasma-mass spectrometry imaging (LA–ICP–MSI) has been developed within this study as an alternative to the current gold standard using fresh-frozen samples or other preparation techniques such as formalin fixation (FFix) and formalin-fixed paraffin-embedding (FFPE). Samples were vacuum dried at room temperature (RT) and stored in sealed vacuum containers for storage and shipping between collaborating parties. We compared our new protocol to established methods using prostate tissue sections investigating typical endogenous elements such as zinc, iron, and phosphorous with LA–ICP–MSI. The new protocol yielded comparable imaging results as fresh-frozen sections. FFPE sections were also tested due to the wide use and availability of FFPE tissue. However, the FFPE protocol and the FFix alone led to massive washout of the target elements on the sections tested in this work. Therefore, our new protocol presents an easy and rapid alternative for tissue preservation with comparable results to fresh-frozen sections for LA–ICP–MSI. It overcomes washout risks of commonly used tissue fixation techniques and does not require expensive and potentially unstable and time-critical shipping of frozen material on dry ice. Additionally, this protocol is likely applicable for several bioimaging approaches, as the dry condition may act comparable to other dehydrating fixatives, such as acetone or methanol, preventing degradation while avoiding washout effects.

Barriers to increase surgical productivity in Sierra Leone: a qualitative study

OBJECTIVE

To explore factors influencing surgical provider productivity and identify barriers against and opportunities to increase individual surgical productivity in Sierra Leone, in order to explain the observed increase in unmet surgical need from 92.2% to 92.7% and the decrease in surgical productivity to 1.7 surgical procedures per provider per week between 2012 and 2017.

DESIGN AND METHODS

This explanatory qualitative study consisted of in-depth interviews about factors influencing surgical productivity in Sierra Leone. Interviews were analysed with a thematic network analysis and used to develop a conceptual framework.

PARTICIPANTS AND SETTING

21 surgical providers and hospital managers working in 12 public and private non-profit hospitals in all regions in Sierra Leone.

RESULTS

Surgical providers in Sierra Leone experience a broad range of factors within and outside the health system that influence their productivity. The main barriers involve both patient and facility financial constraints, lack of equipment and supplies, weak regulation of providers and facilities and a small surgical workforce, which experiences a lack of recognition. Initiation of a Free Health Care Initiative for obstetric and paediatric care, collaborations with partners or non-governmental organisations, and increased training opportunities for highly motivated surgical providers are identified as opportunities to increase productivity.

DISCUSSION

Broader nationwide health system strengthening is required to facilitate an increase in surgical productivity and meet surgical needs in Sierra Leone. Development of a national strategy for surgery, obstetrics and anaesthesia, including methods to reduce financial barriers for patients, improve supply-mechanisms and expand training opportunities for new and established surgical providers can increase surgical capacity. Establishment of legal frameworks and appropriate remuneration are crucial for sustainability and retention of surgical health workers.

Evaluation of treatment with two weeks of doxycycline on macrolide-resistant strains of Mycoplasma genitalium: a retrospective observational study

BACKGROUND

Increasing macrolide resistance makes treatment of Mycoplasma genitalium infections challenging. The second-line treatment is moxifloxacin, an antibiotic drug best avoided due to the potential of severe side effects and interactions. This study evaluates the effects of treatment with doxycycline 100 mg twice daily for 2 weeks as an alternative to moxifloxacin.

METHODS

This retrospective observational study examined the medical records of patients testing positive for macrolide resistant Mycoplasma genitalium from January 1st, 2016 to September 1st, 2019 in Trondheim, Norway. Information regarding symptoms as well as clinical and microbiological cure was collected.

RESULTS

263 infections from 259 patients (161 females/98 males) were examined. 155 (58.9%) had a negative test of cure following treatment. 34.7% of symptomatic patients not achieving microbiological cure experienced symptom relief or clearance. There was no statistical difference between bacterial loads in symptomatic versus asymptomatic patients. The mean difference was 1.6 × 105 copies/ml (95% CI - 1.4 × 105-4.8 × 105, p = 0.30) for women and 1.4 × 106 copies/ml (95% CI -4.0 × 105-3.2 × 106, p = 0.12) for men.

CONCLUSIONS

The cure rate of doxycycline in this study is higher than previously reported. This adds support to doxycycline's role in treatment before initiating treatment with less favorable drugs such as moxifloxacin.

Incubation temperature and physiological aging in the zebra finch

In birds, incubation temperature has received increased attention as an important source of phenotypic variability in offspring. A lower than optimal incubation temperature may negatively affect aspects of nestling physiology, such as body growth and energy metabolism. However, the long-term effects of sub-optimal incubation temperature on morphology and physiology are not well understood. In a previous study, we showed that zebra finches from eggs incubated at a low temperature (35.9°C) for 2/3 of the total incubation time suffered a lower post-fledging survival compared to individuals that had been incubated at higher temperatures (37.0 and 37.9°C). In the present study, we investigated whether these variations in incubation temperature could cause permanent long-lasting differences in body mass, body size, or basal metabolic rate. Furthermore, we tested whether the observed differences in survival between treatment groups would be reflected in the rate of physiological deterioration, assessed through oxidative damage and decreased metabolic rate with age (i.e. 'metabolic aging'). Incubation temperature did not significantly affect embryonic or nestling body growth and did not influence final adult body mass or body size. Nor was there any long-term effect on basal metabolic rate. Birds from eggs incubated at the lowest temperature experienced an accumulation of oxidative damage with age, although this was not accompanied by an accelerated rate of metabolic aging. The present results suggest that the low survival in these birds was possibly mediated by increased oxidative stress, but independent of body growth and the basal metabolic rate.

Maternal PCOS status and metformin in pregnancy: Steroid hormones in 5-10 years old children from the PregMet randomized controlled study

Objective

Polycystic ovary syndrome (PCOS) is a common endocrine disorder, with potential effects on offspring both genetically and through altered intrauterine environment. Metformin, which ameliorate hormonal disturbances in non-pregnant women with PCOS is increasingly used in pregnancy. It passes the placenta, and the evidence on potential consequences for offspring endocrine development is scarce. We explore the potential effects of maternal PCOS status and intrauterine metformin exposure on offspring steroid hormone levels.

Design

This is a follow-up study of 5–10 years old children from the PregMet-study–a randomized controlled trial comparing metformin (2000 mg/day) to placebo during PCOS pregnancies. Of the 255 children invited, 117 (46%) were included.

Methods

There was no intervention in this follow-up study. Outcomes were serum levels of androstenedione, testosterone, SHBG, cortisol, 17-hydroxyprogesterone, 11-deoxycortisol and calculated free testosterone converted to gender-and age adjusted z-scores from a Norwegian reference population. These were compared in i) placebo-exposed children versus children from the reference population (z-score zero) by the deviation in z-score by one-sample t-tests and ii) metformin versus placebo-exposed children by two-sample t-tests. Holm-Bonferroni adjustments were performed to account for multiple endpoints.

Results

Girls of mothers with PCOS (n = 30) had higher mean z-scores of androstenedione (0.73 (95% confidence interval (CI) 0.41 to 1.06), p<0.0001), testosterone (0.76 (0.51 to 1.00), p<0.0001), and free testosterone (0.99 (0.67 to 1.32), p<0.0001) than the reference population. Metformin-exposed boys (n = 31) tended to have higher 11-deoxycortisol z-score than placebo-exposed boys (n = 24) (mean difference 0.65 (95% CI 0.14–1.17), p = 0.014).

Conclusion

Maternal PCOS status was associated with elevated androgens in 5- to 10-year-old daughters, which might indicate earlier maturation and increased risk of developing PCOS. An impact of metformin in pregnancy on steroidogenesis in children born to mothers with PCOS cannot be excluded. Our findings need confirmation in studies that include participants that have entered puberty.

Trace Elements in the Large Population-Based HUNT3 Survey

The Nord-Trøndelag Health Study (The HUNT Study) is a large health survey population study in the county of Trøndelag, Norway. The survey has been repeated four times in about 10-year intervals. In the HUNT3 survey (2006-2008), we collected 28,000 samples for trace element analysis. Blood samples from 758 healthy persons without known occupational exposure were selected for multielement analysis of a small sample of blood (0.25 mL). The aim of the study was to determine the minimum blood volume that can be used for the analytical procedure and to compare our results with previously published results of similar surveys in healthy populations. Samples were digested and the concentration of selected trace elements was determined by ICP-MS. We report results on essential elements (B, Co, Cu, Mn, Se and Zn) as well as non-essential elements (As, Be, Br, Cd, Cs, In, La, Pb, Hg, Nd, Ni, Nb, Pd, Pt, Sm, Ta and Sn). Results are similar to previous studies on the HUNT3 population, and with a few exceptions, our data compares very well with results obtained in recent studies from other countries. We wanted to test a minimum volume of blood in a large-scale analytical program. For a number of nonessential elements, our results were below the limit of detection. We suggest that future studies using similar ICP-MS equipment as analytical tool should use at least 0.5 mL of blood.

Selective Vacuum Evaporation by the Control of the Chemistry of Gas Phase in Vacuum Refining of Si

The evaporation of P from liquid Si under vacuum and reduced pressures of H₂, He, and Ar was studied to evaluate the feasibility of effective P removal with insignificant Si loss. It was found that the introduction of Ar and He inert gases at low pressures reduces the rate of P removal, and their pressure decrease will increase the process rate. Moreover, the kinetics of P removal was higher in He than in Ar, with simultaneous lower Si loss. Under reduced pressures of H₂ gas, however, the P removal rate was higher than that under vacuum conditions with the lowest Si loss. Quantum chemistry and dynamics simulations were applied, and the results indicated that P can maintain its momentum for longer distances in H₂ once it is evaporated from the melt surface and then can travel far away from the surface, while Si atoms lose their momentum in closer distances, yielding less net Si flux to the gas phase. Moreover, this distance is significantly increased with decreasing pressure for H₂, He, and Ar gases; however, it is the largest for H₂ and the lowest for Ar for a given pressure, while the temperature effect is insignificant. The rate of P evaporation was accelerated by applying an additional vacuum tube close to the melt surface for taking out the hot gas particles before they lose their temperature and velocity. It was shown that this technique contributes to the rate of process by preventing condensing gas stream back to the melt surface.

Metabolic adaptation is associated with less weight and fat mass loss in response to low-energy diets

BACKGROUND

The practical relevance of metabolic adaptation remains a controversial issue. To the best of our knowledge, no study has properly evaluated the role of metabolic adaptation in modulating weight loss outcomes. Therefore, the aim of this study was to determine the association between metabolic adaptation, at the level of resting metabolic rate (RMR), and weight and fat mass (FM) loss after low-energy diets (LED), after adjusting for dietary adherence and other confounders.

METHODS

71 individuals with obesity (BMI: 34.6 ± 3.4 kg/m2; age: 45.4 ± 8.2 years; 33 males) were randomized to one of three 1000 kcal/day diets for 8 weeks. Body weight, FM and fat-free mass (FFM) (air displacement plethysmography), RMR (indirect calorimetry) and physical activity level (PAL) (armbands) were measured at baseline and at week 9. Metabolic adaptation at week 9 was defined as measured RMR minus predicted RMR at week 9. An equation to predict RMR was derived from baseline data of all participants that were part of this analysis and included age, sex, FM and FFM as predictors. Dietary adherence was calculated from RMR, PAL and body composition changes. Linear regression was used to assess the potential role of metabolic adaptation in predicting weight and FM loss after adjusting for dietary adherence, average PAL, sex, baseline FM and FFM and randomization group.

RESULTS

Participants lost on average 14 ± 4 kg of body weight (13 ± 3%) and presented with metabolic adaptation (-92 ± 110 kcal/day, P < 0.001). Metabolic adaptation was a significant predictor of both weight (β = -0.009, P < 0.001) and FM loss (β = -0.008, P < 0.001), even after adjusting for confounders (R2 = 0.88, 0.93, respectively, P < 0.001 for both). On average, an increase in metabolic adaptation of 50 kcal/day was associated with a 0.5 kg lower weight and FM loss in response to the LED.

CONCLUSION

In individuals with obesity, metabolic adaptation at the level of RMR is associated with less weight and FM loss in response to LED. Trial registration ID: NCT02944253.

Forest management affects seasonal source-sink dynamics in a territorial, group-living bird

The persistence of wildlife populations is under threat as a consequence of human activities, which are degrading natural ecosystems. Commercial forestry is the greatest threat to biodiversity in boreal forests. Forestry practices have degraded most available habitat, threatening the persistence of natural populations. Understanding population responses is, therefore, critical for their conservation. Population viability analyses are effective tools to predict population persistence under forestry management. However, quantifying the mechanisms driving population responses is complex as population dynamics vary temporally and spatially. Metapopulation dynamics are governed by local dynamics and spatial factors, potentially mediating the impacts of forestry e.g., through dispersal. Here, we performed a seasonal, spatially explicit population viability analysis, using long-term data from a group-living territorial bird (Siberian jay, Perisoreus infaustus). We quantified the effects of forest management on metapopulation dynamics, via forest type-specific demography and spatially explicit dispersal, and how forestry impacted the stability of metapopulation dynamics. Forestry reduced metapopulation growth and stability, through negative effects on reproduction and survival. Territories in higher quality natural forest contributed more to metapopulation dynamics than managed forests, largely through demographic processes rather than dispersal. Metapopulation dynamics in managed forest were also less resilient to disturbances and consequently, may be more vulnerable to environmental change. Seasonal differences in source-sink dynamics observed in managed forest, but not natural forests, were caused by associated seasonal differences in dispersal. As shown here, capturing seasonal source-sink dynamics allows us to predict population persistence under human disturbance and to provide targeted conservation recommendations.