Customer satisfaction research is widely recognized as one of the most utilized key performance indicators in marketing theory and practice. Extensive research underscores its positive correlation with revenue generation. This study empirically examines the relationship between customer satisfaction and changes in customer revenue at the individual customer level. Using a dataset comprising of 19,054 bank customers, the findings reveal a significant relationship between the customer satisfaction index (CSI) and revenue changes. Notably, the analysis demonstrates that this relationship is not strictly linear. Customers with satisfaction levels between 80 and 89 exhibit greater revenue changes compared to those with CSI levels of 90-100. These findings challenge the notion of customer satisfaction as a universal marketing tool for revenue generation. They suggest that satisfaction initiatives are most effective among already satisfied customers contributing to substantial revenue growth, except for those with the highest CSI scores. For customers with exceptionally high satisfaction levels, alternative marketing strategies may be required to optimize revenue generation.   

The Radio & Plasma Wave Investigation (RPWI) onboard the ESA JUpiter ICy moons Explorer (JUICE) is described in detail. The RPWI provides an elaborate set of state-of-the-art electromagnetic fields and cold plasma instrumentation, including active sounding with the mutual impedance and Langmuir probe sweep techniques, where several different types of sensors will sample the thermal plasma properties, including electron and ion densities, electron temperature, plasma drift speed, the near DC electric fields, and electric and magnetic signals from various types of phenomena, e.g., radio and plasma waves, electrostatic acceleration structures, induction fields etc. A full wave vector, waveform, polarization, and Poynting flux determination will be achieved. RPWI will enable characterization of the Jovian radio emissions (including goniopolarimetry) up to 45 MHz, has the capability to carry out passive radio sounding of the ionospheric densities of icy moons and employ passive sub-surface radar measurements of the icy crust of these moons. RPWI can also detect micrometeorite impacts, estimate dust charging, monitor the spacecraft potential as well as the integrated EUV flux. The sensors consist of four 10 cm diameter Langmuir probes each mounted on the tip of 3 m long booms, a triaxial search coil magnetometer and a triaxial radio antenna system both mounted on the 10.6 m long MAG boom, each with radiation resistant pre-amplifiers near the sensors. There are three receiver boards, two Digital Processing Units (DPU) and two Low Voltage Power Supply (LVPS) boards in a box within a radiation vault at the centre of the JUICE spacecraft. Together, the integrated RPWI system can carry out an ambitious planetary science investigation in and around the Galilean icy moons and the Jovian space environment. Some of the most important science objectives and instrument capabilities are described here. RPWI focuses, apart from cold plasma studies, on the understanding of how, through electrodynamic and electromagnetic coupling, the momentum and energy transfer occur with the icy Galilean moons, their surfaces and salty conductive sub-surface oceans. The RPWI instrument is planned to be operational during most of the JUICE mission, during the cruise phase, in the Jovian magnetosphere, during the icy moon flybys, and in particular Ganymede orbit, and may deliver data from the near surface during the final crash orbit.

Aims: Helicobacter pylori (H. pylori) and its cytotoxin-associated gene A (CagA) have been associated with myocardial infarction (MI), but existing data are conflicting possibly due to limitations in study designs and lack of data on important confounders. The aim of this study was to determine whether H. pylori or CagA seropositivity is associated with incident MI, including MI phenotypes, and to describe temporal trends.

Methods: We used the Northern Sweden Health and Disease study, a prospective biobank with data from residents enrolled in a population-based cohort from health examinations between 1986 and 2006. A total of 826 first time MI cases with available blood samples from their index health examination were identified up to 2006. Each case was 1:2 matched with controls by age, sex, sample date and geographical area. Blood samples were analysed using ELISA to determine seroprevalence of H. pylori and CagA, which were then used to study the association with incident MI.

Results: The median age at baseline was 50 years, and 71% of participants were male. Seroprevalence of H. pylori and CagA was 46.5% and 32.1% in cases, respectively, compared to 43.7% and 30.6% in controls. Overall, H. pylori prevalence decreased over the study period. After multivariable adjustments, no significant association was observed between H. pylori seropositivity and incident MI (odds ratio: 1.15, 95% CI 0.94–1.42) nor between CagA-positive H. pylori and incident MI.

Conclusion: In a Swedish population-based cohort, no significant association was observed between H. pylori or CagA seropositivity and incidence of MI.

Background: Hereditary Multiple Osteochondromas (HMO), previously known as Multiple Hereditary Exostoses (MHE), is a genetic disorder characterized by the formation of multiple, benign, exostoses (osteochondromas) growing from the metaphyseal region of long bones as well as from the axial skeleton. Lesions originating from the lumbar spine region are rare, and are most common growing from the posterior element of the vertebrae. HMO associated osteochondromas are difficult to treat due to continuous and incontrollable growth of these lesions and a lifetime risk for malignant transformation.

Case report: We describe a case of a 16-year old patient with known HMO who developed a giant ilio-lumbo-sacral osteochondroma. The tumor protruded into the L4-S1 intraspinal foramina with exophytic expansion to the right psoas muscle and lumbar plexus with compression of the right common iliac vein. To plan and execute the resection and minimize the risk of complications, we used a 3D printed model of the lesion with intraabdominal vessels. The patient was operated during a two-stage procedure - first by mini-open, transabdominal, navigated resection of the lesion, followed by delayed posterior, mini-invasive, navigated resection. The outcome was uneventful and there were no signs of regrowth or malignant transformation during 4 years of follow-up.

Conclusion: We describe a 360-degree surgical resection with application of a 3D printed model, navigation, and mini-invasive techniques. Our report may be useful and inspire spine surgeons to apply similar techniques to treat complex spine lesions.

The timing of flowering in plants is modulated by both carbon (C) and nitrogen (N) signaling pathways. In a previous study, we established a pivotal role of the sucrose-signaling trehalose 6-phosphate pathway in regulating flowering under N-limited short-day conditions. In this work, we show that both wild-type Arabidopsis (Arabidopsis thaliana) plants grown under N-limited conditions and knock-down plants of TREHALOSE PHOSPHATE SYNTHASE 1 induce FLOWERING LOCUS C (FLC) expression, a well-known floral repressor associated with vernalization. When exposed to an extended period of cold, a flc mutant fails to respond to N availability and flowers at the same time under N-limited and full-nutrition conditions. Our data suggest that SUCROSE NON-FERMENTING 1 RELATED KINASE 1-dependent trehalose 6-phosphate-mediated C signaling and a mechanism downstream of N signaling (likely involving NIN-LIKE PROTEIN 7) impact the expression of FLC. Collectively, our data underscore the existence of a multi-factor regulatory system in which the C and N signaling pathways jointly govern the regulation of flowering in plants.

The detailed ash transformation process during the combustion of agricultural biomass containing moderate to high amounts of P was studied in entrained flow conditions. The selected fuels were grass and brewer’s spent grain (BSG) containing a moderate and high amount of P in the fuel, respectively. The experiments were conducted in a lab-scale drop tube furnace at 1200 and 1450 °C. The residual chars, ashes, and particulate matter (PM) were collected and analyzed by scanning electron microscopy-energy-dispersive X-ray spectroscopy (SEM-EDS), X-ray diffraction (XRD), inductively coupled plasma atomic emission spectroscopy (ICP-AES) and ion chromatography (IC), and CHN-analysis. Additionally, the obtained results were interpreted through thermodynamic equilibrium calculations (TECs). For both fuels, P was primarily identified in the residual coarse ash (>1 μm) fractions. In contrast, a minor to moderate amount of fuel inherent P was detected in the fine particulate (<1 μm) fraction at 1200 and 1450 °C, respectively. For grass, the retained P in the residual coarse ash fractions was mainly identified as amorphous K–Ca–Mg-rich phosphosilicate melt. These phosphosilicates were most likely formed through the initial formation of molten K-rich silicates, with subsequent incorporation of Ca, P, and Mg. For BSG, a P–Si-rich fuel with moderate to minor amounts of Ca, Mg, and K, most P was retained in a Ca–Mg-rich phosphosilicate melt, likely originating from phytate-derived Ca–Mg phosphates interacting with fuel-inherent Si-rich particles. The results obtained from this study could be used to address the ash-related challenges and potential P-recovery routes during pulverized fuel combustion of P-containing biomass.

Objective: To test the efficacy of a web-based psychoeducational intervention, Fex-Can Sex, in reducing sexual dysfunction in young adults with cancer.

Methods: This randomized controlled trial evaluated a 12-week web-based self-help intervention. Young adults aged 19–40 who reported sexual dysfunction 1.5 years after cancer diagnosis were drawn from a population-based cohort. Participants were randomized to an intervention group (IG, n = 72) or a control group (CG, n = 66) that solely received standard care. Primary outcome was assessed by a domain of the Patient Reported Outcome Measures Information Systems® SexFS: "Satisfaction with sex life." Secondary outcomes included additional SexFS domains, body image (BIS), emotional distress (HADS), health-related quality of life (EORTC QLQ-C30), and self-efficacy related to sex. Surveys were completed at baseline, post-intervention, and three months later. Effects of the intervention were tested with t-tests, and linear mixed models (LMMs), including intention-to-treat and subgroup analyses. Additionally, the IG was asked about their experiences of the program with study-specific questions.

Results: There were no differences in primary or secondary outcomes between the IG and the CG at post-intervention. Subgroup analyses showed that individuals with greater sexual problems at baseline improved over time, regardless of group allocation. Participants spent a mean time of 20.7 min on the program. The study-specific items showed that the majority of participants in the IG appreciated the program and would recommend it to others.

Conclusion: The Fex-Can Sex intervention did not show effect on primary and secondary outcomes. Adherence to the intervention was low, and future interventions are recommended to include more interactive components to enhance usage.

Clinical trial registration: The trial was registered on 25 January, 2016 (trial number: 36621459).

The relative contribution of adiabatic and non-adiabatic processes to electron heating across collisionless shocks remains an open question. We analyze the evolution of suprathermal electrons across 310 quasi-perpendicular shocks with Alfvénic Mach numbers in the normal-incidence frame (M_A-NIF) ranging from 1.7 to 48, using in situ measurements of Earth's bow shock by the Magnetospheric Multiscale (MMS) spacecraft. We introduce a novel non-adiabaticity measure derived from the electron distribution function and based on Liouville's theorem. Our results reveal, for the first time, that the electron heating mechanism is governed by the Alfvénic Mach number in the de Hoffman-Teller frame (M_A-HT), with a transition from predominantly adiabatic to non-adiabatic heating occurring at MA-HT greater than or similar to 30. Furthermore, by examining the spectral index of the suprathermal electron distribution, we find that for shocks exhibiting dominant non-adiabatic electron dynamics, the observed electron heating is consistent with the predictions of the stochastic shock drift acceleration (SSDA) mechanism.

Molecular characterization of the oral microbiome is a crucial first step in experiments which aim to understand the complex dynamics of the oral microbiome or the interplay with host health and disease. Third-generation Oxford Nanopore Technology (ONT) offers advanced long-read sequencing capabilities, which hold promise for improved molecular characterization by distinguishing closely related microbial species within oral ecosystems in health and disease states. However, the performance of ONT sequencing of oral samples requires validation, and the consistency of this approach across different analytical and sampling conditions is not well understood. This study evaluates various factors that may influence the ONT sequencing outputs of saliva microbiota and compares results with those from Illumina MiSeq's v3v4 amplicon sequencing. Our analysis includes assessments of various stages in the workflow, including different collection and extraction methods, such as robot-extracted saliva DNA used in population-based biobanks, the effects of limited DNA quantities, different bioinformatics pipelines, and different 16S rRNA gene databases. The results demonstrate that ONT provides superior resolution in identifying oral species and subspecies compared to Illumina MiSeq, though the choice of bioinformatics strategy significantly affects the outcomes. Additionally, we confirm the suitability of biobank saliva DNA for large-scale cohort studies, which facilitates the mapping of oral bacterial phylotypes associated with disease states, including less prevalent conditions. Overall, our findings confirm a markedly improved resolution of oral microbiomes by ONT and offer an evidence base to guide the conduct of experiments using this method.

This paper introduces a concrete relation between genus zero closed Gromov-Witten invariants of Calabi-Yau threefolds and genus zero open Gromov-Witten invariants of a Lagrangian A-brane in the same threefold. Symplectic cutting is a natural operation that decomposes a symplectic manifold (X,ω) with a Hamiltonian U(1) action into two pieces glued along an invariant divisor. In this paper we study a quantum uplift of the cut construction defined in terms of equivariant gauged linear sigma models. The nexus between closed and open Gromov-Witten invariants is a quantum Lebesgue measure associated to a choice of cut, that we introduce and study. Integration of this measure recovers the equivariant quantum volume of the whole CY3, thereby encoding closed Gromov-Witten invariants. Conversely, the monodromies of the quantum measure around cycles in Kähler moduli space encode open Gromov-Witten invariants of a Lagrangian A-brane associated to the cut. Both in the closed and the open string sector we find a remarkable interplay between worldsheet instantons and semiclassical volumes regularized by equivariance. This leads to equivariant generating functions of GW invariants that extend smoothly across the entire moduli space, and which provide a unifying description of standard GW potentials. The latter are recovered in the non-equivariant limit in each of the different phases of the geometry.

Objective: We report data of non-invasive prenatal testing (NIPT) at Uppsala University Hospital between 2017-2022. Furthermore, we illustrate the potential capacity of massive parallel sequencing-based NIPT beyond identification of common trisomies.

Methods: Maternal blood samples were analyzed using the Verifi NIPT or VeriSeq NIPT assays. Diagnostic testing, performed on amniotic fluid samples, included QF-PCR, microarray (SNP-array) and metaphase FISH.

Results: Among 4532 NIPT tests performed between 2017-2022, 125 samples (2.76%) showed increased risk for trisomies 13, 18, 21 and sex chromosome aneuploidy. For three patients with normal NIPT result further microarray indicated other types of chromosomal rearrangement which were not analyzed by NIPT. For another patient (case 1) the Verifi NIPT indicated trisomy 13. Fetal fraction (FF) was estimated to be 10%. Confirmatory microarray detected a segmental duplication on chromosome 13, as well as a terminal duplication and a terminal deletion on chromosome 10. A complex karyotype was observed in the fetus with metaphase FISH. In the second case the VeriSeq NIPT indicated trisomy 13. FF was estimated to be 11%. Confirmatory microarray detected a mosaicism of trisomy 13 in 30 % of cells.

Conclusion: This study illustrates detection of peculiar abnormalities of chromosome 13 and supports potential to screen copy number variations with genome-wide NIPT.

Background: Physical activity (PA) after stroke has significant health benefits if it is conducted regularly, with sufficient intensity and duration. Because of the health benefits, it is important to identify those below the World Health Organization (WHO) recommended level of PA. However, few studies have assessed the level of PA after stroke in relation to the WHO recommendations and which sociodemographic factors and stroke characteristics are associated with those below the WHO recommendations.

Objective: To assess survivors of stroke at least 1 year after onset and (1) describe their self-reported level of PA; (2) explore the association between PA, sociodemographics, and stroke characteristics, and (3) determine the characteristics of those below the WHO recommended level of PA.

Design: Cross-sectional descriptive survey.

Setting: Community settings.

Participants: Data were collected from 160 survivors of stroke (mean age 73 years, 46% women, mean time since stroke onset 35 months).

Interventions: Not applicable.

Main outcome measures: The Swedish National Board of Health and Welfare Physical Activity Questionnaire and the following sociodemographics and stroke characteristics: gender, age, marital status, vocational situation, need for home help, use of mobility devices, time since stroke onset, first-time stroke, type of stroke, location of stroke, and stroke treatment.

Results: Two thirds (66.3%) of the participants were below the WHO recommendations. The hierarchical regression analysis explained 13% of the variance in PA with need for home help as a single significant contributor. Those who did not meet the WHO recommendations were significantly older, more likely to live alone, and in need of home help and mobility devices.

Conclusions: A majority of survivors of stroke do not meet the WHO recommended level of PA. Future studies should assess how other factors characterize those who are physically inactive. This knowledge could help rehabilitation professionals to target interventions and self-management programs to promote PA among survivors of stroke.

Occupant packaging design is usually done using computer-aided design (CAD) and digital human modelling (DHM) tools. These tools help engineers and designers explore and identify vehicle cabin configurations that meet accommodation targets. However, studies indicate that current working methods are complicated and iterative, leading to time-consuming design procedures and reduced investigations of the solution space, in turn meaning that successful design solutions may not be discovered. This paper investigates potential advantages and challenges in using an automated simulation-based multi-objective optimization (SBMOO) method combined with a DHM tool to improve the occupant packaging design process. Specifically, the paper studies how SBMOO using a genetic algorithm can address challenges introduced by human anthropometric and postural variability in occupant packaging design. The investigation focuses on a fabricated design scenario involving the spatial location of the seat and steering wheel, as well as seat angle, taking into account ergonomics objectives and constraints for various end-users. The study indicates that the SBMOO-based method can improve effectiveness and aid designers in considering human variability in the occupant packaging design process.

Introduction: The association between increasing diagnosis rates of autism-related disorders (ASD-R) in Swedish regions and diagnosis rates of major depressive disorders (MDD) in adolescents remains unexplored.

Methods: Following STROBE guidelines, this pre-registered (https://osf.io/duvq7) observational study, utilizing registry data from 2008 to 2022 across the 21 Swedish regions, employed a generalized linear mixed model (GLMM) to analyze the association between ASD-R (ICD-10: F84) and MDD diagnosis rates (ICD-10: F32) in 15–19 year olds, with registered primary diagnoses considered. The GLMM included psychiatric care affiliation rates (PCAR) as fixed effects and variations across years and regions as random intercepts. The model incorporated bipolar disorder (BD) rates and the male-to-female ratio of ASD-R diagnoses when justified. Separate models were created for combined sexes, males, and females.

Results: A significant inverse relationship was observed between ASD-R and MDD diagnosis rates across all sex groups. In the combined-sex model, the mean ratio was 0.40 (P = 0.003), while the sex-specific models showed ratios of 0.28 for males (P < 0.001) and 0.37 for females (P = 0.017). All ratios were significantly below 1, indicating a negative association between ASD-R and MDD diagnosis rates.

Conclusions: The study's observational nature limits causal inferences, but findings reveal that higher primary diagnosis rates of ASD-R correlate with lower primary diagnosis rates of MDD in adolescents of both sexes, although more pronounced in males. These results highlight the importance of further research on the relationship between ASD-R and MDD diagnosis rates, emphasizing the need for prospective, longitudinal, and individualized register data that include both primary and co-diagnoses.

Purpose: Proctitis distal to colorectal anastomosis is rare and infrequently reported. We evaluated the incidence, symptoms, treatment, and potential risk factors associated with this condition.

Methods: We conducted a retrospective population-based cohort study in V & auml;stmanland County, Sweden. This investigation included all patients who underwent sigmoidectomy with colorectal anastomosis between 2008 and 2020. We excluded patients without an anastomosis and those with inflammatory bowel disease.

Results: Of the 546 patients identified, 233 fulfilled the inclusion criteria, of whom 26 (11.2%) developed proctitis distal to colorectal anastomosis. The most frequent symptoms included urgency (n= 16, 61.5%), increased stool frequency (n= 12, 46.2%), and anorectal pain (n= 12, 46.2%). Endoscopic balloon dilation was performed in 20 cases (76.9%), with 10 requiring only a single therapeutic procedure. The median number of dilations was 3 (range, 1-8). Multivariable analysis revealed that surgery due to malignancy and emergency surgery were associated with elevated risk of proctitis. A subgroup analysis of patients who underwent surgery due to malignancy indicated that smoking (odds ratio, 3.9; 95% confidence interval, 1.1-14.0) and emergency surgery (odds ratio, 6.5; 95% confidence interval, 1.1-37.1) were also associated with increased proctitis risk.

Conclusion: Proctitis distal to colorectal anastomosis is not uncommon following sigmoidectomy. Patients undergoing emergency surgery or surgery due to malignancy and who had a history of smoking displayed an increased risk of developing proctitis. Due to the paucity of symptoms observed, particularly in patients with a diverting stoma, routine endoscopic rectal examination should be performed during follow-up after sigmoidectomy.

A unique internal mould of the patelliform mollusc Eesticonus aariensis n. gen. n. sp. is described from the Middle Ordovician (Darriwilian Series, Kunda Stage) of northern Estonia. Well-preserved muscle attachment scars are compared to those of Floripatella from strata of Middle Ordovician (Dapingian Series) age in Utah, originally considered to be the oldest known patelloidean gastropod but possibly an untorted mollusc. Comparison with the muscle scar pattern in Archinacellina from the Ordovician of Bohemia suggests that Eesticonus is an archinacelloidean gastropod, but not a patellogastropod.

A measurement of the invisible width of the boson using events with jets and missing transverse momentum is presented using 37 fb(-1) of 13 TeV proton-proton data collected by the ATLAS detector in 2015 and 2016. The ratio of Z -> inv to Z -> ll events, where inv refers to non-detected particles and l is either an electron or a muon, is measured and corrected for detector effects. Events with at least one energetic central jet with p(T) >= 110 GeV are selected for both the Z -> inv and Z -> ll final states to obtain a similar phase space in the ratio. The invisible width is measured to be 506 +/- 2 (stat.) +/- 12 (syst.) MeV and is the single most precise recoil-based measurement. The result is in agreement with the most precise determination from LEP and the Standard Model prediction based on three neutrino generations.

Background: While efforts to improve the educational preparedness of nurses to care for lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people have increased, the influence of role-modeled behaviors by healthcare professionals working with nursing students and recent graduates is not well understood. The purpose of this study is to describe the role-modeled behaviors of healthcare professionals observed by nursing students and recent graduates caring for LGBTQ+ patients in clinical settings.

Methods: A cross-sectional, online survey was conducted. Recruitment of nursing students who had completed one or more clinical rotations or were recent graduates (≤ 2 years) was performed through university emails and social media. Items included measurement of stigmatizing attitudes, observed stigmatizing behaviors, and ability to provide inclusive/affirming care for LGBTQ+ patients. Open-text items prompted participants to describe observed behaviors. Data were analyzed using descriptive statistics and Wilcoxon signed rank sum tests to evaluate differences between LGB (lesbian, gay, bisexual) and T+ (transgender and gender diverse) subscales. Open-text responses were analyzed using thematic analysis to identify relevant themes.

Results: Participants (N = 73) had a low level of stigmatizing attitudes toward LGBTQ+ people (M= 1.8, SD= 0.4), although higher stigmatizing attitudes toward T+ people were reported (M= 3.0, SD= 0.2; Z= -7.254, p < .001). Half of the participants reported that they observed LGBTQ+ stigmatizing behaviors role-modeled by two + healthcare professional roles; approximately one-third of participants personally engaged in one + LGBTQ+ stigmatizing behaviors, most commonly toward T+ people. Themes from participants' examples of observed stigmatizing behaviors included: cis-heteronormative bias, non-affirmation of chosen name/pronouns, outing patients, and rejected competency.

Conclusions: The majority of participants described observing stigmatizing behaviors toward LGBTQ+ people in clinical settings. Poorer attitudes and a higher frequency of stigmatizing behaviors observed towards T+ people point to deficits in healthcare provided to T+ people in particular. Efforts to address LGBTQ+ stigma in healthcare should be expanded to include clinical settings to address role-modeled behaviors and socialization of nurses.

E-science, or networked, collaborative and multidisciplinary scientific research on a shared e-infrastructure using computational tools, methods and applications, has also brought about new networked organizational forms in the transition of higher education towards the entrepreneurial academy. While the under-representation of women in ICTs is well-recorded, it is also known that the potential of new organizational forms such as networked structures to promote gender equality remains ambiguous, as they tend to perpetuate already existing inequalities due to their embeddedness in larger and longer-term structural or institutional gender effects. Based on a year-long ethnographic study in a networked academic e-science collaboration in Sweden and 45 in-depth, semi-structured interviews with its affiliated researchers, this article analyzes the multi-level obstacles to achieving gender equality in e-science to highlight the ways in which gendered disparities persist in this new, project-based academic networked organization in Sweden, hereafter called eSec. At the organizational level eSec remains deeply embedded in the traditional disciplinary and institutional academic setting, inadvertently reproducing existing gender imbalances across sciences. Furthermore, as a project-based organization, it is also embedded in the shift towards an entrepreneurial university model driven by new managerialism, the latter having a well-documented adverse effect in gender equality. This represents a structural-level obstacle which leads to especially female junior faculty leaving academy for industry. An individual level obstacle is observed alongside these as disavowal (Verleugnung) of gender disparities, an affect identified as a key mechanism of subjectivation in neoliberalism.

The mucin O-glycan sialyl Tn antigen (sTn, Neu5Acα2-6GalNAcα1-O-Ser/Thr) is an antigen associated with different types of cancers, often linked with a higher risk of metastasis and poor prognosis. Despite efforts to develop anti-sTn antibodies with high specificity for diagnostics and immunotherapy, challenges in eliciting high-affinity antibodies for glycan structures have limited their effectiveness, leading to low titers and short protection durations. Experimental structural insights into anti-sTn antibody specificity are lacking, hindering their optimization for cancer cell recognition. In this study, we used a comprehensive structural approach, combining X-ray crystallography, NMR spectroscopy, computational methods, glycan/glycopeptide microarrays, and biophysical techniques, to thoroughly investigate the molecular basis of sTn recognition by L2A5, a novel preclinical anti-sTn monoclonal antibody (mAb). Our data unequivocally show that the L2A5 fragment antigen-binding (Fab) specifically binds to core sTn moieties. NMR and X-ray structural data suggest a similar binding mode for the complexes formed by the sTn moiety linked to Ser or Thr and the L2A5 Fab. The sugar moieties are similarly oriented in the paratope of mAb, with the Neu5Ac moiety establishing key interactions with the receptor and the GalNAc moiety providing additional contacts. Furthermore, L2A5 exhibits fine specificity toward cancer-related MUC1 and MUC4 mucin-derived sTn glycopeptides, which might contribute to its selective targeting against tumor cells. This newfound knowledge holds promise for the rational improvement and potential application of this anti-sTn antibody in diagnosis and targeted therapy against sTn expressing cancers such as breast, colorectal, and bladder cancer, improving patient care.

The purpose of this study is to investigate how children's rights and their opportunities for active travel can be met in transport and urban planning. The project includes four sub-projects: a literature study, description of methods, workshops with civil servants and interviews with actors in traffic and urban planning.

Previous studies shows that children's health and well-being are affected by the physical and social environment. A child-friendly environment promotes active travel and improves children's health. The Convention on the Rights of the Child, which became law in Sweden 2020, requires that children are involved in decisions that affect them. Child Rights Impact Assessment (CRIA) are used to put the convention into practice, although application varies between municipalities. Clear political objectives, further training, and cooperation are crucial to ensuring that the best interests of the child are considered.

Methods and tools to highlight children's interests are presented, including dialogue-based methods, place-based methods, and GIS-based tools. Dialogues with children can be time-consuming but are crucial for understanding their experiences. Place-based methods assess the qualities of physical places, while GIS tools visualize geographical data. Combining these methods provides a comprehensive picture of children's needs. Workshops with officials from three municipalities discussed these methods. Participants emphasize the importance of understanding how children use their physical space and noted that site visits can identify deficiencies in safety and traffic security. GIS methods are regarded as useful in order to obtain an overall picture of children’s needs and preferences and could be combined with other methods to identify conflict of interest.

Interviews with officials and politicians showed that schools are important actors for establishing contact with children. Obstacles include a lack of resources and competence, as well as some reluctance to involve children. The Convention on the Rights of the Child supports working with children's issues, but the application of CRIA needs to be systematized.

The report concludes with four recommendations to strengthen work with the child perspective: early dialogue and continuous work, competence on children's needs, anchoring decisions at all levels, and combining methods for broader insights.

AgBiS2 nanocrystals have been shown to be a promising material for solar cell applications due to their high absorption coefficient, solution-processability and stability. However, detailed and systematic insight into how different surface passivation agents affect the overall material properties and corresponding device performance is still limited. Herein, a study about AgBiS2 nanocrystals treated with five different halide-based compounds - TBAI, TMAI, TBABr, TMABr and TMACl - is presented, with the nanocrystals themselves being synthesised via a newly adapted route under atmospheric conditions. For the differently passivated samples, variation in the ligand uptake, as well as shifts in the position of the valence and conduction bands could be observed. Incorporating these ligand-treated thin films into solar cell devices allowed for further investigation of their overall performance as well as into their respective charge carrier dynamics. Markedly longer charge carrier lifetimes were observed for the bromide- and chloride-passivated samples through transient photovoltage and photocurrent measurements as well as impedance spectroscopy. The effect of the surface modification on the charge carrier transport behaviour, on the other hand, was found to be less pronounced. Overall, this work demonstrates the importance of better understanding how different ligands affect nanocrystal properties, showcasing how it influences a wide variety of parameters controlling final device performance.

The paternally inherited, male-specific part of the Y chromosome (MSY) is an ideal marker for studying the origin, genealogies, and historical connections of horse patrilines. Here, we performed fine-scaled MSY haplotype (HT) analysis in two Baroque horse breeds, the Lipizzaner and the Kladruber, both known for their long-standing tradition of sire line breeding and interconnected genealogies. We genotyped 95 MSY markers using KASP^TM technology in 90 stallions representing all patrilines of both breeds. We identified 14 HTs across eight Lipizzaner sire lines and six HTs in eight Kladruber lines. Y-chromosomal analysis confirmed the presumed Arabian and Iberian origins of two Lipizzaner and two Kladruber foundation sires. Interestingly, six Lipizzaner sire lines clustered into the MSY haplogroup (HG) daC_Tb, a HG previously associated with the Turkoman horse, suggesting a Turkish origin of several Lipizzaner foundation sires, contrary to documented records. We also found evidence for an undocumented Arabian founder in the Lipizzaner breed. Furthermore, three private HTs were detected in Kladruber horses, highlighting the uniqueness of their foundation sires. HTs in shared patrilines between Lipizzaner and Kladruber were consistent, while three Lipizzaner sublines showed discrepancies between MSY results and recorded pedigree data. In conclusion, MSY haplotyping validated historical breed documentation, revealed new insights into the origins and distribution of sire lines, and proved effective in resolving parentage issues across generations.

With the increasing popularity of the Metaverse concept, human beings have stepped to a new height in the intelligent technology progress. This work presents a literature review of the current research on Human-Computer Interaction in the Metaverse. Keywords like "Metaverse," "Human-Computer Interaction (HCI)," "virtual space," "virtual technology," "three-dimensional (3D) reconstruction," "parallel universe," "independent identity," "access to interests," and "blockchain" are used to search for relevant articles in the literature in databases like Scopus, Web of Science, and Google Academic. Nearly 100 advanced studies on the Metaverse are selected from over 20,000 documents covering 2018-2023. Finally, the current application state of the Metaverse's underlying technologies is explored and described using the PRISMA principles; these technologies include the fifth-generation (5 G) communication, HCI, virtual technology, blockchain, and 3D reconstruction. Moreover, the predictions for HCI's future growth in the Metaverse are made. The review concludes that the rapid advancement of the 5 G connection has made the concept of the Metaverse possible. The blockchain ensures the safety of currency transactions in the Metaverse virtual space. There will be a shift toward "invisibility" in the way that humans and computers interact in virtual worlds. In other words, HCI will be transparent to the user in the digital realm, and people will get along with the computer in a natural and equitable way. In the interaction, wearable devices allow for an immersive experience in the interaction, but they restrict the participants' freedom of movement and perception. The more humanized somatosensory connection will gain traction in the future, bringing people one step closer to the Metaverse.

Vibrio parahaemolyticus (Vp) and Vibrio harveyi (Vh) are two pathogenic vibriosis causing agents which are prevalent in commercial aquaculture practices. In spite of the increasing Antimicrobial Resistance (AMR) in pathogenic organisms due to inappropriate usage of conventional antibiotics, there is an urgent need of alternative therapeutic antimicrobials. Metallic nanoparticles, particularly silver nanoparticles (AgNPs), are considered effective antimicrobials against a wide spectrum of microorganisms. Tunable properties such as size, shape, and surface functionalization enhance the properties and activities of AgNPs. Studies have explored the use of carbon dots (CDs) as an alternative source for reducing and capping AgNPs, given the limitations of using plant extracts as reducing agents for AgNP synthesis. Most of the studies synthesized CDs using various chemical precursors; however, plant-derived or biomass-derived CDs offer several advantages, such as biocompatibility, easy availability of precursors, renewability, hydrophilicity, and no requirement of heteroatom doping. In the present study, an eco-friendly hydrothermal technique was employed to synthesize high fluorescent, Biomass derived carbon dots (CDs) from the leaves of two medicinal plants, Aegle marmelos (AM) and Euphorbia hitra (EH). These CDs were then used as reducing agents for the green synthesis of silver nanoparticles (AgNPs). The absorbance peaks of synthesized AM CDs and EH CDs were at 267 nm and 274 nm, indicating π–π* electronic transitions. Upon adding CDs to AgNO₃ led to a decline in CD absorption peaks and the emergence of AgNP SPR peaks at 467 nm and 479 nm, confirming AgNP formation. AM CDs showed a narrow peak at 530 nm (excitation at 360 nm), while EH CDs had a broad peak at 560 nm and AM CDs exhibited a narrow peak at 530 nm. AgNP@CD NCs did not emit luminescence, likely due to quenching during the AgNPs reduction. FTIR identified O-H, C≡C, and N-H functional groups in CDs. AgNP@AM CD NCs showed minor vibrational signals, while AgNP@EH CD NCs showed a complete reduction. The average particle sizes of the synthesized AgNPs were 8.51 nm and 23.59 nm for AM and EH, respectively. The synthesized AgNP@CD nanocomposites showed effective antivibriocidal activity with the lowest Minimum Inhibitory Concentration (MIC) of 3.9 μg/mL on Vibrio parahaemolyticus (Vp) by EH AgNP@CD NCs. The in vitro antioxidant studies revealed effective radical scavenging activity with the lowest IC₅₀ value of 5.29 μg/mL on DPPH nitrogen free radical by AM AgNP@CD NCs. The present study found effective antivibriocidal and antioxidant properties of biomass derived AgNP@CD NCs.

The genus Paramollugo Thulin (Molluginaceae) comprises herbs or small shrubs or subshrubs mainly distributed in the Madagascar region, but one species also widespread in the tropics and subtropics of the Old World, two restricted to the Caribbean and one to New Caledonia. In the revision presented here 11 species are recognized: P. decandra (Scott Elliot) Thulin, P. caespitosa (Scott Elliot) Thulin comb. nov., P. compressa Thulin sp. nov., P. simulans Sukhor. and P. elliotii Sukhor. endemic to Madagascar, P. nudicaulis (Lam.) Thulin in Madagascar and also widespread on neighbouring islands and in tropical and subtropical parts of Africa and Asia, P. angustifolia (M.G. Gilbert & Thulin) Thulin in Madagascar and Somalia, P. digyna (Montrouz.) Sukhor. endemic to New Caledonia, P. nesophila Thulin et al. sp. nov. endemic to îles Éparses (Scattered Islands) in the Mozambique Channel, P. spathulata (Sw.) Sukhor. widespread in the Caribbean, and P. cuneifolia (Griseb.) Thulin endemic to Cuba. For each species descriptions and discussions are provided, as well as illustrations and distribution maps. New lectotypes are designated for Mollugo caespitosa Scott Elliot and M. digyna Montrouz. The phylogeny of the genus is reconstructed based on plastid trnK-matK and nuclear ITS sequences. Conflict between the datasets is seen as a result of the genus probably being a polyploid complex. Dating of the phylogeny resulted in two alternative topologies, both estimating the age of the stem clade to the Eocene, with a presumed origin in Africa, and mid-Miocene as the age of the crown clade, with a presumed origin in Madagascar and/or the Caribbean. The age of the crown clade is also the estimated date for a split between a Caribbean clade and the rest of the genus, long distance dispersal from Madagascar to the Greater Antilles being the most likely explanation.

This article describes the architecture life cycle effect analysis (ALCEA) method, a structured method for evaluating proposed new architectures for software-intensive systems. The method evaluates a proposed architecture by quantifying its effect on the performance of system life-cycle phases. The method is instantiated by identifying the relevant life-cycle phases of the system under investigation and a set of evaluation functions that capture, in terms of basic factors, the effect of different architectural decisions on key life-cycle PAs, such as revenue, operating resources, and investments. The method results in a transparent cost and revenue structure, documented in a tabular form, based on quantifiable factors from the developing organization. The results of the method can be used directly as part of a business case, and their robustness can be estimated by sensitivity analysis. The ALCEA method is designed for system-level architectural analysis, covering both software and hardware aspects. In this article, we introduce the ALCEA method and provide a detailed example of how to apply it in the evolution of embedded systems. Moreover, we share early experiences of using the method in large-scale industrial settings.

Sensorimotor difficulties are common in children with autism spectrum disorder, and it has been suggested that motor planning problems underlie their atypical movements. At early school-age, motor planning development typically involves changes in visuomotor integration, a function known to be affected in autism spectrum disorder. However, there is a lack of detailed characterization of typical motor planning development during this stage, and how motor planning develops in children with autism spectrum disorder is largely unknown. This longitudinal kinematic study examined goal-directed sequential manual movements in children with autism spectrum disorder and in typically developing children across ages 7, 8, and 9 years. We manipulated goal-difficulty and availability of initial visual information to investigate visuomotor integration and chaining of subparts during movement performance. The results revealed emerging group differences at older age, suggesting atypical motor planning development in children with autism spectrum disorder. Notably, unlike the typically developing group, availability of initial visual information did not facilitate motor planning for the autism spectrum disorder group. The results show that motor planning differences in autism spectrum disorder appear related to atypical visuomotor integration and global processing of sensorimotor information. The findings also emphasize the importance of considering developmental aspects in research and practice related to motor problems in children with autism spectrum disorder.

The problem of determining the maximum number of maximal independent sets in certain graph classes dates back to a paper of Miller and Muller and a question of Erdos and Moser from the 1960s. The minimum was always considered to be less interesting due to simple examples such as stars. In this paper we show that the problem becomes interesting when restricted to twin-free graphs, where no two vertices have the same open neighbourhood. We consider the question for arbitrary graphs, bipartite graphs and trees. The minimum number of maximal independent sets turns out to be logarithmic in the number of vertices for arbitrary graphs, linear for bipartite graphs and exponential for trees. In the latter case, the minimum and the extremal graphs have been determined earlier by Taletskiii and Malyshev, but we present a shorter proof.

This publication is a culmination of the challenges, lessons learned, and good practices of cycling in the capital cities and regions of the Nordic countries. Derived from the research and discussions among network participants, this publication highlights eight common myths about the role of the bicycle as a mode of transport in the Nordic Region. Each myth is followed by an evidence-based rebuttal, confronting the inaccurate claims and uprooting the underlying problem. After each reality statement, we provide suggestions and good practices, based on both desk research and contributions from practitioners in the Nordic Cycle Power Network.

Background: Sarcoidosis is an immune-mediated inflammatory disease whose natural development is not well understood. We aimed to determine if inflammatory plasma protein levels are elevated before sarcoidosis diagnosis compared to controls. Furthermore, we investigated which proteins are increased and how long before diagnosis they are increased.

Methods: Cases with sarcoidosis and controls matched 2:1 on sex, birthdate, subcohort and sample date were identified in the Northern Sweden Health and Disease Study to perform a nested case–control study. Cases were validated and included if they provided one or more plasma samples at least 2 years before sarcoidosis diagnosis. Plasma protein levels were measured using the Olink Inflammation panel and expressed in normalised protein expression values. Unconditional logistic regression models adjusted for age, sex, subcohort and time since sampling were used to estimate log odds ratios with 95% confidence intervals for each protein overall and by time to diagnosis. p-values were adjusted for multiple comparisons using the Benjamini–Hochberg method.

Results: We included 152 cases and 341 controls. Mean time between sample and sarcoidosis diagnosis was 13.4 years. 44 proteins were significantly elevated prior to sarcoidosis compared to controls in multivariable-adjusted analyses. The 10 proteins with the lowest p-values were CCL-3, CCL-19, cub domain-containing protein 1, CXCL9, CXCL10, interferon-γ, interleukin-12B, monocyte chemoattractant protein-3, tumour necrosis factor (TNF), and TNF receptor superfamily 9. Fewer proteins were associated with sarcoidosis in samples taken longer before diagnosis. Restricting to samples taken ≥10 years prior to sarcoidosis diagnosis, 27 proteins remained statistically significant.

Conclusion: Several inflammatory proteins were elevated in plasma many years before sarcoidosis onset compared to controls, revealing a pre-clinical phase characterised by inflammation.

IntroductionChildhood obesity is associated with maternal obesity, but the link to gestational weight gain (GWG) is not fully elucidated. We examined the relationship between early pregnancy maternal body mass index (BMI) and GWG on early childhood growth.Material and MethodsData from 30 197 mother-child pairs from Uppsala County Mother and Child Cohort were divided into 15 groups according to maternal BMI and GWG, based on World Health Organization classification and Institute of Medicine guidelines, respectively. Postnatal growth patterns were analyzed with linear mixed regression models within maternal BMI groups. Odds ratios of overweight and obesity at 4 years of age were assessed with logistic regression analyses. We treated children of mothers with normal weight and adequate GWG as the reference group, and all analyses were adjusted for potential confounders.ResultsGWG was associated with infant BMI z-score at birth, independent of potential confounding factors. Independent of GWG, we observed an overall decrease in BMI z-score from 18 months to 5 years in children of mothers who were underweight, while an increase in BMI z-score was seen in children of mothers who were overweight or obese. In children of normal- and overweight mothers, the risk of childhood overweight and obesity was associated with excessive compared to adequate GWG (adjusted odds ratio [aOR] 1.17, 95% confidence interval [CI] 1.01-1.36 for normal-weight mothers, and aOR 1.25, 95% CI 1.04-1.51 for overweight mothers, respectively). Children of mothers with obesity and excessive GWG had the highest risk of being overweight or obese at 4 years (aOR 2.88, 95% CI 2.40-3.44, and 4.38, 95% CI 3.37-5.67, respectively). Associations did not differ between children of mothers with obesity class 1 and 2-3 when comparing excessive and adequate GWG (aOR 1.33, 95% CI 0.96-1.85, and 1.12, 95% CI 0.74-1.70, respectively).ConclusionsMaternal GWG affects infant birth size and growth until 18 months, although maternal BMI is more crucial for childhood growth beyond 18 months. Further, children of mothers who are normal- or overweight and experience excessive GWG have an increased risk of obesity at 4 years. Maternal gestational weight gain (GWG) affects growth patterns in early childhood. Excessive GWG increases the risk of overweight and obesity in children of mothers with normal weight and overweight, while children of mothers with obesity are at increased risk of childhood overweight and obesity independent of GWG.image

This work presents a matrix-free finite element solver for finite-strain elasticity adopting an hpmultigrid preconditioner. Compared to classical algorithms relying on a global sparse matrix, matrix-free solution strategies significantly reduce memory traffic by repeated evaluation of the finite element integrals.

Following this approach in the context of finite-strain elasticity, the precise statement of the final weak form is crucial for performance, and it is not clear a priori whether to choose problem formulations in the material or spatial domain. With a focus on hyperelastic solids in biomechanics, the arithmetic costs to evaluate the material law at each quadrature point might favor an evaluation strategy where some quantities are precomputed in each Newton iteration and reused in the Krylov solver for the linearized problem. Hence, we discuss storage strategies to balance the compute load against memory access in compressible and incompressible neo-Hookean models and an anisotropic tissue model. Additionally, numerical stability becomes increasingly important using lower/mixed-precision ingredients and approximate preconditioners to better utilize modern hardware architectures.

Application of the presented method to a patient-specific geometry of an iliac bifurcation shows significant speed-ups, especially for higher polynomial degrees, when compared to alternative approaches with matrix-based geometric or black-box algebraic multigrid preconditioners.

The Singaporean state is often conceptualised as neoliberal, but I argue that this conceptualisation is mistaken. While Singapore embraces the neoliberal 'all you have is yourself' ethos, I contend, the state does not apply this ethos to individuals and families, but to society as a whole: to the relation between Singapore and 'the world', rather than to the domestic realm within Singapore. That is, Singapore is a communalist and not an individualist society - a society in which the group is paramount, and in which the rights and responsibilities of individuals are subordinated to group interests. I introduce the term 'middleman minority state' (MM state) to capture this social phenomenon, whereby the state scales up the tactics of the classic middleman minority to the level of a small nation-state. I argue that the uniqueness of Singapore as a polity is not fully reflected in 20th-century economists' views on society and economics, which provide only a partial map of Singapore. Instead, we must look to Singapore's history as a centre for middleman minorities, whose values and behaviour patterns were transformed into a successful state strategy as the country became an independent nation-state in the 1960s.

Combinations of colistin and beta-lactam/beta-lactamase inhibitors (BLBLIs) have shown in vitro synergy against beta-lactamase-producing strains. However, data are limited and conflicting, potentially attributed to variations among the examined strains. This study investigated whether loss of porins OmpK35 and OmpK36 impacts the synergistic potential of colistin in combination with ceftazidime-avibactam or meropenem-avibactam against beta-lactamase-producing Klebsiella pneumoniae. Genetically modified strains were constructed by introducing bla(CTX-M-15), bla(KPC-2), and bla(OXA-48) chromosomally into K. pneumoniae ATCC 35657, in which the major porin-encoding genes (ompK35, ompK36) were either intact or knocked out. The in vitro activity of colistin in combination with ceftazidime-avibactam or meropenem-avibactam was evaluated by time-lapse microscopy screening and in static time-kill experiments. The deletion of porins in the beta-lactamase-producing strains resulted in 2- to 128-fold increases in MICs for the beta-lactams and BLBLIs. The activity of avibactam was concentration-dependent, and 4- to 16-fold higher concentrations were required to achieve similar inhibition of the beta-lactamases in strains with porin loss. In the screening, synergy was observed for colistin and ceftazidime-avibactam against the CTX-M-15-producing strains and colistin and meropenem-avibactam against the KPC-2- and OXA-48-producing strains. The combination effects were less pronounced in the time-kill experiments, where synergy was rarely detected. No apparent associations were found between the loss of OmpK35 and OmpK36 and combination effects with colistin and BLBLIs, indicating that additional factors determine the synergistic potential of such combinations.

Thiele's Hydrocarbons (THs) featuring a 9,10-anthrylene core with switchable geometric and electronic configurations offer exciting possibilities in advanced functional materials. Despite significant advances in main group-based diradicaloids in contemporary chemistry, main group THs containing an anthrylene cores have remained elusive, primarily due to the lack of straightforward synthetic strategies and the inherent high reactivity of these species. In this study, we utilize an anthracene-based phosphine synthon to demonstrate, for the first time, a facile and high-yielding synthetic strategy for robust P-functionalized overcrowded ethylenes (OCEs) within the TH family. These OCEs feature a non-symmetric environment, incorporating (thio) xanthyl and phosphaalkene termini. We systematically probe the electronic structures of these derivatives to illustrate the impact of the isolobal phosphaalkene motif on the quinoidal/diradicaloid character. Notably, the compounds exhibit dynamic redox behavior, leading to orthogonally twisted conformational changes upon oxidation, with a kinetically locked redox-couple.

Quantitative transcriptomics offers a new way to obtain a detailed picture of freshly isolated cells. By direct isolation, the cells are unaffected by in vitro culture, and the isolation at cold temperatures maintains the cells relatively unaltered in phenotype by avoiding activation through receptor cross-linking or plastic adherence. Simultaneous analysis of several cell types provides the opportunity to obtain detailed pictures of transcriptomic differences between them. Here, we present such an analysis focusing on four human blood cell populations and compare those to isolated human skin mast cells. Pure CD19⁺ peripheral blood B cells, CD14⁺ monocytes, and CD4⁺ and CD8⁺ T cells were obtained by fluorescence-activated cell sorting, and KIT+ human connective tissue mast cells (MCs) were purified by MACS sorting from healthy skin. Detailed information concerning expression levels of the different granule proteases, protease inhibitors, Fc receptors, other receptors, transcription factors, cell signaling components, cytoskeletal proteins, and many other protein families relevant to the functions of these cells were obtained and comprehensively discussed. The MC granule proteases were found exclusively in the MC samples, and the T-cell granzymes in the T cells, of which several were present in both CD4⁺ and CD8⁺ T cells. High levels of CD4 were also observed in MCs and monocytes. We found a large variation between the different cell populations in the expression of Fc receptors, as well as for lipid mediators, proteoglycan synthesis enzymes, cytokines, cytokine receptors, and transcription factors. This detailed quantitative comparative analysis of more than 780 proteins of importance for the function of these populations can now serve as a good reference material for research into how these entities shape the role of these cells in immunity and tissue homeostasis.

Aims: Doctors have an increased risk of SARS-CoV-2 infection caused by exposure to contagious patients. We aimed to identify which clinical specialities among medical doctors had the highest occupation-related risk of testing positive for SARS-CoV-2, utilizing data for all publicly employed medical doctors in Sweden.

Methods: Data regarding positive SARS-CoV-2 test results and employment for publicly employed doctors in Sweden were divided into three observation periods: 1) 1 February to 31 December 2020, 2) 1 January to 30 June 2021 and 3) 1 July 2021 to 31 March 2022. Individuals were stratified according to occupation clinic and compared with clinical occupations with little to no patient contact. The risk of testing positive for SARS-CoV-2 was estimated using Cox proportional hazards regression, with sex, age and vaccination status as covariates.

Results: The study cohort included all publicly employed doctors in Sweden: 35,028 individuals. In the first period, Infectious Disease doctors had the highest incidence of SARS-CoV-2 positive tests, with an incidence of 20.2 %, compared with 8.7 % in the reference group, and an adjusted hazard ratio of 2.5 (95% confidence interval 2.02–3.04), which decreased during period 2–3. Doctors in Geriatric Medicine had an elevated risk throughout the whole study period.

Conclusions: Our study shows an association between working in a speciality that involves caring for contagious COVID-19 patients, which raises concerns about infection control measures and routines being insufficient to prevent occupational infection in future pandemics.

Introduction: Brachial plexus birth injury (BPBI) has an incidence of 0.9 per 1,000 live births in the population. Techniques for repair classically include supraclavicular exploration and nerve grafting (SENG) and more recently nerve transfer, namely of the spinal accessory nerve (SAN) to the suprascapular nerve (SSN) to improve functional outcomes such as glenohumeral abduction and external rotation. This systematic review was conducted to evaluate whether spinal accessory nerve transfer produced significantly better outcomes for shoulder abduction in BPBI.

Methods: A search was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analysis Individual Patient Data guidelines. Standardized comparisons were made using the Mallet Score for shoulder abduction.

Results: 10 full-text articles with itemized patient outcome measures were selected. 110 patients were identified with 51 patients in the SENG group and 59 patients in the SAN transfer group. The mean shoulder abduction Mallet score in the SENG group was 3.50 ± 0.84, while the mean Mallet score in the SAN transfer group was 3.58 ± 0.77, which displayed no significant differences (p = 0.9012). There was no significant relationship between the age at time of surgery and post-operative Mallet scores for shoulder abduction after SENG (p = 0.3720).

Discussion: Our systematic review found that there was no difference observed in post-operative outcomes of shoulder abduction when comparing SAN transfer and nerve grafting. Continued support for nerve grafting lies in the argument that it incorporates the patient's native neuroanatomy and allows for sensory reinnervation.

Rehmannia glutinosa, an extensively utilized Chinese herbal medicine, is highly valued for its medicinal properties. In this study, the complete mitochondrial genome (mitogenome) of R. glutinosa was sequenced and assembled for the first time. The mitogenome is 547,032 bp in length, with an overall GC content of 44.97%. The mitogenome contains 67 unique genes, comprising 43 protein-coding, three rRNA, and 21 tRNA genes, with six protein-coding and nine tRNA genes being chloroplast-derived. The phylogenetic analysis, based on the maximum-likelihood criterion, demonstrated that R. glutinosa is closely related to Aeginetia indica and Castilleja paramensis within the family Orobanchaceae.

The waste hierarchy prioritises reuse over recycling, energy recovery, and disposal. However, exporting textiles for reuse in developing countries has raised concerns about factors such as waste management, challenging the hierarchy’s priorities when geographical context is considered. The aim of this study is to support European stakeholders in future textile management decisions by evaluating the environmental, social, and economic sustainability of different approaches to managing textiles collected in Sweden.

This study examines key reasons (for and against) that influence business-to-business (B2B) managers’ intention to adopt generative artificial intelligence (GenAI). We also investigate how GenAI adoption influences firm performance, along with the moderating effect of ethical leadership. Study 1 undertakes a series of in-depth interviews, yielding a set of hypotheses that are tested in Study 2. A total of 277 responses was collected from respondents in the USA, the UK, Canada, India, Australia, Malaysia, and Japan to test the proposed model using structural equation modeling. The findings highlight that need for uniqueness, information completeness, convenience, and deceptiveness significantly impact GenAI adoption. The results also highlight that GenAI adoption boosts firm performance. Finally, ethical leadership was found to moderate the effect of GenAI adoption on firm performance. This study enriches the GenAI, technology adoption, and behavioral reasoning theory literatures while also providing pertinent insights for firms intending to adopt GenAI.

In disciplines like toxicology and pharmacology, oxygen (O-2) respiration is a universal metric for evaluating the effects of chemicals across various model systems, including mammalian and microalgal cells. However, for these cells the common practice is to segregate populations into control and exposure groups, which assumes direct equivalence in their responses and does not take into account heterogeneity among individual cells. This lack of resolution impedes our ability to precisely investigate differences among experimental groups with small or limited sample sizes. To overcome this barrier, we introduce SlipO(2)Chip, an innovative glass microfluidic platform for precisely quantifying single-cell O-2 respiration in the coordinated absence and presence of chemical solutes. SlipO(2)Chip comprises a wet-etched fused silica channel plate on the top and a dry-etched borosilicate microwell plate at the bottom. The microwells are coated with Pt(ii) meso-tetra(pentafluorophenyl)porphine (PtTFPP), an O-2 sensing optode material and an O-2-independent reference dye. A custom 3D-printed holder facilitates the controlled horizontal movement ('slipping') of the channel plate over the microwell plate, thereby establishing or disrupting the fluid path over microwells. Collectively, these design elements enable the immobilization of single-cells in microwells, their exposure to controlled fluid flows, the coordinated opening and closing of microwells and repeated measurements of single-cell O-2 respiration. Uniquely, by sequentially executing opening and closing it becomes possible to measure single-cell respiration prior to and after exposure to chemical solutes. In a proof-of-concept application, we utilized SlipO(2)Chip to measure the impact of increasing exposures of the marine bacterial signal 2-heptyl-4-quinolone (HHQ) on the dark respiration of the diatom Ditylum brightwellii at single-cell resolution. Results revealed a concentration-dependent decrease in per-cell O-2 dark respiration, with a maximum reduction of 40.2% observed at HHQ concentrations exceeding 35.5 mu M, and a half-maximal effective concentration (EC50) of 5.8 mu M, consistent with that obtained via conventional bulk respiration methods. The ability of SlipO(2)Chip to sequentially assess the effects of chemical substances on single-cell O-2 metabolism is advantageous for research where sample volumes are limited, such as clinical biopsies, studies involving rare microbial isolates, and toxicological studies aiming to address exposure effects while accounting for cell-to-cell variability.<br />

Phosphorus (P) is one of the most important elements for soil biology and biogeochemistry worldwide. Yet, despite decades of research, important uncertainties persist about the drivers and changes in soil P forms during long-term soil formation. Here, we analyzed topsoils from nine globally distributed retrogressive soil chronosequences aiming to evaluate the relative contribution of key environmental factors (that is, soil age, substrate origin, climate, soil attributes, and vegetation) in explaining the long-term dynamics of primary, occluded, non-occluded, organic, and total P across different terrestrial ecosystems. We found that, rather than soil age, substrate origin was the main driver controlling the fate of different P fractions across contrasting environmental conditions. Moreover, our findings suggest that temporal patterns governing the long-term dynamics of different P forms as soils develop are not consistent among soil chronosequences, which is a result of contrasting environmental conditions, especially substrate origin. We further showed that topsoil total P was the greatest at intermediate soil development stage across the globe. Lastly, our results showed that P fractions were highly correlated with multiple surrogates of ecosystem services, such as carbon sequestration, plant productivity, and biodiversity. Together, our work provides new insights into the natural history of P availability, and further highlights that substrate origin, rather than soil age, is essential to predict changes in P availability in response to physical perturbation and climate change.

Although inflammation may disrupt immunoendocrine crosstalk essential for female reproductive function, causal links to disorders like polycystic ovary syndrome (PCOS) and endometriosis remain unestablished. This study aimed to utilise Mendelian randomisation (MR) methods to explore causal associations between serum inflammatory markers and common reproductive disorders, aiming to identify novel mechanisms and potential avenues for treatment. Total causal effects of serum inflammatory markers (interleukins, monocyte chemoattractant protein-1, etc.) on female reproductive disorders in large sample cohorts of Finnish ancestry were assessed using univariable two-sample MR methods, including the inverse variance weighted (IVW) method as the primary analysis, with relevant quality assessments (e.g., leave-one out, heterogeneity, and horizontal pleiotropy testing). The main outcome measures were PCOS (642 cases and 118,228 controls) and endometriosis (8288 cases and 68,969 controls) from the FINNGEN cohort. Monocyte chemoattractant protein-1/C-C motif chemokine ligand demonstrated a positive causal association with polycystic ovary syndrome (odds ratio [95% CI]: 1.48 [1.10, 2.00], p = 0.0097), while higher interleukin-9 levels were positively associated with endometriosis (1.15 [1.02, 1.30], p = 0.0277), both via the IVW method. These markers should be investigated as key candidates for future research into the mechanistic pathways underpinning these conditions.

Online advertising opportunities are bought and sold in automated auctions driven by real-time bidding. In the case of contextual advertising, the size of a bid is informed by the media context in which the ad will be displayed. In contrast to personalised advertising, contextual advertising is better aligned with privacy acts such as GDPR and CCPA. We investigate how reinforcement learning with human feedback can help optimise contextual advertising under budget constraints. We propose a dynamic epsilon-greedy algorithm that considers the rate of budget consumption during a finite transaction time. The goal is to maximise long-term rewards in a sustainable manner. Our comparative evaluation of fundamental reinforcement learning algorithms on real data suggests that the approach is feasible and effective.

Neuroblastoma is a pediatric cancer with a five-year survival rate of merely 50% for high-risk cases. The treatment regimen is aggressive, leading to extensive side effects that significantly impact patients’ quality of life.

Targeted radionuclide therapy (TRT) involves the systemic administration of cancer-specific radioconjugates. This thesis focuses on TRT against the somatostatin receptor 2 (SSTR2) and the antigen CD44v6, two targets that are overexpressed in neuroblastoma,  

Radiosensitization renders cells more sensitive to radiation, which can improve the therapeutic efficacy and potentially reduce the radiation dose required to achieve an antitumor effect. This thesis investigates radiosensitization through the stabilization of p53 and the inhibition of heat shock protein 90 (HSP90), two proteins involved in the cellular response to DNA damage.

In papers I and II, we investigated the combination of the SSTR2-targeting radioconjugate ¹⁷⁷Lu-DOTATATE with the p53-stabilizing peptide VIP116 for neuroblastoma treatment. The combination therapy demonstrated enhanced antitumor effects in both in vitro and in vivo studies using mice bearing human neuroblastoma xenografts. Notably, the untreated and monotreated controls showed no nephrotoxicity.

In paper III, we demonstrated that combining external beam radiotherapy with the HSP90-inhibitor Onalespib produced additive or synergistic effects in vitro across a panel of neuroblastoma cell lines. Additionally, mice bearing syngeneic neuroblastoma tumor xenografts treated with this combination exhibited significantly improved therapeutic efficacy compared to control groups.

In paper IV, we developed and characterized human anti-CD44v6 antibodies for molecular radiotherapy. This work identified a lead candidate, UU-40, which demonstrated high affinity, strong tumor uptake, and favorable in vivodistribution, making it a promising candidate for future use against CD44v6-expressing cancers.

In conclusion, this thesis demonstrates that radiosensitization enhances the antitumor effects of radiation therapy in preclinical models of neuroblastoma. It is our hope that these discoveries will enable more effective and less harmful treatments for children with neuroblastoma. This thesis also produced an anti-CD44v6 antibody that holds great potential for future use in targeted radionuclide therapy, paving the way for innovative treatments for CD44v6-expressing cancers, including neuroblastoma. 

Digitalization drives societal transformation to reform existing practices in the evolving environment. Central to this transformation is the creation of interoperable digital public services across diverse organizations, increasingly guided by human-centric principles and life-event orientation. This paper explores the complex process of achieving digital service innovation, emphasizing the need for inter-organizational balancing between radical transformation and efficiency through collective ambidexterity, where multiple ecosystem actors coordinate to balance innovation and efficiency simultaneously. While previous research predominantly studied ambidexterity at the organizational level, focusing on its antecedents, mechanisms, and outcomes, our study extends this inquiry to the broader ecosystem. Via a single-case study, we investigate how collective ambidexterity can be governed in a large-scale digital service ecosystem. To address the research question, we developed a multi-level conceptual model of governing mechanisms, antecedents, and outcomes of collective ambidexterity across three analytical levels: the ecosystem, organization group, and organization. Our theoretical contribution is twofold. First, we enhance conceptual clarity on collective ambidexterity and show how Modes of Collaboration (MoC) can facilitate innovation and efficiency of human-centric digital services throughout the three levels of governance. Second, the resulting governance model emphasizes the need to connect centralized, decentralized, and group-level governance strategies for developing digital services—to achieve and govern collective ambidexterity in the development of digital services in the public sector.