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Abstract We analyze the chiral separation effect (CSE) in QCD by using the gauge/gravity duality. In QCD, this effect arises from a combination of chiral anomalies and the axial U(1) anomaly. Due to the axial gluon anomaly, the value of the CSE conductivity is not determined by the anomalies of QCD but receives radiative corrections, which leads to nontrivial dependence on temperature and density. To analyze this dependence, we use different variants of the V-QCD, a complex holographic model, carefully fitted to QCD data. We find our results for the anomalous CSE conductivity at small chemical potential and nonzero temperature to be in good qualitative agreement with recent results from lattice QCD simulations. We furthermore give predictions for the behavior of the conductivity at finite (vectorial and axial) chemical potentials.

Background:. The Finnish Shaft of the Humerus (FISH) trial compared open reduction and internal plate fixation (ORIF) with functional bracing in adult patients with displaced, closed humeral shaft fractures. Here, we compare the results of the patients in the randomized clinical trial (RCT [the randomized cohort]) with those of the cohort of patients who were also eligible but declined randomization (the nonrandomized cohort) to investigate if patients’ treatment preference was associated with the outcomes during a 2-year follow-up. Methods:. A total of 321 patients were treated at 2 university hospitals in Finland between November 2012 and January 2018. Of the 140 eligible patients, 82 were randomized to ORIF or functional bracing. Of the 58 patients declining randomization, 42 consented to participate in a nonrandomized cohort in which the patients were able to choose the treatment method. The primary outcome of this study was the Disabilities of the Arm, Shoulder and Hand (DASH) score. Patients in the randomized cohort and the nonrandomized cohort were analyzed separately in 3 groups: those who had (1) initial surgery, (2) successful functional bracing, and (3) late surgery due to failed functional bracing. We used mixed-model, repeated-measures analysis of variance to compare the treatment effect among the 3 groups. Results:. In the randomized cohort, 38 patients had an initial surgical procedure. Of the 44 patients randomized to functional bracing, 30 (68%) healed successfully and 14 (32%) underwent a late surgical procedure. In the nonrandomized cohort, 9 patients preferred an initial surgical procedure. Of the 33 patients preferring functional bracing, 26 (79%) healed successfully and 7 (21%) underwent late surgery. The DASH scores in the randomized cohort and the nonrandomized cohort were 6.8 (95% confidence interval [CI], 2.3 to 11.4) and 12.3 (95% CI, 0.3 to 24.3) for the initial surgery groups, 6.0 (95% CI, 1.0 to 11.0) and 3.4 (95% CI, 0 to 9.3) for the bracing groups, and 17.5 (95% CI, 10.5 to 24.5) and 20.5 (95% CI, 9.4 to 31.6) for the late surgery groups at 2 years. Conclusions:. The results of the randomized cohort and the nonrandomized cohort were comparable and suggest that patients’ treatment preferences are not associated with the treatment outcomes of these injuries. Level of Evidence:. Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Objectives: To investigate the cost-effectiveness of protein-rich meals and snacks for increasing protein intake in home-dwelling older adults. Design: Cost effectiveness analysis from a randomized controlled trial, the Power Meals study. Setting: Participants were randomized into one of three groups for eight weeks: a protein-rich meal, snack and bread (Protein), a regular meal (Normal) and a control group without meal service (Control). Participants: Home-dwelling home care clients, caregivers and care recipients aged ≥65 years (n = 65). Measurements: Protein intake was assessed by a three-day food diary at the end of the study. Cost for the daily diet was estimated by using Finnish grocery store databases and the prices of the food service. The cost-effectiveness was assessed by an incremental cost-effectiveness ratio (ICER). Results: Costs for the daily diet in the Protein (8.35 €/d) and the Normal (7.94 €/d) groups were significantly higher than in the control group (5.65 €/d) (p

BackgroundPervasive technologies are used to investigate various phenomena outside the laboratory setting, providing valuable insights into real-world human behavior and interaction with the environment. However, conducting longitudinal field trials in natural settings remains challenging due to factors such as low recruitment success and high dropout rates due to participation burden or data quality issues with wireless sensing in changing environments. ObjectiveThis study gathers insights and lessons from 3 real-world longitudinal field studies assessing human behavior and derives factors that impacted their research success. We aim to categorize challenges, observe how they were managed, and offer recommendations for designing and conducting studies involving human participants and pervasive technology in natural settings. MethodsWe developed a qualitative coding framework to categorize and address the unique challenges encountered in real-life studies related to influential factor identification, stakeholder management, data harvesting and management, and analysis and interpretation. We applied inductive reasoning to identify issues and related mitigation actions in 3 separate field studies carried out between 2018 and 2022. These 3 field studies relied on gathering annotated sensor data. The topics involved stress and environmental assessment in an office and a school, collecting self-reports and wrist device and environmental sensor data from 27 participants for 3.5 to 7 months; work activity recognition at a construction site, collecting observations and wearable sensor data from 15 participants for 3 months; and stress recognition in location-independent knowledge work, collecting self-reports and computer use data from 57 participants for 2 to 5 months. Our key extension for the coding framework used a stakeholder identification method to identify the type and role of the involved stakeholder groups, evaluating the nature and degree of their involvement and influence on the field trial success. ResultsOur analysis identifies 17 key lessons related to planning, implementing, and managing a longitudinal, sensor-based field study on human behavior. The findings highlight the importance of recognizing different stakeholder groups, including those not directly involved but whose areas of responsibility are impacted by the study and therefore have the power to influence it. In general, customizing communication strategies to engage stakeholders on their terms and addressing their concerns and expectations is essential, while planning for dropouts, offering incentives for participants, conducting field tests to identify problems, and using tools for quality assurance are relevant for successful outcomes. ConclusionsOur findings suggest that field trial implementation should include additional effort to clarify the expectations of stakeholders and to communicate with them throughout the process. Our framework provides a structured approach that can be adopted by other researchers in the field, facilitating robust and comparable studies across different contexts. Constantly managing the possible challenges will lead to better success in longitudinal field trials and developing future technology-based solutions.

Abstract Background Upper tract urothelial carcinoma (UTUC) is a rare malignancy, with typically only few new cases annually per urological department. Adherence to European association of urology (EAU) guidelines on UTUC in the Nordic countries is unknown. The objective of this survey was to examine the implementation of EAU guidelines, the perioperative management and organization of the treatment of UTUC in the Nordic countries. Methods The electronic survey was distributed to 93 hospitals in the Nordic countries performing radical nephroureterectomy (NU). The survey consisted of 57 main questions and data was collected between December 1st, 2021 and April 23rd, 2022. Results Overall response rate was 47/93 (67%) with a completion rate of 98%. Five out of the 6 examined subjects on diagnostic practice are applied by ≥ 72% of the participating centers. NU as treatment for high-risk UTUC is performed by 37/47 (79%), and 91% include a bladder cuff excision. Conclusions Adherence to EAU guidelines is high on diagnostic practice in the Nordic countries, whereas disease management is less coherent.

Abstract Human milk (HM) components affect immune cell toll-like receptor 4 (TLR4) signaling. However, studies examining the immunomodulatory impacts of HM on TLR4 signaling in intestinal epithelial cells (IECs) are limited. This study utilized both a TLR4 reporter cell line and a Caco-2 IEC model to examine the effects of HM on lipopolysaccharide (LPS)-induced TLR4 activation and cytokine responses, respectively. Additionally, we performed fast protein liquid chromatography and mass spectrometry to identify a HM component that contributes to the effect of HM on LPS/TLR4 signaling. HM enhances LPS-induced TLR4 signaling as well as LPS-induced IEC gene expression of pro-inflammatory cytokines and negative regulators of NF-κB. Human serum albumin (HSA) present in HM contributes to these effects. HSA within HM synergizes with LPS to induce IEC gene expression of pro-inflammatory cytokines and negative regulators of NF-κB. Altogether, this study provides mechanistic evidence behind the immunomodulatory function of HM on IECs, which may contribute to an enhanced immune response in breast-fed neonates.

IntroductionIn this prospective cohort study over 40 years we investigated the effect of childhood attention-deficit/hyperactivity disorder (ADHD) and subthreshold ADHD on cognitive performance in adulthood.MethodsThe cohort comprised individuals with mild perinatal risks. Childhood ADHD group (cADHD, n = 39) was compared to a group with subthreshold childhood attention or hyperactivity symptoms (cAP; n = 79), a group with similar perinatal risks but no ADHD symptoms (n = 255), and to controls without ADHD symptoms or perinatal risks (n = 69). The groups were assessed with multiple neuropsychological measures in domains of verbal reasoning, perceptual skills, memory, working memory, attention, executive functions, and speed. Group-level differences and frequencies of deficient functioning were analyzed.ResultsOverall, the groups’ performance differed in all cognitive domains at age 40. Verbal reasoning, perceptual skills, memory, and speed had the largest effect sizes (0.51–0.62). The cADHD group’s performance was lower than the other groups’ on 13 out of 21 measures. The cAP group performed poorer than controls on five measures. In the cADHD group, 23% had three or more deficient cognitive domains, compared to 4–6% in the other groups.DiscussionChildhood ADHD is associated with impaired cognitive functioning in adulthood on several cognitive domains whereas childhood subthreshold ADHD is linked to fewer cognitive deficits. Task complexity was linked to poorer performance within the ADHD group. Our results add to the scarce longitudinal evidence of cognitive outcomes related to childhood ADHD and subthreshold symptoms.

Given the gradual nature of the energy transition, retrofitting coal-fired power plants with carbon capture technology is crucial. The calcium looping (CaL) process is a promising solution, with challenges like absorbent deactivation and reduced thermal efficiency mitigated by absorbent reactivation and heat recovery systems. This study evaluated the techno-economic feasibility of integrating a novel wet extraction and precipitation process for absorbent reactivation within a solar-assisted CaL system, alongside an existing coal power plant. The process incorporated a secondary steam cycle and an ammonia absorption chiller for enhanced heat recovery and district cooling. The integrated project could increase daily power generation by 50% and reduce CO2 emissions from 820.4 g/kWh to 54.5 g/kWh. Over its lifespan, the reactivation facility could reduce limestone extraction by 21 Mt with 90% capture efficiency. With a levelized cost of electricity (LCOE) of 116.1 €/MWh and breakeven electricity selling price (BESP) of 56.6 €/MWh, the system demonstrated promising commercial viability, with the reactor and concentrated solar heating (CSH) system making up over 60% of investment costs. CSH cost and solar abundance were identified as key factors, indicating potential feasibility even in higher latitude regions. At CO2 revenues of 150 €/t, a stand-alone capture project can break even based solely on CO2 sales, demonstrating its potential for expansion to other areas. A case study highlighted the benefits of integrating absorbent reactivation and an ammonia absorption chiller, improving both economics and carbon capture efficiency. The study also confirmed the viability of solar-assisted projects in high-latitude regions, with optimistic future CO2 revenues and advancements in carbon capture technology enhancing feasibility.

Recently, the use of information and communications technology (ICT) at school has been extensively increased in Finland. This study investigated whether the use of ICT at school is linked to students 'learning outcomes in Finland. We used the Finnish PISA 2015 data (N=5037). Cognitive learning outcomes (i.e. science, mathematics, reading, collaborative problem-solving) were evaluated with computer-based tests. ICT use at school, ICT availability at school, and students' perceived ICT competence were assessed with self-rating questionnaires. Frequent ICT use at school predicted students' weaker performance in all the cognitive learning outcomes, when adjusted for age, gender, parental socioeconomic status, students' ICT competence, and ICT availability at school. Further, the effect of ICT use on learning outcomes was more negative in students with higher than lower ICT skills. Frequent use of ICT at school appears to be linked to weaker cognitive learning outcomes in Finland. This may be explained by working memory overload and task-switching during the use of digital technologies. This finding also suggests that even though students with ICT skills are good at mechanical use of digital device, they may not have abilities for a goal- oriented and self-directed use of digital technologies that could promote their learning.

In recent years, there has been a notably increased interest in the study of multivariate interactions and emergent higher-order dependencies. This is particularly evident in the context of identifying synergistic sets, which are defined as combinations of elements whose joint interactions result in the emergence of information that is not present in any individual subset of those elements. The scalability of frameworks such as partial information decomposition (PID) and those based on multivariate extensions of mutual information, such as O-information, is limited by combinational explosion in the number of sets that must be assessed. In order to address these challenges, we propose a novel approach that utilises stochastic search strategies in order to identify synergistic triplets within datasets. Furthermore, the methodology is extensible to larger sets and various synergy measures. By employing stochastic search, our approach circumvents the constraints of exhaustive enumeration, offering a scalable and efficient means to uncover intricate dependencies. The flexibility of our method is illustrated through its application to two epidemiological datasets: The Young Finns Study and the UK Biobank Nuclear Magnetic Resonance (NMR) data. Additionally, we present a heuristic for reducing the number of synergistic sets to analyse in large datasets by excluding sets with overlapping information. We also illustrate the risks of performing a feature selection before assessing synergistic information in the system.

The present study examines the educational speech that appears in the upper secondary school curriculum. Teaching and the organisation of teaching is guided by the written reality of the curriculum.The Foucaultian approach is applied to study the discursive events, i.e. expressions presented as true. The study is based on the interest in the role of education policy and working life in the construction of the general Finnish upper secondary education curriculum. As an educational policy management document, the curriculum creates an aim for the reality of teaching and learning. It maintains values related to upper secondary education, in this case for career orientation, as discourses of task, fluency, anticipation, and activation. The working life discourses emphasise efforts to accelerate transitions in working life, bring forward career-related decisions, and glorify success and activity. This article discusses the emphasis the working life in the curriculum has for the ideal of Bildung in contemporary upper secondary school education.

This dataset provides longitudinal survey data from a European project, ySKILLS, which was focused on the role of digital skills in youths’ development. It contains data from 10,821 participants from Grades 6–10 (in Wave 1) in Estonia, Finland, Germany, Italy, Poland, and Portugal. The data was collected between Spring 2021 and Spring 2023, the participants were recruited through schools, where the data collection also took place, except for online data collections due to restrictions caused by COVID-19. The dataset is novel in its multidimensional approach to the construct of digital literacy. It provides insight into the development of digital skills in youth and the role of digital skills and internet usage in youths’ positive and negative online experiences and wellbeing. It also contains data that allows for the analysis of the role of digital skills in class networks. The data are beneficial for researchers interested in the examination of youths’ online skills, internet usage, online experiences, and wellbeing from a longitudinal perspective.

Among various Hybrid Electric Vehicles (HEVs), Plug-in Hybrid Electric Vehicles (PHEVs) charged from the grid are seen as the most advanced ones, as they can drive dozens of kilometers using only the electric engine and thus producing less tailpipe greenhouse gas emissions than vehicles with internal combustion engines or other HEVs. The proportion of PHEVs among all vehicles is still relatively low but increasing rapidly in many countries. However, the real-world emissions from these novel hybrid technologies are not straightforward to estimate. This study investigates multiple properties of the particle emissions of a PHEV, with gasoline direct injection, GDI, compared to two conventional gasoline vehicles, one with port fuel injection, PFI and one with GDI. Distance-based emission factors (EFs) for each vehicle in various driving modes, including battery-hold and battery-charge driving modes for the PHEV, were analyzed. The results showed that the PHEV produced smaller particles in size, resulting that particle mass (PM) and black carbon (BC) were lower by factor of ten in comparison to EFs from the vehicles with PFI and GDI engines. The PHEV consistently emitted lower distance-based EFs than the PFI and GDI vehicles in all driving modes, though EF for particle number (PN) in battery-charge mode was close to the EFs from the other two vehicles. The study also found that the vehicle cold start effect was present in the case of the shorter driving route but not as significant in the longer one. Overall, the study demonstrated that PHEVs could produce lower particle and BC emissions compared to traditional gasoline-powered vehicles. The vehicle cold start and systematic combustion engine restart effects still can have significant impacts on particle emissions, especially in shorter trips.

The target of this study is the Takanen greenstone belt (TGB), a small 11-km-long and east-west oriented supracrustal belt in the northern Lentua complex of the Western Karelia Subprovince (eastern Finland). We present a new geological interpretation of the TGB based on lithology, geochemistry, stratigraphy, and two new zircon U-Pb age determinations and Lu-Hf-in-zircon data. The TGB forms a ≥800-m-thick synclinal sequence composed of intercalated mafic-komatiitic and felsic-intermediate volcanic and volcaniclastic rocks (lavas, tuffs, and tuffites) crosscut by granitoid dykes, and metamorphosed in lower amphibolite facies with few primary volcanic textures visible. The felsic-intermediate rocks are calc-alkaline and split into strongly and weakly REE-fractionated groups. The mafic-ultramafic rocks are tholeiitic with flat REE-patterns, but some samples show LREE-enrichment. Massive Fe-sulfide layers (≤1 m) are associated with volcaniclastic rocks. Komatiites are Al-undepleted and comprise differentiated (peridotite-gabbro) and undifferentiated (dunite/serpentinite) cumulates and thin undifferentiated flows. Channel-facies komatiitic cumulates are found stratigraphically above Fe-sulfide-rich units and have potential for komatiite-hosted Ni-deposits. Our new isotope data from two felsic-intermediate volcanic rock samples shows that the TGBs stratigraphically lowermost and uppermost units are 2.96 Ga and 2.71 Ga old, respectively. Based on Hf isotope data, the older 2.96 Ga sample contains reworked crustal material, possibly originating from ~3.2 Ga crust. In contrast, the 2.71 Ga sample is isotopically juvenile (near-chondritic), indicating an episode of juvenile crust formation in the northern Lentua Complex. No unconformity is found between the stratigraphically upper and lower parts of the TGB, but the ~250 Ma age difference (and geochemical indicators) suggests they may have formed in different tectonic settings. The lower part of TGB stratigraphy is correlated with the ~2.94 Ga Luoma Formation in the nearby Suomussalmi greenstone belt. The 2.71 Ga volcanic unit does not have a known equivalent in greenstone belts in Finland, but a corollary is found in Russia, and a tentative correlation to a possible 2.75–2.70 Ga arc-system in Takanen–Khedozero-Bolshozero–Ilomantsi is suggested.

Abstract CAR (CARSKNKDC) is a wound-homing peptide that recognises angiogenic neovessels. Here we discover that systemically administered CAR peptide has inherent ability to promote wound healing: wounds close and re-epithelialise faster in CAR-treated male mice. CAR promotes keratinocyte migration in vitro. The heparan sulfate proteoglycan syndecan-4 regulates cell migration and is crucial for wound healing. We report that syndecan-4 expression is restricted to epidermis and blood vessels in mice skin wounds. Syndecan-4 regulates binding and internalisation of CAR peptide and CAR-mediated cytoskeletal remodelling. CAR induces syndecan-4-dependent activation of the small GTPase ARF6, via the guanine nucleotide exchange factor cytohesin-2, and promotes syndecan-4-, ARF6- and Cytohesin-2-mediated keratinocyte migration. Finally, we show that genetic ablation of syndecan-4 in male mice eliminates CAR-induced wound re-epithelialisation following systemic administration. We propose that CAR peptide activates syndecan-4 functions to selectively promote re-epithelialisation. Thus, CAR peptide provides a therapeutic approach to enhance wound healing in mice; systemic, yet target organ- and cell-specific.

Background: Although hydrocele is one of the most common urologic pathologies, it is seldom studied, and the major urologic associations have no guidelines for the management of adult hydroceles. Objective: To characterize international practice variation in the treatment of adult hydroceles. Design, setting, and participants: An international survey was conducted addressing the management of hydroceles among urologists in Belgium, Denmark, Finland, Iceland, Japan, and the Netherlands from September to December 2020. We invited a random sample of 170 urologists from each country (except Iceland). Outcome measurements and statistical analysis: Urologists’ treatment options, factors relevant for decision-making, expected patient satisfaction, and outcomes after aspiration versus surgery were assessed. Results and limitations: Of the 864 urologists contacted, 437 (51%) participated. Of the respondents, 202 (53%) performed both hydrocelectomies and aspiration, 147 (39%) performed hydrocelectomies only, and 30 (8%) performed aspiration only. In Belgium (83%), the Netherlands (75%), and Denmark (55%), urologists primarily performed hydrocelectomies only, whereas in Finland (84%), Japan (61%), and Iceland (91%), urologists performed both hydrocelectomies and aspiration. Urologists favored hydrocelectomy for large hydroceles (78.8% vs 37.5% for small), younger patients (66.0% for patients

Abstract A (toy) model for cold and luke-warm strongly-coupled nuclear matter at finite baryon density, is used to study neutrino transport. The complete charged current two-point correlators are computed in the strongly-coupled medium and their impact on neutrino transport is analyzed. The full result is compared with various approximations for the current correlators and the distributions, including the degenerate approximation, the hydrodynamic approximation as well as the diffusive approximation and we comment on their successes. Further improvements are discussed.

AbstractObjectives The study aimed to find whether Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) predicts the severity of fibromyalgia symptoms after one year in patients with fibromyalgia. The second aim of the study was to observe how symptoms evolved during a one-year follow-up.Design Prospective cohort and observational study. Five questionnaires were sent to patients. The same questionnaires (excluding ÖMPSQ) were sent after one year. The patients were allocated into two cohorts using the results of ÖMPSQ. Other variables were analyzed and observed separately.Setting Primary healthcare center in the city of Nokia, Pirkanmaa, FinlandSubjects Patients with fibromyalgia were included in the study after a physician’s examination and confirmation of diagnosis with the assistance of the American College of Rheumatology (ACR) 2010 criteria.Main outcome measures Fibromyalgia impact questionnaire (FIQ) scoresResults The FIQ scores increased slightly in both ÖMPSQ-cohorts with no statistically significant differences. The patients mostly reported that the symptoms were unchanged or got worse when asked separately from other questionnaires. There was a statistically significant decrease in PHQ-9 score in depressed patients who received antidepressants and/or psychological therapy. In addition, FIQ scores also decreased in depressed patients. Patients who received alterations to the treatment plan reported positive changes in the symptoms more often.Conclusion With these results, we cannot conclude that ÖMPSQ predicts the patient’s severity of symptoms. On the contrary, we can conclude that antidepressants and/or psychological therapy might reduce fibromyalgia symptoms for depressed patients with fibromyalgia. Patients with fibromyalgia might benefit from clinical evaluation and modifications to the treatment plan if necessary.

Abstract Background There is a power imbalance between authors and reviewers in single-blind peer review. We explored how switching from single-blind to double-blind peer review affected 1) the willingness of experts to review, 2) their publication recommendations, and 3) the quality of review reports. Methods The Finnish Medical Journal switched from single-blind to double-blind peer review in September 2017. The proportion of review invitations that resulted in a received review report was counted. The reviewers’ recommendations of “accept as is”, “minor revision”, “major revision” or “reject” were explored. The content of the reviews was assessed by two experienced reviewers using the Review Quality Instrument modified to apply to both original research and review manuscripts. The study material comprised reviews submitted from September 2017 to February 2018. The controls were the reviews submitted between September 2015 and February 2016 and between September 2016 and February 2017. The reviewers’ recommendations and the scorings of quality assessments were tested with the Chi square test, and the means of quality assessments with the independent-samples t test. Results A total of 118 double-blind first-round reviews of 59 manuscripts were compared with 232 single-blind first-round reviews of 116 manuscripts. The proportion of successful review invitations when reviewing single-blinded was 67%, and when reviewing double-blinded, 66%. When reviewing double-blinded, the reviewers recommended accept as is or minor revision less often than during the control period (59% vs. 73%), and major revision or rejection more often (41% vs 27%, P = 0.010). For the quality assessment, 116 reviews from the double-blind period were compared with 104 reviews conducted between September 2016 and February 2017. On a 1–5 scale (1 poor, 5 excellent), double-blind reviews received higher overall proportion of ratings of 4 and 5 than single-blind reviews (56% vs. 49%, P

Boron Neutron Capture Therapy (BNCT) is a cancer treatment which combines tumor-selective boron delivery agents with thermal neutrons in order to selectively eradicate cancer cells. In this work, we focus on the early-stage development of carbohydrate delivery agents for BNCT. In more detail, we expand upon our previous GLUT-targeting approach by synthesizing and evaluating the potential embedded in a representative set of fluorinated carbohydrates bearing a boron cluster. Our findings indicate that these species may have advantages over the boron delivery agents in current clinical use, e.g., significantly improved boron delivery capacity at the cellular level. Simultaneously, the carbohydrate delivery agents were found to bind strongly to plasma proteins, which may be a concern requiring further action before progression to in vivo studies. Altogether, this work brings new insights into factors which need to be accounted for if attempting to develop theranostic agents for BNCT based on carbohydrates in the future.

Aerosol–cloud interaction is considered one of the largest sources of uncertainty in radiative forcing estimations. To better understand the role of black carbon (BC) aerosol as a cloud nucleus and the impact of clouds on its vertical distribution in the Arctic, we report airborne in situ measurements of BC particles in the European Arctic near Svalbard during the “Arctic CLoud Observations Using airborne measurements during polar Day” (ACLOUD) campaign held in the summer of 2017. BC was measured with a single-particle soot photometer aboard the Polar 6 research aircraft from the lowest atmospheric layer up to approximately 3500 m a.s.l (metres above sea level). During in-cloud flight transects, BC particles contained in liquid droplets (BC residuals) were sampled through a counterflow virtual impactor (CVI) inlet. Four flights, conducted in the presence of low-level, surface-coupled, inside-inversion, and mixed-phase clouds over sea ice, were selected to address the variability in BC above, below, and within the cloud layer. First, the increase in size and coating thickness of BC particles from the free troposphere to the cloud-dominated boundary layer confirmed that ground observations were not representative of upper atmospheric layers. Second, although only 1 % of liquid droplets contained a BC particle, the higher number concentration of BC residuals than BC particles sampled below cloud indicated that the totality of below-cloud BC was activated by nucleation scavenging but also that alternative scavenging processes such as the activation of free-tropospheric BC at the cloud top might occur. Third, the efficient exchange of aerosol particles at cloud bottom was confirmed by the similarity of the size distribution of BC residuals and BC particles sampled below cloud. Last, the increase in the BC residual number concentration (+31 %) and geometric mean diameter (+38 %) from the cloud top to the cloud bottom and the absolute enrichment in larger BC residuals compared with outside of the cloud supported the hypothesis of concomitant scavenging mechanisms but also suggested the formation of BC agglomerates caused by cloud processing. The vertical evolution of BC properties from inside the cloud and below the cloud indicated an efficient aerosol exchange at cloud bottom, which might include activation, cloud processing, and sub-cloud release of processed BC agglomerates. In the case of persistent low-level Arctic clouds, this cycle may reiterate multiple times, adding an additional degree of complexity to the understanding of cloud processing of BC particles in the Arctic.

Low-level (cloud tops below 2 km) mixed-phase clouds are important in amplifying warming in the Arctic region through positive feedback in cloud fraction, water content and phase. In order to understand the cloud feedbacks in the Arctic region, good knowledge of the vertical distribution of the cloud water content, particle size and phase is required. Here we investigate the vertical extent of the cloud-phase and ice-phase optical properties in six case studies measured in the European Arctic during the ACLOUD campaign. Late spring- and summertime stratiform clouds were sampled in situ over pack ice, marginal sea ice zone and open-ocean surface, with cloud top temperatures varying between −15 and −1.5 ∘C. The results show that, although the liquid phase dominates the upper parts of the clouds, the ice phase was frequently observed in the lower parts down to cloud top temperatures as warm as −3.8 ∘C. In the studied vertical cloud profiles, the maximum of average liquid phase microphysical properties, droplet number concentration, effective radius and liquid water content, varied between 23 and 152 cm−3, 19 and 26 µm, 0.09 and 0.63 g m−3, respectively. The maximum of average ice-phase microphysical properties varied between 0.1 and 57 L−1 for the ice number concentration, 40 and 70 µm for the effective radius, and 0.005 and 0.08 g m−3 for the ice water content. The elevated ice crystal number concentrations and ice water paths observed for clouds, with cloud top temperatures between −3.8 and −8.7 ∘C can be likely attributed to secondary ice production through rime splintering. Low asymmetry parameters between 0.69 and 0.76 were measured for the mixed-phase ice crystals with a mean value of 0.72. The effect of the ice-phase optical properties on the radiative transfer calculations was investigated for the four cloud cases potentially affected by secondary ice production. Generally the choice of ice-phase optical properties only has a minor effect on the cloud transmissivity and albedo, except in a case where the ice phase dominated the upper cloud layer extinction. In this case, cloud albedo at solar wavelengths was increased by 10 % when the ice phase was given its measured optical properties instead of treating it as liquid phase. The presented results highlight the importance of accurate vertical information on cloud phase for radiative transfer and provide a suitable data set for testing microphysical parameterizations in models.

Abstract Background The Oxford Elbow Score (OES) and the short version of Disabilities of Arms, Shoulder and Hand (QuickDASH) are common patient-reported outcomes for people with elbow problems. Our primary objective was to define thresholds for the Minimal Important Difference (MID) and Patient-Acceptable Symptom State (PASS) for the OES and QuickDASH. The secondary aim was to compare the longitudinal validity of these outcome measures. Methods We recruited 97 patients with clinically-diagnosed tennis elbow for a prospective observational cohort study in a pragmatic clinical setting. Fifty-five participants received no specific intervention, 14 underwent surgery (11 as primary treatment and 4 during follow-up), and 28 received either botulinum toxin injection or platelet rich plasma injection. We collected OES (0 to 100, higher is better) and QuickDASH (0 to 100, higher is worse), and global rating of change (as an external transition anchor question) at six weeks, three months, six months and 12 months. We defined MID and PASS values using three approaches. To assess the longitudinal validity of the measures, we calculated the Spearman’s correlation coefficient between the change in the outcome scores and external transition anchor question, and the Area Under the Curve (AUC) from a receiver operating characteristics (ROC) analysis. To assess signal-to-noise ratio, we calculated standardized response means. Results Depending on the method, MID values ranged from 16 to 21 for OES Pain; 10 to 17 for OES Function; 14 to 28 for OES Social-psychological; 14 to 20 for OES Total score, and − 7 to -9 for QuickDASH. Patient-Acceptable Symptom State (PASS) cut offs were 74 to 84 for OES Pain; 88 to 91 for OES Function; 75 to 78 with OES Social-psychological; 80 to 81 with OES Total score and 19 to 23 with Quick-DASH. OES had stronger correlations with the anchor items, and AUC values suggested superior discrimination (between improved and not improved) compared with QuickDASH. OES also had superior signal-to-noise ratio compared with QuickDASH. Conclusion The study provides MID and PASS values for OES and QuickDASH. Due to better longitudinal validity, OES may be a better choice for clinical trials. Trial registration ClinicalTrials.gov NCT02425982 (first registered April 24, 2015).