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Electronic and vibrational degrees of freedom, and their interactions, control the chemical and physical properties of solids. Core-level spectroscopies, such as transient extreme ultraviolet (XUV) spectroscopy, provide detailed information on the electronic structure and local coordination environment of a material. In this work, we employ transient XUV reflection spectroscopy to measure surface carrier and structural dynamics in solar energy materials. To interpret experimental spectra, excited state valence effects are incorporated into the OCEAN code (Obtaining core excitations from ab initio electronic structure and the NIST Bethe-Salpeter equation solver). The modeling of core-level spectra from first principles enables the extraction of carrier kinetics via the robust assignment of spectral features. Moreover, this thesis explores experimental and theoretical methods for understanding carrier-structural coupling in solids relevant to solar energy applications. Specifically, we explore the chemical and physical information contained in core-level spectra for various solar energy material systems and present guiding principles for designing a core-level electronic spectroscopy experiments to determine photoexcited carrier and structural dynamics. We report on experimental measurements of ultrafast surface carrier and structural dynamics in photocathodes zinc telluride and copper iron oxide. Further, complementary excited state theory is presented to extract excited state valence dynamics from experimental core-level spectra based on ground state implementations of the Bethe-Salpeter equation.

Terrestrial animals are key elements in the cycling of elements in the Arctic where nutrient availability is low. Waste production by herbivores, in particular urine deposition, has a crucial role for nitrogen (N) recycling, still, it remains largely unexplored. Also, experimental evidence is biased toward short-term studies and Arctic regions under high herbivore pressure. In this study, we aimed to examine the fate of N derived from urine in a nutrient poor tundra heath in West Greenland, with historical low level of herbivory. We performed a pulse labelling with 15N-urea over the plant canopy and explored ecosystem N partition and retention in the short-term (2 weeks and 1 year) and longer-term (5 years). We found that all vascular plants, irrespective of their traits, could rapidly take up N-urea, but mosses and lichens were even more efficient. Total 15N enrichment was severely reduced for all plants 5 years after tracer addition, with the exception of cryptogams, indicating that non-vascular plants constituted a long-term sink of 15N-urea. The 15N recovery was also high in the litter suggesting high N immobilization in this layer, potentially delaying the nutrients from urine entering the soil compartment. Long-term 15N recovery in soil microbial biomass was minimal, but as much as 30% of added 15N remained in the non-microbial fraction after 5 years. Our results demonstrate that tundra plants that have evolved under low herbivory pressure are well adapted to quickly take advantage of labile urea, with urine having only a transient effect on soil nutrient availability., Published online: 12 November 2023

Climate change in high latitude regions leads to both higher temperatures and more precipitation but their combined effects on terrestrial ecosystem processes are poorly understood. In nitrogen (N) limited and often moss-dominated tundra and boreal ecosystems, moss-associated N2 fixation is an important process that provides new N. We tested whether high mean annual precipitation enhanced experimental warming effects on growing season N2 fixation in three common arctic-boreal moss species adapted to different moisture conditions and evaluated their N contribution to the landscape level. We measured in situ N2 fixation rates in Hylocomium splendens, Pleurozium schreberi and Sphagnum spp. from June to September in subarctic tundra in Sweden. We exposed mosses occurring along a natural precipitation gradient (mean annual precipitation: 571–1155 mm) to 8 years of experimental summer warming using open-top chambers before our measurements. We modelled species-specific seasonal N input to the ecosystem at the colony and landscape level. Higher mean annual precipitation clearly increased N2 fixation, especially during peak growing season and in feather mosses. For Sphagnum-associated N2 fixation, high mean annual precipitation reversed a small negative warming response. By contrast, in the dry-adapted feather moss species higher mean annual precipitation led to negative warming effects. Modelled total growing season N inputs for Sphagnum spp. colonies were two to three times that of feather mosses at an area basis. However, at the landscape level where feather mosses were more abundant, they contributed 50% more N than Sphagnum. The discrepancy between modelled estimates of species-specific N input via N2 fixation at the moss core versus ecosystem scale, exemplify how moss cover is essential for evaluating impact of altered N2 fixation. Importantly, combined effects of warming and higher mean annual precipitation may not lead to similar responses across moss species, which

The breakdown of plant material fuels soil functioning and biodiversity. Currently, process understanding of global decomposition patterns and the drivers of such patterns are hampered by the lack of coherent large-scale datasets. We buried 36,000 individual litterbags (tea bags) worldwide and found an overall negative correlation between initial mass-loss rates and stabilization factors of plant-derived carbon, using the Tea Bag Index (TBI). The stabilization factor quantifies the degree to which easy-to-degrade components accumulate during early-stage decomposition (e.g. by environmental limitations). However, agriculture and an interaction between moisture and temperature led to a decoupling between initial mass-loss rates and stabilization, notably in colder locations. Using TBI improved mass-loss estimates of natural litter compared to models that ignored stabilization. Ignoring the transformation of dead plant material to more recalcitrant substances during early-stage decomposition, and the environmental control of this transformation, could overestimate carbon losses during early decomposition in carbon cycle models.

English abstract: This paper examines how Tårnby becomes a welfare municipality in the period 1920-1970 by analyzing newspaper sources from the city of Kastrup in Tårnby municipality. During this time, the Danish welfare system evolved into a universalistic welfare state, where welfare benefits were made available for all citizens. Thus, this analysis draws on Sørens Kolstrup’s theory of how the Danish welfare state evolved from municipal socialism to universalism. Furthermore, the thesis will ex-amine if Kastrup has had a distinct social democratic civil society. This raises the main question; has Kastrup’s development in 1920-70 been specifically social democratic? The analysis draws on more than 600 different newspaper sources from the local archive, which have been gathered in a dataset and further divided into four categories; population growth and housing; schools and childcare; healthcare, em-ployment and eldercare; urban development, traffic, and water supply. By examin-ing how these four categories are being discussed in the local press, the paper shows that the social democrat ideology played an important role in the city’s de-velopment. This is exemplified in the way that the municipal council makes long term plans for the city and in the way that the municipality takes part in building af-fordable homes for the working class citizens – both of which align with Social Democratic policy. This was made possible by the fact that the Social Democratic Party led the municipal council from 1914 till now. In spite of this, Tårnby was not a pioneer municipality, unlike other predominantly socialist municipalities of the time. Different local circumstances obstructed the social democratic politics, which is why the municipality's restraint can be seen as pragmatic considerations instead of rejection of ideology. The suburban movement in Kastrup was in large part driven by the labor movement. The working class used the suburbs as a way to gain access to aff

Introduktion: Søvnforstyrrelser har været associeret med selvmordsadfærd blandt unge. Men på grund af små studiepopulationer i tidligere studier samt det faktum, at incidensen af selvmordsforsøg er lav, mangler der store og longitudinelt studier til at kunne udføre meningsfulde justerede analyser. Dette speciale har til formål at estimere om søvnforstyrrelser er associeret med højere risiko for selvmordstanker og -forsøg blandt unge. Metode: Selv-rapporteret data på søvnforstyrrelser var målt iblandt børn i 11-årsalderen og indsamlet fra den danske fødselskohorte og sammenlignet med information om selvmordsadfærd blandt unge i 18-årsalderen baseret på selvrapporteret og registrerede data på hospitalskontakter for selvmordsforsøg. Relative risiko ratio med 95% konfidensintervaller var estimeret ved brug af multinomiale logistiske regressions analyser justeret for køn, sociodemografiske karakteristika og psykiatriske diagnoser blandt forældre. Inverse probability weighting blev anvendt for at tage højde for selektionsbias. Resultater: Dette studie inkluderede 28,251 deltagere, hvor 32.0% havde oplevet selvmordstanker, mens 3.3% havde forsøgt selvmord. Blandt børn i 11-årsalderen var de som sov under 8 timer i højere risiko for selvmordstanker (jRRR= 1.66; 95% CI, 1.32-2.07) og selvmordsforsøg (jRRR= 3.71; 95% CI, 2.56-5.39) sammenlignet med børn, som sov 9 timer eller derover. Sammenlignelige estimeret risiko var observeret blandt børn, som gik i seng efter kl. 22:30 for selvmordstanker (jRRR= 1.58; 95% CI, 1.28-1.95) og selvmordsforsøg (jRRR= 3.34; 95% CI, 2.30-4.86) sammenlignet med børn, som gik i seng kl. 21:00 eller tidligere. Hyppige mareridt var også associeret med selvmordstanker (jRRR= 1.39; 95% CI, 1.30-1.49) og selvmordsforsøg, (jRRR= 2.10; 95% CI, 1.80-2.45) sammenlignet med børn som sjældent eller aldrig oplevede mareridt. Dosis-responssammenhænge blev fundet for probl

Danish abstract: Denne her opgave har til formål at undersøge hvordan visuelle æstetiske fænomener påvirker vores oplevelse af liminale byrum via en semiotisk analyse af forskellige typer tegndannelser, derfor udlægges en række termer relateret til liminalitet, urbanitet, semiotik og fænomenologi. Flere typer liminalitet bliver undersøgt og relaterede begreber såsom non-places, antropologiske steder og æstetisk liminalitet bliver forklaret; dette hjælper os til at forstå hvordan vi opfatter steder på en dynamisk måde. Dernæst bliver markørerne i begrebet om imageability forklaret, samt kædet sammen med begreberne place og space, og uddybet af begrebet Thirdspace, hvilket giver os sproget til at tale om steder, fysisk, konceptuelt og på en blandet måde. Grundlæggende begreber i semiotik bliver forklaret, da disse skal bruges i metoden og analysen for at forstå tegndannelse. Maurice Merleau-Pontys fænomenologi bliver gennemgået og præciseret til kunst via Wollheims teori, hvilket giver os et godt ordforråd til at tale om subjektiv observation og dannelse af oplevelser. Disse begreber bliver brugt i en metode udviklet til at analysere flere facetter af visuelle fænomener i liminale urbane rum. Der udvikles fire trin: Beskrivelse, forankring, definering og afkodning. Hvert trin fokuserer på at beskrive det visuelle fænomen samt tilhørende liminale område. Tre cases bliver valgt: en kunstinstallation, et vægmaleri og noget graffiti. Analysen finder at forskellige imageabilitymarkører har indflydelse på hvordan offentligheden interagerer med de tre forskellige værker. Der er desuden en forskelligartethed i hvordan værkerne inddrager offentligheden i relation til den måde værkerne forholder sig til deres konceptuelle rum, og hvordan nærmiljøet forholder sig til værkets visuelle udtryk. Slutvist bliver det konkluderet at en speciel semiotisk analyse kombineret med urban teori og fænomenologi, giver et specielt perspektiv, der gør det muligt at beskrive visuelle oplevelser i

Arbuscular-mycorrhizal (AM) symbiosis is one of the most important and ubiquitous mutualisms on Earth, providing plants with a great number of nutritional, fitness and resilience benefits. Within plant communities, mineral resources and photosynthates are relocated from plant to plant through the common mycelial network (CMN) connecting their roots. Both the quantitative characteristics of resource relocation within CMN and the reasons behind its dynamics are not yet fully understood. Most studies investigating AM and CMNs have focused on a plant-centered approach, but in this study, perspective is shifted to the fungal side, asking how the properties of CMN itself, specifically, structural complexity, affect AM functioning and inter-plant communication in terms of carbon transfer. Different levels of CMN complexity were achieved by varying AM inoculum potential by soil dilution. Directional photosynthate distribution was manipulated by shading, and subsequent carbon fluxes were tracked using 13C labelling. Higher amounts of carbohydrates were transferred from source to sink plant through a more complex hyphal network than a less complex one. This suggests that the physical properties of the mycorrhizal system may shape its functioning and thus should not be overlooked.

Det nordiske funksjonshindersamarbeidet involverer sivilsamfunnet, politikkområder og akademia. Denne rapporten beskriver et robust samarbeid som bidrar til politikk- og kunnskapsutvikling. Samarbeidet er med på å bygge det nordiske fellesskapet, er nyttig for å nå våre nordiske visjoner, og for å bedre velferdstjenester til mennesker med funksjonshinder. Resultatene av det nordiske tverrsektorielle samarbeidet på funksjonshinderområdet rapporteres regelmessig til embetsmannskomiteen for sosial- og helsepolitikk (EK-S), og annethvert år til Nordisk råd. Dette er den første rapporteringen fra nordisk samarbeid om funksjons­hinderspørsmål i den nye programperioden 2023–2027. Rapporten omfatter temaet digital inklusjon, som ordførerlandet Island løftet fram i 2023, samt aktiviteter på fokusområder i programperioden 2023–2027: menneskelige rettigheter, deltakelse og fri bevegelse. Rapporten redegjør også for hvordan det går med døvblindvirksomheten, støtteordningen for økt samarbeid mellom funksjonshinder­organisasjoner og forskning og utviklingsarbeid. Det redegjøres her også for aktiviteter i Rådet for nordisk samarbeid om funksjonshinderspørsmål, som er Nordisk ministerråds rådgivende organ for implementering av funksjonshinder­perspektiv i alle virksomhets- og politikkområder.

The breakdown of plant material fuels soil functioning and biodiversity. Currently, process understanding of global decomposition patterns and the drivers of such patterns are hampered by the lack of coherent large-scale datasets. We buried 36,000 individual litterbags (tea bags) worldwide and found an overall negative correlation between initial mass-loss rates and stabilization factors of plant-derived carbon, using the Tea Bag Index (TBI). The stabilization factor quantifies the degree to which easy-to-degrade components accumulate during early-stage decomposition (e.g. by environmental limitations). However, agriculture and an interaction between moisture and temperature led to a decoupling between initial mass-loss rates and stabilization, notably in colder locations. Using TBI improved mass-loss estimates of natural litter compared to models that ignored stabilization. Ignoring the transformation of dead plant material to more recalcitrant substances during early-stage decomposition, and the environmental control of this transformation, could overestimate carbon losses during early decomposition in carbon cycle models.

OBJECTIVES: Insufficient training and the absence of guidelines increase the risk of retraumatisation in torture survivors during surgical procedures. This study aims to develop guidelines to mitigate this risk and gather healthcare professionals' experiences treating torture survivors and insights on the guideline's feasibility and acceptability. DESIGN: The study was conducted in two phases. Phase 'a' involved developing guidelines based on reviews of torture survivors' encounters in somatic care and potential retraumatisation triggers, as well as a qualitative study on survivors' experiences during surgical interventions. The development process adhered to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) principles and the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument for methodological rigour. Phase 'b' involved focus groups and individual interviews with healthcare professionals to explore challenges in caring for torture survivors and to evaluate the guidelines. SETTING: The study, conducted from May to August 2023, involved participants from surgical departments in three hospitals in southern and southeastern Norway. PARTICIPANTS: Twenty-one healthcare professionals, including surgeons, anaesthesiologists, nurses and a dentist, participated in the study. Both focus group interviews and individual interviews were conducted. RESULTS: Phase 'a': guidelines comprising six sections were developed: an introduction, general guidelines and four sections covering the preoperative, perioperative and postoperative surgical stages. Phase 'b': healthcare professionals struggled to understand torture's complexities and identify survivors' unique needs. They faced challenges using interpreters and assisting patients with strong reactions. While the guidelines were viewed as practical and useful for raising awareness, their length was questioned. CONCLUSIONS: We provide recommendations for preventing retraumatisation i, This work is funded by a PhD fellowship from Oslo Metropolitan University and Akershus University Hospital (Ahus). The Norwegian Nursing Association (NSF) provided financial assistance.

Objective: Interactive patient education, referred to as Heart School (HS), is an important part of cardiac rehabilitation (CR) after myocardial infarction (MI), which has been associated with improved outcomes. Little is known about HS attendance among foreign-born patients. The aims were to assess; 1) HS attendance in foreign-born versus native-born patients, 2) the association between the provision of professional interpreters and HS attendance, and 3) secondary prevention goal attainment after MI based on HS attendance. Methods: The provision of professional interpreters during post-MI follow-up was assessed by a questionnaire sent to all 78 Swedish CR sites. Patient-specific data was retrieved from the SWEDEHEART registry. The association between the provision of professional interpreters and HS attendance was estimated with logistic regression models. HS attendance and attainment of secondary prevention goals by country of birth were investigated. Results: In total, 8377 patients < 75 years (78 % male) were included. Foreign-born (19.8 %) had a higher prevalence of cardiovascular risk factors and were less likely to attend HS (33.7 vs 51.3 %, p < 0.001), adjusted odds ratio (OR) 0.59 (95 % confidence interval (CI) 0.52-0.68), compared with native-born patients. CR centers providing professional interpreters had higher HS attendance among foreign-born (adjusted OR 1.55, 95 % CI 1.20-2.01) but not among native-born patients. Attending HS was similarly associated with improved secondary prevention goal attainment in both groups. Conclusions: Despite similar positive association between HS attendance and attainment of secondary prevention goals, foreign-born patients attended HS less often. With the provision of professional interpreters, HS attendance increased in foreign-born patients.

Background Providing secondary prevention through structured and comprehensive cardiac rehabilitation programmes to patients after a myocardial infarction (MI) reduces mortality and morbidity and improves health-related quality of life. Cardiac rehabilitation has the highest recommendation in current guidelines. While treatment target attainment rates at Swedish cardiac rehabilitation centres is among the highest in Europe, there are considerable differences in service delivery and variations in patient-level outcomes between centres. In this trial, we aim to study whether centre-level guideline adherence and patient-level outcomes across Swedish cardiac rehabilitation centres can be improved through a) regular audit and feedback of cardiac rehabilitation structure and processes through a national quality registry and b) supporting cardiac rehabilitation centres in implementing guidelines on secondary prevention. Furthermore, we aim to evaluate the implementation process and costs. Methods The study is an open-label cluster-randomized effectiveness-implementation hybrid trial including all 78 cardiac rehabilitation centres (attending to approximately 10 000 MI patients/year) that report to the SWEDEHEART registry. The centres will be randomized 1:1:1 to three clusters: 1) reporting cardiac rehabilitation structure and process variables to SWEDEHEART every six months (audit intervention) and being offered implementation support to implement guidelines on secondary prevention (implementation support intervention); 2) audit intervention only; or 3) no intervention offered. Baseline cardiac rehabilitation structure and process variables will be collected. The primary outcome is an adherence score measuring centre-level adherence to secondary prevention guidelines. Secondary outcomes include patient-level secondary prevention risk factor goal attainment at one-year after MI and major adverse coronary outcomes for up to five-years post-MI. Implementation outcomes include

Arctic and alpine tundra ecosystems are large reservoirs of organic carbon1,2. Climate warming may stimulate ecosystem respiration and release carbon into the atmosphere3,4. The magnitude and persistency of this stimulation and the environmental mechanisms that drive its variation remain uncertain5–7. This hampers the accuracy of global land carbon–climate feedback projections7,8. Here we synthesize 136 datasets from 56 open-top chamber in situ warming experiments located at 28 arctic and alpine tundra sites which have been running for less than 1 year up to 25 years. We show that a mean rise of 1.4 °C [confidence interval (CI) 0.9–2.0 °C] in air and 0.4 °C [CI 0.2–0.7 °C] in soil temperature results in an increase in growing season ecosystem respiration by 30% [CI 22–38%] (n = 136). Our findings indicate that the stimulation of ecosystem respiration was due to increases in both plant-related and microbial respiration (n = 9) and continued for at least 25 years (n = 136). The magnitude of the warming effects on respiration was driven by variation in warming-induced changes in local soil conditions, that is, changes in total nitrogen concentration and pH and by context-dependent spatial variation in these conditions, in particular total nitrogen concentration and the carbon:nitrogen ratio. Tundra sites with stronger nitrogen limitations and sites in which warming had stimulated plant and microbial nutrient turnover seemed particularly sensitive in their respiration response to warming. The results highlight the importance of local soil conditions and warming-induced changes therein for future climatic impacts on respiration.

Plant biomass is a fundamental ecosystem attribute that is sensitive to rapid climatic changes occurring in the Arctic. Nevertheless, measuring plant biomass in the Arctic is logistically challenging and resource intensive. Lack of accessible field data hinders efforts to understand the amount, composition, distribution, and changes in plant biomass in these northern ecosystems. Here, we present The Arctic plant aboveground biomass synthesis dataset, which includes field measurements of lichen, bryophyte, herb, shrub, and/or tree aboveground biomass (g m−2) on 2,327 sample plots from 636 field sites in seven countries. We created the synthesis dataset by assembling and harmonizing 32 individual datasets. Aboveground biomass was primarily quantified by harvesting sample plots during mid- to late-summer, though tree and often tall shrub biomass were quantified using surveys and allometric models. Each biomass measurement is associated with metadata including sample date, location, method, data source, and other information. This unique dataset can be leveraged to monitor, map, and model plant biomass across the rapidly warming Arctic.

Background Providing secondary prevention through structured and comprehensive cardiac rehabilitation programmes to patients after a myocardial infarction (MI) reduces mortality and morbidity and improves health-related quality of life. Cardiac rehabilitation has the highest recommendation in current guidelines. While treatment target attainment rates at Swedish cardiac rehabilitation centres is among the highest in Europe, there are considerable differences in service delivery and variations in patient-level outcomes between centres. In this trial, we aim to study whether centre-level guideline adherence and patient-level outcomes across Swedish cardiac rehabilitation centres can be improved through a) regular audit and feedback of cardiac rehabilitation structure and processes through a national quality registry and b) supporting cardiac rehabilitation centres in implementing guidelines on secondary prevention. Furthermore, we aim to evaluate the implementation process and costs.Methods The study is an open-label cluster-randomized effectiveness-implementation hybrid trial including all 78 cardiac rehabilitation centres (attending to approximately 10 000 MI patients/year) that report to the SWEDEHEART registry. The centres will be randomized 1:1:1 to three clusters: 1) reporting cardiac rehabilitation structure and process variables to SWEDEHEART every six months (audit intervention) and being offered implementation support to implement guidelines on secondary prevention (implementation support intervention); 2) audit intervention only; or 3) no intervention offered. Baseline cardiac rehabilitation structure and process variables will be collected. The primary outcome is an adherence score measuring centre-level adherence to secondary prevention guidelines. Secondary outcomes include patient-level secondary prevention risk factor goal attainment at one-year after MI and major adverse coronary outcomes for up to five-years post-MI. Implementation outcomes include b, Funding Agencies|Forskningsrdet om Hlsa, Arbetsliv och Vlfrd

The breakdown of plant material fuels soil functioning and biodiversity. Currently, process understanding of global decomposition patterns and the drivers of such patterns are hampered by the lack of coherent large-scale datasets. We buried 36,000 individual litterbags (tea bags) worldwide and found an overall negative correlation between initial mass-loss rates and stabilization factors of plant-derived carbon, using the Tea Bag Index (TBI). The stabilization factor quantifies the degree to which easy-to-degrade components accumulate during early-stage decomposition (e.g. by environmental limitations). However, agriculture and an interaction between moisture and temperature led to a decoupling between initial mass-loss rates and stabilization, notably in colder locations. Using TBI improved mass-loss estimates of natural litter compared to models that ignored stabilization. Ignoring the transformation of dead plant material to more recalcitrant substances during early-stage decomposition, and the environmental control of this transformation, could overestimate carbon losses during early decomposition in carbon cycle models.

Arctic and alpine tundra ecosystems are large reservoirs of organic carbon1,2. Climate warming may stimulate ecosystem respiration and release carbon into the atmosphere3,4. The magnitude and persistency of this stimulation and the environmental mechanisms that drive its variation remain uncertain5,6,7. This hampers the accuracy of global land carbon–climate feedback projections7,8. Here we synthesize 136 datasets from 56 open-top chamber in situ warming experiments located at 28 arctic and alpine tundra sites which have been running for less than 1 year up to 25 years. We show that a mean rise of 1.4 °C [confidence interval (CI) 0.9–2.0 °C] in air and 0.4 °C [CI 0.2–0.7 °C] in soil temperature results in an increase in growing season ecosystem respiration by 30% [CI 22–38%] (n = 136). Our findings indicate that the stimulation of ecosystem respiration was due to increases in both plant-related and microbial respiration (n = 9) and continued for at least 25 years (n = 136). The magnitude of the warming effects on respiration was driven by variation in warming-induced changes in local soil conditions, that is, changes in total nitrogen concentration and pH and by context-dependent spatial variation in these conditions, in particular total nitrogen concentration and the carbon:nitrogen ratio. Tundra sites with stronger nitrogen limitations and sites in which warming had stimulated plant and microbial nutrient turnover seemed particularly sensitive in their respiration response to warming. The results highlight the importance of local soil conditions and warming-induced changes therein for future climatic impacts on respiration., Arctic and alpine tundra ecosystems are large reservoirs of organic carbon1,2. Climate warming may stimulate ecosystem respiration and release carbon into the atmosphere3,4. The magnitude and persistency of this stimulation and the environmental mechanisms that drive its variation remain uncertain5–7. This hampers the accuracy of global land carbon–climate feedback projections7,8. Here we synthesize 136 datasets from 56 open-top chamber in situ warming experiments located at 28 arctic and alpine tundra sites which have been running for less than 1 year up to 25 years. We show that a mean rise of 1.4 °C [confidence interval (CI) 0.9–2.0 °C] in air and 0.4 °C [CI 0.2–0.7 °C] in soil temperature results in an increase in growing season ecosystem respiration by 30% [CI 22–38%] (n = 136). Our findings indicate that the stimulation of ecosystem respiration was due to increases in both plant-related and microbial respiration (n = 9) and continued for at least 25 years (n = 136). The magnitude of the warming effects on respiration was driven by variation in warming-induced changes in local soil conditions, that is, changes in total nitrogen concentration and pH and by context-dependent spatial variation in these conditions, in particular total nitrogen concentration and the carbon:nitrogen ratio. Tundra sites with stronger nitrogen limitations and sites in which warming had stimulated plant and microbial nutrient turnover seemed particularly sensitive in their respiration response to warming. The results highlight the importance of local soil conditions and warming-induced changes therein for future climatic impacts on respiration.

Objective To investigate real-world retention and remission rates in PsA patients initiating a 2nd or 3rd TNFi and the association with reason for discontinuation from the previous TNFi-treatment. Methods Prospectively collected routine care data from 12 European registries were pooled. Retention rates (Kaplan-Meier estimation) and crude/LUNDEX-adjusted rates of Disease Activity Score 28 and Disease Activity index for PSoriatic Arthritis (DAS28 and DAPSA28) remission were calculated and compared with adjusted Cox regression analyses and Chi-squared test, respectively). Results We included 5233 (2nd TNFi) and 1906 (3rd TNFi) patients. Twelve-month retention rates for the 2nd and 3rd TNFi were 68% (95%CI: 67–70%) and 66% (64–68%), respectively. Patients who stopped the previous TNFi due to AE/LOE had 12-month retention rates of 66%/65% (2nd TNFi), and 65%/63% (3rd TNFi), respectively. Patients who stopped the previous TNFi due to LOE after less vs more than 24 weeks had 12-month retention rates of 54%/69% (2nd TNFi), and 58%/65% (3rd TNFi). Six-month crude/LUNDEX-adjusted DAS28 remission rates were 48%/35% and 38%/27%, and DAPSA28 remission rates were 19%/14% and 14%/10%, for the 2nd and 3rd TNFi. Conclusion Two-thirds of patients remained on TNFi at 12 months for both the 2nd and 3rd TNFi, while one-third and one-quarter of patients were in DAS28 remission after 6 months on the 2nd and 3rd TNFi. While drug effectiveness was similar in patients who stopped the previous TNFi due to AE compared to overall LOE, drug effectiveness was better in patients who had stopped the previous TNF due to secondary LOE compared to primary LOE., Objective: To investigate real-world retention and remission rates in PsA patients initiating a 2nd or 3rd TNFi and the association with reason for discontinuation from the previous TNFi-treatment. Methods: Prospectively collected routine care data from 12 European registries were pooled. Retention rates (Kaplan-Meier estimation) and crude/LUNDEX-adjusted rates of Disease Activity Score 28 and Disease Activity index for PSoriatic Arthritis (DAS28 and DAPSA28) remission were calculated and compared with adjusted Cox regression analyses and Chi-squared test, respectively). Results: We included 5233 (2nd TNFi) and 1906 (3rd TNFi) patients. Twelve-month retention rates for the 2nd and 3rd TNFi were 68% (95%CI: 67–70%) and 66% (64–68%), respectively. Patients who stopped the previous TNFi due to AE/LOE had 12-month retention rates of 66%/65% (2nd TNFi), and 65%/63% (3rd TNFi), respectively. Patients who stopped the previous TNFi due to LOE after less vs more than 24 weeks had 12-month retention rates of 54%/69% (2nd TNFi), and 58%/65% (3rd TNFi). Six-month crude/LUNDEX-adjusted DAS28 remission rates were 48%/35% and 38%/27%, and DAPSA28 remission rates were 19%/14% and 14%/10%, for the 2nd and 3rd TNFi. Conclusion: Two-thirds of patients remained on TNFi at 12 months for both the 2nd and 3rd TNFi, while one-third and one-quarter of patients were in DAS28 remission after 6 months on the 2nd and 3rd TNFi. While drug effectiveness was similar in patients who stopped the previous TNFi due to AE compared to overall LOE, drug effectiveness was better in patients who had stopped the previous TNF due to secondary LOE compared to primary LOE.

Objective To evaluate patient-reported outcomes (PROs) after initiation of tumor necrosis factor inhibitor (TNFi) treatment in European real-world patients with psoriatic arthritis (PsA). Further, to investigate PRO remission rates across treatment courses, registries, disease duration, sex, and age at disease onset. Methods Visual analog scale or numerical rating scale scores for pain, fatigue, patient global assessment (PtGA), and the Health Assessment Questionnaire–Disability Index (HAQ-DI) from 12,262 patients with PsA initiating a TNFi in 13 registries were pooled. PRO remission rates (pain ≤ 1, fatigue ≤ 2, PtGA ≤ 2, and HAQ-DI ≤ 0.5) were calculated for patients still on the treatment. Results For the first TNFi, median pain score was reduced by approximately 50%, from 6 to 3, 3, and 2; as were fatigue scores, from 6 to 4, 4, and 3; PtGA scores, from 6 to 3, 3, and 2; and HAQ-DI scores, from 0.9 to 0.5, 0.5, and 0.4 at baseline, 6, 12, and 24 months, respectively. Six-month Lund Efficacy Index (LUNDEX)–adjusted remission rates for pain, fatigue, PtGA, and HAQ-DI scores were 24%, 31%, 36%, and 43% (first TNFi); 14%, 19%, 23%, and 29% (second TNFi); and 9%, 14%, 17%, and 20% (third TNFi), respectively. For biologic-naïve patients with disease duration < 5 years, 6-month LUNDEX-adjusted remission rates for pain, fatigue, PtGA, and HAQ-DI scores were 22%, 28%, 33%, and 42%, respectively. Corresponding rates for patients with disease duration > 10 years were 27%, 32%, 41%, and 43%, respectively. Remission rates were 33%, 40%, 45%, and 56% for men and 17%, 23%, 24%, and 32% for women, respectively. For patients aged < 45 years at diagnosis, 6-month LUNDEX-adjusted remission rate for pain was 29% vs 18% for patients ≥ 45 years. Conclusion In 12,262 biologic-naïve patients with PsA, 6 months of treatment with a TNFi reduced pain by approximately 50%. Marked differences in PRO remission rates across treatment courses, registries, di, Objective. To evaluate patient-reported outcomes (PROs) after initiation of tumor necrosis factor inhibitor (TNFi) treatment in European real-world patients with psoriatic arthritis (PsA). Further, to investigate PRO remission rates across treatment courses, registries, disease duration, sex, and age at disease onset. Methods. Visual analog scale or numerical rating scale scores for pain, fatigue, patient global assessment (PtGA), and the Health Assessment Questionnaire–Disability Index (HAQ-DI) from 12,262 patients with PsA initiating a TNFi in 13 registries were pooled. PRO remission rates (pain ≤ 1, fatigue ≤ 2, PtGA ≤ 2, and HAQ-DI ≤ 0.5) were calculated for patients still on the treatment. Results. For the first TNFi, median pain score was reduced by approximately 50%, from 6 to 3, 3, and 2; as were fatigue scores, from 6 to 4, 4, and 3; PtGA scores, from 6 to 3, 3, and 2; and HAQ-DI scores, from 0.9 to 0.5, 0.5, and 0.4 at baseline, 6, 12, and 24 months, respectively. Six-month Lund Efficacy Index (LUNDEX)–adjusted remission rates for pain, fatigue, PtGA, and HAQ-DI scores were 24%, 31%, 36%, and 43% (first TNFi); 14%, 19%, 23%, and 29% (second TNFi); and 9%, 14%, 17%, and 20% (third TNFi), respectively. For biologic-naïve patients with disease duration < 5 years, 6-month LUNDEX-adjusted remission rates for pain, fatigue, PtGA, and HAQ-DI scores were 22%, 28%, 33%, and 42%, respectively. Corresponding rates for patients with disease duration > 10 years were 27%, 32%, 41%, and 43%, respectively. Remission rates were 33%, 40%, 45%, and 56% for men and 17%, 23%, 24%, and 32% for women, respectively. For patients aged < 45 years at diagnosis, 6-month LUNDEX-adjusted remission rate for pain was 29% vs 18% for patients ≥ 45 years. Conclusion. In 12,262 biologic-naïve patients with PsA, 6 months of treatment with a TNFi reduced pain by approximately 50%. Marked differences in PRO remission rates across treatment courses, registries, disease duration, sex

Objective Women with psoriatic arthritis (PsA) may have reduced tumor necrosis factor inhibitor (TNFi) effectiveness compared to men. We examined sex differences in treatment response and retention rates during 24 months of follow-up among patients with PsA initiating their first TNFi. Methods Data from patients with PsA across 13 European Spondyloarthritis Research Collaboration Network registries starting their first TNFi were pooled. Logistic regression was used to analyze the association between sex and treatment response using low disease activity (LDA) according to the Disease Activity Score in 28 joints using the C-reactive protein level (DAS28-CRP) (<3.2) at six months as the primary outcome. Analyses were adjusted for age, country, conventional synthetic disease-modifying antirheumatic drug treatment, and TNFi start year. Retention rates were explored using the Kaplan–Meier estimator. Results We analyzed the treatment response of 7,679 patients with PsA (50% women) with available data on LDA at six months. At baseline, women and men had similar characteristics, including mean DAS28-CRP (women vs men, 4.4 [SD 1.2] vs 4.2 [SD 1.2]), though patient-reported outcome measures were worse in women. At six months, 64% of women and 78% of men had LDA (relative risk [RR] 0.82; 95% confidence interval [CI] 0.80–0.84). This difference was similar after adjustment (RR 0.83; 95% CI 0.81–0.85). TNFi retention rates were evaluated in 17,842 patients with PsA. Women had significantly lower retention rates than men at all time points (women 79%, 64%, and 50% vs men 88%, 77%, and 64% at 6, 12, and 24 months, respectively). Conclusion Despite comparable disease characteristics at baseline, women with PsA have reduced treatment response and retention rates to their first TNFi, highlighting the need to consider sex differences in PsA research and management., Objective: Women with psoriatic arthritis (PsA) may have reduced tumor necrosis factor inhibitor (TNFi) effectiveness compared to men. We examined sex differences in treatment response and retention rates during 24 months of follow-up among patients with PsA initiating their first TNFi. Methods: Data from patients with PsA across 13 European Spondyloarthritis Research Collaboration Network registries starting their first TNFi were pooled. Logistic regression was used to analyze the association between sex and treatment response using low disease activity (LDA) according to the Disease Activity Score in 28 joints using the C-reactive protein level (DAS28-CRP) (<3.2) at six months as the primary outcome. Analyses were adjusted for age, country, conventional synthetic disease-modifying antirheumatic drug treatment, and TNFi start year. Retention rates were explored using the Kaplan–Meier estimator. Results: We analyzed the treatment response of 7,679 patients with PsA (50% women) with available data on LDA at six months. At baseline, women and men had similar characteristics, including mean DAS28-CRP (women vs men, 4.4 [SD 1.2] vs 4.2 [SD 1.2]), though patient-reported outcome measures were worse in women. At six months, 64% of women and 78% of men had LDA (relative risk [RR] 0.82; 95% confidence interval [CI] 0.80–0.84). This difference was similar after adjustment (RR 0.83; 95% CI 0.81–0.85). TNFi retention rates were evaluated in 17,842 patients with PsA. Women had significantly lower retention rates than men at all time points (women 79%, 64%, and 50% vs men 88%, 77%, and 64% at 6, 12, and 24 months, respectively). Conclusion: Despite comparable disease characteristics at baseline, women with PsA have reduced treatment response and retention rates to their first TNFi, highlighting the need to consider sex differences in PsA research and management.

Objectives In bio-naïve patients with PsA initiating a TNF inhibitor (TNFi), we aimed to identify baseline predictors of Disease Activity index for PsA in 28 joints (DAPSA28) remission (primary objective) and DAPSA28 moderate response at 6 months, as well as drug retention at 12 months across 13 European registries. Methods Baseline demographic and clinical characteristics were retrieved and the three outcomes investigated per registry and in pooled data, using logistic regression analyses on multiply imputed data. In the pooled cohort, selected predictors that were either consistently positive or negative across all three outcomes were defined as common predictors. Results In the pooled cohort (n = 13 369), 6-month proportions of remission, moderate response and 12-month drug retention were 25%, 34% and 63% in patients with available data (n = 6954, n = 5275 and n = 13 369, respectively). Five common baseline predictors of remission, moderate response and 12-month drug retention were identified across all three outcomes. The odds ratios (95% CIs) for DAPSA28 remission were: age, per year: 0.97 (0.96–0.98); disease duration, years (<2 years as reference): 2–3 years: 1.20 (0.89–1.60), 4–9 years: 1.42 (1.09–1.84), ≥10 years: 1.66 (1.26–2.20); men vs women: 1.85 (1.54–2.23); CRP of >10 vs ≤10 mg/l: 1.52 (1.22–1.89) and 1 mm increase in patient fatigue score: 0.99 (0.98–0.99). Conclusion Baseline predictors of remission, response and adherence to TNFi therapy were identified, of which five were common for all three outcomes, indicating that the predictors emerging from our pooled cohort may be considered generalizable from country level to disease level., Objectives: In bio-naïve patients with PsA initiating a TNF inhibitor (TNFi), we aimed to identify baseline predictors of Disease Activity index for PsA in 28 joints (DAPSA28) remission (primary objective) and DAPSA28 moderate response at 6 months, as well as drug retention at 12 months across 13 European registries. Methods: Baseline demographic and clinical characteristics were retrieved and the three outcomes investigated per registry and in pooled data, using logistic regression analyses on multiply imputed data. In the pooled cohort, selected predictors that were either consistently positive or negative across all three outcomes were defined as common predictors. Results: In the pooled cohort (n=13 369), 6-month proportions of remission, moderate response and 12-month drug retention were 25%, 34% and 63% in patients with available data (n=6954, n=5275 and n=13 369, respectively). Five common baseline predictors of remission, moderate response and 12-month drug retention were identified across all three outcomes. The odds ratios (95% CIs) for DAPSA28 remission were: age, per year: 0.97 (0.96-0.98); disease duration, years (<2 years as reference): 2-3 years: 1.20 (0.89-1.60), 4-9 years: 1.42 (1.09-1.84), ≥10 years: 1.66 (1.26-2.20); men vs women: 1.85 (1.54-2.23); CRP of >10 vs ≤10 mg/l: 1.52 (1.22-1.89) and 1mm increase in patient fatigue score: 0.99 (0.98-0.99). Conclusion: Baseline predictors of remission, response and adherence to TNFi therapy were identified, of which five were common for all three outcomes, indicating that the predictors emerging from our pooled cohort may be considered generalizable from country level to disease level.

Objectives In patients with axial spondyloarthritis (axSpA) or psoriatic arthritis (PsA) initiating secukinumab, we aimed to assess and compare the proportion of patients achieving 6-, 12- and 24-month patient-reported outcomes (PRO) remission and the 24-month retention rates. Patients and methods Patients with axSpA or PsA from 16 European registries, who initiated secukinumab in routine care were included. PRO remission rates were defined as pain, fatigue, Patient Global Assessment (PGA) ≤2 (Numeric Rating Scale (NRS) 0–10) and Health Assessment Questionnaire (HAQ) ≤0.5, for both axSpA and PsA, and were calculated as crude values and adjusted for drug adherence (LUNDEX). Comparisons of axSpA and PsA remission rates were performed using logistic regression analyses (unadjusted and adjusted for multiple confounders). Kaplan-Meier plots with log-rank test and Cox regression analyses were conducted to assess and compare secukinumab retention rates. Results We included 3087 axSpA and 3246 PsA patients initiating secukinumab. Crude pain, fatigue, PGA and HAQ remission rates were higher in axSpA than in PsA patients, whereas LUNDEX-adjusted remission rates were similar. No differences were found between the patient groups after adjustment for confounders. The 24-month retention rates were similar in axSpA vs. PsA in fully adjusted analyses (HR [95 %CI] = 0.92 [0.84–1.02]). Conclusion In this large European real-world study of axSpA and PsA patients treated with secukinumab, we demonstrate for the first time a comparable effectiveness in PRO remission and treatment retention rates between these two conditions when adjusted for confounders., Objectives: In patients with axial spondyloarthritis (axSpA) or psoriatic arthritis (PsA) initiating secukinumab, we aimed to assess and compare the proportion of patients achieving 6-, 12- and 24-month patient-reported outcomes (PRO) remission and the 24-month retention rates. Patients and methods: Patients with axSpA or PsA from 16 European registries, who initiated secukinumab in routine care were included. PRO remission rates were defined as pain, fatigue, Patient Global Assessment (PGA) ≤2 (Numeric Rating Scale (NRS) 0–10) and Health Assessment Questionnaire (HAQ) ≤0.5, for both axSpA and PsA, and were calculated as crude values and adjusted for drug adherence (LUNDEX). Comparisons of axSpA and PsA remission rates were performed using logistic regression analyses (unadjusted and adjusted for multiple confounders). Kaplan-Meier plots with log-rank test and Cox regression analyses were conducted to assess and compare secukinumab retention rates. Results: We included 3087 axSpA and 3246 PsA patients initiating secukinumab. Crude pain, fatigue, PGA and HAQ remission rates were higher in axSpA than in PsA patients, whereas LUNDEX-adjusted remission rates were similar. No differences were found between the patient groups after adjustment for confounders. The 24-month retention rates were similar in axSpA vs. PsA in fully adjusted analyses (HR [95 %CI] = 0.92 [0.84–1.02]). Conclusion: In this large European real-world study of axSpA and PsA patients treated with secukinumab, we demonstrate for the first time a comparable effectiveness in PRO remission and treatment retention rates between these two conditions when adjusted for confounders.

Background In the COVID-STEROID 2 trial there was suggestion of heterogeneity of treatment effects (HTE) between patients enrolled from Europe vs. India on the primary outcome. Whether there was HTE for the remaining patient-centred outcomes is unclear. Methods In this post hoc analysis of the COVID-STEROID 2 trial, which compared 12 mg vs. 6 mg dexamethasone in adults with COVID-19 and severe hypoxemia, we evaluated HTE by geographical region (Europe vs. India) for secondary outcomes with analyses adjusted for stratification variables. Results are presented as risk differences (RDs) or mean differences (MDs) with 99% confidence intervals (CIs) and P-values from interaction tests. Findings There were differences in mortality at day 28 (RD for Europe −8.3% (99% CI: −17.7 to 1.0) vs. India 0.1% (99% CI: −10.0 to 10.0)), mortality at day 90 (RD for Europe −7.4% (99% CI: −17.1 to 2.0) vs. India −1.4% (99% CI: −12.8 to 9.8)), mortality at day 180 (RD for Europe −6.7% (99% CI: −16.4 to 2.9) vs. India −1.0% (99% CI: −12.3 to 10.3)), and number of days alive without life support at day 90 (MD for Europe 6.1 days (99% CI: −1.3 to 13.4) vs. India 1.7 days (99% CI: −8.4 to 11.8)). For serious adverse reactions, the direction was reversed (RD for Europe −1.0% (99% CI: −7.1 to 5.2) vs. India −5.3% (99% CI: −16.2 to 5.0). Interpretation Our analysis suggests higher dose dexamethasone may have less beneficial effects for patients in India as compared with those in Europe; however, the evidence is weak, and this could represent a chance finding., Background: In the COVID-STEROID 2 trial there was suggestion of heterogeneity of treatment effects (HTE) between patients enrolled from Europe vs. India on the primary outcome. Whether there was HTE for the remaining patient-centred outcomes is unclear. Methods: In this post hoc analysis of the COVID-STEROID 2 trial, which compared 12 mg vs. 6 mg dexamethasone in adults with COVID-19 and severe hypoxemia, we evaluated HTE by geographical region (Europe vs. India) for secondary outcomes with analyses adjusted for stratification variables. Results are presented as risk differences (RDs) or mean differences (MDs) with 99% confidence intervals (CIs) and P-values from interaction tests. Findings: There were differences in mortality at day 28 (RD for Europe −8.3% (99% CI: −17.7 to 1.0) vs. India 0.1% (99% CI: −10.0 to 10.0)), mortality at day 90 (RD for Europe −7.4% (99% CI: −17.1 to 2.0) vs. India −1.4% (99% CI: −12.8 to 9.8)), mortality at day 180 (RD for Europe −6.7% (99% CI: −16.4 to 2.9) vs. India −1.0% (99% CI: −12.3 to 10.3)), and number of days alive without life support at day 90 (MD for Europe 6.1 days (99% CI: −1.3 to 13.4) vs. India 1.7 days (99% CI: −8.4 to 11.8)). For serious adverse reactions, the direction was reversed (RD for Europe −1.0% (99% CI: −7.1 to 5.2) vs. India −5.3% (99% CI: −16.2 to 5.0). Interpretation: Our analysis suggests higher dose dexamethasone may have less beneficial effects for patients in India as compared with those in Europe; however, the evidence is weak, and this could represent a chance finding. Funding: None for this analysis. The COVID STEROID 2 trial was funded by The Novo Nordisk Foundation and supported by Rigshospitalet's Research Council.

Background In the context of rising costs of raw materials and environmental degradation caused by livestock farming, the agri-food sector faces significant challenges in sourcing sustainable proteins. Grain legumes have emerged as cost-effective protein sources, with lower water footprint and GHG emissions compared to animal sources. However, their cultivation is threatened by strong yield fluctuations. Leveraging intra-specific diversity through cultivar mixtures in cropping systems can effectively buffer biotic and abiotic stresses, hence increasing yield stability. In this study, we investigate the effect of intra-specific diversity on lentil nitrogen uptake under pot (2020) and field conditions (2021). We hypothesize that cultivars with higher affinity for nitrogen fixation influence the other components of the mixture, and that nitrogen uptake dynamics are a possible driver in modulating cultivar mixture behaviour. We designed two-, three-, and four-cultivar mixtures with a trait-blind approach and compared them to sole cultivars. Results and conclusions Our results show inconsistencies across the two experimental years, indicating that lentils may shift their nitrogen source from the atmosphere to the soil when grown in pots. Mixtures 15N enrichment was not always consistent with pure stand performance, suggesting that cultivar mixtures may have an unpredictable cumulative effect on nitrogen uptake. Regarding correlations with agronomic parameters, we observed a significant correlation between nodules number and nitrogen concentration, regardless of experimental conditions. Finally, we found that 15N excess emerged as a significant predictor for pure stands’ yield, but the differences were diluted with the increase in diversity levels. The findings on 15N enrichment responses, cultivar impacts, and complex mixture effects on soil microbiota underscore the need for further research., Background: In the context of rising costs of raw materials and environmental degradation caused by livestock farming, the agri-food sector faces significant challenges in sourcing sustainable proteins. Grain legumes have emerged as cost-effective protein sources, with lower water footprint and GHG emissions compared to animal sources. However, their cultivation is threatened by strong yield fluctuations. Leveraging intra-specific diversity through cultivar mixtures in cropping systems can effectively buffer biotic and abiotic stresses, hence increasing yield stability. In this study, we investigate the effect of intra-specific diversity on lentil nitrogen uptake under pot (2020) and field conditions (2021). We hypothesize that cultivars with higher affinity for nitrogen fixation influence the other components of the mixture, and that nitrogen uptake dynamics are a possible driver in modulating cultivar mixture behaviour. We designed two-, three-, and four-cultivar mixtures with a trait-blind approach and compared them to sole cultivars. Results and conclusions: Our results show inconsistencies across the two experimental years, indicating that lentils may shift their nitrogen source from the atmosphere to the soil when grown in pots. Mixtures 15N enrichment was not always consistent with pure stand performance, suggesting that cultivar mixtures may have an unpredictable cumulative effect on nitrogen uptake. Regarding correlations with agronomic parameters, we observed a significant correlation between nodules number and nitrogen concentration, regardless of experimental conditions. Finally, we found that 15N excess emerged as a significant predictor for pure stands’ yield, but the differences were diluted with the increase in diversity levels. The findings on 15N enrichment responses, cultivar impacts, and complex mixture effects on soil microbiota underscore the need for further research.

Increasing temperatures and winter precipitation can influence the carbon (C) exchange rates in arctic ecosystems. Feedbacks can be both positive and negative, but the net effects are unclear and expected to vary strongly across the Arctic. There is a lack of understanding of the combined effects of increased summer warming and winter precipitation on the C balance in these ecosystems. Here we assess the short-term (1–3 years) and long-term (5–8 years) effects of increased snow depth (snow fences) (on average + 70 cm) and warming (open top chambers; 1–3°C increase) and the combination in a factorial design on all key components of the daytime carbon dioxide (CO2) fluxes in a wide-spread heath tundra ecosystem in West Greenland. The warming treatment increased ecosystem respiration (ER) on a short- and long-term basis, while gross ecosystem photosynthesis (GEP) was only increased in the long term. Despite the difference in the timing of responses of ER and GEP to the warming treatment, the net ecosystem exchange (NEE) of CO2 was unaffected in the short term and in the long term. Although the structural equation model (SEM) indicates a direct relationship between seasonal accumulated snow depth and ER and GEP, there were no significant effects of the snow addition treatment on ER or GEP measured over the summer period. The combination of warming and snow addition turned the plots into net daytime CO2 sources during the growing season. Interestingly, despite no significant changes in air temperature during the snow-free time during the experiment, control plots as well as warming plots revealed significantly higher ER and GEP in the long term compared to the short term. This was in line with the satellite-derived time-integrated normalized difference vegetation index of the study area, suggesting that more factors than air temperature are drivers for changes in arctic tundra ecosystems.

Roots and extramatrical mycelia (EMM) influence carbon (C) and nitrogen (N) cycling in soil, but the effects of roots and EMM on the composition of soil organic carbon (SOC) and N are still unknown, especially in subtropical forests. A two-year field study was conducted in Cryptomeria japonica and Cyclobalanopsis multinervis forests in a subtropical montane forest. Ingrowth cores with different mesh sizes (2 mm, 48 µm, and 1 µm) were used to distinguish the effects of roots and EMM on SOC and total N concentrations, and the composition of SOC and N. Compared to the R0Emm0 (ingrowth cores with 1 µm mesh, no presence roots and EMM), presence roots and EMM (R1Emm1, ingrowth cores with 2 mm mesh) increased SOC concentration in the C. japonica forest, but had no effect on the composition of SOC. In the C. multinervis forest, R1Emm1 had no effect on SOC concentration, but increased the proportion of recalcitrant C. Presence of EMM but no roots (R0Emm1, ingrowth cores with 48 µm mesh) had no effect on SOC concentration in the C. japonica forest, but decreased the proportion of recalcitrant C in the C. multinervis forest. In the C. multinervis forest, R0Emm1 decreased SOC concentration but had no effect on the composition of SOC. Compared to the R0Emm0, R1Emm1 had higher soil total N concentration and the proportion of recalcitrant N in both forests, while R0Emm1 had no effect on total N concentration and the proportions of N fractions. The proportions of soil recalcitrant C and N were positively affected by fine root biomass, indicating that roots are important sources of recalcitrant C and N. These results highlight that in subtropical forest, roots could potentially enhance soil C and N accumulation, especially of recalcitrant C and N compounds, while EMM alone might potentially induce soil C loss, especially recalcitrant C loss. These findings enhance our understanding of the underlying mechanisms of SOC stabilization and plant-soil-fungi relationship., Roots and extramatrical mycelia (EMM) influence carbon (C) and nitrogen (N) cycling in soil, but the effects of roots and EMM on the composition of soil organic carbon (SOC) and N are still unknown, especially in subtropical forests. A two-year field study was conducted in Cryptomeria japonica and Cyclobalanopsis multinervis forests in a subtropical montane forest. Ingrowth cores with different mesh sizes (2 mm, 48 µm, and 1 µm) were used to distinguish the effects of roots and EMM on SOC and total N concentrations, and the composition of SOC and N. Compared to the R0Emm0 (ingrowth cores with 1 µm mesh, no presence roots and EMM), presence roots and EMM (R1Emm1, ingrowth cores with 2 mm mesh) increased SOC concentration in the C. japonica forest, but had no effect on the composition of SOC. In the C. multinervis forest, R1Emm1 had no effect on SOC concentration, but increased the proportion of recalcitrant C. Presence of EMM but no roots (R0Emm1, ingrowth cores with 48 µm mesh) had no effect on SOC concentration in the C. japonica forest, but decreased the proportion of recalcitrant C in the C. multinervis forest. In the C. multinervis forest, R0Emm1 decreased SOC concentration but had no effect on the composition of SOC. Compared to the R0Emm0, R1Emm1 had higher soil total N concentration and the proportion of recalcitrant N in both forests, while R0Emm1 had no effect on total N concentration and the proportions of N fractions. The proportions of soil recalcitrant C and N were positively affected by fine root biomass, indicating that roots are important sources of recalcitrant C and N. These results highlight that in subtropical forest, roots could potentially enhance soil C and N accumulation, especially of recalcitrant C and N compounds, while EMM alone might potentially induce soil C lo

Subarctic ecosystems are exposed to elevated temperatures and increased cloudiness in a changing climate with potentially important effects on vegetation structure, composition, and ecosystem functioning. We investigated the individual and combined effects of warming and increased cloudiness on vegetation greenness and cover in mesocosms from two tundra and one palsa mire ecosystems kept under strict environmental control in climate chambers. We also investigated leaf anatomical and biochemical traits of four dominant vascular plant species (Empetrum hermaphroditum, Vaccinium myrtillus, Vaccinium vitis-idaea, and Rubus chamaemorus). Vegetation greenness increased in response to warming in all sites and in response to increased cloudiness in the tundra sites but without associated increases in vegetation cover or biomass, except that E. hermaphroditum biomass increased under warming. The combined warming and increased cloudiness treatment had an additive effect on vegetation greenness in all sites. It also increased the cover of graminoids and forbs in one of the tundra sites. Warming increased leaf dry mass per area of V. myrtillus and R. chamaemorus, and glandular trichome density of V. myrtillus and decreased spongy intercellular space of E. hermaphroditum and V. vitis-idaea. Increased cloudiness decreased leaf dry mass per area of V. myrtillus, palisade thickness of E. hermaphroditum, and stomata density of E. hermaphroditum and V. vitis-idaea, and increased leaf area and epidermis thickness of V. myrtillus, leaf shape index and nitrogen of E. hermaphroditum, and palisade intercellular space of V. vitis-idaea. The combined treatment caused thinner leaves and decreased leaf carbon for V. myrtillus, and increased leaf chlorophyll of E. hermaphroditum. We show that under future warmer increased cloudiness conditions in the Subarctic (as simulated in our experiment), vegetation composition and distribution will change, mostly dominated by graminoids and forbs. These, Subarctic ecosystems are exposed to elevated temperatures and increased cloudiness in a changing climate with potentially important effects on vegetation structure, composition, and ecosystem functioning. We investigated the individual and combined effects of warming and increased cloudiness on vegetation greenness and cover in mesocosms from two tundra and one palsa mire ecosystems kept under strict environmental control in climate chambers. We also investigated leaf anatomical and biochemical traits of four dominant vascular plant species (Empetrum hermaphroditum, Vaccinium myrtillus, Vaccinium vitis-idaea, and Rubus chamaemorus). Vegetation greenness increased in response to warming in all sites and in response to increased cloudiness in the tundra sites but without associated increases in vegetation cover or biomass, except that E. hermaphroditum biomass increased under warming. The combined warming and increased cloudiness treatment had an additive effect on vegetation greenness in all sites. It also increased the cover of graminoids and forbs in one of the tundra sites. Warming increased leaf dry mass per area of V. myrtillus and R. chamaemorus, and glandular trichome density of V. myrtillus and decreased spongy intercellular space of E. hermaphroditum and V. vitis-idaea. Increased cloudiness decreased leaf dry mass per area of V. myrtillus, palisade thickness of E. hermaphroditum, and stomata density of E. hermaphroditum and V. vitis-idaea, and increased leaf area and epidermis thickness of V. myrtillus, leaf shape index and nitrogen of E. hermaphroditum, and palisade intercellular space of V. vitis-idaea. The combined treatment caused thinner leaves and decreased leaf carbon for V. myrtillus, and increased leaf chlorophyll of E. hermaphroditum. We show that under future warmer increased cloudiness conditions in the Subarctic (as simulated in our experiment), vegetation composition and distribution will change, mostly dominated by graminoids and forbs. The

Mortality disparities among persons with intellectual disability are important to guide health-care practices. The objective was to evaluate mortality patterns of persons with intellectual disability in a nationwide study from 1976 to 2020. This study establishes a Danish nationwide cohort of persons with intellectual disability and age- and sex-matched reference cohort through linkage between several registers. We established a cohort of 79,114 persons with intellectual disability. Standardized mortality ratios were increased for persons with intellectual disability, most pronounced among younger persons and among females. Life expectancies were markedly lower; among persons with intellectual disability 63.6 years among females and 59.8 years among males in 2016-2020 compared to 82.4 and 78.7 years among females and males in the reference cohort. Life expectancies decreased with severity of intellectual disability. This study reports the establishment of a nationwide Danish cohort of persons with intellectual disability.

Plant biomass is a fundamental ecosystem attribute that is sensitive to rapid climatic changes occurring in the Arctic. Nevertheless, measuring plant biomass in the Arctic is logistically challenging and resource intensive. Lack of accessible field data hinders efforts to understand the amount, composition, distribution, and changes in plant biomass in these northern ecosystems. Here, we present The Arctic plant aboveground biomass synthesis dataset, which includes field measurements of lichen, bryophyte, herb, shrub, and/or tree aboveground biomass (g m−2) on 2,327 sample plots from 636 field sites in seven countries. We created the synthesis dataset by assembling and harmonizing 32 individual datasets. Aboveground biomass was primarily quantified by harvesting sample plots during mid- to late-summer, though tree and often tall shrub biomass were quantified using surveys and allometric models. Each biomass measurement is associated with metadata including sample date, location, method, data source, and other information. This unique dataset can be leveraged to monitor, map, and model plant biomass across the rapidly warming Arctic.

We have characterized soot particles measured in situ in a laminar co-flow ethylene-air diffusion flame using small-angle X-ray scattering (SAXS). The analysis includes temperature measurements made with coherent anti-Stokes Raman spectroscopy (CARS) and complements soot volume-fraction and maturity measurements made with laser-induced incandescence (LII). We compared the results of fits to the SAXS measurements using a unified model and a fractal core-shell model. Power-law parameters yielded by the unified model indicate that aggregates of primary particles are in the mass-fractal regime, whereas the primary particles are in the surface-fractal regime in the middle of the flame. Higher and lower in the flame, the primary-particle power-law parameter approaches 4, suggesting smooth primary particles. These trends are consistent with fits using the fractal core-shell model, which indicate that particles have an established core-shell structure in the middle of the flame and are internally homogeneous at higher and lower heights in the flame. Primary-particle size distributions derived using the fractal core-shell model demonstrate excellent agreement with distributions inferred from transmission electron microscopy (TEM) images in the middle of the flame. Higher in the flame, a second small mode appears in the size distributions, suggesting particle fragmentation during oxidation. Surface oxidation would explain (1) aggregate fragmentation and (2) loss of core-shell structure leading to smoother primary-particle surfaces by removal of carbon overlayers. SAXS measurements are much more sensitive to incipient and young soot particles than LII and demonstrate significant volume fraction from particles low in the flame where the LII signal is negligible.

We have developed a strategy for distinguishing between small-angle X-ray scattering (SAXS) from gas-phase species and newly formed nanoparticles in mixed gas- and particle-phase reacting flows. This methodology explicitly accounts for temperature-dependent scattering from gases. We measured SAXS in situ in a sooting linear laminar partially premixed co-flow ethylene/air diffusion flame. The scattering signal demonstrates a downward curvature as a function of the momentum transfer (q) at q values of 0.2-0.57 Å-1. The q-dependent curvature is consistent with the Debye equation and the independent-atom model for gas-phase scattering. This behavior can also be modeled using the Guinier approximation and could be characterized as a Guinier knee for gas-phase scattering. The Guinier functional form can be fit to the scattering signal in this q range without a priori knowledge of the gas-phase composition, enabling estimation of the gas-phase contribution to the scattering signal while accounting for changes in the gas-phase composition and temperature. We coupled the SAXS measurements with in situ temperature measurements using coherent anti-Stokes Raman spectroscopy. This approach to characterizing the gas-phase SAXS signal provides a physical basis for distinguishing among the contributions to the scattering signal from the instrument function, flame gases, and nanoparticles. The results are particularly important for the analysis of the SAXS signal in the q range associated with particles in the size range of 1-6 nm.

Two prominent factors posing a major threat to biodiversity in marine ecosystems are climate change and the establishment of invasive species, and the interaction between these two. Because of the upwelling of cold, nutrient-rich water, the coast of Portugal is a thermal refuge and distribution edge for cold-adapted species, making it a particularly important study area from a biodiversity point of view. In this study I investigated the physiological tolerance to heat stress of six different native and co-occurring non-native marine species, red algae; C. crispus and G. turuturu, brown algae; S.polyschides and U. pinnatifida, and mussels ; X.securis and M.galloprovincialis, in the intertidal rocky coast of Portugal. Dynamic ramping assays with four different durations and intensity of thermal stress was conducted for each specie to determine a so-called thermal death time (TDT) curve and the thermal tolerance parameters CTmax (the temperature that will cause death within one min) and z (the decrease in thermal decay over time) for each specie. To compare the thermal tolerance between the native vs non-native species a linear mixed effects model was applied. This study found a significantly higher thermal tolerance to extreme temperatures expressed as the upper critical temperature CTmax in the invasive red algae G. turuturu and mussel X.securis compared to its native counterparts C.crispus and M.galloprovincialis. The study found no significant difference in the thermal tolerance expressed for the kelp species S. polyschides and U.pinnatifida which had a similar response to the heat challenge. The implication from these the findings for the coast of Portugal, could be that the invasive algae and mussel might better survive an extreme event such as a heatwave then the co-occurring native, while the invasive kelp species would respond in a similar way to the heat challenge. Hence the invasive capacity might depend more on the invasion window after a stressful even

The Nordic Youth Disability Summit is the Nordic Council of Ministers' annual collaboration meetings with youth disability organisations. The aim of the meetings is to strengthen the perspectives of children and youth in Nordic cooperation on disability issues. This publication is a meeting report from the first Summit. Youth disability organisations met in Copenhagen in October 2023 to discuss current issues and challenges and identify areas of cooperation. This is a report on the results and implementations of the Summit. It presents statements developed during the summit on key topics in the Nordic Council of Ministers’ programme for cooperation on disability issues. The summit resulted in statements from a youth perspective on inclusive working life, cross-border obstacles in the Nordic region, how to take into account the child and youth perspective in the Nordic Council of Ministers’ policies and recommendations on inclusion in student democracy.

While there are EU laws for priority allergenic ingredients information on food product packaging, there is no legislation about Precautionary Allergen Labelling (PAL) for unintended allergen presence (UAP). As a result, PAL is used in different ways by different manufacturers and retailers, which hampers consumers’ interpretation of the information in the PAL. Previous research has focused on the forms of PAL that are used and on the way they are interpreted and used by consumers. This study adds the perspective of producers, retailers and branch organizations. Thirteen interviews with QA- and QC-professionals were conducted to find out more about the reasoning behind their PAL-use and to find out how PAL could be optimized. Results show that harmonization is needed, on different levels: in the way information on UAP is shared between parties involved in the food chain; in the way PAL is presented and phrased; and in the rules and regulations on PAL. More research is needed on possible ways to share (updates on) information on UAP with consumers.

We investigated the pyrolysis of propyne and propene using aerosol mass spectrometry coupled with tunable synchrotron vacuum ultraviolet photoionization. The results show that propyne forms particles at pyrolysis temperatures approximately 100 K below the lowest temperature at which propene produces particles. The aerosol mass spectra show that the carbon-to-hydrogen (C/H) ratios of the pyrolysis products from both reactants increase with temperature between the particle onset temperature and 1275 K. In this temperature range, the mass peaks corresponding to species with 18 or more carbon atoms are more saturated (i.e., have lower C/H ratios) than species predicted by the stabilomer grid. The observation of relatively high saturation (low C/H ratios) at temperatures near particle onset is consistent with the presence of aliphatically linked hydrocarbons during the preliminary stages of soot formation. The masses of the species presumed to be aliphatically linked suggest that these linked species are adducts of species smaller than chrysene (C18H12). We performed a comparative analysis of the initial PAH-growth pathways consistent with aerosol mass spectra and associated mass-specific photoionization-efficiency curves. The results from the comparative analysis indicate that the development of PAHs up to the size of acenaphthylene (C12H8) follow similar formation pathways for propyne and propene, but the isomeric composition of species larger than acenaphthylene diverges for the two reactants.

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Funksjonshindersrådets årsrapport redegjør for hvordan Nordisk ministerråds handlingsplan for funksjonshinderssamarbeidet 2018–2022 har blitt realisert. Rapporten beskriver også hvordan Nordisk ministerråd har samarbeidet med Funksjonshindersrådet om utviklingen av et nytt samarbeidsprogram om funksjonshindersspørsmål i Norden 2023–2027. Mennesker med nedsatt funksjonsevne er særlig sårbare når kriser og konflikter oppstår. Spørsmålet har blitt diskutert av rådet ved flere anledninger. På sitt høstmøte vedtok rådet en resolusjon der det blant annet etterlyses dialog med gruppene som blir berørt av kriser, begrensninger og samfunnsendringer. Personer med urfolksbakgrunn med nedsatt funksjonsevne er ekstra utsatt for klimaendringer og miljøproblemer. Dette var temaet for den nordiske fagseminaret ved FNs årlige behandling av implementering av konvensjonen om rettighetene til personer med nedsatt funksjonsevne (CRPD) i New York i juni. Kunst og kultur skal være tilgjengelig for alle, og alle skal ha rett til å utvikle sitt eget kunstneriske potensial. På oppdrag fra Nordisk ministerråd for kultur arrangerte Nordens velferdssenter Kunst og kultur for alle – Konferanse om kultur og funksjonshemninger i Norden. Funksjonshindersrådet møttes to ganger i løpet av 2022, i Oslo om våren og i Stockholm om høsten. Rådet for nordisk samarbeid om funksjonshinder er et rådgivende organ for alle politikk- og virksomhetsområder i Nordisk ministerråd når det gjelder spørsmål som angår funksjonshinderspørsmål.

Background: Numerous intrauterine factors may affect the offspring’s growth during childhood. We aimed to explore if maternal and paternal prenatal lipid, apolipoprotein (apo)B and apoA1 levels are associated with offspring weight, length, and body mass index from 6 weeks to eight years of age. This has previously been studied to a limited extent. Methods: This parental negative control study is based on the Norwegian Mother, Father and Child Cohort Study and uses data from the Medical Birth Registry of Norway. We included 713 mothers and fathers with or without self-reported hypercholesterolemia and their offspring. Seven parental metabolites were measured by nuclear magnetic resonance spectroscopy, and offspring weight and length were measured at 12 time points. Data were analyzed by linear spline mixed models, and the results are presented as the interaction between parental metabolite levels and offspring spline (age). Results: Higher maternal total cholesterol (TC) level was associated with a larger increase in offspring body weight up to 8 years of age (0.03 ≤ Pinteraction ≤ 0.04). Paternal TC level was not associated with change in offspring body weight (0.17 ≤ Pinteraction ≤ 0.25). Higher maternal high-density lipoprotein cholesterol (HDL-C) and apoA1 levels were associated with a lower increase in offspring body weight up to 8 years of age (0.001 ≤ Pinteraction ≤ 0.005). Higher paternal HDL-C and apoA1 levels were associated with a lower increase in offspring body weight up to 5 years of age but a larger increase in offspring body weight from 5 to 8 years of age (0.01 ≤ Pinteraction ≤ 0.03). Parental metabolites were not associated with change in offspring height or body mass index up to 8 years of age (0.07 ≤ Pinteraction ≤ 0.99). Conclusions: Maternal compared to paternal TC, HDL-C, and apoA1 levels were more strongly and consistently associated with offspring body weight during childhood, supporting a direct intrauterine effect.

Syntetiskt oxytocin är en vanlig behandling under förlossning. Oxytocin används som induktionsmetod och för att behandla värksvaghet. För att diagnostisera värksvaghet behöver kvinnan vara i aktiv fas, men varken för diagnosen värksvaghet eller för begreppet aktiv fas råder konsensus. Konsensus saknas även för längden på en normal förlossning och det råder individuell variation. Idag administreras oxytocin utan hänsyn till Body Mass Index. Syftet med litteraturöversikten var att belysa om och i så fall hur dosen av syntetiskt oxytocin påverkas av kvinnans Body Mass Index under förlossning. Metoden var en litteraturöversikt med systematisk ansats. Databassökningen utfördes i CINAHL och PubMed. Artiklarna kvalitetsgranskades och 15 kvantitativa artiklar inkluderades. Artiklarna analyserades med integrerad analys med en induktiv ansats. Dataanalysen resulterade i fyra huvudkategorier: exponering av syntetiskt oxytocin, oxytocindos, infusionslängd/duration av oxytocininfusion och varierande förlossningsutfall. Tre subkategorier påträffades under huvudkategorin oxytocindos: genomsnittlig medelhastighet, administrerad totaldos och högsta infusionshastighet. Resultatet visade att dosen av oxytocin under förlossning delvis påverkas av kvinnans Body Mass Index. Det sågs att ett högre Body Mass Index ökar sannolikheten att exponeras med oxytocin under förlossning. Ingen entydighet gällande oxytocindos i relation till Body Mass Index sågs för övriga kategorier. Det sågs en viss antydan att kvinnor som induceras behöveren högre högsta infusionshastighet och totaldos i relation till ett högre Body Mass Index. Slutsatsen var att sannolikt påverkas oxytocinadministreringen av fler faktorer än kvinnans Body Mass Index. Då oxytocin är en vanlig förlossningsintervention behövs fortsatt forskning på hur oxytocin kan doseras på ett mer individanpassat sätt., Synthetic oxytocin is a common treatment during labor. Oxytocin is used as a method for induction and for augmentation of labor. To diagnose dystocia the woman needs to be in active stage, however there is no common definition either for the diagnose dystocia or concept of active stage. There is no agreement about the length of a normal labor and individual variety occurs. Today oxytocin is administrated without consideration for Body Mass Index. The aim of the literature review was to illustrate if and is so how the dose of synthetic oxytocin is affected by maternal Body Mass Index during labor. The method was a literature review with a systematic approach. The search was conducted in CINAHL and PubMed. The quality of the studies was assessed and 15 quantitative studies were included. The studies were analyzed through integrated analysis with an inductive approach. The data analysis resulted in four main categories: exposure of synthetic oxytocin, oxytocin dose, duration of oxytocin and varying labor outcomes. Three subcategories were found in the main category oxytocin dose: average rate, total dose and peak infusion rate. The result was that the oxytocin dose used during labor was partly affected by maternal Body Mass Index. A higher Body Mass Index was seen to increase probability for oxytocin exposure during labor. No unambiguity was seen regarding oxytocin dose in relation to Body Mass Index for the other categories. A trend towards the need of a higher peak infusion rate and total dose regarding a higher Body Mass Index was shown for women who underwent induction. In conclusion the administration of oxytocin is plausibly affected by other factors than maternal Body Mass Index. Since oxytocin is a common intervention during labor further research is needed to explore how administration of oxytocin could occur in a more individualized manner.

BACKGROUND: Benefits of cardiac rehabilitation (CR) programme components on attaining risk factor targets post-myocardial infarction (MI) and their predictive strength relative to patient characteristics remain unclear. We aimed to identify organizational and patient-level predictors of risk factor target attainment at one-year post-MI. METHODS: In this observational study data on CR organization at 78 Swedish CR centres was collected and merged with patient-level registry data (n = 7549). Orthogonal partial least squares discriminant analysis identified predictors (Variables of Importance for the Projection (VIP) values >0.8) of attaining low-density lipoprotein-cholesterol (LDL-C) <1.8 mmol/L, blood pressure (BP) <140/90 mmHg and smoking abstinence. RESULTS: The strongest predictors (VIP [95% CI]) for attaining LDL-C and BP targets were offering psychosocial management (2.14 [1.78-2.50]; 2.45 [1.91-2.99]), having a psychologist in the CR team (1.62 [1.36-1.87]; 2.05 [1.67-2.44]), extended opening hours (2.13 [2.00-2.27]; 1.50 [0.91-2.10]), adequate facilities (1.54 [0.91-2.18]; 1.89 [1.38-2.40]), and having a medical director (1.70 [0.91-2.48]; 1.46 [1.04-1.88]). The strongest patient-level predictors of attaining LDL-C and/or BP targets were low baseline LDL-C (3.95 [3.39-4.51]) and having no history of hypertension (2.93 [2.60-3.26]), respectively, followed by exercise-based CR participation (1.38 [0.66-2.10]; 1.46 [1.14-1.78]). For smoking abstinence, the strongest organizational predictor was varenicline being prescribed by CR physicians (1.88 [0.95-2.80]) and patient-level predictors were participation in exercise-based CR (2.47 [2.07-2.88]) and group education (1.92 [1.43-2-42]), and no cardiovascular disease history (2.13 [1.78-2.48]). CONCLUSIONS: We identified multiple CR organizational and patient-level predictors of attaining risk factor targets post-MI. These results may influence the future design of comprehensive CR programmes.

Background: Benefits of cardiac rehabilitation (CR) programme components on attaining risk factor targets post-myocardial infarction (MI) and their predictive strength relative to patient characteristics remain unclear. We aimed to identify organizational and patient-level predictors of risk factor target attainment at one-year post-MI. Methods: In this observational study data on CR organization at 78 Swedish CR centres was collected and merged with patient-level registry data (n = 7549). Orthogonal partial least squares discriminant analysis identified predictors (Variables of Importance for the Projection (VIP) values >0.8) of attaining low-density lipoprotein-cholesterol (LDL-C) <1.8 mmol/L, blood pressure (BP) <140/90 mmHg and smoking abstinence. Results: The strongest predictors (VIP [95% CI]) for attaining LDL-C and BP targets were offering psychosocial management (2.14 [1.78-2.50]; 2.45 [1.91-2.99]), having a psychologist in the CR team (1.62 [1.36-1.87]; 2.05 [1.67-2.44]), extended opening hours (2.13 [2.00-2.27]; 1.50 [0.91-2.10]), adequate facilities (1.54 [0.91-2.18]; 1.89 [1.38-2.40]), and having a medical director (1.70 [0.91-2.48]; 1.46 [1.04-1.88]). The strongest patient-level predictors of attaining LDL-C and/or BP targets were low baseline LDL-C (3.95 [3.39-4.51]) and having no history of hypertension (2.93 [2.60-3.26]), respectively, followed by exercise-based CR participation (1.38 [0.66-2.10]; 1.46 [1.14-1.78]). For smoking abstinence, the strongest organizational predictor was varenicline being prescribed by CR physicians (1.88 [0.95-2.80]) and patient-level predictors were participation in exercise-based CR (2.47 [2.07-2.88]) and group education (1.92 [1.43-2-42]), and no cardiovascular disease history (2.13 [1.78-2.48]). Conclusions: We identified multiple CR organizational and patient-level predictors of attaining risk factor targets post-MI. These results may influence the future design of comprehensive CR programmes., Funding Agencies|Swedish Research Council for Health, Working Life and Welfare (FORTE) [2019-00365]; Swedish Heart and Lung Association [20190431]; Swedish Heart and Lung Patient Organization; Swedish Cardiology Society; Faculty of Medicine, Lund University, Sweden; Astra Zeneca; Amgen

“Groundwater: Making the invisible visible” is the theme of the World Water Day 2022 and the title of the corresponding UN World Water Development Report (United Nations 2022). It describes our dilemma quite well: Groundwater is of vital importance, but being hidden, it is out of sight and out of mind. Hence, current efforts aim at increasing the awareness for this undervalued resource.

01 augustus 2023, Contains fulltext : 295991.pdf (Publisher’s version ) (Closed access), OBJECTIVE: To investigate the distribution of patient-reported outcomes (PROs) in patients with axial spondyloarthritis (axSpA) initiating a tumor necrosis factor inhibitor (TNFi), to assess the proportion reaching PRO "remission" across registries and treatment series, and to compare patients registered to fulfill the modified New York (mNY) criteria for ankylosing spondylitis (AS) vs patients with nonradiographic axSpA (nr-axSpA). METHODS: Fifteen European registries contributed PRO scores for pain, fatigue, patient global assessment (PtGA), Bath Ankylosing Spondylitis (AS) Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), and Health Assessment Questionnaire (HAQ) from 19,498 patients with axSpA. Changes in PROs and PRO remission rates (definitions: ≤ 20 mm for pain, fatigue, PtGA, BASDAI, and BASFI; ≤ 0.5 for HAQ) were calculated at 6, 12, and 24 months of treatment. RESULTS: Heterogeneity in baseline characteristics and outcomes between registries were observed. In pooled data, 6 months after the start of a first TNFi, pain score was reduced by approximately 60% (median at baseline/6/12/24 months: 65/25/20/20 mm) in patients on treatment. Similar patterns were observed for fatigue (68/32/30/25 mm), PtGA (66/29/21/20 mm), BASDAI (58/26/21/19 mm), BASFI (46/20/16/16 mm), and HAQ (0.8/0.4/0.2/0.2). Patients with AS (n = 3281) had a slightly better response than patients with nr-axSpA (n = 993). The Lund Efficacy Index (LUNDEX)-adjusted remission rates at 6 months for pain/fatigue/PtGA/BASDAI/BASFI/HAQ were 39%/30%/38%/34%/35%/48% for the AS cohort and 30%/21%/26%/24%/33%/47% for the nr-axSpA cohort. Better PRO responses were seen with a first TNFi compared to a second and third TNFi. CONCLUSION: Patients with axSpA starting a TNFi achieved high PRO remission rates, most pronounced in those fulfilling the mNY criteria and for the first TNFi.

Popular modern diets are often seen as a panacea for improving health and promoting weight reduction. While there is a large body of literature reporting the health benefits of popular diets, few studies have described their planetary benefits. Our investigation aims to evaluate the simultaneous impacts of six popular diets within the United States on both human and planetary health. Using carbon footprint databases and representative meal plans, the environmental and health-related impacts of the Standard American, Mediterranean, vegan, paleo, keto, and climatarian diets are compared using the currently available literature. Results indicate that diets that exhibit lower carbon footprints also have positive effects on human health. The diets found to have the lowest environmental impacts were the vegan, climatarian, and Mediterranean diets. These low-carbon-footprint diets can likely be attributed to a reduced reliance on ruminant meat (cattle and sheep) and processed food consumption, while diets with high carbon footprints are more dependent on ruminant meat and saturated fat. Moderate consumption of meats such as chicken, pork, and fish in conjunction with an emphasis on locally grown fruits and vegetables can be maintained without adversely affecting the planetary carbon footprint and with the added benefit of promoting good health. Thus, making simple substitutions within each individual's diet can be advertised as an effective approach to collectively lower the environmental impact in tandem with improving health and longevity.