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Loss of species in food webs can set in motion a cascade of additional (secondary) extinctions.A species' position in a food web (e.g. its trophic level or number of interactions) is known to affect its ability to persist following disturbance.These simple measures, however, offer only a coarse description of how species fit into their community.One would therefore expect that more detailed structural measures such as participation in three‐species motifs (meso‐scale structures which provide information on a species' direct and indirect interactions) will also be related to probability of persistence.Disturbances affecting the basal resources have particularly strong effects on the rest of the food web.However, how disturbances branch out and affect consumer persistence depends on the structural pattern of species interactions in several steps.The magnitude, for example, the proportion of basal resources lost, will likely also affect the outcome.Here, we analyse whether a consumer's risk of secondary extinction after the removal of basal resources depends on the consumer's motif participation and how this relationship varies with the severity of disturbance.We show that consumer species which participate more frequently in the direct competition motif and less frequently in the omnivory motif generally have higher probability of persistence following disturbance to basal resources.However, both the strength of the disturbance and the overall network structure (i.e. connectance) affect the strength and direction of relationships between motif participation and persistence.Motif participation therefore captures important trends in species persistence and provides a rich description of species' structural roles in their communities, but must be considered in the context of network structure as a whole and of the specific disturbance applied. [ABSTRACT FROM AUTHOR]

This paper examines teacher education, with a focus on student experiences of comfort, discomfort, and sense of belonging or not belonging in the educational setting. The analysis is conducted with an intersectional corpomaterial perspective and based on 12 individual and two group interviews with student teachers, who identify as breaching norms within an intersectional power dynamic, or as interested in discussing such norms. The participants describe situations where they felt excluded and where they adjusted to try to fit their educational spaces. In contrast, some talk about a desirable, but rare, state of comfort, belonging or ‘just being’. This state is intertwined with the spatiality and embodiment of class, racialisation, dis/ability and gender. The analysis challenges a dualistic understanding of comfort and discomfort in education, and shows how the participants’ critique of teacher education could be formulated as a longing for, and a simultaneous production of, another kind of education. [ABSTRACT FROM AUTHOR]

In the Atlantic Ocean island state of Cabo Verde, silence about hunger is perennial. Elderly people who lived through devastating famines during Portuguese colonialism seldom talk about their memories, and contemporary experiences of food deprivation are buried in silence. Yet there is one space in which the silence is broken: music. Exploring that space, this article analyses representations of drought and hunger in Cabo Verdean music and explores the social contexts, positionalities and sentiments that the lyrics evoke. The article portrays the everyday listening to and singing of the lyrics as a kind of 'organic remembering' and demonstrates how it contributes to a view of hunger as a key symbol of the nation at the same time as the experience of hunger is surrounded by silence in everyday life. Furthermore, the article brings up the silencing of the Portuguese' colonial responsibility for the sufferings. It also presents some reasons for this, including Cabo Verde's hybrid position in the Portuguese empire as an uneasy mixture between a distant and neglected appendage to the metropole and a colony. Finally, it argues that not blaming the ex-colonisers has been an important way forward for the small and dependent postcolonial state. [ABSTRACT FROM AUTHOR]

BACKGROUND: It is unknown whether dietary intake of polyunsaturated fatty acids (PUFA) modifies the cardiovascular disease (CVD) risk associated with a family history of CVD. We assessed interactions between biomarkers of low PUFA intake and a family history in relation to long-term CVD risk in a large consortium. METHODS: Blood and tissue PUFA data from 40 885 CVD-free adults were assessed. PUFA levels =25th percentile were considered to reflect low intake of linoleic, alpha-linolenic, and eicosapentaenoic/docosahexaenoic acids (EPA/DHA). Family history was defined as having =1 first-degree relative who experienced a CVD event. Relative risks with 95% CI of CVD were estimated using Cox regression and meta-analyzed. Interactions were assessed by analyzing product terms and calculating relative excess risk due to interaction. RESULTS: After multivariable adjustments, a significant interaction between low EPA/DHA and family history was observed (product term pooled RR, 1.09 [95% CI, 1.02-1.16]; P=0.01). The pooled relative risk of CVD associated with the combined exposure to low EPA/DHA, and family history was 1.41 (95% CI, 1.30-1.54), whereas it was 1.25 (95% CI, 1.16-1.33) for family history alone and 1.06 (95% CI, 0.98-1.14) for EPA/DHA alone, compared with those with neither exposure. The relative excess risk due to interaction results indicated no interactions. CONCLUSIONS: A significant interaction between biomarkers of low EPA/DHA intake, but not the other PUFA, and a family history was observed. This novel finding might suggest a need to emphasize the benefit of consuming oily fish for individuals with a family history of CVD. [ABSTRACT FROM AUTHOR]

In this paper I use a feminist corpomaterial lens to examine how students are shaped by and shape their education. The analysis, based on individual and group interviews with twelve student teachers, shows how intersectional somatic norms in teacher education produce situations where students feel forced to educate, inform and take responsibility for others’ learning when it comes to knowledge concerning their own identities and/or social justice issues. The educational assemblages examined impact both the education and participants. I discuss how the created concept of ‘becoming carving-bodies’ might enhance the understanding of student experiences. Becoming carving-bodies entails, for example, acts of caring for oneself and for others. However, it can also drain students’ energy and limit students’ chances of developing and learning. Furthermore, students may need to avoid appearing too emotional in order to be taken seriously. [ABSTRACT FROM AUTHOR]

Increased platelet destruction is central in the pathogenesis of immune thrombocytopenia. However, impaired platelet production is also relevant and its significance underlies the rationale for treatment with thrombopoietin receptor agonists (TPO-RAs). Previous studies have associated enhanced complement activation with increased disease severity. Additionally, treatment refractoriness has been demonstrated to resolve by the administration of complement-targeted therapeutics in a subset of patients. The association between complement activation and the platelet response to TPO-RA therapy has previously not been investigated. In this study, blood samples from patients with immune thrombocytopenia (n = 15) were prospectively collected before and two, six and 12 weeks after the initiation of TPORA therapy. Plasma levels of complement degradation product C4d and soluble terminal complement complexes were assessed. Patients with significantly elevated baseline levels of terminal complement complexes exhibited more often an inadequate platelet response (p = .04), were exclusively subjected to rescue therapy with intravenous immunoglobulin (p = .02), and did not respond with a significant platelet count increase during the study period. C4d showed a significant (p = .01) ability to distinguish samples with significant terminal complement activation, implying engagement of the classical complement pathway. In conclusion, elevated levels of complement biomarkers were associated with a worse TPO-RA treatment response. Larger studies are needed to confirm these results. Biomarkers of complement activation may prove valuable as a prognostic tool to predict which patients that potentially could benefit from complement-inhibiting therapy in the future. [ABSTRACT FROM AUTHOR]

The Light Dark Matter eXperiment (LDMX) is an electron-beam fixed-target experiment designed to achieve comprehensive model independent sensitivity to dark matter particles in the sub-GeV mass region. An upgrade to the LCLS-II accelerator will increase the beam energy available to LDMX from 4 to 8 GeV. Using detailed GEANT4-based simulations, we investigate the effect of the increased beam energy on the capabilities to separate signal and background, and demonstrate that the veto methodology developed for 4 GeV successfully rejects photon-induced backgrounds for at least 2 × 1014 electrons on target at 8 GeV. [ABSTRACT FROM AUTHOR]

Anastomotic defect (AD) after esophagectomy can lead to severe complications with need for surgical or endoscopic intervention. Early detection enables early treatment and can limit the consequences of the AD. As of today, there are limited methods to predict AD. In this study, we have used microdialysis (MD) to measure local metabolism at the intrathoracic anastomosis. Feasibility and possible diagnostic use were investigated. Sixty patients planned for Ivor Lewis esophagectomy were enrolled. After construction of the anastomosis, surface MD (S-MD) probes were attached to the outer surface of the esophageal remnant and the gastric conduit in close vicinity of the anastomosis and left in place for 7 postoperative days (PODs). Continuous sampling of local tissue concentrations of metabolic substances (glucose, lactate, and pyruvate) was performed postoperatively. Outcome, defined as AD or not according to Esophagectomy Complications Consensus Group definitions, was recorded at discharge or at first postoperative follow up. Difference in concentrations of metabolic substances was analyzed retrospectively between the two groups by means of artificial neural network technique. S-MD probes can be attached and removed from the gastric tube reconstruction without any adverse events. Deviating metabolite concentrations on POD 1 were associated with later development of AD. In subjects who developed AD, no difference in metabolic concentrations between the esophageal and the gastric probe was recorded. The technical failure rate of the MD probes/procedure was high. S-MD can be used in a clinical setting after Ivor Lewis esophagectomy. Deviation in local tissue metabolism on POD 1 seems to be associated with development of AD. Further development of MD probes and procedure is required to reduce technical failure. [ABSTRACT FROM AUTHOR]

The aim was to collect and appraise scientific evidence that could be used to derive an upper intake level for folic acid/folate. Five systematic reviews of the literature were conducted to identify evidence to i) characterize the dose‐response curve between plasma/serum (P/S) folate and dietary folate intake expressed as dietary folate equivalents (DFE) in adults, and to assess the relationship between 'high' folate (intake/biomarkers) in humans with low B12 status and the ii) development of neuropathy and iii) cognitive impairment or dementia, and risk of iv) colorectal adenomas and colorectal cancer (CRC) and v) and prostate cancer. Narrative reviews were also performed. The linear meta‐regression model P/S folate (nmol/L) = 6.0 + 0.034*DFE/d (95% confidence interval, CI; 0.027‐0.040), R2 = 0.68, based on 22 studies and 60 data points could be used to predict mean P/S folate (and 95% CI) based on DFE intake. In view of the paucity of data, no comprehensive uncertainty analysis and evidence integration were performed for effects of 'high' folate intake on neuropathy, cognitive function/dementia. Comprehensive uncertainty analyses and evidence integration for a detrimental effect at high folate intake/status were performed for folic acid interventions and development of colorectal adenomas, for P/S folate from observational studies in relation to CRC incidence, and for total folate intake from observational studies in relation to prostate cancer incidence. The folic acid interventions were few (n = 4) and revealed both beneficial and detrimental effects on adenoma recurrence. For CRC the meta‐analyses on P/S folate indicated no association, but the risk estimates in the highest folate exposure groups were compared to levels indicating folate inadequacy or deficiency, thus, the research question could not be adequately addressed. For prostate cancer incidence too few studies with mixed results prevented any clear conclusion on total folate intake and risk of prostate cancer. [ABSTRACT FROM AUTHOR]

A high-resolution paleoecological record provides a 2690 year-long fossil pollen and charcoal history from Lake Ayauchi, Ecuador, in lowland Amazonia. The record begins with a landscape that is already partially deforested and in which maize is being grown. Dated charcoal fragments from local soils coincide with fire events and peaks of land clearance seen in the lake sediment record. After c. AD 550 grass pollen becomes less abundant, as a broad array of forest types show small increases in abundance. Between c. AD 750 and 1280, Zea mays pollen was at its most abundant. Although maize cultivation continued until the AD 1700s, forest pollen abundance showed a significant increase at c. AD 1260. Another transition at c. AD 1420, which saw a transition from dominance by early successional taxa and an increase in mid-successional elements, suggests the onset of reduced human activity at the site. Fossil maize is found in a lower proportion of samples, disappearing altogether for a century in the late 1700s. Forest taxa increase in abundance and charcoal disappears from the record at c. AD 1790. These data suggest a complex social history prior to and following European arrival with phases of forest clearing and episodes of apparent regrowth at c. AD 500, 950, and 1260. Increased forest pollen after c. AD 1260 and a reduction in maize pollen abundance suggests some abandonment, with a second, relatively late, depopulation following European Conquest (c. AD 1790). Evidence is not found supporting reforestation associated with European arrival. [ABSTRACT FROM AUTHOR]

Right ventricular (RV) volumes are commonly obtained through time-consuming manual delineations of cardiac magnetic resonance (CMR) images. Deep learning-based methods can generate RV delineations, but few studies have assessed their ability to accelerate clinical practice. Therefore, we aimed to develop a clinical pipeline for deep learning-based RV delineations and validate its ability to reduce the manual delineation time. Quality-controlled delineations in short-axis CMR scans from 1114 subjects were used for development. Time reduction was assessed by two observers using 50 additional clinical scans. Automated delineations were subjectively rated as (A) sufficient for clinical use, or as needing (B) minor or (C) major corrections. Times were measured for manual corrections of delineations rated as B or C, and for fully manual delineations on all 50 scans. Fifty-eight % of automated delineations were rated as A, 42% as B, and none as C. The average time was 6 min for a fully manual delineation, 2 s for an automated delineation, and 2 min for a minor correction, yielding a time reduction of 87%. The deep learning-based pipeline could substantially reduce the time needed to manually obtain clinically applicable delineations, indicating ability to yield right ventricular assessments faster than fully manual analysis in clinical practice. However, these results may not generalize to clinics using other RV delineation guidelines. [ABSTRACT FROM AUTHOR]

Increased platelet destruction is central in the pathogenesis of immune thrombocytopenia. However, impaired platelet production is also relevant and its significance underlies the rationale for treatment with thrombopoietin receptor agonists (TPO-RAs). Previous studies have associated enhanced complement activation with increased disease severity. Additionally, treatment refractoriness has been demonstrated to resolve by the administration of complement-targeted therapeutics in a subset of patients. The association between complement activation and the platelet response to TPO-RA therapy has previously not been investigated. In this study, blood samples from patients with immune thrombocytopenia (n = 15) were prospectively collected before and two, six and 12 weeks after the initiation of TPO-RA therapy. Plasma levels of complement degradation product C4d and soluble terminal complement complexes were assessed. Patients with significantly elevated baseline levels of terminal complement complexes exhibited more often an inadequate platelet response (p =.04), were exclusively subjected to rescue therapy with intravenous immunoglobulin (p =.02), and did not respond with a significant platelet count increase during the study period. C4d showed a significant (p =.01) ability to distinguish samples with significant terminal complement activation, implying engagement of the classical complement pathway. In conclusion, elevated levels of complement biomarkers were associated with a worse TPO-RA treatment response. Larger studies are needed to confirm these results. Biomarkers of complement activation may prove valuable as a prognostic tool to predict which patients that potentially could benefit from complement-inhibiting therapy in the future. What is the context? Primary immune thrombocytopenia (ITP) is a potentially serious illness associated with an increased risk of bleeds. Manifestations range from confined skin bruising to life-threatening intracranial hemorrhages. It is an acquired immune disorder characterized by increased destruction and impaired production of platelets. Treatments aim at suppressing the destruction and supporting the production of platelets. Thrombopoietin receptor agonists (TPO-RA) are medically approved platelet growth factors that contribute to the generation of new platelets. The complement system is an evolutionary preserved part of innate immunity. Previous studies have indicated that complement activation may be an important contributor to disease and that the administration of complement-inhibiting therapy improves the platelet count in a subset of patients with primary ITP. What is new? The potential association between complement activation and a poor platelet response to TPO-RA therapy in primary ITP has not been previously studied. In fifteen patients with primary ITP starting TPO-RA therapy, we prospectively followed the platelet response and levels of complement biomarkers for 12 weeks. We showed that patients with high levels of complement biomarkers exhibited a worse treatment response during the study period. What is the impact? Our results suggest that levels of complement biomarkers may be valuable to predict which patients with treatment-refractory ITP that potentially could benefit from complement-inhibiting therapy in the future Larger studies are needed to confirm our results. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate recurrences and survival in endometrioid endometrial cancer (EC) in a complete population-based cohort. A regional population-based study including women with endometrioid EC, identified by the Swedish Quality Registry for Gynecological Cancer (SQRGC), where primary surgery was performed between 2010 and 2017. Patient characteristics and outcomes, including recurrences, were retrieved from the SQRGC and completed by records reviews. Overall (OS), net (NS) and disease-free survival (DFS) were calculated using the Kaplan-Meier method. The Fine and Gray proportional subdistribution hazards' regression model was used for risk factors for recurrence. There were 1630 women included in the study, whereof 136 (8.3%) had a recurrence with a median time to recurrence of 22.5 months (range 3.2–59.3). One site of recurrence was diagnosed in 69.1%, while 27.2% being only vaginal. The total 5-year OS was 88.0%(95% CI:86.4–89.7) and the 5-year NS 98.6%(95% CI:96.5–100.7). If no recurrence occurred, the OS was 91.9%(95% CI:90.4–93.3) and NS 102.8%(95% CI:100.9–104.8). For only vaginal recurrence, 5-year OS was 77.0%(95% CI:64.0–92.6) compared to 36.1%(95% CI:27.5–47.3) for all other recurrences. The total 5-year DFS was 83.9%(95% CI:82.0–85.7). In the multivariable analysis, age, FIGO stage and primary treatment were found independent factors for recurrence with a HR of 1.29(95% CI:1.11–1.51; p = 0.001) for age, 2.78(95% CI:1.80–4.29; p < 0.001) for FIGO stage III and 1.84(95% CI:1.22–2.78; p 0.004) for adjuvant treatment. There is an overall low recurrence rate for endometrioid ECs with a minor portion being only vaginal, associated with a favorable survival in contrast to other recurrences with a poor prognosis. Age, FIGO stage III and adjuvant treatment were found independent prognostic factors for recurrence. • Five-year overall survival in endometroid EC is favorable although having a recurrence decreases survival to <50%. • There is a low rate of recurrences of approximately 8% in endometrioid EC. • Only 27% of the recurrences are only vaginal. • The median time to a recurrence in endometroid EC is 22 months. • Higher age, FIGO stage III and adjuvant therapy are independent risk factors for a recurrence. [ABSTRACT FROM AUTHOR]

To investigate if the diagnostic accuracy of transvaginal ultrasound (TVUS) performed by gynaecologists is sufficient for preoperative assessment of low-grade endometrial cancer (EC) compared to magnetic resonance imaging (MRI). MRI and TVUS performed by gynaecologists were assessed at the participating centres. The MRI examinations were interpreted by two radiologists at the tertiary centre. Deep myometrial and cervical stroma invasion were visually assessed and compared to postoperative histopathology. Two hundred and fifty-nine patients were included. There was a statistically significant difference in specificity assessing deep myometrial invasion between MRI and TVUS (MRI 0.88, TVUS 0.68). There was no difference in sensitivity (MRI 0.73, TVUS 0.68). When assessing cervical stroma infiltration, MRI had a higher specificity (MRI 0.96, TVUS 0.90), but there was no difference in sensitivity (MRI 0.41, TVUS 0.32). MRI has higher specificity than TVUS performed by gynaecologists for assessing deep MI and CSI in low-grade EC, but similar sensitivities. The use of TVUS as a first-line test, rather than MRI, may be supported by this study in centres where access to MRI may be limited. • Transvaginal ultrasound may be used for preoperative staging of endometrial cancer. • MRI has higher diagnostic accuracy than transvaginal ultrasound. • MRI can be performed locally and images reviewed at a tertiary centre. [ABSTRACT FROM AUTHOR]

The superior biocompatibility and biodegradability of polyhydroxyalkanoates (PHAs) compared to man-made biopolymers such as polylactic acid promise huge potential in biomedical applications, especially tissue engineering (TE). Textile fiber-based TE scaffolds offer unique opportunities to imitate the anisotropic, hierarchical, or strain-stiffening properties of native tissues. A combination of PHAs' enhanced biocompatibility and fiber-based TE scaffolds could improve the performance of TE scaffolds. However, the PHAs' complex crystallization behavior and the resulting intricate spinning procedures remain a challenge. This review focuses on discussing the developments in PHA melt and wet spinning, their challenges, process parameters, and fiber characteristics while revealing the lack of an in-depth fiber characterization of wet-spun fibers compared to melt-spun filaments, leading to squandered potential in scaffold development. Additionally, the biomedical application of PHAs other than poly-4-hydroxybutyrate is hampered by a failure of polymer purity to meet the requirements for biomedical applications. [ABSTRACT FROM AUTHOR]

This article explores the workings of some familiar keywords when applied in a context where migration patterns diverge from conventional expectations in public debate and research. It focuses on the Portuguese seeking a better future in Angola, and it analyses emerging configurations of keywords of migration in this postcolonial setting. By focusing on this unconventional case, the article illuminates some of the stereotypical notions linked to central keywords of migration. Departing from the concepts "migrant", "expatriate", "returnee" and "integration", it explores emic constructions of the Portuguese mobile subjects' identities, incorporation processes in Angola and shifting postcolonial power positions. Moreover, it uses the emic viewpoints to discuss some globalised connotations of the four keywords. The analysis will make clear that the context-specific workings of these concepts are influenced not only by the particularities of this case but also by powerful international discourses on human mobility. On a conceptual level, the article argues for using keywords as a tool for social analysis. Arguably, ethnographic explorations of the usage and understanding of purportedly simple words can open up profound insights into shifting social values. [ABSTRACT FROM AUTHOR]

Post-fracture care (PFC) programs evaluate and manage patients with a minimal trauma or fragility fracture to prevent subsequent fractures. We conducted a literature review to understand current trends in PFC publications, evaluate key characteristics of PFC programs, and assess their clinical effectiveness, geographic variations, and cost-effectiveness. We performed a search for peer-reviewed articles published between January 2003 and December 2020 listed in PubMed or Google Scholar. We categorized identified articles into 4 non-mutually exclusive PFC subtopics based on keywords and abstract content: PFC Types, PFC Effectiveness/Success, PFC Geography, and PFC Economics. The literature search identified 784 eligible articles. Most articles fit into multiple PFC subtopics (PFC Types, 597; PFC Effectiveness/Success, 579; PFC Geography, 255; and PFC Economics, 98). The number of publications describing how PFC programs can improve osteoporosis treatment rates has markedly increased since 2003; however, publication gaps remain, including low numbers of publications from some countries with reported high rates of osteoporosis and/or hip fractures. Fracture liaison services and geriatric/orthogeriatric services were the most common models of PFC programs, and both were shown to be cost-effective. We identified a need to expand and refine PFC programs and to standardize patient identification and reporting on quality improvement measures. Although there is an increasing awareness of the importance of PFC programs, publication gaps remain in most countries. Improvements in established PFC programs and implementation of new PFC programs are still needed to enhance equitable patient care to prevent occurrence of subsequent fractures. [ABSTRACT FROM AUTHOR]

To study differences between men and women in physical activity (PA) and health-related quality of life (HRQoL) before and after participating in a supported osteoarthritis (OA) self-management programme. A prospective observational study using data from a Swedish National Quality Register. Patients recorded between 2008 and 2013 with hip and/or knee OA with data at baseline, at 3 and 12 months follow-up (n = 7628) were included. Outcome measures were patient-reported PA and HRQoL (EQ-5D-3L). A greater proportion of men (p = 0.002) changed to being physically active ≥150 min/week at 3 months follow-up. The proportion of women being physically active ≥150 min/week was larger than for men at baseline (p = 0.003) and at follow-up at 12 months (p = 0.035). Women reported lower HRQoL than men at baseline (p < 0.001), at follow-up at 3 (p < 0.001) and 12 months (p = 0.010). There were no differences between men and women in change in HRQoL at 3 (p = 0.629) and 12 months (p = 0.577) follow-up. This study showed differences between men and women in PA and HRQoL before and after participating in a supported OA self-management programme. These differences should be considered when supporting PA and HRQoL. Men with hip and/or knee osteoarthritis (OA) might need more support during rehabilitation in order to maintain or even increase physical activity (PA) in the long run. Women with hip and/or knee OA might need more support during rehabilitation in order to maintain or even increase health-related quality of life (HRQoL) in the long run. Booster sessions might be suggested in order to enable both men and women with hip and/or knee OA to sustain improvements in PA and HRQoL after participating in a supported OA self-management programme. [ABSTRACT FROM AUTHOR]

To investigate recurrence and survival in non-endometrioid endometrial cancer in a population-based cohort and evaluate the implementation of the first national guidelines (NGEC) recommending pelvic and paraaortic lymphadenectomy for surgical staging and tailored adjuvant therapy. A population-based cohort study that used the Swedish quality registry for gynaecological cancer for the identification of all women with early-stage non-endometrioid endometrial cancer between 2010 and 2017. Five-year overall (OS) and disease-free survival (DFS) were calculated using the Kaplan–Meier method. The Cox proportional hazards regression model was used to evaluate the effect of age, FIGO stage, primary treatment and lymph node dissection on DFS. There were 228 patients included in the study cohort and 67 (29%) patients had a recurrence within five years. In the recurrence cohort, the OS was 13.4% (95%CI:7.3–24.7) compared to 88.5% (95%CI:83.4–93.9) if no recurrence occurred (log-rank p < 0.001). The DFS for the complete cohort was 61.9% (95%CI:55.7–68.7). The OS before implementation of NGEC was 57.3% (95%CI:48.2–68.1) and the DFS was 52.1% (95%CI:43.0–63.1) compared to an OS of 72.0% (95%CI:64.2–80.7; log-rank p = 0.018) and a DFS of 70.1% (95%CI:62.4–78.7; log-rank p = 0.008) after implementing NGEC. Patients received adjuvant radiotherapy in 92.7% before and 42.4% after NGEC implementation (p < 0.001). In the multivariable regression analysis, age, FIGO stage and lymph node dissection were found to be significant prognostic factors, where having a lymph node dissection decreased the risk of recurrence or death with a HR of 0.58 (95%CI:0.33–1.00). In this population-based cohort of preoperative early-stage non-endometrioid EC, a significant improvement in survival was seen after NGEC implementation where lymph node staging for tailoring adjuvant therapy was introduced and less pelvic radiotherapy was given. • Improved survival with lymphadenectomy in non-endometrioid endometrial cancer (EC). • Poor survival when a recurrence occurs in non-endometrioid EC. • Lymphadenectomy decreased the risk of recurrence or death in non-endometrioid EC. [ABSTRACT FROM AUTHOR]

Background: In Sweden, core treatment for osteoarthritis is offered through a Supported Osteoarthritis Self-Management Programme (SOASP), combining education and exercise to provide patients with coping strategies in self-managing the disease. The aim was to study enablement and empowerment among patients with osteoarthritis in the hip and/or knee participating in a SOASP. An additional aim was to study the relation between the Swedish version of the Patient Enablement Instrument (PEI) and the Swedish Rheumatic Disease Empowerment Scale (SWE-RES-23).Methods: Patients with osteoarthritis participating in a SOASP in primary health care were recruited consecutively from 2016 to 2018. The PEI (score range 0-12) was used to measure enablement and the SWE-RES-23 (score range 1-5) to measure empowerment. The instruments were answered before (SWE-RES-23) and after the SOASP (PEI, SWE-RES-23). A patient partner was incorporated in the study. Descriptive statistics, the Wilcoxon's signed rank test, effect size (r), and the Spearman's rho (rs) were used in the analysis.Results: In total, 143 patients were included in the study, 111 (78%) were women (mean age 66, SD 9.3 years). At baseline the reported median value for the SWE-RES-23 (n = 142) was 3.6 (IQR 3.3-4.0). After the educational part of the SOASP, the reported median value was 6 (IQR 3-6.5) for the PEI (n = 109) and 3.8 (IQR 3.6-4.1) for the SWE-RES-23 (n = 108). At three months follow-up (n = 116), the reported median value was 6 (IQR 4-7) for the PEI and 3.9 (IQR 3.6-4.2) for the SWE-RES-23. The SWE-RES-23 score increased between baseline and three months (p ≤ 0.000). The analysis showed a positive correlation between PEI and SWE-RES-23 after the educational part of the SOASP (rs = 0.493, p < 0.00, n = 108) and at follow-up at three months (rs = 0.507, p < 0.00, n = 116).Conclusions: Patients reported moderate to high enablement and empowerment and an increase in empowerment after participating in a SOASP, which might indicate that the SOASP is useful to enable and empower patients at least in the short term. Since our results showed that the PEI and the SWE-RES-23 are only partly related both instruments can be of use in evaluating interventions such as the SOASP.Trial Registration: ClinicalTrials.gov. NCT02974036 . First registration 28/11/2016, retrospectively registered. [ABSTRACT FROM AUTHOR]

This article follows the call in decolonial research to recognise other ways of knowing. It explores a specific kind of knowledge: namely, what we describe as 'counterhegemonic civilising discourses', or everyday efforts by the ex-colonised to civilise the ex-coloniser. In the article, we analyse Mozambican workers' discursive attempts to teach what they see as 'proper' or 'moral' behaviour to Portuguese bosses and managers whom they meet at workplaces in Maputo. We have chosen to discuss this transmission of knowledge as a civilisation process, and we focus on forms of knowledge that concerns knowing how to do, or practical competences. This constitutes a break with the (post-)colonial civilising mission. The 'white man's burden' of civilising the unwilling colonial worker is implicitly turned on its head when Mozambicans describe their strong dislike of uneducated Portuguese people's behaviour and their own attempts at correcting this. Research on labour relations in colonial Mozambique is extensive and established, but this article moves the focus to contemporary relations of coloniality. It brings up three different sets of counter-hegemonic civilising discourses. The first concerns language and the use of blasphemies; the second has to do with social and moral norms and values in relation to sickness and death; the third concerns civic integration or the compliance with Mozambican rules and regulations. The everyday character of these discourses is important, and we see them as emerging from people's struggle to challenge the abyssal line separating the epistemologies of the global north and south. The delineation of these inconspicuous discourses of civilisation is our contribution to the field of decolonial studies in lusophone Africa and to post-abyssal research on 'emergence'. [ABSTRACT FROM AUTHOR]

Large carnivores are elusive and use large areas, which causes monitoring to be challenging and costly. Moreover, management to reduce conflicts and simultaneously ensure long‐term population viability require precise population estimates. In Scandinavia, the monitoring of wolves (Canis lupus) is primarily based on counting packs, identifying reproduction, and genetically identifying territorial wolves from noninvasive DNA samples. We assessed the reliability of wolf monitoring in Scandinavia by estimating the detectability of territorial pairs, packs, and reproduction. Our data, comprising snow‐tracking data and DNA‐identified individuals from 2005–2016, covered 11 consecutive winter monitoring seasons (Oct–Mar). Among 343 cases where we identified a wolf pack, territorial wolves were also detected in the same area during the previous season in 323 (94.2%) cases. In only 6 of the remaining 20 cases, there was no prior knowledge of territorial wolves in the area. Among the 328 detected reproduction events (litter born to a pack), we detected 97% during the monitoring period and identified the rest ≥1 year later from kinship assessments of all DNA‐detected individuals. These results suggest that we failed to detect only few packs with reproduction events during the monitoring season that followed breeding. Yearly monitoring of territorial individuals and continuous updates of the pedigree allowed us to retrospectively identify reproduction events and packs that were not identified earlier. [ABSTRACT FROM AUTHOR]

Platelet transfusion refractoriness is a serious clinical concern that complicates the management of thrombocytopenic patients. Previous studies have suggested a potential role for both complement and platelet activation based on in vitro analyses of platelet concentrates. In this study, the post-transfusion platelet response, as indicated by the corrected count increment at 1 and 24 h after prophylactic platelet transfusions, respectively, was correlated with the 1 h post-transfusion Δconcentration (1 h post-transfusion – pretransfusion) of complement and platelet activation biomarkers. The study was registered as a clinical trial at ClinicalTrials.gov (identifier: NCT02601131) and patients were recruited during inpatient care in the hematological department. Soluble terminal complement complexes, soluble P-selectin and soluble CD40 ligand were analyzed. Confirmed alloimmunized patients were excluded. Included subjects were either given platelet transfusions (n = 43) and categorized into four clinical study groups or included in a non-transfused control group (n = 10). In total, 54 transfusions were included. No transfusion-mediated complement activation was observed. The transfusions were associated with a significant increase in the concentration of soluble P-selectin (p <.001), primarily corresponding to the passive infusion of soluble P-selectin-containing plasma residuals. The Δconcentration of soluble P-selectin was, however, not significantly correlated with the corrected count increments. Thus, significant correlations between biomarkers of complement and platelet activation and the post-transfusion platelet response could not be demonstrated in this study. [ABSTRACT FROM AUTHOR]

Aim: Understanding the spatial ecology of animal movements is a critical element in conserving long‐lived, highly mobile marine species. Analyzing networks developed from movements of six sea turtle species reveals marine connectivity and can help prioritize conservation efforts. Location: Global. Methods: We collated telemetry data from 1235 individuals and reviewed the literature to determine our dataset's representativeness. We used the telemetry data to develop spatial networks at different scales to examine areas, connections, and their geographic arrangement. We used graph theory metrics to compare networks across regions and species and to identify the role of important areas and connections. Results: Relevant literature and citations for data used in this study had very little overlap. Network analysis showed that sampling effort influenced network structure, and the arrangement of areas and connections for most networks was complex. However, important areas and connections identified by graph theory metrics can be different than areas of high data density. For the global network, marine regions in the Mediterranean had high closeness, while links with high betweenness among marine regions in the South Atlantic were critical for maintaining connectivity. Comparisons among species‐specific networks showed that functional connectivity was related to movement ecology, resulting in networks composed of different areas and links. Main conclusions: Network analysis identified the structure and functional connectivity of the sea turtles in our sample at multiple scales. These network characteristics could help guide the coordination of management strategies for wide‐ranging animals throughout their geographic extent. Most networks had complex structures that can contribute to greater robustness but may be more difficult to manage changes when compared to simpler forms. Area‐based conservation measures would benefit sea turtle populations when directed toward areas with high closeness dominating network function. Promoting seascape connectivity of links with high betweenness would decrease network vulnerability. [ABSTRACT FROM AUTHOR]

Background: Anastomotic leakage after esophagectomy is a serious and demanding complication. Early detection and treatment can probably prevent clinical deterioration of the patient. We have used early endoscopic assessment and a novel endoscopy score to predict anastomotic complications. Methods: 57 patients planned for Ivor Lewis esophagectomy were included. Endoscopy videos were recorded and biopsies were taken from the gastric conduit on day 7 or 8 after esophagectomy. A scoring system based on the endoscopic appearance, the combined endoscopy score (0–6), was developed. Scoring of the videos was done blinded. Patient outcome with regards to anastomotic complications was registered on postoperative day 30 in accordance with the ECCG definitions and compared to histopathology assessment and the combined endoscopy score retrospectively. Results: The rate of anastomotic defect (necrosis and leakage, ECCG definitions) was 19%. 7 out of 8 patients with a combined endoscopy score of ≥ 4 developed anastomotic defects. The combined endoscopy score was the only predictor for anastomotic complications. Conclusion: Prediction of anastomotic complications enables early detection and treatment which often limits the clinical extent of the complication. Early postoperative endoscopy is safe and a relatively simple procedure. The combined endoscopy score is an accurate tool to predict anastomotic complications. [ABSTRACT FROM AUTHOR]

How preschool teachers and children spend their time in preschool sets the stage for child engagement and learning. To describe characteristics of environments and activities and to compare child engagement in indoor and outdoor free play, systematic observations of children and teachers were performed in 78 Swedish preschool units. Results showed that indoor and outdoor free play were the main activity settings. Children interacted as much with other children as with teachers. The content focus was dominated by non-pretend play, construction, art and music, followed by pretend play and academic contents. Child engagement was significantly higher in free play indoors compared to outdoors. Teachers engaged in varied tasks, but their central task was managing. Teachers were typically in proximity to small groups of children, or by themselves, and mostly talked to or listened to a single child. Findings are discussed in relation to the preschool curriculum and future research needs. [ABSTRACT FROM AUTHOR]

The purpose of this study was to systematically search for long-term complications, including Nephrogenic Systemic Fibrosis (NSF), in patients who were previously administered the gadolinium-based contrast agent Gadofosveset at our institute. All patients who were administered Gadofosveset at our institute between 2006 and 2009 were identified in our Radiological Information System (RIS). Clinical data such as cause of death during follow-up, and dermatological or nephrological diseases were systematically searched for in electronic patient records (EPR). During 2006–2009, Gadofosveset was administered a total of 67 times to 62 patients. One patient was unavailable for follow-up. The remaining 61 patients were followed up for up to 14 (median 12) years based on RIS and EPR data. There were 13 deaths among the 61 patients, all assessed as unrelated to Gadofosveset administration. No dermatological or renal disease suggestive of NSF, or potentially related to Gadofosveset administration, was found. At the time of examination, six patients were diagnosed with various stages of renal insufficiency, three of whom were on hemodialysis. Another three patients were diagnosed with renal insufficiency during the follow-up period, but none of these diagnoses were suspected to be related to the administration of Gadofosveset. Based on the results of this retrospective safety analysis of up to 14 years following 1–2 exposures, we conclude that Gadofosveset in clinical practice is safe in the long-term. [ABSTRACT FROM AUTHOR]

Retreat of marine outlet glaciers often initiates depletion of inland ice through dynamic adjustments of the upstream glacier. The local topography of a fjord may promote or inhibit such retreat, and therefore fjord geometry constitutes a critical control on ice sheet mass balance. To quantify the processes of ice–topography interactions and enhance the understanding of the dynamics involved, we analyze a multitude of topographic fjord settings and scenarios using the Ice-sheet and Sea-level System Model (ISSM). We systematically study glacier retreat through a variety of artificial fjord geometries and quantify the modeled dynamics directly in relation to topographic features. We find that retreat in an upstream-widening or upstream-deepening fjord does not necessarily promote retreat, as suggested by previous studies. Conversely, it may stabilize a glacier because converging ice flow towards a constriction enhances lateral and basal shear stress gradients. An upstream-narrowing or upstream-shoaling fjord, in turn, may promote retreat since fjord walls or bed provide little stability to the glacier where ice flow diverges. Furthermore, we identify distinct quantitative relationships directly linking grounding line discharge and retreat rate to fjord topography and transfer these results to a long-term study of the retreat of Jakobshavn Isbræ. These findings offer new perspectives on ice–topography interactions and give guidance to an ad hoc assessment of future topographically induced ice loss based on knowledge of the upstream fjord geometry. [ABSTRACT FROM AUTHOR]

This article analyses the universe of the traditional ballad from a perspective that problematizes gender power relations and masculinity. This universe is generally characterised by masculine domination, separation of male and female spheres, and manifest structures of power. Masculine violence, not least sexual violence, tends to be normative, especially in heroic ballads and ballads of chivalry, although other masculinities also exist. Feminine power is usually circumscribed, and feminine violence is accepted only under certain conditions. Several narrative motifs concerning masculinity, femininity, violence and power structures can be traced across different ballad types. The author analyses some of these motifs, and clusters of motifs, using the methods of re-reading, close reading and cross-reading. Examples are taken from the Scandinavian and English-Scottish ballad corpora. [ABSTRACT FROM AUTHOR]

Motivation Network-based disease modules have proven to be a powerful concept for extracting knowledge about disease mechanisms, predicting for example disease risk factors and side effects of treatments. Plenty of tools exist for the purpose of module inference, but less effort has been put on simultaneously utilizing knowledge about regulatory mechanisms for predicting disease module hub regulators. Results We developed MODalyseR, a novel software for identifying disease module regulators and reducing modules to the most disease-associated genes. This pipeline integrates and extends previously published software packages MODifieR and ComHub and hereby provides a user-friendly network medicine framework combining the concepts of disease modules and hub regulators for precise disease gene identification from transcriptomics data. To demonstrate the usability of the tool, we designed a case study for multiple sclerosis that revealed IKZF1 as a promising hub regulator, which was supported by independent ChIP-seq data. Availability and implementation MODalyseR is available as a Docker image at https://hub.docker.com/r/ddeweerd/modalyser with user guide and installation instructions found at https://gustafsson-lab.gitlab.io/MODalyseR/. Supplementary information Supplementary data are available at Bioinformatics Advances online. [ABSTRACT FROM AUTHOR]

Background: Osteoarthritis is a common joint disease, globally. Guidelines recommend information, exercise and, if needed, weight reduction as core treatment. There is a gap between evidence-based recommended care for osteoarthritis and clinical practice. To increase compliance to guidelines, implementation was conducted. The aim of the study was to explore physiotherapists' experiences of osteoarthritis guidelines and their experiences of implementation of the guidelines in primary health care in a region in southern Sweden. Methods: Eighteen individual, semi-structured interviews with physiotherapists in primary health care were analysed with inductive qualitative content analysis. Results: The analysis resulted in two categories and four subcategories. The physiotherapists were confident in their role as primary assessors for patients with osteoarthritis and the guidelines were aligned with their professional beliefs. The Supported Osteoarthritis Self-Management Programme, that is part of the guidelines, was found to be efficient for the patients. Even though the physiotherapists followed the guidelines they saw room for improvement since all patients with hip and/or knee osteoarthritis did not receive treatment according to the guidelines. Furthermore, the physiotherapists emphasised the need for management's support and that guidelines should be easy to follow. Conclusion: The physiotherapists believed in the guidelines and were confident in providing first line treatment to patients with osteoarthritis. However, information about the guidelines probably needs to be repeated to all health care providers and management. Data from a national quality register on osteoarthritis could be used to a greater extent in daily clinical work in primary health care to improve quality of care for patients with osteoarthritis. [ABSTRACT FROM AUTHOR]

Purpose: Glioma patients have poor prognosis. The amount of detail of disease-related information patients wish to receive is not known. The aim of this study was to explore glioma patients' experiences and preferences regarding receiving information on diagnosis and prognosis.Methods: Semi-structured interviews were performed with patients diagnosed with glioma. The interviews were analysed by qualitative content analysis without predefined categories by two independent coders.Results: Ten women and 15 men, with newly diagnosed grade II-IV glioma, age 25-76 years, were interviewed. Participants' experience on diagnosis communication was either indirect, meaning they found out their diagnosis unintentionally, e.g., from their electronic health record (EHR) instead of from their doctor, this causing anxiety and feelings of abandonment, insufficiently tailored: lacking in many aspects or individualised and compassionate. Participants generally wanted to know "the truth" about diagnosis and prognosis, but what they meant varied; some desired full honest information to allow for autonomous choices, others preferred general information without details, and some wanted no bad news at all, only positive information. Participants disclosed vulnerability after receiving their diagnosis, being cast into the unknown. They expressed a need for better everyday practical information to help create some control. Supportive staff could reduce participants' distress.Conclusion: There is a need to further develop and implement individually tailored information to glioma patients, both in consultations and patient-accessed EHR systems, which should have safe guards for sensitive information. Not all patients want to know it all, one size does not fit all. [ABSTRACT FROM AUTHOR]

A site in mid-western Sweden contaminated with chlorinated solvents originating from a previous dry cleaning facility, was investigated using conventional groundwater analysis combined with compound-specific isotope data of carbon, microbial DNA analysis, and geoelectrical tomography techniques. We show the value of this multidisciplinary approach, as the different results supported each interpretation, and show where natural degradation occurs at the site. The zone where natural degradation occurred was identified in the transition between two geological units, where the change in hydraulic conductivity may have facilitated biofilm formation and microbial activity. This observation was confirmed by all methods and the examination of the impact of geological conditions on the biotransformation process was facilitated by the unique combination of the applied methods. There is thus significant benefit from deploying an extended array of methods for these investigations, with the potential to reduce costs involved in remediation of contaminated sediment and groundwater. [ABSTRACT FROM AUTHOR]

Plasma cystatin C and shrunken pore syndrome (SPS) are associated with increased mortality in older adults. The objective was to assess the association between these markers of kidney function at admission and mortality in hip fracture patients. Hip fracture patients presenting at Lund University Hospital were eligible for inclusion. Cox regression was used to assess association between plasma cystatin C, creatinine, cystatin C- or creatinine-based estimations of glomerular filtration rate (eGFRCYS and eGFRCREA), or SPS (defined as eGFRCYS/eGFRCREA < 0.7) and mortality during one year follow up. Improvement in discrimination relative to the Nottingham Hip fracture score was assessed by Receiver Operational Characteristics (ROC) analysis and calculation of Net Reclassification Index (NRI). 996 patients were included in the study. Cystatin C, creatinine, eGFRCYS and eGFRCREA were associated with one-year mortality in both unadjusted and adjusted analyses. The association with mortality was stronger for cystatin C and for eGFRCYS than for creatinine and eGFRCREA. Patients with SPS had doubled mortality compared with patients without SPS (43.7 and 20.2%, respectively, p <.001). Hazard ratio for SPS in the adjusted analysis was 1.66 (95%CI; 1.16–2.39, p =.006). None of the markers improved discrimination compared to the Nottingham Hip Fracture Score using ROC analysis whereas eGFRCYS and eGFRCREA improved NRI. Our conclusion is that plasma concentrations of creatinine or cystatin C, eGFRCYS or eGFRCREA or SPS at admission in hip fracture patients are associated with mortality when known risk factors are accounted for. Identification of high risk patients may be improved by eGFRCYS or eGFRCREA. [ABSTRACT FROM AUTHOR]

Massive bird migration across continents and seas is one of the most spectacular phenomena in nature, involving billions of birds annually. In the autumn, most birds on migration are juveniles migrating for the first time while adults are repeating their migrations. Migration syndrome in individual bird migrants involves multiple behavioural, morphological and physiological adaptations, and migration performance may improve with experience and age. In this review, we discuss in what ways young and adult birds differ with respect to migration performance and compass orientation during migration, how they respond to external information including topography and winds during migration, and what phenotypic characteristics related to migratory behaviour may change over a lifetime in individual birds. Here, we present the prevailing concepts of navigation, including compass mechanisms leading birds across the globe to predictable goals, and the underlying sources of variability within and between individuals and age groups. In particular, we focus on what changes in the endogenous migration program may lead to more efficient realizations of migration with age. We review our data combined with other data presented in the literature, based on different techniques to study the migration phenotype expression in caged and free-flying birds with different migratory adaptations. The widespread use of tracking technology to study birds in different environments and geographical areas has largely contributed to our current knowledge on how migration performance improves with age. Still, there is a need to understand in more detail how migration performance, timing and route choices develop across time in individual migrants, and what navigational information is used to guide birds across the globe from the first and following migrations. [ABSTRACT FROM AUTHOR]

This article is about people living in the Global South who in their daily interactions cross what Boaventura de Sousa Santos calls ‘the abyssal line’. It portrays encounters between Portuguese migrants and Mozambican locals in the capital city of Maputo. The article specifically focuses on their interactions at workplaces and highlights the narratives through which they talk about and practise the transfer of knowledge taking place between them. An absolute fundament in these processes is the coloniality of knowledge or the epistemic dimension of (post) colonial domination. As the author demonstrates, both parties have naturalised the coloniality of knowledge, which implies that Portuguese migrants tend to see it as their inherent and natural right and duty to lecture and train the Mozambicans they work with. The Portuguese’s epistemological approach is intimately tied to their understanding of Mozambicans as human beings – or, in other words, the coloniality of knowledge goes hand in hand with the coloniality of being, or the existential dimension of (post)colonial domination. The author’s analysis revolves around the attitudes of the Portuguese, as described by themselves, but the article ends with a representation of Mozambican discursive attempts to unsettle Portuguese dominant positions and thereby resist the coloniality of being. [ABSTRACT FROM AUTHOR]

Aims: The aim of the study was to estimate the effect of household relative poverty on the risk of diabetic ketoacidosis at diagnosis of children with type 1 diabetes using an international standard measurement of relative poverty. Methods: A national population‐based retrospective study was conducted. The Swedish National Diabetes Register (NDR) was linked with data from Sweden's public statistical agency (Statistics Sweden). Children who were diagnosed with new‐onset type 1 diabetes in the period of 2014–2019 were common identifiers. The definition of diabetic ketoacidosis was venous pH <7.30 or a serum bicarbonate level <18 mmol/L. The exposure variable was defined according to the standard definition of the persistent at‐risk‐of‐poverty rate used by the statistical office of the European Union (Eurostat) and several other European public statistical agencies. Univariate and multi‐variable analyses were used to calculate the effect of relative poverty on the risk of diabetic ketoacidosis. Results: Children from households with relative poverty had a 41% higher risk of diabetic ketoacidosis (1.41, CI 1.12–1.77, p = 0.004) and more than double the risk of severe diabetic ketoacidosis (pH <7.10) (RR 2.10, CI 1.35–3.25, p = 0.001), as compared to children from households without relative poverty. Conclusions: Relative poverty significantly increases the risk of diabetic ketoacidosis at onset of type 1 diabetes in children, even in a high‐income country with publicly reimbursed health care. [ABSTRACT FROM AUTHOR]

Background: Hub transcription factors, regulating many target genes in gene regulatory networks (GRNs), play important roles as disease regulators and potential drug targets. However, while numerous methods have been developed to predict individual regulator-gene interactions from gene expression data, few methods focus on inferring these hubs. Results: We have developed ComHub, a tool to predict hubs in GRNs. ComHub makes a community prediction of hubs by averaging over predictions by a compendium of network inference methods. Benchmarking ComHub against the DREAM5 challenge data and two independent gene expression datasets showed a robust performance of ComHub over all datasets. Conclusions: In contrast to other evaluated methods, ComHub consistently scored among the top performing methods on data from different sources. Lastly, we implemented ComHub to work with both predefined networks and to perform stand-alone network inference, which will make the method generally applicable. [ABSTRACT FROM AUTHOR]

This paper presents a new hydromechanical model, developed with the intention to be used for predicting the mechanical evolution of compacted bentonite components in repositories for spent nuclear fuel. The model is based on a thermodynamic relation for the chemical potential of the clay water, and uses empirical functions which are parametrized and calibrated with data on water retention properties at free swelling conditions, swelling pressure, and shear strength; the latter two are central for defining technical requirements for the bentonite buffer components. This results in a model which at its core incorporates all these properties, as well as the hysteresis behaviour. The validity of the model was investigated by analysing nine experimental test conditions, using COMSOL Multiphysics®, with a single set of parameter values. Model results were compared with experimental data for both saturated conditions (free swelling retention test; oedometer tests and triaxial compression tests) and for unsaturated conditions (swelling pressure build-up; swelling or shrinkage at constant load; compression at constant water or constant suction and unconfined compression tests). These comparisons gave a broad demonstration of the predictive capabilities of the model. Some limitation of the model regarding the representation of shrinkage, the shear strength at lower water contents, and the path dependence can nevertheless be noted. • New hydromechanical model for prediction of the mechanical evolution of compacted bentonite • Model based on experimental data and a thermodynamic relation for the chemical potential of the clay water • Model parametrized considering water retention, swelling pressure and shear strength properties • The hysteresis behaviour of bentonite is at the core of the model • Model validated by analysing nine different test conditions with a single set of parameter values [ABSTRACT FROM AUTHOR]

There is a concern that pesticide residues, regularly detected in foods, might pose a health risk to the consumer, but epidemiological evidence is limited. We assessed the associations between dietary exposure to a mixture of pesticide residues and mortality. Food consumption was assessed in 68,844 participants from the Swedish Mammography Cohort and the Cohort of Swedish Men, 45–83 years at baseline (1997). Concentrations of pesticide residues detected in foods on the Swedish market (1996–1998), mainly fruits and vegetables, were obtained via monitoring programs. To assess mixture effects, we summed per food item the ratios of each single pesticide mean residue concentration divided by its acceptable daily intake to create for each participant a Dietary Pesticide Hazard Index (adjusted for energy intake and expressed per kilogram of body weight). Multivariable-adjusted Cox proportional hazards models were used to estimate hazard ratios (HR) and 95 % confidence intervals (95 %CI). During 15 years of follow-up (1998–2014), a total of 16,527 deaths occurred, of which 6,238 were caused by cardiovascular disease (CVD) and 5,364 by cancer. Comparing extreme quintiles of Dietary Pesticide Hazard Index, the highest category was inversely associated with CVD mortality HR, 0.82 (95 % CI, 0.75–0.90) and with cancer mortality HR 0.82 (95 % CI 0.75–0.91). In analyses stratified by high/low Dietary Pesticide Hazard Index, similar inverse associations were observed by increasing fruit and vegetable consumption. We observed no indications that dietary exposure to pesticide residue mixtures was associated with increased mortality, nor any clear indications that the benefits of fruit and vegetable consumption on mortality was compromised. Yet, our results need to be interpreted with caution. [ABSTRACT FROM AUTHOR]

Modifications of Amazonian forests by pre‐Columbian peoples are thought to have left ecological legacies that have persisted to the modern day. Most Amazonian palaeoecological records do not, however, provide the required temporal resolution to document the nuanced changes of pre‐Columbian disturbance or post‐disturbance succession and recovery, making it difficult to detect any direct, or indirect, ecological legacies on tree species.Here, we investigate the fossil pollen, phytolith and charcoal history of Lake Kumpaka, Ecuador, during the last 2,415 years in c. 3–50 year time intervals to assess ecological legacies resulting from pre‐Columbian forest modification, disturbance, cultivation and fire usage.Two cycles of pre‐Columbian cultivation (one including slash‐and‐burn cultivation, the other including slash‐and‐mulch cultivation) were documented in the record around 2150–1430 cal. year BP and 1250–680 cal. year BP, with following post‐disturbance succession dynamics. Modern disturbance was documented after c. 10 cal. year BP. The modern disturbance produced a plant composition unlike those of the two past disturbances, as fire frequencies reached their peak in the 2,415‐year record. The disturbance periods varied in intensity and duration, while the overturn of taxa following a disturbance lasted for hundreds of years. The recovery periods following pre‐Columbian disturbance shared some similar patterns of early succession, but the longer‐term recovery patterns differed.Synthesis. The trajectories of change after a cessation of cultivation can be anticipated to differ depending on the intensity, scale, duration and manner of the past disturbance. In the Kumpaka record, no evidence of persistent enrichment or depletion of intentionally altered taxa (i.e. direct legacy effects) was found but indirect legacy effects, however, were documented and have persisted to the modern day. These findings highlight the strengths of using empirical data to reconstruct past change rather than relying solely on modern plant populations to infer past human management and ecological legacies, and challenge some of the current hypotheses involving the persistence of pre‐Columbian legacies on modern plant populations. [ABSTRACT FROM AUTHOR]

Objective: Survival in epithelial ovarian cancer (EOC) remains poor. Most patients are diagnosed in late stages. Early diagnosis increases the chance of survival. We used the proximity extension assay from Olink Proteomics to search for new protein biomarkers with the potential to improve the diagnostic performance of CA125 and HE4 in patients with ovarian tumors. Material and methods: Plasma samples were obtained from 180 women with ovarian tumors; 30 cases of benign tumor, 28 cases with borderline tumors, 25 early EOC cases (FIGO stage I) and 97 advanced EOC cases (FIGO stages II-IV). Proteins were measured using the Olink® Oncology II and Inflammation panels. For statistical analyses, patients were categorized into benign tumors versus cancer and benign tumors versus borderline + cancer, respectively. Results: We analyzed 177 biomarkers. Thirty-four proteins had ROC AUC > 0.7 for discrimination between benign tumors and cancer. Fifteen proteins had ROC AUC > 0.7 for discrimination between benign tumors and borderline tumors + cancer. HE4 ranked highest for both comparisons. A reference model with HE4, CA125 and age (AUC 0.838 for benign tumors vs. cancer and AUC 0.770 for benign tumors vs. borderline tumors + cancer) was compared to the reference model with the addition of each of the remaining proteins with AUC > 0.7. ITGAV was the only individual biomarker found to improve diagnostic performance of the reference model, to AUC 0.874 for benign tumors vs. cancer and AUC 0.818 for benign tumors vs. borderline tumors + cancer (p < 0.05). Cross-validation and LASSO regression was combined to select multiple biomarker combinations. The best performing model for discrimination between benign tumors and borderline tumors + cancer was a 6-biomarker combination (HE4, CA125, ITGAV, CXCL1, CEACAM1, IL-10RB) and age (AUC 0.868, sensitivity 0.86 and specificity 0.82, p = 0.016 for comparison with the reference model). Conclusion: HE4 was the best performing individual biomarker for discrimination between benign ovarian tumors and EOC including borderline tumors. The addition of other carcinogenesis-related biomarkers in a multiplex biomarker panel can improve the diagnostic performance of the established biomarkers HE4 and CA125. [ABSTRACT FROM AUTHOR]

Spectacular long‐distance migration has evolved repeatedly in animals enabling exploration of resources separated in time and space. In birds, these patterns are largely driven by seasonality, cost of migration, and asymmetries in competition leading most often to leapfrog migration, where northern breeding populations winter furthest to the south. Here, we show that the highly aerial common swift Apus apus, spending the nonbreeding period on the wing, instead exhibits a rarely found chain migration pattern, where the most southern breeding populations in Europe migrate to wintering areas furthest to the south in Africa, whereas the northern populations winter to the north. The swifts concentrated in three major areas in sub‐Saharan Africa during the nonbreeding period, with substantial overlap of nearby breeding populations. We found that the southern breeding swifts were larger, raised more young, and arrived to the wintering areas with higher seasonal variation in greenness (Normalized Difference Vegetation Index) earlier than the northern breeding swifts. This unusual chain migration pattern in common swifts is largely driven by differential annual timing and we suggest it evolves by prior occupancy and dominance by size in the breeding quarters and by prior occupancy combined with diffuse competition in the winter. [ABSTRACT FROM AUTHOR]

Summary: Children diagnosed with a combination of type 1 diabetes (T1D) and celiac disease (CD) show a dysregulated T helper type 1 (Th1)/Th17 response. Besides the cellular involvement, several soluble immune markers are involved in the autoimmune process of both T1D and CD. Only few studies have examined the peripheral pattern of different cytokines, chemokines and acute‐phase proteins (APP) in children with combined T1D and CD. To our knowledge, no studies have evaluated the serum levels of adipocytokines and matrix metalloproteinases (MMPs) in this context. The purpose of the present study was to acquire more knowledge and to gain deeper understanding regarding the peripheral immunoregulatory milieu in children with both T1D and CD. The study included children diagnosed with both T1D and CD (n = 18), children with T1D (n = 27) or CD (n = 16) and reference children (n = 42). Sera were collected and analysis of 28 immune markers (cytokines, chemokines, APPs, adipocytokines and MMPs) was performed using the Luminex technique. The major findings showed that children with a double diagnosis had lower serum levels of interleukin (IL)‐22, monocyte chemoattractant protein (MIP)‐1α, monocyte chemoattractant protein (MCP)‐1, procalcitonin, fibrinogen, visfatin and matrix metalloproteinase (MMP)‐2. These results indicate a suppressed immune profile in children with combined T1D and CD, including Th17 cytokines, chemokines, APPs, adipocytokines and MMPs. We conclude that, besides cytokines and chemokines, other immune markers, e.g. APPs, adipocytokines and MMPs, are of importance for further investigations to elucidate the heterogeneous immune processes present in patients diagnosed with T1D in combination with CD. [ABSTRACT FROM AUTHOR]

Shrunken pore syndrome (SPS) is defined by a cystatin C-based estimation of glomerular filtration rate (eGFRCYS) being less than 60% or 70% of a creatinine-based GFR estimation (eGFRCR) in the absence of extrarenal influences on cystatin C or creatinine concentrations. SPS has been associated with a substantial increase in mortality or morbidity in all investigated populations. However, in these studies, neither the diagnoses, nor causes of death were described, and only estimated GFR was available. The present study concerns 2781 individuals with measured GFR (mGFR), known diagnoses, and known causes of death during 5.6 years in median. Cox multivariate proportional hazards regression model was used to estimate hazard ratios (HR) for all-cause and cancer, cardiovascular, diabetes or chronic kidney disease (CKD) as cause-specific mortality among patients with SPS. At an eGFRCYS/eGFRCR-ratio <0.70, the adjusted SPS death risk in the total cohort (HR 3.0, 95% CI 2.4-3.7) was clearly higher than that for the other diagnosis groups. In a sub-cohort of 1300 persons with or without diagnosis, but with normal mGFR, the all-cause mortality of SPS was markedly increased (HR 4.1, 95% CI 2.6-6.5). In a sub-cohort of 567 persons with normal mGFR and no diagnosis, the all-cause mortality of SPS was even more increased (HR 7.3, 95% CI 2.3-23). The prevalence of SPS in the total cohort was 23% and in the sub-cohorts 17 and 12%, respectively. As SPS is associated with a high mortality, occurs in the absence of reduced mGFR and albuminuria, it expands the spectrum of kidney disorders. [ABSTRACT FROM AUTHOR]

Resource dispersion or kin selection are commonly used to explain animal spatial and social organization. Despite this, studies examining how these factors interact in wild populations of solitary animals are rare. We used 16 years of individual‐level spatial and genetic data to disentangle how resources and relatedness influence spatial organization of a solitary predator, the Eurasian lynx Lynx lynx. As expected, space‐use overlap between neighbouring individuals increased when food resources were heterogeneous and unpredictably distributed (as predicted from resource dispersion) or when neighbours were closely related (as predicted from kin selection). However, these patterns were highly dependent on each other. Increased spatial overlap was restricted to mother–daughter dyads, with this effect only occurring in areas and during seasons when prey was clumped and irregularly distributed in the landscape. Additionally, full‐siblings with similar levels of genetic relatedness did not show these patterns, suggesting that kin selection is mediated through mother–daughter recognition, and is only beneficial under specific resource dispersion circumstances. Our results provide key insights into the flexibility of spatial organization of solitary animals, and clearly show the importance of considering the interaction between resources and kinship when assessing animal space use patterns. [ABSTRACT FROM AUTHOR]

Fixed-target experiments using primary electron beams can be powerful discovery tools for light dark matter in the sub-GeV mass range. The Light Dark Matter eXperiment (LDMX) is designed to measure missing momentum in high-rate electron fixed-target reactions with beam energies of 4 GeV to 16 GeV. A prerequisite for achieving several important sensitivity milestones is the capability to efficiently reject backgrounds associated with few-GeV bremsstrahlung, by twelve orders of magnitude, while maintaining high efficiency for signal. The primary challenge arises from events with photo-nuclear reactions faking the missing-momentum property of a dark matter signal. We present a methodology developed for the LDMX detector concept that is capable of the required rejection. By employing a detailed Geant4-based model of the detector response, we demonstrate that the sampling calorimetry proposed for LDMX can achieve better than 10−13 rejection of few-GeV photons. This suggests that the luminosity-limited sensitivity of LDMX can be realized at 4 GeV and higher beam energies. [ABSTRACT FROM AUTHOR]

It is essential to gain knowledge about the causes and extent of migratory connectivity between stationary periods of migrants to further the understanding of processes affecting populations, and to allow efficient implementation of conservation efforts throughout the annual cycle. Avian migrants likely use optimal routes with respect to mode of locomotion, orientation and migration strategy, influenced by external factors such as wind and topography. In self‐powered flapping flying birds, any increases in fuel loads are associated with added flight costs. Energy‐minimizing migrants are therefore predicted to trade‐off extended detours against reduced travel across ecological barriers with no or limited foraging opportunities.Here, we quantify the extent of detours taken by different populations of European nightjars Caprimulgus europaeus, to test our predictions that they used routes beneficial according to energetic principles and evaluate the effect of route shape on seasonal migratory connectivity.We combined data on birds tracked from breeding sites along a longitudinal gradient from England to Sweden. We analysed the migratory connectivity between breeding and main non‐breeding sites, and en route stopover sites just south of the Sahara desert. We quantified each track's route extension relative to the direct route between breeding and wintering sites, respectively, and contrasted it to the potential detour derived from the barrier reduction along the track while accounting for potential wind effects.Nightjars extended their tracks from the direct route between breeding and main non‐breeding sites as they crossed the Mediterranean Sea–Sahara desert, the major ecological barrier in the Palaearctic–African migration system. These clockwise detours were small for birds from eastern sites but increased from east to west breeding longitude. Routes of the tracked birds were associated with partial reduction in the barrier crossing resulting in a trade‐off between route extension and barrier reduction, as expected in an energy‐minimizing migrant.This study demonstrates how the costs of barrier crossings in prevailing winds can disrupt migratory routes towards slightly different goals, and thereby promote migratory connectivity. This is an important link between individual migration strategies in association with an ecological barrier, and both spatially and demographic population patterns. [ABSTRACT FROM AUTHOR]

This article juxtaposes two types of actors who offer migration services: a state-managed EU programme in Cape Verde and two Cameroonian development NGOs run by businessmen. By framing both as managers of mobility, the article contributes to debates on migration management and the migration industry. The article takes the paradox between official narratives and migrant experiences as a starting point to ask why and how both types of mobility managers can mobilise legitimacy. Staying clear of normative evaluations of the respective legitimacy and success of market and state actors, the article shows that both types of migration managers are involved in producing 'the legal migrant' in different ways. On the basis of ethnographic material from Cameroon (2007–2014) and Cape Verde (2010–2012), the article discusses the functioning of the two kinds of mobility managers, their relations with aspiring migrants and respective modes of self-representation. In conclusion, the article shows that despite apparent differences between migration brokers and the EU, the article's mobility managers share the use of 'development' as a trope for legitimising their activities. [ABSTRACT FROM AUTHOR]