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Background: Authenticity in schools has been highlighted as important for improving students' engagement and learning, and to prepare them for future job markets, especially in science and technology. Purpose: This study investigates students' perceived authenticity of a developed innovation project when implemented in an upper secondary technology education program. Sample: Three cohorts of students (n = 199) attended a first-year technology course at a Swedish upper secondary school in 2016, 2017 and 2018, respectively. In addition, eleven students from the 2016 cohort were interviewed two years later to obtain their views on how the innovation project in the first-year course influenced their performance in a subsequent advanced technology course taken in 2017-2018. Design and Methods: Groups of students participated in the first phase of an innovation project in the first-year course, a five-week module, cooperatively designing solutions to real-world problems. A Likert scale questionnaire measured the degree of perceived authenticity in line with Herrington, Reeves and Oliver's (2010) key elements. Focus group interviews were conducted after the second phase - a 20-week follow-up module in the subsequent advanced course - about how authentic they perceived the first and second phases to be. Results A questionnaire measured the degree of perceived authenticity of the students for the first phase, for each of the three years. "Coaching and scaffolding" received the highest ratings across all three years, whereas "Reflection" was perceived as having the lowest authenticity. In a qualitative component of the study students found both phases positive, and five new themes of students' perception of their experiences were revealed. Coaching and scaffolding Reflection Conclusions: The similarities in perceived authenticity between the three cohorts suggest consistency in students' perceptions of authenticity. However, they did not feel that the project gave them the opportunity to reflect on their learning. According to interviews conducted two years later, they perceived their experiences of the innovation project as having induced creativity, commitment, ownership, motivation, and real-world connection, although at times it was also a challenge to think for themselves and to collaborate with others.

Abstract Background This study explores how the goals of collaboration in the return-to-work (RTW) process for people with common mental disorders are described by the stakeholders involved, and how they experience stakeholders’ roles and responsibilities in relation to these goals. Methods Interviews were conducted with 41 participants from three Swedish regions. Nine of the participants were workers, six employer representatives, four occupational health professionals, four social insurance officers, 18 RTW coordinators and five physicians. Thematic analysis was conducted. Results Three main themes and overarching goals when collaborating on RTW were identified. In the first theme, ‘creating an informative environment’, all stakeholders emphasised clear roles and responsibilities. The second theme, ‘striving for consensus in an environment of negotiations’, addressed negotiations about when and how to collaborate, on what and with whom, and reveal different views on stakeholders’ goals, roles and responsibilities in collaboration. The third theme identified goals for ‘creating a supportive environment’ for both workers and other stakeholders. Coordinators are found to have an important role in achieving a supportive environment, and in neutralising power imbalances between workers and their employers and social insurance officers. Conclusions Competing goals and priorities were identified as hindering successful collaboration, contributing to a spectrum of complex versus easy RTW collaboration. This study suggests some basic conditions for achieving a collaborative arena that is neutral in terms of power balance, where all stakeholders can share their views.

Lars-Olaf Cardell,1,2,* Thomas Sterner,3,* Waqas Ahmed,4 Andreas Kallsoy Slættanes,5 Mikael Svärd,6 Richard F Pollock4 1Division of ENT Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden; 2Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden; 3Department of Economics, School of Business, Economics and Law, University of Gothenburg, Gothenburg, Sweden; 4Covalence Research Ltd, Harpenden, UK; 5ALK, Hørsholm, Denmark; 6ALK Nordic, Kungsbacka, Sweden*These authors contributed equally to this workCorrespondence: Richard F Pollock, Email pollock@covalence-research.comAim: In Sweden, allergy immunotherapy (AIT) is available as either subcutaneous immunotherapy (SCIT) injections or sublingual immunotherapy (SLIT) tablets and is used to treat moderate-severe allergic rhinitis (AR). This study sought to determine direct and indirect annual costs stemming from treatment-related travel, appointments, waiting times and medication costs, before exploring likely CO2 emission-related cost-savings for 20,330 patients receiving SCIT or SLIT-tablets in Sweden.Methods: A model was developed in Python to capture each category of costs in the target patient population. Absenteeism costs arising from treatment-related travel were determined by obtaining average hourly pay data from Swedish Government sources. Absenteeism costs were also calculated for 30-minute post-dose observation times, which occurred during one clinical appointment for SLIT patients, and all clinical appointments for SCIT patients. Clinical appointment costs were obtained from healthcare price lists for Sweden. Medication costs were retrieved from the Pharmaceutical Specialities in Sweden (Fass) website, and treatment doses required for SCIT and SLIT-tablets were determined based on product labels and previously-calculated dosage regimes. High-cost protection and reimbursement scheme payment caps were applied when determining patient appointment and medication costs, respectively, and when identifying financial burdens for individual payers.Results: Mean total annual costs for SCIT were Swedish Krona (SEK) 604.1 million (m), with clinical appointments contributing the largest share of these costs (52.7%), followed by medication (34.4%), travel-related absenteeism (8.9%), waiting time-related absenteeism (2.7%) and private transportation (1.3%). Mean total annual costs for SLIT-tablets were SEK 336.2m. Medication contributed the most to these costs (72.3%), followed by clinical appointments (22.7%), travel-related absenteeism (3.8%), waiting time-related absenteeism (0.6%) and private transportation (0.6%).Conclusion: For patients with moderate-severe AR receiving AIT in Sweden, SLIT-tablets displayed large potential cost savings to patients, the healthcare system, and the government, whilst possessing reduced societal costs of carbon emissions relative to SCIT.Keywords: allergic rhinitis, costs, subcutaneous immunotherapy, sublingual immunotherapy

Abstract Background The COVID-19 pandemic led to vast changes in working life and conditions in which we work. These changes may affect people with multiple sclerosis (PwMS) differently. We aimed to describe the working situation of PwMS during the COVID-19 pandemic and the pandemic’s impact on their working lives. Methods All individuals aged 20–50 listed in the Swedish Multiple Sclerosis Registry were invited to participate in an online survey in 2021. Closed and open-ended responses linked to individual-level register data were used in this exploratory mixed-methods study. Differences in the proportions reporting specific impacts were assessed with chi-square tests by sex, MS severity, education, and profession. The open-ended answers were analysed through content analysis. Results Over 8500 PwMS were invited (52% response rate). We included the 3887 respondents who answered questions about the impact of the pandemic on working life. Most (93.7%) reported being in paid work. An impact of the ongoing pandemic to one’s daily occupation was reported by 26.2%, with different characteristics observed across the impacts. Four categories of type of answers were identified from the open-ended answers: Direct impact on one’s occupation, Disclosing or concealing MS in the workplace, Worry and uncertainty, and Broader impact to life situation. Conclusions PwMS navigated the pandemic by interrupting as well as continuing their working lives. Many PwMS reported that the pandemic did not affect their work situation. However, the reported impacts differed among the participants and a sense of uncertainty and worry was often underlying their statements. Lessons from the pandemic may support future work participation.

Abstract Background Our population‐based study has previously shown that being born in winter or spring was associated with adult‐onset asthma. The aim was to study if season of birth (SOB) is associated with airway allergy and related diseases: NSAID exacerbated respiratory disease (N‐ERD), asthma, allergic rhinitis (AR), nonallergic rhinitis (NAR), chronic rhinosinusitis with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP) in Finland. Methods A randomly sampled retrospective registry‐based follow‐up data (n = 74,868) of patients visiting Hospital District of Helsinki and Uusimaa (HUS) in Finland was used. The birth date, sex, visit date and comorbidities were collected from electronic health record data during visits from 2005 to 2019. Results The mean (SD, range) age of the sample was 34.53 (25.47, 0–102) years, with 48.7 % being men. We divided the whole population in four groups based on the season they were born (SOB‐groups). When observing these four SOB‐groups, the proportion of those having asthma was 43.1%, 42.1%, 41.1%, 42.7%, in winter, spring, summer, and autumn SOB‐groups, respectively. The proportion of those having AR was 12.6%, 12.0%, 10.7%, 12.1%, respectively. When having summer as a reference, being born in any other time of year was significantly associated with AR and, being born in autumn or winter was associated with asthma. No significant association was observed in CRS or N‐ERD or NAR groups in adjusted models. Conclusions The study suggests that early life immunological events may have a role a role in pathogenesis of asthma and AR. As no association was observed between SOB and CRSsNP, CRSwNP, N‐ERD or NAR, further studies on this are warranted.

Abstract In Sweden, allergy immunotherapy (AIT) is available as either subcutaneous immunotherapy (SCIT) injections or sublingual immunotherapy (SLIT) tablets and is used to treat moderate-severe allergic rhinitis (AR). This study sought to determine treatment-related CO2 emissions and travel times in Swedish patients receiving either SCIT or SLIT-tablets. A list of specialized Swedish AR clinics that administer AIT was determined, and respective co-ordinates retrieved. Swedish municipality population data were obtained from a national database. The mean distance from each Swedish municipality to the nearest AR clinic was calculated, adjusted using a detour index, and weighted by estimated patient population size. Transport modality data were obtained from a Swedish urban transport study and CO2 emissions were obtained from Government sources. The mean number of annual SLIT-tablets and SCIT doses required were calculated based on product labels and clinical expert input. The annual number of healthcare professional interactions were layered into the model to estimate changes in mean patient travel time, distance, and travel-related CO2 emissions associated with using SCIT versus SLIT-tablets. Mean annual travel-related CO2 emissions were 410 tonnes (to two significant figures [s.f.]; standard deviation [SD] 90) with SLIT-tablets, versus 1700 tonnes (SD 380) for SCIT, resulting in mean annual savings of approximately 1300 tonnes (SD 290) of CO2 if all AIT patients were to receive SLIT-tablets instead of SCIT, over 380 times greater than 2021 average Swedish CO2 emissions per capita. Approximate mean annual travel times for patients taking SLIT-tablets were 66,500 h (three s.f.; SD 14,400), and 278,000 h (SD 60,200) for SCIT, resulting in mean annual savings of 211,000 h (SD 45,800) if all AIT patients were to receive SLIT-tablets instead of SCIT. Compared with SCIT injections, SLIT-tablets led to substantial reductions in treatment-related CO2 emissions and travel times for Swedish patients.

Abstract Background Periodontitis is a common disease in dogs, and daily dental home care in the form of tooth brushing is essential for prevention and treatment. Despite this, many studies reveal low adherence to tooth brushing advice. This study aimed to assess compliance with dental home care among dogs with periodontitis and understand the factors influencing brushing routines. A questionnaire survey was emailed to 63 dog owners whose dogs had been diagnosed with periodontitis, received dental cleaning at the University Animal Hospital, Swedish University of Agricultural Sciences and were given tooth brushing instructions. The survey was supplemented by telephone interviews, resulting in a 57% response rate. Results The study presents dog owners' routines, experiences, attitudes, and motivation regarding tooth brushing. Approximately 42% brushed their dogs' teeth daily while others did so less frequently or not at all. Reported challenges, such as uncooperative dogs and difficulty establishing a routine, may explain infrequent brushing. Conclusions While the study suggests that owners of dogs with periodontitis tend to follow dental care recommendations better than the general dog owner population, it also reveals that preventive care is inadequate for more than half of the dogs. Given the high prevalence of periodontitis, there's a need for resources to address infrequent tooth brushing. Understanding dog owners' needs can help establish daily brushing as a routine, improving canine oral health and overall well-being.

Introduction: Overweight/obesity and strenuous working conditions are associated with work disability, but their joint contributions to sickness absence (SA) are unknown. We aimed to examine their joint contributions to SA periods of 1–7 and ≥8 days. Methods: Self-reported data on body mass index and working conditions, including perceived physically and mentally strenuous work and hours per day spent in heavy physical work, were linked to the employer’s SA register for the City of Helsinki, Finland, employees (n = 4,323, women 78%) who were 19–39 years old at baseline. We calculated rate ratios (RRs) and 95% confidence intervals (CIs) for SA periods using negative binomial regression models among participants with healthy weight and overweight/obesity, with and without exposure to strenuous working conditions. The mean follow-up time was 2.1 years. Results: Participants with overweight/obesity and exposure to physically strenuous working conditions had the highest age- and gender-adjusted RRs for SA periods of both 1–7 and ≥8 days (physically strenuous work: RR: 1.38, CI: 1.25–1.52, and RR: 1.87, CI: 1.60–2.18, respectively; ≥3 h per day spent in physical work: RR: 1.40, CI: 1.26–1.55 and 2.04, CI: 1.73–2.40, respectively). The interaction between overweight/obesity and physically strenuous working conditions was additive for SA periods of 1–7 days and weakly synergistic for SA periods of ≥8 days. For mentally strenuous work, participants with overweight/obesity and exposure to mentally strenuous work had the highest age-adjusted RRs for SA periods of ≥8 days, and the interaction was additive. Conclusion: The joint contributions of overweight/obesity and exposure to strenuous working conditions to SA should be considered when aiming to reduce employees’ SA. Employers might benefit from providing employees adequate support for weight management and adherence to healthy lifestyles while improving employees’ working conditions.

Metronidazole (MTZ) is a clinically important antimicrobial agent that is active against both bacterial and protozoan organisms. MTZ has been used extensively for more than 60 years and until now resistance has been rare. However, a recent and dramatic increase in the number of MTZ resistant bacteria and protozoa is of great concern since there are few alternative drugs with a similarly broad activity spectrum. To identify key factors and mechanisms underlying MTZ resistance, we utilized the protozoan parasite Giardia intestinalis, which is commonly treated with MTZ. We characterized two in vitro selected, metronidazole resistant parasite lines, as well as one revertant, by analyzing fitness aspects associated with increased drug resistance and transcriptomes and proteomes. We also conducted a meta-analysis using already existing data from additional resistant G. intestinalis isolates. The combined data suggest that in vitro generated MTZ resistance has a substantial fitness cost to the parasite, which may partly explain why resistance is not widespread despite decades of heavy use. Mechanistically, MTZ resistance in Giardia is multifactorial and associated with complex changes, yet a core set of pathways involving oxidoreductases, oxidative stress responses and DNA repair proteins, is central to MTZ resistance in both bacteria and protozoa.

Benzimidazole-2-carbamates (BZ, e.g., albendazole; ALB), which bind β-tubulin to disrupt microtubule polymerization, are one of two primary compound classes used to treat giardiasis. In most parasitic nematodes and fungi, BZ-resistance is caused by β-tubulin mutations and its molecular mode of action (MOA) is well studied. In contrast, in Giardia duodenalis BZ MOA or resistance is less well understood, may involve target-specific and broader impacts including cellular damage and oxidative stress, and its underlying cause is not clearly determined. Previously, we identified acquisition of a single nucleotide polymorphism, E198K, in β-tubulin in ALB-resistant (ALB-R) G. duodenalis WB-1B relative to ALB-sensitive (ALB-S) parental controls. E198K is linked to BZ-resistance in fungi and its allelic frequency correlated with the magnitude of BZ-resistance in G. duodenalis WB-1B. Here, we undertook detailed transcriptomic comparisons of these ALB-S and ALB-R G. duodenalis WB-1B cultures. The primary transcriptional changes with ALB-R in G. duodenalis WB-1B indicated increased protein degradation and turnover, and up-regulation of tubulin, and related genes, associated with the adhesive disc and basal bodies. These findings are consistent with previous observations noting focused disintegration of the disc and associated structures in Giardia duodenalis upon ALB exposure. We also saw transcriptional changes with ALB-R in G. duodenalis WB-1B consistent with prior observations of a shift from glycolysis to arginine metabolism for ATP production and possible changes to aspects of the vesicular trafficking system that require further investigation. Finally, we saw mixed transcriptional changes associated with DNA repair and oxidative stress responses in the G. duodenalis WB-1B line. These changes may be indicative of a role for H2O2 degradation in ALB-R, as has been observed in other G. duodenalis cell cultures. However, they were below the transcriptional fold-change threshold (log2FC > 1) typically employed in transcriptomic analyses and appear to be contradicted in ALB-R G. duodenalis WB-1B by down-regulation of the NAD scavenging and conversion pathways required to support these stress pathways and up-regulation of many highly oxidation sensitive iron-sulphur (FeS) cluster based metabolic enzymes.

Anthelmintic resistance in equine parasite Parascaris univalens, compromises ivermectin (IVM) effectiveness and necessitates an in-depth understanding of its resistance mechanisms. Most research, primarily focused on holistic gene expression analyses, may overlook vital tissue-specific responses and often limit the scope of novel genes. This study leveraged gene co-expression network analysis to elucidate tissue-specific transcriptional responses and to identify core genes implicated in the IVM response in P. univalens. Adult worms (n = 28) were exposed to 10-11 M and 10-9 M IVM in vitro for 24 hours. RNA-sequencing examined transcriptional changes in the anterior end and intestine. Differential expression analysis revealed pronounced tissue differences, with the intestine exhibiting substantially more IVM-induced transcriptional activity. Gene co-expression network analysis identified seven modules significantly associated with the response to IVM. Within these, 219 core genes were detected, largely expressed in the intestinal tissue and spanning diverse biological processes with unspecific patterns. After 10-11 M IVM, intestinal tissue core genes showed transcriptional suppression, cell cycle inhibition, and ribosomal alterations. Interestingly, genes PgR028_g047 (sorb-1), PgB01_g200 (gmap-1) and PgR046_g017 (col-37 & col-102) switched from downregulation at 10-11 M to upregulation at 10-9 M IVM. The 10-9 M concentration induced expression of cuticle and membrane integrity core genes in the intestinal tissue. No clear core gene patterns were visible in the anterior end after 10-11 M IVM. However, after 10-9 M IVM, the anterior end mostly displayed downregulation, indicating disrupted transcriptional regulation. One interesting finding was the non-modular calcium-signaling gene, PgR047_g066 (gegf-1), which uniquely connected 71 genes across four modules. These genes were enriched for transmembrane signaling activity, suggesting that PgR047_g066 (gegf-1) could have a key signaling role. By unveiling tissue-specific expression patterns and highlighting biological processes through unbiased core gene detection, this study reveals intricate IVM responses in P. univalens. These findings suggest alternative drug uptake of IVM and can guide functional validations to further IVM resistance mechanism understanding.

ABSTRACTInhomogeneous lignin from a canola (rapeseed) straw was isolated and valorized as regularly shaped spherical microparticles for drug delivery formulations. Lignin with a purity of 83% and broad molecular weight distribution (Ð > 5.0) was extracted by alkali pulping and acetylated to increase spheronization ability. Lignins with high degrees of acetylation (0.76 and 0.89) were successfully assembled into microparticles with uniform sizes (approximately 2 μm) and smooth spherical surfaces via solvent–antisolvent precipitation. Hydrophobic coumarin 153 and positively charged ciprofloxacin were used as model drugs to assess the encapsulation and release performance of lignin microparticles. Highly acetylated lignin microparticles displayed encapsulation efficiencies of 89.6% for coumarin 153% and 90.6% for ciprofloxacin. Scanning electron microscope images showed that coumarin 153 was encapsulated in the hydrophobic core, while ciprofloxacin was adsorbed on the less hydrophobic shell. The synthesis of lignin microcarriers not only provides a facile approach to utilizing waste canola straw lignin for drug delivery matrices but also has the potential to serve as an alternative lignin powder feedstock for bio-based materials.

Editors' Introduction to the volume Mesopotamian identities in the last centuries of cuneiform writing by Sebastian Fink & Saana Svärd.

The aim of this article is to discuss several groups of sources which are of special interest regarding the question of Mesopotamian identities after 539 bce, towards the end of the use of cuneiform writing. In this late period, several languages and scripts were in use in Mesopotamia; therefore, groups of Akkadian, Aramaic, Greek, and Sumerian texts are discussed. The scripts used are Aramaic letters, cuneiform, and the Greek alphabet. A scholar who is interested in late Mesopotamian identities needs to take all these documents into account. This article aims at giving a brief overview on available textual material and where to find it. The topics of these texts vary from administrative documents to highly literary texts. The authors discuss Aramaic inscriptions, legal and administrative cuneiform texts, the astronomical diaries, the Seleucid Uruk scholarly texts, the late Babylonian priestly literature, Emesal cult-songs from the Hellenistic period, the Graeco-Babyloniaca (clay tablets containing cuneiform and Greek), and finally Greek inscriptions from Mesopotamia.