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Summary: Chromatin immunoprecipitation (ChIP) combined with sequencing has revolutionized our understanding of gene regulation; however, its application to frozen adipose tissue presents unique challenges due to the high levels of lipid content. Here, we present a protocol for ChIP of histone modifications in human frozen adipose tissue. We describe steps for tissue preparation, chromatin isolation, sonication, pre-clearing of chromatin, and immunoprecipitation. We then detail procedures for elution, crosslink reversal, chromatin purification, quality control, and library synthesis. : Publisher’s note: Undertaking any experimental protocol requires adherence to local institutional guidelines for laboratory safety and ethics.

Abstract Background Children and adolescents with complex health complaints are often referred to several different healthcare specialists for assessments and treatment. This may result in fragmented care, higher risks of medical errors, and sub-optimal health outcomes. The aim of this non-controlled open label trial was to evaluate the feasibility of implementing a new interdisciplinary intervention for children and adolescents with multiple referrals and complex health complaints and to gather experiences from participating children, adolescents and parents. Methods In all, 47 children and adolescents aged 6–16 years with multiple referrals at a tertiary hospital were invited to participate. The intervention was a half-day consultation based on a biopsychosocial model. The aim of the intervention was to clarify the child/adolescent’s condition(s) and provide a joint understanding and treatment plan in collaboration with the family. A team consisting of a pediatrician, a physiotherapist and a psychologist delivered the intervention. Acceptance and completion rate was recorded, and child- and parent-experience measures were collected; the children and adolescents completed the Visual Consultation and Relational Empathy Scale (CARE) five questions and parents completed two de novo created measures about their experiences. Results Almost all invited families consented to participate (96%) and ultimately received the interdisciplinary intervention (92%). Mean age of the children and adolescents was 12 years, and under half were boys (40%). Before the intervention, 39 (91%) parents completed a questionnaire about previous experiences with healthcare. After the consultation 39 children and adolescents (91%) and 40 (93%) parents completed the questionnaire regarding their experience with the interdisciplinary intervention. Of the children and adolescents, 18–30 (47–77%) rated relational empathy in the intervention as “Very good” or “Excellent”. Of the parents, 35–39 (92–100%) rated their experience with the consultation using the more positive response options. The parents were significantly more content with the intervention compared to previously received healthcare (p

Rationale & Objective: Deterioration of kidney graft function is associated with accelerated cellular senescence. Marine n-3 polyunsaturated fatty acids (PUFAs) have favorable properties that may counteract cellular senescence development and damage caused by the senescence-associated secretory phenotype (SASP) secretome. Our objective was to investigate the potential effects of marine n-3 PUFA supplementation on the SASP secretome in kidney transplant recipients. Study Design: Exploratory substudy of the Omega-3 Fatty Acids in Renal Transplantation trial. Setting & Participants: Adult kidney transplant recipients with a functional kidney graft (defined as having an estimated glomerular filtration rate of >30 mL/min/1.73 m2) 8 weeks after engraftment were included in this study conducted in Norway. Analytical Approach: The intervention consisted of 2.6 g of a marine n-3 PUFA or olive oil (placebo) daily for 44 weeks. The outcome was a predefined panel of SASP components in the plasma and urine. Results: A total of 132 patients were enrolled in the Omega-3 Fatty Acids in Renal Transplantation trial, and 66 patients were allocated to receive either the study drug or placebo. The intervention with the marine n-3 PUFA was associated with reduced plasma levels of granulocyte colony-stimulating factor, interleukin 1α, macrophage inflammatory protein 1α, matrix metalloproteinase (MMP)-1, and MMP-13 compared with the intervention in the control group. Limitations: Post hoc analysis. Conclusions: The results suggest that marine n-3 PUFA supplementation has mitigating effects on the plasma SASP components granulocyte colony-stimulating factor, interleukin 1α, macrophage inflammatory protein 1α, MMP-1, and MMP-13 in kidney transplant recipients. Future studies with kidney transplant recipients in maintenance phase, combined with an evaluation of cellular senescence markers in kidney transplant biopsies, are needed to further elucidate the potential antisenescent effect of marine n-3 PUFAs. This trial is registered as NCT01744067.

Climate change and urbanization increase the pressure on combined sewer systems in urban areas resulting in elevated combined sewer overflows, degraded water quality in receiving waters, and changing stream flows. Permeable surfaces offer infiltration potential, which can contribute to alleviate the runoff to combined sewer systems. The variation in urban soil characteristics and the initial moisture conditions before a rainfall event are important factors affecting the infiltration process and consequently runoff characteristics. In this study, the urban hydrological models SWMM and STORM are used to evaluate the Green-Ampt, Horton, and Holtan infiltration methods for three urban sandy soils. A sensitivity analysis was carried out on a set of key parameter values. In addition, long-term simulations were conducted to evaluate the ability to account for initial soil moisture content. The results showed that the Holtan method's ability to account for both available storage capacity and maximum infiltration rate, as well as evapotranspiration in the regeneration of infiltration capacity, gave the best result with regard to runoff behaviour, especially for long-term simulations. Furthermore, the results from the urban sandy soils with different infiltration rate at saturation, together with a high sensitivity to the degree of sensitivity for maximum infiltration rate under dry conditions and minimum infiltration rate under wet conditions, indicate that field measurements of infiltration rate should be carried out at saturation for these soils. HIGHLIGHTS This research examines three commonly used infiltration models, Horton, Green-Ampt, and Holtan, in two urban stormwater modelling systems, SWMM and STORM.; This research contributed new information about the sensitivity of the infiltration models applied to urban soils.; The results provide enhanced understanding of the parameter sensitivity and selection for urban pervious surfaces.;

Paved surfaces, increased precipitation intensities in addition to limited capacity in the sewer systems, cause a higher risk of combined sewer overflows (CSOs). Sustainable drainage systems (SUDS) offer an alternative approach to mitigate CSO by managing the stormwater locally. Seven SUDS scenarios, developed based on the concept of effective impervious area reduction, have been implemented in the Grefsen catchment using the Mike Urban model. This study evaluated the hydrological performance of two SUDS controls (i.e. green roof (GR) and rain garden (RG)) modules of the model and the effect of the SUDS scenarios on the CSOs using event-based and continuous simulations. The Nash–Sutcliffe efficiency (NSE) along with flow duration curves (FDCs) has been used for evaluating the model performance. Event-based evaluations revealed the superior performance of the RG in reducing CSOs for larger precipitation events, while GRs were proven to have beneficial outcomes during smaller events. The study illustrated another way of assessing the continuous simulations by employing the FDCs. The FDCs were assessed against a discharge threshold at the outlet (which authorities can set as design criteria) of the catchment in terms of the extent, each scenario reduced occurrence and duration of outflow that invokes flow in the overflow pipe. HIGHLIGHTS This paper demonstrates merits of the SUDS concept for mitigating the challenges climate change pose on combined sewer systems using two SUDS controls and seven SUDS scenarios.; It illustrates how the flow duration curve (FDC) based evaluation approach can be of great practical significance, thereby contributing to the discussion on adaptation of such design criteria in the future.; It evaluates efficiency of the implemented SUDS measures extensively by employing a range of performance evaluation techniques.; The use of Mike Urban model's low-impact-development module for implementing SUDS controls makes this manuscript a pioneering research work, as this is the model of choice among many practitioners across the world.;

Abstract Background Children with combined mental and somatic conditions pose a challenge to specialized health services. These cases are often characterized by multi-referrals, frequent use of health services, poor clinical and cost effectiveness, and a lack of coordination and consistency in the care. Reorganizing the health services offered to these children seems warranted. Patient reported experiences give important evidence for evaluating and developing health services. The aim of the present descriptive study was to explore how to improve specialist health services for children with multiple referrals for somatic and mental health conditions. Based on parent reported experiences of health services, we attempted to identify key areas of improvement. Methods As part of a larger, ongoing project; “Transitioning patients’ Trajectories”, we asked parents of children with multiple referrals to both somatic and mental health departments to provide their experiences with the services their children received. Parents/guardians of 250 children aged 6–12 years with multi-referrals to the Departments of Pediatrics and Child and Adolescent Mental Health at Haukeland University Hospital between 2013 and 2015 were invited. Their experience was collected through a 14 items questionnaire based on a generic questionnaire supplied with questions from parents and health personnel. Possible associations between overall experience and possible predictors were analyzed using bivariate regression. Results Of the 250 parents invited, 148 (59%) responded. Mean scores on single items ranged from 3.18 to 4.42 on a 1–5 scale, where five is the best possible experience. In the multiple regression model, perception of wait time (r = .56, CI = .44–.69 / β = 0.16, CI = .05–.28), accommodation of consultations (r = .71, CI = .62–.80 / β = 0.25, CI = .06–.45 / β = 0.27, CI = .09–.44), providing adequate information about the following treatment (r = .66, CI = .55–.77 / β = 0.26, CI = .09–.43), and collaboration between different departments at the hospital (r = .68, CI = .57–.78 / β = 0.20, CI = -.01–.40) were all statistically significantly associated with parents overall experience of care. Conclusions The study support tailored interdisciplinary innovations targeting wait time, accommodation of consultations, communication regarding the following treatment and collaboration within specialist health services for children with multi-referrals to somatic and mental specialist health care services.

Climate change combined with urbanization increases the performance demand on urban drainage systems. Green roofs are one of the most used green infrastructure measures to alleviate the pressure on the urban drainage system through the detention and retention of runoff. The rational method with the runoff coefficient (C) is one of the most commonly used design tools for stormwater design in Norway. This method relies on a runoff coefficient being available for green roofs, which is typically not the case. This paper compares laboratory and experimental field studies to investigate runoff coefficients from different types of detention-based roofs. The methodology described in the German ‘FLL Guideline’, one of the world's most commonly used green roof standards, was used to measure the runoff coefficients for the different components making up a typical green roof. The contribution from each layer is reflected in the runoff coefficients. The runoff coefficients from the field experiments were calculated using observed precipitation and runoff from existing green roofs in Oslo, Trondheim, Sandnes, and Bergen, Norway. Events that had a cumulative precipitation comparable to the laboratory events, but longer durations, were selected. These events gave significantly lower and varying runoff coefficients, clearly demonstrating the limitation of choosing a suitable runoff coefficient for a given roof. However, laboratory experiments are important in understanding the underlying flow processes in the different layers in a detention-based roof.

Floods are one of the major climate-related hazards and cause casualties and substantial damage. Accurate and timely flood forecasting and design flood estimation are important to protect lives and property. The Distance Distribution Dynamic (DDD) is a parsimonious rainfall-runoff model which is being used for flood forecasting at the Norwegian flood forecasting service. The model, like many other models, underestimates floods in many cases. To improve the flood peak prediction, we propose a dynamic river network method into the model. The method is applied for 15 catchments in Norway and tested on 91 flood peaks. The performance of DDD in terms of KGE and BIAS is identical with and without dynamic river network, but the relative error (RE) and mean absolute relative error (MARE) of the simulated flood peaks are improved significantly with the method. The 0.75 and 0.25 quantiles of the RE are reduced from 41% to 23% and from 22% to 1%, respectively. The MARE is reduced from 32.9% to 15.7%. The study results also show that the critical support area is smaller in steep and bare mountain catchments than flat and forested catchments.

Abstract Aims Complexity of care in patients with coronary artery disease is increasing, due to ageing, improved treatment, and more specialised care. Patients receive care from various healthcare providers in many settings. Still, few studies have evaluated continuity of care across primary and secondary care levels for patients after percutaneous coronary intervention (PCI). This study aimed to determine multifaceted aspects of continuity of care and associations with socio-demographic characteristics, self-reported health, clinical characteristics and follow-up services for patients after PCI. Methods This multi-centre prospective cohort study collected data at baseline and two-month follow-up from medical records, national registries and patient self-reports. Univariable and hierarchical regressions were performed using the Heart Continuity of Care Questionnaire total score as the dependent variable. Results In total, 1695 patients were included at baseline, and 1318 (78%) completed the two-month follow-up. Patients stated not being adequately informed about lifestyle changes, medication and follow-up care. Those experiencing poorer health status after PCI scored significantly worse on continuity of care. Patients with ST-segment elevation myocardial infarction scored significantly better on informational and management continuity than those with other cardiac diagnoses. The regression analyses showed significantly better continuity (P ≤ 0.034) in patients who were male, received written information from hospital, were transferred to another hospital before discharge, received follow-up from their general practitioner or had sufficient consultation time after discharge from hospital. Conclusion Risk factors for sub-optimal continuity were identified. These factors are important to patients, healthcare providers and policy makers. Action should be taken to educate patients, reconcile discharge plans and organise post-discharge services. Designing pathways with an interdisciplinary approach and shared responsibility between healthcare settings is recommended.

Abstract Background Electronic health (e-Health) interventions are emerging as an effective alternative model for improving secondary prevention of coronary artery disease (CAD). The aim of this study was to describe the effectiveness of different modes of delivery and components in e-Health secondary prevention programmes on adherence to treatment, modifiable CAD risk factors and psychosocial outcomes for patients with CAD. Method A systematic review was carried out based on articles found in MEDLINE, CINAHL, and Embase. Studies evaluating secondary prevention e-Health programmes provided through mobile-Health (m-Health), web-based technology or a combination of m-Health and web-based technology were eligible. The main outcomes measured were adherence to treatment, modifiable CAD risk factors and psychosocial outcomes. The quality appraisal of the studies included was conducted using the Joanna Briggs Institute critical appraisal tool for RCT. The results were synthesised narratively. Result A total of 4834 titles were identified and 1350 were screened for eligibility. After reviewing 123 articles in full, 24 RCTs including 3654 participants with CAD were included. Eight studies delivered secondary prevention programmes through m-Health, nine through web-based technology, and seven studies used a combination of m-Health and web-based technology. The majority of studies employed two or three secondary prevention components, of which health education was employed in 21 studies. The m-Health programmes reported positive effects on adherence to medication. Most studies evaluating web-based technology programmes alone or in combination with m-Health also utilised traditional CR, and reported improved modifiable CAD risk factors. The quality appraisal showed a moderate methodological quality of the studies. Conclusion Evidence exists that supports the use of e-Health interventions for improving secondary prevention of CAD. However, a comparison across studies highlighted a wide variability of components and outcomes within the different modes of delivery. High quality trials are needed to define the most efficient mode of delivery and components capable of addressing a favourable outcome for patients. Trial registration Not applicable.

Abstract Background Continuity of cardiac care after hospital discharge is a priority, especially as healthcare systems become increasingly complex and fragmented. There are few available instruments to measure continuity of cardiac care, especially from the patient perspective. The aim of this study was (1) to translate and adapt the Heart Continuity of Care Questionnaire (HCCQ) to conditions in Norway, and (2) to determine its psychometric properties in self-report format administered to patients after percutaneous coronary intervention (PCI). Methods The HCCQ was first translated into Norwegian from the original English version, following a widely used cross-cultural adaptation process. Data were collected before hospital discharge and in a follow-up after 2 months. To assess psychometric properties, a confirmatory factor analysis (CFA) was performed and three aspects of construct validity were evaluated: structural validity, hypotheses testing and cross-cultural validation. Internal consistency of the HCCQ subscales was calculated using Cronbach’s alpha, while intra-class correlation (ICC) was used to assess test-retest reliability. Additionally, socio-demographic and patient-reported data were collected to correlate with HCCQ scores. Results Of those included at baseline, 436 (76%) completed the questionnaires after 2 months. CFA suggested that the fit of the HCCQ data to a 3-factor model was modest (RMSEA = 0.11, CFI = 0.90, TLI = 0.90). However, convergent validity was satisfactory, based on existing research. Internal consistency was good, as indicated by its Cronbach’s alphas: total continuity of care (0.95); informational (0.93), relational (0.87), and management (0.89) continuity. The ICC for the total HCCQ score was 0.80 (95% CI [0.71, 0.87] p

Objectives Sleep disturbances and delirium are frequently observed complications after surgical aortic valve replacement (SAVR) and transcutaneous aortic valve implantation (TAVI), especially in octogenarian patients. However, a knowledge gap exists on patient experiences of sleep and delirium. In particular, patients’ long-term sleep and delirium experiences are unknown. This article explores and describes how octogenarian patients suffering from delirium after aortic valve replacement experience their sleep and delirium situation.Design An explorative and descriptive design with a longitudinal qualitative approach was applied. Qualitative content analysis following the recommended steps of Graneheim and Lundman was performed.Setting Patients were included at a tertiary university hospital with 1400 beds. Delirium and insomnia screening was performed at baseline and five postoperative days after aortic valve treatment. For qualitative data, 10 patients were interviewed 6–12 months after treatment with focus on delirium. Five of these patients were reinterviewed 4 years after treatment, with focus on their sleep situation.Participants Inclusion criteria; age 80+, treated with SAVR or TAVI and had experienced delirium after treatment.Results For the initial interview, we included five men and five women, four following TAVI and six following SAVR, mean age 83. One overarching theme revealed from the content analyses; Hours in bed represented emotional chaos. Whereas three subthemes described the patients’ experiences with sleep and delirium, a cascade of distressful experiences disturbing sleep, the struggle between sleep and activity and elements influencing sleep. Four years after the treatment, sleep disturbances persisted, and patients still remembered strongly the delirium incidences.Conclusions For octogenarian patients, sleep disturbances and delirium are long-term burdens and need a greater attention in order to improve patient care.

Background: Knowledge about the association between frailty and self-reported health among patients undergoing heart valve surgery remains sparse. Thus, the objectives were to I) describe changes in self-reported health at different time points according to frailty status, and to II) investigate the association between frailty status at discharge and poor self-reported health four weeks after discharge among patients undergoing heart valve surgery. Methods: In a prospective cohort study, consecutive patients undergoing heart valve surgery, including transapical/transaortic valve procedures were included. Frailty was measured using the Fried score, and self-reported health using the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the EuroQoL-5 Dimensions 5-Levels Health Status Questionnaire (EQ-5D-5L).To investigate the association between frailty and self-reported health, multivariable logistic regression models were used. Analyses were adjusted for sex, age, surgical risk evaluation (EuroScore) and procedure and presented as odds ratios (OR) with 95% confidence intervals (CI). Results: Frailty was assessed at discharge in 288 patients (median age 71, 69% men); 51 patients (18%) were frail. In the multivariable analyses, frailty at discharge remained significantly associated with poor self-reported health at four weeks, OR (95% CI): EQ-5D-5L Index 3.38 (1.51–7.52), VAS 2.41 (1.13–5.14), and KCCQ 2.84 (1.35–5.97). Conclusion: Frailty is present at discharge in 18% of patients undergoing heart valve surgery, and being frail is associated with poor self-reported health at four weeks of follow-up. This supports a clinical need to address the unique risk of frail patients among heart valve teams broadly, and not only to measure frailty as a marker of operative risk.

A questionnaire was administered to 14 patients admitted at the Department of Old Age Psychiatric 24-h unit at Oslo University Hospital with questions about experiences and fears regarding COVID-19. A similar adjusted questionnaire was administered to 19 outpatients. The purpose was to investigate if the patients had fears, anxieties, and quality of life issues related to COVID-19 that could affect their treatment. A quest back questionnaire with similar questions about patient care and work conditions was sent to the personnel working with these patients, and 46 of 81 responded. Most patients welcomed the strict measures that were applied, including a visitation ban for inpatients and a reduction in consultations for the outpatients. Most patients reported that they were not very scared of getting COVID-19, nor did many believe that they would die if they were infected. A minority of patients reported being very worried. The patients also differed on other issues related to the COVID-19 situation. A minority were negative to the interventions, rules, and regulations, and/or considered the risk of infection to be elevated at the clinic, and/or that the quality of their daily life was negatively impacted. Employees more often than patients were concerned about the COVID-19 influence on their health. They were also concerned about being at work amid the crisis. About half of their comments were related to the fear of inadvertently infecting patients with COVID-19. Also, a majority complained about aspects related to the implemented COVID-19 guidelines. This study is explorative in nature, mainly due to its small sample size, which makes it difficult to draw conclusions from the results. However, the results imply a need for addressing the COVID-19 concerns of both patients and employees, to prevent potential negative effects on treatment and overall life quality. Future research should investigate the self-reported effects of the pandemic situation on a larger sample size of elderly psychiatric patients.

Mathematical stormwater models are often used as tools for planning and analysing urban drainage systems. However, the inherent uncertainties of the models must be properly understood in order to make optimal use of them. One source of uncertainty that has received relatively little attention, particularly for increasingly popular green areas as part of urban drainage systems, is the mathematical model structure. This paper analyses the differences between three different widely-used models (SWMM, MOUSE and Mike SHE) when simulating rainfall runoff from green areas over a 26-year period. Eleven different soil types and six different soil depths were used to investigate the sensitivity of the models to changes in both. Important hydrological factors such as seasonal runoff and evapotranspiration, the number of events that generated runoff, and the initial conditions for rainfall events, varied significantly between the three models. MOUSE generated the highest runoff volumes, while it was rather insensitive to changes in soil type and depth. Mike SHE was mainly sensitive to changes in soil type. SWMM, which generated the least runoff, was sensitive to changes in both soil type and depth. Explanations for the observed differences were found in the descriptions of the mathematical models. The differences in model outputs could significantly impact the conclusions from studies on the design or analysis of urban drainage systems. The amount and frequency of runoff from green areas in all three models indicates that green areas cannot be simply ignored in urban drainage modelling studies. Keywords: Model structure uncertainty, Urban drainage, Green areas, Runoff, Infiltration, Stormwater models

Green and blue-green roofs are emerging as an increasingly popular feature of rooftops, particularly in urban areas. Particular problematic conditions render their usage complex in the Nordic countries. In order to ensure that green roofs are built durable and with the service life expected of them, it is important to know all the relevant factors surrounding their construction and operation. A scoping study was conducted in order to gain an overview on green roof research and available scientific literature. One hundred articles of particular interest for Nordic climates were retrieved and their findings summarized. It is found that the vast majority of green roof research has been conducted on a theoretical basis, or with practical measurements on green roof test beds or isolated components. There is scarcely any literature on the operation of full-scale, building-implemented green roofs, and no articles were found on the building technical performance of aged green roofs. These knowledge gaps indicate a major risk factor in green roof operation, as their performance and integrity over time has not been documented. This despite the fact that green roofs have been implemented and in operation worldwide for decades.

Aims and Objectives: To (i) determine the prevalence of delirium and identify delirium subtypes in surgical and non‐surgical patients aged ≥65 years, (ii) determine whether certain precipitating factors affect the prevalence of delirium and (iii) review patients' medical records for description of delirium symptoms and the presence of International Classification of Diseases (ICD‐10) coding for delirium in discharge summaries. Methodological Design and Justifications: Despite being a robust predictor of morbidity and mortality in older adults, delirium might be inadequately recognised and under‐reported in patients' medical records and discharge summaries. A point prevalence study (24‐h) of patients ≥65 years from surgical and non‐surgical wards was therefore conducted in a tertiary university hospital. Ethical Issues and Approval: The study was approved by the Data Protection Officer at the university hospital (2018/3454). Research Methods, Instruments and/or Interventions: Patients were assessed for delirium with 4AT and delirium subtypes with the Delirium Motor Subtype Scale. Information about room transfers, need and use of sensory aids and medical equipment was collected onsite. Patients' medical records were reviewed for description of delirium symptoms and of ICD‐10 codes. Results: Overall, 123 patients were screened (52% female). Delirium was identified in 27% of them. Prevalence was associated with advanced age (≥85 years). The uncharacterised delirium subtype was most common (36%), followed by hypoactive (30%), hyperactive (24%) and mixed (9%). There were significant associations between positive screening tests and the need and use of sensory aids. Delirium symptoms were described in 58% of the patients who tested positive for delirium and the ICD‐10 code for delirium was registered in 12% of these patients' discharge summaries. Conclusions: The high prevalence of delirium and limited use of discharge codes highlight the need to improve the identification of delirium in hospital settings and at discharge. Increased awareness and detection of delirium in hospital settings are vital to improve patient care. [ABSTRACT FROM AUTHOR]

Aims The recent rise in the number of nonagenarians (age ≥ 90 years) undergoing percutaneous coronary intervention (PCI) has revealed gaps in research, in particular on patients' experiences. Therefore, the aim of the study was to explore and describe nonagenarians' internal resources and their experiences of the in-hospital pathway. Methods and results Nineteen nonagenarian patients (women n = 9), mean age 91 years, 9 acutely, and 10 electively treated, were consecutively enrolled from a tertiary university hospital from June 2021 to February 2023. In-depth interviews were conducted during hospitalization, audiotaped and transcribed. The interviews were analysed using qualitative content analysis. Three sub-themes emerged from the nonagenarians' experiences with the PCI treatment trajectory: (i) Taking lifelong responsibility for own physical and mental health describes a population striving to live a healthy life and to stay independent. Physical and mental activities including healthy food choices had been an integral aspect of their lives from early childhood. (ii) Individual internal resources influenced the PCI pathway describes how their internal resources were used, from actively engaging in the decision-making process to withstanding discomfort during the PCI procedure. (iii) The post-PCI pathway was multifaceted describes a short stay at the cardiac ward with individual post-procedural experiences, close monitoring, and preparation for discharge including cardiac rehabilitation. Conclusion Nonagenarians undergoing PCI demonstrated a personal incentive to stay healthy and independent. Their internal resources of independence, stoicism, and resilience were used during their in-hospital stay contributing to a successful PCI procedure. Individual cardiac rehabilitation strategies were highlighted after discharge from hospital. [ABSTRACT FROM AUTHOR]

We have previously identified increased levels of distinct bacterial taxa within mucosal biopsies from colorectal cancer (CRC) patients. Following prior research, the aim of this study was to investigate the detection of the same CRC‐associated bacteria in fecal samples and to evaluate the suitability of fecal samples as a non‐invasive material for the detection of CRC‐associated bacteria. Next‐generation sequencing (NGS) of the 16S ribosomal RNA (rRNA) V4 region was performed to evaluate the detection of the CRC‐associated bacteria in the fecal microbiota of cancer patients, patients with adenomatous polyp and healthy controls. Furthermore, 19 novel species‐specific quantitative PCR (qPCR) assays were established to detect the CRC‐associated bacteria. Approximately, 75% of the bacterial taxa identified in biopsies were reflected in fecal samples. NGS failed to detect low‐abundance CRC‐associated taxa in fecal samples, whereas qPCR exhibited high sensitivity and specificity in identifying all targeted taxa. Comparison of fecal microbial composition between the different patient groups showed enrichment of Fusobacterium nucleatum, Parvimonas micra, and Gemella morbillorum in cancer patients. Our findings suggest that low‐abundance mucosa‐associated bacteria can be detected in fecal samples using sensitive qPCR assays. [ABSTRACT FROM AUTHOR]

Aims Patients with symptomatic aortic valve stenosis are efficiently treated by aortic valve replacement (AVR), using a biological or mechanical valve. For some patients with mechanical valves, the metallic clicking sound may be problematic. The aim of this study was to investigate the perceived disturbance from the sound of a mechanical valve and the association between noise perception and symptoms of anxiety and depression. Methods and results The study had a cross-sectional design. In April 2013, all patients who had undergone AVR at one university hospital during the period 2000–12 were invited by post to participate. The primary variables were assessed using a valve-specific questionnaire and the Hospital Anxiety and Depression Scale. Of the 912 (77%) respondents, 245 had mechanical valves. Of these, 59 (24%) were women, the mean (standard deviation) age was 61 (11) years, and the mean time since surgery was 7 (3) years. The valve-specific questionnaire showed that 84% of the patients could sometimes or often hear the valve sound. A moderate positive correlation was found between valve prosthesis noise disturbance and anxiety, r = 0.35 (P = 0.001), and depression, r = 0.27 (P = 0.001). In a multiple linear regression analysis, valve noise perception was only significantly associated with anxiety among several other bio-psychosocial factors. Conclusion This study shows an association between valve noise disturbance and symptoms of anxiety and highlights the importance of preparing all patients for the sound from the mechanical valves that arises after surgery. [ABSTRACT FROM AUTHOR]