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Visual working memory (WM) is a central cognitive ability but is capacity-limited due to competition between remembered items. Understanding whether inter-item competition depends on the similarity of the features being remembered has important implications for determining if competition occurs in sensory or post-sensory stages of processing. Experiment 1 compared the precision of WM across homogeneous displays, where items belonged to the same feature type (e.g., colorful circles), and heterogeneous displays (e.g., colorful circles and oriented bars). Performance was better for heterogeneous displays, suggesting a feature-specific component of interference. However, Experiment 2 used a retro-cueing task to isolate encoding from online maintenance and revealed that inter-item competition during storage was not feature-specific. The data support recent models of WM in which inter-item interference - and hence capacity limits in WM - occurs in higher-order structures that receive convergent input from a diverse array of feature-specific representations.

During the 2015–2016 El Niño, the Amazon basin released almost one gigaton of carbon (GtC) into the atmosphere due to extreme temperatures and drought. The link between the drought impact and recovery of the total carbon pools and its biogeochemical drivers is still unknown. With satellite-constrained net carbon exchange and its component fluxes including gross primary production and fire emissions, we show that the total carbon loss caused by the 2015–2016 El Niño had not recovered by the end of 2018. Forest ecosystems over the Northeastern (NE) Amazon suffered a cumulative total carbon loss of ∼0.6 GtC through December 2018, driven primarily by a suppression of photosynthesis whereas southeastern savannah carbon loss was driven in part by fire. We attribute the slow recovery to the unexpected large carbon loss caused by the severe atmospheric aridity coupled with a water storage deficit during drought. We show the attenuation of carbon uptake is three times higher than expected from the pre-drought sensitivity to atmospheric aridity and ground water supply. Our study fills an important knowledge gap in our understanding of the unexpectedly enhanced response of carbon fluxes to atmospheric aridity and water storage deficit and its impact on regional post-drought recovery as a function of the vegetation types and climate perturbations. Our results suggest that the disproportionate impact of water supply and demand could compromise resiliency of the Amazonian carbon balance to future increases in extreme events.

In this study, we demonstrate the utility of available correlative measurements of carbon species to identify regional and local air mass characteristics as well as their associated source types. In particular, we combine different regression techniques and enhancement ratio algorithms with carbon monoxide (CO), carbon dioxide (CO2), and methane (CH4) total column abundance from 11 sites of the Total Carbon Column Observing Network (TCCON) to infer relative contributions of regional and local sources to each of these sites. The enhancement ratios provide a viable alternative to univariate measures of relationships between the trace gases that are insufficient in capturing source-type and transport signatures. Regional enhancements are estimated from the difference between bivariate regressions across a specific time window of observed total abundance of these species (BERr for bulk enhancement regression ratio) and inferred anomalies (AERr for anomaly enhancement regression ratio) associated with a site-specific background. Since BERr and AERr represent the bulk and local species enhancement ratio, respectively, its difference simply represents the site-specific regional component of these ratios. We can then compare these enhancements for CO2 and CH4 with CO to differentiate between combustion and non-combustion air masses. Our results show that while the regional and local influences in enhancements vary across sites, dominant characteristics are found to be consistent with previous studies over these sites and with bottom-up anthropogenic and fire emission inventories. The site in Pasadena shows a dominant local influence (> 60 %) across all species enhancement ratios, which appear to come from a mixture of biospheric and combustion activities. In contrast, Anmyeondo shows more regionally influenced (> 60 %) air masses associated with high-temperature and/or biofuel combustion activities. Ascension Island appears to only show a large regional influence (> 80 %) on CO / CO2 and CO / CH4, which is indicative of transported and combustion-related CO from the nearby African region, consistent with a sharp rise in column CO (3.51 ± 0.43 % ppb yr−1) at this site. These methods have important applications to source analysis using spaceborne column retrievals of these species.

Abstract Middle-aged adults engaging in unhealthy lifestyle behaviors are at higher risk of chronic diseases. However, little is known about the co-occurrence of these behaviors and their determinants. This cohort study examined the co-occurrence of unhealthy lifestyle behaviors (alcohol consumption, diet, physical inactivity, and smoking) in 30,154 middle-aged adults and their associations with sociodemographic factors, social support, and disease history. Alcohol use was measured by the AUDIT, diet by the MiniMeal-Q, and physical inactivity and smoking by single questions. Participants had a mean age of 58 years, with 51% being female. Of them, 14% had no unhealthy behaviors, 38% had one, 36% had two, 10% had three, and 2% had all four. The most common co-occurrence was between physical inactivity and poor diet (38%). Higher education decreased the likelihood of having three or four unhealthy behaviors, while financial difficulties, having no one around who appreciated one’s efforts, and suffering of a lung disease increased it. In conclusion, middle-aged adults exhibit varying levels of unhealthy lifestyle behaviors. Higher education is linked to reduced engagement in multiple unhealthy behaviors, whereas financial strain, lower quality of social support, and lung disease increase the risk.

Abstract Background Identifying problem drinking patterns across industries is essential for addressing drinking problems in the workforce. Still, it is not well understood how problem drinking differs across industries and whether it is associated with industry gender composition. This study aimed to measure the prevalence of problem drinking (PPD) across Swedish industries and investigate possible associations between gender-typed industries and problem drinking. Methods 9,155 current workers were selected from the Swedish Longitudinal Occupational Survey of Health (SLOSH) data collected in 2020. Participants’ work industries were identified through the Swedish Standard Industrial Classification (SNI) codes. Seven gender-typed industry categories were created based on gender composition and main job activity in each industry. Self-reported problem drinking was measured using a slightly modified Cut-down, Annoyed, Guilt, Eye-opener (CAGE) questionnaire and a cut-off score 2 was used to determine problem drinking. Poisson regression with robust standard errors was used to investigate the association between gender-typed industries and problem drinking. Results PPD in the workforce was 6.6%. Men (8.5%) had a higher prevalence than women (5.3%). Across industries, PPD varied from 2.3% in Water supply and waste management to 15.4% in Mining and quarrying. The highest prevalence for men was in Mining and quarrying (18.2%), whereas for women it was in Construction (11.1%). Within gender-typed industries, the highest PPD was in male-dominated Goods and Energy Production (7.7%), and the lowest was in female-dominated Health and Social Care (4.7%). In the regression analysis, both Education (aPR: 1.39, p = 0.03) and Labour-intensive Services (aPR: 1.39, p = 0.02) had higher adjusted prevalence ratios (aPR) compared with Health and Social Care. However, there was no significant difference in aPR among gender-typed industries when considering the gender composition of industries only. Conclusions PPD in the Swedish workforce varied significantly across industries, with differences observed between men and women. Problem drinking differed between industries when categorized by gender composition and main job activity, but not when categorized by gender composition only. Future research should investigate how industry-specific psychosocial factors influence individual alcohol consumption.

Research on school improvement has accumulated an extensive list of factors that facilitate turnarounds at underperforming schools. Given that context or resource constraints may limit the possibilities of putting all of these factors in place, an important question is what is necessary and sufficient to turn a school around. We use qualitative comparative analysis (QCA) of 77 Swedish schools studied over 12 years to answer this question. Our core finding is that there is no "silver bullet" solution. Instead, there are several distinct combinations of factors that can enable school turnaround. The local school context is essential for which combinations of factors are necessary and sufficient for school turnaround. We discuss implications for research on school improvement and education policy.

AIMS – To study the prevalence of cannabis use and drug-related problems among European adolescents and the utility of the prevention paradox. METHODS – Survey data from the European School Survey Project on Alcohol and Other Drugs (ESPAD) in 2007 in the 27 countries with information about drug use and drug-related problems was used. We analysed the proportion of all drug-related problems that occurred in a high risk group and among others who had used cannabis in the previous 12 months. The cut-off for the high risk group was chosen to include 10-15 % of the most frequent cannabis users. RESULTS – The high risk groups accounted for a substantial, but a minority, of drug-related problems among boys as well as girls. A minority of those who had used cannabis reported any drug-related problem. The proportion of adolescents with drug-related problems and the average number of problems increased with frequency of cannabis use. CONCLUSIONS – We find support for policy measures of more general character, supported by the prevention paradox. However, this does not exclude a policy supporting frequent drug users if they can be identified

Abstract Background Emergency medical services (EMS) personnel must rapidly assess and transport patients with time-sensitive conditions to optimise patient outcomes. Serum lactate, a valuable in-hospital biomarker, has become more accessible in EMS settings through point-of-care (POC) testing. Although POC lactate levels are valuable in specific patient groups, its broader application in EMS remains unclear. This study assessed the additional predictive value of POC lactate levels in a general adult EMS population. Methods This prospective observational study (March 2018 to September 2019) involved two EMS organisations in Västra Götaland, Sweden. Patients were triaged using the Rapid Triage and Treatment System (RETTS). POC lactate levels were measured using StatStrip Xpress devices. Non-consecutive patients who received EMS and were aged 18 years and above were available for inclusion if triaged into RETTS levels: red, orange, yellow, or green if respiratory rate of ≥ 22 breaths/min. Outcomes were adverse outcomes, including a time-sensitive diagnosis, sequential organ failure assessment (SOFA) score ≥ 2, and 30-day mortality. Statistical analyses included descriptive statistics, imputation, and regression models to assess the impact of the addition of POC lactate levels to a base model (comprising patient age, sex, presence of past medical conditions, vital signs, pain, EMS response time, assessed triage condition, and triage level) and a RETTS triage model. Results Of 4,546 patients (median age 75 [57, 84] years; 49% male), 32.4% had time-sensitive conditions, 12.5% met the SOFA criteria, and 7.4% experienced 30-day mortality. The median POC lactate level was 1.7 (1.2, 2.5) mmol/L. Patients with time-sensitive conditions had higher lactate levels (1.9 mmol/L) than those with non-time-sensitive conditions (1.6 mmol/L). The probability of a time-sensitive condition increased with increasing lactate level. The addition of POC lactate marginally enhanced the predictive models, with a 1.5% and 4% increase for the base and RETTS triage models, respectively. POC lactate level as a sole predictor showed chance-only level predictive performance. Conclusions Prehospital POC lactate assessment provided limited additional predictive value in a general adult EMS population. However, it may be beneficial in specific patient subgroups, emphasizing the need for its judicious use in prehospital settings.

Abstract Background Dietary habits strongly influence health, with poor diets contributing to numerous deaths annually. Addressing this requires improved dietary habits and consistent monitoring thereof. In northern Sweden, a validated food frequency questionnaire (FFQ) has been used for decades, but trends show that its ability to accurately measure intake has diminished. With changing eating habits and food supply, updating the FFQ was crucial, leading to the development of FFQ2020. This study assessed FFQ2020’s relative validity using 24-hour recalls and evaluated its reproducibility. Methods Participants were recruited from one of the northern-Sweden population-based health screenings and by advertising. Food intake was registered in an electronic food frequency questionnaire (FFQ2020) (test instrument) and reference data were obtained by six repeated electronic 24-hour dietary recalls (24HDR). Intakes of single foods were aggregated into food groups and healthy diet index scores, and daily energy and nutrient intakes were estimated. Results from the two methods were described and tested in univariate analyses and correlation tests, Bland Altman plots, cross-classification validity, and intra-class correlation analyses. Results Totally, 628 adults were invited to participate in the study. Of these, 320 joined, and 244 completed at least four 24HDRs. The median intakes in food groups, as well as the mean index scores and estimated nutrient intakes, were largely similar between the FFQ2020 and 24HDR recordings. The correlation coefficients between the two assessments ranged from 0.253 to 0.693 for food groups, 0.520 to 0.614 for diet indices, and 0.340 to 0.629 for energy and nutrients. Intra-class correlation coefficients indicated at least good reproducibility for intakes of food groups, diet index scores, and nutrients. Generally, Bland-Altman plots did not reveal any gross systematic disagreement between the two methods for any of the assessments. However, there were single observations located outside the upper or lower 95% confidence interval (CI) limits for the difference between FFQ2020 and the 24HDR recordings. Conclusion In concert, the results suggest that the relative validity and reproducibility of FFQ2020 are acceptable for trend analyses and group comparisons in large-scale studies but also that extended reference periods would improve the precision of less frequently consumed foods.

Abstract Current research on metabolic disorders and diabetes relies on animal models because multi-organ diseases cannot be well studied with standard in vitro assays. Here, we have connected cell models of key metabolic organs, the pancreas and liver, on a microfluidic chip to enable diabetes research in a human-based in vitro system. Aided by mechanistic mathematical modeling, we demonstrate that hyperglycemia and high cortisone concentration induce glucose dysregulation in the pancreas-liver microphysiological system (MPS), mimicking a diabetic phenotype seen in patients with glucocorticoid-induced diabetes. In this diseased condition, the pancreas-liver MPS displays beta-cell dysfunction, steatosis, elevated ketone-body secretion, increased glycogen storage, and upregulated gluconeogenic gene expression. Conversely, a physiological culture condition maintains glucose tolerance and beta-cell function. This method was reproducible in two laboratories and was effective in multiple pancreatic islet donors. The model also provides a platform to identify new therapeutic proteins, as demonstrated with a combined transcriptome and proteome analysis.

Abstract Life’s Essential 8 (LE8) is a score that includes modifiable risk factors for cardiovascular disease. Four health behaviors (diet, physical activity, nicotine exposure and sleep health) and four health factors (non-HDL cholesterol, blood glucose, blood pressure and body mass index) are included. These modifiable risk factors promote inflammation, and inflammation is one of the biological mechanisms of cardiovascular disease development. Thus, we examined the relationship between cardiovascular health measured by LE8 and low-grade inflammation measured by high-sensitivity C-reactive protein (hs-CRP) in the cross-sectional population-based Swedish CArdioPulmonary bioImage Study (SCAPIS). The study consisted of 28,010 participants between 50 and 64 years (51.5% women, mean age 57.5 years). All individual LE8 components were assigned a score between 0 (unhealthy) and 100 (healthy) points, and a global score was calculated. The association between LE8 scores and high-risk hs-CRP (defined as > 3.0 mg/L) was analyzed using adjusted logistic regression with spline analyses. There was a strong, dose response and inverse association between LE8 scores and levels of hs-CRP. Thus, those with a low LE8 score (= 50.0 points) had 5.8 higher (95% confidence interval [CI] 5.2–6.4) odds ratio (OR) of having high hs-CRP as compared to those with a high LE8 score (= 80.0 points). In conclusion, our findings show strong inverse associations between LE8 scores and levels of hs-CRP.

Background. RMC-035 is a modified version of alpha-1-microglobulin, an endogenous protein developed as a renoprotective agent. Its intended use is to reduce the risk of irreversible loss of kidney function in cardiac surgery patients and to reduce delayed graft function in kidney transplant recipients. This first-in-human study aimed to evaluate the pharmacokinetics and safety of RMC-035 in kidney transplant recipients. Methods. Eight living-donor kidney transplant recipients were included in 2 dose cohorts. The study drug RMC-035 was administered starting with the first dose during transplantation. Four additional doses were administered once daily following transplantation. In the first cohort, all 5 doses of RMC-035 were equal, whereas in the second cohort, the last 3 doses were doubled. Safety monitoring, laboratory tests, and pharmacokinetic measurements were performed according to protocol for 4 d post-transplantation and during the 90-d follow-up period. Results. All 5 administrations of the study drug were completed in 5 out of 8 treated participants. Pharmacokinetic concentrations were approximately dose proportional, and AUC0–24h decreased between the first and fifth doses, reflecting improved kidney function and RMC-035 renal clearance over time. No accumulation was observed between the administrations. No clinically significant changes were observed in the hematological or biochemical laboratory parameters, electrocardiogram findings, or vital signs. A total of 22 treatment-emergent adverse events (AEs) were reported in 6 subjects. Mild and transient AEs suggestive of infusion-related reactions, such as chills, were reported in 5 patients. There was a clinically significant reduction in serum creatinine levels, reflecting post-transplant improvement in kidney function. Conclusions. Based on the safety data obtained from 8 subjects in the 2 dose cohorts treated with RMC-035, the drug was considered safe. Safety and AE profiles were in line with expectations of the target population, and infusion-related reactions were short-lived and manageable. Dose-limiting toxicity signals were not observed.

Frequent sauna bathing has been associated with a reduced risk of cardiovascular disease and proposed as a mediator for improved health. Therefore, the aim was to describe and compare sauna bathers with non-sauna bathers in northern Sweden based on their demographics, health and life attitudes, and to describe sauna bathers’ sauna habits. Questions on sauna bathing habits were included in the questionnaire for the participants in the Northern Sweden MONICA (multinational monitoring of trends and determinants in cardiovascular disease) study, conducted during spring of 2022, inviting adults 25–74 years living in the two northernmost counties of Sweden (Norr- and Västerbotten), randomly selected from the population register. Of the 1180 participants in MONICA 2022, 971 (82%) answered the question about sauna bathing. Of these, 641 (66%) were defined as sauna bathers. Sauna bathers reported less hypertension diagnosis and self-reported pain. They also reported higher levels of happiness and energy, more satisfying sleep patterns, as well as better general and mental health. Sauna bathers were younger, more often men and found to have a healthier life-profile compared to non-sauna bathers. Additionally, the results suggest that the positive effects associated with sauna bathing plateaued from 1–4 times per month.

The Arctic Monitoring Assessment Program (AMAP) is tasked with monitoring and assessing the status of environmental contaminants in the Arctic, documenting levels and trends, and producing science-based assessments. The objectives of this paper are to present the current levels of persistent organic pollutants (POPs) across the Arctic, and to identify trends and knowledge gaps as detailed in the most recent AMAP Human Health Assessment Report. Many Arctic populations continue to have elevated levels of these contaminants, and the highest levels of POPs were observed in populations from Greenland, Faroe Islands, and Nunavik (Canada), as well as populations in the coastal Chukotka district (Russia) for legacy POPs only. Concentrations of most POPs are declining in Arctic populations in regions where time trends data exist, although the declines are not consistent across all regions. The exceptions are per- and polyfluoroalkyl substances, with concentrations of some long-chain PFAS such as perfluorononanoic acid increasing in populations in Nunavik, Greenland and Sweden. This paper provides a more extensive summary of levels of contaminants in adults, pregnant women, and children across the Arctic than previous AMAP human health assessments, particularly for levels of long-chain PFAS, which are currently under consideration for inclusion in the Stockholm Convention.

The 2021 Arctic Monitoring Assessment Program (AMAP)’s Human Health Assessment report presents a summary of the presence of contaminants in human populations across the circumpolar Arctic and provides an update to the previous assessment released in 2015. The primary objective of this paper is to summarise some of these findings by describing the current levels of metals across the Arctic, including key regional and temporal trends based on available national data and literature, and highlight knowledge gaps. Many Arctic populations continue to have elevated levels of these contaminants, and the highest levels of mercury (Hg) were observed in populations from Greenland, Faroe Islands, and Nunavik (Canada). Still, concentrations of several metals are declining in Arctic populations in regions where time trends data exist, although the declines are not consistent across all regions. The 2021 AMAP human health assessment report and this paper provide an extensive summary of levels of metals and trace elements in adults, pregnant women, and children across the Arctic.

Arctic populations are amongst the highest exposed populations to long-range transported contaminants globally, with the main exposure pathway being through the diet. Dietary advice is an important immediate means to address potential exposure and help minimize adverse health effects. The objective of this work is to enable easier access to dietary advice and communication guidance on contaminants with a focus on the Arctic. This manuscript is part of a special issue summarizing the Arctic Monitoring and Assessment Programme’s Assessment 2021: Human Health in the Arctic. The information was derived with internet searches, and by contacting relevant experts directly. Results include risk communication efforts in European Arctic countries, effectiveness evaluation studies for several Arctic countries, experience of social media use, and the advantages and challenges of using social media in risk communication. We found that current risk communication activities in most Arctic countries emphasize the importance of a nutritious diet. Contaminant-related restrictions are mostly based on mercury; a limited amount of dietary advice is based on other contaminants. While more information on effectiveness evaluation was available, specific information, particularly from Arctic countries other than Canada, is still very limited.

To further research how organizations influence workforce wage inequality, the authors replicate and extend Sorensen and Sorenson’s study on organizational demography and wage inequality in region-industries by (1) replicating original results from Danish regions from 1992 to 1998 using a close-to-identical dataset in Sweden during the same time period, (2) using multiverse analysis to gauge the effect of analytical choices on research results, and (3) expanding the scope of Sorensen and Sorenson’s model by two new measures of organizational diversity. The findings suggest strong to fair test-retest validity of the original model, but model extensions with nuanced measures of organization form diversity do not enhance the model’s explanatory power. The authors analyze and discuss replication anomalies and show how multiverse analysis can be gainfully used more generally in comparative organizational sociology.

Abstract Background Cardiovascular disease (CVD) is a major global health issue, primarily caused by atherosclerosis. Psychological factors may play a role in the development and progression of CVD. However, the relationship between psychological factors and atherosclerosis is complex and poorly understood. This study, therefore, aimed to examine the association of psychological factors with (i) coronary and carotid atherosclerosis and (ii) cardiovascular health according to Life’s Essential 8, in a large Swedish cohort. Methods This study utilized data from the Swedish CArdioPulmonary bioImage Study (SCAPIS), a large population-based project including individuals aged 50 to 65 years. Several psychological factors were analysed: general stress, stress at work, financial stress, major adverse life events, locus of control, feeling depressed, and depression. Coronary atherosclerosis was assessed as the degree of stenosis by coronary computed tomography angiography (CCTA) and coronary artery calcification (CAC) scores. Carotid atherosclerosis was examined using ultrasound. In addition, cardiovascular health was examined using the Life’s Essential 8 concept created by the American Heart Association, which includes four health behaviors and four health factors. Associations were examined through binomial logistic regression (atherosclerosis variables) and linear regression (Life’s Essential 8). Results A total of 25,658 participants were included in the study. The presence of financial stress, higher locus of control, and depression was weakly associated with increased odds of CCTA stenosis, CAC ≥ 1 and the presence of carotid plaques (all odds ratios: 1.10–1.21, 95% CI: 1.02–1.32) after adjusting for sex, age, and study site. However, these associations were attenuated and not statistically significant after additional adjustments for socioeconomic factors and health behaviors. Conversely, we observed inverse associations between the worst category for all psychological factors and cardiovascular health according to Life’s Essential 8 score (all standardized β-Coefficient ≤-0.033, p

The Total Carbon Column Observing Network (TCCON) measures column-average mole fractions of several greenhouse gases (GHGs), beginning in 2004, from over 30 current or past measurement sites around the world using solar absorption spectroscopy in the near-infrared (near-IR) region. TCCON GHG data have been used extensively for multiple purposes, including in studies of the carbon cycle and anthropogenic emissions, as well as to validate and improve observations from space-based sensors. Here, we describe an update to the retrieval algorithm used to process the TCCON near-IR solar spectra and to generate the associated data products. This version, called GGG2020, was initially released in April 2022. It includes updates and improvements to all steps of the retrieval, including but not limited to the conversion of the original interferograms into spectra, the spectroscopic information used in the column retrieval, post hoc air mass dependence correction, and scaling to align with the calibration scales of in situ GHG measurements. All TCCON data are available through https://tccondata.org/ (last access: 22 April 2024) and are hosted on CaltechDATA (https://data.caltech.edu/, last access: 22 April 2024). Each TCCON site has a unique DOI for its data record. An archive of all the sites' data is also available with the DOI https://doi.org/10.14291/TCCON.GGG2020 (Total Carbon Column Observing Network (TCCON) Team, 2022). The hosted files are updated approximately monthly, and TCCON sites are required to deliver data to the archive no later than 1 year after acquisition. Full details of data locations are provided in the “Code and data availability” section.

Abstract During the 2015–2016 El Niño, the Amazon basin released almost one gigaton of carbon (GtC) into the atmosphere due to extreme temperatures and drought. The link between the drought impact and recovery of the total carbon pools and its biogeochemical drivers is still unknown. With satellite‐constrained net carbon exchange and its component fluxes including gross primary production and fire emissions, we show that the total carbon loss caused by the 2015–2016 El Niño had not recovered by the end of 2018. Forest ecosystems over the Northeastern (NE) Amazon suffered a cumulative total carbon loss of ∼0.6 GtC through December 2018, driven primarily by a suppression of photosynthesis whereas southeastern savannah carbon loss was driven in part by fire. We attribute the slow recovery to the unexpected large carbon loss caused by the severe atmospheric aridity coupled with a water storage deficit during drought. We show the attenuation of carbon uptake is three times higher than expected from the pre‐drought sensitivity to atmospheric aridity and ground water supply. Our study fills an important knowledge gap in our understanding of the unexpectedly enhanced response of carbon fluxes to atmospheric aridity and water storage deficit and its impact on regional post‐drought recovery as a function of the vegetation types and climate perturbations. Our results suggest that the disproportionate impact of water supply and demand could compromise resiliency of the Amazonian carbon balance to future increases in extreme events.

There is such a vast proliferation of scientific theories of consciousness that it is worrying some scholars. There are even competitions to test different theories, and the results are inconclusive. Consciousness research, far from converging toward a unifying framework, is becoming more discordant than ever, especially with respect to theoretical elements that do not have a clear neurobiological basis. Rather than dueling theories, an integration across theories is needed to facilitate a comprehensive view on consciousness and on how normal nervous system dynamics can develop into pathological states. In dealing with what is considered an extremely complex matter, we try to adopt a perspective from which the subject appears in relative simplicity. Grounded in experimental and theoretical observations, we advance an encompassing biophysical theory, MaxCon, which incorporates aspects of several of the main existing neuroscientific consciousness theories, finding convergence points in an attempt to simplify and to understand how cellular collective activity is organized to fulfill the dynamic requirements of the diverse theories our proposal comprises. Moreover, a computable index indicating consciousness level is presented. Derived from the level of description of the interactions among cell networks, our proposal highlights the association of consciousness with maximization of the number of configurations of neural network connections ―constrained by neuroanatomy, biophysics and the environment― that is common to all consciousness theories.

IntroductionThe Norwegian Directorate of Health approved the Norwegian Hearing Register for Children in 2022. The main objective of the register is to improve the quality of treatment for children with permanent hearing loss, by measures, follow-ups and monitoring the quality and results of the health care system.MethodsInclusion criteria are children who do not pass universal newborn hearing screening and/or children with permanent hearing loss 20 dB in at least one ear. Data are registered at the Ear, Nose and Throat departments at inclusion and at follow-ups at the age of 3, 6, 10, and 15 years. The register collects information about the child within a holistic perspective. The key elements of the register are (a) data concerning newborn hearing screening; (b) data concerning hearing, medical information, hearing amplification and intervention (c) patient reported outcome measures registered by caregivers using three questionnaires; Pediatric Quality of Life Inventory, Strengths and Difficulties Questionnaire and Parents’ Evaluation of Aural/Oral Performance of Children.ResultsThe register has established four quality indicators regarding newborn hearing screening and early intervention (a) the rate of false positive neonatal screens; (b) testing for congenital cytomegalovirus within 3 weeks of age for children who do not pass newborn hearing screening; (c) audiological evaluation to confirm the hearing status no later than 3 months of age and (d) initiated intervention within 3 months after confirmation of hearing status.DiscussionThe register will include the total population of hearing impaired children over long time periods. Thus, the register enables each hospital to monitor their quality indicator scores continuously and compare them with national levels in real time. This facilitates and accelerates identification of improvement areas in the hospitals and will be an important contributor for quality improvement in NHS, diagnostics and hearing intervention for children in Norway. In addition, data from the register will be a unique source for research, and study designs with a long follow-up time can be applied.

This study explores how traffic safety implementation at local level in line with the 2030 Agenda for Sustainable Development is characterised. By investigating interactions between traffic safety and other sustainability goals (synergies), as well as identifying contradictions between goals and conflicting interests (challenges), the study aims to pinpoint the main enablers for implementing traffic safety as part of sustainability. The emphasis lies on local authorities in Sweden representing a mature traffic safety context when viewed globally. To delve into this issue, interviews were conducted with 37 municipal employees from the city of Gothenburg, encompassing diverse roles that exemplify the significant influence Swedish local authorities wield in shaping traffic safety: as road manager and planner, in maintenance and construction phases, as employer and purchaser, and as influencer of behaviour. The study reveals several synergies between traffic safety and other sustainability goals, as well as contradictions between goals and conflicting interests posing challenges to traffic safety implementation. Main enablers for implementation of traffic safety as part of sustainability at the local level concern, for example, an integrated approach on strategic level where traffic safety could be handled as either a prerequisite (e.g. for active mobility) or a framework condition (e.g. for green cars). The necessity to bridge gaps between strategic and operational levels is also emphasised. Contradicting goals and interests are inevitable and must be managed. The study identifies the traffic strategy and strategic analyses, in the European context referred to as Sustainable Urban Mobility Planning, as a platform for traffic safety implementation as part of sustainability. Such platform highlights implementation areas in common for different target areas. The significance of integrating traffic safety in relevant activities and processes, alongside fostering horizontal collaborations across target areas, becomes apparent when striving to embed traffic safety in a wider sustainability context. While Swedish municipalities may not always recognize traffic safety as part of the sustainability agenda, existing platforms within municipalities serve as a foundation for adopting an integrated approach to traffic safety implementation. However, there is a need for a central coordinating function to ensure robust leadership in integrating traffic safety as a vital component of sustainability.