Objective: To estimate the prevalence of coronary heart disease (CHD) in Mauritius. Over the last half century, rapid socioeconomic development has taken place in the multiethnic Mauritius. It is unclear if this is paralleled with an increasing prevalence of CHD.

Design: Repeated cross-sectional population-based studies.

Setting: Mauritius.

Participants: Seven population-based surveys were performed in Mauritius between 1987 and 2021. Altogether, 29 997 participants aged 35–74 years were included.

Measures: Except in 2004 and 2021, all participants were examined with an ECG. ECG changes were classified as ‘probable CHD’ and ‘possible CHD’ according to the Minnesota Code model. Participants were asked about previous myocardial infarction, stroke and angina pectoris as told by a doctor. An affirmative answer to any of these questions was labelled as the presence of cardiovascular disease (CVD). Since 2009, questions about previous coronary bypass surgery and percutaneous coronary intervention were included. The prevalence estimates were age and sex standardised to the 2008 Mauritian population. Multivariable logistic regression evaluated associations between traditional CVD risk factors and CHD.

Results: The prevalence (with 95% CI) of probable CHD according to ECG did not increase between 1987 and 2015, 1.6% (1.2–2.1%) and 1.9% (1.5–2.3%), respectively, whereas the prevalence of possible CHD decreased, 23.7% (22.3–25.1%) and 17.3% (16.2–18.3%), respectively. Self-reported CVD did not increase between 1987 and 2021. Male sex, diabetes, impaired glucose tolerance (IGT), hypertension, smoking and self-reported history of CVD were associated independently with probable CHD, whereas female sex, IGT, hypertension, high cholesterol and self-reported history of CVD were associated independently with possible CHD. Ethnicity did not associate with probable CHD but with possible CHD. Postload plasma glucose associated with probable and possible CHD.

Conclusions: The prevalence of probable CHD according to ECG and the prevalence of self-reported history of CVD did not increase in Mauritius. Traditional cardiovascular risk factors were associated significantly with the presence of probable and possible CHD.

Towards reliable viability assessment for resilient life stages of invertebrates in ballast water This report presents results from the VIABLEGG project, which made important progress in identifying viable eggs and resting stages of invertebrates in ballast water. The findings show that some methods work well for certain species, offering practical value for inspections at ports. At the same time, the project provides new insight into why some life stages are difficult to assess and what biological and technical challenges must be addressed. The report offers concrete suggestions for future research, practical application, and the need for international coordination. These results lay a valuable foundation for efforts to prevent the spread of invasive species through global shipping. This report is financed by the Swedish Environmental Protection Agency and the Swedish Agency for Marine and Water Management.

This project has mapped and compared technical specifications, test standards and test needs for electric powertrains in the rail and aviation sectors. Through interviews with industry partners such as Heart Aerospace and Alstom, as well as extensive literature studies, the project has analyzed similarities and differences in the powertrain design, operating conditions and environmental requirements. A central part of the work has been to investigate the possibilities for a cross-industry approach to testing and development. The analysis has identified common needs within performance testing, energy measurements and environmental testing. To enable more flexible and cost-effective testing of powertrain converters, a motor emulator has been developed, which makes it possible to develop and verify the converter function without the need of a physical motor. The project has also carried out a detailed mapping of test facilities in Sweden, where SEEL and Alstom Powerlab are considered to have high potential to support joint testing initiatives between the rail and aviation sectors. The results show that harmonizing testing methods and standards across these sectors can not only lead to increased cost-effectiveness but also promote innovation and collaboration in electrified transport. The report recommends continued investment in common testing infrastructure and the development of standards that can strengthen the competitiveness and safety of both sectors. This project was funded by the Swedish Transport Administration.

Model checking has become a widely used and precise technique for verifying software systems. However, a major challenge in model checking is state space explosion, which occurs due to the exponential memory usage required by the model checker. To address this issue, meta-heuristic and evolutionary algorithms offer a promising solution by searching for a state where a property is either satisfied or violated. Recently, various evolutionary algorithms, such as Genetic Algorithms and Particle Swarm Optimization, have been applied to detect deadlock states. While these approaches have been useful, they primarily focus on deadlock detection. This paper proposes a fuzzy algorithm to analyse reachability properties in systems specified through Graph Transformation Systems with large state spaces. To achieve this, the existing Particle Swarm Optimisation algorithm, which is typically used for deadlock detection, has been extended to analyse reachability properties. To further enhance accuracy, a Fuzzy Adaptive Particle Swarm Optimization algorithm is introduced to determine which states and paths should be explored at each step-in order to find the corresponding reachable state. Additionally, the proposed hybrid algorithm was applied to models generated through rule composition to assess the impact of rule composition on execution time and the number of explored states. These approaches were implemented within an open-source toolset called GROOVE, which is used for designing and model checking Graph Transformation Systems. Experimental results demonstrate that proposed hybrid algorithm reduced verification time by up to 49.86% compared to Particle Swarm Optimization and 65.17% compared to Genetic Algorithms in reachability analysis of complex models. Furthermore, it explored 32.7% fewer states on average than the hybrid method based on Particle Swarm Optimization and Gravitational Search Algorithms, and 57.4% fewer states compared to Genetic Algorithms, indicating improved search efficiency. The application of rule composition further reduced execution time by 35.7% and the number of explored states by 41.2% in large-scale models. These results confirm that proposed hybrid algorithm significantly enhances reachability analysis in the systems modelled via Graph Transformation, improving both computational efficiency and scalability.

This study examines long-term patterns in rural-to-urban migration in the northern Swedish county of Västerbotten from 1900 to 2019. The study is based on individual-level register data that have been harmonized across time. The main focus is on the development of the sex and age profile of the rural-urban migrants. The analysis is conducted using discrete-time event history analysis in terms of the logistic hazard rate of rural-urban migration. The results, as expected, show that the development of the hazard of rural-urban migration increased substantially over time, closely following the general development of urbanization in Sweden. Furthermore, that the hazard among women was continuously larger than among men. However, the relative differences between the sexes were largest at the beginning of the investigated period and have become smaller over time, primarily due to men gradually adopting migration patterns similar to those of women. The study suggests that this is due to the rural labor market, which for a long time offered more compelling pathways for men to stay in rural areas. However, as these rural labor markets gradually declined during the 20th century, coupled with the increasing importance of higher education, rural men began moving to urban areas to a greater degree. While young adults constituted the age group with the highest risk of rural-urban migration throughout the period, the earliest rural-urban migrants started to move directly as they reached working age, however, after the 1980s, movers typically postpone migration until their early 20s, the same time as they enter into tertiary education.

Cellulose filaments with a unique microtape-like shape (width/thickness ratio ≈ 40) were studied for their potential as reinforcement in bio-epoxy resin with the hypothesis that their gross-sectional geometry would allow for efficient stress transfer and a higher transverse modulus. The microstructure of the spun filaments, orientation of the cellulose fibrils within them, and their mechanical properties were analyzed. Unidirectional (UD) composites with bio-epoxy resin were fabricated using vacuum infusion resulting in filament content of ≈ 23 vol% and low density 1.18 gcm−3.

Wide-angle X-ray scattering showed that the cellulose fibrils were relatively well aligned in the filament axis, having an orientation factor of 0.78. The axial filament modulus was measured to 33 GPa, the in-plane transverse modulus to 12 GPa and the axial strength was approx. 380 MPa. The longitudinal E-modulus of the UD composites was measured to 10 GPa and the strength to 120 MPa, both 3 times higher than the used bio-epoxy agreeing well with the estimated values. The transverse elongation at break of the UD composite was higher than typical values reported for glass-fiber epoxy composites, but the effect of filament shape on the transverse modulus was less significant than the predicted 4.5 GPa but still better than estimated for circular fibers. The lower property is likely due to the low filament content and the partially uneven in-plane filament arrangement. Simulations based on shear stress analysis suggest that the transverse properties of the UD composite could be improved by ensuring that the filament planes remain predominantly parallel in-plane during fabrication, and the overall mechanical properties could be improved by increasing the filament content.

ImportanceThe management of complications following oral cavity squamous cell carcinoma (OCSCC) surgery can be challenging. Previous studies show conflicting results on complication risks after preoperative radiotherapy (RT), necessitating a randomized controlled trial (RCT).ObjectiveTo compare early complications during hospitalization for OCSCC surgery between patients receiving preoperative accelerated fractionated RT and those planned for but not yet exposed to RT.DesignA part of the ARTSCAN 2 RCT comparing preoperative accelerated RT with postoperative conventionally fractionated RT for OCSCC.SettingA multicentre trial in 6 tertiary care hospitals in Sweden.ParticipantsUntreated and resectable OCSCC patients of all stages recommended combination treatment by the local multidisciplinary board.InterventionPreoperative accelerated RT was administered twice daily to a total dose of 68 Gy, completed 4 to 6 weeks before surgery.Main Outcome MeasuresComplications during hospitalization included wound infection, neck flap necrosis, chyle leakage, oro/pharyngocutaneous fistula, free flap necrosis, tracheostomy, revision surgery, and medical complications. Length of surgery, perioperative blood loss, and transfusions were also monitored.ResultsTwo hundred and twenty-one patients were eligible for analysis: 103 in the preoperative RT group and 118 not yet exposed to RT. Complication rates were low, with no statistically significant differences between groups. Patients receiving preoperative RT had similar wound infection rates (12/103; 11.7%) to those not exposed (9/118; 7.6%) (P = .31). Among free flap patients, 1/40 (2.5%) in the preoperative RT group and 3/52 (5.8%) in the unirradiated group had free flap necrosis (P = .63). No differences were found in oro/pharyngocutaneous fistula frequency (3/103; 2.9% vs 3/118; 2.5%) (P = 1.00).Conclusion and RelevancePreoperative accelerated RT at 68 Gy, administered 4 to 6 weeks before surgery, does not increase early complications. Although survival rates, morbidities, quality of life, and societal costs need consideration in the ARTSCAN 2 assessment, our findings show that early postoperative complication risks remain unchanged by preoperative RT.Trial RegistrationISRCTN, ISRCTN00608410, Registered 20 March 2008-Retrospectively registered, https://www.isrctn.com/ISRCTN00608410.

This scoping review examines research on journalistic practices in the Nordic countries during societal crises, focusing on how such events disrupt newsroom routines and shape journalistic roles. Mapping the extent and focus of research on crises like the global Covid-19 pandemic, the 2011 Utøya terror attack in Norway, and the Jokela school shooting in Finland, the review identifies key challenges faced by journalists. These include balancing service and watchdog roles, navigating ethical dilemmas, and managing the growing influence of social media. The 32 studies (2007-2024) reveal a modest but growing research focus on journalistic practice during crises in the Nordic region. Findings show that, particularly in the acute phase, journalists prioritise information dissemination over critical scrutiny, often aligning with government messaging. While crises drive technological innovation and accelerate digital adaptation, they also raise ethical challenges, such as how to approach those affected and verify user-generated content. Furthermore, the findings show that the Nordic media systems demonstrated resilience and adaptability during crises.

BackgroundThe Utrecht Work Engagement Scale is a frequently used instrument for measuring work engagement. However, the instrument’s conceptual underpinnings, theoretical clarity and dimensional structure has been criticized, and its construct validity has not been evaluated appropriately in samples of nurses. The study purpose was to assess the psychometric properties of the Utrecht Work Engagement 9-item Scale (UWES-9) in a sample from the haemodialysis nurse population using approaches that take the ordinal nature of the data into account.

Methods

The psychometric properties were evaluated in accordance with classical test theory focusing on data completeness, unidimensionality, scaling assumptions, targeting and reliability. The analyses were conducted using data derived from a cross sectional study.

Results

Missing item responses were < 2%. Exploratory factor analysis based on polychoric correlations and parallel analysis identified one factor. Scaling assumptions were supported based on desirable levels of corrected item-total correlations. The targeting analyses displayed expected score distribution, no floor effect and acceptable ceiling effect. However, the mean total score was above the scale midpoint. The reliability, estimated using Ordinal alpha, was 0.93.

Conclusions

The study findings, evaluated using methods that consider the ordinal nature of the scale ratings, indicate that the UWES-9 is a reliable and valid unidimensional measure with high data completeness, strong internal consistency, and a supported factor structure. These results support the use of the UWES-9 in research and practice for assessing work engagement. However, further studies are recommended to examine its applicability across diverse populations and settings.

Bipolar disorder is a heritable mental illness with complex etiology. While the largest published genome-wide association study identified 64 bipolar disorder risk loci, the causal SNPs and genes within these loci remain unknown. We applied a suite of statistical and functional fine-mapping methods to these loci and prioritized 17 likely causal SNPs for bipolar disorder. We mapped these SNPs to genes and investigated their likely functional consequences by integrating variant annotations, brain cell-type epigenomic annotations, brain quantitative trait loci and results from rare variant exome sequencing in bipolar disorder. Convergent lines of evidence supported the roles of genes involved in neurotransmission and neurodevelopment, including SCN2A, TRANK1, DCLK3, INSYN2B, SYNE1, THSD7A, CACNA1B, TUBBP5, FKBP2, RASGRP1, FURIN, FES, MED24 and THRA among others in bipolar disorder. These represent promising candidates for functional experiments to understand biological mechanisms and therapeutic potential. Additionally, we demonstrated that fine-mapping effect sizes can improve performance of bipolar disorder polygenic risk scores across diverse populations and present a high-throughput fine-mapping pipeline.

Introduction: Climate change is a pressing public health issue. Urban populations, especially in coastal areas, are highly vulnerable. As climate change progresses, local adaptation becomes increasingly important. We present a case study about the inclusion of public health concerns in local climate change adaptation in Porto (Portugal).

Methods: We analysed two local adaptation plans using qualitative content analysis and conducted semi-structured interviews with a purposeful sample of 6 key stakeholders with different profiles. We did a qualitative content analysis of the respective transcripts.

Results: Porto is undergoing health-relevant consequences of climate change, which are expected to worsen further in the future. Porto's geographical and demographic characteristics and urban environment make its population highly vulnerable to climate change-related health risks. Public health is recognized as a central element in local adaptation efforts. Drivers for integrating health concerns include growing climate change awareness, a sense of urgency, social capital, institutional networks, access to resources, and political commitment. Nevertheless, challenges like data limitations, resource constraints, climate knowledge gaps, communication issues, and political cycles hinder both local adaptation and the integration of health considerations.

Discussion/conclusion: In Porto, health seems both a powerful mobilizing issue and a central topic concerning local adaptation. However, the complex and long-term nature of climate change and the associated uncertainty hinder adaptation efforts. High-quality data about both the local climate and population health are thus essential. The transversal nature of risk is recognized and multi-sectorial approaches, public participation, mainstreaming, and policy integration are necessary to prevent imbalances. Local adaptation efforts, including health-related efforts, are shaped by the international (belonging to the European Union), national, and local contexts. Successful local adaptation and inclusion of health aspects require mainstreaming and policy integration across different areas and involvement of multiple stakeholders, including the population, in order to maximize resources and avoid undesired trade-offs.

Background: Stable housing is important for overall health and well-being among young people, and poor-quality housing can trigger multiple diseases, including infections, injuries, chronic diseases, and psychological problems. However, many young people in Sweden struggle with an unstable housing situation. It is therefore important to illuminate how health, social, and civic society professionals and volunteers see the overall health situation for young people (16-27 years) in unstable housing situations.

Method: Sixteen health, social, and civic society professionals and volunteers, from both municipal and governmental organizations and civic society, were interviewed during 2024 and were reached through convenience and purposive sampling. The data was analyzed with content analysis.

Results: The results showed that the professionals and volunteers considered that there is a lack of basic necessities, such as food and clothes and often also a place to sleep, among young people in unstable housing situations. They also recounted that the bodies of those young people are weakened as a result of the unstable situation, with its stress and lack of proper care. There are, however, challenges with regard to accessing healthcare and the young people in question are often hesitant to seek care, and inclined to avoid it. Furthermore, the participants mentioned psychosocial challenges, due to loneliness and lack of close contacts with family and friends, and said that people struggling with homelessness tend to suffer from mental illness.

Conclusion: Young people in unstable housing situations need support to stabilize them for the future, and in order to work toward a more stable housing situation for these people in the county of Scania, a holistic approach is necessary. This is crucial in view of their overall health, as well as their well-being and life satisfaction.

Soil-transmitted helminths primarily comprise Ascaris lumbricoides, Trichuris trichiura, and hookworms, infecting more than 600 million people globally, particularly in underserved communities. Manual microscopy of Kato-Katz thick smears is a widely used diagnostic method in monitoring and control programs, but is time-consuming, requires on-site experts and has low sensitivity, especially for light intensity infections. In this study, portable whole-slide scanners and deep learning-based artificial intelligence (AI) were deployed in a primary healthcare setting in Kenya. Stool samples (n = 965) were collected from school children and Kato-Katz thick smears were digitized for AI-based detection. Light-intensity infections accounted for 96.7% of cases. Three diagnostic methods - manual microscopy, autonomous AI and human expert-verified AI - were compared to a composite reference standard, which combined expert-verified helminth eggs in physical and digital smears. Sensitivity for A. lumbricoides, T. trichiura and hookworms was 50.0%, 31.2%, and 77.8% for manual microscopy; 50.0%, 84.4%, and 87.4% for the autonomous AI; and 100%, 93.8%, and 92.2% for expert-verified AI in smears suitable for analysis (n = 704). Specificity exceeded 97% across all methods. The expert-verified AI had higher sensitivity than the other methods while maintaining high specificity for the detection of soil-transmitted helminths in Kato-Katz thick smears, especially in light-intensity infections.

We study the discovery potential for a light Higgs boson via gg → H_SM-like → hh → bb<overline>γγ process at the Large Hadron Collider (LHC). Focusing on the 2-Higgs Doublet Model Type-I, which can accommodate light neutral Higgs states, of O(100) GeV or less in mass, while agreeing with theoretical and up-to-date experimental constraints, we explore the feasibility of a light CP-even Higgs state h via the largely unexplored final state bb<overline>γγ at Run-3 of the LHC. We further propose a few benchmark points for future searches.

Background: Caesarean section on maternal request (CSMR) is a complex ethical issue. Sweden is an intriguing case for studying CSMR due to its restrictive policy that curtail women autonomous choice regarding the mode of birth, despite overall policy developments aiming to strengthen patients' rights, promote person-centred care, and adopt a more individualized approach. This study aims to understand how the tension surrounding CSMR is manifested in Swedish media. An ethical principles approach is used to investigate what image of CSMR is created and conveyed to the public and what main arguments are used for and against CSMR.

Methods: This study covers news media and specialist press material in Sweden between March 2019 and March 2024. Searches were carried out in Retriever Research and resulted in 188 search hits. The content analysis had both an inductive and a deductive approach based on Beauchamp and Childress's four ethical principles: respect for autonomy, non-maleficence, beneficence, and justice.

Results: The analysis reveals a struggle in Swedish media over how to approach CSMR, touching on all ethical principles. Regarding autonomy, the debate focuses on whether CSMR is a medical decision about non-indicated surgery or a private choice. In terms of non-maleficence-which is the health professionals' main concern-the media highlights conflicts over interpreting risks associated with caesarean section and vaginal birth. Beneficence involves a tension between portraying vaginal birth as healthy and normal versus caesarean section as a method to protect sexual and bodily function. As regards justice, CSMR is portrayed as a challenge to the fundamental needs-principle in the healthcare system.

Conclusions: Ultimately, the ethical principles approach to analyzing the media portrayal of CSMR in Sweden highlights the need for decision guidelines and practices that are more open to a woman's own evaluation of different risks while also encouraging critical reflection on the underlying factors shaping treatment preferences for both women and healthcare professionals.

Objective: The aims of the study were to explore the attitudes of parents of young children towards prevention and screening for congenital cytomegalovirus infection, and to map the practices and recommendations in prenatal care regarding the prevention of fetal infection.

Methods: A survey was distributed across Sweden to parents of children under 2 years. Information about congenital cytomegalovirus infection was provided. Questions followed, pertaining to attitudes towards screening and prevention, hygiene behaviours during pregnancy, and recommendations from midwives.

Results: 4405 parents completed the survey; 4263 were pregnant less than 2 years prior. Parents were positive towards screening, with 85% agreeing that screening should be offered. A predicted increase in stress was positively associated with positive attitudes towards screening. Attitudes towards prevention were positive (90%). Most did not regularly perform hygiene measures to prevent cytomegalovirus infection during pregnancy, though behaviours preventing other infections were common. Recommendations by midwives rarely included cytomegalovirus prevention.

Conclusion: Parents have positive attitudes toward screening and prevention of congenital cytomegalovirus infection, despite a predicted increase in stress. Information is not being conveyed by prenatal providers about how to protect oneself against cytomegalovirus infection, which reflects a lack of hygiene routines during pregnancy related to its prevention.

Multivesicular bodies (MVBs) are vesicles of endosomal origin containing intraluminal vesicles, which upon fusion with plasma membrane, secrete exosomes. They play a significant role in the physiology and pathology of type-2 diabetes (T2D) due to disrupted intercellular communication. The role of MVBs and their influence on insulin secretory granules (ISGs) of beta-cells or their characterization is yet to be uncovered. In our study, we compared MVBs to largely well-characterized ISGs in beta-cells. This study compares the density, localization, and exocytosis of CD63+ compartments (CD63+c) with NPY labelled ISGs (NISGs) in beta-cells. For this, tetraspanin CD63 was exploited to majorly label MVBs in beta-cells. These labels preserve the structural integrity of labelled compartments and mostly do not localize with other endo-lysosomal compartments. This study showed that the beta-cells have a significantly higher density of NISGs than CD63+c. CD63+c and NISGs are spatially localized apart within beta-cells. The proteins that localize with CD63+c are different from the ones that localize with NISGs. Exocytosis of NISGs occurs at the periphery of the beta-cells and takes significantly less time when compared to the release of CD63+c, which is non-peripheral and takes a longer duration. Mechanistically, the availability of CD63+c for exocytosis was assessed and found that an equilibrium is maintained between docking and undocking states at the plasma membrane. Although there are a high number of short-term residing, visiting CD63+c at the plasma membrane, the availability of CD63+c for exocytosis is maintained due to docking and undocking states. Further, a significant reduction in the density of NISGs and CD63+c was observed in beta-cells isolated from T2D donors compared to healthy counterparts. Studying the effect of MVBs on insulin secretion in physiological and T2D conditions has huge potential. This study provides a strong basis to open new avenues for such future studies.

Pregnancy is a psycho-neuro-endocrinological transition phase presenting a window of vulnerability for mental health. Emotion regulation, a transdiagnostic factor for psychopathology, is influenced by estradiol across the menstrual cycle on the behavioral and neural level. Whether this is also the case in the antepartum period remains unknown. For the first time, behavioral and neural emotion regulation were investigated in healthy pregnant females with extremely high estradiol levels during the second trimester (N = 15) using a functional magnetic resonance imaging (fMRI) paradigm. Results were compared with naturally cycling females with high (N = 16) and low estradiol levels (N = 16). Although pregnant females reported the lowest trait use of cognitive reappraisal, all participants successfully regulated their emotions by applying cognitive reappraisal in the scanner. During downregulation of negative emotions, all females had increased activity in the left middle frontal gyrus. Pregnant females showed no significant differences in functional connectivity (psychophysiological interaction, resting-state) related to emotion regulation compared with the nonpregnant groups. However, group differences emerged for amygdala activation. In pregnant females, increased amygdala activity predicted reduced regulation success and was positively associated with depression scores. This first fMRI study during pregnancy indicates that depression scores are reflected in heightened amygdala activity already observable in the antepartum period. Thus, through its association with reduced regulation success, increased amygdala activity suggests a neural risk marker for peripartum mental health. The findings highlight the importance of investigating neural and behavioral emotion regulation in the ante- and postpartum period, eventually allowing enhanced identification, prevention, and treatment of peripartum mental ill-health.

Background: In randomized trials, the intention-to-treat effect is the effect of assignment to treatment strategies. The concept of assignment may not be clearly defined when using observational data to emulate a target trial.

Aims: We aimed to assess the practical implications of using data on prescription versus dispensation as analogues of treatment assignment in observational analyses.

Methods: We used the primary care-derived Swedish Primary Care Cardiovascular Database of individuals with newly diagnosed hypertension between 2006 and 2014 and linked registers. We compared the effect of two antihypertensive drug classes on the five-year risk of cancer and ischemic heart disease. Treatment assignment was first mapped using prescription data, and then dispensation data. With unique confounding structures, we sequentially adjusted for different classes of risk factor due to uncertainty over the choice of relevant confounders for prescription vs. dispensation.

Results: 7770 individuals were eligible when assignment was defined using prescription compared with 5964 when defined using dispensation. For both cancer and ischemic heart disease outcomes, both higher and lower relative risks of the outcome were consistent with our data. Effect estimates did not vary with the choice of prescription or dispensation data as analogues of assignment, nor with sequential adjustment for class of risk factor.

Conclusion: The mapping of prescription or dispensation data to treatment assignment influences the size and characteristics of the study population and the structure of confounding. However, we found no clear numerical differences in effect estimates in this study. Further investigation is required in other settings.

Objectives: This study aimed to estimate the prevalence of atrial fibrillation (AF) and identify its associated comorbidities in adults aged 45 years and older, using data from the Swedish general population study EpiHealth.

Design: In a cross-sectional design, data of health history, lifestyle factors, anthropometric measurement, and 1-lead ECG recordings from participants in the EpiHealth study were linked to data from the Swedish Patient Registry.

Results: Among the 22,616 participants (56.2% women), the overall prevalence of AF was 3.9%, of which 0.3% were newly diagnosed cases identified by single 1-lead ECG at cohort examination. AF prevalence was higher in men than in women across all age groups and increased with age, reaching 17.2% among men aged 75 years and older. Participants with AF had a higher prevalence of cardiovascular comorbidities compared to those without AF.

Conclusions: The findings highlight the increasing prevalence of AF with advancing age and its higher occurrence in men compared to women. The screening-detected prevalence of AF of 0.3% among participants in this general population study suggests that simple 1-lead ECG could be a manageable approach to screen for AF. The strong association between AF and cardiovascular comorbidities emphasizes the need for management strategies to address this condition, particularly in older adults.

Prostate cancer (PCa) incidence has steadily increased in Sweden, more steeply in the mid-1990s caused by increased opportunistic prostate-specific antigen (PSA) testing. Tallness, normal weight, and non-smoking are associated with more PSA testing, which increases detection of low-risk and localised PCa. We investigated time trends of height, body mass index (BMI), and smoking with PCa risk in 171,889 men in Sweden aged 50-64 years at baseline, who were linked to nationwide cancer registers during follow-up. Cox regression determined the association of these factors assessed before 1980, 1980-1994, and 1995-2004 with PCa risk. During 15 follow-up years, 8,049 men were diagnosed with PCa. The association of height with PCa was weakly positive across all calendar periods. For obesity (BMI >= 30 kg/m2) vs. normal weight (BMI 18.5-24.9 kg/m2) and current vs. never smoking, the associations changed from null before 1980 (HR 1.03, 95% CI 0.86-1.23, and 1.11, 95% CI 0.97-1.27) to negative in 1995-2004 (HR 0.83, 95% CI 0.74-0.93, and 0.86, 95% CI 0.79-0.93; pinteraction between periods = 0.05 and 0.001). In men with clinical characteristics available, height was positively associated with both aggressive and non-aggressive PCa whilst obesity and smoking showed negative associations only with non-aggressive PCa. These findings likely reflect differences in PSA testing by BMI and smoking habits and contribute important knowledge for etiological studies of PCa.

High blood pressure (BP) is a frequent cause for visits to primary healthcare centers (PHCCs) in Sweden. Guidelines on methods for BP measurements for diagnosis of hypertension have recently been updated. We aimed to study adherence to diagnostic guidelines in hypertension management and evaluate whether adherence to guidelines was related to organizational or sociodemographic characteristics. Interviews with representatives from 76 randomly selected PHCCs from eight regions in Sweden were conducted. PHCCs' use of 24-h ambulatory BP monitoring (ABPM), home BP monitoring (HBPM) and BP measurements in both arms for the diagnosis of hypertension were chosen as proxy markers for adherence to diagnostic guidelines. An adherence index was created as a composite score of these diagnostic methods. The proportion of PHCCs stating they "often use" ABPM and HBPM were 13.7% and 16.0%, respectively, and 57.3% stated they performed BP measurements in both arms. Two PHCCs did not use ABPM, HBPM or BP measurements in both arms to diagnose hypertension. None of the organizational or sociodemographic characteristics (number of listed patients, Care Need Index (CNI), geographical location, ownership, investigation primarily led by doctor/nurse, dedicated team management, special training for hypertension and local routines) were associated with the adherence index. This study shows that adherence to diagnostic guidelines vary largely between PHCCs. No organizational characteristic, not even team-based management, was associated with adherence to diagnostic guidelines. The variation raises questions about inequity healthcare and novel strategies that may be needed to improve PHCCs' adherence to diagnostic guidelines in hypertension management. 

Regular exercise has been shown to increase heart rate variability (HRV) for different populations. Acute and short-term studies using heat therapy and sauna bathing have also shown HRV improvements. However, long-term adaptations in HRV to regular exercise and sauna bathing remain unexplored. In this 1:1:1 multi-arm trial, sedentary participants (n = 38) aged 49 ± 9 years with at least one CVD risk factor were randomly assigned to regular exercise and 15-min postexercise sauna (EXS), regular exercise only (EXE), or control (CON) group, for an 8-week intervention. Indices of HRV (RR interval, RMSSD, SDNN, resting heart rate [HR], HRMAX-HRMIN, high frequency power [HFP], and low frequency power [LFP]) were measured before (PRE) and after (POST) the trial. Compared to CON, EXE increased the time-domain measure of HR_MAX-HR_MIN (p = 0.003), and elicited significantly smaller decreases in the frequency-domain measure of LFP (p = 0.022). There were no statistically significant differences between EXS and EXE for any of the HRV indices measured. Eight weeks of regular exercise conferred positive changes in both time- and frequency-domain measures of HRV. However, adding regular sauna bathing postexercise offered no additional benefits to HRV over regular exercise alone.

Clinical research is no longer a monopolistic environment wherein patients and participants are the sole voice of information. The introduction and acceleration of AI-based methods in healthcare is creating a complex environment where human-derived data is no longer the sole mechanism through which researchers and clinicians explore and test their hypotheses. The concept of self-agency is intimately tied into this, as generative data does not encompass the same person-lived experiences as human-derived data. The lack of accountability and transparency in recognizing data sources supporting medical and research decisions has the potential to immediately and negatively impact patient care. This commentary considers how self-agency is being confronted by the introduction and proliferation of generative AI, and discusses future directions to improve, rather than undermine AI-fueled healthcare progress.

We propose a method for probing CP-violation in the heavy (pseudo)scalar sector of an extended Higgs model, in which we make simultaneous use of the HVV (V=W^±,Z) and Htt<overline> interactions of a heavy Higgs state H. The CP-even component of H can be probed through the tree-level HVV interaction, while the CP-odd component of H can be probed if the final tt<overline> pair can be tested to form a ¹S₀ state. We can then confirm CP-violation if both CP-even and CP-odd components of H are discovered. This is possible at the Compact Linear Collider (CLIC) by exploiting H production from vector-boson fusion (VBF) and decay to tt<overline> pairs. We analyze the distribution of the azimuthal angle between the leptons coming from top and antitop quarks, which allows one to disentangle the CP nature of such a heavy Higgs state. We also show its implications for the two-Higgs-doublet model (2HDM) with CP-violation.

Objectives: Smartphone applications (apps) for antibiotic prescribing have been studied in observational studies. Here, we assessed whether the use of a smartphone app increased appropriate antibiotic therapy (AAT) in hospitals.

Methods: An antibiotic stewardship app (Firstline.org) was populated with local guidelines and tested in a stepped-wedged cluster randomized trial in three hospitals in the Netherlands, Sweden, and Switzerland. Defined clusters were randomized per hospital for the intervention (use of app) or standard of care. Primary outcome was AAT assessed by chart review in 15 random patients per cluster per intervention period. Secondary outcomes included clinical outcomes and user analytics. A questionnaire identifying barriers to app use was disseminated. Multivariable multilevel logistic models with time periods as fixed effects to adjust for time trend and treatment as fixed effects were employed to estimate the odds ratio of treatment.

Results: Twelve clusters in the Netherlands (1085 patients) were included, 12 in Sweden (362 patients) and 8 in Switzerland (653 patients). Overall, AAT was not increased (2.0% [95% CI,-5.92% to 9.97%]) in the intervention arm compared with control across the three centres. Mean frequency of app use by cluster was associated with an AAT increase (1.9% [95% CI, 1.18-2.62%]) across study centres; 3.2% in the Netherlands (p < 0.01), 2.8% in Switzerland (p < 0.01), and remained similar in Sweden (0.4%; p 0.46). No difference was found for the other secondary outcomes. Main barriers for app use reported in the questionnaire were easily forgetting using the app and having other tools to help prescribing antibiotics.

Discussion: Overall, the introduction of a stewardship app did not significantly increase AAT, but a prespecified secondary analysis of app use frequency was associated with a small but significant improvement of AAT. Variable uptake of the app, coexisting routes to guidelines and the impact of the COVID-19 pandemic during the trial likely had an impact on the results.

Introduction: The children of female sex workers are the victims of their circumstances from the beginning and are deprived of an environment that encourages optimal physical and psychological development. This study aimed to assess the prevalence of emotional and behavioral problems among adolescent offspring of female sex workers and compare that with adolescent offspring of slum-dwellers in Daulatdia and Dhaka city, Bangladesh.

Methods: A cross-sectional study was conducted with a sample of 394 adolescent children (196 adolescent offspring of sex workers and 198 adolescent offspring of slum dwellers) from March 2024 to May 2024 using a structured questionnaire. The study was conducted through face-to-face interviews where sociodemographic details, along with information regarding emotional and behavioral health problems, were assessed through the Strength and Difficulties Questionnaire (SDQ) scale, and health-related quality of life was assessed through the Kidscreen-10 scale. Descriptive analysis, bivariate analysis, and binary logistic regression analysis were performed.

Results: The prevalence of emotional and behavioral problems was 13% for adolescent offspring of Daulatdia and 15% for Korail slum. Age and gender in brothel settings and HRQoL in both settings were found to be significantly associated with emotional and behavioral difficulties. Adolescent offspring of FSWs with low HRQoL (OR = 4.09, p-value < 0.05, CI 1.579-10.595) were 4.09 times more likely to suffer from abnormal mental disorders than those with average or high HRQoL. While in a slum setting, it is 2.825 times higher (OR = 2.825, p-value < 0.05, CI 1.142-6.987).

Conclusion: The study concluded that the overall prevalence of emotional and behavioral problems for adolescent offspring of FSWs was significantly lower than for adolescent offspring of slum dwellers in the emotional problem subscale. Tailored interventions should be developed to address the specific needs of individuals with emotional and behavioral health problems while minimizing the detrimental impacts of their stigmatized identity.

Many neurological diseases remain difficult to treat, necessitating further elucidation of their pathogenesis. Conditional inactivation of Pdgfra in Nestin-expressing cells leads to the depletion of platelet-derived growth factor receptor-alpha⁺ (PDGFRα⁺) oligodendroglial lineage cells responsible for myelination, resulting in forebrain hypomyelination and severe, progressive neurological deficits in neonatal mice. The present study examined the cerebral cortex of these mice to better understand the mechanisms underlying such progressive neurological deficits, that are often observed in refractory neurological diseases. Histological and single-cell RNA sequencing analyses showed that, following activation of meningeal border-associated macrophages (BAMs), PDGFRα⁺ fibroblasts that escaped gene inactivation were extensively recruited from the meninges into the hypomyelinated subpial cerebral cortex. Transcriptional reprogramming suggested that these fibroblasts originated from the pial fibroblast lineage and adopted a myofibroblast-like transcriptional phenotype. The recruited fibroblasts established stable cell-cell interactions with activated brain macrophages, including BAMs and microglia, accompanied by signaling pathways associated with chronic, tissue-damaging inflammation. Subsequently, inflammatory cortical lesions emerged, characterized by glial activation, angiogenesis, and neuronal oxidative stress. Treatment with a PDGFRα-neutralizing antibody significantly reduced fibroblast recruitment and mitigated glial activation and angiogenesis. These findings suggest that meningeal BAMs and pial fibroblasts are key contributors to the formation of tissue-damaging subpial cortical lesions. The interactions between brain macrophages and pial fibroblasts may contribute to the mechanisms underlying chronic and progressive neurological deficits and represent potential therapeutic targets for refractory neurological diseases.

This article reviews recent developments in our understanding of the electron diffusion region (EDR) of magnetic reconnection, focusing on how the structure and dynamics of the EDR vary with the background plasma conditions. In particular, we highlight results from the Magnetospheric Multiscale (MMS) mission, a four-satellite NASA mission that measures plasma particles and electromagnetic fields in and around Earth's magnetosphere. Theoretical and modeling-driven predictions regarding the structure of the EDR and the key processes that enable reconnection are compared and contrasted with observational studies using in-situ MMS measurements.

We utilize Mars Atmosphere and Volatile Evolution (MAVEN) observations to investigate the ionopause boundary at Mars, the formation process of which is not yet well described. We focus on the eighth deep dip campaign (DD8), which consists of 50 consecutive orbits, and we develop an automated routine to identify ionopause boundaries in electron density and temperature data. We find ionopause boundaries in 54 out of 100 ionospheric crossings and an average ionopause altitude of 368 km. Having detected the ionopause boundaries, we then examine in detail all the DD8 orbits using complementary observations from several MAVEN instruments. We show examples of two orbits, illustrating how the shapes of the topside ionosphere and ionopause can differ among ionospheric crossings and how the ionopause formation is correlated with changes in magnetic topology and the plasma pressure balance between the ionosphere and the magnetic pile-up region (MPR). We find that 70% of the detected ionopauses are formed where there are changes in magnetic topology, particularly from closed to either open or draped magnetic field lines, and 80% of the boundaries are also formed where the ionospheric plasma pressure becomes equal to the plasma pressure of the MPR. Finally, we confirm that the ionopause boundary is more likely to be formed under high solar wind dynamic pressure conditions.

The warm plasma cloak (WPC) is a plasma population located in the outer magnetosphere. It is composed primarily of electrons and H⁺ ions with energies of tens to hundreds electronvolts and can contain significant amounts of O⁺. We conduct a statistical survey of the WPC using 9 years of observations in the dayside magnetosphere from the Magnetospheric Multiscale mission. WPC is found in 51% of the observations and it is 1.6 times more abundant in the dawn than in the dusk sector. O⁺-rich WPC is detected in 7.5% of the observations, being 3 times more probable in the dawn sector. We find that after a peak of strong geomagnetic activity, it takes approximately 9 hr to detect the WPC in the dayside magnetosphere.

  Objectives

Little is known whether the number of systemic medications, indicating worsened general health, affects the number of dental appointments needed. The hypothesis is that patients purchasing more systemic medications would have an increased number of dental appointments and respective need for treatments than patients who do not purchase as many medications.

Materials and Methods

Our cohort consists of 1495 participants from the Stockholm area, Sweden, initially examined in 1985. Using national population and patient registers (2005–2017), the association between the number of medication purchases and dental appointments was analyzed. The Anatomical Therapeutic Chemical Classification System for Medicines (ATC) was used. Descriptive statistics, chi-square tests, and logistic regressions were used with several covariates like gender and socioeconomic status.

Results

Purchases above the median of all medications showed a statistically significant association with more dental appointments and respective treatments. Most of the ATC system's main drug categories were significantly associated with more dental appointments, even when adjusting for covariates. Purchases of medications from 32 different ATC subgroups were significantly associated with the number of dental appointments above the median.

Conclusion

In the group of adult Swedes who were studied, it was found that increased purchasing of nearly all types of drugs was associated with an increased number of dental appointments between the study years 2005–2017.

Interpersonal Psychotherapy (IPT), originally developed for depression, is recommended in Sweden’s national treatment guidelines as an option for binge eating disorder and bulimia nervosa. Despite documented efficacy, IPT has primarily been studied as a comparison treatment in eating disorder research. There remains limited knowledge about the method’s functioning in Swedish clinical settings, the mechanisms of change, and how therapeutic work unfolds in practice. This thesis, using a mixed method design, examines the applicability of IPT for individuals with eating disorders and co-occurring depression. The results indicate that IPT is a promising treatment for patients within the bulimic spectrum, showing significant improvements in both eating disorder and depressive symptoms. Notably, improvements in depression preceded symptom relief in the eating disorder – but not the other way around – suggesting a potentially change-driving association. Symptom improvement occurred more rapidly when treatment explicitly and consistently linked current symptoms to emotionally charged relational themes. The qualitative findings demonstrate that this connection – the so-called mood-event connection – is co-created through a collaborative process, in which therapist and patient jointly develop an understanding of what is meaningful and what the next step in therapy should be. Patients with a more restrictive symptomatology showed no improvement. This may possibly be explained by patients’ descriptions of living with the eating disorder as something ever-present in the relating to themselves, others, and life as a whole. The findings suggest that treatment should support the externalisation of the eating disorder as an ego-dystonic condition, foster more functional ways of relating to self and others, and facilitate motivation for a new social role beyond the illness. This thesis supports IPT as a credible and independent treatment for eating disorders, especially in cases involving binge eating, compensatory behaviours, and co-occurring depression.

In digital mental health engagement rates are consistently low, which may limit its effects. Using an international multidisciplinary consensus method, including lived experience expertise and a systematic review, we identified three key challenges: (i) lack of agreed metrics for engagement; (ii) lack of evidence on how better engagement improves outcomes; (iii) lack of standards for user involvement. Three potential solutions encompassed: (i) standardisation of frameworks for reporting engagement metrics and optimal doses of digital tools, (ii) measuring engagement with more precise reporting of outcomes, including potential harms; (iii) defining standards of user involvement (including appropriate diversity, and clinician as well as user input). Digital interventions have real potential in meeting the shortfall in service provision for mental health, but this will require focus on high quality research studies of the underlying mechanisms of engagement and optimal outcomes. Our findings identify and highlight the next best steps in this process.

The early-type contact binary DU Boo exhibits consistent O'Connell effect for many years. Studies in the literature of the system are insufficient to explain this consistency in the observed O'Connell effect. Based on this gap in the literature, the aim of this study is to investigate the surface brightness distribution of the system using the Doppler imaging technique as well as the mid-resolution time series spectra.

Context: At the end of their lives, low- to intermediate-mass stars reach the asymptotic giant branch (AGB), during which their photospheres expand by up to several hundred times and strong stellar winds develop. These changes lead to various interactions with celestial bodies in their close circumstellar environments, including mass- and angular-momentum transfer.

Aims: We aim to characterize the properties of the inner companion of the S-type AGB star π¹ Gru and to identify plausible future evolutionary scenarios for this triple system.

Methods: We observed π¹ Gru with the Atacama Large Millimeter/sub-millimeter Array (ALMA) and the Spectro-Polarimetric High-contrast Exoplanet REsearch (SPHERE) instrument of the Very Large Telescope (VLT), collected archival photometric data, and used the HIPPARCOS-Gaia proper motion anomaly. We derived the best orbital parameters using Bayesian inference.

Results: In June-July 2019, the inner companion, π¹ Gru C, was located at 37.4±2.0 mas from the primary (a projected separation of 6.05±0.55 au at 161.7±11.7 pc). The best orbital solution yields a companion mass of 0.86^+0.22_-0.20 M (using the derived mass of the primary) and a semi-major axis of 7.05_-0.57^+0.54 au, corresponding to an orbital period of 11.0_-1.5^+1.7 yr. The preferred solution is an elliptical orbit with eccentricity e = 0.35_-0.17^+0.18, although a circular orbit cannot be fully excluded. The close companion could be either a K1V_K7V^F9.5V star or a white dwarf (WD). Ultraviolet and millimeter continuum photometry are consistent with the presence of an accretion disk around the close companion. The ultraviolet emission may originate from hot spots in an overall cooler disk, or from a hot disk if the companion is a WD.

Conclusions: Although the close companion and the AGB star are interacting and an accretion disk is observed around the companion, the mass-accretion rate is too low to trigger a Type Ia supernova, but it could produce novae every ≈900 yr. Short-wavelength, spatially resolved observations are required to further constrain the nature of the C companion. Searches for close-in companions similar to this system will improve our understanding of the physics of mass and angular momentum transfer, as well as orbital evolution during late evolutionary stages.

BACKGROUND: Falls threaten the health and well-being of older adults. While studies have presented effective fall prevention exercises, determining how to deliver these interventions in a way that ensures engagement and long-term sustainability is challenging. Additionally, understanding how older adults perceive and are motivated to participate in such programs is critical for broad public health promotion. This study aimed to explore older adults' experiences and perceptions regarding participation in a newly developed 8-week peer-led group-based exercise program, FallFitness.

METHODS: Participants were recruited from a randomized controlled trial (RCT) exploring a newly developed 8-week peer-led group-based exercise program. A total of 2 focus groups were conducted post intervention, comprising ten participants (8 women and 2 men) from the exercise arm of the RCT. Inductive and conventional qualitative content analysis was performed.

RESULTS: From the interviews, 5 main categories and 6 subcategories capturing the study aim are presented. Main categories included: a) social interaction and community, more than just exercise, b) increased motivational drive and self-efficacy, c) group exercise as fun, safe, and inclusive activity, d) enhanced collaboration between healthcare providers and retirement organizations for fall prevention, and e) professional peer-led trainers.

CONCLUSION: Peer-led, well-designed group-based exercise programs can holistically support physical, emotional, and social well-being. Programs that include enjoyable, multicomponent elements, both physically and mentally stimulating, can enhance participants' motivation and adherence. Additionally, the group setting is thought to promote meaningful social interaction, which is widely recognized as important for overall well-being. From a public health perspective, collaborative models for fall prevention involving older adults as a "golden resource" should be established.

TRIAL REGISTRATION: ClinicalTrials.gov, NCT06265480 (2024-02-08).

Using 20.3 fb^-1 of e⁺e^- collision data collected at a center-of-mass energy of 3.773 GeV with the BESIII detector operating at the BEPCII collider, the branching fractions of three hadronic charm meson decays, D⁺ → φπ⁺π⁺π^-, D⁺ → K⁰_SK⁺π⁺π^-π⁰, and D⁺ → K⁰_S K⁺ω, are measured for the first time to be (0.54 ± 0.19 ± 0.02) x 10^-4, (2.51 ± 0.34 ± 0.14) x 10^-4, and (2.02 ± 0.35 ± 0.10) x 10^-4, respectively. Futhermore, the branching fractions of D⁺ → K⁺K^-π+π+π- and D⁺ → K⁰_SK⁺η are measured with improved precision, yielding values of (0.66 ± 0.11 ± 0.03) x 10^-4 and (2.27 ± 0.22 ± 0.05) x 10^-4, respectively.

BACKGROUND: As climate change continues to challenge global health, nursing education must evolve to prepare future nurses for the impacts on care delivery and promote sustainable practices within the healthcare system which is itself a contributor to the climate crisis through emissions and waste. In this study we aimed to i) explore undergraduate nursing students' attitudes towards and awareness of climate change and sustainability issues and its inclusion in nursing education at a Swedish university, and ii) explore differences in awareness and attitudes across student groups in different semesters.

METHODS: In this cross-sectional descriptive research study, nursing students from six groups (semester 1,2,3,4,5,6) of a three-year BSc Nursing programme were asked to complete the Sustainability Attitudes in Nursing Survey (SANS_2) questionnaire. Descriptive statistics were used to present mean scores for each item, and the Kruskal-Wallis test was used to identify differences in responses between different student groups. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement has been used to report this research.

RESULTS: A total of 211 (32%) students completed the questionnaires. The findings showed that nursing students across the six semesters had relatively good awareness of, and positive attitudes towards, sustainability and climate change (no mean rating below 4 on a scale 1-7). Statistically significant differences between student groups were found in four out of nine items of the SANS_2 questionnaire, with students in their second semester consistently providing the highest ratings (p < 0.05). Notably, the lowest ratings across these four items were provided by students in their last year of the programme.

CONCLUSIONS: This study found that whilst students initially felt equipped to address sustainability issues and climate change in practice, this confidence appears to diminish by the programme's end, raising concerns about the preparedness of the future workforce. This underscores the urgency and importance of continuous reinforcement of sustainability concepts in nursing education, aligning with a spiral curriculum approach which advocates for reiterating themes throughout the curriculum to deepen understanding.

CLINICAL TRIAL NUMBER: Not applicable.

BACKGROUND: The transition to undertaking rehabilitation in the home or local neighbourhood calls for an extensive understanding of which aspects of the built environment are important for people with stroke.

OBJECTIVE: This qualitative study aims to explore how home and local neighbourhood environments support or hinder rehabilitation for people who have had a stroke from the perspectives of various stakeholders.

METHODS: Through a purposive selection method, data were collected through semi-structured interviews with 16 stakeholders: people with stroke (n = 3), significant others (n = 3), healthcare professionals (n = 4), care managers (n = 3) and architects (n = 3). Content analysis was used to identify patterns and create themes.

FINDINGS: Sixteen stakeholders, including 12 women and 4 men aged 30-74, participated in this study. Our findings identify areas linked to the WHO age-friendly environment framework, which addresses environmental limitations relevant to stroke rehabilitation. The categories used and factors identified: (1) Outdoor environments: accessibility, safety and supportiveness. (2) Transport and mobility: accessible and reach central services. (3) Housing: adaptations, layout and accessibility. (4) Social participation: spaces that are varied and flexible. (5) Social inclusion and non-discrimination: shared decision-making. (6) Civic engagement and employment: supporting environments. (7) Communication and information: digital accessibility. (8) Community and health services: patient-centred approach and access to varied rehabilitation.

CONCLUSION: This study brings together multiple perspectives from key stakeholders with experience within stroke care. By integrating insights, these findings highlight how built environmental factors in the home and local neighbourhood can support the transition to home-based rehabilitation, which can improve recovery and return to everyday life. In turn, this study contributes to the innovative development of home and neighbourhood environments to influence and support stroke rehabilitation. Linking the findings to the WHO framework increases our understanding of a supportive environment for people with stroke, but also for people with other long-term conditions.

PATIENT OR PUBLIC CONTRIBUTION: This qualitative study is part of a comprehensive research project '(Built Environments to support rehabilitation for people with stroke, B-SURE)', which aims to investigate how factors in the built environment influence stroke rehabilitation and to develop built environment solutions. B-SURE has a participatory methodology that essentially includes and involves the stakeholders in the multiple stages of the study and ensures an iterative and collaborative process.

The first measurement of the CP asymmetry of the decay rate (A_CP) and the CP average (ΣA_FB) and CP asymmetry (ΔA_FB) of the forward-backward asymmetry in the muon system of Λ⁺_c → pμ⁺μ^- decays is reported. The measurement is performed using a data sample of proton-proton collisions, recorded by the LHCb experiment from 2016 to 2018 at a center-of-mass energy of 13 TeV, which corresponds to an integrated luminosity of 5.4 fb^-1. The asymmetries are measured in two regions of dimuon mass near the φ-meson mass peak. The dimuon-mass integrated results are A_CP = (-1.1 ± 4.0 ± 0.5)%, ΣA_FB = (3.9 ± 4.0 ± 0.6)%, ΔA_FB = (3.1 ± 4.0 ± 0.4)%, where the first uncertainty is statistical and the second systematic. The results are consistent with the conservation of CP symmetry and the Standard Model expectations.

We study the constraint on f(R) gravity that can be obtained by photometric primary probes of the Euclid mission. Our focus is the dependence of the constraint on the theoretical modelling of the nonlinear matter power spectrum. In the Hu-Sawicki f(R) gravity model, we consider four different predictions for the ratio between the power spectrum in f(R) and that in Lambda cold dark matter (Lambda CDM): a fitting formula, the halo model reaction approach, ReACT, and two emulators based on dark matter only N-body simulations, FORGE and e-Mantis. These predictions are added to the MontePython implementation to predict the angular power spectra for weak lensing (WL), photometric galaxy clustering, and their cross-correlation. By running Markov chain Monte Carlo, we compare constraints on parameters and investigate the bias of the recovered f(R) parameter if the data are created by a different model. For the pessimistic setting of WL, one-dimensional bias for the f(R) parameter, log10|fR0|, is found to be 0.5 sigma when FORGE is used to create the synthetic data with log10|fR0| = -5.301 and fitted by e-Mantis. The impact of baryonic physics on WL is studied by using a baryonification emulator, BCemu. For the optimistic setting, the f(R) parameter and two main baryonic parameters are well constrained despite the degeneracies among these parameters. However, the difference in the nonlinear dark matter prediction can be compensated for the adjustment of baryonic parameters, and the one-dimensional marginalised constraint on log10|fR0| is biased. This bias can be avoided in the pessimistic setting at the expense of weaker constraints. For the pessimistic setting, using the Lambda CDM synthetic data for WL, we obtain the prior-independent upper limit of log10|fR0| < -5.6. Finally, we implement a method to include theoretical errors to avoid the bias due to inaccuracies in the nonlinear matter power spectrum prediction.

The Lund jet plane (LJP) is measured for the first time in t (t) over bar events, using 140 fb(-1) of root s = 13 TeV pp collision data collected with the ATLAS detector at the LHC. The LJP is a two-dimensional observable of the sub-structure of hadronic jets that acts as a proxy for the kinematics of parton showers and hadron formation. The observable is constructed from charged particles and is measured for R = 1.0 anti-k(t) jets with transverse momentum above 350 GeV containing the full decay products of either a top quark or a daughter W boson. The other top quark in the event is identified from its decay into a b-quark, an electron or a muon and a neutrino. The measurement is corrected for detector effects and compared with a range of Monte Carlo predictions sensitive to different aspects of the hadronic decays of the heavy particles. In the W-boson-initiated jets, all the predictions are incompatible with the measurement. In the top quark initiated jets, disagreement with all predictions is observed in smaller subregions of the plane, and with a subset of the predictions across the fiducial plane. The measurement could be used to improve the tuning of Monte Carlo generators, for better modelling of hadronic decays of heavy quarks and bosons, or to improve the performance of jet taggers.

The diffusion of two volatile fission products, xenon (Xe) and krypton (Kr), in zirconia (ZrO2) is investigated. Samples of Yttria (Y2O3)-stabilised tetragonal ZrO2 were implanted with either Xe or Kr, at 300 key, with a fluence of 1017 at./cm2, and subsequently analysed with time-of-flight elastic recoil detection analysis (ToF-ERDA) to obtain elemental composition depth profiles. Samples were then annealed at 1200 degrees C for 9 h, and the effect of the annealing was assessed by ToF-ERDA measurements. From these measurements, first-order approximations of diffusion coefficients for Xe and Kr in ZrO2 were derived, using a model based on Fick's second law, these being (1.36 +/- 0.87) x 10-19 m2/s and (2.94 +/- 1.96) x 10-19 m2/s at 1200 degrees C for Kr and Xe respectively. It was shown that ToF-ERDA can provide data to analyse the diffusion of elements in solid sample matrices and that a model based on Fick's Law can predict the diffusion of the implanted ions.

We describe and compare two techniques to extract the electronic stopping power of solid materials for energetic ions from energy loss spectra recorded in transmission geometry. Particular attention is attributed to the contribution of the nuclear energy loss to the total energy loss. Energy loss spectra were measured for slow N+ and Ar+ projectiles transmitted through 200 nm (N+ projectile) and 50 nm (Ar+ projectile) thick SiC membranes. The measured energy losses are successfully separated into electronic and nuclear losses with the help of a Binary Collision Approximation (BCA) code. The simulations show that the nuclear stopping power in any forward scattering geometry strongly deviates from SRIM predictions. Electronic stopping powers are calculated by two different iterative processes, yielding electronic stopping power at the mean energy or the energy for the mean stopping. The accuracy of the electronic stopping functions gained from these methods is verified by controlling whether the BCA code predicts the measured energy losses correctly using these functions for the simulated electronic stopping power. We show that both algorithms are suitable for extracting the electronic stopping power, even if it shows a pronounced non-linear energy dependence and if the contribution from elastic scattering to the energy loss is large. We compare their performance and show that simultaneous iteration of the electronic and nuclear stopping power provides the most accurate results.

Using a dataset of (27.12 ± 0.14) x 10⁸ ψ(3686) events collected by the BESIII detector operating at the BEPCII collider, we report the first observation of the decay ψ(3686) → Σ⁰Σ<over bar>⁰ω. with a statistical significance of 8.9σ. The measured branching fraction is (1.24 ± 0.16_stat ± 0.11_sys) x 10^-5, where the first uncertainty is statistical and the second is systematic. Additionally, we investigate potential intermediate states in the invariant mass distributions of Σ⁰ω, Σ<over bar>⁰ω. and Σ⁰Σ<over bar>⁰ω. A hint of a resonance is observed in the invariant mass distribution of M_Σ0_{(Σ<over bar>}0_)ω, located around 2.06 GeV/c², with a significance of 2.5σ.

By analyzing e⁺e^- collision data with an integrated luminosity of 7.9 fb^-1 collected with the BESIII detector at the center-of-mass energy of 3.773 GeV, the branching fraction of D⁺→ τ⁺ν_τ is determined as B = (9.9 ± 1.1_stat ± 0.5_syst) x 10^-4. Using the most precise result B(D⁺ → μ⁺ν_μ) = (3.981 ± 0.079_stat ± 0.040_syst) x 10^-4 [1], we determine R_τ/μ = Γ(D⁺ → τ⁺ν_τ)/Γ(D⁺ → μ⁺ν_μ) = 2.49 ± 0.31, achieving a factor of two improvement in precision compared to the previous BESIII result. This measurement is in agreement with the standard model prediction of lepton flavor universality within one standard deviation.