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In this article, I explore how a for-profit interest group in the Swedish educational system discursively attempts to legitimize its member organizations. For-profit welfare providers are highly contested in Sweden, and a clear majority of the population, regardless of political affiliation, believe profits should be prohibited in education. Against this backdrop, I seek to problematize the view of cunning lobbyists presented in earlier literature on lobbying. I show how the studied interest group mobilizes disjointed discourses that seemingly have little to no effect, as evidenced by the increasing opposition to for-profit schools. For example, independent schools are simultaneously portrayed as victims of a witch hunt and as sovereign actors fighting for the good of Swedish education. I call the identified discourses factualization, victimization, and crypticization. Contrary to the widely held assumption that lobbyists engage in resourceful and calculative actions, I suggest that they instead engage in muddling through. I try to explain the interest group’s discursive legitimation attempts through the lens of the asymmetric pliability of conversational norms, which is a novel tool for understanding micro-rhetorical devices in discursive legitimation.

A perennial conflict in historical linguistics centers around the theoretical and practical virtues of tree-like divergence and wave-like diffusion. This paper presents the Dialect Chain Tree, an extension of the tree model that incorporates both tree-like descent and disintegration of dialect chains in a systematic fashion. As such, it provides a formalization and sharpening of Ross’ (1997: 212–228) linkage concept that allows integration into quantitative approaches.

In this paper, nouns of the Torricelli languages Au and Olo are analyzed from a historical-comparative perspective. By careful comparison of potential cognates, 19 soundcorrespondences and circa 70 cognates are proposed for Au and Olo. In the final part, a thirdlanguage, Elkei, is fitted into the framework of sound correspondences. The results supportprevious ideas of subgrouping.

In this work we conjecture the Coulomb branch partition function, including flux and instanton contributions, for the N\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \mathcal{N} $$\end{document} = 2 vector multiplet on weighted projective space CPN2\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ {\mathbbm{CP}}_N<^>2 $$\end{document} for equivariant Donaldson-Witten and "Pestun-like" theories. More precisely, we claim that this partition function agrees with the one computed on a certain branched cover of CP2\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ {\mathbbm{CP}}<^>2 $$\end{document} upon matching conical deficit angles with corresponding branch indices. Our conjecture is substantiated by checking that similar partition functions on spindles agree with their equivalent on certain branched covers of CP1\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ {\mathbbm{CP}}<^>1 $$\end{document}. We compute the one-loop determinant on the branched cover of CP2\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ {\mathbbm{CP}}<^>2 $$\end{document} for all flux sectors via dimensional reduction from the N\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \mathcal{N} $$\end{document} = 1 vector multiplet on a branched five-sphere along a free S1-action. This work paves the way for obtaining partition functions on more generic symplectic toric orbifolds.

We use the theory of Tambara modules to extend and generalize the reconstruction theorem for module categories over a rigid monoidal category to the nonrigid case. We show a biequivalence between the 2-category of cyclic module categories over a monoidal category C and the bicategory of algebra and bimodule objects in the category of Tambara modules on C. Using it, we prove that a cyclic module category can be reconstructed as the category of certain free module objects in the category of Tambara modules on C, and give a sufficient condition for its reconstructability as module objects in C. To that end, we extend the definition of the Cayley functor to the nonclosed case, and show that Tambara modules give a proarrow equipment for C-module categories, in which C-module functors are characterized as 1-morphisms admitting a right adjoint. Finally, we show that the 2-category of all C-module categories embeds into the 2-category of categories enriched in Tambara modules on C, giving an “action via enrichment” result.

We develop a theory of adjunctions in semigroup categories, that is, monoidal categories without a unit object. We show that a rigid semigroup category is promonoidal, and thus one can naturally adjoin a unit object to it. This extends the previous results of Houston in the symmetric case, and addresses a question of his. It also extends the results in the non-symmetric case with additional finiteness assumptions, obtained by Benson-Etingof-Ostrik, Coulembier, and Ko-Mazorchuk-Zhang. We give an interpretation of these results using comonad cohomology, and, in the absence of finiteness conditions, using enriched traces of monoidal categories. As an application of our results, we give a characterization of finite tensor categories in terms of the finitary 2-representation theory of Mazorchuk–Miemietz.

By building on the notions of internal projective and injective objects in a module category introduced by Douglas, Schommer-Pries, and Snyder, we extend the reconstruction theory for module categories of Etingof and Ostrik. More explicitly, instead of algebra objects in finite tensor categories, we consider quasi-finite coalgebra objects in locally finite tensor categories. Moreover, we show that module categories over non-rigid monoidal categories can be reconstructed via lax module monads, which generalize algebra objects. For the monoidal category of finite-dimensional comodules over a (non-Hopf) bialgebra, we give this result a more concrete form, realizing module categories as categories of contramodules over Hopf trimodule algebras -- this specializes to our tensor-categorical results in the Hopf case. In this context, we also give a precise Morita theorem, as well as an analogue of the Eilenberg--Watts theorem for lax module monads and, as a consequence, for Hopf trimodule algebras. Using lax module functors we give a categorical proof of the variant of the fundamental theorem of Hopf modules which applies to Hopf trimodules. We also give a characterization of fusion operators for a Hopf monad as coherence cells for a module functor structure, using which we similarly reinterpret and reprove the Hopf-monadic fundamental theorem of Hopf modules due to Bruguières, Lack, and Virelizier. 

Postsynthetic, position-selective addition of properties to materials constitutes a paradigm shifting step in materials engineering. The approach enables creation of material systems inaccessible by equilibrium and near-equilibrium synthesis and can be applied in novel practical applications as well as fundamental physics studies over a range of length and energy scales. Ion implantation is a versatile, scalable, industry-compatible tool, enabling the next step in this development. Herein, ion implantation is used to design and functionalize a mesoscopic magnetic architecture. A self-supporting mask is combined with implantation of 60 keV Fe ions to create an embedded array of ≈8 μm-wide circular ferromagnetic regions in a Pd film. The approach is contactless, free from surface residues, and requires no focusing or scanning of the beam. Magnetic properties of the array are probed with longitudinal magneto-optic Kerr effect measurement while varying sample temperature and applied magnetic field. Microstructures are visualized with Kerr microscopy and compared to the Fe distribution measured with microbeam proton-induced X-Ray emission. Sample topography after implantation is obtained by atomic force microscopy, while ion beam analysis is used to probe concentration depth profiles of implanted Fe, impurities, and to investigate material mixing.

We present a method for the additive fabrication of planar magnetic nanoarrays with minimal surface roughness. Synthesis is accomplished by combining electron-beam lithography, used to generate nanometric patterned masks, with ion implantation in thin films. By implanting Fe-56(+) ions, we are able to introduce magnetic functionality in a controlled manner into continuous Pd thin films, achieving 3D spatial resolution down to a few tens of nanometers. Our results demonstrate the application of this technique in fabricating square artificial spin ice lattices, which exhibit well-defined magnetization textures and interactions among the patterned magnetic elements.

We investigate the design of magnetic ordering in one-dimensional mesoscopic magnetic Ising chains by modulating long-range interactions. These interactions are affected by geometrical modifications to the chain, which adjust the energy hierarchy and the resulting magnetic ground states. Consequently, the magnetic ordering can be tuned between antiferromagnetic and antiferromagnetic dimer phases. These phases are experimentally observed in chains fabricated using both conventional electron-beam lithography and ion implantation techniques, demonstrating the feasibility of controlling magnetic properties at the mesoscale. The ability of attaining these magnetic structures by thermal annealing, underlines the potential of using such systems instead of simulated annealers in tackling combinatorial optimization tasks.

We study experimentally the impact of the additive fabrication method on the magnetic properties of Fe⁺-implanted Pd square artificial spin ice lattices. Our findings show that these lattices undergo magnetic collapse at higher temperatures than their continuous film counterparts. This behavior is attributed to the additive fabrication process, which induces an inhomogeneous Fe concentration within the lattice building blocks. Moreover, the implantation process creates a magnetic depth profile, enabling temperature-dependent tunability of the magnetic thickness. These additional internal degrees of freedom broaden the design possibilities for magnetic metamaterials, allowing precise fine-tuning of their static and dynamic properties to achieve complex and customizable behaviors.

Context. The characteristic variability of cool giants and supergiants is attributed to a combination of stellar pulsation and large-scale convective flows. Full 3D radiation-hydrodynamical modelling is an essential tool for understanding the nature of these dynamical processes. The parameter space in our 3D model grid of red giants has expanded in recent years. These models can provide many insights on the nature and properties of the pulsations, including the interplay between convection and pulsations.

Aims. We treat 3D dynamical models of asymptotic giant branch (AGB) stars and red supergiants (with current masses 1 M-circle dot <= M-* <= 12 M-circle dot) similar to observational data. We aim to explore the relation between stellar parameters and the properties of the self-excited pulsations.

Methods. Output from global 'star-in-a-box' models computed with the CO5BOLD radiation-hydrodynamics code were analysed, particularly in regards to the pulsation properties, to find possible correlations with input and emergent stellar parameters. The fast Fourier transform was applied to spherically averaged mass flows to identify possible radial pulsation periods beneath the photosphere of the modelled stars. Stellar parameters were investigated for correlations with the extracted pulsation periods.

Results. We find that the pulsation periods varied with the stellar parameters in good agreement with the current expectations. The pulsation periods follow Ritter's period-mean density relation well and our AGB models agree with period-luminosity relations derived from observations. A mass estimate formula was derived from the 3D models, relating the stellar mass to the fundamental mode pulsation period and the stellar radius.

Conclusions. While the non-linearity of the interplay between the self-excited pulsations and the self-consistent convection complicates analyses, the resulting correlations are in good agreement with respect to current theoretical and observational understandings.

Stars on the AGB can exhibit acoustic pulsation modes of different radial orders, along with non-radial modes. These pulsations are essential to the mass-loss process and influence the evolutionary pathways of AGB stars. P-L relations serve as a valuable diagnostic for understanding stellar evolution along the AGB. 3D RHD simulations provide a powerful tool for investigating pulsation phenomena driven by convective processes and their non-linear coupling with stellar oscillations. We investigate multi-mode pulsations in AGB stars using advanced 3D 'star-in-a-box' simulations with the CO5BOLD code. Signatures of these multi-mode pulsations were weak in our previous 3D models. Our focus is on identifying and characterising the various pulsation modes, examining their persistence and transitions, and comparing the results with 1D model predictions and observational data where applicable. We produced a new model grid comprising AGB stars with current masses of 0.7, 0.8, and 1M⊙. Fourier analysis was applied to dynamic, time-dependent quantities to extract dominant pulsation modes and their corresponding periods. Additionally, wavelet transforms were employed to identify mode-switching behaviour over time. The models successfully reproduce the P-L sequences found in AGB stars. Mode-switching phenomena are found in both the models and wavelet analyses of observational data, allowing us to infer similarities in the underlying pulsation dynamics. These 3D simulations highlight the natural emergence of multi-mode pulsations, including both radial and non-radial modes, driven by the self-consistent interplay of convection and oscillations. Our findings underscore the value of 3D RHD models in capturing the non-linear behaviour of AGB pulsations, providing insights into mode switching, envelope structures, and potential links to episodic mass-loss events. 

Viral infection of the insulin-producing cells in the pancreas has been proposed in the etiology of type 1 diabetes. Protein kinase R (PKR) is a cytoplasmic protein activated through phosphorylation in response to cellular stress and particularly viral infection. As PKR expression in pancreatic beta-cells has been interpreted as a viral footprint, this cross-sectional study aimed at characterizing the PKR expression in non-diabetic human pancreases. PKR expression was evaluated in pancreas tissue from 16 non-diabetic organ donors, using immunohistochemistry, qPCR, and western blot. Immunohistochemistry and western blot showed readily detectable PKR expression in the pancreatic parenchyma. The qPCR detected PKR mRNA in both endocrine and exocrine samples, with a slightly higher expression in the islets. In conclusion, PKR is constitutively expressed in both endocrine and exocrine parts of the pancreas and its expression should not be interpreted as a viral footprint in pancreatic beta cells.

In experimental studies, pancreatic islet microvasculature is essential for islet endocrine function and mass, and islet vascular morphology is altered in diabetic subjects. Even so, almost no information is available concerning human islet microvascular endothelial cell (MVEC) physiology and gene expression. In this study, islets and exocrine pancreatic tissue were acquired from organ donors with normoglycemia or impaired glucose metabolism (IGM) immediately after islet isolation. Following single-cell dissociation, primary islet- and exocrine MVECs were obtained through fluorescence-activated cell sorting (FACS) and transcriptional profiles were generated using AmpliSeq. Multiple gene sets involved in general vascular development and extracellular matrix remodeling were enriched in islet MVEC. In exocrine MVEC samples, multiple enriched gene sets that relate to biosynthesis and biomolecule catabolism were found. No statistically significant enrichment was found in gene sets related to autophagy or endoplasmic reticulum (ER) stress. Although ample differences were found between islet- and exocrine tissue endothelial cells, no differences could be observed between normoglycemic donors and donors with IGM at gene or gene set level. Our data is consistent with active angiogenesis and vascular remodeling in human islets and support the notion of ongoing endocrine pancreas tissue repair and regeneration even in the adult human.

Macrophages reside in all organs and participate in homeostatic- and immune regulative processes. Little is known about pancreatic macrophage gene expression. In the present study, global gene expression was characterized in human pancreatic macrophage subpopulations. CD206- and CD206 + macrophages were sorted separately from pancreatic islets and exocrine tissue to high purity using flow cytometry, followed by RNA-seq analysis. Comparing CD206- with CD206 + macrophages, CD206- showed enrichment in histones, proliferation and cell cycle regulation, glycolysis and SPP1-associated immunosuppressive polarization while CD206 + showed enrichment in complement and coagulation-, IL-10 and IL-2RA immune regulation, as well as scavenging-related gene sets. Comparing islet CD206- with exocrine CD206-, enrichments in islet samples included two sets involved in immune regulation, while enrichments in exocrine samples included sets related to extracellular matrix and immune activation. Fewer differences were found between CD206 + macrophages, with enrichments in islet samples including two IL2-RA related gene sets, while enrichments in exocrine samples included sets related to extracellular matrix and immune activation. Comparing macrophages between individuals with normoglycemia, elevated HbA1c or type 2 diabetes, only a few diverse differentially expressed genes were identified. This work characterizes global gene expression and identifies differences between CD206- and CD206 + macrophage populations within the human pancreas.

PurposeHuman resource analytics (HRA) is an HR activity that companies and academics increasingly pay attention to. Existing literature conceptualises HRA mostly from an objectivist perspective, which limits understanding of actual HRA activities in the complex organisational environment. This paper therefore draws on the practice-based approach, using a novel framework to conceptualise HRA-as-practice.Design/methodology/approachThe authors conducted a systematic literature review of 100 academic and practitioner-oriented publications to analyse existing HRA literature in relation to practice theory, using the "HRA-as-practice" frame.FindingsThe authors identify the main practices involved in HRA, by whom and how these practices are enacted, and reveal three topics in nomological network of HRA-as-practice: HRA technology, HRA outcomes and HRA hindrances and facilitators, which the authors suggest might actualize enactment of HRA practices.Practical implicationsThe authors offer HR function and HR professionals a basic ground to evaluate HRA as a highly contextual activity that can potentially generate business value and increase HR impact when seen as a complex interaction between HRA practices, HRA practitioners and HRA praxis. The findings also help HR practitioners understand multiple factors that influence the practice of HRA.Originality/valueThis systematic review differs from the previous reviews in two ways. First, it analyses both academic and practitioner-oriented publications. Second, it provides a novel theoretical contribution by conceptualising HRA-as-practice and comprehensively compiling scattered topics and themes related to HRA.

Purpose

This study explores the rationale behind the utilisation of human resource (HR) analytics in public sector organisations. The existing HR analytics literature exhibits limited empirical evidence and has predominantly focused on the business context of private firms. In addressing this gap, the study seeks to answer the following research question: What reasons for the adoption of HR analytics can be identified in public sector organisations?

Design/methodology/approach

The study employs a qualitative approach drawing on the empirical data collected from three public administrations in Sweden - national, regional and local. A total of 51 in-depth interviews are conducted with HR and other organisational practitioners engaged in HR analytics practices.

Findings

Drawing on the institutional legitimacy perspective, this paper suggests that public sector organisations adopt HR analytics to secure cognitive, socio-political and technological legitimacy, stemming from explanations rooted in economic rationality. This encompasses organisational and HR-related outcomes achieved through data management and analysis, driven by the personal interests of specific individuals.

Research limitations/implications

This study contributes to ongoing debates about the adoption of HR analytics in diverse contextual settings. Future research is needed in other organisational contexts, including various national and international settings.Practical implicationsThe results of this study offer practical insights for HR practitioners in public sector organisations seeking to adopt HR analytics to enhance organisational and HR legitimacy.

Originality/value

This study contributes to the HR analytics literature by providing empirical evidence from the public sector. Furthermore, it advocates for a synthesis of economic rationality with legitimacy gains and individual interests to elucidate the rationale behind the adoption of HR analytics.

The topic of human resource (HR) analytics has recently attracted increasing interest. Despite its numerous advantages, the adoption of HR analytics remains limited, particularly within the public sector. This study aims to explore the reasons behind this limitation. It applies the Ability, Motivation, and Opportunity (AMO) framework to examine the preconditions for HR analytics among HR professionals in the public sector. The study is based on 30 interviews with HR practitioners from three public administration authorities in Sweden, analysed using thematic template analysis. The findings reveal that although HR practitioners are highly motivated to align with government agendas, enhance decision-making, and ensure transparency, they face significant barriers. These include a lack of analytical skills and technical knowledge, limited data availability, inadequate technical support, scarce resources, and complex organisational structures. This study contributes to the growing HR analytics literature by highlighting the complexity involved in HR analytics adoption in the public sector context.

The study examines the implementation of human resource analytics (HRA) within the context of public sector organisations, drawing upon the organisational translation perspective. We conduct a longitudinal process study of real-time HRA implementation projects in two public sector organisations in Sweden. The findings reveal that the content of the HRA concept undergoes significant transformation during the translation process, with components being copied, omitted, added, and altered. As a result, HRA in practice diverges substantially from its original idea. The study identifies three translation patterns: alignment to the needs of final users, technological determinism, and organisational complexity. We argue that these translation patterns may explain the outcomes from the unique translation processes. The study contributes to the organisational translation literature by integrating principles of heterogeneity and homogeneity of translation results. Additionally, it provides empirical evidence to the field of HRA, enhancing understanding of HRA in public sector organisations.

Ectomycorrhiza (ECM) is a symbiotic relation between plant and fungi that is essential for nutrient uptake of many stand forming trees. There are two conflicting views about the evolution of ECM in fungi suggesting (1) relatively few transitions to ECM followed by reversals to non-ECM, or (2) many independent origins of ECM and no reversals. In this study, we compare these, and other, hypotheses and test the impact of different models on inference. We assembled a dataset of five marker gene sequences (nuc58, nucLSU, nucSSU, rpb1, and rpb2) and 2,174 fungal taxa covering the three subphyla: Agaricomycotina, Mucoromycotina and Pezizomycotina. The fit of different models, including models with variable rates in clades or through time, to the pattern of ECM fungal taxa was tested in a Bayesian framework, and using AIC and simulations. We find that models implementing variable rates are a better fit than models without rate shift, and that the conclusion about the relative rate between ECM and non-ECM depend largely on whether rate shifts are allowed or not. We conclude that standard constant-rate ancestral state reconstruction models are not adequate for the analysis of the evolution of ECM fungi, and may give contradictory results to more extensive analyses.

The genomes of ectomycorrhizal (ECM) fungi have a reduced number of genes encoding Carbohydrate-Active EnZymes (CAZymes), expansions in transposable elements (TEs) and small secreted proteins (SSPs) compared with saprotrophs. Fewer genes for specific peptidases and lipases in ECM fungi are also reported. It is unclear whether these changes occur at the shift to the ECM habit or are more gradual throughout the evolution of ECM lineages.

We generated a genomic dataset of 20 species in the ECM lineage Inocybaceae and compared them with six saprotrophic species.

Inocybaceae genomes have fewer CAZymes, peptidases, lipases, secondary metabolite clusters and SSPs and higher TE content than their saprotrophic relatives. There was an increase in the rate of gene family evolution along the branch with the transition to the ECM lifestyle. This branch had very high rate of evolution in CAZymes and had the largest number of contractions. Other significant changes along this branch included expansions in transporters, transposons-related genes and communication genes such as fungal kinases.

There is a high concentration of changes in proximity to the transition to the ECM lifestyle, which correspond to the identified key changes for the gain of this lifestyle.

Fe-based metallic glass composites, consisting of dispersed nanocrystallites within an amorphous metallic glass matrix, are used as low-loss soft-magnetic components in energy conversion devices. The nanocrystallites are formed by partial devitrification of the amorphous alloy and the properties of the composite depend on the alloy composition and the devitrification process. Understanding the rate-dependent crystallisation kinetics is therefore essential for tailoring the properties of metallic glass composites. In this study, we monitor the devitrification process in situ during rapid heating of metallic glasses with composition (Fe0.75Co0.25)95−xNb5Bx, x = 15 − 20 at.%, by using high-energy wide angle X-ray scattering. The results are compared to samples devitrified at low heating rates, analysed using differential scanning calorimetry, X-ray diffraction, and magnetometry. Additionally, we present a model describing the crystallisation kinetics based on classical nucleation and growth theory coupled to thermodynamic data for a generalised Fe-B system. The model successfully captures the onset of devitrification as a function of time, temperature, and B-concentration, providing valuable insights for the design of Fe-based soft-magnetic materials.

Metallic glasses exhibit unique mechanical properties. For metallic glass composites (MGC), composed of dispersed nanocrystalline phases in an amorphous matrix, these properties can be enhanced or deteriorated depending on the volume fraction and size distribution of the crystalline phases. Understanding the evolution of crystalline phases during devitrification of bulk metallic glasses upon heating is key to realizing the production of these composites. Here, results are presented from a combination of in situ small- and wide-angle X-ray scattering (SAXS and WAXS) measurements during heating of Zr-based metallic glass samples at rates ranging from 10² to 10⁴ Ks⁻¹ with a time resolution of 4ms. By combining a detailed analysis of scattering experiments with numerical simulations, for the first time, it is shown how the amount of oxygen impurities in the samples influences the early stages of devitrification and changes the dominant nucleation mechanism from homogeneous to heterogeneous. During melting, the oxygen rich phase becomes the dominant crystalline phase whereas the main phases dissolve. The approach used in this study is well suited for investigation of rapid phase evolution during devitrification, which is important for the development of MGC.

Additive manufacturing makes the production of bulk metallic glasses possible in thicknesses exceeding the critical casting thickness. However, a crucial challenge is the build-up of thermally induced stress, often resulting in printed parts suffering from cracking. In this study, the process parameters are optimised for printing soft-magnetic metallic glass samples of an Fe-based alloy (Fe_73.8P_10.6Mo_4.2B_2.3Si_2.3C_6.7), using laser beam powder bed fusion. In addition, the structural and magnetic properties of as-received and heat-treated powder are investigated and compared to those of the printed samples. Kerr microscopy is used for imaging the magnetic domains on single track cross-sections produced on top of a polished printed sample. This reveals the shape of the melt pool of a single laser track, as well as the magnetic domains around it and in other regions of the printed sample. The shape and size of the magnetic domains reflect the residual stress in the sample through the effect of magneto-elastic coupling. This magnetic contrast could be used to get further insights into how to control the development of stress during the printing process.

Additive manufacturing of Fe-based metallic glass alloys can be used to fabricate customised soft-magnetic components with an unprecedented geometrical freedom. In this work, we present an efficient parameter development process for PBF-LB processing of the Fe-based metallic glass alloy Kuamet 6B2. The development is focused on combining che-querboard and double exposure printing to achieve high relative density, high amorphous content, low coercivity, and low enough residual stress so that large parts can be manufactured. As single track study was used to increase the efficiency of the process development; images of single track melt pools produced using different process parameters were used to make informed decisions about which parameters to proceed with for the second exposure. The produced samples were investigated using XRD, magnetometry, magneto-optical imaging, and EBSD. The developed parameters were used to produce large ring-shaped cores with radii of 5 cm, used for measuring the relative permeability.

The agonistic potentials of therapeutic anti-CD40 antibodies have been profiled in relation to antibody isotype and epitope specificity. Still, clinical impact relies on a well-balanced clinical efficacy versus target-mediated toxicity. As CD40-mediated immune activation must rely on a combination of stimulation of antigen-presenting cells (APCs) alongside antigen presentation, for efficient T cell priming, alternative approaches to improve the therapeutic outcome of CD40-targeting strategies should focus on providing optimal antigen presentation together with CD40 stimulation. Herein, a bispecific antibody targeting CD40 as a means to deliver cargo (i.e., synthetic peptides) into APCs through a non-covalent, high-affinity interaction between the antibody and the cargo peptide, further referred to as the Adaptable Drug Affinity Conjugate (ADAC) technology, has been developed. The ADAC platform demonstrated a target-specific CD4(+) and CD8(+) T cell expansion in vitro and significantly improved peptide-specific CD8(+) T cell proliferation in vivo. In addition, the strategy dramatically improved the in vitro and in vivo half-life of the synthetic peptides. Future applications of ADAC involve pandemic preparedness to viral genetic drift as well as neoepitope vaccination strategies where the bispecific antibody is an off-the-shelf product, and the peptide antigen is synthesized based on next-generation sequencing data mining.

The transition from preclinical biological drug development into clinical trials requires an efficient upscaling process. In this context, bispecific antibody drugs are particularly challenging due to their propensity to form aggregates and generally produce low titers. Here, the upscaling process for a tetravalent bispecific antibody expressed by a piggyBac transposon-mediated stable HEK293 cell pool has been evaluated. The project was performed as a case study at Testa Center, a non-GMP facility for scale-up testing of biologics in Sweden, and encompassed media adaptation strategies, fed-batch optimization and a novel antibody purification technology. The cell pool was adapted to different culture media for evaluation in terms of cell viability and titers compared to its original Expi293 Expression Medium. These parameters were assessed in both sequential stepwise adaption and direct media exchanges. By this, a more affordable medium was identified that did not require stepwise adaptation and with similar titers and viability as in the Expi293 Expression Medium. Fed-batch optimizations resulted in culture densities reaching up to 20 x 106 viable cells/mL with over 90 % viability 12 days postinoculum, and antibody titers three times higher than corresponding batch cultures. By implementing a novel high-speed protein A fiber technology (Fibro PrismA) with a capture residence time of only 7.5 s, 8 L of supernatant could be purified in 4.5 h without compromising the purity, structural integrity and function of the bispecific antibody. Results from this study related to medium adaptation and design of fed-batch protocols will be highly beneficial during the forthcoming scale-up of this therapeutic antibody.

Current antibody-based immunotherapy depends on tumor antigen shedding for proper T cell priming. Here we select a novel human CD40 agonistic drug candidate and generate a bispecific antibody, herein named BiA9*2_HF, that allows for rapid antibody-peptide conjugate formation. The format is designed to facilitate peptide antigen delivery to CD40 expressing cells combined with simultaneous CD40 agonistic activity. In vivo, the selected bispecific antibody BiA9*2_HF loaded with peptide cargos induces improved antigen-specific proliferation of CD8⁺ (10-15 fold) and CD4⁺ T cells (2-7 fold) over control in draining lymph nodes. In both virus-induced and neoantigen-based mouse tumor models, BiA9*2_HF demonstrates therapeutic efficacy and elevated safety profile, with complete tumor clearance, as well as measured abscopal impact on tumor growth. The BiA9*2_HF drug candidate can thus be utilized to tailor immunotherapeutics for cancer patients.

Microplastics accumulate in stormwater and can ultimately enter freshwater recipients, and pose a serious risk to aquatic life. This study investigated the effectiveness of lab-scale horizontal flow sand filters of differing lengths (25, 50 and 100 cm) in retaining four types of thermoplastic microplastics commonly occurring in stormwater runoff (polyamide, polyethylene, polypropylene, and polyethylene terephthalate). Despite the differences in particle shape, size and density, the study revealed that more than 98% of the spiked microplastics were retained in all filters, with a slightly increased removal with increased filter length. At a flow rate of 1 mL/min and after one week of operation, 62–84% of the added microplastics agglomerated in the first 2 cm of the filters. The agglomerated microplastics included 96% of high-density fibers. Larger-sized particles were retained in the sand media, while microplastics smaller than 50 μm were more often detected in the effluent. Microplastics were quantified and identified using imaging based micro Fourier Transform Infrared Spectroscopy. The efficient retention of microplastics in low-flow horizontal sand filters, demonstrated by the results, highlights their potential importance for stormwater management. This retention is facilitated by various factors, including microplastic agglomeration, particle sedimentation of heavy fibers and favorable particle-to-media size ratios.

Organic materials such as bark and biochar can be effective filter materials to treat stormwater. However, the efficiency of such filters in retaining microplastics (MPs) - an emerging stormwater pollutant - has not been sufficiently studied. This study investigated the removal and transport of a mixture of MPs commonly associated with stormwater. Different MP types (polyamide, polyethylene, polypropylene, and polystyrene) were mixed into the initial 2 cm material of horizontal bark and biochar filters of 25, 50, and 100 cm lengths. The MP types consisted of spherical and fragmented shapes in size ranges of 25-900 μm. The filters were subjected to a water flow of 5 mL/min for one week, and the total effluents were analyzed for MPs by μFTIR imaging. To gain a deeper insight, one 100 cm bark filter replica was split into 10 cm segments, and MPs in each segment were extracted and counted. The results showed that MPs were retained effectively, >97%, in all biochar and bark filters. However, MPs were detected in all effluents regardless of filter length. Effluent concentrations of 5-750 MP/L and 35-355 MP/L were measured in bark and biochar effluents, respectively, with >91% of the MP counts consisting of small-sized (25 μm) polyamide spherical particles. Combining all data, a decrease in average MP concentration was noticed with longer filters, likely attributed to channeling in a 25 and 50-cm filter. The analyses of MPs in the bark media revealed that most MPs were retained in the 0-10 cm segment but that some MPs were transported further, with 19% of polyamide retained in the 80-90 cm segment. Overall, this study shows promising results for bark and biochar filters to retain MPs, while highlighting the importance of systematic packing of filters to reduce MP emissions to the environment from polluted stormwater.

Education is widely believed to predict attitudes toward immigration, but what causal relationship underlies this descriptive pattern? This research employs three distinct natural experiments and considers genetic factors to triangulate this relationship: Study 1 analyses discordant monozygotic twins; Study 2 assesses the impact of a Swedish education reform; and Study 3 analyses dizygotic twins with the use of a polygenic index for education, a DNA-based measure for genetic predispositions toward education. The results indicate that education does modestly promote open views toward immigration (Study 1), yet the reform’s effect remains uncertain (Study 2). Study 3 offers direct evidence of the effects of genetic predispositions and suggests that genetics related to education may influence attitudes beyond achieved educational attainment. These findings confirm the positive impact of education while pointing to the combined influence of genetic and social pathways in shaping immigration attitudes.

The consequences of migration-induced diversity for social cohesion have received significant attention, yet recent research also highlights the positive influence of social trust in shaping native-born people’s perceptions and views on immigration. It remains unclear, however, whether the relationship is partially driven by prosociality, which is closely associated with but distinct from trust, or other confounders. This study uses survey data from a large sample of Swedish twins to examine these relationships, with twin fixed effects to control for confounding factors shared within families. The findings show that generalised social trust and several forms of prosocial behaviour are associated with pro-immigration policy views. In the identical twin sub-sample, only the trust effects remain robust. The influence of trust appears independent of prosociality, but mainly relates to immigrant acceptance. The findings support that generalised trust contains an inclusive outlook and have important implications for discussions surrounding immigration and social cohesion. 

Research on the relationship between ethnic diversity and social trust suggests that this association is often negative, but not universal. Rather, interethnic exposure is argued to be a key condition underlying a negative relationship. This study builds on prior research and uses micro-context data to examine the role of casual interethnic exposure in one’s immediate surroundings. I investigate its relationship with generalised trust and multiple theoretically relevant outcomes, accounting for potential genetic confounding and exploring the moderating role of predisposition to neuroticism using a genetics-based measure. The findings indicate that casual interethnic exposure is associated with slightly lower generalised trust, but has minimal or inconsistent associations with other attitudinal and behavioural outcomes related to outgroup negativity and social avoidance. Moreover, its negative association with trust is more pronounced among individuals predisposed to neuroticism. These findings suggest that the influence of casual interethnic exposure, as a common way individuals experience diversity, is limited in scope; however, for trust, its negative association can be moderated by individual differences related to sensitivity to social contexts. 

Objectives: This study aimed to assess whether trigger tools were useful identifying triage errors among patients referred to non-emergency care by emergency medical dispatch nurses, and to describe the characteristics of these patients.

Design: An observational study of patients referred by dispatch nurses to non-emergency care.

Setting: Dispatch centres in two Swedish regions.

Participants: A total of 1089 adult patients directed to non-emergency care by dispatch nurses between October 2016 and February 2017. 53% were female and the median age was 61 years.

Primary and secondary outcome measures: The primary outcome was a visit to an emergency department within 7 days of contact with the dispatch centre. Secondary outcomes were (1) visits related to the primary contact with the dispatch centre, (2) provision of care above the primary level (ie, interventions not available at a typical local primary care centre) and (3) admission to hospital in-patient care.

Results: Of 1089 included patients, 260 (24%) visited an emergency department within 7 days. Of these, 209 (80%) were related to the dispatch centre contact, 143 (55%) received interventions above the primary care level and 99 (38%) were admitted to in-patient care. Elderly (65+) patients (OR 1.45, 95% CI 1.05 to 1.98) and patients referred onwards to other healthcare providers (OR 1.58, 95% CI 1.15 to 2.19) had higher likelihoods of visiting an emergency department. Six avoidable patient harms were identified, none of which were captured by existing incident reporting systems, and all of which would have received an ambulance if the decision support system had been strictly adhered to.

Conclusion: The use of these patient outcomes in the framework of a Global Trigger Tool-based review can identify patient harms missed by incident reporting systems in the context of emergency medical dispatching. Increased compliance with the decision support system has the potential to improve patient safety.

Background: Clinical feedback is often lacking in prehospital care, and while performance data is increasingly available to clinical and operational leadership, it is seldom made available to care providers themselves. In this study, we investigate the impact of a simple intervention consisting of the provision of monthly feedback reports via email to emergency medical dispatch nurses in three Swedish regions.

Method: Individualised reports consisting of 14 measures divided into descriptive (eg, priority-setting and call times), process (eg, dispatch times and documentation completeness) and outcome (eg, over/under triage rate) categories were developed with staff and management input. Report delivery was implemented using a stepped-wedge design, and effects were evaluated using a hierarchical regression-based interrupted time series analysis.

Results: 40 dispatchers were included in the study between March 2020 and October 2023, who handled a total of 246 353 incidents. Some impacts on documentation-related process measures were identified, with the odds of complete documentation increasing by 7.5% (95% CI 5.1 to 9.9) and the odds of having a documented contact reason increasing by 3.8% (1.5-5.9). These effects remained robust over the post-intervention period. Weaker impacts on outcome measures were identified which could be explained by a higher priority given to emergency medical dispatches overall.

Conclusion: Providing performance data can influence care providers to adjust their behaviour to improve process-related quality metrics under their direct control. The intervention may also have induced nurses to more often upgrade the priority of their patients. Improving outcome metrics may however require more intensive, multifaceted interventions.

BACKGROUND: The triage of patients in prehospital care is a difficult task, and improved risk assessment tools are needed both at the dispatch center and on the ambulance to differentiate between low- and high-risk patients. This study validates a machine learning-based approach to generating risk scores based on hospital outcomes using routinely collected prehospital data.

METHODS: Dispatch, ambulance, and hospital data were collected in one Swedish region from 2016-2017. Dispatch center and ambulance records were used to develop gradient boosting models predicting hospital admission, critical care (defined as admission to an intensive care unit or in-hospital mortality), and two-day mortality. Composite risk scores were generated based on the models and compared to National Early Warning Scores (NEWS) and actual dispatched priorities in a prospectively gathered dataset from 2018.

RESULTS: A total of 38203 patients were included from 2016-2018. Concordance indexes (or areas under the receiver operating characteristics curve) for dispatched priorities ranged from 0.51-0.66, while those for NEWS ranged from 0.66-0.85. Concordance ranged from 0.70-0.79 for risk scores based only on dispatch data, and 0.79-0.89 for risk scores including ambulance data. Dispatch data-based risk scores consistently outperformed dispatched priorities in predicting hospital outcomes, while models including ambulance data also consistently outperformed NEWS. Model performance in the prospective test dataset was similar to that found using cross-validation, and calibration was comparable to that of NEWS.

CONCLUSIONS: Machine learning-based risk scores outperformed a widely-used rule-based triage algorithm and human prioritization decisions in predicting hospital outcomes. Performance was robust in a prospectively gathered dataset, and scores demonstrated adequate calibration. Future research should explore the robustness of these methods when applied to other settings, establish appropriate outcome measures for use in determining the need for prehospital care, and investigate the clinical impact of interventions based on these methods.

Well‐being is rarely considered in studies of residential segregation. This paper explores the spatial distribution of well‐being and its relationship to various forms of residential segregation. External well‐being indices are obtained for Swedish individuals through register data. The mean well‐being of 13 scales of bespoke neighbourhoods is classified into 12 clusters. Similar to previous findings, a strongly polarised pattern of neighbourhood well‐being is found. Neighbourhood well‐being is found to strongly correlate with more traditional measures of segregation. Areas in cities found in more traditional segregation studies have lower well‐being. Half of the working population lives in areas that have homogenised levels of well‐being;14% live in a well‐being‐deprived neighbourhood. Low‐scoring areas are deprived in most well‐being dimensions, while middle and high‐scoring neighbourhoods vary in the domains they excel in. The paper is one of the first to connect segregation studies to explore the causes of the spatial sorting of well‐being. Moreover, it is one of the few that explores well‐being on scales below the regional level.

Recently, spatial sorting of well-being at the neighbourhood level has received attention. Nevertheless, most studies focus merely on the distribution itself or one aspect of the neighbourhood in relation to well-being. This study examines well-being by neighbourhood type and how attitudes to the neighbourhood might mediate this. The study uses a survey, based on a sample stratified among ten different neighbourhood types. We find that residents living in low-income, high migration, high unemployment neighbourhood types experience lower well-being. This association disappears if controls for attitudes to the neighbourhood are included. Residents in homogeneously Swedish areas have lower well-being that cannot be explained by neighbourhood attitudes. We conclude that there is a clear heterogeneous spatial sorting of well-being. These findings illustrate the importance of the neighbourhood for individual well-being. The findings suggest that the spatial sorting of people does not only affect economic prospects but also daily emotional life.

Residential relocation is a life course event that most people undergo several times in their life course. Nevertheless, how overall well-being changes as a consequence thereof is rarely assessed. Moreover, relocation is often taken as a one-size-fits-all life event. This study explores how external well-being develops differently in relation to residential relocation depending on gender, ethnicity, moving history, and moving distance. Using Swedish register data, a measure of well-being was created. Subsequently, the outcomes of residential relocations are explored and how these changes over time are different according to previous mobility events, moving distance, and individual demographic characteristics. In general, residential relocations are associated with a positive and then negative fluctuation in external well-being in the first two years after relocation. Subsequently, quick recovery is found. However, visible minorities and long-distance movers are more negatively affected and do not have a recovery. For visible minorities, a negative trend in well-being already started before moving, which might indicate forced mobility. No positive adjustment through subsequent short-distance mobility or long-distance moves has been found. This contrasts with previous findings that indicate positive effects based on internal measures and long-distance relocations. Moreover, it illustrates that relocation does not have a uniform impact.

Background and Introduction The dispersible tablet formulation (DTF) of pretomanid has been developed to facilitate future use in children. This work aimed to assess the pharmacokinetics (PK) and relative bioavailability of the DTF compared to the marketed formulation (MF) and the potential influence of dose. Methods Pretomanid DTF was investigated in a single-dose, randomized, four-period, cross-over study, with 7 days of washout between doses. Forty-eight healthy volunteers were enrolled and randomized into one of two panels to receive doses either in the fasted state or after a high-fat meal. Each volunteer received doses of 10, 50, and 200 mg DTF, and 200 mg MF pretomanid. Blood samples for pharmacokinetic assessment were drawn following a rich schedule up to 96 h after each single dose. The study data from the panel receiving the high-fat meal were analyzed using a nonlinear mixed-effects modeling approach, and all data were characterized with noncompartmental methods. Results A one-compartment model with first-order elimination and absorption through a transit compartment captured the mean and variability of the observed pretomanid concentrations with acceptable precision. No significant difference in bioavailability was found between formulations. The mean absorption time for the DTF was typically 137% (86-171%) of that for the MF. The bioavailability was found to be dose dependent with a small positive and larger negative correlation under fed and fasted conditions, respectively. Conclusion Using data from a relative bioavailability study in healthy adult volunteers, a mathematical model has been developed to inform dose selection for the investigation of pretomanid in children using the new dispersible tablet formulation. Under fed conditions and at the currently marketed adult dose of 200 mg, the formulation type was found to influence the absorption rate, but not the bioavailability. The bioavailability of the DTF was slightly positively correlated with doses when administered with food.

Aim

Delamanid is a novel drug for the treatment of drug-resistant tuberculosis, manufactured as 50-mg solid and 25-mg dispersible tablets. We evaluated the effects of dispersing the 50-mg tablet, focusing on the relative bioavailability.

Methods

Delamanid, 50-mg tablets administered dispersed vs swallowed whole, was investigated in a phase I, four-period, crossover study. Two of three dose strengths of delamanid (25, 50 or 100 mg) were given to healthy adult participants, in both whole and dispersed forms, with a 7-day washout period. Blood samples were collected over 168 h after each dose. Delamanid and its metabolite DM-6705 were analysed with a validated liquid chromatography tandem mass spectrometry assay. The pharmacokinetics of both analytes were analysed using nonlinear mixed-effect modelling. Palatability and acceptability were determined using a standardized questionnaire.

Results

Twenty-four participants completed the study. The bioavailability of dispersed tablets was estimated to be 107% of whole tablets, with a 90% confidence interval of 99.7-114%, fulfilling bioequivalence criteria. The two formulations were not significantly different regarding either bioavailability or its variability. Bioavailability increased at lower doses, by 34% (26-42%) at 50 mg and by 74% (64-86%) at 25 mg, relative to 100 mg. The majority of participants (93%) found the dispersed formulation acceptable in palatability across all delamanid doses.

Conclusions

Dispersed 50-mg delamanid tablets have similar bioavailability to tablets swallowed whole in adult volunteers. This can be an option for children and other patients who cannot swallow whole tablets, improving access to treatment.

Aims: Moxifloxacin is a priority drug for treating rifampicin-resistant tuberculosis (RR-TB). We assessed the pharmacokinetics of a child-friendly, dispersible 100 mg tablet moxifloxacin formulation (dispersed in water) compared to the standard 400 mg non-dispersible formulation (crushed and suspended in water) in children and evaluated current dosing recommendations.

Methods: The CATALYST trial investigated the pharmacokinetics of moxifloxacin in children with RR-TB. Children were enrolled in South Africa, India and the Philippines. Intensive pharmacokinetic sampling was undertaken while children were taking the standard non-dispersible 400 mg moxifloxacin tablet formulation and repeated after switching to the novel dispersible formulation. Pharmacokinetic data were analysed using population pharmacokinetic modelling. Simulations were per- formed to evaluate moxifloxacin exposures in children compared to consensus adult reference exposures using current World Health Organization (WHO)-recommended doses and more recent model-based doses.

Results: Thirty-six children were enrolled [median age 4.8 (range 0.4–15) years and weight 15.6 (range 6.9–42.1) kg]. A two-compartment disposition model with first- order elimination and delayed absorption was developed. The bioavailability of dis- persible versus standard formulations fulfilled standard bioequivalence criterion (ratio 1.05 with 90% confidence interval 0.95–1.15). Simulations showed WHO- recommended doses achieved exposures similar to those in adults in children >10 kg, while children <10 kg may require 33%–56% higher doses to reach adult reference exposures.

Conclusions: Dosing recommendations for children can be the same for the dispers- ible paediatric and standard non-dispersible adult moxifloxacin formulation. The cur- rent WHO dosing recommendation risks underdosing moxifloxacin in children <10 kg. We propose optimized moxifloxacin doses for both formulations.

Respiratory tract infections require early diagnosis and adequate treatment. With the antibiotic overuse and increment in antibiotic resistance there is an increased need to accurately distinguish between bacterial and viral infections. We investigated the diagnostic performance of calprotectin in respiratory tract infections and compared it with the performance of heparin binding protein (HBP) and procalcitonin (PCT). Biomarkers were analyzed in patients with viral respiratory infections and patients with bacterial pneumonia, mycoplasma pneumonia and streptococcal tonsillitis (n=135). Results were compared with values obtained from 144 healthy controls. All biomarkers were elevated in bacterial and viral infections compared to healthy controls. Calprotectin was significantly increased in patients with bacterial infections; bacterial pneumonia, mycoplasma pneumonia and streptococcal tonsillitis compared with viral infections. PCT was significantly elevated in patients with bacterial pneumonia compared to viral infections but not in streptococcal tonsillitis or mycoplasma caused infections. HBP was not able to distinguish between bacterial and viral causes of infections. The overall clinical performance of calprotectin in the distinction between bacterial and viral respiratory infections, including mycoplasma was greater than performance of PCT and HBP. Rapid determination of calprotectin may improve the management of respiratory tract infections and allow more precise diagnosis and selective use of antibiotics.

Calprotectin is one of the most abundant proteins of neutrophil granulocytes. It is released upon neutrophil activation and is considered a sensitive and clinically useful marker for neutrophil-mediated inflammation, including bacterial infections. However, early kinetics of calprotectin activation following inflammatory activation has hitherto been unknown. The aim of the present study was to determine the early phase of the kinetics of calprotectin, in comparison with the inflammatory markers CRP, IL-6, TNF-α, and procalcitonin, in plasma following a standardized temporary mild inflammatory response, using uncomplicated inguinal hernia surgery as a model. The study cohort consisted of 17 adult patients (15 male and 2 female) undergoing elective surgery for hernia. Values of calprotectin increased significantly at 2 h following surgery, and continued to increase to reach the highest level at 24-36 h after surgery, values still not exceeding upper normal reference level. This contrasts to IL-6 and CRP, for which an elevation was found first later, 4 h and 24-36 h post-surgery, respectively, for IL-6, and CRP. No significant increase was seen for TNF-α, or procalcitonin. The data demonstrate a very rapid and significant but modest increase in calprotectin following induction of mild inflammation, supporting that calprotectin can be useful for early detection of inflammatory response.

Objectives

The aim of the present study was to evaluate the performance of serum and SF levels of the granulocyte protein calprotectin as an inflammatory biomarker in RA patients with knee synovitis.

Methods

Seventy-six RA patients with ongoing knee synovitis were included. Data on DAS with 28 joints and their subcomponents and radiological destruction of the affected knee were collected. White blood cell count, CRP, ACPA against cyclic citrullinated peptide version 2 (anti-CCP2), IgM RF and calprotectin were analysed in parallel in circulation and in SF. Counts of polynuclear and mononuclear cells were measured in SF.

Results

Serum (S)-calprotectin correlated more strongly than SF-calprotectin with inflammatory markers and disease activity. Instead, SF-calprotectin showed a strong correlation to SF counts of white blood cells, and especially to polymorphonuclear cell counts (Spearman’s ρ = 0.72, P < 0.001). S-calprotectin showed markedly stronger correlation with inflammatory markers and disease activity in ACPA positive as compared with ACPA negative RA patients; a similar difference was observed for patients with and without IgM RF.

Conclusion

The particularly strong association between circulating calprotectin and inflammation in ACPA positive RA is a new argument for a specific role for polymorphonuclear granulocytes/neutrophils in this RA subset. Measurement of calprotectin in SF does not convey any additional benefit compared with measurement in the circulation in RA patients with knee synovitis.

Calprotectin is a 24 kD heterodimer of calcium-binding proteins S100A8 and S100A9. At present, there is a lack of knowledge about the specificity of various methods for calprotectin detection, whether they measure only dimers between S100A8 and S100A9, S100A8-S100A8 dimers, S100A9/S100A9 dimers, or free subunits. This study aimed to compare total calprotectin levels with those of its subunits, S100A8 and S100A9, in ICU patients. This prospective observational study includes 271 sepsis and non-sepsis patients. Inclusion criteria were admission to intensive care and the presence or need for an arterial catheter. Plasma total calprotectin was measured at ICU admission and the following two days by particle-enhanced turbidimetric (PETIA) calprotectin reagents from Gentian AS and a Mindray BS380 chemistry analyzer. S100A8 and S100A9 were analyzed by commercial sandwich ELISA DY4570-05, and DY5578, R&D Systems, respectively. Sepsis was defined according to Sepsis-3 as suspected infection and a Sequential organ failure assessment (SOFA) >2 on admission. Receiver operating characteristic (ROC) analysis showed that total calprotectin had a larger area under the curve (AUC) for distinguishing sepsis from non-sepsis patients (0.67) compared to S100A8 (0.59) and S100A9 (0.52). For predicting 30-day mortality, S100A9 had a higher AUC value (0.64) than S100A8 (0.59). However, correlations between total calprotectin and its subunits were weak, indicating no significant relationship for predicting 30-day mortality, and highlighting potential issues with assay harmonization across manufacturers.

We investigate the link between warm-temperature extremes in Europe and the persistence of large-scale atmospheric-circulation patterns for both winter and summer, along with some possible physical mechanisms connecting the two. We assess atmospheric persistence, leveraging concepts from dynamical systems theory, and reconcile this approach with the more conventional meteorological views of persistence. We find that wintertime warm spells are partly associated with persistent zonal advection at the surface level but display no statistically significant persistence anomaly in the mid-troposphere. For summertime heatwaves, we find a weak yet significant link to anomalously persistent circulation patterns in the mid-troposphere, while there are few significant persistence anomalies of the surface circulation pattern. We further find no evidence of a strong warm-temperature advection signal. This suggests that other radiative and dynamical processes, for example sensible heating and adiabatic warming, as well as local effects, could play a more important role than large-scale warm-temperature advection for these events. We thus argue that persistent atmospheric configurations are not a necessary requirement for warm-temperature extremes and that the results depend to a considerable extent on region and tropospheric level.

Extreme temperatures can cause severe disruptions to society, from negative health consequences to infrastructure damage. Accurate and timely weather forecasts contribute to minimise these detrimental effects, by supporting early warning systems. In this context, information on the expected performance of the forecasts is valuable. Here, we investigate whether there is a relationship between the persistence of atmospheric circulation patterns in the Euro-Atlantic sector and forecast skill for temperatures and temperature extremes in Europe. We first apply an objective method to compute the persistence of large-scale atmospheric patterns to European Centre for Medium-range Weather Forecasts (ECMWF) sub-seasonal retrospective forecasts. We find that the forecasts successfully predict atmospheric persistence up to timescales of approximately two weeks. We next investigate the relationship between the persistence of an atmospheric state and the practical predictability of temperature in terms of the error in surface temperature forecasts. The relationship between the two varies depending on season and location. Nonetheless, in a number of cases atmospheric persistence provides potentially valuable information on the practical predictability of temperature. We specifically highlight the cases of wintertime temperature forecasts up to 3 weeks lead time and wintertime cold spells up to roughly two weeks lead time.

Europe is a heatwave hotspot: numerous temperature records have been broken in recent summers, and roughly 60,000 and 50,000 heat-related deaths occurred in the summers of 2022 and 2023, respectively. With recent summers, like that of 2022, projected to become the new norm, there is a pressing need to further develop heat-health warning systems to help society adapt to a warming climate. Here, we forecast heat-related mortality by applying a statistical epidemiological framework to temperature forecasts extending up to two weeks in advance. Focusing on two recent and exceptional summers in Europe, namely 2022 and 2023, we evaluate the skill of the daily heat-related mortality forecasts, and assess its association with temperature. For most of Europe, milder temperatures, close to the minimum mortality temperature, are associated with more skilful heat-related mortality forecasts. However, some of the hottest regions in Europe instead showed enhanced forecast skill associated with higher temperatures. This suggests that heat-related mortality forecasts can provide valuable information in European regions associated with high levels of heat-related mortality. Consequently, we advocate for local health authorities to include information from forecasts of heat-related mortality in their heat warning systems.

Heat poses a critical risk to human health around the world. Recent work has investigated how anthropogenic climate change can modulate atmospheric circulation patterns, finding that circulation patterns increasing in frequency are associated with high temperatures in Europe. Here, we investigate the role of these changes in the dynamics of the atmosphere for European heat-related mortality. We find that dynamical changes have reinforced the thermodynamic warming trend, and are associated with increased heat-related mortality in northern and central continental Europe. Furthermore, dynamical changes appear to have played an important role for the extreme temperatures of the European summer of 2003, and the associated heat-related mortality. We thus highlight the importance of considering the role of changes in atmospheric circulation patterns when investigating the role of climate change for heat events and their impacts. Furthermore, we argue that heat action plans should consider the possibility of record-shattering heat events, where dynamical changes contributing to anomalously high temperatures could coincide with the peak of the seasonal temperature cycle, as seen in 2003.

A study through the lens of Routine Dynamics theory was conducted among small- and medium-sized firms in Bhutan to examine knowledge management in their data analytics system. In such an economic setting, firms perform data analytics using in-house systems together with cloud computing to transform data into knowledge, mainly for predictive insights and competitive advantage. They use just-in-time (JIT) data analytics for knowledge on demand as a pragmatic approach, thus minimising uneconomical analytics. Firms also employ an in-house platform as a service system to monetise analytical outputs and knowledge. Since the primary focus of data analytics among firms is to support administrative functions, enhance business processes, and improve profit margins, systematic construction and use of tacit and explicit knowledge have received little attention. Hence, it is high time organisations augment their data analytics systems with practical knowledge management models for creating, managing, and using knowledge in a competitive digital environment.

Organisational routines are repetitive, recognisable patterns of interdependent action by human and digital actors to accomplish tasks. Routine Dynamics is a theoretical base that informs discussion and analysis of such routines. We note that there is a knowledge gap in the literature on organisational routines to consolidate the constructs and ontologies of routines into an abstract data model. In this paper, we design and implement a data model of routines using the Unified Modelling Language. We present a demonstration to illustrate our data model’s use, and how one can then use instantiations of the model to analyse and simulate organisational routines based on real-world data. This example examines recurrent patterns of action inferred from data in the GitHub issue tracking system about the open-source software project, scikit-learn. Our study extends the theoretical/empirical understanding and knowledge base of Routine Dynamics by laying the groundwork towards examining organisational routines from a model-driven perspective that gives rise to simulating the dynamics of routines. 

The cornerstone for the performance evaluation of computer systems is the benchmark suite. Among the many benchmark suites used in high-performance computing and multicore research, Splash-2 has been instrumental in advancing knowledge for both academia and industry. Published in 1995 and with over 5276 citations and counting, this benchmark suite is still in use to evaluate novel architectural proposals. Recently, the Splash-3 suite eliminates important performance bugs, data races, and improper synchronization that plagued Splash-2 benchmarks after the formal definition of the C memory model.

However, keeping up with architectural changes while maintaining the same workloads and algorithms (for comparative purposes) is a real challenge. Benchmark suites can misrepresent the performance characteristics of a computer system if they do not reflect the available features of the hardware and architects may end up overestimating the impact of proposed techniques or underestimating others.

In this work we introduce a revised version of Splash-3, designated Splash-4, that introduces modern programming techniques to improve scalability on contemporary hardware. We then characterize Splash-3 and Splash-4 in a state-ofthe-art simulated architecture, Intel's Ice Lake with gem5-20 simulator, as well as a real contemporary hardware processor (AMD's EPYC 7002 series). Our evaluation shows that for a 64-thread execution Splash-4 reduces the normalized execution time by an average of 52% and 34% for AMD's EPYC and Intel's Ice Lake, respectively.

Critical sections that read, modify, and write (RMW) a small set of addresses are common in parallel applications and concurrent data structures. However, to escape from the intricacies of finegrained locks, which require reasoning about all possible thread interleavings, programmers often resort to coarse-grained locks to ensure atomicity. This results in atomic protection of a much larger set of potentially conflicting addresses, and, consequently, increased lock contention and unneeded serialization. As many before us have observed, these problems would be solved if only general RMW multi-address atomic operations were available, but current proposals are impractical because of deadlock scenarios that appear due to resource limitations. Alternatively, transactional memory can detect conflicts at run-time aiming to maximize concurrency, but it has significant overheads in highly-contended critical sections. In this work, we propose multi-address atomic operations (MAD atomics). MADatomics achieve complexity-effective, non-speculative, non-deadlocking, fine-grained locking for multiple addresses, relying solely on the coherence protocol and a predetermined locking order. Unlike prior works, MAD atomics address the challenge of enabling atomic modification over a set of cachelines with arbitrary addresses, simultaneously locking all of them while sidestepping deadlock. MAD atomics only require a small storage per core (around 68 bytes), while significantly outperforming typical lock implementations. Indeed, our evaluation using gem5-20 shows that MAD atomics can improve performance by up to 18x (3.4x, on average, for the applications and concurrent data structures evaluated in this work) over a baseline implemented with locks running on 16 cores. More importantly, the improvement still reaches 2.7x, on average, compared to an Intel hardware transactional memory implementation running on 16 cores.

We investigate the global boundedness of Fourier integral operators with amplitudes in the general Hormander classes Sm rho,delta (Rn), rho, delta E [0, 1] and non-degenerate phase functions of arbitrary rank kappa E {0, 1, ... , n - 1} on Besov-Lipschitz Bsp,q(Rn) and Triebel-Lizorkin Fsp,q(Rn) of order s and 0 < p < oo, 0 < q < oo. The results that are obtained are all up to the end-point and sharp and are also applied to the regularity of Klein-Gordon-typ e oscillatory integrals in the aforementioned function spaces. (c) 2023 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license (http:// creativecommons .org /licenses /by /4 .0/).

In this paper, we prove bilinear sparse domination bounds for a wide class of Fourierintegral operators of general rank, as well as oscillatory integral operators associated toHörmander symbol classes S^m_{ρ ,δ} for all 0 ≤ ρ ≤ 1 and 0 ≤ δ < 1, a notable exampleis the Schrödinger operator. As a consequence, one obtains weak (1, 1) estimates,vector-valued estimates, and a wide range of weighted norm inequalities for theseclasses of operators.

Background As a response to many years of repetitive budget deficits, Region Dalarna in Sweden started a restructuring process in 2015, and implemented a decommissioning programme to achieve a balanced budget until 2019. Leading politicians and public servants took the overall decisions about the decommissioning programme, but the clinical decision-making and implementation was largely run by the clinic managers and their staff. As the decommissioning programme improved the finances, met relatively little resistance from the clinical departments, and neither patient safety nor quality of care were perceived to be negatively affected, the initial implementation could be considered successful. The aim of this study was to investigate clinic managers' experience of important factors enabling the successful implementation of a decommissioning programme in a local healthcare organization. Methods Drawing on a framework of factors and processes that shape successful implementation of decommissioning decisions, this study highlights the most important factors that enabled the clinic managers to successfully implement the decommissioning programme. During 2018, an interview study was conducted with 26 clinic managers, strategically selected to represent psychiatry, primary care, surgery and medicine. A deductive content analysis was used to analyze the interviews. By applying a framework to the data, the most important factors were illuminated. Results The findings highlighted factors and processes crucial to implementing the decommissioning programme: 1) create a story to get a shared image of the rationale for change, 2) secure an executive leadership team represented by clinical champions, 3) involve clinic managers at an early stage to ensure a fair decision-making process, 4) base the decommissioning decisions on evidence, without compromising quality and patient safety, 5) prepare the organisation to handle a process characterised by tensions and strong emotions, 6) communicate demonstrable benefits, 7) pay attention to the need of cultural and behavioral change and 8) transparently evaluate the outcome of the process. Conclusions From these findings, we conclude that in order to successfully implement a decommissioning programme, clinic managers and healthcare professions must be given and take responsibility, for both the process and outcome.

Purpose: A local healthcare organisation providing healthcare to 288,000 residents in Sweden struggled with a longstanding budget deficit. Several attempts to overcome the demanding financial situation have failed. A decommissioning programme was launched, and two years later, an evaluation indicated positive outcomes. The aim of this study was to explore factors politicians and public servants perceived as enablers to the successful implementation of the programme.

Design/methodology/approach: A deductive content analysis approach using a framework of factors facilitating successful implementation of decommissioning decisions was applied to analyse interviews with 18 informants.FindingsImportant factors were: (1) a review report contributing to the clarity of evidence, which (2) made the clarity of the rationale for change undeniable and (3) strengthened the political support for change. Additional factors were: (4) the strength of executive leadership, (5) the strength of clinical leadership supported by (6) the quality of project management and (7) a cultural and behavioural change seen as an important outcome for the path forward. A way to maximise the potential for a successful implementation of a large-scale decommissioning programme is to build a shared vision and a collaboration grounded in convincing evidence. Include public servants with a clinical background in the executive leadership team to contribute with legitimacy, competence, and trust in the decommissioning programme's intention.

Originality/value: The paper addresses the limited knowledge of best practices in decommissioning processes and contributes empirical knowledge from a successful case.

Decommissioning programmes pose a substantial risk of failure compared to other change processes in healthcare. A better understanding of the challenges associated with change processes initiated by resource scarcity faced by healthcare managers is crucial. This study describes and compares department and unit managers' experiences during the implementation of a large-scale decommissioning programme in a Swedish region. A survey was developed and a cross-sectional study was performed, measuring 172 healthcare managers' experiences of (1) the region's leadership, (2) their own participation and (3) their own commitment and responsibility during the implementation of the decommissioning programme. Respondents were 50 department managers and 122 unit managers (93% and 58% response rate, respectively). There was a significant difference between department and unit managers in their experiences of the region's leadership and their own participation in the decommissioning programme. Unit managers were more dissatisfied with the way it developed compared to department managers. For example, unit managers reported a lower level of leadership support, incentives to participate, and that their knowledge and skills were not fully utilised. Involvement of unit managers in a more fruitful way might enhance the results of decommissioning programmes. This study highlights a key actor in this context: the unit manager.

An investigation of the radiationless decay of core excited Xe atoms in the region of Xe L3M4,5M4,5 Auger electron kinetic energies (using x-ray energies in the vicinity of the L3 threshold) is presented for Xe adsorbed on Cu, Ag, and Au. The intensity distribution of the decay channels is different compared with Xe in the gas phase. Charge transfer of the core excited electron occurs within tens of attoseconds in all systems for excitation energies approaching the ionization threshold of the condensed system, whereas charge transfer times are substrate-dependent for lower excitation energies. The determination of partial yields into the decay channels allows for the observation of a decay channel present in the Xe/Cu and Xe/Ag systems but not in the case of Xe/Au. Theoretical calculations allow us to interpret this difference as emanating from varying amounts of the ground state hybridization between Xe and the substrates, which impacts the energy of the Auger final states enabling identification of these states giving rise to system specific features in the experimental data.

The conductivity of organic polymer heterojunction devices relies on the electron dynamics occurring along interfaces between the acceptor and donor moieties. To investigate these dynamics with chemical specificity, spectroscopic techniques are employed to obtain localized snapshots of the electron behavior at selected interfaces. In this study, charge transfer in blends (by weight 10, 50, 90, and 100%) of p-type polymer P(g(4)2T-T) (bithiophene-thiophene) and n-type polymer BBL (poly(benzimidazo-benzo-phenanthroline)) was measured by resonant Auger spectroscopy. Electron spectra emanating from the decay of core-excited states created upon X-ray absorption in the donor polymer P(g(4)2T-T) were measured in the sulfur KL2,3L2,3 Auger kinetic energy region as a function of the excitation energy. By tuning the photon energy across the sulfur K-absorption edge, it is possible to differentiate between decay paths in which the core-excited electron remained on the atom with the core-hole and those where it tunneled away. Analyzing the competing decay modes of these localized and delocalized (charge-transfer) processes facilitated the computation of charge-transfer times as a function of excitation energy using the core-hole clock method. The electron delocalization times derived from the measurements were found to be in the as/fs regime for all polymer blends, with the fastest charge transfer occurring in the sample with an equal amount of donor and acceptor polymer. These findings highlight the significance of core-hole clock spectroscopy as a chemically specific tool for examining the local charge tunneling propensity, which is fundamental to understanding macroscopic conductivity. Additionally, the X-ray absorption spectra near the sulfur K-edge in the P(g(4)2T-T) polymer for different polymer blends were analyzed to compare molecular structure, orientation, and ordering in the polymer heterojunctions. The 50% donor sample exhibited the most pronounced angular dependence of absorption, indicating a higher level of ordering compared to the other weight blends. Our studies on the electron dynamics of this type of all-polymer donor-acceptor systems, in which spontaneous ground-state electron transfer occurs, provide us with critical insights to further advance the next generation of organic conductors with mixed electron-hole conduction characteristics suitable for highly stable electrodes of relevance for electronic, electrochemical, and optoelectronic applications.

There is a great fundamental interest in charge dynamics of PbS quantum dots, as they are promising for application in photovoltaics and other optoelectronic devices. The ultrafast charge transport is intriguing, offering insight into the mechanism of electron tunneling processes within the material. In this study, we investigated the charge transfer times of PbS quantum dots of different sizes and non-quantized PbS reference materials by comparing the propensity of localized or delocalized decays of sulfur 1s core hole states excited by X-rays. We show that charge transfer times in PbS quantum dots decrease with excitation energy and are similar at high excitation energy for quantum dots and non-quantized PbS. However, at low excitation energies a distinct difference in charge transfer time is observed with the fastest charge transfer in non-quantized PbS and the slowest in the smallest quantum dots. Our observations can be explained by iodide ligands on the quantum dots creating a barrier for charge transfer, which reduces the probability of interparticle transfer at low excitation energies. The probability of intraparticle charge transfer is limited by the density of available states which we describe according to a wave function in a quantum well model. The stronger quantum confinement effect in smaller PbS quantum dots is manifested as longer charge transfer times relative to the larger quantum dots at low excitation energies.

Nano-impact (NIE) (also referred to as collision) single-entity electrochemistry is an emerging technique that enables electrochemical investigation of individual entities, ranging from metal nanoparticles to single cells and biomolecules. To obtain meaningful information from NIE experiments, analysis and feature extraction on large datasets are necessary. Herein, a method is developed for the automated analysis of NIE data based on unsupervised machine learning and template matching approaches. Template matching not only facilitates downstream processing of the NIE data but also provides a more accurate analysis of the NIE signal characteristics and variations that are difficult to discern with conventional data analysis techniques, such as the height threshold method. The developed algorithm enables fast automated processing of large experimental datasets recorded with different systems, requiring minimal human intervention and thereby eliminating human bias in data analysis. As a result, it improves the standardization of data processing and NIE signal interpretation across various experiments and applications. Nano-impact (NIE) electrochemistry is an emerging technique for studying individual entities. Analyzing large NIE datasets, often with low signal-to-noise ratios, is challenging. Herein, an automated approach is introduced using unsupervised machine learning and template matching for accurate feature extraction from spike-shaped NIE signals. It improves data processing, accuracy and standardization, reducing human bias in signal interpretation across experiments.image (c) 2023 WILEY-VCH GmbH

Single-entity electrochemistry (SEE) is an emerging field within electrochemistry focused on investigating individual entities such as nanoparticles, bacteria, cells, or single molecules. Accurate identification and analysis of SEE signals require effective data processing methods for unbiased and automated feature extraction. In this study, we apply and compare two approaches for step detection in SEE data: discrete wavelet transforms (DWT) and convolutional neural networks (CNN).

Plasmon-enhanced electrocatalysis (PEEC), based on a combination of localized surface plasmon resonance excitation and an electrochemical bias applied to a plasmonic material, can result in improved electrical-to-chemical energy conversion compared to conventional electrocatalysis. Here, we demonstrate the advantages of nano-impact single-entity electrochemistry (SEE) for investigating the intrinsic activity of plasmonic catalysts at the single-particle level using glucose electrooxidation and oxygen reduction on gold nanoparticles as model reactions. We show that in conventional ensemble measurements, plasmonic effects have minimal impact on photocurrents. We suggest that this is due to the continuous equilibration of the Fermi level (E_F) of the deposited gold nanoparticles with the E_F of the working electrode, leading to fast neutralization of hot carriers by the measuring circuit. The photocurrents detected in the ensemble measurements are primarily caused by photo-induced heating of the supporting electrode material. In SEE, the E_F of suspended gold nanoparticles is unaffected by the working electrode potential. As a result, plasmonic effects are the dominant source of photocurrents under SEE experimental conditions.

In this work, we present single-entity protein electrochemistry (SEPE) experiments on catalase, along with a theoretical model to simulate its enzymatic activity and predict the experimentally observed current responses. We perform SEPE measurements at various enzyme concentrations and use protein film voltammetry to investigate the origin of the observed electrochemical signals in SEPE. The modeling approach we develop combines finite element simulations in COMSOL Multiphysics with random walk simulations in MATLAB. The enzyme is represented as a partially active sphere, with an arc on the surface corresponding to the enzyme’s diffusion channel leading to the active site. Notably, the model reproduces the experimental data for catalase without invoking fluctuations in enzymatic activity. This modeling approach, which accounts for the active site geometry of the enzyme, can be useful for simulating single-entity protein electrochemistry data for other enzymes.

Photoplethysmography performed on the peripheral extremities or the earlobes cannot always provide sufficiently rapid and accurate calculation of arterial oxygen saturation. The purpose of this study was to evaluate a novel photoplethysmography prototype to be fixed over the sternum. Our hypotheses were that arterial oxygen saturation can be determined from an intraosseous photoplethysmography signal from the sternum and that such monitoring detects hypoxemia faster than pulse oximetry at standard sites. Sixteen healthy male volunteers were subjected to incremental hypoxemia using different gas mixtures with decreasing oxygen content. The sternal probe was calibrated using arterial haemoglobin CO-oximetry (SaO2%). Sternal probe readings (SRHO2%) were then compared to SaO2% at various degrees of hypoxia. The time to detect hypoxemia was compared to measurements from standard finger and ear pulse oximeters. A significant association from individual regression between SRHO2% and SaO2% was found (r(2) 0.97), Spearman R ranged between 0.71 and 0.92 for the different inhaled gas mixtures. Limits of agreement according to Bland-Altman plots had a increased interval with decreasing arterial oxygen saturation. The sternal probe detected hypoxemia 28.7 s faster than a finger probe (95% CI 20.0-37.4 s, p < 0.001) and 6.6 s faster than an ear probe (95% CI 5.3-8.7 s, p < 0.001). In an experimental setting, arterial oxygen saturation could be determined using the photoplethysmography signal obtained from sternal blood flow after calibration with CO-oximetry. This method detected hypoxemia significantly faster than pulse oximetry performed on the finger or the ear.

PURPOSE: This study intended to determine, and non-invasively evaluate, sternal intraosseous oxygen saturation (SsO₂) and study its variation during provoked hypoxia or hypovolaemia. Furthermore, the relation between SsO₂ and arterial (SaO₂) or mixed venous oxygen saturation (SvO₂) was investigated.

METHODS: Sixteen anaesthetised male pigs underwent exsanguination to a mean arterial pressure of 50 mmHg. After resuscitation and stabilisation, hypoxia was induced with hypoxic gas mixtures (air/N₂). Repeated blood samples from sternal intraosseous cannulation were compared to arterial and pulmonary artery blood samples. Reflection spectrophotometry measurements by a non-invasive sternal probe were performed continuously.

RESULTS: At baseline SaO₂ was 97.0% (IQR 0.2), SsO₂ 73.2% (IQR 19.6) and SvO₂ 52.3% (IQR 12.4). During hypovolaemia, SsO₂ and SvO₂ decreased to 58.9% (IQR 16.9) and 38.1% (IQR 12.5), respectively, p < 0.05 for both, whereas SaO₂ remained unaltered (p = 0.44). During hypoxia all saturations decreased; SaO₂ 71.5% (IQR 5.2), SsO₂ 39.0% (IQR 6.9) and SvO₂ 22.6% (IQR 11.4) (p < 0.01), respectively. For hypovolaemia, the sternal probe red/infrared absorption ratio (SQV) increased significantly from baseline (indicating a reduction in oxygen saturation) + 5.1% (IQR 7.4), p < 0.001 and for hypoxia + 19.9% (IQR 14.8), p = 0.001, respectively.

CONCLUSION: Sternal blood has an oxygen saturation suggesting a mixture of venous and arterial blood. Changes in SsO₂ relate well with changes in SvO₂ during hypovolaemia or hypoxia. Further studies on the feasibility of using non-invasive measurement of changes in SsO₂ to estimate changes in SvO₂ are warranted.