Stroke survivors’ priorities for research related to life after stroke

Background - Stroke has transitioned from an untreatable, unpreventable disease to a highly treatable and preventable disease over recent decades, and the number of stroke survivors is expected to increase. The number is also foreseen to grow larger as a result of an aging population. With an escalating number of stroke survivors, research on how to improve life after stroke is needed. Aims - The primary aim was to determine which area of research related to life after stroke that stroke patients and their informal carers prioritized as being relevant and valuable. Methods - A cross-sectional study of all patients who had completed the 12 months of follow-up in the EFFECTS trial. In the questionnaire the stroke patients and their informal carers were asked to prioritize areas of research they considered important and valuable with respect to their life after stroke. Results - Of the 731 patients who were still alive after the 12 months-follow-up, 589 responded. The most prioritized areas of research were Balance and walking difficulties (290 (49%) responders) and Post-stroke fatigue (173 (29%) responders). Women answered the undefined alternative “other” more often than men (43 women (11%) versus 11 men (6%), p = .04). Younger patients prioritized Post-stroke fatigue to a higher extent (88 (45%) versus (22%), p Balance and walking difficulties (214 (54%) versus 76 (40%), p = .002) and Speech difficulties (38 (10%) versus 9 (5%), p = .045). Conclusions - Life after stroke is perceived differentely with aging. Future research should address strategies to face challenges such as imbalance and walking difficulties and post-stroke-fatigue

Long-term effects of no-take zones in Swedish waters

Marine protected areas (MPAs) are increasingly established worldwide to protect and restore degraded ecosystems. However, the level of protection varies among MPAs and has been found to affect the outcome of the closure. In no-take zones (NTZs), no fishing or extraction of marine organisms is allowed. The EU Commission recently committed to protect 30% of European waters by 2030 through the updated Biodiversity Strategy. Importantly, one third of these 30% should be of strict protection. Exactly what is meant by strict protection is not entirely clear, but fishing would likely have to be fully or largely prohibited in these areas. This new target for strictly protected areas highlights the need to evaluate the ecological effects of NTZs, particularly in regions like northern Europe where such evaluations are scarce. The Swedish NTZs made up approximately two thirds of the total areal extent of NTZs in Europe a decade ago. Given that these areas have been closed for at least 10 years and can provide insights into long-term effects of NTZs on fish and ecosystems, they are of broad interest in light of the new 10% strict protection by 2030 commitment by EU member states.In total, eight NTZs in Swedish coastal and offshore waters were evaluated in the current report, with respect to primarily the responses of focal species for the conservation measure, but in some of the areas also ecosystem responses. Five of the NTZs were established in 2009-2011, as part of a government commission, while the other three had been established earlier. The results of the evaluations are presented in a synthesis and also in separate, more detailed chapters for each of the eight NTZs. Overall, the results suggest that NTZs can increase abundances and biomasses of fish and decapod crustaceans, given that the closed areas are strategically placed and of an appropriate size in relation to the life cycle of the focal species. A meta-regression of the effects on focal species of the NTZs showed that CPUE was on average 2.6 times higher after three years of protection, and 3.8 times higher than in the fished reference areas after six years of protection. The proportion of old and large individuals increased in most NTZs, and thereby also the reproductive potential of populations. The increase in abundance of large predatory fish also likely contributed to restoring ecosystem functions, such as top-down control. These effects appeared after a 5-year period and in many cases remained and continued to increase in the longer term (>10 years). In the two areas where cod was the focal species of the NTZs, positive responses were weak, likely as an effect of long-term past, and in the Kattegat still present, recruitment overfishing. In the Baltic Sea, predation by grey seal and cormorant was in some cases so high that it likely counteracted the positive effects of removing fisheries and led to stock declines in the NTZs. In most cases, the introduction of the NTZs has likely decreased the total fishing effort rather than displacing it to adjacent areas. In the Kattegat NTZ, however, the purpose was explicitly to displace an unselective coastal mixed bottom-trawl fishery targeting Norway lobster and flatfish to areas where the bycatches of mature cod were smaller. In two areas that were reopened to fishing after 5 years, the positive effects of the NTZs on fish stocks eroded quickly to pre-closure levels despite that the areas remained closed during the spawning period, highlighting that permanent closures may be necessary to maintain positive effects.We conclude from the Swedish case studies that NTZs may well function as a complement to other fisheries management measures, such as catch, effort and gear regulations. The experiences from the current evaluation show that NTZs can be an important tool for fisheries management especially for local coastal fish populations and areas with mixed fisheries, as well as in cases where there is a need to counteract adverse ecosystem effects of fishing. NTZs are also needed as reference for marine environmental management, and for understanding the effects of fishing on fish populations and other ecosystem components in relation to other pressures. MPAs where the protection of both fish and their habitats is combined may be an important instrument for ecosystembased management, where the recovery of large predatory fish may lead to a restoration of important ecosystem functions and contribute to improving decayed habitats.With the new Biodiversity Strategy, EUs level of ambition for marine conservation increases significantly, with the goal of 30% of coastal and marine waters protected by 2030, and, importantly, one third of these areas being strictly protected. From a conservation perspective, rare, sensitive and/or charismatic species or habitats are often in focus when designating MPAs, and displacement of fisheries is then considered an unwanted side effect. However, if the establishment of strictly protected areas also aims to rebuild fish stocks, these MPAs should be placed in heavily fished areas and designed to protect depleted populations by accounting for their home ranges to generate positive outcomes. Thus, extensive displacement of fisheries is required to reach benefits for depleted populations, and need to be accounted for e.g. by specific regulations outside the strictly protected areas. These new extensive EU goals for MPA establishment pose a challenge for management, but at the same time offer an opportunity to bridge the current gap between conservation and fisheries management

Citrullinated histone H3 as a novel prognostic blood marker in patients with advanced cancer

Citrullinated histone H3 (H3Cit) is a central player in the neutrophil release of nuclear chromatin, known as neutrophil extracellular traps (NETs). NETs have been shown to elicit harmful effects on the host, and were recently proposed to promote tumor progression and spread. Here we report significant elevations of plasma H3Cit in patients with advanced cancer compared with age-matched healthy individuals. These elevations were specific to cancer patients as no increase was observed in severely ill and hospitalized patients with a higher non-malignant comorbidity. The analysis of neutrophils from cancer patients showed a higher proportion of neutrophils positive for intracellular H3Cit compared to severely ill patients. Moreover, the presence of plasma H3Cit in cancer patients strongly correlated with neutrophil activation markers neutrophil elastase (NE) and myeloperoxidase (MPO), and the inflammatory cytokines interleukin-6 and -8, known to induce NETosis. In addition, we show that high levels of circulating H3Cit strongly predicted poor clinical outcome in our cohort of cancer patients with a 2-fold increased risk for short-term mortality. Our results also corroborate the association of NE, interleukin-6 and -8 with poor clinical outcome. Taken together, our results are the first to unveil H3Cit as a potential diagnostic and prognostic blood marker associated with an exacerbated inflammatory response in patients with advanced cancer

Recent smell loss is the best predictor of COVID-19 among individuals with recent respiratory symptoms

In a preregistered, cross-sectional study we investigated whether olfactory loss is a reliable predictor of COVID-19 using a crowdsourced questionnaire in 23 languages to assess symptoms in individuals self-reporting recent respiratory illness. We quantified changes in chemosensory abilities during the course of the respiratory illness using 0-100 visual analog scales (VAS) for participants reporting a positive (C19+; n=4148) or negative (C19-; n=546) COVID-19 laboratory test outcome. Logistic regression models identified univariate and multivariate predictors of COVID-19 status and post-COVID-19 olfactory recovery. Both C19+ and C19- groups exhibited smell loss, but it was significantly larger in C19+ participants (mean±SD, C19+: -82.5±27.2 points; C19-: -59.8±37.7). Smell loss during illness was the best predictor of COVID-19 in both univariate and multivariate models (ROC AUC=0.72). Additional variables provide negligible model improvement. VAS ratings of smell loss were more predictive than binary chemosensory yes/no-questions or other cardinal symptoms (e.g., fever). Olfactory recovery within 40 days of respiratory symptom onset was reported for ~50% of participants and was best predicted by time since respiratory symptom onset. We find that quantified smell loss is the best predictor of COVID-19 amongst those with symptoms of respiratory illness. To aid clinicians and contact tracers in identifying individuals with a high likelihood of having COVID-19, we propose a novel 0-10 scale to screen for recent olfactory loss, the ODoR-19. We find that numeric ratings ≤2 indicate high odds of symptomatic COVID-19 (4<10). Once independently validated, this tool could be deployed when viral lab tests are impractical or unavailable

Hur redovisas miljöansvar i flygbranschen - En studie av de sex största aktörerna i Europa

Bakgrund och problem: Begreppet Corporate Social Responsibility kan delas upp i ekonomiska, sociala och miljömässiga aspekter. I takt med det växande klimathotet ökar trycket på företag att redovisa för de miljömässiga aspekterna. Då CSR-redovisningen är frivillig finns inga gällande lagar utan istället har principer och riktlinjer ifrån olika organisationer tagits fram. Flygbranschen har på senare tid hamnat i fokus för miljödiskussionen dels genom ett ökat resande och dels genom EU: s förslag om att flygtrafiken ska ingå i handeln med utsläppsrätter. Det här leder fram till problemformuleringen i uppsatsen; Vad redovisar företag i flygbranschen gällande miljöåtaganden och andra miljöaspekter? Syfte: Syftet med undersökningen är att kartlägga och analysera hur flygbranschen i Europa redovisar miljöaspekter och miljöåtaganden. Vidare är syftet att se hur väl deras rapportering stämmer överens med en framtagen checklista utifrån vad GRI har för direktiv samt miljöprinciperna enligt Global Compact. Avgränsningar: I den här uppsatsen kommer endast den europeiska flygbranschen att granskas. Vidare undersöks bara den information som externa intressenter får ta del av såsom årsredovisningar, hållbarhetsrapporter samt företagens webbsidor. Slutligen, inom området för CSR ska undersökningen enbart fokusera på den del som rör miljöansvar. Metod: Uppsatsen bygger på en kvalitativ undersökning av företagens års- och hållbarhetsredovisningar. I studien analyseras de sex största flygbolagen i Europa utifrån en framtagen checklista som bygger till stor del på riktlinjer framtagna av GRI och FN: s organ Global Compact. Därefter har resultatet sammanställts företagsvis i empirin vilket sedan ställts mot de valda teorierna intressent- och legitimitetsteorin i analysen. Resultat och slutsatser: Slutsatsen i den här uppsatsen är att det finns skillnader mellan flygbolagen i vad de redovisar. De traditionella bolagen redovisade betydligt mer än lågprisbolagen. Skillnaderna kan förklaras genom att de traditionella bolagen anses vända sig mot en annan marknad samt ha andra intressenter med andra krav än lågprisbolagen. Vidare kan skillnader uppstå genom att informationen som lämnas är frivillig. Till sist har företagen olika behov att skapa legitimitet eftersom de strävar efter att ha likasinnade värderingar som sina intressenter. Förslag till fortsatt forskning: Göra om studien om några år för att se om miljöredovisningen har ändrats alternativt utöka studiens urval och på så sätt genomföra en mer kvantitativ undersökning av flygbranschens miljöredovisning

Rapid effects of a fishing closure on whitefish (Coregonus maraena) in the northern Baltic Sea

Areas closed to fishing year-round (no-take zones, NTZs) or during spawning time (spawning closures) are used as a management tool to increase declining fish populations. We evaluated the effects of a 147 km2 NTZ and a 3980 km2 spawning closure on whitefish populations in the northern Baltic Sea, and also accounted for fish consumption by seals and cormorants. Fish monitoring with multimesh gillnets in 2011–2016 showed a significant increase in catch per unit effort (CPUE) of mature whitefish (> 30 cm) both in the spawning closure and the NTZ compared with the reference area open to fishing. The rate of increase was significantly higher in the NTZ than in the spawning closure. Our results suggest that NTZs may strengthen coastal fish populations in temperate regions and that also seasonal closures under a critical period of the life cycle may benefit the populations

Shopper Mode- Shopper Marketing from a shopper perspective

Title: Shopper Mode - Shopper marketing from a shopper perspective Date of the Seminar: Lund, 2012-05-30 Course: BUSN29. Master thesis Authors: Charlotte Borgeke Nilsson & Caroline Lundström Ek Advisor: Karin Alm Keywords: Shopper Marketing, shopper perspective, shopper mode, Swedish pharmacy market, Apoteket Hjärtat The thesis purpose: The purpose of this research is to contribute to a greater understanding and new knowledge in the conceptual area of Shopper marketing from a shopper's perspective Today, there is not much available research of the shoppers’ perspective of Shopper marketing. By accessing insights from the shopper's point of view of the retail situation this knowledge can be used when developing strategies for how to get shoppers to turn to more positive perceptions and an increased shopper experience. Methodology: This research is designed in two steps where we firstly want to explore the shopping situation at the Swedish pharmacy market. Through a quantitative interview session of 100 persons inside the case company’s facilities. The second session is based on 10 qualitative research interviews were we strive to fully understand the shopper and to create shopper insights which are important to highlight as they contribute to the answer of the research question. This dual approach makes us chose an abductive course of action in the processing of the research findings and theory frame. Theoretical perspective: The main theories that are used in Shopper Mode are shopper marketing theories and retail marketing theories. Empirical data: The empirical data is gathered through 100 shorter interviews and 10 in depth interviews; with this we have reached both a width and depth in the insights of the shopping situation. Apoteket Hjärtat is used as a case company for the study Conclusion: We can conclude that that Alexander’s (2008) different shopping categories can be used as interpreter of the retail situation within Shopper marketing Strategies. This together with the visualization of the 360° approach of the shopper can be useful in extern marketing strategies. It can also be useful in intern marketing as a pedagogic tool to visualize the picture of the most valuable shopper to the staff in a business organization. By this a clearer and more consistent message from the business/ brand/ shop will most likely be experienced by the shopper. We also can conclude that Shopper marketing can be seen as a new dialect of already existing marketing approaches. However, dialects do affect us and the way we say things can often affect the result. In this view Shopper marketing can be thought of as a new tool in the tool box or a new color in the crayon box. Thus, Shopper marketing is promoted and branded as a whole new knowledge but we see it more as old wine in a new bottle, and just like with other new things it arouse our curiosity