Umeå University

Reservoir shorelines of regulated rivers, created by over 2.8 million dams worldwide, have experienced substantial biodiversity loss, particularly in plant communities. While actively introducing local riparian plants is a common restoration strategy, existing approaches often lack applicability and transferability across river basins. To address this, we propose a guild‐based restoration framework that classifies plant species used for restoration into guilds based on shared functional traits and adaptive strategies. This approach allows for evaluating restoration outcomes across guilds along environmental gradients, optimizing restoration design. We tested this framework along the shorelines of the Three Gorges Reservoir (TGR), characterized by steep environmental gradients. Plant guilds were identified based on shared functional traits, focusing on hydrological and geomorphological associations. The effectiveness of guild introductions was assessed across gradients of submergence intensity, topography and substrate properties by comparing outcomes to those of spontaneous colonization. Results showed that under intermediate and high submergence intensity, active plant introduction and spontaneous colonization yielded similar restoration outcomes, with short‐clonal flood‐tolerant herbs naturally dominating. At low submergence intensity, the introduction of flood‐tolerant woody plants increased functional diversity, whereas tall‐clonal flood‐tolerant herbs reduced diversity due to competitive exclusion. Actively introduced plants did not suppress invasive species. Unexpectedly, under intermediate submergence intensity, the introduction was associated with increased invasive plant presence. Synthesis and applications. Our study validates the guild‐based framework as an effective approach for shoreline vegetation restoration in regulated rivers. We show that guild identity and submergence intensity jointly shape restoration outcomes, offering insights for optimizing active plant introduction strategies in the TGR and similar reservoirs in the upper Yangtze River. Furthermore, this framework enhances the transferability of restoration practices by offering a functionally driven approach to species selection across river basins.

Transcriptomics is an important OMICs method that is often unavailable in biobank research. Frozen blood samples are routinely collected and stored in medical biobanks, but transcriptional studies have been limited due to technical difficulties of extracting high-quality RNA from blood frozen in standard tubes (without RNA preservatives). We aimed to determine whether biobanked buffy coat samples stored at -80°C for up to 23 years could be successfully used for mRNA sequencing. We used a CryoXtract CXT 350 to remove frozen sample cores, which were immersed in RNA preservative during thawing prior to RNA extraction. RNA sequencing was then performed on extractions from pooled samples as well as from 23 buffy coat samples from prospective colorectal cancer cases and 23 matched controls included in the population-based, prospective Northern Sweden Health and Disease Study (NSHDS). For all samples, two library preparation methods were used (Illumina TruSeq Stranded mRNA poly-A selection and Illumina Stranded Total RNA with Ribo-Zero Globin). RNA yields of over 1 µg were obtained from the majority of NSHDS samples (mean = 2.57 µg), and over 92% of samples had RIN values of ≥ 6, indicating suitability for downstream analyses. In conclusion, we developed a method for successfully extracting and sequencing high-quality mRNA from frozen buffy coat samples stored long term in tubes with no RNA preservative.

Background Clinical education in Emergency services (EMS) is unique due to its dynamic environment, brief patient encounters, and unpredictable cases. EMS provides valuable learning opportunities for nursing students, fostering person-centered care approaches and a variation of clinical training and learning. Formative feedback is crucial to develop knowledge and skills. Multisource feedback (MSF) offers a comprehensive assessment by incorporating feedback from various individuals, promoting self-reflection and targeted learning. MSF has not, to our knowledge, been systematically evaluated in the context of EMS, and therefore, the aim of the study was to describe nursing students’ experiences with MSF during their clinical education in the EMS, using a digital instrument as a facilitating tool. Methods A qualitative design with an inductive approach was used. Data were collected in 2021, using focus group interviews (n = 4) with 31 final-semester nursing students in Stockholm, Sweden, who had conducted clinical education in the EMS and received MSF through a digital instrument. Data were analyzed using reflexive thematic analysis, guided by Braun and Clarke’s methodology. Results Three themes revealed: feedback from sources familiar with the student’s learning objectives, feedback from sources unfamiliar with the learning objectives, and general perceptions of MSF in the EMS. Students valued self-reflection and feedback from peers and supervisors for personal and professional growth. Patient feedback was challenging due to their limited contextual understanding and emotional states, while feedback from other healthcare professionals was appreciated but hindered by the healthcare professionals’ workload and timing constraints. Overall, students appreciated MSF’s diverse perspectives, enriching their learning, performance, and development. Conclusion This study underscores the value of MSF in nursing students’ clinical education within the EMS. Feedback from peers, supervisors, and self-reflection enhances self-awareness, professional growth, and mutual support. Despite challenges like stress and logistical barriers, structured support and a digital instrument improved accessibility and alignment with learning objectives for the students. Incorporating patient and healthcare professionals’ feedback enriches education by promoting patient-centred care and collaboration. MSF supported reflective practice, and team dynamics and highlights the need for refined feedback processes to optimize learning and professional development for nursing students during clinical education.

This study explores the role of humour in shaping digital death discourses on TikTok. examining how users engage with mortality, the afterlife, and dying in playful yet profound ways. Through an analysis of three content strands-#celebritydeathprank, Heaven Receptionist skits, and mourning-dedicated accounts-it investigates how TikTok's participatory culture enables users to navigate and reframe death through creative and often comedic means. Rather than centering grief, this study highlights how humour serves as a mechanism for engaging with existential themes, fostering communal rememberence, and reimagining collective imaginaries of death. By leveraging TikTok's affordances-such as remixing, commenting, and algorithmic visibility-users produce content that blurs the boundaries between adversity and the absurd, intimacy and spectacle. This study contributes to research on digital death by demonstrating how social media platforms cultivate new vernaculars and ephemeralities of death discourse, where humour becomes the central mode of engagement with mortality.

Background Recent trends indicate that the frequency of major incidents (MIs) is increasing. Healthcare systems are vital actors in societies’ responses to MIs. Well-prepared healthcare systems may mitigate the effects of MIs. Disaster preparedness is based on region-specific risk and vulnerability analyses (RVAs). Hospital incident command groups (HICGs) are commonly formed per hospital’s contingency plan MI to aid in disaster response. Acquiring situational awareness and decision-making in the face of uncertainty are known challenges for HICGs during MIs. However, the remoteness of rural hospitals presents unique challenges. Aim The aim of this study was to explore HICG leaders’ perceptions of disaster preparedness in rural hospitals. Methods A qualitative study with semi-structured, focus group, and individual interviews was used. The data were analyzed through inductive content analysis. Results The analysis generated the main category, HICGs’ confidence in handling major incidents and four categories. These were Uncertainty and level of recognition (containing two subcategories); Awareness of challenges and risks (containing two subcategories); Factors that facilitate preparedness, response, and leadership (containing three subcategories); and Prerequisites for decision-making (containing three subcategories and four subcategories). Conclusions HICG leaders generally perceived their hospital’s disaster preparedness as adequate. However, preparedness was found to be influenced by several factors. The findings revealed a complex interplay of factors influencing preparedness and response, particularly highlighting challenges related to geographical isolation and resource constraints. Effective preparedness requires a comprehensive understanding of local contexts, hospital capabilities, and risks, which directly impacts training, decision-making, and resource allocation. Addressing the identified vulnerabilities necessitates targeted interventions focused on situational awareness, decision-making, collaboration, and training. Clinical trial number Not applicable.

Background Destructive leadership has been linked to negative consequences for both organizations and followers. Research has also shown that leader gender affects follower perceptions of leadership behavior and follower outcomes [1, 2–3]. However, knowledge is limited as to whether this also applies to destructive leadership [4]. This study aims to combine gendered organization theory with destructive leadership research to investigate the role that gender plays in the relation between destructive leadership behavior and follower outcomes. Methods The data were collected in collaboration with Statistic Sweden. It is a representative sample from the working population in Sweden. We used a two-wave survey design and included 1,121 participants in the analysis. Results The results from structural equation models indicated that destructive leadership has negative consequences for follower burnout, job satisfaction, and turnover intention 6 months later. The results also showed that followers reported a greater intention to leave the organization if the leader was the same gender and used destructive leadership. Conclusions Our study contributes to destructive leadership research by showing that the gender of both the leader and follower matters for the relation between destructive leadership behavior and follower outcomes. Additionally, our study makes a theoretical contribution by integrating a gender research perspective into destructive leadership research.

Spasticity is characterized by increased muscle tone, which can result in pain, contractures, impaired hygiene, and deformities. Stroke is a leading cause of paresis, and nearly 40% of stroke patients will develop spasticity. Objective: To assess trends in upper and lower extremity spasticity-reducing surgery and botulinum toxin A (BoNT-A) treatment. Design: A national cohort register study. Methods: Upper and lower extremity spasticity-reducing surgery and BoNT-A treatment in Swedish stroke patients over a 12-year period was assessed using the National Patient Register. Results: A total of 6,258 patients were treated during this period; their mean age was 58, and the majority were male. In both upper and lower extremities, tenotomy was the most common surgical procedure, followed by tendon lengthening. The need for BoNT-A injections was significantly reduced after surgery compared with before surgery. The total number of BoNT-A treatments increased during the study period, and ultrasound guidance of injections became more common. Conclusion: The frequency of BoNT-A treatments was significantly reduced in patients who underwent surgery. Even though no causative association can be established due to the nature of these registry data, this may indicate that surgery reduces the need for further BoNT-A treatments.

Tendons are vital for maintaining integrity and movement, but current treatment options are insufficient for their regeneration after injuries. Previous studies have shown that the secretome from mesenchymal stem cells (MSCs) promoted tendon regeneration. However, limited studies have explored the impact of the physical microenvironment on the secretome's efficacy of MSCs. In this study, it is shown that the topographic orientation regulates the secretome of human adipose‐derived stem cells (ADSCs) and promotes tendon regeneration. Conditioned medium (CM) is collected from ADSCs cultured on the scaffolds with different topography. The results show that CM generated from aligned structure group has a potent effect in promoting cell migration and proliferation, tenogenic differentiation, macrophage polarization toward M2 phenotype, tendon structure and mechanical function recovery. Proteomic analysis revealed that the aligned structure can up‐regulate the secretion of Extracellular matrix (ECM) proteins while down‐regulate proinflammatory factors. This modulation activates the MAPK, GPCR and Integrin signaling pathways which may account for the enhanced effect on tendon regeneration. This study offers a promising and safer non‐cell‐based treatment option for tendon repair.

This study explored the adsorption capacity of hydrochars derived from a strain of microalgae biomass native to northern Sweden for contaminants of emerging concern (CECs) such as caffeine, chloramphenicol, trimethoprim, carbamazepine, bisphenol A, diclofenac, and triclosan. The findings indicate that the surface functionality of the microalgae-derived hydrochars – a blend of alkane/alkene and aromatic structures, coupled with different oxygen-containing functional groups (hydroxyl, carboxyl, and lactone) – significantly influenced the adsorption of the contaminants. The alkane/alkene and aromatic structures increased with increasing hydrothermal treatment temperature, while the oxygen- and nitrogen-containing groups diminished. Bisphenol A and triclosan, which were the compounds with the highest distribution coefficients, displayed improved adsorption on the hydrochars. The study measured peak adsorption values for the hydrochars processed at 180 °C, which achieved adsorption levels of 25.8 mg g− 1 for bisphenol A and 58.8 mg g− 1 for triclosan. The hydrochars produced using lower carbonisation temperatures (180 and 220 °C) exhibited enhanced adsorption of positively charged molecules such as trimethoprim, which was attributed to the increased presence of negatively charged oxygen-containing functional groups. Contrastingly, negatively charged molecules such as diclofenac and chloramphenicol demonstrated either low adsorption (2.5 mg g− 1 for chloramphenicol on hydrochar prepared at 180 °C) or no adsorption (diclofenac) due to repulsion by the negatively charged functional groups on the surface of the hydrochars.

Background Identifying cognitive impairment at an early stage is important to enable preventive treatment and lifestyle changes. As gait deviations precede cognitive impairment, the aim of this study was to investigate if step parameters during different Timed Up and Go (TUG) conditions could discriminate between people with different cognitive ability. Methods Participants (N = 304) were divided into the following groups: (1) controls, n = 50, mean age:73, 44% women; (2) Subjective cognitive Impairment (SCI), n = 71, mean age:67, 45% women; (3) Mild Cognitive Impairment (MCI), n = 126, mean age: 73, 42% women; and (4) dementia disorders, n = 57, mean age: 78, 51% women. Participants conducted TUG and two motor-cognitive TUG-conditions: TUG while naming animals (TUGdt-NA) and reciting months in reverse order (TUGdt-MB). Tests were video recorded for data extraction of valid spatiotemporal parameters: step length, step width, step duration, single step duration and double step duration. Step length was investigated with the step length/body height ratio (step length divided by body height). Logistic regression models (adjusted for age, sex and education) investigated associations between step parameters and dichotomous variables of groups adjacent in cognitive ability: dementia disorders vs. MCI, MCI vs. SCI, and SCI vs. controls. Results were presented as standardized odds ratios (sORs), with 95% confidence intervals (CI⁹⁵) and p-values (significance level: p < 0.05). The areas under the Receiver Operating Characteristic curves were presented for the step parameters/conditions with the highest sORs and, where relevant, optimal cutoff values were calculated. Results Step length showed greatest overall ability to significantly discriminate between adjacent groups (sOR ≤ . 67, CI⁹⁵: .45-.99, p = ≤ . 047) during all group comparisons/conditions except three. The highest sOR for step-length was obtained when discriminating between SCI vs controls during TUGdt-MB (sOR = .51, CI⁹⁵:.29- .87, p = .014), whereby the area under the curve was calculated (c-statistics = .700). The optimal cut-off indicated a step length of less than 32.9% (CI⁹⁵ = 22.1–43.0) of body height to identify SCI compared with controls. Conclusions The results indicate that step length may be important to assess during TUG, for discrimination between groups with different cognitive ability; and that the presented cut-off has potential to aid early detection of cognitive impairment. Trial registration number NCT05893524 (retrospectively registered 08/06/23).

Hearing loss is the third most significant cause of disability globally and is associated with anxiety, depression, loneliness, and cognitive decline. For those unable to utilize conventional hearing aids due to conditions such as ear canal atresia, eczema, recurrent external otitis or extensive ear surgery, implantable hearing aids provide an alternative. This narrative review provides an overview of available bone conduction devices and active middle ear implants. The rapid advancements in implantable hearing aid technology necessitate ongoing education of healthcare professionals to enable informed patient decisions.

We argue that negative references to amicus curiae briefs in high court judgments – instances where a court explicitly signals disagreement with the legal arguments in such briefs – are a significant and understudied feature of judicial reasoning. We theorize that such references may provide courts with a tool for increasing the precision of its case law, fostering its legitimacy, and increasing compliance pressure. Our empirical analysis of the Court of Justice of the European Union indicates that negative references are used both to boost its legitimacy and to specify not only what the law is, but what it is not.

As an example for the potential use of multi‐block chemometric methods to provide improved unsupervised characterization of compositionally complex materials through the integration of multi‐modal spectrometric data sets, we analysed spectral data derived from five field instruments (one XRF, two NIR, and two FT‐Raman), collected on 76 bedrock samples of diverse composition. These data were analysed by single‐ and multi‐ block latent variable models, based on principal component analysis (PCA) and partial least squares (PLS). For the single‐block approach, PCA and PLS models were generated; whilst hierarchical partial least squares (HPLS) regression was applied for the multi‐block modelling. We also tested whether dimensionality reduction resulted in a more computationally efficient muti‐block HPLS model with enhanced model interpretability and geological characterization power using the variable influence on projection (VIP) feature selection method. The results showed differences in the characterization power of the five spectrometer data sets for the bedrock samples based on their mineral composition and geological properties; moreover, some spectroscopic techniques under‐performed for distinguishing samples by composition. The multi‐block HPLS and its VIP‐strengthened model yielded a more complete unsupervised geological aggrupation of the samples in a single parsimonious model. We conclude that multi‐block HPLS models are effective at combining multi‐modal spectrometric data to provide a more comprehensive characterization of compositionally complex samples, and VIP can reduce HPLS model complexity, while increasing its data interpretability. These approaches have been applied here to a geological data set, but are amenable to a broad range of applications across chemical and biomedical disciplines.

Lung pathogenic T helper type 2 (pTh2) cells are important in mediating allergic asthma, but fundamental questions remain regarding their heterogeneity and epigenetic regulation. Here we investigate immune regulation in allergic asthma by single-cell RNA sequencing in mice challenged with house dust mite, in the presence and absence of histone deacetylase 1 (HDAC1) function. Our analyses indicate two distinct highly proinflammatory subsets of lung pTh2 cells and pinpoint thymic stromal lymphopoietin (TSLP) and Tumour Necrosis Factor Receptor Superfamily (TNFRSF) members as important drivers to generate pTh2 cells in vitro. Using our in vitro model, we uncover how signalling via TSLP and a TNFRSF member shapes chromatin accessibility at the type 2 cytokine gene loci by modulating HDAC1 repressive function. In summary, we have generated insights into pTh2 cell biology and establish an in vitro model for investigating pTh2 cells that proves useful for discovering molecular mechanisms involved in pTh2-mediated allergic asthma.

Background Treatment with mechanical thrombectomy (MT) remains inaccessible for many patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO) and under‐utilization prevails across healthcare systems. Increasing the number of thrombectomy centers and ambulance helicopters may alleviate these issues. Aim This study aims to determine the most effective combination of optimally located ambulance helicopters and thrombectomy centers for the economically constrained healthcare system. Methods This nation‐wide, observational study analyses anonymized patient‐level registry data stretching over a 6‐year study period in Sweden. It combines optimization modeling with cost‐effectiveness analysis to generate combinations of optimally located thrombectomy centers and ambulance helicopters to compare with the current eight locations of thrombectomy centers in Sweden and no ambulance helicopters. The analysis extends to evaluate the cost‐effectiveness of increasing the number of thrombectomy centers and ambulance helicopters when the current eight locations remain fixed. Results The most cost‐effective solution comprises 11 thrombectomy centers and 14 ambulance helicopters, corresponding to densities of 1.05 and 1.34 per one million inhabitants, respectively. It yields an estimated annual incremental net monetary benefit (INMB) close to €13.6 million. In the extended scenario analysis, the most cost‐effective solution comprised nine thrombectomy centers and 13 ambulance helicopters, with an estimated annual INMB of €3.8 million. Conclusions The most cost‐effective combination of optimally located thrombectomy centers and ambulance helicopters brings about substantial health gains for patients with AIS due to LVO, compared with the current eight locations of thrombectomy centers in Sweden and ambulance helicopters.

Recently family firms seen a delicate renewed interest in regional science, regional studies and economic geography and similarly, spatial and regional contexts have been addressed in family business studies. Those strands are driven by interest in the heterogeneity of family firms as the most common type of organization all over the world (family spatialities) and the heterogeneity of spatial and regional context as a significant selection filter for the behavior and performance of family firms (spatial familiness). This editorial addresses these unique settings of family firms and the nature of spatial/regional contexts in a greater depth, by providing a concise literature overview on contextualizing research, by presenting a star shaped model to systemize research around spatial and regional contexts, and by suggesting further research directions. Our proposed star-shaped model frames a holistic view on spatial and regional contexts though a scientific agenda that differentiates between theoretical explanations and modelling (spatial concepts), empirical descriptions and analyses (spatial factors, spatial structures, spatial settings), and policy recommendations All authors have contributed equally to the work (e.g. organization pertinent sessions at conferences (EURAM, RSAI, RSA, GCEG), acquiring potential authors, handling and reviewing papers, writing the editorial). For pragmatic reasons authors appear in alphabetical order.