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School Meals Case Study: Sweden
No full textThis school meals case study forms part of a collection led by the Research Consortium for School Health and Nutrition’s "Good Examples" Community of Practice. The School Meals Case Study of Sweden serves to document how the national school meals programme is organized, funded, and monitored throughout the country. The objectives of this case study include presenting an introduction to the country profile, outlining the design and implementation of school feeding programmes, describing their monitoring and evaluation processes, and highlighting lessons learned, best practices, and challenges. This case study is written as a working paper, and can be updated to reflect evolving circumstances
Profiling Associations Between IGHG-FCGR Ligand-Receptor Interactions and Disease Progression From Stage 1 and 2 to Stage 3 Type 1 Diabetes
No full textUNLABELLED: The primary objective of this study was to investigate whether ligand-receptor interactions (LRIs) between IGHG and FCGR gene products are associated with progression to type 1 diabetes (T1D). Using two completed clinical trials (DPT-1 and TN07), we applied next-generation targeted sequencing to genotype IGHG and FCGR genes in a cohort of 1,214 individuals and assessed LRI associations with disease progression. A Cox regression model was used to quantify LRI associations. IGHG or FCGR alone was found to have weak and sporadic associations with progression. Multiple LRIs between IGHG and FCGR gene products were found to be associated with progression, especially LRIs of IGHG2 with multiple FCGR receptors that accelerate progression and those of IGHG4 with multiple FCGR receptors (some overlapping) that delay progression. Furthermore, as several crystal structures of FcγRs complexed with distinct IgG molecules are known, application of this knowledge here was hampered by the absence of any information on the subclass distribution of each of the several T1D-related autoantibodies. It cannot be excluded that their respective state of glycosylation may influence binding affinity to various FcγRs and the function of thus-formed complexes. Our findings suggest that LRIs of the IGHG and FCGR gene products probably influence progression, shedding new insights into some of the immunological mechanisms involved in progression to T1D. Our findings potentially facilitate the search for new immunotherapeutic treatment through intervening at key steps in the progression.ARTICLE HIGHLIGHTS: This study investigated ligand-receptor interactions (LRIs) between IGHG and FCGR gene products in type 1 diabetes progression. Genes of 1,214 participants from the DPT-1 and TN07 trials were sequenced using next-generation targeted sequencing technology, and LRI associations with the progression time to type 1 diabetes were analyzed using Cox regression modeling. Weak associations were found for IGHG or FCGR variants individually, but multiple LRIs significantly impacted progression. Several IGHG2-FCGR interactions accelerated progression, while a few other IGHG4-FCGR interactions delayed it. The results may provide insights into certain immunogenetic mechanisms of T1D and suggest therapeutic potential of targeting specific LRIs
Exploring the effect of menstrual loss and dietary habits on iron deficiency in teenagers : A cross-sectional study
No full textAdolescent girls are particularly susceptible to iron deficiency due to increased iron requirements during the pubertal growth spurt, combined with iron loss following menarche. This study aimed to investigate the prevalence of heavy menstrual bleeding in an adolescent population using the SAMANTA questionnaire and to explore its relationship with dietary habits and iron deficiency. This cross-sectional study was conducted in two Swedish high schools in 2023. Post-menarchal female students, aged 15 and older, were included (n = 394). Data were collected on-site through a patient-reported survey, including the SAMANTA questionnaire for heavy menstrual bleeding, and by blood sampling. Meat-restricted diet was analyzed in relation to iron status. Descriptive analysis and regression analysis were used to assess the prevalence of heavy menstrual bleeding and its relationship with dietary habits and iron deficiency, defined as ferritin <15 µg/L. The prevalence of heavy menstrual bleeding and iron deficiency in the cohort was 53% (208/394) and 40% (157/394), respectively. In univariate analysis, heavy menstrual bleeding (OR 3.0, 95% CI [2.0, 4.6]) and a meat-restricted diet (OR 3.5, 95% CI [2.2, 5.6]) were both associated with increased odds of iron deficiency. When assessing the joint effect of having heavy menstrual bleeding and a meat-restricted diet, the odds of iron deficiency were 13.5 times higher compared to omnivore individuals with normal menstruation (OR 13.5, 95% CI [6.4, 28.7]). Overall, the prevalence of iron deficiency in this population of adolescent girls was very high. Heavy menstrual bleeding and a meat-restricted diet were both independently associated with increased odds of iron deficiency. However, odds for iron deficiency were monumentally higher when combining these two variables, thus highlighting the importance of assessing and addressing both excessive output and low intake of iron
Pseudo-Boolean Proof Logging for Optimal Classical Planning
No full textWe introduce lower-bound certificates for classical planning tasks, which can be used to prove the unsolvability of a task or the optimality of a plan in a way that can be verified by an independent third party. We describe a general framework for generating lower-bound certificates based on pseudo-Boolean constraints, which is agnostic to the planning algorithm used. As a case study, we show how to modify the A∗ algorithm to produce proofs of optimality with modest overhead, using pattern database heuristics and hmax as concrete examples. The same proof logging approach works for any heuristic whose inferences can be efficiently expressed as reasoning over pseudo-Boolean constraints
The Role and Meaning of Time in European Migration Law
No full textThis special issue deals with temporalities in migration law with particular emphasis on the European context. At the crossroads of several legal fields, including public law, human rights law, EU law and public international law, the topic is cutting-edge in migration law. The articles collected were originally presented at a conference organized at Vrije Universiteit in Amsterdam in June 2023 and another organized at Uppsala University in September 2024, both dealing with time and temporalities in migration law from a variety of perspectives. The aim of these conferences was to further develop the study of the roles of time in European migration law by unpacking the diversity of ways in which time works as an instrument of migration control in Europe. While temporal governance is far from limited to the European context – the US ‘remain in Mexico’ policy7 and the Australian temporary protection visa8 being only two examples – Europe is an interesting site of analysis. It is a forerunner in creating ‘innovative’ migration control policies9; it combines opposites, such as unhindered international movement within Europe for some, e.g., European citizens, alongside fierce immobility and stuckedness for others; it is characterized by a multilevel interplay marking the complexities of interaction between a multitude of different legal regimes and jurisdictions – domestic, EU and international (including the ECHR) – with strong human rights institutions and frameworks. This combination makes Europe a privileged site of inquiry. Drawing on this ‘forerunner quality’ and characterizing elements, this Introduction poses the question whether it is possible to distinguish a form of time one could call ‘European time’ to describe a specifically European approach to implementing temporal governance techniques in the field of migration
Addressing infection in totally implantable venous access ports : An ex vivo study on bacterial transfer and the Forsvall Port needle design
No full textBACKGROUND: Totally implantable venous access ports (TIVAPs) are essential for administering chemotherapeutic drugs and nutritional support, but carry a risk of infectious complications. We hypothesized that the design of the current port needle (Huber) could facilitate the collection of bacteria from the skin during puncture, potentially introducing them into TIVAPs and causing infections. This study examines bacterial transfer via needles during TIVAP access and proposes a novel needle design to reduce the risk of infection.METHODS: A novel needle, the Forsvall Port needle, was developed with a closed tip to reduce bacterial transmission inside the needle during tissue and port penetration. In a randomized ex vivo setting, human skin samples covered in physiological levels of Staphylococcus aureus were placed over port membranes and punctured repeatedly by the standard Huber needle and the Forsvall Port needle. Cultures from the needle tips were plated after puncture and used to compare bacterial transfer into TIVAPs using a generalized linear mixed-effects model. Punctures were performed in a separate human skin to examine the mechanism of bacterial transfer.RESULTS: The Forsvall Port needle reduced average bacterial transfer by 87.0% (95% CI: 77.8%-92.4%, p < 0.0001) compared with the Huber needle, based on 10 punctures per needle across four skin samples. Additional testing on a separate skin sample showed that a defectively fitted Forsvall Port needle prototype did not reduce bacterial transfer relative to the Huber needle (95% CI: 58.3% decrease to 30.0% increase, p = 0.289), whereas a steel rod simulating a perfectly closed Forsvall Port needle achieved a 99.9% (95% CI: 99.5%-100%, p < 0.0001) reduction in bacterial transfer.CONCLUSION: The Forsvall Port needle significantly reduces bacterial transfer into TIVAPs, which could potentially decrease TIVAP-related infections. This study demonstrates a strong association between needle design and bacterial transfer during TIVAP access
Protocol to model tumor hypoxia in vitro using real-time phosphorescence-based sensing of O2 gradients generated by metastatic cancer cells
No full textTumor hypoxia plays a critical role in cancer progression and therapeutic resistance. Here, we present a protocol for the self-generation of hypoxia by metastatic cancer cells using phosphorescence-based O2 sensing. We describe steps for phosphorescent film calibration, system assembly, and real-time imaging of hypoxia development. We then detail approaches to spatially map resulting O2 gradients. This protocol supports applications for studying key behaviors linked to metastatic progression, including motility and aerotaxis, under physiologically relevant hypoxic conditions. For complete details on the use and execution of this protocol, please refer to Hosny et al
New-Onset Atrial Fibrillation During ST-Segment–Elevation Myocardial Infarction : Risk of Recurrence and Its Clinical Impact During 10Years of Follow-Up
No full textBACKGROUND: Atrial fibrillation (AF) often complicates ST-segment–elevation myocardial infarction (STEMI), but data on AF recurrence after first-ever AF during STEMI are scarce. We aimed at assessing the risk of AF recurrence after first-ever transient AF during admission for STEMI. METHODS: We performed a single-center, register-based cohort study. Patients with STEMI discharged alive after primary percutaneous coronary intervention during 2007 to 2010 were followed until 2018. Clinical characteristics, date of AF diagnosis, and mortality status were retrieved from Swedish national registries. All ECGs recorded before, during, or after STEMI were reviewed. The primary end point was the first documented AF episode after discharge, and the secondary end point was mortality. The risk of AF during follow-up was calculated using the Fine-Gray subdistributional hazard model for AF and total mortality, regressed on prespecified clinical and demographic covariates. In patients with first-ever transient AF during STEMI, we looked for the factors associated with AF recurrence. RESULTS: Of 2120 patients discharged alive, 127 (5.9%) had AF during admission for STEMI. Patients with AF during STEMI were more likely to develop AF during follow-up (hazard ratio [HR], 4.82 [95% CI, 3.86–6.02]; P<0.001), with 28% AF recurrence by 1 year. Compared with no AF, patients with AF during STEMI had a higher risk of death (HR, 1.17 [95% CI, 1.01–1.35]; P=0.033). No clinical or demographic characteristics predicted recurrent AF during follow-up. Low P-wave voltage in lead I at predischarge electrocardiography was independently associated with recurrent AF during follow-up (HR, 2.39 [95% CI, 1.23–4.62]; P=0.010). CONCLUSIONS: Transient AF during STEMI is associated with an increased risk of AF after discharge and long-term mortality