Corrosion is the main factor limiting the lifetime of metallic materials, and a fundamental understanding of the governing mechanism and surface processes is difficult to achieve since the thin oxide films at the metal-liquid interface governing passivity are notoriously challenging to study. In this work, a combination of synchrotron-based techniques and electrochemical methods is used to investigate the passive film breakdown of a Ni-Cr-Mo alloy, which is used in many industrial applications. This alloy is found to be active toward oxygen evolution reaction (OER), and the OER onset coincides with the loss of passivity and severe metal dissolution. The OER mechanism involves the oxidation of Mo4+ sites in the oxide film to Mo6+ that can be dissolved, which results in passivity breakdown. This is fundamentally different from typical transpassive breakdown of Cr-containing alloys where Cr6+ is postulated to be dissolved at high anodic potentials, which is not observed here. At high current densities, OER also leads to acidification of the solution near the surface, further triggering metal dissolution. The OER plays an important role in the mechanism of passivity breakdown of Ni-Cr-Mo alloys due to their catalytic activity, and this effect needs to be considered when studying the corrosion of catalytically active alloys.

In spring 2020, a global SARS-Cov-2 pandemic was declared. The number of patients in need of intensive care exceeded the number of available care places at intensive care units (ICUs) and certified registered nurse anesthetists (CRNAs) were relocated to ICUs to support the care during the pandemic. The aim of this study was to illuminate the experiences of the CRNAs regarding relocation to COVID-19 intensive care. An interview study based on qualitative content analysis was conducted. The participants were CRNAs who usually work in the operating unit, however, were relocated to work in the COVID-19 ICU at a university hospital in southern Sweden during the pandemic. Four themes emerge in the results: sense of pride, competence, work environment, and nursing. The results illuminate the CRNAs' experience of relocating from their usual working environment to caring for critically ill patients in a COVID-19 ICU. The CRNAs managed the relocation well, although sometimes it was difficult. The CRNAs showed great loyalty, dedication, competence, and flexibility in their professional capacity. The time they worked in COVID-19 intensive care was a challenging period, but it gave them a well-deserved sense of pride and competence.

Biofilm-associated infections, which are able to resist antibiotics, pose a significant challenge in clinical treatments. Such infections have been linked to various medical conditions, including chronic wounds and implant-associated infections, making them a major public-health concern. Early-detection of biofilm formation offers significant advantages in mitigating adverse effects caused by biofilms. In this work, we aim to explore the feasibility of employing a novel wireless sensor for tracking both early-stage and matured-biofilms formed by the medically relevant bacteria Staphylococcus aureus and Pseudomonas aeruginosa. The sensor utilizes electrochemical reduction of an AgCl layer bridging two silver legs made by inkjet-printing, forming a part of near-field-communication tag antenna. The antenna is interfaced with a carbon cloth designed to promote the growth of microorganisms, thereby serving as an electron source for reduction of the resistive AgCl into a highly-conductive Ag bridge. The AgCl-Ag transformation significantly alters the impedance of the antenna, facilitating wireless identification of an endpoint caused by microbial growth. To the best of our knowledge, this study for the first time presents the evidence showcasing that electrons released through the actions of bacteria can be harnessed to convert AgCl to Ag, thus enabling the wireless, battery-less, and chip-less early-detection of biofilm formation.

Introduction: Incontinence-associated dermatitis (IAD) is irritant contact dermatitis and skin damage associated with prolonged skin contact with urine and/or faeces. Identifying prognostic factors for the development of IAD may improve management, facilitate prevention and inform future research.

Methods and analysis: This protocol follows the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Prospective and retrospective observational studies or clinical trials in which prognostic factors associated with the development of IAD are described are eligible. There are no restrictions on study setting, time, language, participant characteristics or geographical regions. Reviews, editorials, commentaries, methodological articles, letters to the editor, cross-sectional and case-control studies, and case reports are excluded. MEDLINE, CINAHL, EMBASE and The Cochrane Library will be searched from inception until May 2023. Two independent reviewers will independently evaluate studies. The Quality in Prognostic Studies tool will be used to assess the risk of bias, and the Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies-Prognostic Factors checklist will be used for data extraction of the included studies. Separate analyses will be conducted for each identified prognostic factor, with adjusted and unadjusted estimated measures analysed separately. Evidence will be summarised with a meta-analysis when possible, and narratively otherwise. The Q and I2 statistics will be calculated in order to quantify heterogeneity. The quality of the evidence obtained will be evaluated according to the Grades of Recommendation Assessment, Development and Evaluation guidance.

Ethics and dissemination: No ethical approval is needed since all data is already publicly accessible. The results of this work will be published in a peer-reviewed scientific journal.

Since the dawn of modern sport, Swedish athletes and leaders have made a significant impact in the global sport community, and Swedish scientists and entrepreneurs have contributed to the development of coaching and training. But when it comes to football, Sweden has rather taken influence from others. Two names contradict this relative anonymity – Sven-Göran Eriksson and Pia Sundhage. They both have had long and successful careers which have brought Swedish coaching ideals to an international audience. The purpose of this study is to investigate how their respective coaching philosophies have developed over time and how they have been shaped by education, previous experiences, and influences in the coaches’ own lives. The developments of Eriksson’s and Sundhage’s coaching philosophies are analysed through the lens of theories about scientisation, specialisation and professionalisation. We build on their own publications, as well as interviews and archival sources.

In times of democratic decline, unanimous choices and approaches and the idea of a singular best practice may be less conducive to democracy and sustainability. Therefore, the aim of this study is to suggest a multivocal approach to education and teaching by studying the question of what may characterise teaching in preschool for a sustainable future. The knowledge contribution and originality of the article is evident in the introduction, method, and results. In abductive analyses, models can summarize what we need to know and teach in pursuit of the creation of open life chances for every child. The results show that didaktik models are open and can provide support for teachers and leaders to consider and base informed decisions on, as well as to motivate their didaktik choices based on scientific foundations and proven experiences. Multivocal didaktik mo-delling intends to open up teaching—cultivating collaboration in preschool for a sustainable future in a world of change. In conclusion, we recommend cultivating an orientation (1) between knowledges, values and didaktik/education/special education in the pursuit of the creation of conditions for good education for all children; (2) between teaching realities and scientific foundations, which are founded in a critical–reflective didaktik, with a choice of direction in relation to an uncertain future; and (3) between continuity, progression and teaching adventures—which can include consolidating, deepening, broadening, raising, and cultivating knowledge and values for multivocality, democracy and sustainability in teaching realities. In the future the concept of multivocal didaktik modelling can be studied in relation to complex teaching realities as in a teaching universe or a teaching multiverse.

INTRODUCTION: The prevalence of COPD tends to level off in populations with decreasing prevalence of smoking but the extent of underdiagnosis in such populations needs further investigation.

AIM: To investigate underdiagnosis and misclassification of COPD with a focus on socio-economy, lifestyle determinants and healthcare utilization.

METHOD: was defined according to the fixed post-bronchodilator spirometric criteria FEV1/FVC<0.70 in combination with respiratory symptoms.

RESULTS: , the underdiagnosis was 83.6% (n = 107) of which 57.9% were men. The undiagnosed participants were younger, had higher FEV1% of predicted and less frequently a family history of bronchitis. One in four of the undiagnosed had utilized healthcare and had more frequently utilized healthcare due to a burden of respiratory symptoms than the general population without COPD. Underdiagnosis was not related to educational level. Misclassification of COPD was characterized by being a woman with low education, ever smoker, having respiratory symptoms and having a previous asthma diagnosis.

CONCLUSION: In the high income country Sweden, the underdiagnosis of COPD was highly prevalent. Reduced underdiagnosis can contribute to risk factor modification, medical treatment and self-management strategies in early stages of the disease, which may prevent disease progression and improve the quality of life among those affected. Therefore, there is a need to increase the use of spirometry in primary care to improve the diagnostic accuracy.

AIM: Triggering receptor expressed on myeloid cells 1 (TREM-1) and peptidoglycan recognition protein 1 (PGLYRP1) are elevated in biofluids in the presence of various inflammatory conditions. This cross-sectional study aimed to evaluate the effect of age, sex, smoking and different oral and systemic non-communicable diseases on the levels of TREM-1 and PGLYRP1 in saliva.

MATERIALS AND METHODS: In total, 445 individuals (mean age 48.7 ± 16.9 years, female:male 51%:49%) were included. All provided self-reported information on smoking and systemic diseases and whole stimulated saliva. Periodontal and cariological parameters were recorded. Salivary levels of TREM-1, PGLYRP1 and total protein were measured using commercially available assays.

RESULTS: Salivary TREM-1 levels were significantly higher in stages III-IV periodontitis compared to other periodontal diagnoses (p < .05). Smoking, bleeding on probing (BOP), percentage of pockets ≥4 mm and the number of manifest caries were associated with TREM-1 (p < .05), while sex, BOP, number of manifest caries and muscle and joint diseases were associated with PGLYRP1 (p < .05).

CONCLUSIONS: Salivary TREM-1 is associated with periodontitis and caries, while PGLYRP1 is associated with gingival inflammation and caries. Additionally, TREM-1 levels are modified by smoking, while PGLYRP1 is modified by sex and muscle and joint diseases. TREM-1 and PGLYRP1 in saliva could serve as potential biomarkers for detecting and monitoring non-communicable diseases.

BACKGROUND: Primary headache syndromes such as migraine are among the most common neurological syndromes. Chronic facial pain syndromes of non-odontogenic cause are less well known to neurologists despite being highly disabling. Given the pain localization, these patients often consult dentists first who may conduct unnecessary dental interventions even if a dental cause is not identified. Once it becomes clear that dental modalities have no effect on the pain, patients may be referred to another dentist or orofacial pain specialist, and later to a neurologist. Unfortunately, neurologists are also often not familiar with chronic orofacial pain syndromes although they share the neural system, i.e., trigeminal nerve and central processing areas for headache disorders.

CONCLUSION: In essence, three broad groups of orofacial pain patients are important for clinicians: (i) Attack-like orofacial pain conditions, which encompass neuralgias of the cranial nerves and less well-known facial variants of primary headache syndromes; (ii) persistent orofacial pain disorders, including neuropathic pain and persistent idiopathic facial/dentoalveolar pain; and (iii) other differential diagnostically relevant orofacial pain conditions encountered by clinicians such as painful temporomandibular disorders, bruxism, sinus pain, dental pain, and others which may interfere (trigger) and overlap with headache. It is rewarding to know and recognize the clinical picture of these facial pain syndromes, given that, just like for headache, an internationally accepted classification system has been published and many of these syndromes can be treated with medications generally used by neurologists for other pain syndromes.

We present two binary lipid-sterol membrane systems that exhibit fluid-fluid coexistence. Partial phase diagrams of binary mixtures of dimyristoylphosphatidylcholine with 25-hydroxyxholesterol and 27-hydroxycholesterol, determined from small-angle X-ray scattering and fluorescence microscopy studies, show closed-loop fluid-fluid immiscibility gaps, with the appearance of a single fluid phase both at higher and lower temperatures. Computer simulations suggest that this unusual phase behavior results from the ability of these oxysterol molecules to take different orientations in the membrane depending on the temperature.

PURPOSE: To evaluate the survival rate of full-coverage tooth-supported fixed prosthetic restorations, single crowns (SCs), and fixed dental prostheses (FDPs), taking into consideration the potential influence of tooth-vitality, presence and type of post, and type of prosthetic restoration material.

MATERIALS AND METHODS: In October 2022, two authors independently conducted a search in PubMed, Web of Science, and Scopus electronic databases as well as a hand search to identify clinical human studies on full-coverage SCs and FDPs supported by vital and/or non-vital abutments and/or a combination of both, with a minimum observation period of 24 months.

RESULTS: Out of 4198 studies identified through the database search and 22 through hand searching, 26 studies fulfilled the inclusion criteria and were included in the analysis of the present systematic review. Included studies scored six points and more according to Newcastle-Ottawa Scale (NOS). The highest estimated 5-year survival rate was observed for (metal-ceramic and all-ceramic) SCs on vital teeth (98.3%; 95% CI [98.1, 98.6%]) and all ceramic SCs on non-vital teeth with fiber post (95.0%; 95% CI [94.5-95.4%]). Metal-ceramic SCs on vital teeth (97.1%; 95% CI [95.6-98.7%]) showed a statistically significant higher estimated 5-year survival rate compared to metal-ceramic SCs with cast metal post (90.7%; 95% CI [87.4-94.0%], P < 0.001), fiber post (91.3%; 95% CI [90.9-91.6%], P < 0.001) and without post (85.7%; 95% CI [80.7, 90.6%], P < 0.032). All-ceramic SCs with fiber post had a statistically significant higher estimated 5-year survival rate (95.0%; 95% CI [94.5-95.4%]) compared to metal-ceramic SCs on non-vital teeth with fiber post (91.3%; 95% CI [90.9-91.6%], P < 0.001). SCs (all-ceramic and metal-ceramic) with fiber post had a statistically significantly higher estimated 5-year survival rate of (92.7%; 95% CI [92.4-92.9%]) than SCs made of metal-ceramic and retained by cast metal post (90.7%; 95% CI [87.4-94.0%], P < 0.001). For FDPs, the 5-year survival rate was significantly higher for FDPs on vital abutments (84.9%; 95% CI [75.9, 93.9%]) compared to FDPs retained by non-vital abutment/s (81.3%; 95% CI [80.3, 82.2%], P = 0.049) irrespective to presence, type of post, and FDPs material. The results are limited by the limited number of studies and the presence of uncontrolled confounding clinical variables.

CONCLUSIONS: Within the limitations of the study, tooth vitality is suggested to contribute positively to the survival of SCs and FDPs.

INTRODUCTION: Oral appliance (OA) therapy in obstructive sleep apnea (OSA) could be a risk factor for normal jaw function, given the prolonged effect of an OA in keeping the mandible in a protruded position away from a normal position. This study aimed to assess changes in symptoms and clinical findings related to jaw function after 1 year of treating OSA with an OA.

METHODS: In this follow-up clinical trial, 302 patients with OSA were assigned to treatment with either monobloc or bibloc OA. Baseline and 1-year follow-up assessment included using the Jaw Functional Limitation Scale, self-reported symptoms and signs related to jaw function. The clinical examination of jaw function included mandibular mobility, dental occlusion, and tenderness in the temporomandibular joints and masticatory muscles. Descriptive analyses of variables are presented for the per-protocol population. To evaluate differences between the baseline and the 1-year follow-up, paired Student t tests and the McNemar change test was used.

RESULTS: One-hundred and ninety-two patients completed the 1-year follow-up (male 73%, mean aged 55 ± 11 years). There was no change in the Jaw Functional Limitation Scale score at the follow-up (nonsignificant). The patients described no change in symptoms at the follow-up, except for improvements in morning headache (P <0.001) and increased frequency of difficulties in opening the mouth or chewing on awakening (P = 0.002). Subjectively reported changes in dental occlusion during biting/chewing increased significantly at the follow-up (P = 0.009).

CONCLUSIONS: No changes in measurements of jaw mobility, dental occlusion, or pain on palpation of the temporomandibular joints or masticatory muscles were seen at the follow-up. Thus, using an OA in treating OSA had limited influence on jaw functions and related symptoms. Moreover, the risk of developing pain and functional impairment in the masticatory system was infrequent, indicating that this treatment is safe and can be recommended.

Based on bioecological systems theory, engagement is the mechanism for children's learning and development. However, children with hyperactive behavior tend to be less engaged in early childhood education and care (ECEC), which might negatively influence their learning and development. On the other hand, social interaction might support children with hyperactive behavior staying engaged in these activities. The current study investigates whether the association between teacher responsiveness, positive peer-to-child interaction (i.e., the quality of peer interaction) and children's hyperactive behavior and engagement levels are transactional. Two hundred and three children aged 1 to 5 in Swedish preschool settings were followed. Data was collected at three points in time between 2012 and 2014. This data was then analyzed to identify associations and how they changed over time. Transactional paths were found between children's levels of core engagement, teacher responsiveness, and the quality of positive peer-to-child interaction. Children's core engagement increases the probability of better quality positive peer-to-child interaction and teacher responsiveness, increasing core engagement over time. Teacher responsiveness and the quality of positive peer-to-child interaction are predictors of reduced hyperactive behavior over time. Meanwhile, children's hyperactive behavior does not significantly influence these two types of social interaction, that is, decreased hyperactivity may not improve social interaction to the same extent as increased engagement. The findings are discussed in relation to how special support for children with hyperactive behavior can be designed, with a focus on increasing core engagement in preschool settings.

As the most abundant element in the universe after hydrogen and helium, oxygen plays a key role in planetary, stellar, and galactic astrophysics. Its abundance is especially influential in terms of stellar structure and evolution, and as the dominant opacity contributor at the base of the Sun's convection zone, it is central to the discussion on the solar modelling problem. However, abundance analyses require complete and reliable sets of atomic data. We present extensive atomic data for O I by using the multiconfiguration Dirac-Hartree-Fock and relativistic configuration interaction methods. We provide the lifetimes and transition probabilities for radiative electric dipole transitions and we compare them with results from previous calculations and available measurements. The accuracy of the computed transition rates is evaluated by the differences between the transition rates in Babushkin and Coulomb gauges, as well as via a cancellation factor analysis. Out of the 989 computed transitions in this work, 205 are assigned to the accuracy classes AA-B, that is, with uncertainties smaller than 10%, following the criteria defined by the Atomic Spectra Database from the National Institute of Standards and Technology. We discuss the influence of the new log(gf) values on the solar oxygen abundance, ultimately advocating for log epsilon(O) = 8.70 +/- 0.04.

This article explores monetization and networking strategies within the consolidating creator economy. Through a large-scale study of linking practices on YouTube, we investigate how creators seek to build their online presence across multiple platforms and widen their income streams. In particular, we build on a near-complete sample of 153,000 "elite" YouTube channels with at least 100,000 subscribers, retrieved at the end of 2019, and investigate the URLs found in 137 million video descriptions to analyze traces of these strategies. We first situate our study within relevant literature around the creator economy, the role of platforms, and issues such as social capital building and economic precarity. We then outline our data and analytical approach, followed by a presentation of our findings. The article finishes with a discussion on how monetization and networking strategies via placing URLs in video descriptions have become more important over time, but also differ substantially between channel sizes, content categories, and geographic locations. Our empirical analysis shows that YouTube, as a highly unequal platformed media system, thrives on the economic pressures it exerts on its creators.

Predicting breakdowns is becoming one of the main goals for vehicle manufacturers so as to better allocate resources, and to reduce costs and safety issues. At the core of the utilization of vehicle sensors is the fact that early detection of anomalies facilitates the prediction of potential breakdown issues, which, if otherwise undetected, could lead to breakdowns and warranty claims. However, the making of such predictions is too complex a challenge to solve using simple predictive models. The strength of heuristic optimization techniques in solving np-hard problems, and the recent success of ensemble approaches to various modeling problems, motivated us to investigate a hybrid optimization- and ensemble-based approach to tackle the complex task. In this study, we propose a snapshot-stacked ensemble deep neural network (SSED) approach to predict vehicle claims (in this study, we refer to a claim as being a breakdown or a fault) by considering vehicle operational life records. The approach includes three main modules: Data pre-processing, Dimensionality Reduction, and Ensemble Learning. The first module is developed to run a set of practices to integrate various sources of data, extract hidden information and segment the data into different time windows. In the second module, the most informative measurements to represent vehicle usage are selected through an adapted heuristic optimization approach. Finally, in the last module, the ensemble machine learning approach utilizes the selected measurements to map the vehicle usage to the breakdowns for the prediction. The proposed approach integrates, and uses, the following two sources of data, collected from thousands of heavy-duty trucks: Logged Vehicle Data (LVD) and Warranty Claim Data (WCD). The experimental results confirm the proposed system's effectiveness in predicting vehicle breakdowns. By adapting the optimization and snapshot-stacked ensemble deep networks, we demonstrate how sensor data, in the form of vehicle usage history, contributes to claim predictions. The experimental evaluation of the system on other application domains also indicated the generality of the proposed approach.

IntroductionMedical adhesives are adhesives used in medical devices to establish and maintain contact with the body over a period of time (usually by application to the skin) and are widely used in most care settings. Application of medical adhesives to the skin can lead to skin stripping, mild or severe allergic reactions and skin irritation that may manifest as redness, itching or rash. Adhesive-related skin injury can lead to infection, delayed wound healing and an increased risk of scarring. These injuries can cause severe discomfort and pain, and can affect the patient's quality of life. A systematic review summarising patient's experiences on this topic will contribute to informing adhesive producers and policy makers, and guiding further development and improvement of available technologies. Methods and analysisThis systematic review protocol is based on the principles of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guideline. A systematic search will be conducted in CINAHL, EMBASE, MEDLINE and PsycINFO. In addition, manual searches will be performed, reviewing the reference lists of relevant reviews and articles included for quality assessment. Qualitative studies using various methods will be considered for inclusion. Screening of title, abstract and full text will be done by two reviewers. The methodological quality of studies under consideration will be critically assessed by two reviewers using the Joanna Briggs Institute Critical Appraisal Tool for Qualitative Research. Data extraction will be performed independently by two reviewers using a predefined data extraction form. Meta-aggregation will be used to summarise the evidence. Ethics and disseminationNo ethical approval or consent is required because no participants will be recruited. This systematic review protocol is published in an open access journal to increase transparency of the research methods used. Results will be disseminated at national and international conferences.

User location is becoming an increasingly common and important feature for a wide range of services. Smartphone owners increasingly use location-based services, as service providers add context-enhanced functionality such as car-driving routes, COVID-19 tracking, crowdedness indicators, and suggestions for nearby points of interest. However, positioning a user indoors is still problematic due to the fading of the radio signal caused by multipath and shadowing, where both have complex dependencies on the indoor environment. Location fingerprinting is a common positioning method where Radio Signal Strength (RSS) measurements are compared to a reference database of previously stored RSS values. Due to the size of the reference databases, these are often stored in the cloud. However, server-side positioning computations make preserving the user's privacy problematic. Given the assumption that a user does not want to communicate his/her location, we pose the question of whether a passive system with client-side computations can substitute fingerprinting-based systems, which commonly use active communication with a server. We compared two passive indoor location systems based on multilateration and sensor fusion using an Unscented Kalman Filter (UKF) with fingerprinting and show how these may provide accurate indoor positioning without compromising the user's privacy in a busy office environment.

The basis of this article is a follow-up study of a cohort of pupils in the third largest city of Sweden, Malmo. The pupils finished fourth grade at compulsory school in 2008. We have data about every individual in the cohort as well as corresponding information about their parents. The information concern educational choices, educational accomplishments, employment relations, incomes from work and different kinds of social benefits and allowances. We got annual data on these variables from 2008 until the last follow-up year 2019 when most of the individuals were 21 years old. Most of them left upper secondary school in 2017 when they were 19 years old. They were therefore in the beginning of their transition 2019, either aiming for education or work. The results show that vocational education generated favourable conditions for work and incomes provided that the diploma goals ware reached. Individuals with foreign background and with unfavourable socioeconomic origins were overrepresented among those that didn't reach the diploma goals; this was true for students on VET-programmes as well as higher education preparatory programmes. It should also be mentioned that experiences from a national programme in upper secondary school generally improved conditions for establishment. Those that didn't reach the goals of compulsory school and weren't eligible for studying at a national programme met the greatest difficulties in finding jobs and decent income levels.

Extracellular vesicles (EVs) are derived from the membrane of platelets and released in the circulation upon activation or injury. Analogous to the parent cell, platelet derived EVs play an important role in hemostasis and immune responses by transfer of bioactive cargo from the parent cells. Platelet activation and release of EVs increases in several pathological inflammatory diseases, such as sepsis. We have previously reported that the M1 protein released from the bacterial pathogen Streptococcus pyogenes directly mediates platelet activation. In this study, EVs were isolated from these pathogen-activated platelets using acoustic trapping and their inflammation phenotype was characterized using quantitative mass spectrometry-based proteomics and cell-based models of inflammation. We determined that M1 protein mediated release of platelet derived EVs that contained the M1 protein. The isolated EVs derived from pathogen-activated platelets contained a similar protein cargo to those from physiologically activated platelets (thrombin), and included platelet membrane proteins, granule proteins and cytoskeletal proteins, coagulation factors and immune mediators. Immunomodulatory cargo, complement proteins and IgG3, were significantly enriched in EVs isolated from M1 protein-stimulated platelets. Acoustically enriched EVs were functionally intact and exhibited proinflammatory effects on addition to blood, including platelet-neutrophil complex formation, neutrophil activation, and cytokine release. Collectively, our findings reveal novel aspects of pathogen-mediated platelet activation during invasive streptococcal infection.

Objective: To map oral health-related standard of care in the context of head and neck cancer (HNC) treatment across the European Union (EU).

Materials and Methods: Six hundred and ninety centers across the European Union were contacted. The questionnaire contained questions focusing on the team/department structure, HNC treatment planning routines, and assessment and handling of dental treatment needs prior to cancer treatment.

Results: Eighty-seven centers across the EU responded. Department structure and number of HNC patients treated per year varied widely and dental professionals are included as part of the team in about 25% of the centers. Standard of care, in terms of dental assessment and preventive dentistry routines, such as recording an orthopantomogram, offering dental treatment, and providing a radiation protection splint and splint for fluoride application, differed significantly among the European regions. Independent of the region, these aspects are positively affected if dental professionals are part of the interdisciplinary treatment team and if dental treatment is offered within the center.

Conclusion: Dental professionals are still only to a very limited extent included in interdisciplinary treatment planning teams of HNC patients. However, their inclusion and/or offering dental treatment within the same hospital/center appears to improve oral health-related standard of care.

Clinical Relevance: Inclusion of dental professionals in treatment planning teams of HNC patients appears to improve oral health-related standard of care within HNC treatment.

Digitisation is among the macro-trends that significantly influence the business world in the twenty-first century. Firms striving to succeed in this environment must develop new strategic approaches. The accelerating development of information technology (IT) drives digitisation. Therefore, IT and business strategies must be integrated. In this context, the information systems literature promotes the concept of digital business strategies (DBSs), reflecting a fusion between IT and business strategies. However, knowledge of the types and characteristics of such DBSs is currently scarce. Therefore, we developed a conceptually and empirically grounded typology of DBS based on the well-known business strategy classification by Miles and Snow (1978). Using a dataset comprising 192 firms worldwide, we conducted a cluster analysis, identified basic types of DBS, and evaluated their effects on firm performance. Moreover, we identified four types of DBS: non-digital reactor, analyser, digital opportunist, and digital producer. The study contributes to a better understanding of new business strategy concepts in the digitisation context.

In Europe and other parts of the world, many new schools are to be built. In Sweden, for instance, some 1000 new schools are to be built between year 2020-2025. As a response to this need of new school buildings, there are policies emerging. One example is the Swedish National Board of Housing, Building and Planning (SNBHP), who published policy by presenting a digital collection good examples. In this paper we are zooming in on the learning environments in the policy and examining the meaning that is made of the learning environments. With the aid of the practical epistemological analysis (PEA), four the learning environments are identified: 1) general and flexible learning environment; 2) stimulating learning environment with spatial diversity; 3) an exciting learning environment that encourages creativity; and 4) an open learning environment. How these learning environments come about is further analysed with the concept of material classification, which helps identify some of the implications on teaching and learning and how the pedagogical vocabulary and material classification condition behaviours. This is further discussed in terms of what happens when"good learning environments" are made into policy.

Problem-based learning (PBL) has been implemented with different levels of success in first-year engineering education in response to the rapidly growing requirements for a higher degree of learner agency in graduates. This study is contextualised in a systemic problem-based learning environment and explores the sources of first-year engineering students' learner agency development in relation to the main features and skillsets of PBL, such as teamwork, student-centredness, problem orientation and project organisation. Q methodology was employed, including both qualitative and quantitative data collection and analysis based on a 39-statement Q sample and 102 valid Q sorts. The Q analysis identified four statistically distinct viewpoints on the key sources of learner agency for students: (1) Team dynamism and self-directed learning within the project team, (2) Trust and peer support within the project team, (3) Individual efforts at career readiness and (4) Team efforts at project management. The findings highlight the potential of PBL for offering more and better pedagogical support for first-year engineering students in developing learner agency.

We present a spectroscopic analysis of a sample of 48 M-dwarf stars (0.2 M (& ODOT;) < M < 0.6 M (& ODOT;)) from the Hyades open cluster using high-resolution H-band spectra from the Sloan Digital Sky Survey/Apache Point Observatory Galactic Evolution Experiment (APOGEE) survey. Our methodology adopts spectrum synthesis with LTE MARCS model atmospheres, along with the APOGEE Data Release 17 line list, to determine effective temperatures, surface gravities, metallicities, and projected rotational velocities. The median metallicity obtained for the Hyades M dwarfs is [M/H] = 0.09 & PLUSMN; 0.03 dex, indicating a small internal uncertainty and good agreement with optical results for Hyades red giants. Overall, the median radii are larger than predicted by stellar models by 1.6% & PLUSMN; 2.3% and 2.4% & PLUSMN; 2.3%, relative to a MIST and DARTMOUTH isochrone, respectively. We emphasize, however, that these isochrones are different, and the fractional radius inflation for the fully and partially convective regimes have distinct behaviors depending on the isochrone. Using a MIST isochrone there is no evidence of radius inflation for the fully convective stars, while for the partially convective M dwarfs the radii are inflated by 2.7% & PLUSMN; 2.1%, which is in agreement with predictions from models that include magnetic fields. For the partially convective stars, rapid rotators present on average higher inflation levels than slow rotators. The comparison with SPOTS isochrone models indicates that the derived M-dwarf radii can be explained by accounting for stellar spots in the photosphere of the stars, with 76% of the studied M dwarfs having up to 20% spot coverage, and the most inflated stars with & SIM;20%-40% spot coverage.

Lipid nanoparticles (LNPs) are the most versatile and successful gene delivery systems, notably highlighted by their use in vaccines against COVID-19. LNPs have a well-defined core-shell structure, each region with its own distinctive compositions, suited for a wide range of in vivo delivery applications. Here, we discuss how a detailed knowledge of LNP structure can guide LNP formulation to improve the efficiency of delivery of their nucleic acid payload. Perspectives are detailed on how LNP structural design can guide more efficient nucleic acid transfection. Views on key physical characterization techniques needed for such developments are outlined including opinions on biophysical approaches both correlating structure with functionality in biological fluids and improving their ability to escape the endosome and deliver they payload.

Young LGBTQ+ people are over-represented in various forms of state care. They experience hardships during their placements and staff competence in addressing specific needs among LGBTQ+ youth is lacking. In this article, we investigate whether and how LGTBQ+ issues are considered and described in digital marketing for state care providers. The material consists of the homepages of residential care homes and secure state care institutions, which we analyse using critical discourse analysis. The results show that LGBTQ+ issues are largely invisible. Of the approximately 1,000 existing state care providers, only twenty stated that they worked with or had competence in LGBTQ+ issues. Among these, no secure state care institution offered LGBTQ+ competence at the time of the study. The descriptions of how care providers work with LGBTQ+ issues are characterised by heteronormativity where there is a mix of two types of language on the homepages regarding LGBTQ+ youth; on the one hand, a heteronormative, traditional description based on a binary understanding of gender; and, on the other, an LGBTQ+ inclusive language is used. However, the LGBTQ+ affirmative language has been imposed upon the traditional rather than being integrated into it, which comes across as superficial and unclear. International studies show that LGBTQ+ youth are over-represented in various forms of state care. Using critical discourse analysis, we investigated how LGBTQ+ youth, as a target group, are described and how LGBTQ+ competence is presented on the home pages of residential care homes and secure state care institutions for young people in Sweden. The results show that LGBTQ is largely invisible. Of the approximately 1,000 existing residential care homes, only 20 stated that they worked with or had competence in LGBTQ+ issues. No secure state care institution offered LGBTQ+ competence at the time of the study.

Continuous deployment has been practiced for many years by companies developing web- and cloud-based applications. To succeed with continuous deployment, these companies have a strong collaboration culture between the operations and development teams. In addition, these companies use AI, analytics, and big data to assist with time-consuming postdeployment activities such as continuous monitoring and fault identification. Thus, the term AIOps has evolved to highlight the importance and difficulty of maintaining highly available applications in a complex and dynamic environment. In contrast, software-intensive embedded systems often provide customer product-related services, such as maintenance, optimization, and support. These services are critical for these companies as they provide significant revenue and increase customer satisfaction. Therefore, the objective of our study is to gain an in-depth understanding of the impact of continuous deployment on product-related services provided by software-intensive embedded systems companies. In addition, we aim to understand how AIOps can support continuous deployment in the context of software-intensive embedded systems. To address this objective, we conducted a case study at a large and multinational telecommunications systems provider focusing on the radio access network (RAN) systems for 4G and 5G networks. The company provides RAN products and three complementing services: rollout, optimization, and customer support. The results from the case study show that the boundaries between product-related services become blurry with continuous deployment. In addition, product-related services, which were conducted in sequence by independent projects, converge with continuous deployment and become part of the same project. Further, AIOps platforms play an important role in reducing costs and increasing postdeployment activities' efficiency and speed. These results show that continuous deployment has a profound impact on the software-intensive system's provider service organization. The service organization becomes the connection between the R&D organization and the customer. In order to cope with the increased speed of releases, deployment and postdeployment activities need to be largely automated. AIOps platforms are seen as a critical enabler in managing the increasing complexity without increasing human involvement.

Introduction: According to the Convention on the Rights of the Child, all children have the right to health. Since good health is a decisive factor for children's future, investing in children's health is important, especially children from vulnerable areas. The purpose of this study was to investigate the perceptions of health among school-aged children from socially vulnerable areas.

Methods: The study has an explorative mixed-method design with a participatory and inductive approach based on focus group interviews with children and youth leaders, respectively, at Multi-activity Centers in three of the vulnerable areas in Malmö Municipality, as well as results from the Multi-activity Centers' own questionnaire. The data has been analyzed with inductive and deductive content analysis.

Results: The children and the youth leaders described health in terms of well-being, participation, and activity. Well-being included feeling good and safe, having a healthy body, and having fun by doing things together with friends and leaders. Participating in activities was described as having a feeling of involvement, being able to have an influence on the organization of the activities and participating on one's own terms.

Discussion: The result of this study shows that participating in activities increases the child's sense of well-being.

BackgroundAlthough dietary adjustments are recommended frequently for bowel symptoms, evidence of diet's impact on bowel function is lacking. The aim was to develop a patient-reported outcome instrument, for children with and without Hirschsprung's disease (HD), to explore experiences of dietary effects on bowel function.MethodsChildren with and without HD and their parents participated. Questionnaire items regarding the impact of diet on bowel function originated from focus group discussions. Specific food items, reported in the literature or in focus groups to cause bowel functional effects, were listed requesting each item's effect size and effect type. Content validity was tested within two separate semistructured interviews. A pilot test was performed. Assessing comprehension, relevance and wording clarity structurally, revisions were made accordingly. Children's bowel function was assessed through the validated Rintala Bowel Function Score.ResultsA total of 13 children with and without HD, median age 7 (range 2-15) years, and 18 parents participated in the validation. Each question's relevance had been ranked highly early in the validation process but most questions needed refining for improving clarity and comprehension. Wordings regarding bowel symptoms and emotions connected to food in particular were perceived to be sensitive and complex. Specifically wording regarding some bowel symptoms (gases, pain) and parental stress emotions (guilt, ambivalence) were, consistent with participants' opinions, subjected to multiple step revisions. Following the validation process, which included two semistructure interviews with different participants and then a pilot test with a third cohort, a full track overview of changes and rewording made in all steps of the validation process was presented. The final questionnaire then comprised 13 questions assessing foods' significance for bowel function, emotions, social impact and 90 specific food items' possible effects and effect sizes on bowel function.ConclusionsThe Diet and Bowel Function questionnaire, enabling answering by children, was developed and the content validated qualitatively. This report presents insights into the whole validation process, declaring reasons for the selected question- and answering options, and their wordings. The Diet and Bowel Function questionnaire can be used as a survey questionnaire to enhance understanding of dietary effects on bowel function in children, and its results can be supportive in improving dietary-treatment programs.

Introduction: Social determinants of health impact health, and migrants are exposed to an inequitable distribution of resources that may impact their health negatively, leading to health inequality and social injustice. Migrant women are difficult to engage in health-promotional activities because of language barriers, socioeconomic circumstances, and other social determinants. Based on the framework of Paulo Freire, a community health promotion program was established in a community-academic partnership with a community-based participatory research approach.

Aim: The aim of this study was to describe how a collaborative women's health initiative contributed to migrant women's engagement in health promotion activities.

Materials and methods: This study was part of a larger program, carried out in a disadvantaged city area in Sweden. It had a qualitative design with a participatory approach, following up on actions taken to promote health. Health-promotional activities were developed in collaboration with a women's health group, facilitated by a lay health promoter. The study population was formed by 17 mainly Middle Eastern migrant women. Data was collected using the story-dialog method and the material was analyzed using thematic analysis.

Result: Three important contributors to engagement in health promotion were identified at an early stage of the analysis process, namely, the group forming a social network, the local facilitator from the community, and the use of social places close to home. Later in the analysis process, a connection was made between these contributors and the rationale behind their importance, that is, how they motivated and supported the women and how the dialog was conducted. This therefore became the designated themes and were connected to all contributors, forming three main themes and nine sub-themes.

Conclusion: The key implication was that the women made use of their health knowledge and put it into practice. Thus, a progression from functional health literacy to a level of critical health literacy may be said to have occurred.

Background: Excessive jaw muscle activity is a frequent complication after acquired brain injury (ABI).

Objective: The study aimed to identify the occurrence and severity of jaw muscle activity and its association with altered state of consciousness in patients with ABI.

Methods: A total of 14 severe ABI patients with varied altered state of consciousness were recruited. A single-channel electromyographic (EMG) device was used to assess the jaw muscle activity for three consecutive nights during Week 1 and Week 4 following admission. Differences in number of EMG episodes/h between Week 1 and 4 were analysed using non-parametric tests and association between the EMG activity and altered state of consciousness were analysed using Spearman's correlation test.

Results: Nine of fourteen (64%) patients showed indications of bruxism (cutoff: >15 EMG episodes/h). The average EMG episodes/h at admission were 44.5 ± 13.6 with no significant changes after Week 4 of admission (43 ± 12.9; p = .917). The EMG episodes/h ranged from 2 to 184 during Week 1 and 4-154 during Week 4. There were no significant correlations between the number of EMG episodes/h during the three nights and the individuals altered state of consciousness during Week 1 and Week 4.

Conclusion: Patients with ABI had a conspicuously high but variable level of jaw muscle activity at admission and it tend to remain high after 4 week of hospitalisation which could potentially lead to adverse effects such as excessive tooth wear, headaches and pain in jaw muscles. The lack of associations between individuals altered level of consciousness and EMG activity could be due to low sample size and further studies are clearly warranted in this patient group with special needs. Single-channel EMG devices can record jaw muscle activity early in the hospitalisation period and might be a helpful tools for early detection of bruxism in ABI patients.

Objectives: The aim of this study was to monitor changes in Osteoprotegerin (OPG) and receptor activator of nuclear factor-kappa ligand (RANKL) levels in the saliva during orthodontic tooth movement (OTM). Materials and Methods: Nine healthy females (15-20 y of age) with four pre-molar extractions and fixed appliance were included. In total, 134 stimulated and 134 unstimulated saliva samples were collected: at baseline and then every 6-8 weeks at follow-up appointments during the whole orthodontic treatment. Twelve age-matched females with no active orthodontic treatment served as a control group. Saliva samples were analysed by enzyme-linked immunosorbent assay (Elisa). The mean levels of OPG and RANKL were calculated according to the different orthodontic treatment stages: alignment, space closure and finishing. A mixed model analysis was used to compare the means of treatment stages. Baseline OPG levels were compared with the control group using an independent t-test. OPG levels were measured in stimulated saliva due to low levels in unstimulated saliva. Results: No significant difference was observed between baseline OPG values and the control group. OPG increased significantly at all treatment stages: alignment, space closure and finishing compared with baseline (P = 0.002, P = 0.039, P = 0.001, respectively). The salivary levels of OPG increased gradually, except during space closure, reaching peak levels at finishing. RANKL was undetectable in stimulated and unstimulated saliva by sandwich Elisa during OTM. Conclusions: This novel approach shows the changes in the levels of OPG in OTM and indicates how and when to sample saliva during orthodontic treatment to analyse bone remodelling.

Background: WHO recommends repeated measurement of patient safety climate in health care and to support monitoring an 11 item questionnaire on sustainable safety engagement (HSE) has been developed by the Swedish Association of Local Authorities and Regions. This study aimed to validate the psychometric properties of the HSE.

Methods: Survey responses (n = 761) from a specialist care provider organization in Sweden was used to evaluate psychometric properties of the HSE 11-item questionnaire. A Rasch model analysis was applied in a stepwise process to evaluate evidence of validity and precision/reliability in relation to rating scale functioning, internal structure, response processes, and precision in estimates.

Results: Rating scales met the criteria for monotonical advancement and fit. Local independence was demonstrated for all HSE items. The first latent variable explained 52.2% of the variance. The first ten items demonstrated good fit to the Rasch model and were included in the further analysis and calculation of an index measure based on the raw scores. Less than 5% of the respondents demonstrated low person goodness-of-fit. Person separation index > 2. The flooring effect was negligible and the ceiling effect 5.7%. No differential item functioning was shown regarding gender, time of employment, role within organization or employee net promotor scores. The correlation coefficient between the HSE mean value index and the Rasch-generated unidimensional measures of the HSE 10-item scale was r = .95 (p < .01).

Conclusions: This study shows that an eleven-item questionnaire can be used to measure a common dimension of staff perceptions on patient safety. The responses can be used to calculate an index that enables benchmarking and identification of at least three different levels of patient safety climate. This study explores a single point in time, but further studies may support the use of the instrument to follow development of the patient safety climate over time by repeated measurement.

The current article reports findings from a research project on partnership policing in Stockholm, Sweden, to investigate how partnership policing strategies translate into social action. Consideration is given to the ways in which police officers and city employees produce chains of administrative tasks as they navigate their institutional environment and strive to produce legitimacy for partnership policing. More broadly, the findings suggest that the inner mechanisms of a partnership approach to policing are shaped by the self-referential (Eigendynamik) character of administration. The article discusses implications for partnership policing and for the broader literature on policing.

Introduction: A dominant narrative, referred to as “the standard tale,” prevails in popular representations about female genital cutting (FGC) that often contrast with how cut women traditionally narrate their FGC experience as meaningful in contexts where FGC is customary. However, scholarship has increasingly highlighted how global eradication campaigns and migration to countries where FGC is stigmatized provide women with new frames of understanding which may lead to a reformulation of previous experiences. This article subjects the storytelling itself to analysis and explores how participants narrate and make sense of their FGC experience in a post-migration setting where FGC is stigmatized.

Methods: Semi-structured focus groups (9) and individual interviews (12) with Swedish-Somali girls and women (53) were conducted.

Results: The article highlights how the participants navigate their storying in relation to "the standard tale" of FGC in their efforts to make sense of their experiences. Navigation was conducted both at an intrapersonal level through continuous identity work, and in relation to the social context in interpersonal encounters, i.e., with service providers and others, among whom the standard tale has become a truth.

Discussion: The article places the analysis within broader discussions about anti-FGC work and considers the implications in relation to efforts to end FGC.

An electronic tongue is a powerful analytical instrument based on an array of non-selective chemical sensors with a partial specificity for data gathering and advanced pattern recognition methods for data analysis. Connecting electronic tongues with electrochemical techniques for data collection has led to various applications, mostly within sensing for food quality and environmental monitoring, but also in biomedical research for the analyses of different bioanalytes in human physiological fluids. In this paper, an electronic tongue consisting of six electrodes (viz., gold, platinum, palladium, titanium, iridium, and glassy carbon) was designed and tested in authentic (undiluted, unpretreated) human saliva samples from eight volunteers, collected before and during the COVID-19 pandemic. Investigations of 11 samples using differential pulse voltammetry and a principal component analysis allowed us to distinguish between SARS-CoV-2-free and infected authentic human saliva. This work, as a proof-of-principle demonstration, provides a new perspective for the use of electronic tongues in the field of enzyme-free electrochemical biosensing, highlighting their potential for future applications in non-invasive biomedical analyses.

Background: Recently, it has been suggested that gender disparity in Occupational Therapy has to do with segregated gendered job norms that position female dominated professions as a 'step down' for many males. Interestingly, this suggestion was not underpinned by experiences of males in the profession.

Aims and methods: Thirteen male Occupational Therapists with a variety of backgrounds were invited to this Round Table research, focussing on the broader issue of the existing gender imbalance in Occupational Therapy.

Results: Two themes emerged: 'The core values of the profession', and 'Broadening the scope of the profession'; none of them suggesting that male/female imbalance was necessarily the most pressing issue.

Conclusions: A gender-unrelated approach to everyday problem-solving was put forward to achieve increased diversity in Occupational Therapists' backgrounds, better reflecting the people they serve. By broadening the scope and the way the profession is presented, and encouraging innovative and more entrepreneurially driven approaches, diversity in the workforce could be further facilitated. These findings are discussed within the context of 'The mutual constitution of cultures and selves' model.

Significance: Diversity in the Occupational therapy workforce could be further facilitated with a shift in focus away from the male/female perspective to an intersectional approach.

BackgroundThe functional integration of the jaw and neck motor systems, of great importance to everyday oral activities, is established in early childhood. Detailed characterisation of this developmental progress is largely unknown. ObjectiveTo establish developmental changes in jaw-neck motor function in children over the ages 6-13 years compared to adults. MethodsJaw and head movement kinematics during jaw opening-closing and chewing were longitudinally recorded in 20 Swedish children (8 girls) at 6 (6.3 & PLUSMN; 0.4), 10 (10.3 & PLUSMN; 0.3) and 13 (13.5 & PLUSMN; 0.7) years of age and 20 adults (9 women, 28.2 & PLUSMN; 6.7). Movement amplitudes, jaw movement cycle time (CT), coefficient of variation (CV) and head/jaw ratio for amplitudes were analysed. Linear mixed effect analysis and Welch's t-test were used. ResultsChildren showed pronounced movement variability and longer CT at 6 and 10 years old during opening and chewing (p < .001). Compared to adults, 6-year-olds showed higher head/jaw ratios (p < .02) and longer CT (p < .001) during opening and chewing, and higher CV-head (p < .001) during chewing. Whereas 10-year-olds showed larger jaw and head amplitudes (p < .02) and longer CT (p < .001) during opening, and longer CT (p < .001) and higher CV-head (p < .001) during chewing. For 13-year-olds, longer CT (p < .001) during chewing was found. ConclusionChildren showed pronounced movement variability and longer movement cycle time at 6-10 years and developmental progress in jaw-neck integration from 6 to 13 years, with 13-year-olds displaying adult-like movements. These results add new detailed understanding to the typical development of integrated jaw-neck motor function.

Periodontal diseases include pathological conditions elicited by the presence of bacterial biofilms leading to a host response. In the diagnostic process, clinical signs such as bleeding on probing, development of periodontal pockets and gingival recessions, furcation involvement and presence of radiographic bone loss should be assessed prior to periodontal therapy, following active therapy, and during long-term supportive care. In addition, patient-reported outcomes such as increased tooth mobility, migration, and tilting should also be considered. More important to the patient, however, is the fact that assessment of signs of periodontal diseases must be followed by an appropriate treatment plan. Furthermore, it should be realized that clinical and radiographic periodontal diagnosis is based on signs which may not reflect the presence of active disease but rather represent the sequelae of a previous bacterial challenge. Hence, the aim of the present review is to provide a summary of clinical and radiographic diagnostic criteria required to classify patients with periodontal health or disease.

The COVID-19 pandemic precipitated numerous changes in daily life, including the cancellation and restriction of sports globally. Because sports participation contributes positively to the development of student-athletes, restricting these activities may have led to long-term mental health changes in this population. Using a repeated cross-sectional study design, we measured rates of depression using the Patient Health Questionnaire-2 and anxiety using the Generalized Anxiety Disorder-2 scale in student-athletes attending elite sport high schools in Sweden during the second wave of the pandemic (February 2021; n = 7021) and after all restrictions were lifted (February 2022; n = 6228). Depression among student-athletes decreased from 19.8% in 2021 to 17.8% in 2022 (p = .008, V = .026), while anxiety screening did not change significantly (17.4% to 18.4%, p > .05). Comparisons between classes across years revealed older students exhibited decreases in depressive symptoms, while younger cohorts experienced increases in symptoms of anxiety from 2021 to 2022. Logistic regressions revealed that being female, reporting poorer mental health due to COVID-19, and excessive worry over one's career in sports were significant predictors of both depression and anxiety screenings in 2022. Compared to times when sports participation was limited, the lifting of restrictions was associated with overall reduced levels of depression, but not anxiety.

Objectives: To assess the impact of implantoplasty (IP) on maximum implant failure strength of narrow diameter implants of different type/design and material, with simulated advanced bone loss.

Materials and Methods: Narrow, parallel-walled implants (3.3 mm in diameter x 10 mm long) with an internal connection of different type/design [bone level (BL), tissue level (TL)] and material [Titanium grade IV (Ti), Titanium-Zirconium alloy (TiZr)] from one specific manufacturer were used. Half of the implants were subjected to IP in their coronal 5 mm; the remaining were used as controls (seven implants per group). Dynamic loading prior to maximum load strength testing was included.

Results: During dynamic loading, the fracture rate of BL implants was low and independent of IP, while that of TL implants increased significantly with IP compared with controls (p = .001). Maximum implant failure strength reduction (in %) due to IP, was 1.3%-25.4%; TiZr BL implants were least affected. Implants subjected to IP compared to those without IP as well as TL implants compared to BL implants showed a significantly lower maximum implant failure strength (p < .002); implant material was not significant (p = .845).

Conclusions: Based on data from implants of one specific manufacturer, IP has a significant negative impact on the fracture strength of narrow implants suffering from advanced peri-implantitis. TL implants have been more severely affected compared to BL implants and presented an increased risk for failure during normal chewing forces. In addition, this negative impact of IP on TL implants was independent of the implant material (i.e., Ti or TiZr).

Clinical Relevance: Narrow single TL implants with advanced horizontal bone loss (e.g., 5 mm), when subjected to IP, appear to have an increased fracture risk during normal function.

Aim: The aim of this study is to illuminate Diabetes Specialist Nurses' experiences of having a conversation about sexual health with adults with diabetes.

Background: It is well known that diabetes mellitus may affect a person's sexual function. Interview studies with men and women living with diabetes show that conversations about sexual health are important. However, research on Diabetes Specialist Nurses' experiences of having such conversations is limited.

Design: A qualitative approach, with individual interviews, was used.

Method: Purposive sampling was used to recruit 12 informants from adult diabetes care, within primary health care and within hospital settings in southern Sweden, between September and November 2021. A qualitative latent content analysis was used for data analysis. The COREQ guidelines were followed to ensure rigour for this study.

Results: One theme, 'Sexual health is a hot topic', could be understood in light of three categories: 'Obstructive factors that complicate the conversation', 'Promoting factors that facilitate the conversation' and 'Improvements that may facilitate the conversation'. The findings embrace the Diabetes Specialist Nurses' experiences of having a conversation about sexual health with persons with diabetes.

Conclusions: Diabetes Specialist Nurses often experience difficulty having a conversation about sexual health with their patients. The findings provide a deeper understanding of their experiences of obstructive as well as promoting factors related to conversations about what is considered a 'hot topic'.

Relevance to Clinical Practice: To increase knowledge on how to have a conversation about sexual health within diabetes care, support is needed from the organisation; the organisation could, for instance, support the diabetes care staff in gaining education and training regarding sexual health.

Patient or Public Contribution: Not applicable due to the current method.

Objective: The study aimed to compare self-perceived oral health and orofacial appearance in three different cohorts of 60-year-old individuals. Method: A cross-sectional design, based on data obtained from a questionnaire used in the Swedish National Study of Aging and Care. The sample comprised 478 individuals, from baseline, 2001-2003 (n = 191), 2007-2009 (n = 218) and 2014-2015 (n = 69). Comparisons were made within and between the cohorts, with bivariate analysis and Fisher's exact test. Statistical significance was considered at p < 0.05. Results: The result showed that a low number of the participants reported self-perceived problems with oral health. Of the problems reported, a higher proportion in cohort 2014-2015 (39.3%) experienced problems with bleeding gums. The experience of bleeding gums increased between the cohorts 2001-2003 and 2014-2015 (p = 0.040) and between 2007-2009 and 2014-2015 (p = 0.017). The prevalence of discomfort with sensitive teeth was experienced in 7%-32%. Twice as many women compared to men experienced discomfort in all cohorts (no significant differences between the cohorts). Satisfaction with dental appearance was experienced in 75%-84%. Twice as many women compared to men were dissatisfied with their dental appearance in 2001-2003 (p = 0.011) and with discoloured teeth (p = 0.020). No significant differences could be seen between the cohorts regarding discomfort with dental appearance or discoloured teeth. Conclusion: The 60-year-olds irrespective of birth cohort, perceived their oral health and orofacial appearance as satisfactory.

Probiotic bacteria show promising results in prevention of the biofilm-mediated disease caries, but the mechanisms are not fully understood. The acid tolerance response (ATR) allows biofilm bacteria to survive and metabolize at low pH resulting from microbial carbohydrate fermentation. We have studied the effect of probiotic strains: Limosilactobacillus reuteri and Lacticaseibacillus rhamnosus on ATR induction in common oral bacteria. Communities of L. reuteri ATCC PTA5289 and Streptoccus gordonii, Streptococcus oralis, Streptococcus mutans or Actinomyces naeslundii in the initial stages of biofilm formation were exposed to pH 5.5 to allow ATR induction, followed by a low pH challenge. Acid tolerance was evaluated as viable cells after staining with LIVE/ DEAD & REG;BacLightTM. The presence of L. reuteri ATCC PTA5289 caused a significant reduction in acid tolerance in all strains except S. oralis. When S. mutans was used as a model organism to study the effects of additional probiotic strains (L. reuteri SD2112, L. reuteri DSM17938 or L. rhamnosus GG) as well as L. reuteri ATCC PTA5289 supernatant on ATR development, neither the other probiotic strains nor supernatants showed any effect. The presence of L. reuteri ATCC PTA5289 during ATR induction led to down-regulation of three key genes involved in tolerance of acid stress (luxS, brpA and ldh) in Streptococci. These data suggest that live cells of probiotic L. reuteri ATCC PTA5289 can interfere with ATR development in common oral bacteria and specific strains of L. reuteri may thus have a role in caries prevention by inhibiting development of an acid-tolerant biofilm microbiota.