Uppsala University Research Articles

Sustainable Education for Sustainable Heritage: Managing the Tension Between Professional Practice and Critical Inquiry

ABSTRACT This paper reflects on Uppsala University’s experiences from organizing higher education in conservation, and argues how curricula can be rethought and reorganized to foster a genuine shift towards sustainable education. It discusses various experiences of developing and planning interdisciplinary higher education programs in conservation and how curricula can be transformed to broaden the sustainability competence of future heritage professionals. We need to foster heritage professionals that are capable of exploiting the dynamic and negotiated nature of heritage for the good of society. By embracing change and loss there are opportunities to use heritage in more benign and sustainable ways. But there are profound differences between how heritage and its role in society are understood in conservation as a field of practice and as a field of inquiry. Based on the experience from Uppsala University, the authors argue that there is a need for a conservation curriculum in higher education that balances and integrates normative competence and critical inquiry: a middle path, where opposing perspectives can thrive in parallel.

Is the Position of Power More Relevant than Gender for Commercialization of Research? An Explorative Longitudinal Study over 21 Years

AbstractThe existing gender gap regarding commercialization of research is a limiting factor for the knowledge economy. The aim of this study is to explore the long-time development of the proportion of women researcher’s involvement in the process of university spin-out (USO) foundations in a longitudinal study over 21 years at the Uppsala University in Sweden, using the perspective of the position of power. It was found that the proportion of women researchers among the USO-founders increased at the same pace as the increase in the proportion of women among full professors at the University and the gender gap was significantly reduced during the last 7 years studied. Furthermore, during the last 7 years studied, 2.7% of the women full professors at the University participated in USO creations compared to 2.6% of their male counterparts. These findings challenge the perception that women in general have a lower entrepreneurial propensity and strongly indicate that the position of power has a significant impact. Furthermore, the prosperity of women researchers to get involved in commercialization efforts in this Scandinavian study seems to be much higher than those previously reported from the Anglo-Saxen context which is discussed from the perspective of other influential factors. Since the study is limited to only one university recommendations for further studies to validate, the findings are given as well as policy recommendations.

Role of CT-derived global longitudinal strain in identifying left ventricular dysfunction in patients with severe aortic stenosis and preserved left ventricular ejection fraction

Abstract Introduction In patients with severe aortic stenosis, LVEF <50% is a current class 1 indication for aortic valve replacement. There are however studies showing increased mortality in patients with asymptomatic severe aortic stenosis and LVEF between 50-59% [1, 2]. Global longitudinal strain (GLS) has emerged as a more sensitive predictor of systolic dysfunction than ejection fraction in a wide number of cardiac diseases [3]. Purpose The aim of our study was to analyze left ventricular global longitudinal strain (GLS) by cardiac computed tomography (CT) in patients with severe aortic stenosis. We hypothesized that a larger portion of patients with LVEF 50-59% have signs of systolic dysfunction by GLS as compared to patients with LVEF ≥60%. Methods We identified 238 patients (median age 81, 51.3% females) with severe aortic stenosis, assessed by cardiac CT before undergoing transcatheter aortic valve replacement at Uppsala University hospital between 2016-2019. Patients in atrial fibrillation was excluded due to suboptimal image quality. Left ventricular mass index (LVMi), EF and peak GLS were calculated. The patients were divided into three groups based on LVEF (Reduced LVEF <50%, Low-Normal LVEF 50-59% and Normal LVEF ≥60%) and compared with each other regarding GLS, biomarkers and background variables. The cut off for significantly reduced GLS was set at <16%, in accordance with recently proposed criteria [4]. Results As expected GLS was significantly reduced in all patients with LVEF <50%. Among patients with Low-Normal LVEF, 62.3% had significantly reduced GLS as compared to only 3.8% patients with Normal LVEF >60% (p < 0.001). Median GLS in Low-Normal LVEF was 15.5% (IQR 14.1 - 17.4) as compared to 20.2% (IQR 18.4 - 21.9) in Normal LVEF (p < 0.001). Patients with Low-Normal LVEF had a significantly higher LV mass as compared to patients with Normal LVEF (median LVMi 85.8 g/m² vs. 75.8 g/m², p < 0.001). NT-pro-BNP was significantly higher in patients with Low-Normal LVEF compared to Normal LVEF (median 1130 vs. 664 ng/l, p = 0.003). Conclusions Almost two third of patients with severe aortic stenosis and lower range of normal LVEF (50-59%) had abnormally reduced GLS, reflecting systolic LV dysfunction, which was uncommon among those with LVEF >60%. Patients with LVEF 50-59% also presented with higher LV mass index and higher levels of NT-pro-BNP than patients with normal LVEF >60%, reflecting hypertrophic response of the myocardium to pressure overload which over time may lead to progressive myocardial decompensation. LVEF in the range of 50-59% might be an early sign of LV decompensation in severe aortic stenosis.

Validation of fat mass metrics in pediatric obesity

Introduction Hudda-Index is a prediction model for fat mass (FM) based on simple anthropometric measures., FM is a crucial factor in the development of comorbidities, i.e., type 2 diabetes. Hence, Hudda-Index is a promising tool to facilitate identification of children at risk for metabolic comorbidities. It has been validated against deuterium dilution assessments, however, independent validation against the gold-standard for body composition analysis, magnetic resonance imaging (MRI), is lacking. The aim of this study is to validate FM calculated by Hudda-Index against FM measured by MRI. The secondary aim is to compare Hudda-Index to other anthropometric measures including body mass index (BMI), BMI-standard deviation score (BMI-SDS), waist/hip-ratio, waist circumference (WC) and skinfold thickness. Methods The study cohort consists of 115 individuals between the age of 9 and 15 years, recruited at Paracelsus Medical University Hospital in Salzburg (Austria) and Uppsala University Children's Hospital (Sweden). Anthropometry, blood samples, and oral glucose tolerance tests followed standard procedures. MRI examinations were performed to determine visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT). Results BMI and WC showed slightly stronger associations with the reference standard VAT (r=0.72 and 0.70, p<0.01, respectively) than Hudda-Index (r= 0.67, p<0.01). There is an almost perfect linear association between BMI and Hudda-Index. Accordingly, BMI and Hudda-Index both showed an acceptable association with cardiometabolic parameters. VAT was strongly associated with markers of liver status (LFF r=0.59, p<0.01) and insulin resistance (HOMA-IR r=0.71, p<0.01) and predicted metabolic dysfunction-associated steatotic liver disease (MASLD). Conclusion BMI, although an imperfect measure, remains the most reliable tool and estimates cardiometabolic risk more reliably than other anthropometry-based measures.

Associations of maternal sedentary behavior and physical activity levels in early to mid-pregnancy with infant outcomes: A cohort study.

Physical activity during pregnancy is beneficial for the woman and the fetus. However, non-objective methods are often used to measure physical activity levels during pregnancy. This study aimed to evaluate objectively measured maternal early to mid-pregnancy sedentary behavior and physical activity in relation to infant well-being. This cohort study included 1153 pregnant women and was performed at Uppsala University Hospital, Uppsala, Sweden, between 2016 and 2023. Sedentary behavior and physical activity levels were measured by accelerometers during 4-7 days in early to mid-pregnancy. Outcome measures were infant birthweight standard deviation score, small-for-gestational-age, large-for-gestational-age, preterm birth (<37 weeks' gestation), spontaneous preterm birth, iatrogenic preterm birth, Apgar <7 at 5 min of age, umbilical artery pH ≤7.05, and admission to the neonatal intensive care unit (NICU). There were no associations of sedentary behavior and physical activity levels with infant birthweight standard deviation score, small-for-gestational-age, or large-for-gestational-age. After adjustment for BMI, age, smoking, parity, maternal country of birth, and a composite of pre-pregnancy disease, the most sedentary women had higher odds of preterm birth (adjusted odds ratio (AOR) 2.47, 95% confidence interval (CI) 1.17-5.24, p = 0.018), and NICU admission (AOR 1.93, CI 1.11-3.37, p = 0.021) than the least sedentary women. The most physically active women had lower adjusted odds for NICU admission (AOR 0.45, CI 0.26-0.80, p = 0.006) than the least physically active women. Objectively measured levels of sedentary behavior and physical activity in early to mid-pregnancy were not associated with standardized infant birth size. Sedentary behavior was associated with an increased likelihood of preterm birth and NICU admission, while high level of physical activity was associated with a decreased likelihood of admission to NICU.

Sex-specific socioeconomic risk factors for spontaneous subarachnoid hemorrhage-a case-control study during the 5 years before ictus.

There is a difference in the incidence of spontaneous subarachnoid hemorrhage (SAH) between sexes, with the majority of cases occurring in female patients. Although this phenomenon has been studied from a medical perspective, the reasons for the predominance of female cases are still unclear. Non-medical factors, such as a patient's socioeconomic situation, can differ between female and male patients, with health implications. The aim of the study was to identify socioeconomic profiles for both sexes that may be vulnerable to developing SAH. This information could potentially be used for active preventive health efforts. This study was based on a 7-year consecutive cohort of 890 patients with SAH treated at Uppsala University Hospital, along with a sex- and age-matched 5:1 control group from Statistics Sweden. The collected information included demographic data, income that was analyzed through "earnings" (EAs), which is defined as the sum of income and other economic compensations related to work, and "disposable income" (DI), which is the net amount that an individual can use. Pension and sickness-related absence from work were measured using early pension (EP), old age pension (OAP), sickness absence (SA), and disability pension (DP). Univariate and multivariate analyses were used. Among the women, the socioeconomic risk profile for SAH included lower education, unemployment, being registered as living single, residing in a sparsely populated municipality, and increased age. For the men, the risk profile included residing in a sparsely populated municipality and changes in civil status. Both women and men with SAH had lower EAs and DI compared to the controls. Notably, a significantly higher proportion of the women with SAH received DP compared to the controls. Residing in a sparsely populated area was associated with an increased risk for SAH for both women and men. The women with SAH were more economically vulnerable, whereas the men faced a different type of vulnerability related to changes in civil status. We suggest that healthcare organizations use this information to identify individuals at risk and actively implement preventive measures according to stroke guidelines for both groups.

Massive parallel sequencing-based non-invasive prenatal test (NIPT) identifies aberrations on chromosome 13

ObjectiveWe report data of non-invasive prenatal testing (NIPT) at Uppsala University Hospital between 2017–2022. Furthermore, we illustrate the potential capacity of massive parallel sequencing-based NIPT beyond identification of common trisomies. MethodsMaternal blood samples were analyzed using the Verifi NIPT or VeriSeq NIPT assays. Diagnostic testing, performed on amniotic fluid samples, included QF-PCR, microarray (SNP-array) and metaphase FISH. ResultsAmong 4532 NIPT tests performed between 2017–2022, 125 samples (2.76%) showed increased risk for trisomies 13, 18, 21 and sex chromosome aneuploidy. For three patients with normal NIPT result further microarray indicated other types of chromosomal rearrangement which were not analyzed by NIPT. For another patient (case 1) the Verifi NIPT indicated trisomy 13. Fetal fraction (FF) was estimated to be 10%. Confirmatory microarray detected a segmental duplication on chromosome 13, as well as a terminal duplication and a terminal deletion on chromosome 10. A complex karyotype was observed in the fetus with metaphase FISH. In the second case the VeriSeq NIPT indicated trisomy 13. FF was estimated to be 11%. Confirmatory microarray detected a mosaicism of trisomy 13 in 30 % of cells. ConclusionThis study illustrates detection of peculiar abnormalities of chromosome 13 and supports potential to screen copy number variations with genome-wide NIPT.

Scholars and Literati at the University of Uppsala (1477–1800)

This note is a summary description of the set of scholars and literati who taught at the University of Uppsala from its inception in 1477 to 1800. For more detailed information about these individuals, please visit the comprehensive database available at https://shiny-lidam.sipr.ucl.ac.be/scholars/.

Understanding the heterogenicity of unicoronal synostosis – A morphometric analysis of cases compared to controls

BackgroundPreoperative severity of unicoronal synostosis varies greatly and involves the frontal bone, skull base and orbits. Degree of deformity affects long-term morphological and functional outcome after surgery. The aim of this study was to describe the morphological heterogenicity and investigate its relation to patient-specific factors. Materials and methodsIn this retrospective cohort study, non-syndromic unicoronal synostosis patients treated between 2006-2022 at Necker Hospital, France, or Uppsala University Hospital, Sweden, were included and matched to controls. Severity of skull base, orbital and posterior skull asymmetry, degree of anterior plagiocephaly and Harlequin deformity, lateralization, head circumference, age, timing of metopic fusion and fusion of peri-pterionic sutures were investigated. ResultsNinety-five patients and ninety-three controls were included. Skull base asymmetry was linearly related to orbital asymmetry (p < 0.001), correlated with earlier CT scans (p = 0.004), anterior (p < 0.001) and posterior (p = 0.03) plagiocephaly. Posterior plagiocephaly was more common in patients (31%) compared with controls (5%) (p < 0.001). A patent metopic suture above nine months of age was associated with severe Harlequin deformity (p = 0.04) and lower head circumference when fused (p = 0.03). Fronto-sphenoidal suture fusion was associated with later CT scans (p < 0.001) and less skull base asymmetry (p = 0.002). Spheno-parietal fusion was correlated with decreased skull base asymmetry. Right lateralization was more common in females. ConclusionHeterogenicity of unicoronal synostosis seems to be predominantly explained by variability in skull base morphology. Peri-pterionic fusions might limit deformity.

Fragility of becoming together: renewing hope through letter writing

ABSTRACT Our writing departed from frustration and discomfort with how academia and society are addressing the pressing sustainability problems we face as humanity. We expressed and explored this frustration through a circle of letter writing. We are a collective of people who have relationships to the master’s program Sustainable Management at Uppsala University in Sweden. Through our readings of Kristeva and Arendt, we developed the notion of becoming together, and by writing letters to each other, we found a way to reconnect with hope. There is a sense of community and ‘real’ exploration when we write together. In offering letter writing as collective writing, we also hope to reach out to those who feel the constraints of academic writing within predefined boundaries and genres. Our goal is to explore how we can use our writing as a way of being differently in academia.

Atten‐SEVNETR for volumetric segmentation of glioblastoma and interactive refinement to limit over‐segmentation

AbstractPrecise localization and volumetric segmentation of glioblastoma before and after surgery are crucial for various clinical purposes, including post‐surgery treatment planning, monitoring tumour recurrence, and creating radiotherapy maps. Manual delineation is time‐consuming and prone to errors, hence the adoption of automated 3D quantification methods using deep learning algorithms from MRI scans in recent times. However, automated segmentation often leads to over‐segmentation or under‐segmentation of tumour regions. Introducing an interactive deep‐learning tool would empower radiologists to rectify these inaccuracies by adjusting the over‐segmented and under‐segmented voxels as needed. This paper proposes a network named Atten‐SEVNETR, that has a combined architecture of vision transformers and convolutional neural networks (CNN). This hybrid architecture helps to learn the input volume representation in sequences and focuses on the global multi‐scale information. An interactive graphical user interface is also developed where the initial 3D segmentation of glioblastoma can be interactively corrected to remove falsely detected spurious tumour regions. Atten‐SEVNETR is trained on BraTS training dataset and tested on BraTS validation dataset and on Uppsala University post‐operative glioblastoma dataset. The methodology outperformed state‐of‐the‐art networks like nnFormer, SwinUNet, and SwinUNETR. The mean dice score achieved is 0.7302, and the mean Hausdorff distance‐95 got is 7.78 mm for the Uppsala University dataset.

Returning to work and health status at 12 months among patients with COVID-19 cared for in intensive care—A prospective, longitudinal study

ObjectiveIntensive care unit (ICU) stay for a serious illness has a long-term impact on patients’ physical and psychological well-being, affecting their ability to return to their everyday life. We aimed to investigate whether there are differences in health status between those who return to work and those who do not, and how demographic characteristics and illness severity impact patients’ ability to return to work 12 months after intensive care for COVID-19. Research methodologyThis was a prospective longitudinal cohort study. The participants were patients who had been in intensive care for COVID-19 and had worked before contracting COVID-19. Data on return to previous occupational status, demographic data, comorbidities, intensive care characteristics, and health status were collected at a 12-month follow-up visit. SettingGeneral ICU at the Uppsala University Hospital in Sweden. ResultsSeventy-three participants were included in the study. Twelve months after discharge from the ICU, 77 % (n = 56) had returned to work. The participants who were unable to return to work reported more severe health symptoms. The (odds ratio [OR] for not returning to work was high for critical illness OR, 12.05; 95 % confidence interval [CI], 2.07–70.29, p = 0.006) and length of ICU stay (OR, 1.06; 95 % CI, 1.01–1.11, p = 0.01) ConclusionTwo-thirds of the participants were able to return to work within 1 year after discharge from the ICU. The primary factors contributing to the failure to work were duration of the acute disease and presence of severe and persistent long-term symptoms. Implications for clinical practicePatients’ health status must be comprehensively assessed and their ability to return to work should be addressed in the rehabilitation process. Therefore, any complications faced by the patients must be identified and treated early to increase the possibility of their successful return to work.

Natural contra human sciences: the conflict between nomothetic and idiographic sciences, with special reference to S. J. Boëthius

ABSTRACT This article tackles issues central to most academic disciplines, including scientific boundary demarcation, the battle of the faculties, the theory of science, and the conflict between nomothetic and idiographic methodologies, that is, between the two main approaches to science. It does so through discovering and rethinking a Methodenstreit in Swedish political science, an academic dispute involving Professor Rudolf Kjellén, the father of geopolitics, and his greatest rival, Professor S. J. Boëthius. Shortly after retiring from the Johan Skytte Professorship at Uppsala University, S. J. Boëthius published a great but inaccessible work on state theory and its history entitled Om statslivet (On the life of the state, 1916). The book critiques the positivistic and nomothetic (law-searching) approaches of the burgeoning social sciences, which were emancipating themselves from their father, history, and becoming independent disciplines. Boëthius critiqued the nomothetic studies of history, economics, statistics, sociology, and geopolitics for overemphasizing the significance of historical, economic, statistical, sociological, and geographical environments and structures. Thus, the exponents of these new or changing disciplines were criticized for neglecting the most important driving force of human affairs in Boëthius’s mind, namely, the power of personality and individual free will.

Exploring adults’ recollections of growing up with childhood motor difficulties: a qualitative study using systematic text condensation

ObjectiveTo explore the ramifications of childhood motor difficulties, providing insights into their impact and consequences over time.DesignA qualitative study using semistructured individual interviews. Data were analysed using systematic text condensation.SettingNeonatal...

On Linnaeus’ (1764) butterfly type materials missing from the Museum of Evolution of Uppsala University (Section of Zoology) and the case of Papilio hermione

We briefly analyse the history of Queen Ulrika’s and of Linnaeus’ butterfly collections. We show that the type materials of some species were likely moved from Queen Ulrika’s to Linnaeus’ collection before 1803. We provide evidence that Honey and Scoble (2001) correctly designated the lectotypes of 101 of the 159 species listed in Linnaeus’ (1764) publication. We likewise conclude that, although it did not respect of the prevailing concept of the species, the lectotype of Papilio hermione was validly designated by Kudrna (1977); consequently, the neotype of P. hermione designated by Russell and Vane-Wright (2024) is invalid.

Outcome of a dedicated complex aortic surgery fellowship program.

Advancements in endovascular therapy, especially in complex aortic procedures, underscore the need for additional post-certification training. Dedicated post-residency vascular fellowship programs offer exposure to diverse cases, research opportunities, and professional networking. The study aims to describe and present outcomes from the complex aortic fellowship program at the Vascular Surgery Department of the Uppsala University Hospital. Nine former fellows who completed the aortic fellowship program at the Uppsala University Hospital from 2018 to 2023 were invited to take part in an anonymous 29-question survey through email. Demographic data, information about the existence of local aortic programs as well as on the types of aortic procedures performed were gained. The overall experience and impact of the fellowship were assessed using multiple interval scale questions, with a rating scale (1 excellent to 5 very poor). Finally, we provided the option to the participants to share additional feedback. Median age of participants was 34 years (IQR, 30.5-36), with 44.4% being women (4/9). There was a significant variation in the number of publications produced during the fellowship, with an overall mean of 4 papers (IQR, 2-10). Regarding the long-term impact of the fellowship, 5/9 (55.6%) of the fellows have contributed to the implementation of a complex aortic program after finishing the fellowship, providing a broad range of complex aortic procedures. All fellows (9/9, 100%) stated that the quality of the fellowship was excellent. The clinical experience 7/9 (77.8%), the academic environment 7/9 (77.8%) and the research opportunities 7/9 (77.8%) together with the mentorship 9/9 (100%) and the work environment 8/9 (88.9%), were considered of most value among the fellows. In general, the survey participants agreed that the fellowship atmosphere was suitable for learning, 9/9 (100%), and that it had a positive impact on their current practice, 7/9 (77.8%). Currently, 5/9 (55.5%) of the fellows hold a position including academic involvement. There is a universal need for additional post-certification training. The current study showed that a balanced clinical and scientific exposure to complex aortic diseases is broadly welcomed among young vascular surgeons. The extension of the fellowship to cover other disciplines dealing with complex aortic procedures can be of value.

Impact of translator mass and buoy choice on a power absorption of point absorbing wave energy converter linear generator with linear generator power take off

AbstractOcean waves have the potential to contribute to future renewable electricity production. A wave energy converter (WEC) is a technology developed to absorb the energy of the wave and convert it to another form of energy. The Uppsala University WEC (UU WEC) is a point absorber with a direct drive permanent magnet synchronous linear generator power take off. Among other parameters affecting the value of absorbed power for UU WEC are the buoy size, mass of the system consisting of the buoy and translator, and available wave energy at the site of interest. This study reviews the earlier static model that considered only static forces as the buoyancy and gravity forces and neglected all dynamic forces. The static model was proposed to simplify the early‐stage design decision. Although the static model was applied to two UU WECs of different dimensions, the present study shows that the static model is not held for certain buoy and translator dimensions. As an alternative, the dynamic model which accounts for the impact of hydrodynamic forces and various translator masses is proposed. The dynamic model is based on Cummins' equation and the linear potential flow theory, and the damping force is approximated as a viscous damper with the constant damping coefficient optimizing the absorbed mechanical power under a particular sea condition. The dynamic model is applied to four fixed buoy geometries of two shapes (cylinder and cylinder with a moonpool), each of two different dimensions, but the method can be extended to other buoy shapes and dimensions. In addition, the impact of translator mass was assessed for two sites located on the west coast of Sweden and near Gran Canaria, Spain. A translator of 10–11 t promotes 16.8% higher annual average power absorption for a cylindrical buoy compared to a translator of 6 t for the same buoy. However, heavier translators up to 15 t provide only 1.1% increase in average annual absorbed power.

An earliest Triassic riparian ecosystem from the Bulgo Sandstone (Sydney Basin), Australia: palynofloral evidence of a high-latitude terrestrial vertebrate habitat after the end-Permian mass extinction

A landmark change in terrestrial ecosystems took place after the end-Permian mass extinction (EPME). This was marked by disappearance of the iconic latest Permian Glossopteris forests in Australian continental successions dated to 252.10 ± 0.06 Ma (mega-annum). Pioneering earliest Triassic spore-producing plants then spread following catastrophic wildfires, soil erosion and algal blooms. These ruderal plant communities were later replaced by vast Dicroidium ‘seed fern’ forests, which established under warm, seasonally dry conditions. By contrast, evidence of coeval vertebrate assemblages is scarce in Australia. The Bulgo Sandstone (Narrabeen Group) fossil biota in the Sydney Basin is, therefore, important as a rare example of associated plant and animal communities from the Early Triassic. The fossils include imprints and organic remains of lycopsid roots and attributed leaves (microphylls), Dicroidium and Lepidopteris foliage, and both erythrosuchid and smaller-bodied archosauromorphs, capitosaurians and other temnospondyls, actinopterygian fishes and sharks. Here, we undertake a palynofloral analysis of the vertebrate fossil-bearing bed within the Bulgo Sandstone to determine the assemblage age and palaeoenvironment. We identified a low-diversity miospore suite that is overwhelmingly dominated by lycopsids (42%), and especially quillworts (Isoëtales/Pleuromeiales) represented by Densoisporites and Aratrisporites. Bryophyte (moss), sphenopsid (horsetail) and ground fern spores are also present. Pollen (14%) comprises forms mainly associated with voltzialean conifers. The non-taeniate bisaccate Falcisporites (Alisporites) produced by Dicroidium is comparatively rare (3%). Based on this taxic composition, we correlate the vertebrate-bearing layer of the Bulgo Sandstone with the lower part of the Protohaploxypinus samoilovichii Oppel Zone and suggest a late Induan to early Olenekian age. Calculated sedimentation rates indicate that the 400 m of sediments between the top of the Vales Point Coal and the base of the Bulgo Sandstone were laid down within a time span of 40–400 ka (kilo-annum). Furthermore, the high portion of spores (37%) implies a parautochthonous organic accumulation that would have derived from local vegetation. This was likely riparian, with Dicroidium (and associated gymnosperm) cuticles (ca 20%) being over-represented because of a deciduous seasonal cycle. Notably, the Bulgo Sandstone accumulated on a high-palaeolatitude floodplain (ca 66–69°S) with dense vegetation flanking waterways that might have provided both shelter and forage for terrestrial vertebrates living less than 1 Ma after the EPME ecosystem collapse. Vivi Vajda* [vivi.vajda@nrm.se], Swedish Museum of Natural History, Svante Arrhenius väg 9, Stockholm 11414, Sweden; Benjamin P. Kear [benjamin.kear@em.uu.se], The Museum of Evolution, Uppsala University, Norbyvägen 16, Uppsala 75236, Sweden.

The value of patient-reported experience in oncoplastic breast conservation following standardized assessment and shared-decision making. A qualitative study

IntroductionPatient-reported outcomes (PROs) are emerging as a quality marker for breast cancer care provision. Patient-reported experience (PRE) is equally important, but challenges in qualitative research and documentation have resulted in limited data on oncoplastic breast-conserving surgery (OPBCS). This qualitative study aimed to explore the experiences of patients who underwent OPBCS. Patients and methodsWomen who underwent OPBCS between 2015 and 2021 at the Breast Unit of Uppsala University Hospital were followed up longitudinally using PROs. All participants were invited to share their experiences beyond PROs through a “diary.” Patients’ experiences with care, pre- and postoperatively, and other insights and thoughts that they considered important were documented and analyzed. A narrative research methodology, along with thematic analysis, was employed. ResultsOf the 122 women, 60 (49.2 %) desired to further elaborate on their experiences beyond PROs-related aspects. The most common themes included postoperative side effects, challenges responding to questionnaires, adverse effects of adjuvant treatment, external factors contributing to the preoperative and postoperative overall health status, and satisfaction with the surgery and medical staff. Specifically, 26.7 % of the respondents stated that they felt that PROs were not adequately specific and had further reflections. ConclusionsPatients did not report different experiences depending on the operative technique. Their experience focused on the perception of wholeness and potential ambiguities in the PRO questionnaires. Documenting PRE is crucial, as it enables individualized assessment following breast cancer treatment, thereby strengthening patient-centered care.

Developing education in environmental health and medicine focusing on neurology: Initiatives in Sweden (the UPRISE model), France, and Turkey

BackgroundThe role of environmental factors in neurological disorders constitutes a topic of increasing importance. Teaching in European universities should expand and update this field gaining future health professionals including adjacent disciplines. AimTo describe recent efforts to create courses that cover crucial interdisciplinary content that we believe should be included in modern education, and to adapt modern pedagogic strategies. MethodsIn collaboration with RISE (Rencontres Internationales Santé Environnement), elective courses focused on Environmental Health and Medicine (EHM) were developed, in France, Sweden, and Turkey. The courses combined classic teaching methods and new pedagogic and digital solutions to create environment-related health awareness and facilitate future interprofessional collaboration in this field. ResultsUPRISE is an innovative elective course introduced in 2020 in Sweden's Uppsala University with the participation of lecturers from several countries and aim to recruit students from different universities. A total of 45, mainly female students (68%), participated in the course. In Strasbourg, France, a novel course on environmental medicine was held in 2019–2023 and examined 90 students, of which more than half were female. Nine graduate nurse students in Turkey attended ten seminar series focused on EHM. Overall, students expressed satisfaction with the courses. ConclusionsThis European project for courses in higher education arising from RISE was met with appreciation and challenges from academic institutions.However, due to considerable efforts to introduce the EHM concept, a unique compulsory course for all medical students in the second year of training started in 2023 in all French medical faculties. In 2023, UPRISE was integrated into ENLIGHT, the European University Network to promote equitable quality of Life, sustainability, and Global engagement through Higher education Transformation.