Luther University

Cancer treatment decision making (CTDM) presents important challenges among older adults due to variation in health and functional status, presence of comorbidities, differing goals/values, quality and quantity of life considerations, and limited inclusion in clinical trials. Nursing standards and guidelines call for competence in supporting CTDM and nurses advocate for greater involvement. However, clear understanding of the existing evidence to inform nursing practice is lacking. We aimed to map and synthesize evidence that provides insight into nursing practice in CTDM among older adults, with attention to nursing roles, required skills and competencies, potential barriers and facilitators, and outcomes studied. Following JBI (formerly Joanna Briggs Institute) methodology for scoping reviews, we included empirical articles that describe nursing contribution, individually or as part of a multidisciplinary team (MDT), related to CTDM for active (curative or non-curative) treatment among adults aged ≥60years diagnosed with cancer. Nine databases were searched systematically from inception to January 2024, no limits applied. Two independent reviewers screened identified records and full texts, then systematically extracted data from included articles. Basic qualitative content analysis was conducted on charted data. Of the 9582 records screened, 980 full texts were assessed for eligibility; 84 reports describing 78 studies were included. Conducted primarily in the United States or United Kingdom, studies described nursing interventions, nursing involvement in geriatric assessment and MDT meetings/clinics, and the perspectives of patients, family, and/or healthcare professionals. Although seldom the primary focus, researchers have highlighted the important roles of nurses in the CTDM process, before, during, and after consultations with physicians and MDT meetings, which require disease-specific knowledge and relational skills. MDT collaboration, training, dedicated time and space, adequate resources, and support from leadership are critical to promoting involvement, with potential impact on decision satisfaction and optimal treatment decisions. The value of nurses' involvement is endorsed by patients, family, and other healthcare professionals. Nurses play a vital role in CTDM among older adults, particularly in the MDT context. However, rigorous studies demonstrating the impact of nursing practice on CTDM outcomes among older adults are lacking. Further research is needed to inform nursing practice and interventions.

Tree species differ in how they acquire nutrients through arbuscular mycorrhizal fungi (AMF) and ectomycorrhizal fungi (EMF) symbioses, yet how these contrasting mycorrhizal strategies regulate soil microbial nutrient mobilization and its coupling to tree nutrient status remains poorly resolved. Here, using a 10-year temperate tree diversity experiment, we quantified soil microbial community structure, phospholipid fatty acid (PLFA)-derived carbon (C) sources tracing, ecoenzymatic stoichiometry, and foliar nutrient pools to test how tree diversity and mycorrhizal type control the linkage between soil microbial nutrient acquisition and foliar nutrient pools. We found that the tree mycorrhizal type exerted a dominant control on microbial community structure. AMF-associated tree mixtures (plots dominated by AMF tree species) were characterized by saprotrophic Ascomycota, which exhibited a higher contribution of root-derived C to fungal biomass, whereas EMF-associated mixtures were dominated by symbiotrophic Basidiomycota that relied more strongly on detritus-derived C. Ecoenzymatic strategies diverged consistently with these contrasting C acquisition pathways. AMF-associated soils exhibited higher C-acquiring enzyme activity and a greater vector length (an index of microbial C acquisition investment), indicating stronger microbial investment in C acquisition from soil organic matter. In contrast, EMF-associated soils exhibited lower vector angles (indicating relative microbial investment in nitrogen versus phosphorus acquisition) and significantly higher nitrogen (N)-acquiring enzyme activity, reflecting enhanced microbial N acquisition. Across all tree mixtures, fungal community composition was tightly linked to ecoenzymatic stoichiometry, and both were significantly associated with foliar N pools. Partial least squares path modelling revealed that mycorrhizal type influenced foliar N pools primarily through indirect pathways contributed by fungal community structure and microbial N-acquisition strategy. Together, these results demonstrate that mycorrhizal type governs how soil microbes channel C from the tree into N mobilization pathways, thereby regulating the strength of belowground–aboveground N coupling. Our findings reveal a mechanism by which mycorrhizal associations, rather than tree diversity alone, shape soil microbe–tree interactions in temperate forest ecosystems.

Aim: The Global Biodiversity Information Facility (GBIF) is the most prominent source of species occurrence data for modeling climate niches, but exhibits strong unevenness in its data coverage across different geographic regions. The impact of this spatial bias on the reliability of GBIF-based plant climate niches in Europe remains unexplored. This study aims to address this gap, and to investigate whether the targeted integration of additional atlas data can reduce the potential impact of the spatial bias. Location: Europe. Time period: 1950s - 2024 Major taxa studied: European grassland plant species. Methods: We analyzed the climate niches of a large number of grassland species, with diverse distribution patterns across Europe, based on a) GBIF and b) on an enriched version of GBIF with national atlas data from Eastern European countries (GBIF+), where data coverage is currently low in GBIF. We followed best practices in niche characterization, particularly by performing environmental subsampling. The accuracy in climate niche properties was determined by comparing niches based on GBIF and GBIF+ data with niches based on a careful implementation of expert range maps as reference dataset. We focused on niche optimum position and niche similarity. Additionally, we investigated how biogeographical indicators can predict variability in climate niche accuracy. Results: Most species exhibited reliable climate niche characterization using GBIF data, especially for widely distributed species. Yet, reliability decreased with continentality; that is, when species were primarily distributed in Eastern Europe. Integrating additional data did not significantly reduce this bias in niche characterization. Main conclusions: Despite the spatial bias in its records, GBIF can be used to reliably characterize the climate niches of many species in Europe if uneven sampling effort is accounted for. The laborious integration of additional data to address spatial bias does not yield the desired increase in niche reliability.

We investigated how mental contrasting, a self-regulation strategy, affects relationship problem-solving in 105 mixed-gender couples. Couples were assigned to a mental contrasting (juxtaposing the desired future with the main inner obstacle) or indulging (imagining only the desired future) condition. We reassessed problem resolution 2 weeks later. Actor-partner interdependence model analyses revealed that mental contrasting improved problem resolution over this period for problems perceived as important to resolve. Right after the intervention, we also recorded couples’ problem-solving behavior during a Zoom discussion among the partners. Men in the mental contrasting (vs. indulging) condition showed more self-disclosure, especially of feelings, attitudes, and behaviors. Women in the mental contrasting condition were more selective when suggesting solutions. Mental contrasting appears to foster problem-solving by enabling men to engage in self-disclosure, making women selective about solution suggestions, and enabling both women and men to effectively implement solutions, especially for high-importance problems.

Antiferromagnets that display very small stray magnetic fields are ideal for spintronic applications. Of particular interest are noncollinear, chiral antiferromagnets of the type Mn 3 X (X = Sn, Ge), which display a large magnetotransport response that is correlated with their antiferromagnetic ordering. The ability to read out and manipulate this ordering is crucial for their integration into spintronic devices. These materials exhibit a tiny unbalanced magnetic moment such that a large external magnetic field can, in principle, be used to set the material into a single antiferromagnetic domain. However, in thin films of Mn 3 Sn , we find that such fields induce only a partial magnetic ordering. By detecting two orthogonal in-plane components of the magnetic order vector, we can demonstrate switching along multiple easy axes in Mn 3 Sn and find that the nonswitchable fraction has a unidirectional anisotropy. Studying the switching at the nanoscale allows us to correlate the pinning behavior to crystal grain boundaries in the Mn 3 Sn nanowire structures.

Primary hyperparathyroidism is one of the most common endocrine disorders and it is only curable by surgery. This study aimed to accurately localize parathyroid adenomas (PTAs) in patients with negative results from conventional diagnostics, consisting of MIBI SPECT/CT and ultrasound, by utilizing F-18-ethylcholine-PET/ultrasound real-time fusion imaging. Fusion ultrasound is a well-established diagnostic tool that enables precise identification and localization of target structures by superimposing MRI, CT, or PET/CT with real-time B-mode ultrasound. The goal was to detect occult PTAs and enable curative targeted parathyroidectomy. A total of 49 patients with primary hyperparathyroidism were consecutively recruited from routine clinical workflows. Given negative standard diagnostics, patients were referred for FEC-PET/CT followed by FEC-PET/ultrasound. PTAs were categorized as positive, ambiguous, or negative based on FEC-PET/ultrasound findings. A retrospective data analysis was performed, examining PTA volume (ml) based on ultrasound results, SUVmax of PTAs and locoregional lymph nodes, as well as parathyroid hormone, calcium, and phosphate levels. Maximal, minimal, median, mean values, and SDs were reported. Forty-nine PTAs were identified, of which 45 were solitary, whereas 2 patients had double adenomas each. The study showed relatively high rates of ectopic PTAs (28%). No significant differences were observed in FUS-based detection rates between ectopic and orthotopic lesions. PTAs, exhibited significantly higher ( P <0.05) tracer uptake [SUVmax 4.5±2.7 (4, 1.4-11.9)] compared with lymph nodes [SUVmax 2.7±1.7 (2.5, 1.2-11.8)]. SUVmax was significantly higher in positive lesions compared with ambiguous cases ( P <0.05). No significant SUVmax difference was found for lymph nodes in ambiguous cases. FUS-based PTA volume ranged from 0.2 to 2.6ml (mean 0.5±0.5ml). Twenty-seven patients underwent surgery, and the diagnosis was confirmed in 90% of cases. This study shows that FEC-PET/ultrasound offers valuable support for preoperative localization and thus can be considered as an effective and precise method for detecting parathyroid adenomas in primary hyperparathyroidism. Because of its high time and technical demands, it is reserved for challenging cases unresolved by standard diagnostics. Future technical advances may increase its accessibility.

BackgroundAdvances in cancer care require ongoing monitoring of patient satisfaction using rigorous questionnaires. The EORTC Quality of Life Group has cross-culturally developed a patient satisfaction core questionnaire (PATSAT-C33) to be used in any hospital cancer care settings and an outpatient satisfaction module (OUT-PATSAT7) to address specific aspects of ambulatory care. This multi-center international prospective study aimed to validate the PATSAT-C33 and OUT-PATSAT7, including assessing its acceptability.MethodsPatients (N = 690) affected by any cancer site or stage equally distributed by age and gender, were enrolled in in- and out-patient cancer settings from 20 institutions, 12 countries and 5 geographic/cultural areas. Among them, 675 completed the PATSAT-C33 alongside the EORTC QLQ-C30, Oberst’s perception of care quality 5-item, and ‘intention to recommend the hospital’ 1-item. Among the 532 outpatients, 526 also completed the OUT-PATSAT7. A subset completed a two-week retest (N = 120 & 96 for the PATSAT-C33 & OUT-PATSAT7, respectively) or one-year responsiveness-to-change assessment (RCA) (N = 166 & 155). Comprehensive psychometric testing was performed.ResultsFull item completion was high (85% & 88%), 83% of patients took ≤ 20 min to complete both questionnaires (40 items); 5% of patients required help with understanding questionnaire items. Confirmatory factor analyses evidenced satisfactory fit on the eleven PATSAT-C33 and two OUT-PATSAT7 multi-item scales (CFI/TLI > 0.90; RMSEA < 0.10 and = 0.108, respectively). Internal consistency was good to excellent (all ≥ 0.80); test–retest reliability was fair (0.48, 1 scale), good (0.60–0.74, 11 scales) to excellent (≥ 0.75, 7 scales). Convergent validity was supported by correlations of ≥ 0.40 with related Oberst’s scales and < 0.30 with unrelated QLQ-C30 scales. Known-groups differences was shown for comorbidity, toxicity, global health, care expectations and intention to recommend the hospital. Change over time was captured in groups defined based on change in global health, cancer care setting, and the receipt of supportive care over the past year.ConclusionsThis study supports the psychometric robustness of the EORTC PATSAT-C33 and OUT-PATSAT7 and their promising usefulness in monitoring cancer care within and across cancer care settings from different cultures and cancer patient populations.Trial registrationClinicalTrials.gov ID: NCT05989191, August 2, 2023.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12885-025-15119-3.

Abstract In this paper we investigate large-scale linear systems driven by a fractional Brownian motion (fBm) with Hurst parameter $H\in [1/2, 1)$ . We interpret these equations either in the sense of Young ( $H&gt;1/2$ ) or Stratonovich ( $H=1/2$ ). In particular, fractional Young differential equations are well suited to modeling real-world phenomena as they capture memory effects, unlike other frameworks. Although it is very complex to solve them in high dimensions, model reduction schemes for Young or Stratonovich settings have not yet been much studied. To address this gap, we analyze important features of fundamental solutions associated with the underlying systems. We prove a weak type of semigroup property which is the foundation of studying system Gramians. From the Gramians introduced, a dominant subspace can be identified, which is shown in this paper as well. The difficulty for fractional drivers with $H&gt;1/2$ is that there is no link between the corresponding Gramians and algebraic equations, making the computation very difficult. Therefore we further propose empirical Gramians that can be learned from simulation data. Subsequently, we introduce projection-based reduced-order models using the dominant subspace information. We point out that such projections are not always optimal for Stratonovich equations, as stability might not be preserved and since the error might be larger than expected. Therefore an improved reduced-order model is proposed for $H=1/2$ . We validate our techniques conducting numerical experiments on some large-scale stochastic differential equations driven by fBm resulting from spatial discretizations of fractional stochastic PDEs. Overall, our study provides useful insights into the applicability and effectiveness of reduced-order methods for stochastic systems with fractional noise, which can potentially aid in the development of more efficient computational strategies for practical applications.