Mid Sweden University

Background: Craniosynostosis, a craniofacial malformation characterized by premature suture fusion, poses significant challenges for surgical correction. Current methods for cranial reconstruction lack the precision required for accurate defect inpainting and depth awareness, limiting their clinical application in complex craniosynostosis cases. Objective: This study aims to develop a novel AI-driven framework to enhance the accuracy of 3D craniofacial reconstruction for pre-surgical planning, with a specific focus on large cranial defects. By integrating advanced Artificial Intelligence (AI) techniques, it enhances the accuracy and efficiency of cranial models, enabling surgeons to plan interventions with greater confidence and to potentially improve patient outcomes. The framework's computational efficiency, achieved through model quantization, further broadens its applicability in resource-limited clinical settings. Methodology: The framework begins with 3D U-Net-based segmentation, followed by depth map generation using Mixed Depth-of-Scale Models (MiDaS). Cranial defect inpainting is accomplished with Depth-augmented Vision Transformers (DA-ViT) guided by depth cues and edge detection, where MeshCNN and bilateral filtering refine the final mesh. Quantization-aware training (QAT) and post-training quantization (PTQ) reduce model size and memory footprint. Results: The framework achieved a Chamfer Distance of 0.14 mm and a Hausdorff Distance of 0.33 mm, significantly outperforming previous methods. Landmark accuracy was 0.10 mm with a consistency ratio of 0.91. After quantization, these values remained similar (0.15 mm, 0.35 mm, and 0.11 mm, respectively), while inference time decreased by 20% (from 35 ms to 28 ms), and memory usage dropped from 12 GB to 5 GB, allowing deployment on mid-range Graphics processing Unit (GPU). 

Microplastic pollution represents a significant environmental challenge, as microplastics accumulate in effluents and soils, causing serious risks to ecosystems and human health. Efficient removal of these contaminants is essential to mitigate their potential adverse effects. This review summarizes and critically analyses current methods for the removal of microplastics from effluents and soils, focusing on their effectiveness, advantages, and limitations. Conventional techniques—including filtration, flotation, chemical coagulation, flocculation, and adsorption—are discussed in the context of wastewater treatment and soil remediation. Emerging approaches, such as flocculation processes with special focus on the application of bio-based flocculants, are also highlighted as promising solutions. Key challenges in microplastic removal, including the diversity of microplastic types, their small size, and the complexity of environmental matrices, are addressed. This work intends to contribute to the urgent need for further research to develop more efficient and sustainable strategies for microplastic removal from environmental systems. 

This article contributes to a deeper understanding of how the background and motivation of PhD students who are simultaneously employed at firms may influence their ability to bridge academia and industry during their education. These students pursue collaborative research projects, which are an understudied yet potentially important form of academic engagement with industry. Our qualitative study is based on interviews with fifteen firm-employed PhD students, selected from one Swedish university, in a field of engineering. Our analysis identifies three modes of entry for firm-employed PhD students – namely supervisor-initiated, master’s thesis-initiated, and employee-initiated projects. We propose that these modes of entry reflect the variation in students’ ability to play a dual boundary spanning role for both the university and the firm. Future research should address how PhD students play an active role in developing academic engagement with industry, as well as the outcomes of projects from these three modes of entry. 

Previous research has indicated that listening comprehension is affected by both linguistic and emotional prosody. Similarly, listening to natural speech (human voice) benefits listening comprehension more than synthesised speech (text-to-speech). The current study aimed to further investigate the effect of prosody on listening comprehension and its impact on memory performance in four different prosody conditions: natural speech (control); synthesised speech, and two manipulated human voice conditions (manipulating lexical stress and prosodic phrasing respectively). Crucially, we measured both immediate and delayed (one-week follow-up) recall of the content. Participants listened to four audio files playing different narrated texts read in each of the four prosody conditions (natural speech, synthesised speech, lexical stress, and prosodic phrasing). The participants then answered multiple-choice questions about the content of said texts. After one week, they answered the content-based multiple-choice questions again. The results showed that listening to the information in the unmanipulated human voice (natural speech) led to better memory retention compared to the other conditions in the immediate recall, but no differences between the conditions were found one week later. The findings indicate that while natural speech initially leads to better comprehension, this advantage may not persist over time. 

Silicon is a leading candidate for next-generation lithium-ion battery anodes thanks to its high theoretical capacity, yet its use is restricted by severe volume expansion and rapid capacity fading. A further challenge is that many approaches to stabilize Si rely on hazardous or complex syntheses.

This thesis presents a green, hydrofluoric acid-free thermochemical route to engineer porous silicon microparticles using urea as an etching agent. The process combines chemical reactions and mechanical stress from urea decomposition, producing mesoporous networks while maintaining crystalline integrity. Under favorable conditions, surface areas up to ~27 m2 g-1 were achieved, along with stabilizing Si–O and Si–N surface species confirmed by structural and chemical analyses.

Porous silicon was then incorporated into graphite composites for lithium-ion battery anodes. Electrodes with 10-20 wt% porous silicon delivered stable specific capacities of 630-880 mAh g-1 after 100 cycles, more than doubling untreated silicon composites and tripling pure graphite, while maintaining coulombic efficiencies above 98%. Higher silicon loadings caused instability, whereas rate tests showed porous silicon retained ~70% of its capacity at 2C.

These results establish urea-assisted porosification as a sustainable path toward practical silicon anodes and highlight the role of porosity in enabling stable, high-capacity batteries. Future work will focus on optimizing porous silicon as a stand-alone active material and performing postmortem analyses to clarify degradation mechanisms and the role of porosity in electrode stability.

Background: The Childhood Trauma Questionnaire-Short Form (CTQ-SF) is a widely used and standardized questionnaire designed to assess five types of childhood abuse. The CTQ-SF demonstrates good validity and reliability. The aim of this study was to assess the validity and reliability of a Dari-translated version of the CTQ-SF. Method: A convenience sample of 240 undergraduate Dari-speaking students at Herat University, Afghanistan, completed an online survey that included the CTQ-SF and the Depression Anxiety Stress Scale (DASS-21). To calculate test-retest reliability, a sub-sample of 44 individuals completed the CTQ-SF again within two weeks. Results: The results from a confirmatory factor analysis indicated that the five-factor structure of the CTQ-SF demonstrated acceptable fit to the data (χ2/df = 1.98, CFI = .90, RMSEA = .06). Furthermore, CTQ-SF showed a moderate positive association with depression, anxiety, and stress (r(238) = .43 - 0.49, p < .05), a strong test-retest reliability, (r(42) = .74, p < .05), and excellent internal consistency (α = .92). Conclusion: The results support the five-factor structure of the CTQ-SF and, together with strong psychometric properties, suggest that the Dari version is reliable for assessing childhood maltreatment. 

The effectiveness of Environmental Assessment (EA) has been intensively discussed in academia and practice. However, few studies provided a longitudinal analysis of a country or examined in-depth the interactions with the institutional context. This article aims to contribute to the understanding of EA-effectiveness by examining the interaction of EA with planning and decision-making institutions. Therefore, we present an in-depth historical analysis of how EA together with the planning and decision-making system evolved over time, using Estonia as a case. We developed an analytical framework to analyse the various effectiveness dimensions of EA (procedural, substantive, transactive, legitimacy, and knowledge& learning) and their interactions with the broader institutional setting of planning and decision-making, and conducted document analysis (of regulations, policies and evaluations), interviews and a focus group, reviewing the period between 1988 and 2024. Important findings include that the dominance of the effectiveness dimensions is dynamic characterized by the interaction between the EA-system and the broader institutional setting of the planning system. Furthermore, there is interaction between the different dimensions of effectiveness over time. This means that EA effectiveness cannot be fully understood by examining one single effectiveness dimension nor by considering EA in isolation; the broader institutional context must be considered. To improve EA effectiveness, it is crucial to acknowledge this, and to address multiple effectiveness dimensions as well as the broader institutional setting. Perhaps the key to enhancing EA effectiveness lies beyond EA itself, which aligns with its original role as an instrument to aid decision-making and planning. 

The objective of this study was to explore the stigma among attendants (close relatives or other caregivers) who brought patients with mental illness to the selected mental health facilities in Bangladesh. This mixed-method study was part of a nationwide survey where respondents were conveniently selected. Cross-sectional data were collected from 176 attendants of patients with mental illness, and qualitative data were collected from 40 respondents. Quantitative data were collected in hand-held tablets using the Day’s Mental Illness Stigma Scale questionnaire. Qualitative data was collected in recorders, using a semi-structured guideline. The attendants had more stigma around the patients’ ability to maintain relationships, hygiene and discretion regarding their illness, with the highest level of stigma towards hygiene issues (score: 5.4). There was more positive attitude towards the treatability, curability, and recovery of the patients due to faith in the professional expertise of the service providers at mental health facilities, with the least level of stigma towards professional expertise (score: 6.4). Older people, females, and educated attendants were generally less stigmatized towards patients with mental illness than their counterparts. This study found that more stigma was present around the domains’ relationships, hygiene, anxiety, and visibility, while less stigma was present around the domains’ treatability, curability, and recovery of the patients. Further studies can be conducted to understand the effect of various factors on stigma, to aid in the development of interventions and counselling frameworks. 

This study investigates how different camera perspectives presented in digital rear-view mirrors in vehicles, also known as Camera Monitor Systems, impact drivers’ distance judgment and decision-making in dynamic driving scenarios. The study examines (1) the effects of field of view and (2) camera height on drivers' ability to judge distances to rearward vehicles and to select safe gaps in potentially hazardous situations. A controlled lab-based video experiment was conducted, involving 27 participants who performed distance estimations and last safe gap selections using a simulated side-view mirror display. Participants viewed prerecorded driving scenarios with varying combinations of field of view (40°, 76°, 112°) and camera heights (1 meter, 2.3 meter). No significant effects were found for camera height, but wider field of views led to more accurate distance estimations. However, the use of a wider field of view also increased the risk of potentially dangerous overestimations of distance, as evidenced by the last safe gap results. This suggests that a wider field of view leads to the selection of smaller and potentially risky gaps. Conversely, narrow field of views resulted in underestimations of distance, potentially leading to overly cautious and less efficient driving decisions. These findings inform Camera Monitor Systems design guidelines on how to improve driver perception and road safety, to reduce accidents from vehicle distance misjudgments. 

The International Telecommunication Union has a project for developing objective quality models called Parametric Bitstream-Based Quality Assessment of Cloud Gaming services. The model will be divided into an interaction quality module and a video coding impairment module. To evaluate these two modules an experimental campaign was conducted where labs from different parts of the world performed user studies to collect data for the evaluation. This paper describes an experiment for collecting data to evaluate the video coding impairment module. The analysis is based on a bootstrapping approach. 

Background

Public and patient involvement and engagement (PPIE) is increasingly valued for improving the quality and relevance of health research. Patient research partners (PRPs) offer lived experience of a previous myocardial infarction and cardiac distress that can enhance study design and implementation. This protocol describes one out of four studies in a larger project aiming to adapt and evaluate a stress recovery intervention for adults (aged < 55) after myocardial infarction with cardiac distress.

Objective

The primary aim of this study is to explore PRPs’ perceived impact on the design, implementation, and evaluation of the internet-delivered behavioral stress recovery intervention Balance in Everyday Life (iBEL), and to describe the process of their involvement in research activities. This study employs a PPIE approach to systematically involve PRP: s throughout all phases of the research project.

Methods

Five to eight PRPs with lived experiences of a previous myocardial infarction and cardiac distress will participate in a series of structured online workshops across all phases of the project. They provide feedback on intervention materials and study procedures. Data are collected using impact logs, semi-structured interviews, and questionnaires, and will be analyzed using thematic analysis.

Discussion

This study is expected to generate insights into how sustained PRP involvement can be integrated into behavioral intervention research. It will highlight how PRPs influence decision-making processes in real time, and how this aligns with scientific and practical considerations.

Conclusion

The present study provides insights into the perceived impact of PRPs on the design, implementation, and evaluation of the iBEL intervention, highlighting both effective aspects and challenges of patient involvement, and offering guidance for integrating PRP input in behavioral intervention research.

This report examines the evolution, structure, and impact of the IntegrationNetwork in Västernorrland (INA) from 1985 to 2024. Through a combination ofdocument analysis, media reviews, interviews, and statistical data, the studyexplores how INA has supported the reception and integration of newly arrivedmigrants in the region. The analysis is structured chronologically, highlights keyprojects and milestones and includes a network analysis and demographicmapping of migration patterns. The report identifies INA as a flexible,collaborative platform that has shifted from informal cooperation to aninstitutionalized regional actor. The findings emphasize the importance of localknowledge, strategic collaboration and development of joint solutions inaddressing migration challenges. Key lessons from the 40-year history of INA offervaluable insights for future integration policy and practice, both withinVästernorrland and beyond.

Background Physical activity on prescription (PAP) is a recommended method in Swedish and European primary healthcare, yet implementation remains inconsistent. This study explored barriers and strategies for strengthening PAP use in a region with low prescription rates, from the perspective of healthcare personnel and managers. Methods A mixed-methods study with an explanatory sequential design was conducted (2024) in a geographically dispersed Swedish region. Digital surveys with healthcare personnel and managers (n = 93) were analysed using uni-, bi- and multivariate analyses, followed by semistructured interviews (n = 14) analysed with qualitative content analysis guided by Normalization Process Theory (NPT). Results The survey was completed by 75 healthcare personnel and 18 managers. Most healthcare personnel (84%, n = 58/69) reported providing basic PA advice regularly, but only 16% (n = 12/74) prescribed PAPs. Physiotherapists prescribed PAP more often than other personnel (32%, n = 8/25 vs. 8%, n = 4/47; p = .018), and this remained significant in adjusted analyses (OR 4.0, 95% CI 1.01-15.83). Documentation of PAP components according to the Classification of Health Care Interventions (KV & Aring;) was generally low. Physiotherapists more often reported high or very high competence in counselling compared with other healthcare personnel (100%, n = 27/27 vs. 72%, n = 34/47; p = .003), prescribing PAP (74%, n = 20/27 vs. 36%, n = 17/47; p = .003), and follow-up (78%, n = 21/27 vs. 32%, n = 15/47; p < .001). Female healthcare personnel expressed stronger trust in PAP evidence than males (p = .013). Few personnel had received PAP training (38%, n = 28/74), and most were unaware of existing guidelines (81%, n = 61/75). Time constraints (53%, n = 41/75) and lack of guidelines (48%, n = 38/75) were the most common barriers, with older healthcare personnel (>= 46 years) more likely to report time constraints (OR 3.6, CI 1.27-10.16). Managers more often highlighted unclear purpose of PAPs and patient reluctance, whereas personnel emphasised lack of training and managerial prioritisation. Despite these differing perspectives, 69% (n = 50/72) of healthcare personnel and 75% (n = 12/16) of managers endorsed increasing PA counselling. Conclusions Strong interest in PAPs indicates favourable conditions for sustainable implementation if legitimacy-building education (coherence), tailored resources and training (cognitive participation), multilevel leadership commitment (collective action), and coordination for monitoring (reflexive monitoring) are secured. These are necessary strategic investments, transferable beyond Sweden to systems facing PAP implementation challenges.

Purpose: Artificial Intelligence (AI) is increasingly recognized for its potential in improving the detection, classification, prediction, and segmentation of colon cancer. Yet, the reliability of these applications depends on the quality and completeness of the underlying studies. This systematic review evaluates the current state of AI applications in colon cancer research, focusing on their impact on diagnostic accuracy, treatment planning, and patient outcomes. Methods: A comprehensive search was conducted in PubMed, Scopus, and Web of Science for articles published between 2020 and 2024. The quality of the included studies was assessed using standardized criteria. A meta-analysis was performed where applicable, and a subgroup analysis was conducted based on the type of AI technology (e.g., deep learning, machine learning) and its application (detection, classification, etc.). Additionally, we recorded whether each study incorporated Explainable AI (XAI) techniques or Generative AI (e.g., GANs) as part of its methodology. Results: In 80 articles, AI models showed significant improvements in diagnostic accuracy, particularly in polyp detection during colonoscopies and histopathological analysis. Deep learning approaches often outperformed traditional methods. However, clinical integration remains challenging due to data and validation gaps. Conclusion: AI holds great promise in colon cancer diagnosis and treatment. Future work should focus on integrating AI tools into clinical workflows through explainable models and standardized validation. 

This paper evaluates the use of supervised machine learning to automatically identify going concern–modified audit reports. Models based on two different classifiers—logistic regression and extreme gradient boosting—achieve strong classification performance for this task. The same classifiers, along with naïve Bayes, also demonstrate strong performance in the ancillary task of identifying audit report pages in financial reports. These results have practical implications, including the application of the presented methods for timely accounting information retrieval for users, automated peer comparison for auditors, or as a data extraction method for researchers, particularly in settings with limited audit data availability. 

In Industry 4.0 intelligent manufacturing, rolling bearings serve as core components of rotating machinery. Their health status directly impacts the safety and reliability of entire manufacturing systems. However, existing fault diagnosis methods face critical challenges in noisy environments, including layer-wise feature information attenuation, insufficient multi-scale feature capture, and limited noise robustness. Such limitations create an urgent need for high-precision and robust deep learning diagnostic techniques. To address these challenges, this study proposes Channel-Time Parallel Attention Network (CT-ParaNet). The network innovatively designs a channel-time parallel attention mechanism that synchronously processes channel and temporal feature correlations to effectively solve information degradation in serial structures. The network constructs multi-scale parallel attention residual blocks using parallel multi-branch architecture with adaptive gating mechanisms to capture and fuse multi-scale fault features. Additionally, it establishes a serial-parallel hybrid processing architecture that systematically integrates parallel attention mechanisms with multi-scale feature extraction modules for hierarchical and parallel fine processing of fault signals. Experimental results on two independent bearing fault datasets show CT-ParaNet achieves accuracies of 98.53% and 98.29%, improving by 15.84 and 16.15% points over traditional methods respectively. Under extreme − 5dB signal-to-noise ratio (SNR) conditions, accuracies remain above 87% across Gaussian white noise, impulse noise, and colored noise environments. With only 0.1 training data ratio, accuracies exceed 92% on both datasets. CT-ParaNet significantly enhances accuracy and robustness of bearing fault diagnosis in noisy environments, providing important technical support for intelligent manufacturing equipment health monitoring. 

The emphasis on digitalization has significantly affected public sector organizations, including municipalities, as they strive to improve operational efficiency, transparency, and public value. Nevertheless, historical examples reveal high failure rates in digitalization projects, often resulting in delays, financial losses, and political repercussions. These failures underscore the importance of conducting value for money (VFM) audits to ensure digitalization projects are accountable and beneficial to the taxpaying citizens. This study critically examines the work of professional auditors in VFM audits related to digitalization projects within Swedish municipalities during the 2016–2023 period. The findings suggest that these audits primarily address organizational aspects, rather than improved economy, efficiency, and effectiveness. In this context, VFM audits appear to function as standardized and time-efficient procedures aimed at providing comfort to various stakeholders, without assessing the actual efficiency gains from digitalization initiatives. A possible reason for this is that the auditors seek to make digitalization initiatives auditable, given the acknowledged challenges of evaluating such projects. Future research is therefore encouraged to further explore this pattern in VFM audits of digitalization projects, ideally incorporating the perspectives of different actors. 

Tibetan highlanders (TH) possess physiological adaptations supporting ventilation, oxygenation, and acid-base regulation with acclimatization to chronic hypobaric hypoxia. Although well-characterized at high altitude, it is unclear whether these traits are evident at low altitude, independent of environmental hypoxic stimuli. To evaluate baseline physiological differences, we compared variables related to ventilatory, blood oxygen, and acid-base balance between unacclimatized ancestral lowlanders (LL; n = 29) and TH (n = 31) residing at 1,400 m, a subthreshold altitude not expected to elicit ventilatory or renal acclimatization. Heated hand capillary blood samples were analyzed for hemoglobin ([Hb]<inf>c</inf>), oxygen content (C<inf>c</inf>O<inf>2</inf>), alveolar ventilation (V<inf>A</inf>), steady-state chemoreflex drive (SSCD), partial pressure of carbon dioxide (P<inf>c</inf>CO<inf>2</inf>), bicarbonate ([HCO<inf>3</inf>-]<inf>c</inf>), and pH<inf>c</inf>. TH demonstrated significantly higher V̇<inf>A</inf> (4.6 ± 0.4 vs. 4.8 ± 0.3 L/min; + 5.2%; P = 0.0101) and SSCD (11.9 ± 1.9 vs. 13.2 ± 1.9 arbitrary units; + 10.3%; P = 0.0127) than LL, despite equivalent Sp<inf>O2</inf> (P = 0.8882). In addition, TH exhibited lower P<inf>c</inf>CO<inf>2</inf> (37.9 ± 2.8 vs. 36.0 ± 2.5 mmHg; -5%; P = 0.0086) and [HCO<inf>3</inf>-]<inf>c</inf> (22.9 ± 1.4 vs. 21.5 ± 1.6 mmol/L; -6.1%; P = 0.0007) compared with LL, with no difference in pH<inf>c</inf> (P = 0.256). The reduction of [HCO<inf>3</inf>-]<inf>c</inf> in TH was greater than expected from passive chemical buffering alone, suggesting differential renal handling while breathing ambient air at low altitude. These findings suggest that TH maintain a distinct ventilatory and acid-base homeostatic set point at low altitude, characterized by augmented resting ventilatory drive and renal excretion of HCO<inf>3</inf>-. These traits, characterized at low altitude, suggest that developmental exposure to hypoxia and/or Tibetan ancestry is associated with developed or evolved physiological traits that optimize respiratory and acid-base homeostasis prior to and/or during high-altitude ascent. 

Rapporten beskriver den planerade verksamheten vid Friforsk – en nationell kunskapsnod för friluftsliv. Friluftsliv omfattar många olika aktiviteter och i stort sett alla i Sverige ägnar sig åt friluftsliv i någon form någon gång – många gör det mycket och ofta. Friluftslivet rymmer många värden för såväl individer, grupper- och samhället i stort genom ökat välbefinnande, hälsovinster, miljöengagemang, regional utveckling, naturkännedom och ökad beredskap. I ekonomiska termer omsätter friluftslivet i Sverige 190 miljarder kronor och bidrar till 165 000 arbetstillfällen. Samtidigt kan allt fler människor som vistas ute i naturen medföra negativa effekter på djur, natur och lokalsamhällen om det inte sker på ett hållbart sätt.

För att uppfylla friluftslivets potential krävs en stabil och vetenskapligt förankrad kunskapsförsörjning som kan förse friluftslivets aktörer med pålitliga underlag. Men vetenskapligt baserad kunskapsproduktion om friluftsliv i Sverige är idag mycket begränsad och fragmenterad. Den är splittrad på olika ämnen och lärosäten, och bärs huvudsakligen upp av enskilda forskare. Det saknas en strukturerad och långsiktig kunskapsuppbyggnad inom friluftslivet som sker i samverkan med friluftslivets aktörer.

Kunskapsnoden Friforsk ska möta de ovan beskrivna behoven. Dess syfte blir att säkerställa en stabil och vetenskapligt förankrad kunskapsförsörjning som främjar människors möjligheter att ägna sig åt friluftsliv och stödjer arbetet med att öka dess positiva och minska dess negativa effekter. För att uppfylla syftet har verksamheten tre uppgifter: att stödja produktion av kunskap, att vårda kunskap och att sprida kunskap om friluftsliv. Friforsk blir en resurs vid uppföljning av de nationella friluftslivsmålen och för att utvärdera effekterna av statens stöd till det organiserade friluftslivet. Tillämpad forskning om friluftsliv ger verksamheten en vetenskaplig grund.  Vidare kommer Friforsk arbeta med strategiskt valda teman i samverkan med aktörer som företräder områden som angränsar till friluftslivet, exempelvis idrotten, folkhälsan, skogen, naturvården och beredskapen.

Menstrual health represents a state of complete physical, mental, and social well-being in relation to a woman's menstrual cycle. From a health literacy perspective, knowledge acquisition and expertise are dependent upon the degree to which an individual can find, access, understand, critically analyse, and apply health information. Therefore, menstrual health literacy can be used to describe the state of knowledge acquisition and application specific to menstrual health-related issues. Menstrual health literacy is low among female athletes, their coaches, and practitioners, and few evidence-informed education or implementation strategies exist to improve menstrual health literacy in sport. Moreover, athletes seldom discuss their menstrual cycles or hormonal contraceptive use with their coaches, despite experiencing menstrual symptoms and/or disturbances and perceiving their menstrual cycles/hormonal contraceptive use to affect performance. Barriers to communication about menstrual cycle-and hormonal contraceptive-related topics include a perceived lack of knowledge among athletes, coaches, and practitioners, concerns about how conversations on these issues will affect interpersonal relationships, and a lack of formal and informal discussion forums. Whilst evidence relating to the effects of the menstrual cycle phase and hormonal contraceptive use on training and performance is currently limited, with existing studies often lacking methodological rigour, impactful steps can still be made to support female athletes. This cornerstone review highlights the current state of menstrual health literacy among athletes, coaches, and practitioners, and provides recommendations for improving menstrual health literacy in sport.

Patient safety culture is a critical component of health care quality in nursing homes. Surveys on patient safety culture can be helpful tools to evaluate care. The aims of the study were to translate a survey on patient safety culture, namely, the Nursing Home Survey on Patient Safety Culture (NHSOPS 1.0) from English into Swedish and to adapt it to Swedish conditions and to validate the translation. The survey was translated into Swedish following the TRAPD translation process —translate, review, adjudicate, pre-test, and document, as suggested by the provider of the original survey. The validity of the items was measured by Cronbach's alpha. Some changes in wording were made according to Swedish conditions. A pre-test with staff working in nursing homes showed adequate results for the translation. In this pilot study, all items and questions were considered valuable for measuring patient safety and were therefore retained in the Swedish version. The translated survey may be a helpful tool for measuring patient safety in nursing homes and prompting staff to reflect on their workplaces.

Aim To explore aspects of interpersonal relationships in palliative care nursing, focusing on confidential conversations between patients and registered nurses (RN).Design A qualitative study employing focused ethnography.Methods Data were collected through unstructured participant observations, field notes and interviews with patients and RN in specialist palliative care. Data were analysed using reflective thematic analysis.Findings Confidential conversations in palliative care are founded on trust that is fragile and develops dynamically through consistent interactions. Small talk, presence and silence are essential for initiating and maintaining trust and the interpersonal relationship. The environment, patient condition and RN emotional presence and competence shape these conversations. As the relationship evolves, conversations adapt to the patient's changing needs. Missed signals or interruptions can disrupt flow, but the potential for repair remains, allowing for restoration and strengthening of trust and connection.Conclusion Confidential conversations in palliative care are grounded in fragile, dynamic trust, necessitating ongoing presence, sensitivity and adaptability from RN. To support these interactions, healthcare environments must prioritise privacy, relational continuity and communication training. Future research should investigate how organisational structures and clinical settings influence confidential conversations.Implications for the Profession and/or Patient Care Healthcare environments should facilitate confidential conversations by ensuring relational continuity and minimising distractions. Communication training that emphasises presence and management of silence can strengthen nurse-patient relationships, enhancing patient care and emotional support.Impact This study explores key aspects of confidential conversations in palliative care, emphasising trust and emotional sensitivity. It addresses a research gap in palliative care using rare observational methods to deepen understanding of nursing relational aspects. The findings offer practical guidance for enhancing communication and relational skills, informing training and policy development and ultimately, improving emotional support and care.Reporting Method Findings are reported in accordance with the Consolidated Criteria for Reporting Qualitative Research guidelines.Patient or Public Contribution This study did not involve patient or public participation in its design, conduct or reporting.

It is difficult to find optimal solutions to multi-objective optimization problems, because they involve balancing conflicting objectives under complicated constraints. Metaheuristics are widely applied for solving problems, since they are easy to apply and may produce promising near-optimum solutions. However, achieving an optimal balance between exploration and exploitation still remains a key challenge, especially in high-dimensional and constrained design spaces. This research work presents MOGWO2Arc, a new multi-objective optimizer utilizing a dual-archive strategy to promote solution diversity and convergence. Eight benchmark truss structure optimization problems were used to test the suggested algorithm with the objectives of minimizing weight and compliance subject to safe stress levels. Other constraints, such as dimensional constraints, standard safety codes, and unique cross-sectional domains, were also considered. The hypervolume, generational distance, inverted generational distance, and spacing were used as the key parameters to compare performance with eight state-of-the-art optimization algorithms. Based on the outcome of the Friedman rank test, MOGWO2Arc outperformed the competing approaches, especially when utilized to solve large-scale structural optimization problems, producing higher-quality solutions at significantly lower computational costs. MOGWO2Arc also provides a powerful and efficient way to solve complex multi-objective structure optimization problems by promoting exploration and diversifying Pareto-optimal solutions across decision and objective spaces.

PurposeResearch has underscored the significance of quality culture in relation to employee performance and stakeholder value. This study aims to develop and assess an extended quality culture framework to align quality culture with organisational values and further identify positions and transformations of quality cultures in organisations through behaviours. Through knowledge of the variation among employee behaviour preferences, it is plausible to increase the organisation's awareness of its current progress in quality cultural transformations.Design/methodology/approachThis study employs a holistic multiple-case study design, encompassing three cases in a county that encompasses 12 municipalities. Drawing on prior research, an extended quality framework was tested through a survey to test and evaluate constructs that measure quality culture using vignettes based on organisational values operationalised as behaviours.FindingsThis study examines the relationship between organisational values and quality culture. It extends quality culture measurement research by operationalising an organisation's values as sustainable behaviours in practice. Combining preferences of behaviours with variations among employees across different values can increase the awareness of the organisation's progress in quality culture transformations with four different positions in terms of their status. Moreover, these four combinations follow different positions with respect to transformations along a quality culture continuum.Originality/valueThis study contributes to the discourse on interpreting and managing quality culture by focusing on organisational values and their expression as behaviours. Moreover, it contributes to the micro-level aspects of quality culture, linking values to the core operations to foster sustainable behaviour within organisations.

The Mountain Gazelle Optimizer (MGO) is a newly emerging nature-inspired metaheuristic algorithm based on mountain gazelles' regionally and adaptively directed behavior. It is intended to solve complex optimization problems with an effective balance of exploration and exploitation. The MGO has several benefits: it is scalable, adaptable, parameter-free, capable of multi-objective optimization , and offers real-world application opportunities. The drawbacks of MGO include susceptibility to premature convergence, high computational complexity, and limited scalability to solve higher dimensional problems. The focus of the work is to investigate the development of MGO in the optimization field thoroughly. This review addresses the capabilities and limitations and express its growing relevance across applications. The investigation will refer to 89 studies published on MGO, categorized into four headings: adapted, variants, hybrid, and enhanced, contributing 37, 3, 33, and 27%, respectively, of all studies. This review is to supply researchers and practitioners with a comprehensive overview of potential optimization strategies. The review will compile and synthesize relevant studies to portray potential development opportunities for MGO and practical applications.

Suicide is one of the leading causes of death in countries experiencing widespread social and psychological crises. In recent years, Afghanistan has faced numerous challenges that have severely affected individuals' mental health. However, there has been no reliable and validated self-report tool with sufficient sensitivity and specificity to identify Afghans at risk of suicidal behavior. This study aimed to translate and validate the Suicidal Behaviors Questionnaire-Revised (SBQ-R) in a sample of Afghan university students using a descriptive and validation-based design. The study included 230 undergraduate students from Herat University during the 2024-2025 academic year, selected through convenience sampling, who completed an online Qualtrics survey. To assess test-retest reliability, 40 participants completed the SBQ-R again after two weeks. The SBQ-R and the Depression Anxiety Stress Scale-21 (DASS-21) were administered. Confirmatory factor analysis indicated a good fit for the one-factor model (chi(2)/df=1.23, CFI=0.99, RMSEA=0.03). Criterion validity showed significant positive correlations between the SBQ-R and depression, anxiety, and stress (P<0.05). Internal consistency and test-retest reliability were both satisfactory. Overall, the Dari version of the SBQ-R demonstrated strong psychometric properties and is recommended as a reliable instrument for research and clinical assessment among Afghan populations.

Multiple-mandate holding (MMH), i.e. the simultaneous exercise ofat least two directly elected political functions, is a widespread butcontroversial political practice. Theoretically it can be argued toconstitute a valuable personal vote earning attribute (PVEA)among candidates due to its’ combination of the incumbencyand local background traits, but previous scholarship has alsoshown that citizens tend to be quite critical towards it. However,whether and how the practice of MMH affects voter preferenceshas not been previously empirically explored. The purpose of thisstudy is thus to contribute to this line of research by exploringthe potential causal impact of the practice of MMH, making avaluable empirical contribution to scholarships of voterpreferences and candidate traits. We examine this question byutilising a conjoint survey experiment carried out in 2023 inFinland, a country that recently (in 2022) established a newregional government tier, thereby enabling the possibility forpoliticians of being simultaneously elected at three differentinstitutional levels. The results of the study confirm that MMH asa candidate trait has the potential to be disadvantageous forindividual candidates during elections.

Fall injury statistics are scarce in low- and middle-income countries like Nepal. This study examines fall-related injuries and associated risk factors to address critical gaps in injury epidemiology and prevention. Data was collected from 18 August to 17 September 2023 from the emergency and inpatient departments of seven hospitals in Nepal, one from each province. A structured questionnaire, based on the WHO Guidelines, was used for data collection from patients or caregivers. Among 1,175 injury patients, 38.6% sustained nonfatal fall injuries. Males comprised 58.9% of cases. Most falls (93.6%) were unintentional, and 64.5% occurred at home. 32% of all fall injury patients were children under 15 years, and 17.7% were those aged 65 years or older. Farmers and students accounted for 58.5% of all falls. Injured limbs were most common, followed by head injuries (21.7%). Regression analysis revealed disparities in fall injuries associated with province, geography, place of residence, occupation groups, castes, and gender of the patients. Marital status and household income were not found to be significantly associated with falls. Males were more likely than females to receive immediate care after fall injuries. Falls occurring at home disproportionately affect children, the elderly, and those involved in agricultural occupations. The findings highlight the urgent need for implementing targeted interventions, particularly in domestic and rural settings, and addressing inequalities in injury treatment. This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicine

Peatland trees are valuable archives of paleoclimatic information; however, gaps persist in understanding the relationships between tree growth, peatland hydrology, and hydroclimate variables. While previous research in peatlands has mainly focused on tree-ring widths (TRW), yielding inconclusive results, the potential of stable carbon (δ13C) and oxygen (δ18O) isotopes in tree rings remains unexplored. In this study, we develop TRW, δ13C, and δ18O chronologies of Scots pine trees located in a Swedish peatland and a reference site on bedrock with a mineral soil layer. We assess their responses to hydroclimate conditions and evaluate their potential for reconstructing hydroclimate variations. Our findings show significant differences in mean TRW and δ13C values between the peatland and reference sites. Moreover, while TRWs do not exhibit distinct common patterns between sites, both δ13C and δ18O site chronologies show uniform year-to-year variations across all sites. Some discrepancies for TRW and δ13C site chronologies emerge, however, regarding multi-decadal trends. While the climate sensitivity of TRW is weak and non-homogenous, the δ13C and δ18O peatland and reference chronologies contain robust and consistent signals, with a maximum sensitivity to water table, precipitation, and vapor pressure deficit (VPD) variations during summer. Both δ13C and δ18O chronologies show stable relationships with three key hydroclimate variables over time. In conclusion, while TRWs from living peatland pines at our sites have limited potential to record high-frequency hydroclimate information, δ13C and δ18O chronologies can serve as excellent proxies for the reconstruction of past hydroclimate changes. 

Lung cancer is a critical health issue, and early detection is crucial for enhancing patient outcomes. This study presents a novel framework for generating three-dimensional (3D) representations of lung tumors from computed tomography (CT) scans, addressing three key challenges in the analysis process. Firstly, we address the precise segmentation of lung tissues, which is complicated by a high proportion of non-lung pixels that skew the classifier. Our method uses a customized generative adversarial network (GAN) enhanced with an off-policy proximal policy optimization (PPO) strategy. This strategy enhances segmentation performance by addressing inherent classifier biases and implementing a reward system to more accurately identify minority samples. Secondly, the framework enhances tumor detection in the segmented areas by employing a specialized GAN trained with an adversarial loss, which helps the generator create tumor regions that match real ones in both shape and internal features, even when contrast is low or boundaries are unclear. Thirdly, after tumor detection, the EfficientNet model extracts essential features for 3D reconstruction. The features are then enhanced by a spatial attention-based transductive long short-term memory (TLSTM) network for better performance. The TLSTM network enhances performance by assigning greater weight to samples near the test point within a transductive learning framework. Tested on the Lung Image Database Consortium Image Collection (LIDC-IDRI) dataset, our methodology achieved Hausdorff distance (HD) and Euclidean distance (ED) metrics of 0.648 and 0.985, respectively, indicating superior performance compared to existing methods. Our research introduces a clinical tool that significantly boosts the capabilities of radiologists in diagnosing and planning treatment for lung cancer. Code is publicly available at https://github.com/ZhisenHe/3D-representation/. 

Background: Whole-body heat exposure, such as sauna bathing or hot water immersion (HWI) has been shown to induce various physiological adaptations that can improve athletic performance. However, the effects of post-exercise heat exposure on acute recovery and promoting training-induced performance adaptations are not well understood. The aim of this systematic review was to summarise the current evidence on the effects of post-exercise heat exposure on physical performance in healthy adults. Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic search for articles was conducted in December 2023 and updated in June 2025 using the PubMed, SPOLIT, Medline, and SPORTDiscus databases. Eligible studies were randomised or crossover trials comparing whole-body post-exercise heat exposure (≥ 36 °C, e.g., hot water immersion to at least sternum level, or sauna bathing) to passive or placebo recovery. The risk of bias of the included studies was assessed using the Cochrane Collaboration Risk of Bias Tool version 2. Only studies that provided results on maximal physical performance outcomes in healthy adults were included. Results: Fourteen studies, including a total of 194 participants, met the inclusion criteria. Nine studies investigated acute effects after heat exposure and five were long-term training intervention studies. The acute studies reported uncertain results, with studies showing no effects (n = 4), beneficial (n = 4), or adverse (n = 1) effects of post-exercise heat exposure on performance recovery. The chronic studies suggested that post-exercise heating may improve running performance, at least in hot conditions. However, repeated heat exposures had no effect on cycling performance or VO<inf>2</inf>max. The overall quality of the evidence was low to moderate. The heterogeneity of study designs, heating protocols, exercise modes, performance outcomes and recovery times precluded meta-analysis. Conclusion: Based on the current evidence, it is not possible to draw definitive conclusions about the effects of post-exercise heat exposure on recovery and physical performance development. Additional high-quality studies are needed to determine the optimal heat exposure methods and recovery strategies for different types of training and performance outcomes. 

This work investigates microstructural and mechanical transitions in multi-material assemblies of American iron and steel institute 316L stainless steel and V4E tool steel, fabricated using a dual-hopper layer alternation strategy via electron beam powder bed fusion (PBF-EB). Two types of layered transitions are produced: alternating transition and alternating incremental transition (AIT). The assemblies are characterized using electron backscattered diffraction and high-speed nanoindentation (HSN), with mechanical phases extracted via Gaussian mixture modeling applied to nanoindentation maps. In the alternating layer sample, localized mechanical features are identified within the elongated austenite grains of 316L, and V4E is observed growing along grain boundaries at the interphase. In the AIT sample, similar interfacial features are observed, but the gradual addition of V4E layers generates a continuous mechanical gradient. Nanoindentation maps reveal increasing hardness and elastic modulus along the transition, ultimately reaching homogenized mechanical behavior in the V4E region. The study demonstrates the feasibility of producing compositionally graded steel assemblies with robust interfaces using PBF-EB. It also emphasizes the value of HSN combined with statistical clustering to resolve micromechanical heterogeneities, enabling more precise design and optimization of advanced multi-material systems.

The aim of this international meta-analysis was to quantify the predictive value of BMI for incident fracture and relationship of this risk with age, sex, follow-up time, and BMD. A total of 1667922 men and women from 32 countries (63 cohorts), followed for a total of 16.0 million person-years were studied. 293325 had FN BMD measured (2.2 million person-years follow-up). An extended Poisson model in each cohort was used to investigate relationships between WHO-defined BMI categories (Underweight: <18.5 kg/m2; Normal: 18.5-24.9 kg/m2; Overweight: 25.0-29.9 kg/m2; Obese I: 30.0-34.9 kg/m2; Obese II: ≥35.0 kg/m2) and risk of incident osteoporotic, major osteoporotic and hip fracture (HF). Inverse-variance weighted β-coefficients were used to merge the cohort-specific results. For the subset with BMD available, in models adjusted for age and follow-up time, the hazard ratio (95% CI) for HF comparing underweight with normal weight was 2.35 (2.10-2.60) in women and for men was 2.45 (1.90-3.17). Hip fracture risk was lower in overweight and obese categories compared to normal weight [obese II vs normal: women 0.66 (0.55-0.80); men 0.91 (0.66-1.26)]. Further adjustment for FN BMD T-score attenuated the increased risk associated with underweight [underweight vs normal: women 1.69 (1.47-1.96); men 1.46 (1.00-2.13)]. In these models, the protective effects of overweight and obesity were attenuated, and in both sexes, the direction of association reversed to higher fracture risk in Obese II category [Obese II vs Normal: women 1.24 (0.97-1.58); men 1.70 (1.06-2.75)]. Results were similar for other fracture outcomes. Underweight is a risk factor for fracture in both men and women regardless of adjustment for BMD. However, while overweight/obesity appeared protective in base models, they became risk factors after additional adjustment for FN BMD, particularly in the Obese II category. This effect in the highest BMI categories was of greater magnitude in men than women. These results will inform the second iteration of FRAX®.

ABSTRACT

Background: People with intellectual disability participate in organised sports to a lesser extent than people in general. The aim of this study was to explore the motivation for engaging in sports among athletes using the theoretical framework of senseof belonging.

Method: Semi-structured online interviews were carried out with athletes (N=15, 8/7 women/men, 29.5±9 years) with intellectual disabilities.

Results: The main theme ‘Empower me to grow as an athlete—adapt the support to help me develop my sport skills and social aspects’ showed that motivation, competence, perception, and opportunities were important factors for engaging in sports.Support was an important factor for creating adapted opportunities.

Conclusion: Athletes with intellectual disabilities have motivation, want to feel competent, and to be athletes who belong insports and develop as such. They also appreciate coaches giving adapted support that enhances understanding and promotesinclusion in the sport community

This licentiate thesis investigates visitor compliance with funding models for recreational infrastructure in legally and geographically open access settings, where payment is requested but not enforceable. Focusing on Swedish cross-country ski trails, the thesis examines how compliance with trail pass systems can be understood and assessed in the context of public access rights and commercial service provision. By combining qualitative interviews with cross-country skiers (Paper I) about the reasons for compliance with a quantitative data-driven triangulation to assess the compliance rate (Paper II), the thesis provides a mixed-methods perspective on compliance behaviour. The findings challenge traditional compliance theories that separate compliance in the context of private and legally enforceable goods from compliance in the context of common goods, arguing that open access products must be understood and conceptualised as a mixture of both, given that they are operating within a legal grey zone. A visualisation presents compliance in the context of private and common goods and where these domains intertwine. Social norms, including perceived peer behaviour, perceived transparency, trust, and fairness in the provider and personal conviction and reward, partly based on legal frameworks, emerge as critical interlinking factors that guide compliance behaviour in the study context. The assessment of a compliance rate can be complemented by focussing on enhancing the social norm of paying for groomed trails and perceived compliance of peers.

The thesis advances research on nature-based tourism and outdoor recreation management, working toward a better understanding of how tourism infrastructure that depends on visitor compliance can be sustainably financed using behavioural insights. It draws on compliance and behavioural theory to better understand request-following in contexts where legal enforcement is limited or absent.

The findings have practical relevance for trail providers, policy makers and tourism destination managers to consider for the framing of payment requests.

Freeride skiing and snowboarding-collectively termed competitive freeriding-have evolved from niche extreme sports into formally recognized disciplines under the International Ski & Snowboard Federation (FIS). Unlike traditional alpine or freestyle events, competitive freeriding emphasizes creative line selection, technical execution, fluidity, style, and aerial maneuvers on natural, ungroomed mountain terrain. Athletes descend complex slopes based solely on visual inspection, without practice runs, facing unique physical and psychological challenges. This perspective article outlines the competition format and judging system, identifies key physiological and biomechanical demands, and reviews essential equipment and safety considerations. Despite growing popularity and institutional recognition, scientific research remains limited-primarily focused on avalanche risk and injury incidence-while other dimensions, such as psychological resilience, creative expression, and environmental connectedness, remain underexplored. Physiologically, competitive freeriders require high levels of eccentric and explosive strength, core stability, reactive control, and anaerobic endurance to navigate variable terrain and absorb impact during aerial maneuvers. Lower-extremity injuries-particularly anterior cruciate ligament (ACL) ruptures-are a major concern. Technological advances in drone-based filming, athlete monitoring, and protective equipment are reshaping freeride competition and broadcasting. As the sport moves toward potential Olympic inclusion, the central challenge lies in embracing innovation without compromising the core values of freedom, improvisation, and connection to the mountain environment.

This study explores tannin and caffeine, natural compounds with inherent antifungal properties, as scalable treatments to enhance the physical and mechanical performance of oriented strand board (OSB). Unlike previous research that primarily focused on durability, this work evaluates the effects of these bio-based treatments on leaching resistance, internal bond strength (IB), bending properties, water absorption, thickness swelling, and vertical density profile (VDP). The results demonstrate significant improvements over commercially available OSB, particularly in mechanical performance. Post-leaching, both treatments exhibited superior IB, with tannin-treated panels achieving the highest IB value (0.27 MPa). The bending analysis revealed that caffeine-treated panels that were not subjected to leaching achieved the highest modulus of rupture (MOR, 62.54 MPa) and modulus of elasticity (MOE, 10.36 GPa). Both treatments retained significantly higher MOR and MOE values post-leaching compared to the industrial reference and untreated panels. Water absorption and thickness swelling were comparable among tannin-treated, caffeine-treated, and untreated panels but were significantly lower than those of the industrial reference, which was included for general benchmarking purposes alongside the laboratory-made control. VDP analysis showed caffeine-treated panels had the lowest density prior to leaching, whereas tannin-treated panels maintained the highest density after leaching. These findings highlight tannin and caffeine as effective and scalable treatments, providing a sustainable alternative as functional additives for industrial engineered wood product manufacturing.

Introduction The midwifery continuity of care model is well-established internationally, but it is rarely offered in Sweden. Pregnant women's interest in midwifery continuity of care has not been investigated in recent years. This study aimed to investigate the interest of pregnant women and new mothers in Sweden regarding midwifery continuity of care and to identify factors associated with this interest.Methods A national longitudinal digital questionnaire was conducted to collect background information, pregnancy-related variables, and childbirth-related variables, as well as to measure interest in midwifery continuity of care among women in Sweden. Odds ratios with 95% CIs and logistic regression analyses were used.Results Of 1697 women who responded, 68.1% expressed a strong interest in midwifery continuity of care during pregnancy, and 74.2% during postpartum. Fear of childbirth was associated with a higher interest in midwifery continuity of care during pregnancy (adjusted odds ratio [aOR] 1.75; 95% CI, 1.34-2.27). Women who had mixed or negative experiences with the care they received were also more likely to be interested in the model (aOR, 2.33; 95% CI, 1.43-3.97).Discussion Pregnant women and new mothers in Sweden show a high level of interest in midwifery continuity of care. However, current maternity services do not adequately meet these preferences, indicating a need to scale up continuity of care models, particularly for women who experience fear of childbirth and dissatisfaction with their care. Therefore, antenatal, intrapartum, and postpartum care in Sweden should be enhanced to better align with the needs and preferences of pregnant women and new mothers.

While fungi have been grown for centuries as food, cultivation knowledge rarely extends to rare fungi, usually confined to those with high biotechnology or food value. A more robust knowledge base on cultivating rare, challenging fungi may be critical for conservation, as many species face extinction. They should be cultivated for gene banks, reintroduction, and other conservation work. This study adapted mushroom growing techniques for seven threatened wood-inhabiting fungi, all red-listed in Finland and Sweden: Antrodia crassa, Antrodia infirma, Amylocystis lapponica, Skeletocutis stellae, Perenniporia tenuis, Radulodon erikssonii, and Haploporus odorus. We grew mycelium of these species (five strains each, two for P. tenuis) under various laboratory conditions. We tested wood dust supplementation (in agar), grain spawn substrate composition, gas exchange rates, two wood types (natural host and birch) on sawdust and dowel spawn, and temperature range (6.0-36.5 degrees C). We measured growth rate in all conditions and ergosterol (mycelial biomass indicator) in wood type and wood dust agar tests. We found wood dust-supplemented agar had an overall positive effect. Temperature effects varied by species, with some preferring relatively warm or cool temperatures, and some having a narrower growth range. Most species grew better on grain when vermiculite was added; gas exchange had no effect. Wood type had a variable effect, but birch was suitable in all cases, sometimes better than the natural host wood. Overall, our treatments had positive to neutral effects on mycelial growth of our fungal species.Key Points center dot Optimized laboratory cultivation methods can benefit fungal conservation and other applied mycology efforts.center dot Certain supplements for increasing media complexity or retaining substrate moisture lead to improved growth of challenging fungi.center dot Optimal conditions vary by species and strain, but general guidelines may apply more broadly, and natural habitat conditions can offer a starting point.Key Points center dot Optimized laboratory cultivation methods can benefit fungal conservation and other applied mycology efforts.center dot Certain supplements for increasing media complexity or retaining substrate moisture lead to improved growth of challenging fungi.center dot Optimal conditions vary by species and strain, but general guidelines may apply more broadly, and natural habitat conditions can offer a starting point.Key Points center dot Optimized laboratory cultivation methods can benefit fungal conservation and other applied mycology efforts.center dot Certain supplements for increasing media complexity or retaining substrate moisture lead to improved growth of challenging fungi.center dot Optimal conditions vary by species and strain, but general guidelines may apply more broadly, and natural habitat conditions can offer a starting point.