Relatively Stable Prevalence of Myopia among Swedish Children Aged 4 to 7 Years between 2015 and 2020.

SIGNIFICANCE: The global increase of myopia has caused a lot of debate the last years. Previous research of myopia in the Nordic population has shown diverse results, and only a few Swedish studies have been published in the subject the last two decades. PURPOSE: This study aimed to analyze trends in the prevalence of myopia in a population of Swedish children. METHODS: A retrospective analysis of medical records for children between 4 and 7 years of age in a region in Sweden was performed. The inclusion criterion was a first glasses prescription for myopia between 2012 and 2020. Children with other eye diseases or syndromes affecting the eye and vision were excluded. Age, sex, uncorrected visual acuity, and cycloplegic refractive values were extracted. The number of myopic children was compared with population data to calculate incidence and estimate prevalence. RESULTS: During the study period, 427 children between 4 and 7 years old in an average population of 17,200 children were prescribed glasses for myopia. The incidence for myopia increased from 0.11% in 2012 to 0.39% in 2020 ( P < .05). In 2015 to 2020, the prevalence of myopia for the same age group increased from 0.5 to 1.2% ( P < .05). Linear regression of the prevalence of myopia showed a significant increase in the age group of 7 years ( ß = 0.2%, R2 = 0.82, P ≤ .05). CONCLUSIONS: This study found a relatively stable prevalence of myopia among Swedish children aged 4 to 7 years between 2015 and 2020. The prevalence of 1.6% among 7-year-old children is not higher than in previous Scandinavian studies.

Forest biomass accumulation is an important source of acidity to forest soils: Data from Swedish inventories of forests and soils 1955 to 2010.

The input of acidity to Swedish forest soils through forestry between 1955 and 2010 is compared with the acid input from atmospheric deposition. Depending on region, input of acidity from forestry was the minor part (25-45%) of the study period's accumulated acid input but is now the dominating source (140-270 molc ha-1 year-1). The net uptake of cations due to the increase in standing forest biomass, ranged between 35 and 45% of the forestry related input of acidity while whole-tree harvesting, introduced in the late 1990s, contributed only marginally (< 2%). The geographical gradient in acid input is reflected in the proportion of acidified soils in Sweden but edaphic properties contribute to variations in acidification sensitivity. It is important to consider the acid input due to increases in standing forest biomass in acidification assessments since it is long-term and quantitatively important.

Assessing critical load exceedances and ecosystem impacts of anthropogenic nitrogen and sulphur deposition at unmanaged forested catchments in Europe.

Anthropogenic emissions of nitrogen (N) and sulphur (S) compounds and their long-range transport have caused widespread negative impacts on different ecosystems. Critical loads (CLs) are deposition thresholds used to describe the sensitivity of ecosystems to atmospheric deposition. The CL methodology has been a key science-based tool for assessing the environmental consequences of air pollution. We computed CLs for eutrophication and acidification using a European long-term dataset of intensively studied forested ecosystem sites (n = 17) in northern and central Europe. The sites belong to the ICP IM and eLTER networks. The link between the site-specific calculations and time-series of CL exceedances and measured site data was evaluated using long-term measurements (1990-2017) for bulk deposition, throughfall and runoff water chemistry. Novel techniques for presenting exceedances of CLs and their temporal development were also developed. Concentrations and fluxes of sulphate, total inorganic nitrogen (TIN) and acidity in deposition substantially decreased at the sites. Decreases in S deposition resulted in statistically significant decreased concentrations and fluxes of sulphate in runoff and decreasing trends of TIN in runoff were more common than increasing trends. The temporal developments of the exceedance of the CLs indicated the more effective reductions of S deposition compared to N at the sites. There was a relation between calculated exceedance of the CLs and measured runoff water concentrations and fluxes, and most sites with higher CL exceedances showed larger decreases in both TIN and H+ concentrations and fluxes. Sites with higher cumulative exceedance of eutrophication CLs (averaged over 3 and 30 years) generally showed higher TIN concentrations in runoff. The results provided evidence on the link between CL exceedances and empirical impacts, increasing confidence in the methodology used for the European-scale CL calculations. The results also confirm that emission abatement actions are having their intended effects on CL exceedances and ecosystem impacts.

Conventional analysis methods underestimate the plant-available pools of calcium, magnesium and potassium in forest soils.

The plant-available pools of calcium, magnesium and potassium are assumed to be stored in the soil as exchangeable cations adsorbed on the cation exchange complex. In numerous forest ecosystems, despite very low plant-available pools, elevated forest productivities are sustained. We hypothesize that trees access nutrient sources in the soil that are currently unaccounted by conventional soil analysis methods. We carried out an isotopic dilution assay to quantify the plant-available pools of calcium, magnesium and potassium and trace the soil phases that support these pools in 143 individual soil samples covering 3 climatic zones and 5 different soil types. For 81%, 87% and 90% of the soil samples (respectively for Ca, Mg and K), the plant-available pools measured by isotopic dilution were greater than the conventional exchangeable pool. This additional pool is most likely supported by secondary non-crystalline mineral phases in interaction with soil organic matter and represents in many cases (respectively 43%, 27% and 47% of the soil samples) a substantial amount of plant-available nutrient cations (50% greater than the conventional exchangeable pools) that is likely to play an essential role in the biogeochemical functioning of forest ecosystems, in particular when the resources of Ca, Mg and K are low.

Browning of freshwaters: Consequences to ecosystem services, underlying drivers, and potential mitigation measures.

Browning of surface waters, as a result of increasing dissolved organic carbon and iron concentrations, is a widespread phenomenon with implications to the structure and function of aquatic ecosystems. In this article, we provide an overview of the consequences of browning in relation to ecosystem services, outline what the underlying drivers and mechanisms of browning are, and specifically focus on exploring potential mitigation measures to locally counteract browning. These topical concepts are discussed with a focus on Scandinavia, but are of relevance also to other regions. Browning is of environmental concern as it leads to, e.g., increasing costs and risks for drinking water production, and reduced fish production in lakes by limiting light penetration. While climate change, recovery from acidification, and land-use change are all likely factors contributing to the observed browning, managing the land use in the hydrologically connected parts of the landscape may be the most feasible way to counteract browning of natural waters.

Forest streams are important sources for nitrous oxide emissions.

Streams and river networks are increasingly recognized as significant sources for the greenhouse gas nitrous oxide (N2 O). N2 O is a transformation product of nitrogenous compounds in soil, sediment and water. Agricultural areas are considered a particular hotspot for emissions because of the large input of nitrogen (N) fertilizers applied on arable land. However, there is little information on N2 O emissions from forest streams although they constitute a major part of the total stream network globally. Here, we compiled N2 O concentration data from low-order streams (~1,000 observations from 172 stream sites) covering a large geographical gradient in Sweden from the temperate to the boreal zone and representing catchments with various degrees of agriculture and forest coverage. Our results showed that agricultural and forest streams had comparable N2 O concentrations of 1.6 ± 2.1 and 1.3 ± 1.8 µg N/L, respectively (mean ± SD) despite higher total N (TN) concentrations in agricultural streams (1,520 ± 1,640 vs. 780 ± 600 µg N/L). Although clear patterns linking N2 O concentrations and environmental variables were difficult to discern, the percent saturation of N2 O in the streams was positively correlated with stream concentration of TN and negatively correlated with pH. We speculate that the apparent contradiction between lower TN concentration but similar N2 O concentrations in forest streams than in agricultural streams is due to the low pH (<6) in forest soils and streams which affects denitrification and yields higher N2 O emissions. An estimate of the N2 O emission from low-order streams at the national scale revealed that ~1.8 × 109  g N2 O-N are emitted annually in Sweden, with forest streams contributing about 80% of the total stream emission. Hence, our results provide evidence that forest streams can act as substantial N2 O sources in the landscape with 800 × 109  g CO2 -eq emitted annually in Sweden, equivalent to 25% of the total N2 O emissions from the Swedish agricultural sector.

Iris suture fixation of out-of-the-bag dislocated three-piece intraocular lenses.

PURPOSE: To evaluate the efficacy and safety of iris suture fixation of out-of-the-bag dislocated three-piece intraocular lenses (IOL). METHODS: In a retrospective interventional consecutive case series, a chart review was performed in two groups of patients: fourteen patients with a dislocated out-of-the-bag three-piece IOL that underwent IOL fixation to the iris using the Siepser sliding knot technique (Iris group) and 18 patients with in-the-bag dislocation that underwent IOL exchange with a new scleral-sutured IOL (Exchange group). The Iris and Exchange groups were compared regarding surgical safety and efficacy. The median follow-up time was 13.5 months [interquartile range (IQR), 10-20] in the Iris group and 12.5 (IQR, 10-14) in the Exchange group. RESULTS: The best corrected visual acuity (BCVA) improved significantly in both groups (p = 0.005 and 0.00006, respectively). No difference in final BCVA was seen between the groups. Significantly less surgically induced astigmatism (p = 0.03) and a lower number of postoperative visits (p = 0.0006) was noted in the Iris group. Considering the type of surgery, there were few complications in the present material. CONCLUSION: In the study, suturing dislocated three-piece IOLs to the iris appeared to be an acceptable surgical management with less surgically induced corneal astigmatism and fewer postoperative visits than IOL exchange. A larger study with a longer follow-up time would be desirable to confirm the results.

Regional diversity of complex dissolved organic matter across forested hemiboreal headwater streams.

Dissolved organic matter (DOM) from soils enters the aquatic environment via headwater streams. Thereafter, it is gradually transformed, removed by sedimentation, and mineralised. Due to the proximity to the terrestrial source and short water residence time, the extent of transformation is minimal in headwaters. DOM has variable composition across inland waters, but the amount of variability in the terrestrial end member is unknown. This gap in knowledge is crucial considering the potential impact large variability would have on modelling DOM degradation. Here, we used a novel liquid chromatography -mass spectrometry method to characterise DOM in 74 randomly selected, forested headwater streams in an 87,000 km2 region of southeast Sweden. We found a large degree of sample similarity across this region, with Bray-Curtis dissimilarity values averaging 8.4 ± 3.0% (mean ± SD). The identified variability could be reduced to two principle coordinates, correlating to varying groundwater flow-paths and regional mean temperature. Our results indicate that despite reproducible effects of groundwater geochemistry and climate, the composition of DOM is remarkably similar across catchments already as it leaves the terrestrial environment, rather than becoming homogeneous as different headwaters and sub-catchments mix.

Long-term changes (1990-2015) in the atmospheric deposition and runoff water chemistry of sulphate, inorganic nitrogen and acidity for forested catchments in Europe in relation to changes in emissions and hydrometeorological conditions.

The international Long-Term Ecological Research Network (ILTER) encompasses hundreds of long-term research/monitoring sites located in a wide array of ecosystems that can help us understand environmental change across the globe. We evaluated long-term trends (1990-2015) for bulk deposition, throughfall and runoff water chemistry and fluxes, and climatic variables in 25 forested catchments in Europe belonging to the UNECE International Cooperative Programme on Integrated Monitoring of Air Pollution Effects on Ecosystems (ICP IM). Many of the IM sites form part of the monitoring infrastructures of this larger ILTER network. Trends were evaluated for monthly concentrations of non-marine (anthropogenic fraction, denoted as x) sulphate (xSO4) and base cations x(Ca+Mg), hydrogen ion (H+), inorganic N (NO3 and NH4) and ANC (Acid Neutralising Capacity) and their respective fluxes into and out of the catchments and for monthly precipitation, runoff and air temperature. A significant decrease of xSO4 deposition resulted in decreases in concentrations and fluxes of xSO4 in runoff, being significant at 90% and 60% of the sites, respectively. Bulk deposition of NO3 and NH4 decreased significantly at 60-80% (concentrations) and 40-60% (fluxes) of the sites. Concentrations and fluxes of NO3 in runoff decreased at 73% and 63% of the sites, respectively, and NO3 concentrations decreased significantly at 50% of the sites. Thus, the LTER/ICP IM network confirms the positive effects of the emission reductions in Europe. Air temperature increased significantly at 61% of the sites, while trends for precipitation and runoff were rarely significant. The site-specific variation of xSO4 concentrations in runoff was most strongly explained by deposition. Climatic variables and deposition explained the variation of inorganic N concentrations in runoff at single sites poorly, and as yet there are no clear signs of a consistent deposition-driven or climate-driven increase in inorganic N exports in the catchments.

Ditch network maintenance in peat-dominated boreal forests: Review and analysis of water quality management options.

The objective of this study was to evaluate the potential of different water management options to mitigate sediment and nutrient exports from ditch network maintenance (DNM) areas in boreal peatland forests. Available literature was reviewed, past data reanalyzed, effects of drainage intensity modeled, and major research gaps identified. The results indicate that excess downstream loads may be difficult to prevent. Water protection structures constructed to capture eroded matter are either inefficient (sedimentation ponds) or difficult to apply (wetland buffers). It may be more efficient to decrease erosion, either by limiting peak water velocity (dam structures) or by adjusting ditch depth and spacing to enable satisfactory drainage without exposing the mineral soil below peat. Future research should be directed towards the effects of ditch breaks and adjusted ditch depth and spacing in managing water quality in DNM areas.

Children with blindness - major causes, developmental outcomes and implications for habilitation and educational support: a two-decade, Swedish population-based study.

PURPOSE: The aim was to describe the population of children with congenital or early infancy blindness in Sweden, with regard to causes of blindness and prevalence of neurodevelopmental impairments. METHODS: Medical, psychological and pedagogical records of Swedish children with congenital or early infancy blindness (total blindness or light perception at the most) born in 1988-2008 were analysed regarding year of birth, gender, cause of blindness, gestational age, associated neurological disorders/syndromes, associated neurodevelopmental impairments, cognitive level and type of school placement. RESULTS: A total of 150 individuals, 80 girls and 70 boys, were identified, corresponding to a prevalence of 7/100 000. Five causes of blindness dominated, constituting 76% of all represented aetiologies: retinopathy of prematurity (ROP), optic nerve hypoplasia (ONH), Leber congenital amaurosis (LCA), optic nerve atrophy (ONA) and microphthalmia/anophthalmia. Nearly three of four children in the study population had at least one additional disability besides blindness; the most common being intellectual disability (ID) and autism spectrum disorder (ASD). More than half of the population had more than one additional disability. Autism spectrum disorder (ASD) was most common in children with ONH, ROP, LCA and microphthalmia/anophthalmia. CONCLUSION: In children born within the last decades, isolated blindness is uncommon and the rate of multidisabilities is high. Autism spectrum disorder (ASD) seems to be more strongly associated with specific aetiological subgroups. Further development of the support to families and schools should be based on knowledge about the considerable heterogeneity of the population of children with blindness, and the common occurrence of coexisting neurodevelopmental disorders, especially ID and ASD.

Multiple sources and sinks of dissolved inorganic carbon across Swedish streams, refocusing the lens of stable C isotopes.

It is well established that stream dissolved inorganic carbon (DIC) fluxes play a central role in the global C cycle, yet the sources of stream DIC remain to a large extent unresolved. Here, we explore large-scale patterns in δ13C-DIC from streams across Sweden to separate and further quantify the sources and sinks of stream DIC. We found that stream DIC is governed by a variety of sources and sinks including biogenic and geogenic sources, CO2 evasion, as well as in-stream processes. Although soil respiration was the main source of DIC across all streams, a geogenic DIC influence was identified in the northernmost region. All streams were affected by various degrees of atmospheric CO2 evasion, but residual variance in δ13C-DIC also indicated a significant influence of in-stream metabolism and anaerobic processes. Due to those multiple sources and sinks, we emphasize that simply quantifying aquatic DIC fluxes will not be sufficient to characterise their role in the global C cycle.

Solar ultraviolet radiation cataract.

Despite being a treatable disease, cataract is still the leading cause for blindness in the world. Solar ultraviolet radiation is epidemiologically linked to cataract development, while animal and in vitro studies prove a causal relationship. However, the pathogenetic pathways for the disease are not fully understood and there is still no perfect model for human age related cataract. This non-comprehensive overview focus on recent developments regarding effects of solar UV radiation wavebands on the lens. A smaller number of fundamental papers are also included to provide a backdrop for the overview. Future studies are expected to further clarify the cellular and subcellular mechanisms for UV radiation-induced cataract and especially the isolated or combined temporal and spatial effects of UVA and UVB in the pathogenesis of human cataract. Regardless of the cause for cataract, there is a need for advances in pharmaceutical or other treatment modalities that do not require surgical replacement of the lens.

Apoptosis in Rat Cornea After In Vivo Exposure to Ultraviolet Radiation at 300 nm.

PURPOSE: Peak toxicity for in vivo ultraviolet radiation (UVR) exposure to the lens is in the 300-nm wavelength region. However, little is known about corneal cell damage at 300 nm. The purpose of the study was to determine the time evolution of apoptosis in the cornea after in vivo exposure to 300-nm UVR. METHODS: Altogether, 16 Sprague Dawley rats were divided into 4 groups and unilaterally exposed to 5 kJ/m UVR (λmax: 300 nm; λ0.5: 10 nm) for 15 minutes. After a predetermined latency period of 1, 5, 24, and 120 hours, depending on the group, the animals were killed and eyes were enucleated. Eye globes were further cryosectioned in 10-µm thick midsagittal sections. For the detection of apoptosis, the TUNEL method was applied. RESULTS: TUNEL-positive signals were observed in the superficial epithelial cells in the exposed and control eyes at all latency periods. At 5 hours, TUNEL staining was detected in the exposed corneas in epithelial cells, keratocytes, and endothelial cells with a maximum signal at 24 hours. At 120 hours, no TUNEL staining was found in endothelial cells and only occasionally in keratocytes in exposed corneas. Signs of ulceration and stromal thinning were observed at 120 hours. CONCLUSIONS: UVR in the 300-nm wavelength region induces TUNEL staining in all 3 corneal layers. TUNEL staining of all 3 corneal layers is an early postexposure event observed after a 5-hour latency period. Corneal sterile keratolysis occurs in the time window of 24 to 120 hours probably induced by neutrophils.

Relationship between structural features and water chemistry in boreal headwater streams--evaluation based on results from two water management survey tools suggested for Swedish forestry.

Forestry may cause adverse impacts on water quality, and the forestry planning process is a key factor for the outcome of forest operation effects on stream water. To optimise environmental considerations and to identify actions needed to improve or maintain the stream biodiversity, two silvicultural water management tools, BIS+ (biodiversity, impact, sensitivity and added values) and Blue targeting, have been developed. In this study, we evaluate the links between survey variables, based on BIS+ and Blue targeting data, and water chemistry in 173 randomly selected headwater streams in the hemiboreal zone. While BIS+ and Blue targeting cannot replace more sophisticated monitoring methods necessary for classifying water quality in streams according to the EU Water Framework Directive (WFD, 2000/60/EC), our results lend support to the idea that the BIS+ protocol can be used to prioritise the protection of riparian forests. The relationship between BIS+ and water quality indicators (concentrations of nutrients and organic matter) together with data from fish studies suggests that this field protocol can be used to give reaches with higher biodiversity and conservation values a better protection. The tools indicate an ability to mitigate forestry impacts on water quality if the operations are adjusted to this knowledge in located areas.

Long-term effects on nitrogen and benthic fauna of extreme weather events: Examples from two Swedish headwater streams.

Climate change is expected to cause an increased frequency of extreme events such as heavy floods and major storms. Such stochastic events have an immediate impact on surface water quality, but the long-term effects are largely unknown. In this study, we assess long-term monitoring data from two Swedish headwater catchments affected by extreme weather events. At one site, where nitrogen effects in soil water, groundwater, and stream water were studied after storm-felling and subsequent forest dieback from bark beetle attack, long-term (> 5 years) but relatively modest (generally <1 mg L⁻¹) increases in ammonium (NH(4)-N) and nitrate (NO(3)-N) concentrations were observed in the various aqueous media. At the other site, where effects on benthic fauna were studied in a stream impacted by extreme geophysical disturbances caused by rainstorm-induced flashflood, only short-term (1 year) effects were revealed both regarding diversity and composition of species.

Long-term trends in water chemistry of acid-sensitive Swedish lakes show slow recovery from historic acidification.

Long-term (1987-2012) water quality monitoring in 36 acid-sensitive Swedish lakes shows slow recovery from historic acidification. Overall, strong acid anion concentrations declined, primarily as a result of declines in sulfate. Chloride is now the dominant anion in many acid-sensitive lakes. Base cation concentrations have declined less rapidly than strong acid anion concentrations, leading to an increase in charge balance acid neutralizing capacity. In many lakes, modeled organic acidity is now approximately equal to inorganic acidity. The observed trends in water chemistry suggest lakes may not return to reference conditions. Despite declines in acid deposition, many of these lakes are still acidified. Base cation concentrations continue to decline and alkalinity shows only small increases. A changing climate may further delay recovery by increasing dissolved organic carbon concentrations and sea-salt episodes. More intensive forest harvesting may also hamper recovery by reducing the supply of soil base cations.

Cataract after repeated daily in vivo exposure to ultraviolet radiation.

Epidemiological data indicate a correlation between lifelong exposure to ultraviolet radiation and cortical cataract. However, there is no quantitative experimental data on the effect of daily repeated in vivo exposures of the eye to UVR. Therefore, this experiment was designed to verify whether the dose additivity for UVR exposures holds through periods of time up to 30 d. Eighty rats were conditioned to a rat restrainer 5 d prior to exposure. All animals were divided into four exposure period groups of 1, 3, 10, and 30 d of exposure to UVR. Each exposure period group of 20 animals was randomly divided into five cumulated UVR dose subgroups. Eighteen-wk-old non-anesthetized albino Sprague-Dawley rats were exposed daily to UVR-300 nm for 15 min. One week after the last exposure, animals were sacrificed. The lenses were extracted for macroscopic imaging of dark-field anatomy, and degree of cataract was quantified by measurement of the intensity of forward lens light scattering. Maximum tolerable dose (MTD(2.3:16)), a statistically defined standard for sensitivity for the threshold for UVR cataract, was estimated for each exposure period. Exposed lenses developed cataract with varying appearance on the anterior surface. Single low doses of UVR accumulated to cause cataract during periods up to 30 d. MTD(2.3:16) for 1, 3, 10, and 30 d of repeated exposures was estimated to 4.70, 4.74, 4.80, and 6.00 kJ m(-2), respectively. In conclusion, the lens sensitivity to UVR-B for 18-wk-old Sprague-Dawley rats decreases with the increasing number of days being exposed.