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Abstract Background Health-related quality of life (HRQoL) assessments and estimates of prognosis are needed for comprehensive care and planning of subsequent treatment in patients with idiopathic pulmonary fibrosis (IPF). We investigated HRQoL and its association with survival using a disease-specific tool in patients with IPF. Methods The patients were recruited from the real-life FinnishIPF study in 2015. HRQoL was assessed with the King’s Brief Interstitial Lung Disease (K-BILD) questionnaire every six months for 2.5 years. Dyspnoea was assessed with the modified Medical Research Council (mMRC) dyspnoea scale. Survival was registered until 31 December 2022. Patient survival according to the K-BILD total score was evaluated using the Kaplan‒Meier method. The Friedman test was used to compare the K-BILD total scores longitudinally, and the Mann‒Whitney U test was used to compare the mMRC groups. P values

Oxygenated organic molecules (OOMs) play an important role in the formation of atmospheric aerosols. Due to various analytical challenges with respect to measuring organic vapors, uncertainties remain regarding the formation and fate of OOMs. The chemical ionization Orbitrap (CI-Orbitrap) mass spectrometer has recently been shown to be a powerful technique that is able to accurately identify gaseous organic compounds due to its greater mass resolution. Here, we present the ammonium-ion-based CI-Orbitrap (NH4+-Orbitrap) as a technique capable of measuring a wide range of gaseous OOMs. The performance of the NH4+-Orbitrap is compared with that of state-of-the-art mass spectrometers, including a nitrate-ion-based chemical ionization atmospheric pressure interface coupled to a time-of-flight mass spectrometer (NO3--LTOF), a new generation of proton transfer reaction-TOF mass spectrometer (PTR3-TOF), and an iodide-based CI-TOF mass spectrometer equipped with a Filter Inlet for Gases and AEROsols (I−-CIMS). The instruments were deployed simultaneously in the Cosmic Leaving OUtdoors Droplets (CLOUD) chamber at the European Organization for Nuclear Research (CERN) during the CLOUD14 campaign in 2019. Products generated from α-pinene ozonolysis under various experimental conditions were simultaneously measured by the mass spectrometers. The NH4+-Orbitrap was able to identify the widest range of OOMs (i.e., O ≥ 2), from less-oxidized species to highly oxygenated organic molecules (HOMs). Excellent agreement was found between the NH4+-Orbitrap and the NO3--LTOF with respect to characterizing HOMs and with the PTR3-TOF for the less-oxidized monomeric species. OOM concentrations measured by NH4+-Orbitrap were estimated using calibration factors derived from the OOMs with high time-series correlations during the side-by-side measurements. As with the other mass spectrometry techniques used during this campaign, the detection sensitivity of the NH4+-Orbitrap to OOMs is greatly affected by relative humidity, which may be related to changes in ionization efficiency and/or multiphase chemistry. Overall, this study shows that NH4+-ion-based chemistry associated with the high mass resolution of the Orbitrap mass analyzer can measure almost all inclusive compounds. As a result, it is now possible to cover the entire range of compounds, which can lead to a better understanding of the oxidation processes.

We conducted a prospective study of 159 cases of Streptococcus dysgalactiae subspecies equisimilis (SDSE) bacteremia in 157 patients at 2 hospitals in Finland during November 2015–November 2019. Cellulitis was associated with nonsevere disease (p = 0.008); necrotizing fasciitis was associated with severe disease (p = 0.004). Fifty percent of patients had >1 clinical characteristic associated with risk for death. The case-fatality rate was 6%, and 7% of patients were treated in an intensive care unit. Blood leukocyte counts on days 2 (p = 0.032) and 3 (p = 0.020) and C-reactive protein levels on days 3 (p = 0.030) and 4 (p = 0.009) after admission were predictors of severe disease. The Pitt bacteremia score was an accurate predictor of death. Using the Pitt bacteremia score, leukocyte counts, and CRP responses during initial treatment can improve treatment strategies and survival for patients with SDSE.

Systems thinking is considered an important skill when teaching biology and sustainable development in the 21st century. The key to understanding biodiversity and thus sustainability in biology is understanding reproduction as a phenomenon. The aim of this study is to analyse student teachers’ systems thinking levels regarding sustainability in connection with reproduction, biodiversity and sustainable development. Second-year primary school student teachers from one Finnish university (N = 174) participated in a questionnaire, and their open-ended answers were categorized using content analysis. The results indicate that most of the student teachers had a relatively low level of systems thinking concerning sustainable development and its relation to the concepts of biodiversity and reproduction. The study also showed that student teachers with higher interest towards biology had a more sophisticated level of systems thinking. For developing sustainability understanding, teaching focusing on the specific systems thinking skills concerning processing and understanding of wholes is crucial.

Abstract Background Modifying the choice architecture of behavioural contexts can facilitate health behaviour change, but existing evidence builds mostly on small-scale interventions limited in duration, targets, strategies, and settings. We evaluated the effectiveness of a one-year hybrid type 2 implementation-effectiveness trial aimed at promoting healthy eating and daily physical activity with subtle modifications to the choice architecture of heterogeneous worksites. The intervention was contextualised to and integrated into the routine operations of each worksite. Effectiveness was evaluated in a quasi-experimental pre-post design. Methods Intervention sites (n = 21) implemented a median of two (range 1–9) intervention strategies for healthy eating and one (range 1–5) for physical activity. Questionnaires pre (n = 1126) and post (n = 943) intervention surveyed employees’ behavioural patterns at work (food consumption: vegetables/roots, fruit/berries, nuts/almonds/seeds, sweet treats, fast food, water; physical activity: restorative movement, exercise equipment use, stair use). The post-intervention questionnaire also measured employees’ perception of and response to three intervention strategies: a packed lunch recipe campaign, a fruit crew-strategy, and movement prompts. Multi- and single-level regression models evaluated effectiveness, treating intervention as a continuous predictor formed of the site-specific dose (n intervention strategies employed) and mean quality (three-point rating per strategy halfway and at the end of the intervention) of implementation relevant to each outcome. Results Multinomial logistic regression models found the intervention significantly associated with a favourable change in employees’ fruit and berry consumption (interaction effect of time and implementation p = 0.006) and with an unfavourable change in sweet treat consumption (p = 0.048). The evidence was strongest for the finding concerning fruit/berry consumption—an outcome that sites with greater dose and quality of implementation targeted by using strategies that reduced the physical effort required to have fruit/berries at work and by covering multiple eating-related contexts at the worksite. The quality of implementation was positively associated with the perception of (p = 0.044) and response to (p = 0.017) the packed lunch recipes, and with response to the fruit crew-strategy (p

AbstractGlobal environmental assessments (GEAs) support international environmental governance by synthesizing state-of-the-art scientific knowledge. Increasingly, they also articulate solutions to environmental risks. The interlinked “triple planetary crisis” (biodiversity loss, climate change, and pollution) requires action that considers potential tradeoffs and seeks to harness synergies between the responses. Subsequently, there are concerted efforts to collaborate across different global assessments and to synthesize messages on synergistic action. But how could these global syntheses and messages be leveraged for national action? We explored the question through two multi-stakeholder workshops organized in Finland in 2020 and 2021, complemented through a literature review. Adopting systemic perspectives, syntheses that integrate various environmental dimensions are well-placed to inform sustainability transformations through shaping national debates and public discourses on the interconnected environmental crises, helping to legitimize contentious, difficult decisions. As processes, they support transdisciplinary learning and capacity-building, understanding different worldviews and challenging assumptions and value systems, while communicating the urgency of action. Yet, while scientists are increasingly bridging disciplinary and thematic silos, corresponding governance structures remain highly sectoral, and a capacity deficit in systems thinking by policymakers prevails. Interlocutors of global knowledge synthesis, including national scientific experts, can be crucial in interpreting messages and catalyzing action that accounts for cross-sectoral synergies and tradeoffs. By empowering local experts and actors not only in utilizing global knowledge syntheses but in participating in the knowledge co-production processes, both the impact and the accuracy of new global assessments can be improved.

Fokus för denna studie är svenska förskolerektorers kontroversiella frågor, ett hittills obeforskat område. Syftet är att synliggöra några av de kontroversiella frågor som rektorer i förskolor hanterar i sin vardag med ambitionen att öka kunskapen om förskolerektorers ledarskap. Studien har en explorativ ansats och den teoretiska utgångspunkten grundas i begreppet dilemmatiska rum vilket vidareutvecklats till kontroversiella rum i artikeln. Vi menar att kontroversiella frågor är konstruerade i en specifik social kontext vilket påverkar hur rektorer positionerar sig. I analysen synliggörs hur de kontroversiella rummen är konstituerade. Resultatet grundas i sju semistrukturerade intervjuer. I resultatet synliggörs hur rektorerna behöver navigera i tre olika kontroversiella rum i relation till lojalitet, ledning och värden. Rektorers kontroversiella rum kan ses som ett uttryck för en utmanande position som kräver att man måste ta hänsyn till många intressen i sitt ledarskap. Att dessutom göra det i en verksamhet som präglats av en stark egalitär kultur gör själva ledarskapet till en utmaning. I denna kontext riskerar många ledarhandlingar upplevas som kontroversiella även om det är en naturlig del av att vara rektor.

Malignant tumors derived from the epithelium lining the nasal cavity region are termed sinonasal cancers, a highly heterogeneous group of rare tumors accounting for 3 – 5 % of all head and neck cancers. Progress with next-generation molecular profiling has improved our understanding of the complexity of sinonasal cancers and resulted in the identification of an increasing number of distinct tumor entities. Despite these significant developments, the treatment of sinonasal cancers has hardly evolved since the 1980s, and an advanced sinonasal cancer presents a poor prognosis as targeted therapies are usually not available. To gain insights into potential targeted therapeutic opportunities, we performed a multiomics profiling of patient-derived functional tumor models to identify molecular characteristics associated with pharmacological responses in the different subtypes of sinonasal cancer. Methods: Patient-derived ex vivo tumor models representing four distinct sinonasal cancer subtypes: sinonasal intestinal-type adenocarcinoma, sinonasal neuroendocrine carcinoma, sinonasal undifferentiated carcinoma and SMARCB1 deficient sinonasal carcinoma were included in the analyses. Results of functional drug screens of 160 anti-cancer therapies were integrated with gene panel sequencing and histological analyses of the tumor tissues and the ex vivo cell cultures to establish associations between drug sensitivity and molecular characteristics including driver mutations. Results: The different sinonasal cancer subtypes display considerable differential drug sensitivity. Underlying the drug sensitivity profiles, each subtype was associated with unique molecular features. The therapeutic vulnerabilities correlating with specific genomic background were extended and validated with in silico analyses of cancer cell lines representing different human cancers and with reported case studies of sinonasal cancers treated with targeted therapies. Conclusion: The results demonstrate the importance of understanding the differential biology and the molecular features associated with the different subtypes of sinonasal cancers. Patient-derived ex vivo tumor models can be a powerful tool for investigating these rare cancers and prioritizing targeted therapeutic strategies for future clinical development and personalized medicine.

Tässä katsausartikkelissa Lapin yliopiston matkailututkijat tarkastelevat teemoja, joiden voidaan katsoa sijoittuvan suomalaisen kriittisen yhteiskuntatieteellisen matkailututkimuksen keskiöön. Uuden työn, matkailun vastuullisen talouden, hitauden ja läheisyyden, monilajisuuden, osallisuuden ja kulttuurisensitiivisyyden teemojen kautta on viime vuosina rakennettu aktiivisesti tutkimusta, jota voisi kuvailla Matkailututkimuksen pohjoista koulukuntaa (Nordic School of Tourism Research) edustavaksi tutkimukseksi – tutkimukseksi, joka pyrkii muun muassa purkamaan vastakkainasetteluita (kuten me ja toiset, luonto ja kulttuuri) ja ottaa aktiivisesti kantaa siihen, millaisia matkailun maailmoja tutkijat ovat tutkimuksen kautta luomassa. Kriittinen yhteiskuntatieteellinen tutkimusote näkyy käsillä olevan katsauksen teemoissa myös siinä, että useampi teemoista tuo esiin myös muiden kuin ihmistoimijoiden roolin yhteiskuntatieteellisiä kysymyksiä käsiteltäessä.

Classification of volatile organic compounds (VOCs) is of interest in many fields. Examples include but are not limited to medicine, detection of explosives, and food quality control. Measurements collected with so-called electronic noses can be used for classification and analysis of VOCs. One type of electronic noses that has seen considerable development in recent years is Differential Mobility Spectrometry (DMS). DMS yields measurements that are visualized as dispersion plots that contain traces, also known as alpha curves. Current methods used for analyzing DMS dispersion plots do not usually utilize the information stored in the continuity of these traces, which suggests that alternative approaches should be investigated. In this work, for the first time, dispersion plots were interpreted as a series of measurements evolving sequentially. Thus, it was hypothesized that time-series classification algorithms can be effective for classification and analysis of dispersion plots. An extensive dataset of 900 dispersion plots for five chemicals measured at five flow rates and two concentrations was collected. The data was used to analyze the classification performance of six algorithms. The highest classification accuracy of 88% was achieved by a Long-Short Term Memory neural network, which supports the hypothesis that interpreting DMS measurements as sequential data is beneficial and outperformed classification algorithms traditionally used for DMS-based VOC identification.

Abstract Background It is a common ethical challenge for ambulance clinicians to care for patients with impaired decision-making capacities while assessing and determining the degree of decision-making ability and considering ethical values. Ambulance clinicians’ ethical competence seems to be increasingly important in coping with such varied ethical dilemmas. Ethics rounds is a model designed to promote the development of ethical competence among clinicians. While standard in other contexts, to the best of our knowledge, it has not been applied within the ambulance service context. Thus, the aim of this study was to describe ambulance clinicians’ experiences of participating in ethics rounds. Methods This was a qualitative descriptive study, evaluating an intervention. Data were collected through sixteen interviews with ambulance clinicians who had participated in an intervention involving ethics rounds. The analysis was performed by use of content analysis. Results Two themes describe the participants’ experiences: (1) Reflecting freely within a given framework, and (2) Being surprised by new insights. The following categories form the basis of the themes; 1a) Gentle guidance by the facilitator, 1b) A comprehensible structure, 2a) New awareness in the face of ethical problems, and 2b) Shared learning through dialogue. Conclusion Incorporating structured ethics rounds seems to create a continuous development in ethical competence that may improve the quality of care in the ambulance service. Structured guidance and facilitated group reflections offer ambulance clinicians opportunities for both personal and professional development. An important prerequisite for the development of ethical competence is a well-educated facilitator. Consequently, this type of ethics rounds may be considered a useful pedagogical model for the development of ethical competence in the ambulance service.

Abstract Background Altering the choice architecture of decision contexts can assist behaviour change, but the acceptability of this approach has sparked debate. Considering hypothetical interventions, people generally welcome the approach for promoting health, but little evidence exists on acceptance in the real world. Furthermore, research has yet to explore the implementers’ perspective, acknowledging the multidimensionality of the acceptability construct. Addressing these knowledge gaps, this study evaluated the acceptability of a quasi-experimental implementation-effectiveness trial that modified the worksite choice architecture for healthy eating and daily physical activity. Methods Fifty-three worksites participated in the 12-month intervention and implemented altogether 23 choice architecture strategies (Mdn 3/site), including point-of-choice prompts and changes to choice availability or accessibility. Retrospective acceptability evaluation built on deductive qualitative content analysis of implementer interviews (n = 65) and quantitative analysis of an employee questionnaire (n = 1124). Qualitative analysis examined implementers’ thoughts and observations of the intervention and its implementation, considering six domains of the Theoretical Framework of Acceptability: ethicality, affective attitude, burden, intervention coherence, opportunity costs, and perceived effectiveness. Quantitative analysis examined employees’ acceptance (7-point Likert scale) of eight specific intervention strategies using Friedman test and mixed-effects logistic regression. Results Implementers considered the choice architecture approach ethical for workplace health promotion, reported mostly positive affective attitudes to and little burden because of the intervention. Intervention coherence supported acceptance through increased interest in implementation, whereas low perceived utility and high intensity of implementation reduced cost acceptance. Perceived effectiveness was mixed and varied along factors related to the implementer, social/physical work environment, employer, and employee. Employees showed overall high acceptance of evaluated strategies (Mdn 7, IQR 6.4–7), though strategies replacing unhealthy foods with healthier alternatives appeared less supported than providing information or enhancing healthy option availability or accessibility (p-values

The basic idea of a Swedish preschool is that it is a place where children can learn and experience growth in a variety of areas, not least in the social area. According to the Education Act all preschools must annually document and evaluate planned work to prevent and remedy abusive treatment. The aim of this article is to analyse if and how the discursive gap between the juridical and pedagogical assignments given to preschools in national policy documents becomes visible in local policy plans concerning the prevention and remedy of abusive treatment. The empirical material consists of 89 documents. The result makes it clear that the juridical and pedagogical discourses contain a gap in local policy plans, making it unclear whether a juridical perspective or a pedagogical perspective on abusive treatment is to be used when preventing and remedying abusive treatment in practice.

Women often embody the central values and practices of their religious tradition. When they leave their community, women find a part of the “religious tapestry” remaining with them long after their disengagement. In this article, we draw from research in the UK and Finland to explore women’s efforts to unlearn parts of their former religious belonging. We draw on in total thirty-five interviews with women who disengaged from the Mormon Church, Jehovah’s Witnesses and Conservative Laestadianism. We conceptualize un/learning as a multi-layered process consisting of both un-learning and re-learning. We explore women’s narratives about negotiating bodily limits, conduct and belonging, and understand these as suggesting experiences of a threefold un/learning: gendered, spatial-social and epistemic. We argue that examining gendered and embodied un/learning helps to understand women’s disengagement processes from minority Christian traditions in Western and Northern European secularized contexts such as the UK and Finland.

With diminishing returns and high clinical failure rates from traditional preclinical and animal-based drug discovery strategies, more emphasis is being placed on alternative drug discovery platforms. Ex vivo approaches represent a departure from both more traditional preclinical animal-based models and clinical-based strategies and aim to address intra-tumoural and inter-patient variability at an earlier stage of drug discovery. Additionally, these approaches could also offer precise treatment stratification for patients within a week of tumour resection in order to direct tailored therapy. One tumour group that could significantly benefit from such ex vivo approaches are high-grade gliomas, which exhibit extensive heterogeneity, cellular plasticity and therapy-resistant glioma stem cell (GSC) niches. Historic use of murine-based preclinical models for these tumours has largely failed to generate new therapies, resulting in relatively stagnant and unacceptable survival rates of around 12-15 months post-diagnosis over the last 50 years. The near universal use of DNA damaging chemoradiotherapy after surgical resection within standard-of-care (SoC) therapy regimens provides an opportunity to improve current treatments if we can identify efficient drug combinations in preclinical models that better reflect the complex inter-/intra-tumour heterogeneity, GSC plasticity and inherent DNA damage resistance mechanisms. We have therefore developed and optimised a high-throughput ex vivo drug screening platform; GliExP, which maintains GSC populations using immediately dissociated fresh surgical tissue. As a proof-of-concept for GliExP, we have optimised SoC therapy responses and screened 30+ small molecule therapeutics and preclinical compounds against tumours from 18 different patients, including multi-region spatial heterogeneity sampling from several individual tumours. Our data therefore provides a strong basis to build upon GliExP to incorporate combination-based oncology therapeutics in tandem with SoC therapies as an important preclinical alternative to murine models (reduction and replacement) to triage experimental therapeutics for clinical translation and deliver rapid identification of effective treatment strategies for individual gliomas.

Abstract Background Large-river decision-makers are charged with maintaining diverse ecosystem services through unprecedented social-ecological transformations as climate change and other global stressors intensify. The interconnected, dendritic habitats of rivers, which often demarcate jurisdictional boundaries, generate complex management challenges. Here, we explore how the Resist–Accept–Direct (RAD) framework may enhance large-river management by promoting coordinated and deliberate responses to social-ecological trajectories of change. The RAD framework identifies the full decision space of potential management approaches, wherein managers may resist change to maintain historical conditions, accept change toward different conditions, or direct change to a specified future with novel conditions. In the Upper Mississippi River System, managers are facing social-ecological transformations from more frequent and extreme high-water events. We illustrate how RAD-informed basin-, reach-, and site-scale decisions could: (1) provide cross-spatial scale framing; (2) open the entire decision space of potential management approaches; and (3) enhance coordinated inter-jurisdictional management in response to the trajectory of the Upper Mississippi River hydrograph. Results The RAD framework helps identify plausible long-term trajectories in different reaches (or subbasins) of the river and how the associated social-ecological transformations could be managed by altering site-scale conditions. Strategic reach-scale objectives may reprioritize how, where, and when site conditions could be altered to contribute to the basin goal, given the basin’s plausible trajectories of change (e.g., by coordinating action across sites to alter habitat connectivity, diversity, and redundancy in the river mosaic). Conclusions When faced with long-term systemic transformations (e.g., > 50 years), the RAD framework helps explicitly consider whether or when the basin vision or goals may no longer be achievable, and direct options may open yet unconsidered potential for the basin. Embedding the RAD framework in hierarchical decision-making clarifies that the selection of actions in space and time should be derived from basin-wide goals and reach-scale objectives to ensure that site-scale actions contribute effectively to the larger river habitat mosaic. Embedding the RAD framework in large-river decisions can provide the necessary conduit to link flexibility and innovation at the site scale with stability at larger scales for adaptive governance of changing social-ecological systems.

The aim was to investigate how the congruence of odors and visual objects in virtual reality (VR) affects later memory recall of the objects. Participants (N = 30) interacted with 12 objects in VR. The interaction was varied by odor congruency (i.e., the odor matched the object’s visual appearance, the odor did not match the object’s visual appearance, or the object had no odor); odor quality (i.e., an authentic or a synthetic odor); and interaction type (i.e., participants could look and manipulate or could only look at objects). After interacting with the 12 objects, incidental memory performance was measured with a free recall task. In addition, the participants rated the pleasantness and arousal of the interaction with each object. The results showed that the participants remembered significantly more objects with congruent odors than objects with incongruent odors or odorless objects. Furthermore, interaction with congruent objects was rated significantly more pleasant and relaxed than interaction with incongruent objects. Odor quality and interaction type did not have significant effects on recall or emotional ratings. These results can be utilized in the development of multisensory VR applications.

Abstract Background Pyometra is a common infectious condition, especially in elderly bitches. In addition to an infected uterus, dogs may have concurrent urinary tract infection (UTI). The preferred treatment is surgical removal of the ovaries and uterus, whereupon the general prognosis is excellent. In addition, antimicrobial therapy is frequently prescribed for postoperative treatment. However, no research exists on the benefit of postoperative antimicrobial treatment in uncomplicated canine pyometra. Antimicrobial resistance has become a major challenge in treatment of bacterial infections. Diminishing overuse of antimicrobial agents is essential for controlling the development of antimicrobial resistance in both animals and humans. Methods This double-blinded, randomized, placebo-controlled two-arm clinical trial is designed to compare the incidence of postoperative infections associated with surgical treatment of uncomplicated pyometra followed by two different treatment protocols. For the study, 150 dogs presenting with an uncomplicated pyometra and that are to undergo surgical treatment will be recruited. Dogs with body weight 93 kg, complicated pyometra, primary disease increasing the risk of infection, or immunosuppressive medication will be excluded. All dogs will receive one dose of sulfadoxine-trimethoprim intravenously as an antimicrobial prophylaxis. Postoperatively, dogs will be randomized to receive either a five-day course of placebo or an active drug, sulfadiazine-trimethoprim orally. During the surgery microbiological samples will be taken from urine and uterine content. The follow-up includes a control visit in 12 days and an interview of the owner 30 days after surgery. If bacteriuria is detected at the time of surgery, a urinary sample will be cultured for bacterial growth at the control visit. The primary outcome is the incidence of a postoperative surgical site infection (SSI), and the secondary outcome is the occurrence of clinical UTI with bacteriuria. Intention-to-treat and per-protocol analyses will be performed to compare outcome incidences between the treatment groups. Discussion Research-based evidence is necessary to create treatment guidelines for judicious use of antimicrobials. The goals of this study are to provide evidence for reducing the use of antimicrobials and targeting the treatment to patients proven to benefit from it. Publishing the trial protocol will increase transparency and promote open science practices.

Abstract Introduction Height, body mass index (BMI), and weight gain are associated with breast cancer risk in the general population. It is unclear whether these associations also exist for carriers of pathogenic variants in the BRCA1 or BRCA2 genes. Patients and methods An international pooled cohort of 8091 BRCA1/2 variant carriers was used for retrospective and prospective analyses separately for premenopausal and postmenopausal women. Cox regression was used to estimate breast cancer risk associations with height, BMI, and weight change. Results In the retrospective analysis, taller height was associated with risk of premenopausal breast cancer for BRCA2 variant carriers (HR 1.20 per 10 cm increase, 95% CI 1.04–1.38). Higher young-adult BMI was associated with lower premenopausal breast cancer risk for both BRCA1 (HR 0.75 per 5 kg/m2, 95% CI 0.66–0.84) and BRCA2 (HR 0.76, 95% CI 0.65–0.89) variant carriers in the retrospective analysis, with consistent, though not statistically significant, findings from the prospective analysis. In the prospective analysis, higher BMI and adult weight gain were associated with higher postmenopausal breast cancer risk for BRCA1 carriers (HR 1.20 per 5 kg/m2, 95% CI 1.02–1.42; and HR 1.10 per 5 kg weight gain, 95% CI 1.01–1.19, respectively). Conclusion Anthropometric measures are associated with breast cancer risk for BRCA1 and BRCA2 variant carriers, with relative risk estimates that are generally consistent with those for women from the general population.

The optimal body mass hypothesis posits that the body reserves of wintering birds are balanced between the risk of starvation and predation. In this study, we tested whether the body mass of wintering Great Tits (Parus major) was higher under conditions of less predictable food resources. We compared body mass, body mass index, the speed at take-off, and apparent survival of Great Tit adult males wintering in small urban areas either near feeders providing permanent access to food for months or near feeders providing irregular access to food. Body mass and body mass index were greater, while take-off speed and apparent survival were lower, in birds wintering near permanent feeders than birds wintering near irregular feeders. Thus, urban birds, with their predictable access to high energy food, did not follow the fattening strategy predicted by the optimal body mass hypothesis. This study shows that regular excess amounts of high-energy food may affect urban birds’ physiological and behavioral strategies in a non-adaptive way. We recommend irregular feeding of wintering birds and the placing of feeders in places that are safe against attacking predators.

Abstract Background Childhood brain tumor (BT) survivors have an increased risk of treatment-related late effects, which can reduce health-related quality of life and increase morbidity. This study aimed to investigate lumbar disc degeneration in magnetic resonance imaging (MRI) in adult survivors of radiotherapy-treated childhood BT compared to age and sex-matched population controls. Methods In this cross-sectional comparative study, 127 survivors were identified from hospital registries. After a mean follow-up of 20.7 years (range 5–33.1), 67 survivors (mean age 28.4, range 16.2–43.5) were investigated with MRI and compared to 75 sex-matched population-based controls. Evaluated MRI phenotypes included Pfirrmann grading, , intervertebral disc protrusions, extrusions, and high-intensity-zone-lesions (HIZ). Groups were also compared for known risk factors of lumbar intervertebral disc (IVD) degeneration. Results Childhood BT survivors had higher Pfirrmann grades than controls at all lumbar levels (all p

Abstract We assessed the PREDICT v 2.2 for prognosis of breast cancer patients with pathogenic germline BRCA1 and BRCA2 variants, using follow-up data from 5453 BRCA1/2 carriers from the Consortium of Investigators of Modifiers of BRCA1/2 (CIMBA) and the Breast Cancer Association Consortium (BCAC). PREDICT for estrogen receptor (ER)-negative breast cancer had modest discrimination for BRCA1 carrier patients overall (Gönen & Heller unbiased concordance 0.65 in CIMBA, 0.64 in BCAC), but it distinguished clearly the high-mortality group from lower risk categories. In an analysis of low to high risk categories by PREDICT score percentiles, the observed mortality was consistently lower than the expected mortality, but the confidence intervals always included the calibration slope. Altogether, our results encourage the use of the PREDICT ER-negative model in management of breast cancer patients with germline BRCA1 variants. For the PREDICT ER-positive model, the discrimination was slightly lower in BRCA2 variant carriers (concordance 0.60 in CIMBA, 0.65 in BCAC). Especially, inclusion of the tumor grade distorted the prognostic estimates. The breast cancer mortality of BRCA2 carriers was underestimated at the low end of the PREDICT score distribution, whereas at the high end, the mortality was overestimated. These data suggest that BRCA2 status should also be taken into consideration with tumor characteristics, when estimating the prognosis of ER-positive breast cancer patients.

A substantial fraction of stars can be found in wide binaries with projected separations between ∼10 ^2 and 10 ^5 au. In the standard lore of binary physics, these would evolve as effectively single stars that remotely orbit one another on stationary Keplerian ellipses. However, embedded in their Galactic environment, the low binding energy of wide binaries makes them exceptionally prone to perturbations from the gravitational potential of the Milky Way and encounters with passing stars. Employing a fully relativistic N -body integration scheme, we study the impact of these perturbations on the orbital evolution of wide binaries along their trajectory through the Milky Way. Our analysis reveals that the torques exerted by the Galaxy can cause large-amplitude oscillations of the binary eccentricity to 1 − e ≲ 10 ^−8 . As a consequence, the wide binary members pass close to each other at periapsis, which, depending on the type of binary, potentially leads to a mass transfer or collision of stars or to an inspiral and subsequent merger of compact remnants due to gravitational-wave radiation. Based on a simulation of 10 ^5 wide binaries across the Galactic field, we find that this mechanism could significantly contribute to the rate of stellar collisions and binary black hole mergers as inferred from observations of luminous red novae and gravitational-wave events by LIGO/Virgo/Kagra. We conclude that the dynamics of wide binaries, despite their large mean separation, can give rise to extreme interactions between stars and compact remnants.

In recent years, many Finnish cities and municipalities have aspired to develop services that support older adults’ well‐being and social inclusion. This study focuses on the Social Hub model, a local social innovation developed in the city of Tampere. Social hubs operate on a neighbourhood level, providing free‐of‐charge service coordination and counselling, group activities, and meeting places for social gatherings. This study aims to look at whether this kind of local innovation can support older adults’ well‐being and social inclusion. The sociomaterial perspective and multidimensional model of well‐being (the having–doing–loving–being approach) provided theoretical and analytical guidelines to examine older adults’ experiences and perceptions of social hubs. The qualitative interview data was collected among people living in service housing, senior housing, or ordinary housing in the proximity of the social hubs studied. Face‐to‐face and “go‐along” interviews with 19 older adults aged between 57 and 96 were analysed with theory‐driven content analysis. The results showed that the hubs are a valuable local resource for older adults, providing free services, accessible and appealing shared spaces, and activities that promote social well‐being, physical activity, creativity, and autonomy. The hubs serve as important gathering points for older adults in the neighbourhood, fostering community‐building among citizens residing in different types of housing. The results highlight the importance of acknowledging well‐being as a multidimensional phenomenon. The Social Hub model provides one practical tool to support older adults’ well‐being and social inclusion by offering various kinds of resources and social and cultural activities.

In this discussion paper, we discuss what benefits Finnish citizens and companies can derive from forest data, and how the benefits of that data depend on rights to forests. Environmental protection, everyone’s forest use, bioeconomy, and tourism may benefit from increased access to forest data. Access to forest data is a democratic right by itself. Forest data allow actors to derive more value from their existing forest rights and may spark demands for clarification or reformulation of forest rights. Transparency of forest data also allows voluntary trade in forest ecosystem services. Increased access to forest data may also contribute to forest-related conflicts, given that various, at times contradictory interests are directed at forests. At best, increased access to forest data and information may support the renewal of forest governance to become more democratic, legitimate, and effective.

Background: Few patients with chronic nonmalignant pulmonary diseases receive specialist palliative care consultation, despite their high symptom burden in end of life. Objectives: To study palliative care decision making, survival, and hospital resource usage in patients with nonmalignant pulmonary diseases with or without a specialist palliative care consultation. Methods: A retrospective chart review of all patients with a chronic nonmalignant pulmonary disease and a palliative care decision (palliative goal of therapy), who were treated in Tampere University Hospital, Finland, between January 1, 2018 and December 31, 2020. Results: A total of 107 patients were included in the study, 62 (58%) had chronic obstructive pulmonary disease (COPD), and 43 (40%) interstitial lung disease (ILD). Median survival after palliative care decision was shorter in patients with ILD than in patients with COPD (59 vs. 213 days, p?=?0.004). Involvement of a palliative care specialist in the decision making was not associated with the survival. Patients with COPD who received palliative care consultation visited less often emergency room (73% vs. 100%, p?=?0.019) and spent fewer days in the hospital (7 vs. 18 days, p?=?0.007) during the last year of life. When a palliative care specialist attended the decision making, the presence and opinions of the patients were recorded more often, and the patients were more frequently referred to a palliative care pathway. Conclusions: Specialist palliative care consultation seems to enable better end-of-life care and supports shared decision making for patients with nonmalignant pulmonary diseases. Therefore, palliative care consultations should be utilized in nonmalignant pulmonary diseases preferably before the last days of life.

Abstract Background Work environments are potential areas for spreading respiratory infections. We hypothesized that certain occupations increase susceptibility to respiratory infections among adults with asthma. Our objective was to compare the occurrence of respiratory infections among different occupations in adults with newly diagnosed asthma. Methods We analysed a study population of 492 working-age adults with newly diagnosed asthma who were living in the geographically defined Pirkanmaa Area in Southern Finland during a population-based Finnish Environment and Asthma Study (FEAS). The determinant of interest was occupation at the time of diagnosis of asthma. We assessed potential relations between occupation and occurrence of both upper and lower respiratory tract infections during the past 12 months. The measures of effect were incidence rate ratio (IRR) and risk ratio (RR) adjusted for age, gender, and smoking habits. Professionals, clerks, and administrative personnel formed the reference group. Results The mean number of common colds in the study population was 1.85 (95% CI 1.70, 2.00) infections in the last 12 months. The following occupational groups showed increased risk of common colds: forestry and related workers (aIRR 2.20, 95% CI 1.15–4.23) and construction and mining (aIRR 1.67, 95% CI 1.14–2.44). The risk of lower respiratory tract infections was increased in the following groups: glass, ceramic, and mineral workers (aRR 3.82, 95% CI 2.54–5.74), fur and leather workers (aRR 2.06, 95% CI 1.01–4.20) and metal workers (aRR 1.80, 95% CI 1.04–3.10). Conclusions We provide evidence that the occurrence of respiratory infections is related to certain occupations.