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We study the evolution of mechanical properties of paper samples during cyclic experiments. The issue is to look at the sample-to-sample variation, and we try to predict the number of loading cycles to failure. We used two concurrent methods to obtain the deformation: the strain was calculated from vertical displacement measured by laser interferometer sensor, as well as, computed by digital image correlation technique from pictures taken each 2s by a camera. Acoustic emission of fracture was also recorded, and an active ultrasonic wave method using piezoelectric transducers is used to follow the viscoelastic behaviour of each sample. We found that a sharp final increase of different variables like deformation, strain rate and fluctuations, are signs of an imminent rupture of the paper. Moreover looking at the evolution of these quantities during the first cycle only is already an indicator about the lifetime of the sample.

Acute kidney injury is a common sequela after major burn injury, but only a small proportion of patients need renal replacement therapy. In the majority of patients, need for renal replacement therapy subsides before discharge from the burn center but limited literature exists on long-term outcomes. A few studies report an increased risk for chronic renal failure after burn injury. We investigated the long-term outcome of severely burned patients receiving renal replacement therapy during acute burn injury treatment. Data on 68 severely burned patients who received renal replacement therapy in Helsinki Burn Centre between November 1988 and December 2015 were collected retrospectively. Thirty-two patients survived and remained for follow-up after the primary hospital stay until December 31, 2016. About 56.3% of discharged patients were alive at the end of follow-up. In 81.3% of discharged patients, need for renal replacement therapy subsided before discharge. Two patients received renal replacement therapy for longer than 3 months; however, need for renal replacement therapy subsided in both patients. One patient required dialysis several years later on after the need for renal replacement therapy had subsided. This study showed that long-term need for renal replacement therapy is rare after severe burn injury. In the vast majority of patients, need for renal replacement therapy subsided before discharge from primary care. Acute kidney injury in association with burns is a potential but small risk factor for later worsening of kidney function in fragile individuals. [ABSTRACT FROM AUTHOR]

We conducted a series of tracer test experiments in 12 outdoor semi-natural flumes to assess the effects of variable flow conditions and sand addition on hyporheic zone conditions in gravel beds, mimicking conditions in headwater streams under sediment pressure. Two tracer methods were applied in each experiment: 2-5 tracer-pulse tests were conducted in all flumes and pulses were monitored at three distances downstream of the flume inlet (0 m, 5 m and 10 m, at bed surface), and in pipes installed into the gravel bed at 5 m and 10 m distances. The tracer breakthrough curves (total of 120 tracer injections) were then analysed with a one-dimensional solute transport model (OTIS) and compared with data from the gravel pipes in point-dilution pulse tests. Sand addition had a strong negative effect on horizontal fluxes (qh), whereas the fraction of the median travel time due to transient storage (F200) was determined more by flow conditions. These results suggest that even small additions of sand can modify the hyporheic zone exchange in gravel beds, thus making headwater streams with low sediment transport capacity particularly vulnerable to sediments transported into the stream from catchment land use activities. [ABSTRACT FROM AUTHOR]

Abstract: Cross‐sectional studies have shown that exposure to indoor moisture damage and mold may be associated with subclinical inflammation. Our aim was to determine whether early age exposure to moisture damage or mold is prospectively associated with subclinical systemic inflammation or with immune responsiveness in later childhood. Home inspections were performed in children's homes in the first year of life. At age 6 years, subclinical systemic inflammation was measured by serum C‐reactive protein (CRP) and blood leukocytes and immune responsiveness by ex vivo production of interleukin 1‐beta (IL‐1β), IL‐6, and tumor necrosis factor alpha (TNF‐α) in whole blood cultures without stimulation or after 24 hours stimulation with phorbol 12‐myristate 13‐acetate and ionomycin (PI), lipopolysaccharide (LPS), or peptidoglycan (PPG) in 251‐270 children. Moisture damage in child's main living areas in infancy was not significantly associated with elevated levels of CRP or leukocytes at 6 years. In contrast, there was some suggestion for an effect on immune responsiveness, as moisture damage with visible mold was positively associated with LPS‐stimulated production of TNF‐α and minor moisture damage was inversely associated with PI‐stimulated IL‐1β. While early life exposure to mold damage may have some influence on later immune responsiveness, it does not seem to increase subclinical systemic inflammation in later life. [ABSTRACT FROM AUTHOR]

The ultimate performance--ratio of electrical conductivity to optical absorbance--of single-walled carbon nanotube (SWCNT) transparent conductive films (TCFs) is an issue of considerable application relevance. Here, we present direct experimental evidence that SWCNT bundling is detrimental for their performance. We combine floating catalyst synthesis of non-bundled, high-quality SWCNTs with an aggregation chamber, in which bundles with mean diameters ranging from 1.38 to 2.90 nm are formed from identical 3 µm long SWCNTs. The as-deposited TCFs from 1.38 nm bundles showed sheet resistances of 310 Ω/□ at 90% transparency, while those from larger bundles of 1.80 and 2.90 nm only reached values of 475 and 670 Ω/□, respectively. Based on these observations, we elucidate how networks formed by smaller bundles perform better due to their greater interconnectivity at a given optical density. Finally, we present a semi-empirical model for TCF performance as a function of SWCNT mean length and bundle diameter. This gives an estimate for the ultimate performance of non-doped, random network mixed-metallicity SWCNT TCFs at ~80 Ω/□ and 90% transparency. [ABSTRACT FROM AUTHOR]

We present a floating catalyst synthesis route for individual, i.e., non-bundled, small diameter single-walled carbon nanotubes (SWCNTs) with a narrow chiral angle distribution peaking at high chiralities near the armchair species. An ex situ spark discharge generator was used to form iron particles with geometric number mean diameters of 3-4 nm and fed into a laminar flow chemical vapour deposition reactor for the continuous synthesis of long and high-quality SWCNTs from ambient pressure carbon monoxide. The intensity ratio of G/D peaks in Raman spectra up to 48 and mean tube lengths up to 4 μm were observed. The chiral distributions, as directly determined by electron diffraction in the transmission electron microscope, clustered around the (n,m) indices (7,6), (8,6), (8,7), and (9,6), with up to 70% of tubes having chiral angles over 20°. The mean diameter of SWCNTs was reduced from 1.10 to 1.04 nm by decreasing the growth temperature from 880 to 750 °C, which simultaneously increased the fraction of semiconducting tubes from 67% to 80%. Limiting the nanotube gas phase number concentration to ~105cm-3 prevented nanotube bundle formation that is due to collisions induced by Brownian diffusion. Up to 80% of 500 asdeposited tubes observed by atomic force and transmission electron microscopy were individual. Transparent conducting films deposited from these SWCNTs exhibited record low sheet resistances of 63 Ω/□ at 90% transparency for 550 nm light. [ABSTRACT FROM AUTHOR]

One hind quarter of 27 healthy lactating cows was infused with 100 μg Escherichic coil endotoxin. Two hours later, nine of the cows were given physiological saline by intramuscular injection, nine were given 4 mg/kg ketoprofen orally, and nine were given 3 mg/kg ketoprofen by intramuscular injection. Ketoprofen administered either orally or parenterally significantly reduced the effect of the endotoxin on rectal temperature, ruminal contractions and respiratory rate. The size of the udder, the signs of pain and the concentrations of thromboxane B2, especially in plasma, were also reduced, and the appearance of their milk was almost normal. The response of cows to the oral treatment was as rapid as it was to intramuscular treatment. [ABSTRACT FROM AUTHOR]

Introduction: Three migrant population studies conducted in Finland over this decade (Migrant Health and Wellbeing Study, Survey on work and well-being among people of foreign origin and Asylum Seekers Health and Wellbeing Survey) has shown that immigrants, especially those who come to Finland as refugees or from similar conditions, experience a higher level of psychological load than general population. Objectives: The aim is to explain how Finland builds the mental health services for refugees. Methods: The PALOMA project (Developing National Mental Health Policies for Refugees) was launched in 2016 to tackle this wellbeing cap in the population. One outcome of the project was PALOMA handbook. The handbook includes recommendations and tools for promoting refugees' mental health and to enhance the services. During the project the need for the regional centers of expertise on refugees mental health work was recognized. To fulfill this need the PALOMA2 project (National support system for refugee mental health work and the knowhow dissemination) started in February 2019. The tasks of the Centre are to coordinate the refugees' mental health work, build networks and organize training. It also provides clinical guidance and consultation and develops the services by implementing best practices. The tasks are assigned to all five university hospitals. Therefore the Centre of Expertise covers the whole country. Results: As a result of the PALOMA work the mental health work with the refugees will be systematically organized as a part of the service system. Conclusions: The PALOMA work has systematically improved the mental health services of the refugees in Finland. [ABSTRACT FROM AUTHOR]

Abstract The role of the α2C-adrenoceptor subtype in mediating the beneficial effect of α2-adrenoceptor agonists on spatial working memory was studied in adult mice with targeted inactivation of the α2C-receptor gene (KO) and their wild-type controls (WT). A delayed alternation task was run in a T-maze with mixed delays varying from 20 s to 120 s. Dexmedetomidine, a specific but subtype non-selective α2-adrenoceptor agonist, dose-dependently decreased the total number of errors. The effect was strongest at the dose of 5 μg/kg (s.c.), and was observed similarly in KO and WT mice. KO mice performed inferior to WT mice due to a higher number of perseverative errors. Dexmedetomidine slowed initiation of the motor response in the start phase at lower doses in WT mice than in KO mice but no such difference was observed in the return phase of the task, suggesting involvement of α2C-adrenoceptors in the cognitive aspect of response preparation or in response sequence initiation. According to these findings, enhancement of spatial working memory is best achieved with α2-adrenoceptor agonists which have neither agonistic nor antagonistic effects at the α2C-adrenoceptor subtype. [ABSTRACT FROM AUTHOR]

Four neonates with convulsions had IgG antibodies in their cerebrospinal fluid (CSF) to varicella zoster virus (VZV). These antibodies were found in the sera of two of these patients after the age of 6 months. Antibodies to 16 different microbes were studied from the serum and CSF of 201 neonates with neurological problems. The presence of DNA specific to HSV-1, HSV-2, and VZV in the CSF was also investigated using the polymerase chain reaction (PCR). Antibodies to VZV were detected in the CSF of four neonates. Antibody indices suggested production of VZV specific antibodies in the central nervous system. These findings suggest that intrathecal production of antibodies to VZV can appear in neonates with neurological problems, which suggests that intrauterine VZV infection can be acquired without cutaneous symptoms in the mother. [ABSTRACT FROM AUTHOR]

The efficacy of the combination of systemic enrofloxacin (5 mg/kg twice with a 24-h interval, first dose i.v., second dose s.c.) and the nonsteroidal antiinflammatory agent ketoprofen (3 mg/kg i.m. or 4 mg/kg per os daily for 1 to 3 d) treatment was compared with antiinflammatory treatment only in dairy cows with naturally occurring acute clinical Escherichia coli mastitis. A total of 132 cows with acute clinical mastitis and with confirmed growth of E. coli in a pretreatment milk sample were randomly allocated to 1 of 2 treatment groups. Response to treatment was evaluated clinically and by bacteriological culturing and determination of N-acetyl-β-d-glucosaminidase (NAGase) activity on d 2 and 21 posttreatment. Enrofloxacin treatment did not increase bacteriological (90.5% of treated vs. 86.8% of nontreated cured) or clinical cure (46.7% of treated vs. 57.1% of nontreated cured), cow survival (95.3% of treated vs. 92.7% of nontreated), or quarter milk production assessed 21 d posttreatment (21.8 vs. 29.3% return to preinfection level for nontreated cows), nor did it decrease mammary gland tissue damage estimated using determination of milk NAGase activity (24.0 ± 0.3 vs. 18.3 ± 1.3 pmol of 4-methylumbelliferone per min per μL for nontreated cows). Treatment did not influence the number of study cows remaining in the herd after 6 mo (71.9% of treated vs. 80.6% of nontreated). The only significant effects of enrofloxacin were enhancing the bacteriological cure (odds ratio = 3.32 for treated cows) and decreasing the clinical cure (odds ratio = 0.05 for treated cows) on d 2 posttreatment. Our results did not support the use of enrofloxacin to treat acute clinical E. coli mastitis. [ABSTRACT FROM AUTHOR]

The efficacy of parenteral (intramuscular) or intramammary (IMM) benzylpenicillin treatment for clinical mastitis caused by gram-positive bacteria susceptible to penicillin in vitro was investigated. Cows with clinical mastitis in 1 udder quarter were randomly placed into 2 treatment groups. The preliminary bacteriological diagnosis of intramammary infection (IMI) was based on on-farm culturing, and the bacteriological diagnoses were later confirmed by a quantitative PCR assay. Clinical mastitis caused by gram-positive bacteria susceptible to benzylpenicillin was treated with penicillin via either the parenteral route (20 mg/kg) or IMM route (600 mg) once per day for 5 d. The outcome of the treatment was evaluated 3 to 4 wk after the onset of the treatment. The affected quarter was examined to assess the clinical cure, and milk samples were collected from the affected quarter to determine the bacteriological cure and milk N-acetyl-β-D-glucosaminidase activity. The survival and the composite milk somatic cell counts of the treated cows were followed up for 6 and 3 mo after treatment, respectively. A total of 140 cows with clinical mastitis were included in the study, 61 being treated with benzylpenicillin parenterally and 79 via the IMM route. From all quarters treated, 108 of 140 (77.1%) were cured clinically and 77 of 140 (55.0%) were cured bacteriologically. The route of treatment did not significantly affect the outcome of the treatment; 80.3% of the quarters with parenteral treatment and 74.7% of the quarters with IMM treatment showed a clinical cure, and 54.1 and 55.7% a bacteriological cure, respectively. The milk N-acetyl-β-D-glucosaminidase activity was significantly lower in the quarters with a clinical or bacteriological cure than in the quarters with no cure. The 6-mo survival and the proportion of cows with composite milk somatic cell counts <200,000/mL among the treated cows during the 3-mo follow-up period did not significantly differ between the treatment groups. In conclusion, the outcome of either parenteral or IMM benzylpenicillin treatment of clinical mastitis caused by penicillin-susceptible bacteria was similar. [ABSTRACT FROM AUTHOR]

Background: Swine flu might serve as a model for challenges that primary care faces during pandemics. This study examined changes in the numbers and diagnoses of general practitioner (GP) visits during and after the Swine flu pandemic in Vantaa, a Finnish city, and how GP activities recovered after the pandemic. Putative sex and age group differences were also evaluated., Methods: The study was an observational retrospective study. The monthly number of patient visits to primary care GPs by women and men in age groups 0-19, 20-64 and 65 + years was recorded before, during and two years after the Swine flu pandemic. The recorded diagnoses were also examined. The investigation period was from 2008 to 2012., Results: The numbers of monthly visits to primary care decreased from 12 324 (mean) to 10 817 in women and from 8563 to 7612 in men during the first six months of the Swine flu, returning to the original level afterwards. This decrease was thus slightly more prominent in women. However, as the size of the population increased during the follow-up period, the actual number of GP visits adjusted for the size of population remained at a decreased level for two years after the Swine flu. This decrease was observed especially in office-hours visits of men (from 3692 to 3260) and women (from 6301 to 5428) of 20-64 years. Swine flu did not alter the number of visits to the primary care Emergency Department. The proportion of visits with diagnostic recordings of common infectious diseases mostly decreased during the Swine flu. Only a minor impact on the distribution of recordings of chronic diagnoses was found., Conclusion: A pandemic, such as Swine flu, may decrease office-hours visits to primary care GPs. This in turn may lead to activities of primary care being adjusted downward for a long time following the pandemic. Especially the age group 20-64 years may be affected. This risk should be considered when recovery from the COVID-19 pandemic begins. Swine flu did not affect the proportion of consultations of chronic diseases, but the number of diagnoses of common infectious diseases had diminished., (© 2024. The Author(s).)

Fabricating dispersed single atoms and size-controlled metal nanoclusters remains a difficult challenge due to sintering. Here, we demonstrate that atoms and clusters can be immobilized using atomically clean defect-engineered graphene as the matrix. The graphene is first cleaned of surface contamination with laser heating, after which low-energy Ar irradiation is used to create spatially well-separated vacancies into it. Metal atoms are then evaporated either via thermal or ebeam evaporation onto graphene, where they diffuse until being trapped into a vacancy. The density of embedded structures can be controlled through irradiation dose, and the size of the structures through evaporation time. The resulting structures are confirmed through atomic-resolution scanning transmission electron microscopy and electron energy loss spectroscopy. We demonstrate here incorporation of Al, Ti, Fe, Ag and Au single atoms or nanoclusters, but the method should work equally well for other elements., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Jani Kotakoski reports financial support was provided by Austrian Science Fund. Harriet Ahlgren reports financial support was provided by Austrian Science Fund. Kimmo Mustonen reports financial support was provided by Austrian Science Fund. Toma Susi reports financial support was provided by European Research Council. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The van der Waals atomic solids of noble gases on metals at cryogenic temperatures were the first experimental examples of two-dimensional systems. Recently, such structures have also been created on surfaces under encapsulation by graphene, allowing studies at elevated temperatures through scanning tunnelling microscopy. However, for this technique, the encapsulation layer often obscures the arrangement of the noble gas atoms. Here we create Kr and Xe clusters in between two suspended graphene layers, and uncover their atomic structure through transmission electron microscopy. We show that small crystals (N < 9) arrange on the basis of the simple non-directional van der Waals interaction. Larger crystals show some deviations, possibly enabled by deformations in the encapsulating graphene lattice. We further discuss the dynamics of the clusters within the graphene sandwich, and show that although all the Xe clusters with up to N ≈ 100 remain solid, Kr clusters with already N ≈ 16 turn occasionally fluid under our experimental conditions (under a pressure of ~0.3 GPa). This study opens a way for the so-far unexplored frontier of encapsulated two-dimensional van der Waals solids with exciting possibilities for fundamental condensed-matter physics research and possible applications in quantum information technology., (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)

Background: Previous electroencephalography (EEG) studies have indicated altered brain oscillatory α-band activity in schizophrenia, and treatment with repetitive transcranial magnetic stimulation (rTMS) using individualized α-frequency has shown therapeutic effects. Magnetic resonance imaging-based neuronavigation methods allow stimulation of a specific cortical region and improve targeting of rTMS; therefore, we sought to study the efficacy of navigated, individual α-peak-frequency-guided rTMS (αTMS) on treatment-refractory schizophrenia., Methods: We recruited medication-refractory male patients with schizophrenia or schizoaffective disorder in this doubleblind, sham-controlled study. We randomized patients to a 3-week course of either active αTMS or sham stimulation applied to the left dorsolateral prefrontal cortex (DLPFC). We assessed participants with the Positive and Negative Syndrome Scale (PANSS) and the Clinical Global Impression Scale (CGI) at baseline and after treatment. We conducted a follow-up assessment with the PANSS 3 months after intervention., Results: We included 44 patients. After treatment, we observed a significantly higher PANSS total score ( p = 0.029), PANSS general psychopathology score ( p = 0.027) and PANSS 5-factor model cognitive-disorganized factor score ( p = 0.011) in the αTMS group than the sham group. In addition, the CGI-Improvement score was significantly higher among those who received αTMS compared with sham stimulation ( p = 0.048)., Limitations: The limited number of study participants included only male patients. Depression was not formally evaluated., Conclusion: Navigated αTMS to the left DLPFC reduced total, general psychopathological, and cognitive-disorganized symptoms of schizophrenia. These results provide evidence for the therapeutic efficacy of individual α-peak-frequency-guided rTMS in treatment-refractory schizophrenia., Clinical Trial Registration: NCT01941251; ClinicalTrials.gov., Competing Interests: Competing interests:: Sara Määttä is vice president of the Finnish Society of Clinical Neurophysiology. Petro Julkunen reports unrelated consulting fees and a patent with Nexstim Plc. No other competing interests were declared., (© 2024 CMA Impact Inc. or its licensors.)

Background: Laparoscopic ventral hernia repair (LVHR) may be associated with chronic pain, seroma formation, bulging and failure to restore abdominal wall function. These outcomes are risk factors for hernia recurrence and poor quality of life (QoL). Our study evaluates whether robotic-assisted ventral hernia repair (rVHR) diminishes these complications compared to LVHR with primary closure of the defect (hybrid)., Methods: Thirty-eight consecutive patients undergoing incisional ventral hernia operation with fascial defect size from 3 to 6 cm were recruited between November 2019 and October 2020. Nineteen patients underwent rVHR and nineteen underwent hybrid operation. The main outcome measure was postoperative pain, evaluated with a visual analogue scale (VAS: 0-10) at 1-month and at 1-year. Hernia recurrence was evaluated with ultrasound examination and QoL using the generic SF-36 short form questionnaire., Results: At the 1-month control visit, VAS scores were significantly lower in the rVHR group; 2.5 in the hybrid group and 0.3 in the rVHR group ( p  < 0.001). At the 1-year control, the difference in VAS scores was still significant, 2.8 vs 0.1 ( p  = 0.023). There was one hernia recurrence in the hybrid group ( p  = 0.331). QoL did not differ significantly between the study groups when compared to preoperative physical status at 1-year follow-up ( p  = 0.121). However, emotional status ( p  = 0.049) and social functioning ( p  = 0.039) improved significantly in the rVHR group., Conclusions: Robotic-assisted ventral hernia repair (rVHR) was less painful compared to hybrid repair at 1-month and at 1-year follow-up. In addition, improvement in social functioning status was reported with rVHR., Trial Registration Id: 5200658.

This study, conducted in a Finnish city, examined whether a long-lasting observed trend in Finnish primary health care, namely, a decreasing rate of office-hour visits to general practitioners (GPs), would lead to reduced services for specific gender, diagnosis or age groups. This was an observational retrospective follow-up study. The annual number of visits to office-hour primary care GPs in different gender, diagnosis and age groups was recorded during a 13-year follow-up period. The effect of the decreasing visit rate on the annual mortality rate in different age and gender groups was also studied. The total number of monthly visits to office-hour GPs decreased slowly over the whole study period. This decrease was stronger in women and older people. The proportion of recorded infectious diseases (Groups A and J and especially diagnoses related to infections of respiratory airways) decreased. Proportions of recorded chronic diseases increased (Group I, cardiovascular diseases, diabetes and osteoarthrosis) during the follow-up. The annual rate of visits to office-hour GP/per GP decreased. There was a decrease in the mortality in two of the age groups (20-64, 65+ years) and no change in the youngest population (0-19 years). The decrease in the office-hours GP activity does not seem to increase mortality either.

Substituting heteroatoms into graphene can tune its properties for applications ranging from catalysis to spintronics. The further recent discovery that covalent impurities in graphene can be manipulated at atomic precision using a focused electron beam may open avenues towards sub-nanometer device architectures. However, the preparation of clean samples with a high density of dopants is still very challenging. Here, we report vacancy-mediated substitution of aluminium into laser-cleaned graphene, and without removal from our ultra-high vacuum apparatus, study their dynamics under 60 keV electron irradiation using aberration-corrected scanning transmission electron microscopy and spectroscopy. Three- and four-coordinated Al sites are identified, showing excellent agreement with ab initio predictions including binding energies and electron energy-loss spectrum simulations. We show that the direct exchange of carbon and aluminium atoms predicted earlier occurs under electron irradiation, although unexpectedly it is less probable than the same process for silicon. We also observe a previously unknown nitrogen-aluminium exchange that occurs at Al─N double-dopant sites at graphene divacancies created by our plasma treatment., Competing Interests: Conflict of interest The authors declare no conflicts of interest.

Background: This study, conducted in a Finnish city, examined whether decreasing emergency department (ED) services in an overcrowded primary care ED and corresponding direction to office-hours primary care would modify service usage for specific gender, age or diagnosis groups., Methods: This was an observational retrospective study carried out by gradually decreasing ED services in primary care. The interventions aimed at decreasing use of EDs were a) application of ABCDE-triage combined with public guidance on the proper use of EDs, b) closure of a minor supplementary ED, and finally, c) application of "reverse triage" with enhanced direction of the public to office-hours services and away from the remaining ED The annual number of visits to office-hours primary care GPs in different gender, age and diagnosis groups (International Classification of Diseases (ICD - 10) were recorded during a 13-year follow-up period., Results: The total number of monthly visits to EDs decreased slowly over the whole study period. This decrease was similar in women and men. The decrease was stronger in the youngest age groups (0-19 years). GPs treated decreasing proportions of ICD-10 groups. Recorded infectious diseases (Groups A and J, and especially diagnoses related to infections of respiratory airways) tended to decrease. However, visits due to injuries and symptomatic diagnoses increased., Conclusion: Decreasing services in a primary health care ED with the described interventions seemed to reduce the use of services by young people. The three interventions mentioned above had the effect of making the primary care ED under study appear to function more like a standard ED driven by specialized health care., (© 2022. The Author(s).)

Heterostructures composed of 2D materials are already opening many new possibilities in such fields of technology as electronics and magnonics, but far more could be achieved if the number and diversity of 2D materials were increased. So far, only a few dozen 2D crystals have been extracted from materials that exhibit a layered phase in ambient conditions, omitting entirely the large number of layered materials that may exist at other temperatures and pressures. This work demonstrates how such structures can be stabilized in 2D van der Waals (vdw) stacks under room temperature via growing them directly in graphene encapsulation by using graphene oxide as the template material. Specifically, an ambient stable 2D structure of copper and iodine, a material that normally only occurs in layered form at elevated temperatures between 645 and 675 K, is produced. The results establish a simple route to the production of more exotic phases of materials that would otherwise be difficult or impossible to stabilize for experiments in ambient., (© 2022 The Authors. Advanced Materials published by Wiley-VCH GmbH.)

Proactive and coordinated action to mitigate and adapt to climate change will be essential for achieving the healthy, resilient, safe, sustainably harvested and biodiverse ocean that the UN Decade of Ocean Science and sustainable development goals (SDGs) seek. Ocean-based mitigation actions could contribute 12% of the emissions reductions required by 2030 to keep warming to less than 1.5 ºC but, because substantial warming is already locked in, extensive adaptation action is also needed. Here, as part of the Future Seas project, we use a "foresighting/hindcasting" technique to describe two scenarios for 2030 in the context of climate change mitigation and adaptation for ocean systems. The "business-as-usual" future is expected if current trends continue, while an alternative future could be realised if society were to effectively use available data and knowledge to push as far as possible towards achieving the UN SDGs. We identify three drivers that differentiate between these alternative futures: (i) appetite for climate action, (ii) handling extreme events, and (iii) climate interventions. Actions that could navigate towards the optimistic, sustainable and technically achievable future include:(i)proactive creation and enhancement of economic incentives for mitigation and adaptation;(ii)supporting the proliferation of local initiatives to spur a global transformation;(iii)enhancing proactive coastal adaptation management;(iv)investing in research to support adaptation to emerging risks;(v)deploying marine-based renewable energy;(vi)deploying marine-based negative emissions technologies;(vii)developing and assessing solar radiation management approaches; and(viii)deploying appropriate solar radiation management approaches to help safeguard critical ecosystems., Supplementary Information: The online version contains supplementary material available at 10.1007/s11160-021-09678-4., Competing Interests: Conflict of interestThe authors declared that they have no conflict of interest., (© Crown 2021.)

One of the most pronounced effects of climate change on the world's oceans is the (generally) poleward movement of species and fishery stocks in response to increasing water temperatures. In some regions, such redistributions are already causing dramatic shifts in marine socioecological systems, profoundly altering ecosystem structure and function, challenging domestic and international fisheries, and impacting on human communities. Such effects are expected to become increasingly widespread as waters continue to warm and species ranges continue to shift. Actions taken over the coming decade (2021-2030) can help us adapt to species redistributions and minimise negative impacts on ecosystems and human communities, achieving a more sustainable future in the face of ecosystem change. We describe key drivers related to climate-driven species redistributions that are likely to have a high impact and influence on whether a sustainable future is achievable by 2030. We posit two different futures-a 'business as usual' future and a technically achievable and more sustainable future, aligned with the Sustainable Development Goals. We then identify concrete actions that provide a pathway towards the more sustainable 2030 and that acknowledge and include Indigenous perspectives. Achieving this sustainable future will depend on improved monitoring and detection, and on adaptive, cooperative management to proactively respond to the challenge of species redistribution. We synthesise examples of such actions as the basis of a strategic approach to tackle this global-scale challenge for the benefit of humanity and ecosystems., Supplementary Information: The online version contains supplementary material available at 10.1007/s11160-021-09641-3., Competing Interests: Conflict of interestThe authors declare that they have no conflict of interest., (© Crown 2021.)

Coastal Indigenous and Traditional communities are starting to see changes to their lives from climate change, whether this is from species range changes or displacement from land changes. For many of these communities, the ability to adequately adapt to these changes is limited by the governance structures they are required to live within, which differ from their customary practices and culture. In November 2019, a group of Indigenous and Traditional Peoples, attended the Future Seas 2030 workshop and discussed the consequences of climate change, the biggest barriers for their communities, and barriers for using traditional knowledge in order to contribute towards a more sustainable future that in the end will benefit all of earth's people. The aim of this workshop was to highlight and give a voice to the various backgrounds and real-life situations impacting on some of the world's Indigenous and Traditional communities whose connection with the oceans and coasts have been disrupted. This paper presents these issues of oppression, colonisation, language and agency, making it difficult for these groups to contribute to the current management of oceans and coasts, and asks scientists and practitioners in this space to be allies and enable the needed shift to earth's guardians taking a leading role in nurturing her for our future., (© The Author(s) 2021.)

To determine the extent to which it is possible to provide continuity of primary care for those who visit Emergency Departments (EDs) we studied how recorded diagnoses in primary care differ, depending on whether the patient is met in an ED or a primary care office-hours practice. In the present, 12-year follow-up study a report generator of the Electronic Health Record-system provided monthly figures for the number of different recorded diagnoses using the International Classification of Diagnoses (10 th edition, ICD-10) and the total number of ED doctors and office-hour visits to General Practitioners (GPs). The 20 most common diagnoses covered 48.1% of the visits with recorded diagnoses to the office hour GPs and 45.9% of the visits to the doctors of the ED. Of these 20 diagnoses, 10 were common in both systems. These 10 diagnoses constituted about 30% of the diagnoses given by ED doctors. Furthermore, five out of the six most common diagnoses were the same in the ED and office-hours practices. The doctors in EDs and office-hour GPs treat quite similar patient material. This may provide organisational ways to reorganise the work of primary care and to guarantee continuity of care for those who may benefit from it.

Single atoms and few-atom nanoclusters are of high interest in catalysis and plasmonics, but pathways for their fabrication and placement remain scarce. We report here the self-assembly of room-temperature-stable single indium (In) atoms and few-atom In clusters (2-6 atoms) that are anchored to substitutional silicon (Si) impurity atoms in suspended monolayer graphene membranes. Using atomically resolved scanning transmission electron microscopy (STEM), we find that the symmetry of the In structures is critically determined by the three- or fourfold coordination of the Si "anchors". All structures are produced without electron-beam induced materials modification. In turn, when activated by electron beam irradiation in the STEM, we observe in situ the formation, restructuring, and translation of the Si-anchored In structures. Our results on In-Si-graphene provide a materials system for controlled self-assembly and heteroatomic anchoring of single atoms and few-atom nanoclusters on graphene.

Structural engineering is the first step toward changing properties of materials. While this can be at relative ease done for bulk materials, for example, using ion irradiation, similar engineering of 2D materials and other low-dimensional structures remains a challenge. The difficulties range from the preparation of clean and uniform samples to the sensitivity of these structures to the overwhelming task of sample-wide characterization of the subjected modifications at the atomic scale. Here, we overcome these issues using a near ultrahigh vacuum system comprised of an aberration-corrected scanning transmission electron microscope and setups for sample cleaning and manipulation, which are combined with automated atomic-resolution imaging of large sample areas and a convolutional neural network approach for image analysis. This allows us to create and fully characterize atomically clean free-standing graphene with a controlled defect distribution, thus providing the important first step toward atomically tailored two-dimensional materials.

The electronic and magnetic properties of graphene can be modulated by doping it with other elements, especially those with a different number of valence electrons. In this article, we first provide a three-dimensional reconstruction of the atomic structure of a phosphorus substitution in graphene using aberration-corrected scanning transmission electron microscopy. Turning then to theoretical calculations based on the density functional theory (DFT), we show that doping phosphorus in various bonding configurations can induce magnetism in graphene. Our simulations reveal that the electronic and magnetic properties of P-doped (Gr-P) and/or phosphono-functionalized graphene (Gr-PO 3 H 2 ) can be controlled by both the phosphorus concentration and configurations, ultimately leading to ferromagnetic (FM) and/or antiferromagnetic (AFM) features with the transition temperature up to room temperature. We also calculate core-level binding energies of variously bonded P to facilitate X-ray photoelectron spectroscopy-based identification of its chemical form present in P-doped graphene-based structures. These results may enable the design of graphene-based organic magnets with tailored properties for future magnetic or spintronic applications.

Here, a scalable floating catalyst chemical vapor deposition (FCCVD) method is developed for the production of single-walled carbon nanotubes (SWCNTs) with a controlled structure. For the first time, water is used as the growth promoter in the FCCVD process to modulate the growth of SWCNTs. At an optimum water concentration of ca. 115 ppm, the water-assisted FCCVD process synthesizes SWCNTs with a significantly narrow chirality distribution. In particular, the proportion of (9,8) and (8,7) semiconducting tubes was dramatically enhanced to 45% with 27% of the (9,8) tube in the end product. This is attributed to the changes in both the SWCNT diameter and the chiral angle. The experiment results and accurate quantum chemical molecular dynamics simulations show that the addition of water affects the nucleation and the size distribution of nanoparticle catalysts, thus resulting in the growth of SWCNTs with a highly uniform structure. This direct and continuous water-assisted FCCVD provides the possibility for the mass production of high-quality SWCNTs with a controlled structure.

Dynamic surface modification of suspended graphene at high temperatures was directly observed with in situ scanning transmission electron microscopy (STEM) measurements. The suspended graphene devices were prepared on a SiN membrane substrate with a hole so that STEM observations could be conducted during Joule heating. Current-voltage characteristics of suspended graphene devices inside the STEM chamber were measured while monitoring and controlling the temperature of graphene by estimating the electrical power of the devices. During the in situ STEM observation at high temperatures, residual hydrocarbon adsorbents that had remained on graphene effectively evaporated creating large, atomically clean graphene areas. At other places, dynamic changes in the shape, position, and orientation of adsorbents could be directly observed. The temperature of the suspended graphene sample was estimated to reach up to 2000 K during the experiment, making graphene an efficient high-temperature micrometer-sized electron-transparent hot plate for future experiments in microscopes.

Objective: It is generally expected that the growth of the older population will lead to an increase in the use of health care services. The aim was to examine the changes in the number of visits made to general practitioners (GP) by the older age groups, and whether such changes were associated with changes in mortality rates. Design and setting: A register-based observational study in a Finnish city where a significant increase in the older population took place from 2003 to 2014. The number of GP visits made by the older population was calculated, the visits per person per year in two-year series, together with respective mortality rates. Subjects: The study population consisted of inhabitants aged 65 years and older (65+) in Vantaa that visited a GP in primary health care. Main outcome measures: The number of GP visits per person per year in the whole older population during the study years. Results: In 2009-2010, there was a sudden drop in GP visits per person in the younger (65-74 years) age groups examined. In the population aged 85+, use of GP visits remained at a fairly constant level. The mortality rate decreased until the year 2008. After that, the positive trend ended and the mortality rate plateaued. Conclusions: Simultaneously with the decline in GP visits per person in the older population, the mortality rate leveled off from its positive trend in 2009-2010. Factors identified being associated with the number of GP consultations were organizational changes in primary health care, economic recession causing retrenchment, and even vaccinations during the swine flu epidemic.Key pointsAlong with an increasingly ageing population, concern over the supply of publicly funded health care has become more pronounced.The amount of GP visits of 65+ decreased in primary health care, especially in the youngest groups.However, in the oldest age groups (85+), the use of GPs remained unchanged regardless of changes in service supply.As the rate of GP visits among the population of 65+ declined, the positive trend in the mortality rate ceased.