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Objective To evaluate the safety and efficacy of percutaneous left atrial appendage occlusion (LAAO) using conscious sedation (CS).Background Several percutaneous structural heart disease interventions are safely and efficiently performed using CS instead of general anaesthesia (GA). This concept has not been evaluated in a large multicenter cohort of patients undergoing LAAO.Methods Patients from the prospective, global Amplatzer Amulet Occluder Observational Study were divided into two groups (GA vs CS). Baseline information, periprocedural and postprocedural efficacy and complications, as well as outcomes through 7 days post implant were compared.Results Patients undergoing transesophageal-guided implants were categorised by GA (n=607, 64%) or CS (n=342, 36%) usage. Mean age was 75 years in both groups. LAAO technical success was achieved in 99% of both groups. The procedure duration (GA: 35±22 min vs CS: 27±19 min, p

Aims To evaluate factors influencing the length of stay in patients undergoing percutaneous left atrial appendage occlusion (LAAO). Methods and results Patient characteristics, procedural data and the occurrence of serious adverse events were analyzed from the AmplatzerTM AmuletTM Occluder Observational Study. Patients were divided into three groups: same day (S, 0day, n = 60, 5.6%) early (E, 1day, n = 526, 48.9%), regular (R, 2-3days, n = 338, 31.4%) and late (L, ≥4days, n = 152, 14.1%) discharge and followed up for 60 days. Procedure and device related SAE during the in-hospital stay (S: 0.0% vs. E: 1.0% vs. R: 2.1% vs. L: 23%, pConclusion Over half of the subjects receiving an Amplatzer Amulet occluder were discharged within 1 day of the implant procedure. Serious adverse events were a major trigger for a late discharge after LAAO. Increased HAS-BLED score was associated with a prolonged in-hospital stay.

Laser-induced breakdown spectroscopy (LIBS) in combination with a time-resolved Fourier-transform technique was applied to obtain spectra of In I in the infrared spectral region. This method was proven to be suitable for measuring the weak energy transitions between highly excited Rydberg atomic levels. The advantage comes from the possibility of selecting an optimal time-delay after the laser pulse, when the low intensity spectral lines are near their maximum intensity and can filter out the disturbing high intensity lines with different emission time profiles. The time-resolved spectra were recorded in the 700-1000, 900-1300, 1200-1680, 1800-4000, 4100-5000 and 5000-7700 cm-1 ranges with a resolution of 0.017 cm-1. Using this technique, we obtained five g- and h-levels of In I that have never been measured previously. We demonstrate a close similarity of wavenumbers for the 7s1/2-7p1/2 and 4f-5g transitions of the In atom. [ABSTRACT FROM AUTHOR]

During 2020, the COVID-19 crisis expanded the use of digital tools in public health and social care. The aim of this qualitative, single-case study was to scrutinize how homecare professionals experienced meaningfulness in their work in the midst of a crisis and with the utilization of the videophone in long-term homecare service provision. The empirical data consisted of 20 thematic interviews carried out among homecare professionals and their managers in the city of Tampere, Finland. The results indicated that the videophone can generate significance, self-realization and broader purposes among homecare professionals, thus providing meaningfulness for work in the midst of a crisis and continuous work-related changes. In addition, a crisis may support change in the meaningfulness of e-welfare in work-related tasks and aid in overcoming reluctance amongst public-sector social care (homecare) professionals towards an e-welfare initiative: the videophone (VideoVisit).

Understanding and working under complexity has become ‘the new normal’ in public administration. Hence complexity must also be integrated into teaching and training of public administrators, not only in higher education but also in in-service training and educating wider society. This can be done by combining the ongoing research agenda into courses and teaching methods. This article describes the integration of complexity thinking and teaching in one university, both by giving examples on the courses and methods applied, student feedback received and by anticipating future developments. Finally, practical advice for teachers of complexity is given.

The thermoluminescent properties of polycrystalline chemical vapour deposition (CVD) diamond, as free-standing CVD cutting tool material, type CVDITE-CDM (De Beers Company), were studied with respect to its use in the dosimetry of soft X-ray emission from laser-produced plasma. The range of linearity for 5.9-keV radiation was measured to be only two orders of magnitude, ranging from a sensitivity threshold of ∼0.01 to ∼2 Gy. In this linearity range, the sensitivity of CVD diamonds is about 65 times lower than the sensitivity of TLD-100 dosimeters. The unpolished (grained) face of CVD diamonds shows ∼1.5-times higher thermoluminescence (TL) response after irradiation than the polished face, in the high-temperature range, but the polished face shows slightly higher TL response in the low-temperature range. A strong TL sensitivity to the blue portion of the visible light spectrum was measured. Simultaneous irradiation of TLD-100 dosimeters and CVD diamonds by soft X-rays emitted from a laser-produced plasma showed that CVDITE-CDM diamonds can be applied as detectors of intense soft X-ray radiation. [Copyright &y& Elsevier]

Abstract Background Atrial fibrillation (AF) is a common arrhythmia that causes numerous visits to emergency departments (ED). The aim of the FinFib2 study was to evaluate whether treatment of patients with AF in ED is consistent with the contemporary European Society of Cardiology (ESC) management guidelines. Here we report the results of antiarrhythmic drug therapy (AAD) in ED. Methods All patients within the two-week study period whose primary reason for the ED visit was symptomatic AF were included into this prospective multicentre study. Comprehensive data on factors contributing to the treatment of AF were collected, including a data of previous use of ADDs, and changes made for them during a visit in ED. Results The study population consisted of 1013 consecutive patients (mean age 70 ± 13 years, 47.6% female). The mean European Heart Rhythm Association (EHRA) symptom score was 2.2 ± 0.8. Rhythm control strategy was opt for 498 (63.8%) and 140 (64.5%) patients with previously and newly diagnosed AF, respectively. In patients with previously diagnosed AF the most frequently used AAD was a beta blocker (80.9%). Prior use of class I (11.4%) and III (9.1%) AADs as well as start or adjustment of their dosage (7.4%) were uncommon. Most of the patients with newly diagnosed AF were prescribed a beta blocker (71.0%) or a calcium channel antagonist (24.0%), and only two of them received class I or class III AADs. Conclusions Our data demonstrated that in patients presenting to the ED with recurrent symptomatic AF and aimed for rhythm control strategy, the use of class I and class III AADs was rare despite ESC guideline recommendations. It is possible that early adaptation of a more aggressive rhythm control strategy might improve a quality of life for symptomatic patients and alleviate the ED burden associated with AF. Beta blockers were used by majority of patients as rate control therapy both in rate and rhythm control groups. Trial registration NCT01990105 . Registered 15 November 2013.

Abstract Background Varenicline is an efficacious medicine for smoking cessation (SC) but little is known about the characteristics of varenicline users. This study examined the characteristics of first-time (naïve) varenicline users in Finland and compared those who had previously used SC pharmacotherapy to those who were trying SC pharmacotherapy for the first time. Methods A cross-sectional survey was conducted in Finnish community pharmacies between February 2014 and January 2015. Pharmacy customers purchasing a varenicline starter package for the first time ever were asked to complete a questionnaire or to participate in a structured interview conducted by the pharmacist (identical questions). The questionnaire included questions about demographic characteristics, smoking habits, previous cessation attempts and factors associated with varenicline use. Results Altogether 98 people completed the survey. The majority were daily smokers (96%, n = 94), with a history of over 10 years of regular smoking (94%, n = 92), and a strong/very strong nicotine dependence (67%, n = 66). Half of the participants (54%, n = 53) were trying a SC pharmacotherapy for the first time. Demographic characteristics and smoking habits were similar between first-time and previous users of SC medications (p > 0.05). Health centers (42%, n = 41) and occupational health care clinics (37%, n = 36) were the most common sources of varenicline prescriptions. The majority of participants received the prescription for varenicline after mentioning their desire for quitting to a physician (70%, n = 69). Conclusions Considering the relatively large proportion of SC naïve medicine users among new users of varenicline, smokers who have previously been reluctant to quit smoking, to use other pharmacological SC interventions, or perhaps unaware of these options may be interested in attempting cessation with varenicline. Most participants made the initiative to discuss their smoking with the physician, which led to varenicline prescribing. This suggests that physicians may not satisfactorily recognize their patients’ nicotine dependence and desire to quit, and they should more actively support patients’ smoking cessation.

Evolution of the extreme ultraviolet (XUV) and soft X-ray (SXR) emission in the 50- to 2000-eV photon energy range from a plasma corona formed by loading a relatively thick Cu wire (with an initial diameter of 120μm) was observed in a Z-pinch discharge with a maximum current of 2 MA and current rise time of 100 ns. A diagnostic complex consisting of a five-channel SXR polychromator, a four-frame X-ray pinhole camera, and a mica crystal spectrograph shows that double-humped emission pulses in the XUV and SXR spectral ranges are generated 70–130 ns after the onset of the discharge current. The total energy of the pulses is 5 kJ, and the maximum power is 60 GW. A part of the observed kiloelectronvolt X-ray emission from three to five spots with diameters of 1–2 mm consists of the Cu K- and L-shell lines. © 2003 MAIK “Nauka / Interperiodica”. [ABSTRACT FROM AUTHOR]

Results are presented from the studies of the magnetic implosion of a tungsten wire liner onto an aluminum wire at currents of 2.0–2.6 MA. The experiments were carried out in the S-300 high-power pulsed facility at the Russian Research Centre Kurchatov Institute. The liner is composed of 50 wires 6μm in diameter and 1 cm in length, which are equally spaced on a circle 1 cm in diameter. An aluminum wire 120μm in diameter is positioned at the array axis. The liner implosion was accompanied by the generation of VUV and soft X-ray emission. The parameters of the pinch plasma produced during the liner implosion onto the aluminum wire were determined from the time-resolved spectral measurements by a five-channel polychromator. The ion and electron densities turned out to be equal to n[sub i]approx. 4×10[sup 19]cm[sup –3] and n[sub e]approx. 4×10[sup 20]cm[sup –3], respectively, and the electron temperature was T[sub e]approx. 40 eV. The radiation energy measured in the range 50–600 eV was 2–10 kJ. The sources of soft X-ray emission in hydrogen- and helium-like aluminum lines were the bright spots and local objects (clouds) formed in the plasma corona at an electron temperature of 200–500 eV and electron density of 10[sup 21]–10[sup 22]cm[sup –3]. The possibility of both the generation of an axial magnetic field during the liner implosion and the conversion of the energy of this field into soft X-ray emission is discussed. © 2002 MAIK “Nauka / Interperiodica”. [ABSTRACT FROM AUTHOR]

Results on iodine laser production of Ag, Au, Pb, Sn and Ta ions are presented and experiments on their implantation into steel, Al and plastics are compared and discussed. Ions were implanted without additional acceleration into metals to the depth of several hundreds of nanometers, and into plastics to a depths of up to several micrometers. [ABSTRACT FROM AUTHOR]

LULUCF vertailutasolaskemat tehtiin Mela-ohjelmistolla maksimoimalla 3,5 %:n nykyarvoa. Valittu korkokanta on Luonnonvarakeskuksen julkaisemien tuottoprosenttien keskiarvo. Osoitan normaalimetsälaskelmien ja teoreettisten tarkastelujen avulla, että metsätalouden tuottoprosentti ja nykyarvolaskennan korkoprosentti ovat kuitenkin vertailukelvottomia. Tuottoprosentin laskennassa metsien arvona käytetään hakkuuarvoa, joka ei ota huomioon paljaan maan arvoa eikä sitä, että kasvatettavan puuston arvo on suurempi metsässä kuin hakattuna. Hakkuuarvo on aliarvio metsien nykyarvoteorian mukaiselle arvolle paitsi silloin, kun paljaan maan arvo on kovin negatii­vinen. Siten tuottoprosentti on pienempi tai yhtä suuri kuin kiertoaikojen määrittelyyn käytetty korkoprosentti ainoastaan kovin huonoilla kasvupaikoilla, korkeilla koroilla ja korkeilla uudistamiskustannuksilla. Kirjoituksessa esitetään myös, että Metsähallituksen tuottoprosentti riippuu niin suoraviivaisesti metsien pääoma-arvon laskennassa käytetystä korosta, että tuottoprosentti on epäinformatiivinen.