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Abstract Background Violence against Emergency Medical Services (EMS) personnel vary between studies. Current studies are mainly based on self-reporting, thus other designs are needed to provide more perspective. The purpose of this study was to explore the rate and predictors of violent behavior targeted at EMS personnel by exploring the Electronic patient care records (ePCR) documentation by EMS personnel. Methods This was a retrospective cohort study of EMS patients in Finland. The data were collected from three regions between 1st June and 30th November 2018. Text mining and manual evaluation were used to identify and explore predictors of violence targeted at EMS personnel from the ePCR narratives. Multivariable logistic regressions were used to determine factors that were independently associated with violent behavior. The results are presented with odds ratios (ORs) with 95% confidence intervals (CIs). Results The EMS personnel reported experiences of violence in a total of 297 identified missions (0.7%) of all EMS missions (n = 40,263). The violence was mostly verbal (62.3%) and the most common violence perpetrator was the patient (98.0%). The police were alarmed to many missions where violence was reported (40.7%). Sometimes violence occurred suddenly although the police were present. The multivariable logistic regression model indicates that violence occurred typically in urban areas (OR 1.699; 95% CI 1.283 to 2.248), at weekend nights (OR 1.357; 95% CI 1.043 to 1.765), by male (OR 1.501; 95% CI 1.160 to 1.942), and patients influenced by alcohol (OR 3.464; 95% CI 2.644 to 4.538). A NEWS2 score of 3 in any parameter (vs. score 0–4, OR 2.386; 95% CI: 1.788 to 3.185) and ALS unit type (vs. BLS, OR 1.373; 95% CI: 1.009 to 1.866) increased the likelihood as well. Conclusions The documentation in ePCRs show low rates of violence targeted at EMS personnel. However, violence is a multidimensional phenomenon connected to unfamiliar patients, rushed situations, and an uncontrolled environment. This means that the EMS personnels’ safety cannot be ensured in all situations. Therefore, a balance between safety margins and treating patients needs to be considered.

Abstract Azobenzenes are versatile photoswitches that garner interest in applications ranging from photobiology to energy storage. Despite their great potential, transforming azobenzene-based discoveries and proof-of-concept demonstrations from the lab to the market is highly challenging. Herein we give an overview of a journey that started from a discovery of hydroxyazobenzene’s humidity sensitive isomerisation kinetics, developed into commercialization efforts of azobenzene-containing thin film sensors for optical monitoring of the relative humidity of air, and arrives to the present work aiming for better design of such sensors by understanding the different factors affecting the humidity sensitivity. Our concept is based on thermal isomerisation kinetics of tautomerizable azobenzenes in polymer matrices which, using pre-defined calibration curves, can be converted to relative humidity at known temperature. We present a small library of tautomerizable azobenzenes exhibiting humidity sensitive isomerisation kinetics in hygroscopic polymer films. We also investigate how water absorption properties of the polymer used, and the isomerisation kinetics are linked and how the azobenzene content in the thin film affects both properties. Based on our findings we propose simple strategies for further development of azobenzene-based optical humidity sensors.

Abstract We compute the transverse and longitudinal diffractive structure functions to full next-to-leading order accuracy in the dipole picture of deep inelastic scattering. Our calculation uses the standard light-cone perturbation theory method for the partonic content of the virtual photon, together with the Color Glass Condensate description of the target color field. Our result includes as a subset the $$q\overline{q }g$$ contribution calculated earlier. We show that there is a rapidity divergence that can be factorized into the BK/JIMWLK evolution of the target Wilson lines, and that all other divergences cancel.

BackgroundMusculoskeletal (MSK) disorders represent a significant burden to society and can be unpleasant for the affected individuals. Physical activity (PA) can prevent MSK disorders while conferring other health benefits. The present study aimed to investigate associations between device-measured PA and perceived MSK disorders among young adult men.MethodsPA at different intensity levels, standing, and sedentary behavior were measured with a hip-worn accelerometer in a cohort of 422 young adult Finnish men aged 26 years on average. The incidences of three common MSK disorders (viz., knee pain, lumbar radicular pain, and lumbago pain) during the last month were inquired by a questionnaire. Binary logistic regression was used to examine the associations between the MSK outcomes and explanatory PA variables (PA times at different intensity levels, standing, and sedentary times). The models were controlled for age, education, smoking, BMI, and maximal oxygen uptake.ResultsPA, standing, and sedentary times were not significantly associated with the incidence of perceived MSK pain during the last month, except for lumbago pain. Lumbago pain was slightly more probable if the time spent in light PA increased, even after controlling for potential confounding factors, including moderate-to-vigorous PA, with an odds ratio (OR) of 1.07 (95% CI: 1.02–1.14). Sedentary time showed an opposite association, with an OR of 0.98 (95% CI: 0.96–1.00).ConclusionsThere were neither positive nor negative clinically meaningful associations between PA and recent MSK disorders among young adult men. The result is surprising and requires further confirmation.

Anemia is the most common hematological disorder affecting humans. In Peru, anemia is a pressing issue that present the most significant concern due to its adverse effects, such as delayed growth and psychomotor development, in addition to a deficiency in cognitive development. Anemia is a significant public health issue in Peru, which has one of the highest prevalence rates in infants in the Latin American and Caribbean (LAC) region, affecting approximately 43.6 % of children under three years nationally as of 2017, with rural areas experiencing a higher prevalence of approximately 53.3 %. In 2019, the prevalence was highest in the Sierra (48.8 %) and Selva regions (44.6 %), whereas the coast had a lower rate of 33.9 % in children under 36 months.Although the composition of the gut microbiota is relatively well described in children, there is little information on the identification of the microbiota in iron-deficiency anemia. There is evidence that diseases or health conditions can change the microbiota, or vice versa. This study aimed to identify the microbiota in children with anemia who did not recover after iron treatment. In a previous study, we found that the phylum Actinobacteria was predominant in the microbiota of children with anemia. These data will be useful for understanding the functionality of the most important bacteria found in each group at the genus or species level, especially the metabolic pathways in which they participate and their links with iron metabolism.Microbial composition data were obtained through next-generation 16S rRNA sequencing (NGS) of stool samples from children with anemia in southern Peru. Numerous studies have underscored the importance of early symbiotic development in infant health and its long-term impact on health. From infancy, modulation of the gut microbiota can promote long-term health. According to the National Institute of Health (NIH), iron-deficiency anemia may cause serious complications, such as fatigue, headaches, restless legs syndrome, heart problems, pregnancy complications, and developmental delays in children. The development of the gut microbiota is regulated by a complex interplay between host and environmental factors. The bidirectional link between the gut microbiota and anemia plays an important role in tracking the gut microbiota and will be useful in understanding the composition of the intestinal microbiota and its implications in anemia, which has now become a public health problem. Our previous study investigated the microbial composition in children with iron-deficiency anemia and revealed the presence of several bacterial groups, including Proteobacteria, Actinobacteria, Firmicutes, and Chloroflexi.In addition, these data may be useful for investigating the association between the intestinal microbiota of children with persistent anemia and those who have recovered.

Today, the worldwide economy and society are already taking advantage of the first deployments of 5G networks. However, the challenges that will be posed by 2030 networks on the infrastructure, technologies, and performance requirements call for a further leap in mobile communications. To this aim, evolutions of the 5G concepts in 5G-Advanced, and rethinking of future Radio Access Technologies, i.e., 6G which is expected to be the next revolution in the mobile ecosystem, are already being addressed by the scientific and industrial communities. In this framework, as demonstrated by 3GPP Rel. 17 specifications, Non-Terrestrial Networks (NTN) are expected to play a vital role in near and long term mobile communications, based on the joint optimisation of the terrestrial and non-terrestrial components in a unified 3D architecture. In this paper, we extensively discuss the 3GPP normative activities for 5G (Rel. 17), 5G-Advanced (Rel. 18 onward), and 6G (Rel. 20+) in terms of enabling features, architectures and interfaces, and protocols. Then, we explore the evolution of the 5G services towards 5G-Advanced and 6G NTN applications. Finally, we discuss the evolution to 6G network infrastructures with respect to the main performance requirements.

Sequence variation in the 16S gene is widely used to characterize diverse microbial communities. This was the first pilot study carried out in our region where the pulmonary microbiota of critically ill patients was investigated and analyzed, with the aim of finding a specific profile for these patients that can be used as a diagnostic marker. An study of critical patients mechanically ventilated for non-respiratory indications, in a polyvalent intensive care unit, was carried out; samplee were extracted by endotracheal aspiration and subsequently the microbiota was characterized through Next-Generation Sequencing Technology (NGS). The predominant phyla among the critically ill patients were Proteobacteria, Firmicutes and Bacteroidata. In the surviving patients group, the predominant phyla were Proteobacteria, Bacteroidata and Firmicutes, in the group of deceased patients thy were Firmicutes, Proteobacteria, and Bacteroidata. We found a decrease in commensal bacteria in deceased patients and a progressive increase in in-hospital germs.

Abstract Objectives Survival training can provide a unique setting for scientific examination of human stress responses and physical performance in a realistic operational military context. The aim of the present study was to observe effects of a 36-h recovery period on serum hormone concentrations, salivary cortisol, and marksmanship during 10-day winter military survival training in north of the Arctic Circle. Design and methods Sixty-eight male soldiers were randomly divided into two groups; EXP (n = 26) and CON (n = 42). While CON performed the whole exercise phase in the field, EXP had 36-h recovery period between days 6 and 8. Several hormones were measured during the study to investigate recovery. Results Subjective physical and mental demand as well as catabolic hormone levels increased and anabolic hormones decreased in CON (p

Baryte (BaSO4) is a critical raw material with no functional recycling since the used applications are dissipative. Significant quantities of baryte end up in tailings as a side stream from the mining industry. Baryte from a secondary raw material source was used as a filler in plastics for low duty radiation shielding and as an aggregate in radiation shielding geopolymers needed for safely storing low-radioactive waste ash. Mechanical strength in geopolymers remained at a high level with 0–50 % baryte additions. Low-cost plastic composites with baryte additions showed promising attenuation for X-rays and gamma-rays. The results showed improved qualities in the direct use of the secondary baryte material in concrete and plastics in comparison to primary baryte. Baryte from an industrial waste stream was shown to be applicable to be used in radiation shielding in geopolymers for storing low-radioactive waste, and in plastics. Primary baryte can be replaced with secondary baryte to bring environmental, economic, and even functional benefits.

Introduction: Generative AI is revolutionizing patient education in healthcare, particularly through chatbots that offer personalized, clear medical information. Reliability and accuracy are vital in AI-driven patient education. Research question: How effective are Large Language Models (LLM), such as ChatGPT and Google Bard, in delivering accurate and understandable patient education on lumbar disc herniation? Material and methods: Ten Frequently Asked Questions about lumbar disc herniation were selected from 133 questions and were submitted to three LLMs. Six experienced spine surgeons rated the responses on a scale from “excellent” to “unsatisfactory,” and evaluated the answers for exhaustiveness, clarity, empathy, and length. Statistical analysis involved Fleiss Kappa, Chi-square, and Friedman tests. Results: Out of the responses, 27.2% were excellent, 43.9% satisfactory with minimal clarification, 18.3% satisfactory with moderate clarification, and 10.6% unsatisfactory. There were no significant differences in overall ratings among the LLMs (p = 0.90); however, inter-rater reliability was not achieved, and large differences among raters were detected in the distribution of answer frequencies. Overall, ratings varied among the 10 answers (p = 0.043). The average ratings for exhaustiveness, clarity, empathy, and length were above 3.5/5. Discussion and conclusion: LLMs show potential in patient education for lumbar spine surgery, with generally positive feedback from evaluators. The new EU AI Act, enforcing strict regulation on AI systems, highlights the need for rigorous oversight in medical contexts. In the current study, the variability in evaluations and occasional inaccuracies underline the need for continuous improvement. Future research should involve more advanced models to enhance patient-physician communication.

BackgroundExercise self-efficacy is a crucial aspect of adopting and maintaining a physically active lifestyle. Regular physical activity may enhance exercise self-efficacy. This study aimed to investigate the baseline associations of physical fitness, physical activity, and body composition with exercise self-efficacy and the effects of military service on exercise self-efficacy. Methods: The sample consisted of healthy young Finnish conscripts (n = 243) undergoing military service. The participants were divided into two groups: an intervention group undergoing a high-intensity functional training program (n = 113) and a control group undergoing traditional physical training within their military service (n = 130). Exercise self-efficacy (adoption and barrier) and aerobic and muscular fitness were measured thrice (baseline, month 3, and month 5). Self-reported leisure-time physical activity and measured fat percentage were collected at baseline.ResultsAdoption and barrier exercise self-efficacy correlated positively with aerobic and muscular fitness and leisure time physical activity (r = 0.33–0.59, p

Vastaamme Antti ja Pentti Moilasen artikkelin “Ekososialisaatio ja ekoindividuaatio sivistysideaaleina: ekososiaalisen kasvatuksen teorian kritiikkiä” huomioihin, jotka perustuvat omista näkemyksistämme poikkeaviin tapoihin ymmärtää kasvatustiedettä ja ekologiaa. Moilasten saksalainen kasvatus- ja sivistysteoria ei ole soveltunut kasvatusfilosofisten tarkastelujemme lähtökohdaksi sen ihmiskeskeisyyden vuoksi. Tutkimusperinne, josta oma tarkastelumme kumpuaa, tunnistaa kasvatuksentutkimuksen monenlaisia teoreettisia näkökulmia soveltavana tieteenä. Monitieteisen ja monista teoreettisista perinteistä ammentavan ekososiaalisen kasvatusajattelun peruslähtökohtana on pyrkimys käsittää kasvatus ei-ihmiskeskeisesti ja avartaa mielikuvitusta kohti rakentavaa monilajista vuorovaikutusta ihmisen ja muun luonnon välillä. Ihmiskeskeinen tapa ymmärtää kasvatus ja sen peruskäsitteet uusintaa ekologisesti tuhoavaa suhdetta toisiin eläviin olentoihin. Artikkelimme puolustaa ekososialisaation ja ekoindividuaation käsitteitä, tarkentaa näihin liittyviä ajatuksia sekä oikoo Moilasten niihin liittämiä merkittävimpiä väärinkäsityksiä. Lisäksi puemme sanoiksi joitakin sellaisia ajatuksia, joita emme ole aiemmin katsoneet tarpeellisiksi avata siitä syystä, että nämä käsitykset ovat jo niin laajasti jaettuja moderneissa kasvatuksen teoretisoinneissa.

ABSTRACTThe present study investigated physiological, mental and physical performance changes during a 20-day winter military training course and the following 10-day recovery period. Fifty-eight (age 19 ± 1 years, height 182 ± 6 cm, body mass 78.5 ± 7.2 kg) male soldiers volunteered. Body composition, serum biomarker levels and performance tests were measured four times during the study. In addition, questionnaires were collected daily for subjective stress and rate of perceived exertion. The course induced significant declines in body (−3.9%, p

AbstractBackground In young patients, up to 40% of ischemic strokes remain cryptogenic despite modern-day diagnostic work-up. There are limited data on blood pressure (BP) behavior in these patients. Thus, we aimed to compare ambulatory blood pressure (ABP) profiles between young patients with a recent cryptogenic ischemic stroke (CIS) and stroke-free controls.Patients and Methods In this substudy of the international multicenter case–control study SECRETO (NCT01934725), 24-hour ambulatory blood pressure monitoring (ABPM) was performed in consecutive 18–49-year-old CIS patients and stroke-free controls. The inclusion criteria were met by 132 patients (median age, 41.9 years; 56.1% males) and 106 controls (41.9 years; 56.6% males). We assessed not only 24-hour, daytime, and nighttime ABP but also hypertension phenotypes and nocturnal dipping status.Results 24-hour and daytime ABP were higher among controls. After adjusting for relevant confounders, a non-dipping pattern of diastolic blood pressure (DBP) was associated with CIS in the entire sample (odds ratio, 3.85; 95% confidence interval, 1.20–12.42), in participants without antihypertensives (4.86; 1.07–22.02), and in participants without a patent foramen ovale (PFO) (7.37; 1.47–36.81). After excluding patients in the first tertile of the delay between the stroke and ABPM, a non-dipping pattern of DBP was not associated with CIS, but a non-dipping pattern of both systolic BP and DBP was (4.85; 1.37–17.10). In participants with a PFO and in those without hypertension by any definition, no associations between non-dipping patterns of BP and CIS emerged.Conclusions Non-dipping patterns of BP were associated with CIS in the absence of a PFO but not in the absence of hypertension. This may reflect differing pathophysiology underlying CIS in patients with versus without a PFO. Due to limitations of the study, results regarding absolute ABP levels should be interpreted with caution.Key MessagesNocturnal non-dipping patterns of blood pressure were associated with cryptogenic ischemic stroke except in participants with a patent foramen ovale and in those without hypertension by any definition, which may indicate differing pathophysiology underlying cryptogenic ischemic stroke in patients with and without a patent foramen ovale.It might be reasonable to include ambulatory blood pressure monitoring in the diagnostic work-up for young patients with ischemic stroke to detect not only the absolute ambulatory blood pressure levels but also their blood pressure behavior.

Abstract Evidence on the relationship between psychosocial well-being and physical activity (PA) is insufficient, especially in young adults between 18 and 29 years. Identifying protective factors for psychosocial well-being as well as factors that may promote PA behaviour in this specific age group is crucial. The aim of the present study was to explore the association between self-reported leisure time physical activity (LTPA) and a number of measures of psychosocial well-being in a large sample of Finnish young men. The sample used for this study is based on registers of the Finnish Defence Forces and consist of questionnaire-based data collected from 159,776 young healthy men (18–29 years, mean age 19 years) who started their military service during the period from 2015 to 2021. Sum scores were calculated for self-esteem and prosocial behaviour. Physical activity, number of friends and the relationship with the parents were each measured with a single question. Unadjusted and adjusted (education, financial situation of the family, family structure) logistic regression models were calculated. A multinominal logistic regression analysis showed that a higher level of LTPA was associated with a higher level of both prosocial behaviour (OR 6.12, 95% CI 5.88–6.36) and self-esteem (OR 4.41 95% CI 4.28–4.54). Further, LTPA had a positive relationship with good social relations, both with peers and parents. The odds ratio for participation in any LTPA weekly was higher (OR 2.74; CI 2.27–3.20) among those who had a close and trustworthy relationship with their parents compared to those men with more challenging relationships with their parents (OR 1.77; CI 1.46–2.14). An inactive lifestyle (PA less than once a week) seemed to be most common among men with no friends. About one third (31%) of men with no friends reported to engage in LTPA less than once a week, while only 10% of men with very many good friends reported to engage in similarly inactive LTPA behaviour. LTPA seems to be positively associated with self-esteem, prosocial behaviour and good social relations among young adult men. Actions aimed at promoting LTPA may have a positive impact on psychosocial well-being among young men, or vice versa. The relationship between PA and psychosocial well-being is complex and interrelated.

Autonomy – or rational self-control – is not only fashionable as an educational ideal, but also in present-day economics, ethics, and society in general. However, the concept of traditional autonomy is problematic because it privileges humans and treats the rest of nature primarily as resources fit only for human exploitation. This anthropocentrism has led human beings to see themselves as superior to nature and separate. Ecosocial autonomy is an attempt to redress the balance, by contextualising autonomy so it incorporates the idea of self-control, while taking into account the impact of humankind on our surrounding ecosystems. Our formulation of ecosocial autonomy is an extension of relational autonomy – based mainly on ecological, ecosocial, and ecofeminist ideas. Ecosocial autonomy is thus contextualized within a multispecies society which includes our interdependencies with other living creatures. Whereas the individualist idea of autonomy suggests a human being owes nothing to society, ecosocial autonomy acknowledges the need to cultivate aspects of self-sufficiency that combine reason, emotional maturity, and will. A competitive society presupposes individual autonomy and the need to defend oneself. Ecosocial autonomy advocates a form of social interaction that diverts the human energy misspent on individual competition to mutually beneficial collaboration.

The Fifth Generation (5G) communications systems aim to serve such service classes as Ultra-Reliable Low Latency Communications (URLLC), enhanced Mobile Broadband (eMBB), and massive Machine-Type Communications (mMTC). To meet the growing requirements posed to mobile networks, satellites can be used to complement the Terrestrial Networks (TNs). To increase the efficiency of the satellite communications involved, bandwidth-efficient techniques should be used. Multi- Connectivity (MC) is one such technique. In MC, a User Equipment (UE), for example, a smartphone, can be connected to multiple Next Generation Node Bs (gNBs) simultaneously. In this paper, an adaptive MC activation scheme for throughput enhancement in 5G and beyond Non-Terrestrial Networks (NTNs) is presented. The algorithm is evaluated by system simulations using different traffic split algorithms, namely, even split, data request per connection and per gNB algorithms. In the considered simulation scenario, the maximum throughput enhancement of 9.1%, compared to when MC is turned off, is experienced when using the adaptive Secondary Node (SN) addition algorithm with the combination of the data request algorithms.

Abstract Piezoelectric materials are widely used in electromechanical coupling components including actuators, kinetic sensors, and transducers, as well as in kinetic energy harvesters that convert mechanical energy into electricity and thus can power wireless sensing networks and the Internet of Things (IoT). Because the number of deployed energy harvesting powered systems is projected to explode, the supply of piezoelectric energy harvesters is also expected to be boosted. However, despite being able to produce green electricity from the ambient environment, high‐performance piezoelectrics (i.e., piezoelectric ceramics) are energy intensive in research and manufacturing. For instance, the design of new piezoceramics relies on experimental trials, which need high process temperatures and thus cause high consumption and waste of energy. Also, the dominant element in high‐performance piezoceramics is hazardous Pb, but substituting Pb with other nonhazardous elements may lead to a compromise of performance, extending the energy payback time and imposing a question of trade‐offs between energy and environmental benefits. Meanwhile, piezoceramics are not well recycled, raising even more issues in terms of energy saving and environmental protection. This paper discusses these issues and then proposes solutions and provides perspectives to the future development of different aspects of piezoceramic research and industry.

The Siberian flying squirrel ( Pteromys volans ) is included among the strictly protected species of the Habitats Directive (92/43/EC) of the European Union, which is one of the key instruments for biodiversity preservation in Europe. Strict protection of the species has a potential to cause conflicts in areas where forest management and urban development compete for the same space with the flying squirrel. This study examined attitudes of Finnish citizens toward the protection of flying squirrels in urban areas using survey data collected in three cities: Espoo, Jyväskylä, and Kuopio. Two samples (random and self-selection samples) were collected to investigate how the specific process of giving “voice” to citizens by polls in urban planning affects the results. The analysis was conducted by integrating factor and cluster analysis and multinomial logistic regression modeling. Four attitude groups of citizens were identified and named: “neutral on protection” (share of respondents: 33%), “strongly in favor of protection” (32%), “somewhat against protection” (26%), and “strongly against protection” (9%). Several individual-specific factors were found to be associated with the probability of belonging to different attitude groups. For example, female respondents had a higher probability of belonging to the group that was strongly in favor of protection, and older respondents had a higher probability of belonging to groups against protection. Respondents of the self-selection sample had a higher probability of belonging to the “strongly in favor of protection” group. They therefore had a more positive attitude toward the protection of flying squirrels than the other respondents. This finding indicates that cities may gain an overly positive view of citizens’ attitudes toward the protection of flying squirrels through current public participation methods based on self-selection procedures, such as public hearings used in land use planning.

Abstract Exclusive production of transversely polarized heavy vector mesons in deep inelastic scattering at high energy is calculated at next-to-leading order accuracy in the Color Glass Condensate framework. In addition to the first QCD correction proportional to the strong coupling constant α s, we systematically also include the first relativistic correction proportional to the heavy quark velocity squared v 2. When combined with our previously published results for longitudinal vector meson production at next-to-leading order accuracy, these results make phenomenological calculations of heavy vector meson production possible at the order O $$ \mathcal{O} $$ (α s v 0 , α s 0 $$ {\alpha}_{\mathrm{s}}^0 $$ v 2). When applied to J/ψ and Υ production at HERA and at the LHC, a good agreement between the next-to-leading order calculations and experimental data is found. Additionally, we demonstrate that vector meson production can provide additional constraints compared to structure function analyses when the nonperturbative initial condition for the Balitsky-Kovchegov evolution equation is extracted.

Abstract Background Predictors of subsequent events after Emergency Medical Services (EMS) non-conveyance decisions are still unclear, though patient safety is the priority in prehospital emergency care. The aim of this study was to find out whether machine learning can be used in this context and to identify the predictors of subsequent events based on narrative texts of electronic patient care records (ePCR). Methods This was a prospective cohort study of EMS patients in Finland. The data was collected from three different regions between June 1 and November 30, 2018. Machine learning, in form of text classification, and manual evaluation were used to predict subsequent events from the clinical notes after a non-conveyance mission. Results FastText-model (AUC 0.654) performed best in prediction of subsequent events after EMS non-conveyance missions (n = 11,846). The model and manual analyses showed that many of the subsequent events were planned before, EMS guided the patients to visit primary health care facilities or ED next or following days after non-conveyance. The most frequent signs and symptoms as subsequent event predictors were musculoskeletal-, infection-related and non-specific complaints. 1 in 5 the EMS documentation was inadequate and many of these led to a subsequent event. Conclusion Machine learning can be used to predict subsequent events after EMS non-conveyance missions. From the patient safety perspective, it is notable that subsequent event does not necessarily mean that patient safety is compromised. There were a number of subsequent visits to primary health care or EDs, which were planned before by EMS. This demonstrates the appropriate use of limited resources to avoid unnecessary conveyance to the ED. However, further studies are needed without planned subsequent events to find out the harmful subsequent events, where EMS non-conveyance puts patient safety at risk.

This study encompasses the development of high-performance PC/ABS blends utilizing recycled PC (r-PC) and recycled ABS (r-ABS) polymers from waste electric and electronic equipment (WEEE) fractions heavily contaminated by flame retardants (FRs). Upgrading of mechanical properties was facilitated by addition of virgin ABS and additives. In total three different WEEE fractions -containing high concentrations of bromine, chloride and phosphorous were purified from polymers other than PC and decontaminated from halogenated contaminants by dissolution-precipitation CreaSolv® Process. In two studied cases the WEEE fractions were optically pre-sorted for PC before purification and decontamination. Gas chromatography (GC-ECD) and X-ray fluorescence (XRF) analyses were performed to validate efficient removal of contaminants from r-PC.The targeted mechanical properties of polymers to upgrade are notched impact strength and elastic moduli. Upgrading was achieved by using the suitable compatibilizers, and, optionally by a chain extender. First, small-scale laboratory screening test series were conducted for three compatibilizers and different ABS polymers based on micro-compounding experiments. Upscaling test series based on the pre-screening data was then organized on a conventional bench scale twin-screw extruder.SEM microstructural characterizations of the blend morphology and fractured surfaces are done to correlate structure to the mechanical properties.Dynamic mechanical analysis (DMA) and Rheological Dynamic Analysis (RDA) and Gel permeation chromatography (GPC) provided some insight to the chain branching and molecular weight distribution of r-PC, respectively. Moreover, melt rheology and solid-state mechanical properties of the compatibilized r-PC/ABS blend were thoroughly investigated.Addition of virgin ABS polymer and a suitable compatibilizer enhance the properties of the recycled PC/ABS 60/40 blends towards virgin-like, allowing easily >55% r-PC content, or in favourable cases much higher than 75% recycled polymer content when applying significant concentration of recycled ABS from CreaSolv® together with some virgin ABS.

Purpose: The present study examined the association of vitamin D measured by serum 25(OH)D with physical performance outcomes and serum levels of anabolic hormones in young men.Methods: 412 young men (age 19 ± 1 year) entering their compulsory military service volunteered to participate in the study. The study consisted of two groups from two different military bases: Group A was studied in January and group B in July. The groups were first compared with each other and due to statistically significant (p < 0.001 analyzed with independent samples t-test) differences in physical condition (sit-up, push-up, and standing long jump-tests and testosterone levels) between the groups, groups were analyzed separately. The serum levels of 25(OH)D, testosterone (TES), sex hormone binding globulin (SHBG), and insulin-like growth factor-1 (IGF-1) were analyzed by electrochemiluminescence immunoassay. Physical performance tests consisted of muscular fitness (sit-ups, push-ups, standing long jump) and aerobic fitness (12-minute-running) tests. The association of serum 25(OH)D with physical performance tests and anabolic hormones was analyzed using linear regression.Results: After controlling for the group, body mass index, and leisure-time physical activity, serum 25(OH)D level was positively associated with aerobic and muscular fitness (β = 0.15–0.20, all p < 0.05). Also, the participants with sufficient serum 25(OH)D levels (≥75 nmol/L) had better aerobic and muscular fitness and higher TES in group B, and better upper extremity muscular fitness in group A (all p < 0.05). In group A, there were 166 participants with serum levels of 25(OH) D < 75 nmol/L and 18 ≥ 75 nmol/L. In group B, the amounts were 92 (

Sleep is an important contributor for neural maturation and emotion regulation during adolescence, with long-term effects on a range of white matter tracts implicated in affective processing in at-risk populations. We investigated the effects of adolescent sleep patterns on longitudinal changes in white matter development and whether this is related to the emergence of emotional (internalizing) problems. Sleep patterns and internalizing problems were assessed using self-report questionnaires in adolescents recruited in the general population followed up from age 14–19 years (N = 111 White matter structure was measured using diffusion tensor imaging (DTI) and estimated using fractional anisotropy (FA). We found that longitudinal increases in time in bed (TIB) on weekends and increases in TIB-variability between weekdays to weekend, were associated with an increase in FA in various interhemispheric and cortico-striatal tracts. Extracted FA values from left superior longitudinal fasciculus mediated the relationship between increases in TIB on weekends and a decrease in internalizing problems. These results imply that while insufficient sleep might have potentially harmful effects on long-term white matter development and internalizing problems, longer sleep duration on weekends (catch-up sleep) might be a natural counteractive and protective strategy.

Aleksi Paavilaisen artikkeli Sosialisaatio ja varhaiskasvatus kapitaloseenin aikakaudella – Ekososiaalisen kasvatusteorian ekofeministinen kritiikki sisältää tärkeitä huomioita mutta myös huomattavia ongelmia. Ekososiaalisen kasvatusteorian edustajiksi nimettyinä tutkijoina oikaisemme tässä vastineessamme joitakin artikkelin merkittävimpiä virheitä. Puolustamme ekososiaalista kasvatusta moninaisena tutkimusalana, johon liittyy Paavilaisen edustaman ekofeminismin lisäksi myös muita perspektiivejä. Teorian, joka soveltaa kaikkien elollisten olentojen välistä sosiaalista vuorovaikutusta kasvatukseen, on oltava rakenteeltaan huokoinen, täydentyvä ja moninaisuutta kunnioittava. Ekologian ja sosiaalisen käsitteet sisältävä ekososiaalinen kasvatusteoria ei viittaa Paavilaisen kuvaamalla tavalla erityisesti itsekasvatukseen tai yksilöiden sivistämiseen. Ekososiaalisuuden käsite viittaa pyrkimykseen ratkaista toisiinsa kietoutuvia ekologisia ja sosiaalisia ongelmia, joiden taustalla kapitalisminkin voidaan nähdä vaikuttavan. Paavilaisen valitsema käsite kapitaloseeni viittaa ihmisten välisiin suhteisiin, minkä näemme ekososiaalisen kasvatusteorian kannalta rajallisena. Sukupuolinäkökulmat ja risteävien eriarvoisuuksien tunnistaminen ovat tärkeitä ekososiaalisia kysymyksiä, mutta keskittyminen vain ihmisten väliseen vuorovaikutukseen ei huomioi riittävästi muunlajisten eliöiden toimijuutta sekä niiden ja ihmisten yhteenkietoutuneisuutta.

Abstract Background Accurate measurement of left atrial (LA) volumes is needed in cardiac diagnostics and the follow up of heart and valvular diseases. Geometrical assumptions with 2D methods for LA volume estimation contribute to volume misestimation. In this study, we test agreement of 3D and 2D methods of LA volume detection and explore contribution of 3D LA axis orientation and LA shape in introducing error in 2D methods by cardiovascular magnetic resonance imaging. Methods 30 patients with prior first-ever ischemic stroke and no known heart disease, and 30 healthy controls were enrolled (age 18–49) in a substudy of a prospective case–control study. All study subjects underwent cardiac magnetic resonance imaging and were pooled for this methodological study. LA volumes were calculated by biplane area-length method from both conventional long axis (LAVAL-LV) and LA long axis-oriented images (LAVAL-LA) and were compared to 3D segmented LA volume (LAVSAX) to assess accuracy of volume detection. 3D orientation of LA long axis to left ventricular (LV) long axis and to four-chamber plane were determined, and LA 3D sphericity indices were calculated to assess sources of error in LA volume calculation. Shapiro–Wilk test, Bland–Altman analysis, intraclass and Pearson correlation, and Spearman’s rho were used for statistical analysis. Results Biases were − 9.9 mL (− 12.5 to − 7.2) for LAVAL-LV and 13.4 (10.0–16.9) for LAVAL-LA [mean difference to LAVSAX (95% confidence interval)]. End-diastolic LA long axis 3D deviation angle to LV long axis was 28.3 ± 6.2° [mean ± SD] and LA long axis 3D rotation angle to four-chamber plane 20.5 ± 18.0°. 3D orientation of LA axis or 3D sphericity were not correlated to error in LA volume calculation. Conclusions Calculated LA volume accuracy did not improve by using LA long axis-oriented images for volume calculation in comparison to conventional method. We present novel data on LA axis orientation and a novel metric of LA sphericity and conclude that these measures cannot be utilized to assess error in LA volume calculation. Trial registration Main study Searching for Explanations for Cryptogenic Stroke in the Young: Revealing the Etiology, Triggers, and Outcome (SECRETO; NCT01934725) has been registered previously.

Abstract Background The safety of the Emergency Medical Service’s (EMS’s) non-conveyance decision was evaluated by EMS re-contacts, primary health care or emergency department (ED) visits, and hospitalization within 48 h. The secondary outcome was 28-day mortality. Methods This cohort study used prospectively collected data on non-conveyed EMS patients from three different regions in Finland between June 1 and November 30, 2018. The Adjusted International Classification of Primary Care (ICPC2) as the reason for care was compared to hospital discharge diagnoses (ICD10). Multivariable logistic regressions were used to determine factors that were independently associated with adverse outcomes. Results are presented with adjusted odds ratios (aORs) together with 95% confidence intervals (CIs). Data regarding deceased patients were reviewed by the study group. Results Of the non-conveyed EMS patients (n = 11,861), 6.3% re-contacted the EMS, 8.3% attended a primary health care facility, 4.2% went to the ED, 1.6% were hospitalized, and 0.1% died 0–24 h after the EMS mission. The 0–24 h adverse event rate was higher than 24–48 h. After non-conveyance, 32 (0.3%) patients were admitted to an intensive care unit within 24 h. Primary non-urgent EMS mission (aOR 1.49; 95% CI 1.25 to 1.77), EMS arrival at night (aOR 1.82; 95% CI 1.58 to 2.09), ALS unit type vs BLS (aOR 1.43; 95% CI 1.16 to 1.77), rural area (aOR 1.74; 95% CI 1.51 to 1.99), and older patient age (aOR 1.41; 95% CI 1.20 to 1.66) were associated with subsequent primary health care visits (0–24 h). Conclusions Four in five non-conveyed patients did not have any re-contact in follow-up period. EMS non-conveyance seems to be a relatively safe method of focusing ED resources and avoiding ED crowding.

Artikkelissa tarkastellaan Erich Frommin (1900–1980) ajattelua itsekasvatuksen eli ihmisen omaehtoisen kasvun ja kehityksen näkökulmasta. Tarkastelun pohjalta muodostuu ekoterapeuttisen itsekasvatuksen malli, joka uudelleenkontekstualisoi Frommin rakkauden teoriaa ja yhteiskuntakriittistä otetta kapitaloseenin ajassa. Artikkeli argumentoi kapitaloseenin olevan kaikelle elolliselle haitallinen ajanjakso, jossa vallitsevia käytäntöjä on tarpeen muokata itsekasvatuksen avulla. Tällainen vallitsevien ajattelumallien syvällinen kyseenalaistaminen ja kehittäminen ymmärretään artikkelissa ihmismielen hyvinvointia tukevana itsekasvatuksen muotona, joka sisältää terapeuttisia piirteitä. Ekoterapeuttisen itsekasvatuksen tulkinta kuvaa rakkauden teoriaan sisältyvät rakastamisen käytäntöjen ehdot sekä niitä taustoittavat huolenpidon, kunnioituksen, vastuuntunnon ja tiedon osa-alueet osana ekologisesti kestävämmän itsekasvatuksen harjoittamista. Elonkehän monimuotoisuutta edistävää tunnetta ja ekoterapeuttisen itsekasvatuksen tavoitetta kuvataan artikkelissa biofilian käsitteellä. Nykyistä kapitalistista järjestystä eli kapitaloseenin aikaa jäsennetään puolestaan biofobian eli elollisten asioiden pelon käsitteellä. Frommin teorioiden pohjalta rakennetaan uudenlaista itsekasvatuskäsitystä, ekoterapeuttista itsekasvatusta, jonka lähtökohtana on siirtyminen biofobisesta asenteesta kohti terapeuttisia piirteitä omaavaa biofiliaa.

Muotoilemme tässä artikkelissa teoreettisia lähtökohtia, periaatteita ja tavoitteita ekososiaaliselle kasvatukselle. Ekososiaalisen kasvatuksen teoretisointi antroposeenin ajan kontekstissa ei ole yksiselitteistä, sillä antroposeeni käsitteenä näyttäytyy ristiriitaisena. Ihmisen olisi kyettävä näkemään kirkkaasti oman toimintansa vaikutukset ympärillään olevaan maailmaan mutta samaan aikaan ja yhtä kirkkaasti myös muun elämän olemassaolon oikeutus ja toimijuus. Antroposeenin ajan voikin katsoa luoneen tarvetta ihmisen ja muun elämän välisen vuorovaikutuksen tarkemmalle ymmärtämiselle, ja siksi tarkastelumme keskiössä on monilajinen näkökulma. Lähtökohtanamme on ekososiaalinen ajattelu eli maailmantulkinta, joka korostaa ekologisen ja sosiaalisen todellisuuden olemuksellista yhteenkietoutuneisuutta. Perustamme ekososiaalisen kasvatuksen luonnoksemme erityisesti ekososialisaatio- ja ekoindividuaatioprosessien tunnistamiselle ja näitä kuvaavien teorioiden yhdistämiselle. Näiden kautta muotoilemme viisi teesiä määrittelemään ekososiaalisen kasvatuksen tavoitteita. Ekososiaalinen kasvatus on luonteeltaan ihmisen kokonaisvaltaista maailmassa olemista uudistavaa. Kognitiivisten tavoitteiden lisäksi muun muassa aistisuudella ja empatialla on merkittävä rooli ihmisenä kasvussa. Lopuksi esitämme, miten ekososiaalinen kasvatus voisi tukea monilajisen näkökulman juurruttamista kasvatuksen käytäntöihin.

BackgroundThere is limited evidence of how physical activity (PA) associates with low back pain (LBP) and neck pain (NP). Particularly, the association between occupational or commuting PA and LBP/NP is unclear. The aim of the present cross-sectional study was to investigate the association between spinal disorders and different physical activity domains in young and healthy adult men.MethodsSelf-reported leisure time, occupational and commuting PA, as well as LBP and NP, were studied using questionnaires among young Finnish males (n = 1,630). Logistic regression analysis was used to study the associations of PA domains, physical fitness, and spinal disorders. Regression models were adjusted for age, education, smoking, waist circumference, and the other PA domains.ResultsThere was a positive association between moderate leisure-time PA and both LBP (OR: 1.51, 95% CI: 1.18–1.95) and NP (OR: 1.29, 95% CI: 1.00–1.66) compared to low PA. Furthermore, moderate (OR: 1.31, 95% CI: 1.00–1.71) and high (OR: 1.53, 95% CI: 1.15–2.02) leisure time PA groups had a higher likelihood of lumbago. Moderate (OR: 0.67, 95% CI: 0.51–0.90) and high (OR: 0.68, 95% CI: 0.48–0.95) occupational PA groups had lower likelihood for radiating LBP, while high occupational PA (OR: 0.72, 95% CI: 0.52–0.99) had lower likelihood for lumbago.ConclusionsThe associations between physical activity and LBP or NP seem to vary between different domains of physical activity among young healthy men. Commuting and occupation-related PA appear not to be harmfully associated with LPB or NP, whereas moderate-level leisure time PA may be associated with increased LBP and NP, and the respective high level may be associated with an increase in the prevalence of lumbago.

This study investigates the relationship between first-year higher education students' (N = 405) approaches to learning and academic performance on engineering mathematics courses. In addition, we study what combinations of approaches to learning students apply, how these combinations change over time, and whether they are linked to the pedagogical design. The students were divided into an intervention group taught with an instructional model based on flipped learning, and a control group taught with a modern lecture-based model. The students' approaches to learning were measured five times during one academic year. Multiple linear regression, dominance analysis and cluster analysis were used in analyzing the data. We found that a high level of organized studying and a low level of surface approach to learning were positively linked to exam performance, but a deep approach to learning was not linked to performance. In the last three measurements, the students in the intervention group were overrepresented in the cluster with the most desirable profile in terms of approaches to learning. In the long term, flipped learning seemed to foster deep approach learning and organized studying better than the lecture-based model.

Understanding the effect of stress, fatigue, and sleep deprivation on the ability to maintain an alert and attentive state in an ecologically valid setting is of importance as lapsing attention can, in many safety-critical professions, have devastating consequences. Here we studied the effect of close-quarters battle (CQ battle) exercise combined with overnight military training with sleep deprivation on cognitive performance, namely sustained attention and response inhibition. In addition, the effect of the CQ battle and overnight training on cardiac activity [heart rate and root mean square of the successive differences (RMSSD)] during the cognitive testing and the relationship between cardiac activity and cognitive performance were examined. Cognitive performance was measured with the psychomotor vigilance task (PVT) and the sustained attention to response task (SART). Altogether 45 conscripts participated in the study. The conscripts were divided into control (CON) and experimental (EXP) groups. The CON completed the training day after a night of sleep and the EXP after the overnight military training with no sleep. Results showed that the effect of the overnight training on cognitive performance and the between-group difference in heart rate (HR) and heart rate variability (HRV) depended on the cognitive test. Surprisingly, the cognitive performance was not largely affected by the CQ battle. However, as expected, the CQ battle resulted in a significant decrease in RMSSD and an increase in HR measured during the cognitive testing. Similarly, the HR parameters were related to cognitive performance, but the relationship was found only with the PVT. In conclusion, fatigue due to the overnight training impaired the ability to maintain sufficient alertness level. However, this impairment in arousal upregulation was counteracted by the arousing nature of the SART. Hence, the conscripts' cognitive performance was mainly preserved when performing a stimulating task, despite the fatigue from the sleep loss of the preceding night and physical activity.

Background and purpose — Traditionally, overriding distal radius fractures in children have been reduced and immobilized with a cast or treated with percutaneous pin fixation. There is recent evidence that these fractures heal well if immobilized in the bayonet position without reduction. We evaluated the present treatment of these fractures. Methods — A questionnaire including AP and lateral radiographs of overriding distal radius fractures in 3 pre-pubertal children was answered by 213 surgeons from 28 countries. The surgeons were asked to choose their preferred method of treatment (no reduction, reduction, reduction and osteosynthesis), type and length of cast immobilization, and the number of clinical and radiographic follow-ups. Results — Of the 213 participating surgeons, 176 (83%) would have reduced all 3 presented fractures, whereas 4 (2%) would have treated all 3 children with cast immobilization without reduction. Most reductions (77%) would have been done under general anesthesia. Over half (54%) of the surgeons who preferred anesthesia would have fixed (pins 99%, plate 1%) the fractures. An above-elbow splint or circular cast was chosen in 84% of responses, and the most popular (44%) length of immobilization was 4 weeks. Surgeons from the Nordic countries were more eager to fix the fractures (54% vs. 31%, p < 0.001) and preferred shorter immobilization and follow-up times and less frequent clinical and radiological follow-ups compared with their colleagues from the USA. Interpretation — Most of the participating surgeons prefer to reduce overriding distal radius fractures in children under anesthesia. There is substantial lack of agreement on the indications for osteosynthesis, type of cast, length of immobilization, and follow-up protocol.

Global concerns regarding air quality have over the past decade led to the introduction of regulations by the International Maritime Organisation curbing the emissions of sulphur and nitrogen oxides (SOx, NOx). These limits were implemented initially in so-called “emission control areas”, defined where the density of shipping activity combines with large coastal population centres such as northwest Europe or eastern USA. However, any legislation requires a scientifically robust and rigorous monitoring program to ensure compliance and prove attribution to an individual vessel. We argue the case for adherence to the mantra “faster, better, cheaper”, where widespread adoption of independent low-cost solutions of onboard, in-stack sensors, combined with existing, globally ubiquitous satellite-based “automatic identification system” (AIS) data telemetry, provides an excellent solution to the affordable compliance and attribution conundrum for shipping companies and enforcement agencies alike. We present data from three field-campaigns which have significantly advanced the concept of onboard real-time monitoring of atmospheric ship emissions.

Healthy lifestyle behaviors including physical activity (PA) have been recognized to contribute positively to mental health. Most of the evidence on relationship between PA and mental health relies on self-reported PA results. Device-based measures on PA or sedentary behavior (SB) are less frequently used in mental health research. The present study aimed at examining the relationship between mental health and PA/SB measured by accelerometers in young Finnish men. The sample consisted of 409 men (mean age 28 ± 7 years), who participated in the military refresher training in Finland. Self-rated mental health was measured with Mental Health Inventory (MHI-5) and short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS) measuring mental health both from the perspective of mental health problems and mental well-being. PA was measured with accelerometer from the perspective of light, moderate, vigorous, and total activity, as well as SB. Linear regression models and compositional analysis were applied. Age, education, marital status, employment status, BMI, alcohol use and smoking were used as covariates. Evidence on relationship between total PA (standardized regression coefficient 0.340; 95% CI 0.022–0.657, p = 0.036) and SB (standardized regression coefficient −0.340; 95% CI −0.657 to −0.022, p = 0.036) with symptoms of mental health problems was found after adjusting for age, education, marital and employment status. The relationship was marginally significant (p = 0.056) after adjusting also for BMI, alcohol use and smoking. No evidence on relationship between PA or SB and mental well-being was found, neither in standard linear regression analysis nor in compositional approach. In our sample of young adult men, PA seemed to have a stronger relationship with symptoms of mental health problems rather than with mental well-being. The findings lead to a conclusion that all PA per se may not be independently associated with mental well-being in young adult males and raise the question whether the domain of PA and its context play a critical role in these relationships.