Beyond rest and quiescence (endodormancy and ecodormancy) : A novel model for quantifying plant-environment interaction in bud dormancy release

Bud dormancy of plants has traditionally been explained either by physiological growth arresting conditions in the bud or by unfavourable environmental conditions, such as non-growth-promoting low air temperatures. This conceptual dichotomy has provided the framework also for developing process-based plant phenology models. Here, we propose a novel model that in addition to covering the classical dichotomy as a special case also allows the quantification of an interaction of physiological and environmental factors. According to this plant-environment interaction suggested conceptually decades ago, rather than being unambiguous, the concept of "non-growth-promoting low air temperature" depends on the dormancy status of the plant. We parameterized the model with experimental results of growth onset for seven boreal plant species and found that based on the strength of the interaction, the species can be classified into three dormancy types, only one of which represents the traditional dichotomy. We also tested the model with four species in an independent experiment. Our study suggests that interaction of environmental and physiological factors may be involved in many such phenomena that have until now been considered simply as plant traits without any considerations of effects of the environmental factors.Peer reviewe

Close-range hyperspectral spectroscopy reveals leaf water content dynamics

Water plays a crucial role in maintaining plant functionality and drives many ecophysiological processes. The distribution of water resources is in a continuous change due to global warming affecting the productivity of ecosystems around the globe, but there is a lack of non-destructive methods capable of continuous monitoring of plant and leaf water content that would help us in understanding the consequences of the redistribution of water. We studied the utilization of novel small hyperspectral sensors in the 1350-1650 nm and 2000-2450 nm spectral ranges in non-destructive estimation of leaf water content in laboratory and field conditions. We found that the sensors captured up to 96% of the variation in equivalent water thickness (EWT, g/m(2)) and up to 90% of the variation in relative water content (RWC). Further tests were done with an indoor plant (Dracaena marginate Lem.) by continuously measuring leaf spectra while drought conditions developed, which revealed detailed diurnal dynamics of leaf water content. The laboratory findings were supported by field measurements, where repeated leaf spectra measurements were in fair agreement (R-2 = 0.70) with RWC and showed similar diurnal dynamics. The estimation of leaf mass per area (LMA) using leaf spectra was investigated as a pathway to improved RWC estimation, but no significant improvement was found. We conclude that close-range hyper spectral spectroscopy can provide a novel tool for continuous measurement of leaf water content at the single leaf level and help us to better understand plant responses to varying environmental conditions.Peer reviewe

Redo ventral rectopexy : is it worthwhile?

Background Minimally invasive ventral mesh rectopexy (VMR) is a widely used surgical treatment for posterior pelvic organ prolapse; however, evidence of the utility of revisional surgery is lacking. Our aim was to assess the technical details, safety and outcomes of redo minimally invasive VMR for patients with external rectal prolapse (ERP) recurrence or relapsed symptoms of internal rectal prolapse (IRP). Methods This is a retrospective cohort study of patients with recurrent ERP or symptomatic IRP who underwent redo minimally invasive VMR between 2011 and 2016. The study was conducted at three hospitals in Finland. Data collected retrospectively included patient demographics, in addition to perioperative and short-term postoperative findings. At follow-up, all living patients were sent a questionnaire concerning postoperative disease-related symptoms and quality of life. Results A total of 43 redo minimally invasive VMR were performed during the study period. The indication for reoperation was recurrent ERP in 22 patients and relapsed symptoms of IRP in 21 patients. In most operations (62.8%), the previously used mesh was left in situ and a new one was placed. Ten (23.3%) patients experienced complications, including 2 (4.7%) mesh-related complications. The recurrence rate was 4.5% for ERP. Three patients out of 43 were reoperated on for various reasons. One patient required postoperative laparoscopic hematoma evacuation. Patients operated on for recurrent ERP seemed to benefit more from the reoperation. Conclusions Minimally invasive redo VMR appears to be a safe and effective procedure for treating posterior pelvic floor dysfunction with acceptable recurrence and reoperation rates.Peer reviewe

Women with PCOS have an increased risk for cardiovascular disease regardless of diagnostic criteria - a prospective population-based cohort study

OBJECTIVE: Polycystic ovary syndrome (PCOS) is associated with many cardiovascular disease (CVD) risk factors, such as obesity, type 2 diabetes mellitus and hypertension. However, it remains debatable whether the presence of multiple CVD risk factors translates to increased CVD events. DESIGN: A prospective, population-based Northern Finland Birth Cohort 1966. METHODS: Individuals with an expected date of birth in 1966 in Northern Finland have been followed from birth. Women in the cohort were classified as having PCOS according to either the National Institute of Health (NIH) criteria (n = 144) or the Rotterdam criteria (n = 386) at age 31, and they were compared to women without any PCOS features. The study population was re-examined at age 46, and the incidence of major adverse cardiovascular events (MACE), including myocardial infarction (MI), stroke, heart failure and cardiovascular mortality, was recorded up to age 53. RESULTS: During the 22-year follow-up, both women with NIH-PCOS and women with Rotterdam-PCOS had a significantly higher risk for cardiovascular events than control women. The BMI-adjusted hazard ratio (HR) for MACE in the Rotterdam-PCOS group and the NIH-PCOS group was 2.33 (1.26-4.30) and 2.47 (1.18-5.17), respectively. The cumulative hazard curves in both diagnostic categories began to diverge at age 35. Regarding the individual CVD endpoints, MI was significantly more prevalent in both women with NIH-PCOS (P = .010) and women with Rotterdam-PCOS (P = .019), when compared to control women. CONCLUSIONS: PCOS should be considered a significant risk factor for CVD. Future follow-up will show how the risk of CVD events develops after menopausal age

Climate change alters disease severity in the Endoconidiophora polonica-Norway spruce pathosystem

Posteri201

Validation of Finnish Neecham Confusion Scale and Nursing Delirium Screening Scale using Confusion Assessment Method algorithm as a comparison scale

Background: Delirium is a common clinical problem with acute and fluctuating onset. Early notification of its symptoms can lead to earlier detection and management of this state. Valid and reliable instruments are required for successful nursing practice. The purpose of the study was to psychometrically test the Finnish versions of the Neecham Confusion Scale (NEECHAM) and the Nursing Delirium Screening Scale (Nu-DESC) in surgical nursing care, utilizing the Confusion Assessment Method (CAM) algorithm as a comparison scale. Methods: This randomized, blinded, instrument testing study was conducted at one university hospital in one surgical unit. Study patients (n = 112) meeting the pre-set criteria were assessed by the principal investigator (PI) and a registered nurse (RN, n = 18). Internal consistency, inter-rater reliability, and concurrent validity of the scales were calculated and face validity and usability evaluated. Results: Internal consistency was from .76 to .86 for all three scales. Inter-rater reliability between PI and RNs was .87 with NEECHAM, .60 with CAM and .47 with Nu-DESC. Concurrent validity was .56 and .59 between CAM and NEECHAM, and .68 and .72 between NEECHAM and Nu-DESC. In the PI group, the correlation between CAM and Nu-DESC was .91, in the RN’s group .42. Nu-DESC was evaluated as the most usable scale. Conclusion: The findings strengthen the earlier research on the scales and indicate that the Finnish NEECHAM and Nu-DESC correlates with CAM algorithm and with each other. They seem to be clinically viable in assessing patients’ delirium in surgical wards but more validity testing is needed. Keywords: Confusion, Confusion Assessment Method, Delirium, Instrument testing, Neecham Confusion Scale, Nursing Delirium Screening Scale</p

ECG T-Wave Morphologic Variations Predict Ventricular Arrhythmic Risk in Low- and Moderate-Risk Populations

Background Early identification of individuals at risk of sudden cardiac death (SCD) remains a major challenge. The ECG is a simple, common test, with potential for large‐scale application. We developed and tested the predictive value of a novel index quantifying T‐wave morphologic variations with respect to a normal reference (TMV), which only requires one beat and a single‐lead ECG. Methods and Results We obtained reference T‐wave morphologies from 23 962 participants in the UK Biobank study. With Cox models, we determined the association between TMV and life‐threatening ventricular arrhythmia in an independent data set from UK Biobank study without a history of cardiovascular events (N=51 794; median follow‐up of 122 months) and SCD in patients with coronary artery disease from ARTEMIS (N=1872; median follow‐up of 60 months). In UK Biobank study, 220 (0.4%) individuals developed life‐threatening ventricular arrhythmias. TMV was significantly associated with life‐threatening ventricular arrhythmias (hazard ratio [HR] of 1.13 per SD increase [95% CI, 1.03–1.24]; P=0.009). In ARTEMIS, 34 (1.8%) individuals reached the primary end point. Patients with TMV ≥5 had an HR for SCD of 2.86 (95% CI, 1.40–5.84; P=0.004) with respect to those with TMV <5, independently from QRS duration, corrected QT interval, and left ventricular ejection fraction. TMV was not significantly associated with death from a cause other than SCD. Conclusions TMV identifies individuals at life‐threatening ventricular arrhythmia and SCD risk using a single‐beat single‐lead ECG, enabling inexpensive, quick, and safe risk assessment in large populations

Using the Nursing Interventions Classification to identify nursing interventions in free-text nursing documentation in adult psychiatric outpatient care setting

Aims and objectives To identify and describe nursing interventions in patient documentation in adult psychiatric outpatient setting and to explore the potential for using the Nursing Interventions Classification in documentation in this setting. Background Documentation is an important part of nurses' work, and in the psychiatric outpatient care setting, it can be time-consuming. Only very few research reports are available on nursing documentation in this care setting. Methods A qualitative analysis of secondary data consisting of nursing documentation for 79 patients in four outpatient units (years 2016-2017). The data consisted of 1,150 free-text entries describing a contact or an attempted contact with 79 patients, their family members or supporting networks and 17 nursing care summaries. Deductive and inductive content analysis was used. SRQR guideline was used for reporting. Results We identified 71 different nursing interventions, 64 of which are described in the Nursing Interventions Classification. Surveillance and Care Coordination were the most common interventions. The analysis revealed two perspectives which challenge the use of the classification: the problem of overlapping interventions and the difficulty of naming group-based interventions. Conclusion There is an urgent need to improve patient documentation in the adult psychiatric outpatient care setting, and standardised nursing terminologies such as the Nursing Interventions Classification could be a solution to this. However, the problems of overlapping interventions and naming group-based interventions suggest that the classification needs to be further developed before it can fully support the systematic documentation of nursing interventions in the psychiatric outpatient care setting. Relevance to clinical practice This study describes possibilities of using a systematic nursing language to describe the interventions nurses use in the adult psychiatric outpatient setting. It also describes problems in the current free text-based documentation.Peer reviewe

Wavelength-scale stationary-wave integrated Fourier-transform spectrometry

Spectrometry is a general physical-analysis approach for investigating light-matter interactions. However, the complex designs of existing spectrometers render them resistant to simplification and miniaturization, both of which are vital for applications in micro- and nanotechnology and which are now undergoing intensive research. Stationary-wave integrated Fourier-transform spectrometry (SWIFTS)-an approach based on direct intensity detection of a standing wave resulting from either reflection (as in the principle of colour photography by Gabriel Lippmann) or counterpropagative interference phenomenon-is expected to be able to overcome this drawback. Here, we present a SWIFTS-based spectrometer relying on an original optical near-field detection method in which optical nanoprobes are used to sample directly the evanescent standing wave in the waveguide. Combined with integrated optics, we report a way of reducing the volume of the spectrometer to a few hundreds of cubic wavelengths. This is the first attempt, using SWIFTS, to produce a very small integrated one-dimensional spectrometer suitable for applications where microspectrometers are essential

Congruence between perceived and theoretical knowledge before and after an internet-based continuing education program about VLU nursing care

Background: Previous research has revealed nurses' knowledge gaps in venous leg ulcer (VLU) nursing care, and continuing education is needed. The closer nurses' perceived knowledge is to their evidence-based theoretical knowledge, the better possibilities they have to conduct evidence-based VLU nursing care.Objectives: To assess the congruence between nurses' perceived and theoretical knowledge about VLU nursing care before and after an internet-based education about VLU nursing care (eVLU).Design: Quasi-experimental study with intervention and comparison groups and pre- and post-measurements.Setting: Home health care in two Finnish municipalities.Participants: Nurses (n = 946) working in home health care were invited to participate. In the intervention group, 239 nurses and 229 nurses in the comparison group met the inclusion criteria, and they were all recruited to the study.Method: Nurses were divided into intervention and comparison groups with lottery between the municipalities. Nurses in both groups took care of patients with VLU according to their organizations' instructions. In addition to this, nurses in the intervention group received a 6-week eVLU while those in the comparison group did not. Data were collected with a questionnaire about perceived and theoretical knowledge before education, at six weeks, and at 10 weeks. The percentages of congruence were calculated at every measurement point, and the McNemar test was used to detect statistical significance of changes between measurements.Results: The increase of congruence was more often statistically significant in the intervention group than in the comparison group.Conclusion: The results support the hypothesis that the congruence between perceived and theoretical knowledge will be higher among nurses receiving eVLU. Because of the low participation and drop-outs, the results should be interpreted with caution.</p