Short-term survival of cementless Oxford unicondylar knee arthroplasty based on the Finnish Arthroplasty Register

Background: Cementless unicondylar knee arthroplasty (UKA) was introduced to secure longterm fixation and reduce the risk of revision. Experience with cementless UKA fixation is limited. Methods: The short-term survival (up to five years) of cementless Oxford UKA was assessed using data from the Finish Arthroplasty Register and was compared with that of cemented Oxford 3 UKA and total knee arthroplasty (TKA). Datawere obtained, from the Finnish Arthroplasty Register, on 1076 cementless Oxford UKAs and 2279 cemented Oxford 3 UKAs performed for primary osteoarthritis in 2005-2015. The Kaplan-Meier method, with revision for any reason as the endpoint, was used to assess the survival of these two UKA groups, and the results were compared with that of 65,563 cemented TKAs treated for primary osteoarthritis over the same period. The risk of revision of both Oxford prostheses was compared using Cox regression model, with adjustment for age and sex, with the cemented TKA group as reference. Results: The three-year survival was 93.7% for the cementless Oxford, 922% for the cemented Oxford 3, and 97.3% for the cemented TKA. The corresponding figures at five years were 92.3%, 88.9%, and 96.6%, respectively. The revision rate for both the cementless Oxford and the cemented Oxford 3 was significantly increased when compared with the cemented TKA (P <0.001). Conclusions: The survival of the cementless Oxford method was higher than that of the cemented Oxford 3 in the short term. The overall survival of Oxford UKA was poor in comparison with contemporary TKAs. (C) 2019 Elsevier B.V. All rights reserved.Peer reviewe

Fine particle emissions from sauna stoves : effects of combustion appliance and fuel, and implications for the Finnish emission inventory

Sauna Stoves (SS) are simple wood combustion appliances used mainly in Nordic countries. They generate emissions that have an impact on air quality and climate. In this study, a new measurement concept for comparing the operation, thermal efficiency, and real-life fine particle and gaseous emissions of SS was utilized. In addition, a novel, simple, and universal emission calculation procedure for the determination of nominal emission factors was developed for which the equations are presented for the first time. Fine particle and gaseous concentrations from 10 different types of SS were investigated. It was found that each SS model was an individual in relation to stove performance: stove heating time, air-to-fuel ratio, thermal efficiency, and emissions. Nine-fold differences in fine particle mass (PM1) concentrations, and about 90-fold differences in concentrations of polycyclic aromatic hydrocarbons (PAH) were found between the SS, when dry (11% moisture content) birch wood was used. By using moist (18%) wood, particle number and carbon monoxide concentrations increased, but interestingly, PM1, PAH, and black carbon (BC) concentrations clearly decreased, when comparing to dry wood. E.g., PAH concentrations were 5.5–9.6 times higher with dry wood than with moist wood. Between wood species, 2–3-fold maximum differences in the emissions were found, whereas about 1.5-fold differences were observed between bark-containing and debarked wood logs. On average, the emissions measured in this study were considerably lower than in previous studies and emission inventories. This suggests that overall the designs of sauna stoves available on the market have improved during the 2010s. The findings of this study were used to update the calculation scheme behind the inventories, causing the estimates for total PM emissions from SS in Finland to decrease. However, wood-fired sauna stoves are still estimated to be the highest individual emission source of fine particles and black carbon in Finland

Sujuvaa työtä, vähemmän virheitä : Inhimillisten virheiden vähentäminen työpaikoilla (SUJUVA)

Työhön liittyvät inhimilliset virheet heikentävät työn sujuvuutta ja aiheuttavat tarpeettomia viivästyksiä. Pahimmillaan ne voivat johtaa työtapaturmiin ja onnettomuuksiin. Valtaosassa työtapaturmia taustalla on inhimillinen tekijä. Inhimillinen virhe ei kuitenkaan ole mikään perimmäinen syy ja selitys tapahtumiin, vaan virheillekin on syynsä. SUJUVA-tutkimushankkeen tulokset toivat esiin, että tietyt työolosuhteet ovat yhteydessä paitsi inhimillisiin virheisiin, myös yrityksissä sattuvien työtapaturmien määrään. Kyse on työympäristössä olevista tekijöistä, jotka esimerkiksi vaikeuttavat olennaisten asioiden havaitsemista ja huomaamista tai vallalla olevista työtavoista, joiden vuoksi työtehtävät ja tilanteet eivät ole ihmisen mittaisia. SUJUVA-tutkimushankkeessa kehitetty kysely ja uudenlainen työtapaturmien tutkintamalli osoittautuivat hyviksi ja kustannustehokkaiksi keinoiksi täsmentää millaisista inhimillisistä virheistä on kyse ja millaisissa tilanteissa niitä sattuu. Kun tunnistetaan inhimillisille virheille altistavat tekijät, korjaavat toimenpiteet voidaan kohdentaa oikeisiin asioihin. Näin varmistetaan, että työntekijöillä on jatkossa paremmat mahdollisuudet selviytyä yllättävistäkin tilanteista. SUJUVA-hankkeen tuloksia voidaan soveltaa aloilla, joissa toimitaan monimutkaisten ja muuttuvien tehtävien parissa vaihtelevissa työympäristöissä, kuten huolto-, varasto-, kunnossapito- ja tuotantotyössä

Fecal microbiota in congenital chloride diarrhea and inflammatory bowel disease

Background and aimsSubjects with congenital chloride diarrhea (CLD; a defect in solute carrier family 26 member 3 (SLC26A3)) are prone to inflammatory bowel disease (IBD). We investigated fecal microbiota in CLD and CLD-associated IBD. We also tested whether microbiota is modulated by supplementation with the short-chain fatty acid butyrate.Subjects and methodsWe recruited 30 patients with CLD for an observational 3-week follow-up study. Thereafter, 16 consented to oral butyrate substitution for a 3-week observational period. Fecal samples, collected once a week, were assayed for calprotectin and potential markers of inflammation, and studied by 16S ribosomal ribonucleic acid (rRNA) gene amplicon sequencing and compared to that of 19 healthy controls and 43 controls with Crohn's disease. Data on intestinal symptoms, diet and quality of life were collected.ResultsPatients with CLD had increased abundances of Proteobacteria, Veillonella, and Prevotella, and lower abundances of normally dominant taxa Ruminococcaceae and Lachnospiraceae when compared with healthy controls and Crohn's disease. No major differences in fecal microbiota were found between CLD and CLD-associated IBD (including two with yet untreated IBD). Butyrate was poorly tolerated and showed no major effects on fecal microbiota or biomarkers in CLD.ConclusionsFecal microbiota in CLD is different from that of healthy subjects or Crohn's disease. Unexpectedly, no changes in the microbiota or fecal markers characterized CLD-associated IBD, an entity with high frequency among patients with CLD.Peer reviewe

The type of the functional cardiovascular response to upright posture is associated with arterial stiffness: a cross-sectional study in 470 volunteers

In a cross-sectional study we examined whether the haemodynamic response to upright posture could be divided into different functional phenotypes, and whether the observed phenotypes were associated with known determinants of cardiovascular risk. METHODS: Volunteers (n = 470) without medication with cardiovascular effects were examined using radial pulse wave analysis, whole-body impedance cardiography, and heart rate variability analysis. Based on the passive head-up tilt induced changes in systemic vascular resistance and cardiac output, the principal determinants of blood pressure, a cluster analysis was performed. RESULTS: The haemodynamic response could be clustered into 3 categories: upright increase in vascular resistance and decrease in cardiac output were greatest in the first (+45 % and -27 %, respectively), smallest in the second (+2 % and -2 %, respectively), and intermediate (+22 % and -13 %, respectively) in the third group. These groups were named as 'constrictor' (n = 109), 'sustainer' (n = 222), and 'intermediate' (n = 139) phenotypes, respectively. The sustainers were characterized by male predominance, higher body mass index, blood pressure, and also by higher pulse wave velocity, an index of large arterial stiffness, than the other groups (p < 0.01 for all). Heart rate variability analysis showed higher supine and upright low frequency/high frequency (LF/HF) ratio in the sustainers than constrictors, indicating increased sympathovagal balance. Upright LF/HF ratio was also higher in the sustainer than intermediate group. In multivariate analysis, independent explanatory factors for higher pulse wave velocity were the sustainer (p < 0.022) and intermediate phenotypes (p < 0.046), age (p < 0.001), body mass index (p < 0.001), and hypertension (p < 0.001). CONCLUSIONS: The response to upright posture could be clustered to 3 functional phenotypes. The sustainer phenotype, with smallest upright decrease in cardiac output and highest sympathovagal balance, was independently associated with increased large arterial stiffness. These results indicate an association of the functional haemodynamic phenotype with an acknowledged marker of cardiovascular risk. TRIAL REGISTRATION: ClinicalTrials.gov NCT01742702.BioMed Central open acces

Association of resting heart rate with cardiovascular function: a cross-sectional study in 522 Finnish subjects

ad-up tilt. Methods Hemodynamics were recorded using whole-body impedance cardiography and continuous radial pulse wave analysis in 522 subjects (age 20–72 years, 261 males) without medication influencing HR or BP, or diagnosed diabetes, coronary artery, renal, peripheral arterial, or cerebrovascular disease. Correlations were calculated, and results analysed according to resting HR tertiles. Results Higher resting HR was associated with elevated systolic and diastolic BP, lower stroke volume but higher cardiac output and work, and lower systemic vascular resistance, both supine and upright (p < 0.05 for all). Subjects with higher HR also showed lower supine and upright aortic pulse pressure and augmentation index, and increased resting pulse wave velocity (p < 0.001). Upright stroke volume decreased less in subjects with highest resting HR (p < 0.05), and cardiac output decreased less in subjects with lowest resting HR (p < 0.009), but clear hemodynamic differences between the tertiles persisted both supine and upright. Conclusions Supine and upright hemodynamic profile associated with higher resting HR is characterized by higher cardiac output and lower systemic vascular resistance. Higher resting HR was associated with reduced central wave reflection, in spite of elevated BP and arterial stiffness. The increased cardiac workload, higher BP and arterial stiffness, may explain why higher HR is associated with less favourable prognosis in populations.BioMed Central open acces

Emissions from a modern log wood masonry heater and wood pellet boiler : Composition and biological impact on air-liquid interface exposed human lung cancer cells

The consumption of wood fuel is markedly increasing in developing and industrialized countries. Known side effects of wood smoke inhalation manifest in proinflammatory signaling, oxidative stress, DNA damage and hence increased cancer risk. In this study, the composition and acute biological impact of emissions of state-of-the-art wood combustion compliances: masonry heater (MH) and pellet boiler (PB) were investigated. Therefore A549 cells were exposed to emission aerosols in an automated air-liquid interface exposure station followed by cytotoxicity, transcriptome and proteome analyses. In parallel, aerosols were subjected to a chemical and physical haracterization. Compared to PB, the MH combustion at the same dilution ratio resulted in a 3-fold higher particle mass concentration (PM2.5) and deposited dose (PB: 27 $\pm$ 2 ng/cm2, MH; 73 $\pm$ 12 ng/cm2). Additionally, the MH aerosol displayed a substantially larger concentration of aldehydes, polycyclic aromatic hydrocarbons (PAH) or oxidized PAH. Gene ontology analysis of transcriptome of A549 cells exposed to MH emissions revealed the activation of proinflammatory response and key signaling cascades MAP kinase and JAK-STAT. Furthermore, CYP1A1, an essential enzyme in PAH metabolism, was induced. PB combustion aerosol activated the proinflammatory marker IL6 and different transport processes. The proteomics data uncovered induction of DNA damage-associated proteins in response to PB and DNA doublestrand break processing proteins in response to MH emissions. Taking together, the MH produces emissions with a higher particle dose and more toxic compounds while causing only mild biological responses. This finding points to a significant mitigating effect of antioxidative compounds in MH wood smoke