Estimation of anthropogenic impact within and near shallow coastal bays and classification and evaluation of their underwater vegetation in the Åland Islands

In the summer of 2018 the coverage data for underwater macrophytes was analysed to determine the degree of protection necessary with regards to 79 individual shallow bays on the Åland Islands. This was accomplished by using data gathered by previous research associated with the biological station, but also by mapping seven bays where studies on vegetation cover had yet to be performed. The bays were located all over the islands, and bays from 10 of the islands 16 municipalities were analysed with the NANNUT method, which uses data on vegetation cover to classify and assign ecological value to underwater habitats. The surrounding area of the bays was also analysed to estimate its anthropogenic impact. This was done by counting buildings, determining the area covered by roads, farmland and buildings, determining total meters of jetty, the proportion of modified coastline and the number of streams discharging into the bay. This was accomplished by using GIS data, and by analysing satellite imagery. 53 of the 79 bays were determined to need protection to safeguard their important ecological status. These were bays who were determined to be of NANNUT-ecological value of 3 or more. One further bay with a score less than 3 was also determined to be worthy of protection is also included in these 53 bays. The bays derived their ecological value due to the presence of stonewort meadows, dense and species rich vegetation, red-listed species and habitats especially important to juvenile fish. With regards to the survey of the surrounding area of the bays; 76 of the 79 bays were found to have a high or good rating when estimating the anthropogenic impact on the bays, which suggests that the impact of the surrounding area is moderate for shallow bays on the Åland Islands. It should be noted that the impact is based on a mean value of several parameters, and that these individually often had poorer ratings, especially the parameter based on the amount of buildings in the surrounding area

Health-Related Quality of Life after Restorative Proctocolectomy : A Cross-Sectional Study

Background and Aims: Patients undergoing restorative proctocolectomy have often suffered from active ulcerative colitis which should be remembered when assessing quality of life after operation. The aim of this study was to explore health-related quality of life after restorative proctocolectomy in those with poor or good pouch function and to compare that to patients with active or inactive ulcerative colitis and to the general population. Material and Methods: Altogether, 282 restorative proctocolectomy patients were investigated. The control group comprised 408 ulcerative colitis patients from the local register. Generic 15D and disease-specific inflammatory bowel disease questionnaire health-related quality of life instruments were used. Population-based data were available for 15D. Pouch function was evaluated with oresland score and colitis activity with simple clinical colitis activity index. Results: 15D results showed that patients with good pouch function had health-related quality of life similar to that of the general population. Health-related quality of life with inflammatory bowel disease questionnaire was equally good in patients with good pouch function (n = 131; 70%) and inactive colitis (n = 95; 63%), and equally impaired in patients with poor pouch function (n = 56; 30%) and active colitis (n = 18; 12%). Conclusion: The majority of patients had health-related quality of life comparable to that in general population. Most patients with active ulcerative colitis are likely to improve their health-related quality of life after successful surgery. These findings are important when informing colitis patients about life after surgery.Peer reviewe

Coronary revascularisation in stable patients after an acute coronary syndrome: a propensity analysis of early invasive versus conservative management in a register-based cohort study

OBJECTIVES: To compare the effectiveness of in-hospital medical therapy versus coronary revascularisation added to medical therapy in patients who stabilised after an acute coronary syndrome (ACS). DESIGN: Propensity score-matched cohort study from the database of the Tampere ACS registry. SETTING: A single academic hospital in Finland. PARTICIPANTS: 1149 patients with a recent ACS, but no serious coexisting conditions: recurrent ischaemic episodes despite adequate medical therapy, haemodynamic instability, overt congestive heart failure and serious ventricular arrhythmias. PRIMARY AND SECONDARY OUTCOME MEASURES: The composite endpoint of major acute cardiovascular events (MACEs): unstable angina requiring rehospitalisation, stroke, myocardial infarction and all-cause mortality, at 6-month follow-up. RESULTS: Compared with standard medical treatment, revascularisation was associated with a lower rate of MACEs at 6 months in patients of the first quintile (HR 0.81; 95% CI 0.66 to 0.99), but a higher rate of MACEs in the fifth quintile (HR 4.74, CI 1.36 to 16.49; p=0.014). There were no significant differences in the rates of MACEs in the remaining three quintiles. Patients of the first quintile were the oldest (79.7\ub18.3 years) and had a more significant (p<0.001) history of prior myocardial infarction (37%) and poor renal function (creatine, \ub5mol/l: 114.9\ub170.7). They also showed the highest C reactive protein (7.3\ub19.5 mg/l) levels. CONCLUSIONS: Our findings suggest that in-hospital coronary revascularisation did not lead to any advantage with signal of possible harm in the great majority of patients who stabilised after an ACS. An early invasive management strategy may be best reserved for elderly patients having high-risk clinical features and biochemical evidence of a strong inflammatory activity

Factors associated with decision-making on prophylactic hysterectomy and attitudes towards gynecological surveillance among women with Lynch syndrome (LS) : a descriptive study

To prevent endometrial carcinoma in Lynch syndrome (LS), regular gynecological surveillance visits and prophylactic surgery are recommended. Previous data have shown that prophylactic hysterectomy is an effective means of cancer prevention, while the advantages and disadvantages of surveillance are somewhat unclear. We aimed to evaluate female LS carriers' attitudes towards regular gynecological surveillance and factors influencing their decision-making on prophylactic surgery that have not been well documented. Pain experienced during endometrial biopsies was also evaluated. Postal questionnaires were sent to LS carriers undergoing regular gynecological surveillance. Questionnaires were sent to 112 women with LS, of whom 76 responded (68%). Forty-two (55%) had undergone prophylactic hysterectomy by the time of the study. The majority of responders (64/76; 84.2%) considered surveillance appointments beneficial. Pain level during endometrial biopsy was not associated with the decision to undergo prophylactic surgery. The level of satisfaction the women had with the information and advice provided during surveillance was significantly associated with the history of prophylactic hysterectomy (satisfaction rate of 73.2% versus 31.8% of nonoperated women, p = 0.003). The women who had undergone prophylactic surgery were older than the nonoperated women both at mutation testing (median of 42.3 years versus 31.6 years, p <0.001) and at the time of the study (median of 56.9 years versus 46.0 years, respectively, p <0.001). Women with LS pathogenic variants have positive experiences with gynecological surveillance visits, and their perception of the quality of the information and advice obtained plays an important role in their decision-making concerning prophylactic surgery.Peer reviewe

Generalized Painleve-Gullstrand descriptions of Kerr-Newman black holes

Generalized Painleve-Gullstrand metrics are explicitly constructed for the Kerr-Newman family of charged rotating black holes. These descriptions are free of all coordinate singularities; moreover, unlike the Doran and other proposed metrics, an extra tunable function is introduced to ensure all variables in the metrics remain real for all values of the mass M, charge Q, angular momentum aM, and cosmological constant \Lambda > - 3/(a^2). To describe fermions in Kerr-Newman spacetimes, the stronger requirement of non-singular vierbein one-forms at the horizon(s) is imposed and coordinate singularities are eliminated by local Lorentz boosts. Other known vierbein fields of Kerr-Newman black holes are analysed and discussed; and it is revealed that some of these descriptions are actually not related by physical Lorentz transformations to the original Kerr-Newman expression in Boyer-Lindquist coordinates - which is the reason complex components appear (for certain ranges of the radial coordinate) in these metrics. As an application of our constructions the correct effective Hawking temperature for Kerr black holes is derived with the method of Parikh and Wilczek.Comment: 5 pages; extended to include application to derivation of Hawking radiation for Kerr black holes with Parikh-Wilczek metho

Fermionic microstates within Painlev\'e-Gullstrand black hole

We consider the quantum vacuum of fermionic field in the presence of a black-hole background as a possible candidate for the stabilized black hole. The stable vacuum state (as well as thermal equilibrium states with arbitrary temperature) can exist if we use the Painlev\'e-Gullstrand description of the black hole, and the superluminal dispersion of the particle spectrum at high energy, which is introduced in the free-falling frame. Such choice is inspired by the analogy between the quantum vacuum and the ground state of quantum liquid, in which the event horizon for the low-energy fermionic quasiparticles also can arise. The quantum vacuum is characterized by the Fermi surface, which appears behind the event horizon. We do not consider the back reaction, and thus there is no guarantee that the stable black hole exists. But if it does exist, the Fermi surface behind the horizon would be the necessary attribute of its vacuum state. We also consider exact discrete spectrum of fermions inside the horizon which allows us to discuss the problem of fermion zero modes.Comment: LaTeX, 20 pages, 2 figure

Bundling up carbon nanotubes through Wigner defects

We show, using ab initio total energy density functional theory, that the so-called Wigner defects, an interstitial carbon atom right besides a vacancy, which are present in irradiated graphite can also exist in bundles of carbon nanotubes. Due to the geometrical structure of a nanotube, however, this defect has a rather low formation energy, lower than the vacancy itself, suggesting that it may be one of the most important defects that are created after electron or ion irradiation. Moreover, they form a strong link between the nanotubes in bundles, increasing their shear modulus by a sizeable amount, clearly indicating its importance for the mechanical properties of nanotube bundles.Comment: 5 pages and 4 figure

The Mutational Profile of Unicystic Ameloblastoma

BRAF V600E is the most common mutation in conventional ameloblastoma (AM) of the mandible. In contrast, maxillary AMs appear to harbor more frequently RAS, FGFR2, or SMO mutations. Unicystic ameloblastoma (UAM) is considered a less aggressive variant of ameloblastoma, amenable to more conservative treatment, and classified as a distinct entity. The aim of this study was to characterize the mutation profile of UAM (n = 39) and to compare it to conventional AM (n = 39). The associations between mutation status and recurrence probability were also analyzed. In the mandible, 94% of UAMs (29/31, including 8/8 luminal, 6/8 intraluminal, and 15/15 mural subtypes) and 74% of AMs (28/38) revealed BRAF V600E mutations. Among the BRAF wild-type cases, 1 UAM showed a missense SMO mutation (p.L412F), whereas 2 NRAS (p.Q61R), 2 HRAS (p.Q61R), and 2 FGFR2 (p.C383R) activating mutations were identified in AM. Of the 3 maxillary UAMs, only 1 revealed a BRAF V600E mutation. Taken together, our findings demonstrate high frequency of activating BRAF V600E mutations in both UAM and AM of the mandible. In maxillary UAMs, the BRAF V600E mutation prevalence appears to be lower as was shown for AM previously. It could therefore be argued that UAM and AM are part of the spectrum of the same disease. AMs without BRAF V600E mutations were associated with an increased rate of local recurrence (P = 0.0003), which might indicate that routine mutation testing also has an impact on prognosis.Peer reviewe