Kuolemantapaukset perusterveydenhuollon lyhytaikaisessa sairaalahoidossa

Maassamme kuolee yli 50 000 henkilöä vuosittain. Merkittävä osuus suomalaisista kuolee perusterveydenhuollon (PTH) sairaaloissa; silti tutkimusta aiheesta on tehty verrattain vähän. Tässä tutkimuksessa kuvataan PTH-sairaaloissa kuolemaan päättyneiden hoitojaksojen piirteitä Kuopion yliopistollisen sairaalan erityisvastuualueella (KYS erva-alue). Tutkimukseen osallistuivat kaikki KYS erva-alueen PTH-sairaalat. Tiedonkeruu toteutettiin strukturoitua tiedonkeruulomaketta käyttäen vuoden 2016 tammi–kesäkuussa. Tarkastelu rajattiin enintään 31 vuorokautta kestäneisiin hoitojaksoihin. PTH-sairaaloiden lyhytaikaisista hoitojaksoista (n = 13 869) 4 prosenttia (n = 625) päättyi potilaan kuolemaan. Kuolemaan päättyneistä hoitojaksoista 46 prosentissa hoidon pääasialliseksi syyksi oli määritelty elämän loppuvaiheen hoito. Sydän- ja verenkiertoelimistön sairaudet (29 %) sekä syöpäsairaudet (30 %) olivat yleisimmät päädiagnoosit kuolemaan päättyneillä hoitojaksoilla. Hoito PTH-sairaalassa kesti keskimärin 8,6 vuorokautta, mutta 20 prosentilla potilaista vain vuorokauden tai kaksi. Kuoleman läheisyyttä ei ollut tiedostettu yli puolessa PTH-sairaaloiden hoitojaksoista, jotka päättyivät potilaan kuolemaan. Lisäksi neljäsosa potilaista oli PTH-sairaalassa enintään kaksi vuorokautta ennen kuolemaansa. Pohdittavaksi jää, olisiko näiden potilaiden hoitoa voitu toteuttaa toisin

Nicotinamide riboside improves muscle mitochondrial biogenesis, satellite cell differentiation, and gut microbiota in a twin study

Nicotinamide adenine dinucleotide (NAD(+)) precursor nicotinamide riboside (NR) has emerged as a promising compound to improve obesity-associated mitochondrial dysfunction and metabolic syndrome in mice. However, most short-term clinical trials conducted so far have not reported positive outcomes. Therefore, we aimed to determine whether long-term NR supplementation boosts mitochondrial biogenesis and metabolic health in humans. Twenty body mass index (BMI)- discordant monozygotic twin pairs were supplemented with an escalating dose of NR (250 to 1000 mg/day) for 5 months. NR improved systemic NAD(+) metabolism, muscle mitochondrial number, myoblast differentiation, and gut microbiota composition in both cotwins. NR also showed a capacity to modulate epigenetic control of gene expression in muscle and adipose tissue in both cotwins. However, NR did not ameliorate adiposity or metabolic health. Overall, our results suggest that NR acts as a potent modifier of NAD(+) metabolism, muscle mitochondrial biogenesis and stem cell function, gut microbiota, and DNA methylation in humans irrespective of BMI.Peer reviewe

Normal stroma suppresses cancer cell proliferation via mechanosensitive regulation of JMJD1a-mediated transcription

Tissue homeostasis is dependent on the controlled localization of specific cell types and the correct composition of the extracellular stroma. While the role of the cancer stroma in tumour progression has been well characterized, the specific contribution of the matrix itself is unknown. Furthermore, the mechanisms enabling normal-not cancer-stroma to provide tumour-suppressive signals and act as an antitumorigenic barrier are poorly understood. Here we show that extracellular matrix (ECM) generated by normal fibroblasts (NFs) is softer than the CAF matrix, and its physical and structural features regulate cancer cell proliferation. We find that normal ECM triggers downregulation and nuclear exit of the histone demethylase JMJD1a resulting in the epigenetic growth restriction of carcinoma cells. Interestingly, JMJD1a positively regulates transcription of many target genes, including YAP/ TAZ (WWTR1), and therefore gene expression in a stiffness-dependent manner. Thus, normal stromal restricts cancer cell proliferation through JMJD1a-dependent modulation of gene expression.Peer reviewe

Punnitustietojen keruu ja tuotannon seuranta emolehmätarkkailutiloilla

Punnitustietoja tarvitaan liharotuisten eläinten jalostusindeksien laskentaan. Indeksit kuvaavat eläimen jälkeläisten keskimääräistä perinnöllistä tasoa ja niiden avulla valitaan eläimiä siitokseen. Tutkimuksessa selvitettiin, kuinka aktiivisesti emolehmätarkkailutiloilla kerätään eläinten punnitustietoja, kuinka tuotannon seuranta tiloilla tapahtuu, ja millaisena vastaajat näkevät oman karjan kehittämiskohteet. Tutkimusaineisto kerättiin sähköisellä kyselytutkimuksella, joka lähetettiin Faban asiakasrekisterissä oleville emolehmätarkkailutiloille. Kyselyyn vastasi 34,1 % tarkkailutiloista. 66,1 % vastaajista oli aloittanut emolehmätuotannon 2000-luvulla. Kolmannes vastanneiden tiloista oli kooltaan 20–39 emolehmän tiloja. Emolehmien suosituimmat päärodut tiloilla olivat hereford 27,5 % ja charolais 22,9 %. Kyselyyn vastanneista tiloista 54,1 % käytti astutussonnia emolehmien tiineytykseen. Astutusta ja siemennystä käyttävien tilojen osuus oli 32,1 %. Alkionsiirtoja tehtiin 10,1 %:lla karjoista. 89,9 % tiloista punnitsi syntymäpainon kaikilta vasikoilta ja 84,4 % vieroituspainon. Tiloilta, joilta meni eläimiä alle vuoden ikäisenä myyntiin, 15,7 % vastaajista sai kasvattajalta aina tiedon eläimen vuodenpainosta. Suurin syy siihen, miksi punnituksia jäi tiloilla tekemättä, oli, että se koettiin hankalaksi järjestää. Toiseksi suurimpana syynä olivat vastaajien ilmoittamat muut syyt ja kolmantena eläimen erilainen tuotantorytmi. 66,1 % vastaajista piti kirjaa kiimoista ja astutuksista. Tiineystarkastuksia tehtiin vuosittain 39,4 %:lla tiloista. Vastaajan tuotantokokemus ei vaikuttanut tilastollisesti merkitsevästi muistiinpanojen ja tiineystarkastuksen tekemiseen. Keinosiemennystä käyttävät tilat tekivät tiineystarkastuksia enemmän kuin astutussonnia käyttävät tilat (p=0,038). Säännöllisen emolehmien kuntoluokituksen teki 41,3 % vastaajista ja emolehmät punnittiin 9,2 %:lla tiloista. Vastaajat pitivät oman karjan tärkeimpänä kehittämisen kohteena emoaineksen jalostamista. Pihvivasikoiden tuottajat tavoittelivat vieroituspainojen nostoa, ja pihvivasikoiden teuraskasvattajat sekä charolaiskasvattajat pienempää vasikkakuolleisuutta omassa karjassaan.Recording the weights of live animal is needed to calculate the genetic evaluation of beef cattle. The genetic evaluations describe the genetic value of the animals and are used when selecting breeding animals. The aim of this study was to investigate how extensively the weights are measured on beef cattle farms. The aim of this study was also to find out how actively the farmers are monitoring production and what their most important goals are when developing cattle. Research data was collected using an electronic survey of the farmers involved in Faba's beef cattle recording scheme. The survey's response rate was 34.1-%. 66.1-% of respondents had begun their beef cattle production in the 2000's. Respondents had mainly farms with 20–39 cows. The most common beef breeds were Hereford (27.5-% of the farms) and Charolais (22.9-%). 54.1-% of respondents used only a farm bull for insemination. Both the farm bull and artificial insemination were used on 32.1-% of the farms. Embryo transfer was used on 10.1-% of the farms. The birth weight of all animals was measured by 89.9-% of respondents and the weaning weight of all animals by 84.4-%. If the animal was sold to another farm before recording the yearling weight at the birth farm this data was not usually known on the birth farm. The main reason why the animal's weights were not measured was that it was considered difficult to arrange. This was followed by undefined reasons and the different production rhythm of the animals. 66.1-% of respondents made a note of heats and services and 39.4-% of farmers checked the animal’s gestations. The respondent's experience had no statistically significant effect on making notes of heats and services or checking gestations. The farmers that used artificial insemination checked pregnancies more often than farmers who used a bull (p=0,038). 41.3-% of respondents evaluated the body condition score of the cows yearly and 9.2-% of respondents weighed the cows annually. Respondents considered the improvement of the cow’s genetic rate merit the most important goal in developing their cattle. Farmers specialized in beef calf production desired to raise the weaning weight and Charolais producers wanted to decrease calf mortality

Towards minimizing measurement uncertainty in total petroleum hydrocarbon determination by GC-FID

Abstract Despite tightened environmental legislation, spillages of petroleum products remain a serious problem worldwide. The environmental impacts of these spillages are always severe and reliable methods for the identification and quantitative determination of petroleum hydrocarbons in environmental samples are therefore needed. Great improvements in the definition and analysis of total petroleum hydrocarbons (TPH) were finally introduced by international organizations for standardization in 2004. This brought some coherence to the determination and, nowadays, most laboratories seem to employ ISO/DIS 16703:2004, ISO 9377-2:2000 and CEN prEN 14039:2004:E draft international standards for analysing TPH in soil. The implementation of these methods, however, usually fails because the reliability of petroleum hydrocarbon determination has proved to be poor. This thesis describes the assessment of measurement uncertainty for TPH determination in soil. Chemometric methods were used to both estimate the main uncertainty sources and identify the most significant factors affecting these uncertainty sources. The method used for the determinations was based on gas chromatography utilizing flame ionization detection (GC-FID). Chemometric methodology applied in estimating measurement uncertainty for TPH determination showed that the measurement uncertainty is in actual fact dominated by the analytical uncertainty. Within the specific concentration range studied, the analytical uncertainty accounted for as much as 68–80% of the measurement uncertainty. The robustness of the analytical method used for petroleum hydrocarbon determination was then studied in more detail. A two-level Plackett-Burman design and a D-optimal design were utilized to assess the main analytical uncertainty sources of the sample treatment and GC determination procedures. It was also found that the matrix-induced systematic error may also significantly reduce the reliability of petroleum hydrocarbon determination. The results showed that strict implementation of the ISO and CEN draft standards is necessary owing to the method dependence of the analyzed parameter. Care should be taken to ensure that the methods used for petroleum hydrocarbon determination are comprehensively validated, and that routine quality control is carried out in order to ensure that the validation conclusions are applicable in the daily work

Oxidative Dissolution of Low-Grade Ni-Cu Ore and Impact on Flotation of Pentlandite

The authors would like to acknowledge Thi Minh Khanh Le’s input in reviewing the paper and suggesting some changes, Boliden Kevitsa Mine for providing the samples, and the Department of Bioproducts and Biosystems—Aalto University for supporting this study. Publisher Copyright: © 2022 by the authors.This paper investigated the effect of mineral surface oxidation on the floatability of Kevitsa low-grade Ni-Cu ore. Physicochemical measurements, ethylene diamine tetra acetic acid (EDTA) extraction, and oxygen uptake experiments were carried out with slurry and recycled process water samples obtained from the Kevitsa Cu-Ni sequential concentrator plant. The pH of recycled process water, copper flotation feed, and nickel flotation feed dropped by 0.7, 0.4, and 0.7 points, respectively, from May to July. The oxygen demand increased from recycled process water to the copper flotation feed, then dropped for the nickel flotation feed. The nickel flotation feed Redox potential (ORP) was lowest for July, while EDTA extractable metals increased from May to July. There was a 20% drop in nickel recoveries from May to July. Based on ORP measurements of the nickel flotation feed, good nickel flotation takes place in a moderately oxidizing (75–170 mV) and alkaline (9.2–9.7 pH) environment. Therefore, the ORP/pH of the nickel flotation feed is important to the nickel flotation. The results showed that at the Kevitsa plant, the grinding process is an electrochemically active environment, which, together with the incoming recycled process water quality, defines the degree of mineral surface oxidation for flotation. The increasing corrosiveness of the recycled process water increased mineral surface oxidation and depressed pentlandite flotation. Laboratory flotation experiments confirmed the observed poor plant flotation response when the corrosiveness of recycled process water increased. Total dissolved solids (TDS) was proven to be a reliable online parameter for the corrosiveness of the recycled process water and was inversely proportional to the pentlandite recovery. The findings of this study may help the plant develop ways to enable a timely response to changes in recycled process water quality to prevent harmful impacts on pentlandite flotation.Peer reviewe

Influence of Water Quality on Sulphide Ore Oxidation and Speciation of Sulphur Anions during Autogenous Milling

Earlier studies at the Kevitsa Cu-Ni concentrator plant have indicated that seasonal variations of the properties of the process water affect the oxidation of the surface of the minerals, and further, the pentlandite flotation performance. However, it is not clear whether the differences in flotation performance are solely due to changes in the mineral surface oxidation, and/or also due to surface oxidation-induced changes in the aqueous phase of the pulp. This paper investigates the effects of the mineral surface oxidation of Kevitsa Cu-Ni ore on the properties of the aqueous phase of the slurry. A systematic study was formulated to monitor the surface oxidation related changes in the mill circuit of the Kevitsa concentrator plant. The study was timed to coincide with a seasonally observed drop in the concentrator plant’s flotation performance, which happens during the summer months (June, July, and August). Both physicochemical parameters, as well as sulphur oxyanions in the plant process water, mill discharge, and hydrocyclone overflows were monitored. Also, the bubble size in selected rougher and cleaner cells was monitored. The results show that season-related changes in mineral surface oxidation cause clear differences in the aqueous phase chemistry of the mill circuit. The increased concentration of reduced sulphur species in the mill discharge is an indication of extensive oxidation of the ore during milling. Also, the bubble size of the flotation cells reacts to the observed seasonal change. The findings of the study confirm that the consequences expected, based on the theory of mineral surface oxidation, are observable downstream in the aqueous phase of the milling circuit. Based on these results, it is not yet possible to say whether the poor flotation performance is caused solely by the oxidation of the mineral surface or also by the properties of the aqueous phase of the slurry after milling. However, the results show that the plant needs both to find ways to limit oxidation rates in the summer, and to consider installing a more robust frother, capable of maintaining efficacy during the warm season. The findings of this study may help the plant to develop ways to enable a timely response to changes in the recycled process water quality, to prevent harmful impacts on pentlandite flotation. The former could be achieved by lowering the temperature of the process water and flotation air, whereas the latter could mean using a different frother