Neuromuscular training with injury prevention counselling to decrease the risk of acute musculoskeletal injury in young men during military service: a population-based, randomised study

<p>Abstract</p> <p>Background</p> <p>The rapidly increasing number of activity-induced musculoskeletal injuries among adolescents and young adults is currently a true public health burden. The objective of this study was to investigate whether a neuromuscular training programme with injury prevention counselling is effective in preventing acute musculoskeletal injuries in young men during military service.</p> <p>Methods</p> <p>The trial design was a population-based, randomised study. Two successive cohorts of male conscripts in four companies of one brigade in the Finnish Defence Forces were first followed prospectively for one 6-month term to determine the baseline incidence of injury. After this period, two new successive cohorts in the same four companies were randomised into two groups and followed prospectively for 6 months. Military service is compulsory for about 90% of 19-year-old Finnish men annually, who comprised the cohort in this study. This randomised, controlled trial included 968 conscripts comprising 501 conscripts in the intervention group and 467 conscripts in the control group. A neuromuscular training programme was used to enhance conscripts' motor skills and body control, and an educational injury prevention programme was used to increase knowledge and awareness of acute musculoskeletal injuries. The main outcome measures were acute injuries of the lower and upper limbs.</p> <p>Results</p> <p>In the intervention groups, the risk for acute ankle injury decreased significantly compared to control groups (adjusted hazards ratio (HR) = 0.34, 95% confidence interval (95% CI) = 0.15 to 0.78, <it>P </it>= 0.011). This risk decline was observed in conscripts with low as well as moderate to high baseline fitness levels. In the latter group of conscripts, the risk of upper-extremity injuries also decreased significantly (adjusted HR = 0.37, 95% CI 0.14 to 0.99, <it>P </it>= 0.047). In addition, the intervention groups tended to have less time loss due to injuries (adjusted HR = 0.55, 95% CI 0.29 to 1.04).</p> <p>Conclusions</p> <p>A neuromuscular training and injury prevention counselling programme was effective in preventing acute ankle and upper-extremity injuries in young male army conscripts. A similar programme could be useful for all young individuals by initiating a regular exercise routine.</p> <p>Trial registration</p> <p>ClinicalTrials.gov identifier number <a href="http://www.clinicaltrials.gov/ct2/show/NCT00595816">NCT00595816</a>.</p

Effect of remdesivir post hospitalization for COVID-19 infection from the randomized SOLIDARITY Finland trial

We report the first long-term follow-up of a randomized trial (NCT04978259) addressing the effects of remdesivir on recovery (primary outcome) and other patient-important outcomes one year after hospitalization resulting from COVID-19. Of the 208 patients recruited from 11 Finnish hospitals, 198 survived, of whom 181 (92%) completed follow-up. At one year, self-reported recovery occurred in 85% in remdesivir and 86% in standard of care (SoC) (RR 0.94, 95% CI 0.47-1.90). We infer no convincing difference between remdesivir and SoC in quality of life or symptom outcomes (p > 0.05). Of the 21 potential long-COVID symptoms, patients reported moderate/major bother from fatigue (26%), joint pain (22%), and problems with memory (19%) and attention/concentration (18%). In conclusion, after a one-year follow-up of hospitalized patients, one in six reported they had not recovered well from COVID-19. Our results provide no convincing evidence of remdesivir benefit, but wide confidence intervals included possible benefit and harm.Peer reviewe

Lignin from bioethanol production as a part of a raw material blend of a metallurgical coke

Abstract Replacement of part of the coal in the coking blend with lignin would be an attractive solution to reduce greenhouse gas emissions from blast furnace (BF) iron making and for obtaining additional value for lignin utilization. In this research, both non-pyrolyzed and pyrolyzed lignin was used in a powdered form in a coking blend for replacing 5-, 10- and 15 m-% of coal in the raw material bulk. Graphite powder was used as a comparative replacement material for lignin with corresponding replacement ratios. Thermogravimetric analysis was performed for all the raw materials to obtaining valuable data about the raw material behavior in the coking process. In addition, chemical analysis was performed for dried lignin, pyrolyzed lignin and coal that were used in the experiments. Produced bio cokes were tested in a compression strength experiment, in reactivity tests in a simulating blast furnace shaft gas profile and temperature. Also, an image analysis of the porosity and pore shapes was performed with a custom made MatLab-based image analysis software. The tests revealed that the pyrolysis of lignin before the coking process has an increasing impact on the bio coke strength, while the reactivity of the bio-cokes did not significantly change. However, after certain level of lignin addition the effect of lignin pyrolysis before the coking lost its significance. According to results of this research, the structure of bio cokes changes significantly when replacement of coal with lignin in the raw material bulk is at a level of 10 m-% or more, causing less uniform structure thus leading to a less strong structure for bio cokes

Effect of iron ore pellet size on metallurgical properties

Abstract Iron ore pellets are small and hard spherical particles agglomerated from a fine iron ore concentrate. They are used in the blast furnace process to produce hot metal. The diameter of blast furnace pellets is usually between 8 and 16 mm. In this study, a batch of magnesia iron ore pellets was first sieved into particle sizes of 8–10 mm, 10–12.7 mm, 12.7–16 mm and 16–20 mm, and the four different size fractions were used to study the effect of pellet size on metallurgical properties. The metallurgical experiments showed a decrease both in reducibility under unconstrained conditions and in low-temperature reduction-disintegration but showed an increase in cold crushing strength as the pellet size increased. In the reduction-softening test, pellets sized 10–12.7 mm reached the highest final temperature and the highest reduction degree among the pellet samples of different sizes. Based on the implications drawn from this study, the amount of 10–12.7 mm pellets should be maximized in a blast furnace operation

Gas composition change in a single sinter, pellet and coke layer in simulated blast furnace conditions

Abstract In spite of the vast amount of research regarding the operation of blast furnace, the gas composition change in a single charge material layer in a blast furnace is not an extensively studied research area. Iron-bearing material and coke are charged in turn as layers into the blast furnace as raw material. With no percolation of layers taken into account, the composition of gas varies in turn in the blast furnace shaft, losing its reducing potential in an iron-bearing material layer and being reformed in a coke layer. In this paper, the effect of reactions in sinter, pellet and coke layers on the gas composition between the blast furnace top and the cohesive zone has been discussed. The gas was analysed on-line on multiple heights of a tube furnace loaded with a material bed of 1.0 m in height and uniformly heated at a rate of 2°C/min or 3°C/min up to 1100°C or 1200°C. As a result, the H₂–H₂O gas composition change occurred in a higher temperature than the CO–CO₂ change in sinter, pellet and coke beds. This led to a conclusion that the reduction of iron oxides by hydrogen and gasification of coke by water vapour started in somewhat higher temperatures than the reactions with carbonaceous gas components. Additionally, olivine pellets were more reducible in moderate temperatures compared with sinter and the utilisation rates of CO and H₂ gases rose higher in a pellet bed than in a sinter bed, mainly due to the higher hematite percentage in pellets

Implementation of multimodality therapy and minimally invasive surgery:short- and long-term outcomes of gastric cancer surgery in medium-volume center

Abstract Background: Multimodal treatment of gastric cancer includes careful preoperative staging, perioperative oncological treatment, and selective minimally invasive approach. The aim was to evaluate whether this approach improves short- and long-term outcomes in operable gastric cancer. Methods: This study included 181 gastric cancer patients who underwent curative intent surgery in Central Finland Central Hospital between years 2005 and 2021 for gastric or esophagogastric junction adenocarcinoma. Those 65 patients in group 1 operated between years 2005–2010 had open surgery with possible adjuvant therapy. During the second period including 58 patients (2011–2015), perioperative chemotherapy and minimally invasive surgery were implemented. The period, when these treatments were standard practise, was years 2016–2021 including 58 patients (group 3). Outcomes were lymph node yield, major complications and 1- and 3-year survival rates. Results: Median lymph node yield increased from 17 in group 1 and 20 in group 2 to 23 in group 3 (p &lt; 0.001). Major complication rates in groups 1–3 were 12.3%, 32.8%, and 15.5% (group 1 vs. group 2, p = 0.007; group 2 vs. group 3, p = 0.018), respectively. Overall 1-year survival rates between study groups 1–3 were 78.5% vs. 69.0% vs. 90.2% (p = 0.018) and 3-year rates 44.6% vs. 44.8% vs. 68.1% (p = 0.016), respectively. For overall 3-year mortality, adjusted hazard ratio (HR) was 1.02 (95%CI 0.63–1.66) in group 2 and HR 0.37 (95%CI 0.20–0.68) in group 3 compared to group 1. Conclusions: In medium-volume center, modern multimodal therapy in operable gastric cancer combined with minimally invasive surgery increased lymph node yield and improved long-term survival without increasing postoperative morbidity

Effect of circulating elements on the dynamic reduction swelling behaviour of olivine and acid Iron ore pellets under simulated blast furnace shaft conditions

Abstract Sulphur and alkalis in the blast furnace gas have been associated affecting the reduction swelling behaviour of iron ore pellets. A tube furnace was used in this study to examine the dynamic reduction swelling behaviour of olivine and acid pellets in CO–CO₂–N₂ atmosphere with sulphur and potassium in gaseous phases up to 1100°C simulating the conditions in the blast furnace shaft. No abnormal swelling was detected in sulphur or potassium containing CO–CO₂–N₂ atmospheres during dynamic reduction. Instead, sulphur in the reducing atmosphere was associated with pellet contraction and FeO–FeS melt formation which became more dominant with increasing sulphur partial pressures. In the extreme case, having a maximum of 1.0 vol-% S₂ gas in the reducing atmosphere, the reduction reaction of wüstite to metallic iron was hindered. The formation of FeO–FeS liquid phase extends the cohesive zone towards the blast furnace top and lower temperatures and decreases the gas permeability. Furthermore, large amounts of potassium in the reducing atmosphere (max. 0.03 vol-%) led to swelling and cracking in the olivine pellets still remaining in the range of normal swelling

Reduction behavior of cold-bonded briquettes under simulated blast furnace conditions

Abstract Recycling of fine sized iron-rich by-products back to blast furnace (BF) process in the form of cement-bonded briquettes has become a common procedure in steel plants. Replacing part of the cement by Ground Granulated Blast Furnace Slag (GGBFS) is also a common method to reduce cement consumption. When the briquettes are subjected to high temperature and reducing atmosphere in the BF, the cement phases decompose and the iron oxides undergo a series of phase transformations. To avoid early disintegration and to improve the performance of the briquettes, it is necessary to study these reactions during the reduction. In the present study the reduction behavior of the BF briquette samples was studied by experimental methods in a laboratory scale furnace, which simulates the conditions of the BF shaft in a CO–CO₂–N₂ atmosphere. With interrupted experiments the composition of the briquette was studied in different reduction stages of the BF shaft. The effect of GGBFS as a binder material on the reduction was studied with GGBFS containing briquette samples. The reduction of briquettes was compared to an olivine pellet which was used as a reference sample. Considerably higher reduction rate was detected with the briquettes compared to the pellet at 1100°C when reduced to metallic iron. 25–50 vol-% swelling in the briquette samples was detected during the wüstite-iron reduction step at 900–1000°C. X-ray diffraction (XRD) was used to observe the phase transformations in the Fe–Fe₂O₃–CaO system of the briquette and the results are in agreement with the theory

Evaluating the reduction-softening behaviour of blast furnace burden with an advanced test

Abstract A ferrous burden loses its permeability in the cohesive zone of a Blast Furnace (BF), where the iron burden materials soften and melt. A tailor-made, high-temperature furnace named ARUL (Advanced Reduction under Load) was used here to study the reduction-softening behaviour of acid and olivine pellets and basic sinter under simulated BF gas, temperature and pressure conditions. The ARUL test showed the best reduction-softening properties for the basic sinter. The sinter sample resisted up to 1329°C and achieved a reduction degree of 90.2% until a gas-impermeable structure was formed in a packed bed, whereas the acid pellet lost its permeability at 1160°C and only reduced to a reduction degree of 48.7%. The olivine pellet had intermediate reduction-softening properties with a final temperature of 1252°C and a final reduction degree of 68.7%. The differences between the test materials were assessed as being caused mainly by different chemistry, but it was also revealed that the sinter sample remained its macro-porosity markedly better in relation to the pellets, providing routes for reducing gases. The experimental results were compared to the phase diagrams calculated with the computational thermodynamic software FactSage. Phase diagrams for the 5-component FeO–SiO₂–CaO–MgO–Al2O₃ systems with constant CaO, MgO and Al₂O₃ contents were used to estimate the formation of liquid phases in the test materials. The computed phase diagrams gave an estimate of the liquid formation; however, some limitations were also found in the utilization of the computations because of the need to define the system in certain simplicity

Water-gas shift reaction in an olivine pellet layer in the upper part of blast furnace shaft

Abstract In order to reduce CO₂ emissions in the iron and steel industry, the utilization of H₂ gas as a reducing agent is a feasible option. The use of hydrogen bearing injectants in the lower blast furnace (BF) area increases H₂O concentration in the upper part of the BF shaft and the charging of moist burden has a similar effect as well. For efficient BF operation, it is important to investigate the effect of high H2 and therefore high H₂O concentrations in the reducing gas. This study focuses on the upper BF shaft area where hematite to magnetite reduction takes place and temperature is in the range of the forward water-gas shift reaction (WGSR). The effect of the WGSR on the composition of the reducing gas was estimated by experimental methods. A layer furnace (LF) was used to determine the temperature for the occurrence of the WGSR under simulated BF shaft conditions. The feed gas conversion was investigated in an olivine pellet layer. The WGSR was observed in an empty LF with CO–H₂O–N₂ gas at 500°C. With CO–CO₂–H₂O–N₂ gas the WGSR was observed in an olivine pellet layer at 400–450°C and in a pre-reduced magnetite pellet layer at 300–400°C indicating the catalyzing effect of magnetite on the WGSR. The results offer additional information about the effect of high H₂O concentration on the composition of the reducing gas through the WGSR. The occurrence of the WGSR in the actual BF and its effects were discussed