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Incidence and Timing of Foot Injury Diagnosis in Polytrauma Patients: A Retrospective Registry-Based Study
No full textBackground: Foot injuries are often missed in polytrauma patients, as more severe injuries may overshadow them, leading to delayed diagnosis and treatment. The aim of this study was to assess the incidence of foot injuries in polytrauma patients, evaluate the timing of their diagnosis, and identify risk factors associated with delayed diagnosis. Methods: In this retrospective registry-based study, all polytrauma patients with a New Injury Severity Score of ≥16 treated at Tampere University Hospital (TAUH) from 2016 to 2023 were screened for foot fractures as well as Lisfranc and Chopart injuries. Patient demographics, injury characteristics, and timing of diagnosis were extracted from TAUH’s trauma registry and analyzed. Results: Out of 1327 polytrauma patients, 54 (4.1%) sustained foot injuries, totalling 215 foot injuries (195 fractures). Delayed diagnosis, defined as >24 hours between trauma and diagnosis, occurred in 23 patients (43%), involving 80 injuries (37%). Fractures of the midfoot and metatarsus were most commonly diagnosed with delay. Delayed diagnosis was significantly more common in patients with a higher number of foot fractures and injuries (P < .001). Logistic regression analysis identified number of foot injuries (OR 1.658 [95% CI 1.098-2.504]), lower Glasgow Coma Scale (GCS) scores (OR 0.582 [95% CI 0.340-0.998]), and presence of concomitant facial injuries (OR 18.227 [95% CI 1.643-202.211]) as independent risk factors for delay in diagnosis. Conclusion: A substantial portion of polytrauma patients had foot injuries that were diagnosed >24 hours after the time of trauma. Despite these delays, most injuries were minor and without notable clinical consequences. Current tertiary survey protocols effectively detect most major foot injuries requiring immediate attention. Level of Evidence: Level III, retrospective registry.Peer reviewe
Early substrate-based catheter ablation vs. antiarrhythmic drug therapy for ventricular tachyarrhythmias among patients with prior myocardial infarction: the MANTRA-VT randomized trial
No full textAims Ventricular tachyarrhythmias (VT/VF) are common among patients with prior myocardial infarction (MI). MANTRA-VT trial was designed to compare the efficacy and safety of early substrate-based radiofrequency catheter ablation (RFCA) to antiarrhythmic drug (AAD) therapy for ventricular tachyarrhythmias. Methods We randomly assigned 58 AAD naïve post MI patients with implantable cardioverter defibrillator (ICD) and at least one and results documented VT/VF episode after the device implantation to an initial treatment strategy of substrate-based RFCA or AAD therapy. The primary endpoint was cumulative number of ventricular tachyarrhythmias (VT/VF burden) at 12 months. The secondary endpoints included all-cause mortality, hospitalization, adverse events, and VT/VF burden at 24 months. Analyses were performed on an intention-to-treat basis. The median number of VT/VF episodes at 12 months was zero in both the RFCA (range 0–3) and the AAD group (range 0–23) (P = 0.454), whereas the rate of appropriate ICD shocks was 7% and 30% in the RFCA and the AAD groups (P = 0.026), respectively. During the extended follow-up, 82% of the patients in the RFCA group and 63% in the AAD group had no ICD therapies (P = 0.012). There was no significant difference between the groups in total mortality (HR 1.02, 95% CI 0.20–5.11, P = 0.86) and hospitalization (HR 1.35, 95% CI 0.36–5.09. P = 0.66) at 24 months. Therapy-related adverse events occurred in 3.6% and 16.7% of the patients in the RFCA and the AAD groups (P = 0.10), respectively. Conclusion Early substrate-based RFCA was associated with reduced risk of ICD therapies, but with no meaningful difference in VT/VF burden, mortality, hospitalization, and adverse events.Peer reviewe
Memory of Migration - Migration of Memory: Essays of the last Soviet Generation of Women Abroad
No full textPeer reviewe
Dermal IgA is rare in Celiac Disease and relatives, and lacks Dermatitis Herpetiformis-type co-localization with Transglutaminase 3
No full textNon peer reviewe
Versatile high-power monolithic all-glass fiber amplifier for pulsed signals with a wide range of repetition rates
No full textThis study presents a compact, high-power monolithic all-glass spun tapered double-clad fiber amplifier for single-stage amplification of narrow linewidth picosecond pulsed signals from a few tens of mW to several hundred watts of average power and MW level of peak power, covering a wide range of repetition rates. The absence of free-space elements in the amplifier module enhances its overall reliability by omitting the dependency on the pump alignment and internal back reflections. The versatile all-glass amplifier module delivers 50 ps pulses with over 2 MW peak power at 1 MHz, 50 ps pulses with over 625 W average power at 20 MHz, and 20 ps pulses with over 645 W average power at 1 GHz, all exhibiting excellent spectral, spatial, and polarization characteristics. This monolithic all-glass ultra-large mode area fiber amplifier is verified as a robust solution for direct amplification of short pulses attaining high peak/average power laser systems with excellent spectral, spatial, and polarization characteristics.Peer reviewe
Impacts of Flow-based Market Coupling on Day-ahead Electricity Market Steered by Social Welfare
No full textThe flow-based market coupling (FBMC) method for calculating cross-border transmission capacities has been introduced in the European day-ahead electricity market. Its purpose is to maximize the benefit of cross-border transmission for the entire market. The price solution in the electricity market is steered by social welfare, which maximizes the surpluses of consumers and producers as well as bottleneck incomes. The shapes of the demand and supply curves determine which component has the strongest impact on the maximization of overall social welfare. In situations having a lot of supply or demand volume around the realized price level, even a large transmission volume does not significantly affect the surpluses and in this case bottleneck incomes can become the most influential factor. This leads to the fact that in certain situations the market can maximize bottleneck income at the expense of other components. FBMC enables counterintuitive flows which can in certain situations increase bottleneck incomes in another cross-border transmission connection. Artificially increased bottleneck incomes from the perspective of the overall market benefit or without a genuine bottleneck is contrary to the principle that bottleneck incomes should serve as a signal to steer investments in removing bottlenecks and strengthening cross-border transmission connections.Peer reviewe
Radial longitudinal deficiency: long-term outcomes of radialization and vascularized metatarsophalangeal joint transfer
No full textIntroduction: We studied long-term outcomes of radialization and free vascularized second metatarsophalangeal joint transfer for radial longitudinal deficiency using patient-reported and objective outcome measures. Methods: Patients aged ⩾10 years with Bayne and Klug type III or IV radial longitudinal deficiencies were identified from national referral centres. Patients treated by radialization (n = 15 limbs) and metatarsophalangeal joint transfer (n = 17 limbs) were assessed after a median follow-up of 13 years. Results: The respective scores after metatarsophalangeal joint transfer and radialization were: median Disabilities of Arm, Shoulder, and Hand scores 19 (95% CI: 7 to 25) and 19 (16 to 29); patient-rated wrist evaluation scores 11 (95% CI: 8 to 22) and 24 (95% CI: 10 to 38); and satisfaction with cosmesis 5 (95% CI: 3 to 6) and 8 (95% CI: 7 to 10). Median wrist active range of motion values were 90° (95% CI: 70 to 90) and 50° (95% CI: 30 to 60) and median wrist deviations were 20° (95% CI: 15 to 30) and 30° (95% CI: 15 to 60) after joint transfer and radialization, respectively. Secondary wrist procedures were more frequent in the joint transfer group. Conclusions: Both techniques yield good functional outcomes. Joint transfer produced a more consistent and larger range of active wrist extension–flexion but with poorer cosmetic results than radialization.Peer reviewe
Adaptive law-based feature representation for time series classification
No full textTime series classification (TSC) underpins applications across finance, healthcare, and environmental monitoring, yet real-world series often contain noise, local misalignment, and multiscale patterns. We introduce adaptive law-based transformation (ALT), a multiscale generalization of the earlier linear law-based transformation (LLT). ALT scans each series with variable-length, shifted windows, constructs symmetric delay embeddings, and extracts eigenvectors associated with the eigenvalue of minimal magnitude (“shapelet laws”) that capture locally stable patterns. These laws are assembled into class-specific dictionaries, and new series are projected onto them to yield compact, transparent features that enhance linear separability while remaining compatible with standard classifiers. On the BasicMotions dataset with synthetic Gaussian noise, ALT sustained test accuracy roughly 15–20 percentage points (pp) above raw inputs and 5–10 pp above LLT at moderate noise levels. Across ten datasets from the UCR Time Series Classification Archive—spanning motion, biomedical, spectroscopy, and industrial domains—ALT improved median test accuracy by + 7.6 pp with k-nearest neighbors (KNN) and + 4.8 pp with support vector machines (SVMs), with particularly large gains on long, noisy industrial series (FordA/B: + 23.1–25.3 pp). In addition, ALT often reduced SVM training time (median reductions of 340.6 s on FordB and 717.5 s on FordA) while maintaining or improving accuracy. ALT thus offers a lightweight and transparent alternative to heavyweight TSC pipelines: it requires only a small hyperparameter set, produces stable and discriminative features, and delivers competitive or superior accuracy under challenging conditions.Peer reviewe
'This might sound like I'm wearing a tinfoil hat...' - Knowledge workers' perceptions of privacy and surveillance in group-based communicative AI
No full textThis study examines knowledge workers’ perspectives on privacy implications and surveillant functionalities of group-based communicative AI in the context of work. The objective is to connect the ongoing examination of communicative AI in the workplace to research on privacy and employee surveillance, and to use the framework of privacy as contextual integrity as a theoretical lens through which some of the user perspectives on communicative AI tools are analyzed. Building on 33 qualitative interviews with Finnish knowledge workers, who were presented with scenarios of communicative AI functioning as a ‘team member’ in a work-related chat group, we find that knowledge workers recognize several privacy-related risks in using group-based communicative AI at work, and commonly use surveillant reasoning and logics to make sense of the suggested technology and its privacy implications. We present three distinct approaches knowledge workers had toward privacy in this setting: the detached, the compartmentalized, and the affective. Our findings suggest a wider need to consider communicative AI’s agency and role as an actor contributing to increasing privacy concerns. We highlight how, due to its human-like nature, data-reliant functionalities, and potential capabilities when operating in a group setting, the technology introduces negative affective responses and novel concerns related to privacy and employee surveillance. Specifically, privacy concerns relating to communicative AI expand beyond mere data protection issues to include concerns of how the technology is used by management, how the technology itself interacts within the organization, and how it will develop in the future.Peer reviewe
Protocol for culturing olfactory epithelium organoids supporting neuronal differentiation
No full textThe olfactory epithelium (OE) contains stem cells capable of generating olfactory sensory neurons throughout life, making it a valuable model for studying epithelial neurogenesis. We present a protocol to develop a highly robust 3D mouse organoid model from OE cells. We describe a workflow for dissecting murine OE and subsequent organoid culturing. We also provide guidance on how to perform immunostaining of the organoids. This protocol has been validated for mice and does not require fluorescence-activated cell purification. For complete details on the use and execution of this protocol, please refer to Gameiro et al.Peer reviewe