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Abstract Background There has been a significant expansion in the measurement of healthcare system performance. However, there is a lack of a comprehensive performance measurement framework to assess the effects of telephone triage services on the urgent care system. The aim of our Delphi study was to construct and validate a performance measurement framework designed explicitly for telephone triage services. Methods This study was conducted in Finland with a group of eight experienced senior physicians from the country's 20 largest joint emergency departments, serving over 90% of the population for urgent care. The Nominal Group Technique (NGT) was utilised to achieve consensus on measuring telephone triage performance. Initially, performance indicators (PIs) were identified through Delphi method rounds from December 10th to December 27th, 2021, with eight experts participating, and from December 29th, 2021, to January 23rd, 2022, where five of these experts responded. NGT further deepened these themes and perspectives, aiding in the development of a comprehensive performance measurement framework. The final framework validation began with an initial round from February 13th to March 3rd, 2022, receiving five responses. Due to the limited number of responses, an additional validation round was conducted from October 29th to November 7th, 2023, resulting in two more responses, increasing the total number of respondents in the validation phase to seven. Results The study identified a strong desire among professionals to implement a uniform framework for measuring telephone triage performance. The finalised framework evaluates telephone triage across five dimensions: service accessibility, patient experience, quality and safety, process outcome, and cost per case. Eight specific PIs were established, including call response metrics, service utility, follow-up care type and distribution, ICPC-2 classified encounter reasons, patient compliance with follow-up care, medical history review during assessment, and service cost per call. Conclusions This study validated a performance measurement framework for telephone triage services, utilising existing literature and the NGT method. The framework includes five key dimensions: patient experience, quality and safety, outcome of the telephone triage process, cost per case, and eight PIs. It offers a structured and comprehensive approach to measuring the overall performance of telephone triage services, enhancing our ability to evaluate these services effectively.

Purpose: Calculating an organization's carbon footprint is crucial for assessing and implementing emission reductions. Although Finnish higher education institutions (HEIs) aim for carbon neutrality by 2030, limited research exists on plans to reach a similar target in any country. This paper aims to address the shared and individual challenges Finnish HEIs have with carbon footprint calculations, reductions, resources and offsetting. Design/methodology/approach: A survey was targeted to sustainability experts in all 38 HEIs in Finland to identify key patterns and trends in the focus fields of the study. SWOT analysis was used to classify main strengths, opportunities, weaknesses and threats, based on which a series of policy recommendations was drafted. Findings: Finnish HEIs are committed to carbon footprint tracking (97%, annually by 87%). The lack of standardization and the number of external stakeholders complicate accounting indirect emissions, impeding comparability and reliability. Only 39% had set separate emission reduction targets, suggesting a preference for carbon footprint over other environmental impact indicators. Insufficient monetary and human resources emerged in 23% of institutions, especially those smaller in size. Only 52% had clear offsetting plans, with shared concerns over trust and responsibility. Originality/value: By including both research universities and universities of applied sciences, the findings provide an unprecedented outlook into the entire Finnish HEI sector. The policy recommendations guide HEIs both locally and globally on how to improve their transparency and scientific integrity, reflect on core successes and weaknesses and how they complete their objectives of education, research and social impact while promoting stronger sustainability.

Abstract An under-recognised aspect of the current humanitarian catastrophe in Gaza is the impact of the war on the environment and the associated risks for human health. This commentary contextualises these impacts against the background of human suffering produced by the overwhelming violence associated with the use of military force against the general population of Gaza. In calling for an immediate cessation to the violence, the authors draw attention to the urgent need to rebuild the health care system and restore the physical and human infrastructure that makes a liveable environment possible and promotes human health and well-being, especially for the most vulnerable in the population. Environmental remediation should therefore form one of the most important parts of international efforts to assist reconstruction, through which we hope Palestinians and Israelis will achieve lasting peace, health, and sustainable development, all as part of accepted international human rights obligations.

ABSTRACT Heterobasidion annosum sensu lato comprises some of the most devastating pathogens of conifers. Exploring virocontrol as a potential strategy to mitigate economic losses caused by these fungi holds promise for the future. In this study, we conducted a comprehensive screening for viruses in 98 H. annosum s.l. specimens from different regions of Czechia aiming to identify viruses inducing hypovirulence. Initial examination for dsRNA presence was followed by RNA-seq analyses using pooled RNA libraries constructed from H. annosum and Heterobasidion parviporum, with diverse bioinformatic pipelines employed for virus discovery. Our study uncovered 25 distinct ssRNA viruses, including two ourmia-like viruses, one mitovirus, one fusarivirus, one tobamo-like virus, one cogu-like virus, one bisegmented narna-like virus and one segment of another narna-like virus, and 17 ambi-like viruses, for which hairpin and hammerhead ribozymes were detected. Coinfections of up to 10 viruses were observed in six Heterobasidion isolates, whereas another six harbored a single virus. Seventy-three percent of the isolates analyzed by RNA-seq were virus-free. These findings show that the virome of Heterobasidion populations in Czechia is highly diverse and differs from that in the boreal region. We further investigated the host effects of certain identified viruses through comparisons of the mycelial growth rate and proteomic analyses and found that certain tested viruses caused growth reductions of up to 22% and significant alterations in the host proteome profile. Their intraspecific transmission rates ranged from 0% to 33%. Further studies are needed to fully understand the biocontrol potential of these viruses in planta.IMPORTANCEHeterobasidion annosum sensu lato is a major pathogen causing significant damage to conifer forests, resulting in substantial economic losses. This study is significant as it explores the potential of using viruses (virocontrol) to combat these fungal pathogens. By identifying and characterizing a diverse array of viruses in H. annosum populations from Czechia, the research opens new avenues for biocontrol strategies. The discovery of 25 distinct ssRNA viruses, some of which reduce fungal growth and alter proteome profiles, suggests that these viruses could be harnessed to mitigate the impact of Heterobasidion. Understanding the interactions between these viruses and their fungal hosts is crucial for developing effective, environmentally friendly methods to protect conifer forests and maintain ecosystem health. This study lays the groundwork for future research on the application of mycoviruses in forest disease management.

Forests are crucial for climate change mitigation as they absorb and store large amounts of carbon dioxide. In Finland, ash fertilization of drained peatland forests has been identified as part of the climate change mitigation strategy, yet it is implemented notably less than it could be. Therefore, this study aimed to identify most effective nudges, nudge+ and boosts that could steer Finnish non-industrial private forest (NIPF) owners to adopt ash fertilization in their forest. Semi-structured interviews with 19 NIPF owners were analyzed using the Behaviour change wheel to identify key factors influencing owners’ willingness to engage in ash fertilization. Most factors raised by forest owners were related to reflective motivation encompassing both drivers and barriers to practicing ash fertilization. We also identified possible cognitive biases that were influencing decisions. The suggested nudges, nudge+ and boosts address both the specific concerns of the forest owners and the underlying heuristics. For example, framing ash fertilization as a standard procedure of professional forest management and including it into forest management plans could facilitate overcoming status quo bias that may hinder the adoption of novel forest management practices. These findings are directly applicable for creating nudges, nudge+ and boosts on ash fertilization for experienced, professionally managing NIPF owners with larger forest estates. Our study also offers an approach that can be adapted for broader application in environmental and climate-friendly decision-making, contributing to the growing body of literature on the intersection of behavioral science and environmental management.

Religious disagreement means holding incompatible views of the truth or of the plausibility of some position that is religiously relevant. It is well known that many religious and non-religious worldviews make apparently incompatible claims about ultimate reality. This poses both theoretical and practical challenges that in different ways seek to address the basic question: what should we do when we disagree? Sometimes, disagreement seems to call for conciliation so that all parties relativize their beliefs to some extent. Sometimes disagreements are so complex that it is not apparent what one should do, or one may have other reasons to consider the opposing arguments as non-threatening to one’s own views. In such cases, one may be steadfast in their convictions. In addition to these more philosophical concerns, disagreement often requires practices that help people to understand and manage disagreement. Christian tradition has offered various explanations for why disagreement exists in the first place, and also ways of seeking agreement among those who disagree.

Abstract Trees are natural objects that carry practical, cultural and spiritual meanings to humans. Trees are an elemental part of human daily life, both in urban and rural environments, and even in locations where forests are distant. Conflicts related to tree removal in the close environments of humans indicate that individual trees may have special significance. Despite that, we have little knowledge of the ways these relationships are formed and the meanings they carry. To examine how the properties of trees and humans influence the type of relationships that are formed between them, we conducted a large‐scale survey (n = 1758). We used cluster analysis to identify typical groups of trees and human–tree relationships and conducted cross‐tabulation to correlate human and tree types in the relationships. In studying the human–tree relationship, we applied the framework of natureculture to address how the lives of humans and trees are bound together in interspecies relationships. Our results show that the strongest influence on tree–human relationships originates from human lifestyles and nature connections. Consequently, we identified three main types of human–tree relationships: (1) Admiring relationships towards large, old and charismatic trees, primarily grounded in sensory and emotional experiences, are common among urban nature‐loving people. (2) Nurturing relationships that occur with young trees in people's own gardens, which is most typical for rural outdoorspeople owning houses. (3) Nostalgic relationships are associated with trees with symbolic value in the memories of people who no longer have a material connection to an important environment. Our study revealed that the affection of humans for trees in their close environment strongly varied in emotional intensity and practical actions related to trees. We provide new knowledge of the correlations between human and tree characteristics in forming their interspecies relationship and how this relationship affects human emotional well‐being. Based on our findings, we suggest that understanding human–nature interdependence helps to sustain and create emotionally supportive multispecies environments through green design and management. Read the free Plain Language Summary for this article on the Journal blog.

Research Infrastructures (RIs) are strategic assets facilitating innovation and knowledge advancement across all scientific disciplines. They provide researchers with advanced tools and resources that go beyond individual or institutional capacities and promote collaboration, community-building and the application of scientific standards. Remote and virtual access to RIs enables scientists to use these essential resources without the necessity of being physically present. The COVID-19 pandemic restrictions where a catalyst for the expansion and further development of remote and virtual access models, particularly in fields where physical access had been the predominant model. The eRImote project explores pathways for digital and remote RI access through targeted surveys, stakeholder workshops, expert groups discussions, and the analysis of specific use cases. This paper provides a definition of remote and virtual access and remote training and explores their implementation across various RIs, highlighting the implications for their operational processes and the dynamics of interaction between RIs and their user communities. It presents the identified advantages, obstacles, and best-practices, alongside strategies and recommendations to navigate and mitigate challenges effectively. Key issues and recommendations are summed up separately for remote access, virtual access, and remote training, complemented by general recommendations for facilitating remote and virtual access to RIs. These relate to budgeting and funding, the balancing of RI access models, the need for regulatory frameworks for sample shipments, collaboration among RIs, impact assessment of remote and virtual access on user interactions, operational efficiency and the environment footprint of RIs, and the adaption of data sharing policies. Stakeholders are broadly invited to give their feedback on the paper’s findings and conclusions, which will be integrated into improved versions of this paper.

Kidney diseases such as glomerulopathy and nephron dysfunction are estimated to grow to more than 900 million cases by 2030, in 45% of which kidney transplantation will be required, representing a major challenge for biomedicine. A wealth of progress has been made to model human diseases using induced pluripotent stem cells (iPSCs) in vitro differentiated to a variety of organoids, including kidney organoids, and in developing various microfluidics-based organ-on-a-chip (OoC) systems based on them. With the combination of targeted gene editing capacities, relevant polymorphic genetic variants can be established in such organoid models to advance evidence-based medicine. However, the major drawback of the current organoid disease models is the lack of functional endothelial vasculature, which especially concerns the kidney, the function of which is strongly associated with blood flow. The design of novel medical devices using tissue engineering approaches such as kidney organoids is also strongly dependent on the understanding of the fundamental principles of nephrogenesis and the vascularization of organs and tissues. Developmental vascularization of the kidney has been an area of intense research for decades. However, there is still no consensus among researchers on how exactly the vascularization of the kidney occurs in normal and pathological conditions. This lack of consensus is partly due to the lack of an appropriate model system to study renal vascularization during nephrogenesis. In this review, we will describe recent progress in the areas of kidney vasculature development, kidney organoids in general and assembled on microfluidic devices in particular. We will focus on the in vitro vasculature of kidney organoids in microfluidic OoC model systems to study kidney diseases and on the perspectives of tissue engineering for the modeling of kidney diseases and the design of bioartificial medical devices. We also aim to summarize the information related to the key mechanisms of intercellular communication during nephrogenesis and the formation of the renal vasculature in an OoC setup.

AbstractObjective This article aims to summarize performance indicators used in telephone triage services research, and make recommendations for the selection of valid indicators to measure the performance of telephone triage. We describe what kind of frameworks, performance indicators, or variables have been used for evaluating telephone triage performance by systematically mapping the telephone triage performance measurement. The objective was to find measures for each Triple Aim dimension.Design A scoping review method was used following Joanna Briggs Institute guidelines. Using this method, we defined indicators to measure the performance of telephone triage. We used the Triple Aim framework to identify indicators to measure the overall performance of telephone triage. The Triple Aim framework consists of improving the patient experience of care, improving the health of populations, and reducing cost per capita.Setting The scoping review was performed using CINAHL, Medline, EBSCOhost, and PubMed electronic databases. The eligibility criterion was research published in English between 2015 and 2023. The inclusion focused on the use and performance of telephone triage services and system-focused studies.Results A total of 1098 papers were screened for inclusion, with 57 papers included in our review. We identified 13 performance indicators covering all Triple Aim dimensions: waiting times, access, patient satisfaction, the accuracy of triage decision, severity and urgency of the symptoms, triage response, patient compliance with the advice given, follow-up healthcare service use, and running costs of service. We didn’t find any earlier framework covering all Triple Aim dimensions properly.Conclusions Measuring the performance of telephone triage requires an extensive and comprehensive approach. We presented performance indicators that may be included in the framework for measuring the performance of telephone triage to support overall performance measurements of telephone triage.

Abstract Isolation of extracellular vesicles (EV) has been developing rapidly in parallel with the interest in EVs. However, commonly utilized protocols may not suit more challenging sample matrixes and could potentially yield suboptimal results. Knowing and assessing the pitfalls of isolation procedure to be used, should be involved to some extent for EV analytics. EVs in cow milk are of great interest due to their abundancy and large‐scale availability as well as their cross‐species bioavailability and possible use as drug carriers. However, the characteristics of milk EVs overlap with those of other milk components. This makes it difficult to isolate and study EVs individually. There exists also a lack of consensus for isolation methods. In this study, we demonstrated the differences between various differential centrifugation‐based approaches for isolation of large quantities of EVs from cow milk. Samples were further purified with gradient centrifugation and size exclusion chromatography (SEC) and differences were analyzed. Quality measurements were conducted on multiple independent platforms. Particle analysis, electron microscopy and RNA analysis were used, to comprehensively characterize the isolated samples and to identify the limitations and possible sources of contamination in the EV isolation protocols. Vesicle concentration to protein ratio and RNA to protein ratios were observed to increase as samples were purified, suggesting co‐isolation with major milk proteins in direct differential centrifugation protocols. We demonstrated a novel size assessment of vesicles using a particle mobility analyzer that matched the sizing using electron microscopy in contrast to commonly utilized nanoparticle tracking analysis. Based on the standards of the International Society for Extracellular Vesicles and the quick checklist of EV‐Track.org for EV isolation, we emphasize the need for complete characterization and validation of the isolation protocol with all EV‐related work to ensure the accuracy of results and allow further analytics and experiments.

Abstract Background Hypoxia inducible factors, HIF‐1α and HIF‐2α, and their main regulators, the prolyl hydroxylase domain proteins (PHDs), mediate cellular response to hypoxia and contribute to tumor progression in clear cell renal cell carcinoma (ccRCC). These biomarkers may improve the value of traditional histopathological features in predicting disease progression after nephrectomy for localized ccRCC and guide patient selection for adjuvant treatments. Patients and Methods In this study, we analyzed the associations of PHD2 and PHD3 with histopathological tumor features and recurrence‐free survival (RFS) in a retrospective cohort of 173 patients who had undergone surgery for localized ccRCC at Helsinki University Hospital (HUH), Finland. An external validation cohort of 191 patients was obtained from Turku University Hospital (TUH), Finland. Tissue‐microarrays (TMA) were constructed using the primary tumor samples. Clinical parameters and follow‐up information from 2006 to 2019 were obtained from electronic medical records. The cytoplasmic and nuclear expression of PHD2, and PHD3 were scored based on immunohistochemical staining and their associations with histopathological features and RFS were evaluated. Results Nuclear PHD2 and PHD3 expression in cancer cells were associated with lower pT‐stage and Fuhrman grade compared with negative nuclei. Patients with positive nuclear expression of PHD2 and PHD3 in cancer cells had favorable RFS compared with patients having negative tumors. The nuclear expression of PHD2 was independently associated with a decreased risk of disease recurrence or death from RCC in multivariable analysis. These results were observed in both cohorts. Conclusions The absence of nuclear PHD2 and PHD3 expression in ccRCC was associated with poor RFS and the nuclear expression of PHD2 predicted RFS regardless of other known histopathological prognostic factors. Nuclear PHD2 and PHD3 are potential prognostic biomarkers in patients with localized ccRCC and should be further investigated and validated in prospective studies.

We examined the views of Finnish non-farmers and farmers on the desirable future developments of agriculture and agricultural policy using principal component and cluster analysis by focusing on three key themes: the structure of agricultural production, agri-environmental issues, and the funding of agriculture. There is strong public support for maintaining the viability of domestic agriculture through government intervention, but views differ on allocation of agricultural support and how agricultural production should be developed. A significant number of respondents supported the idea that climate and other environmental issues should be better considered in agricultural policy. However, about half of the respondents accepted environmental damage caused by agriculture and one-fifth perceived the importance of agriculture in a society as declining. These views, not prominent in the public debate, emphasize the importance of regular investigation of citizen opinions for including all the relevant stands in policy discussion to design legitimate policy measures.

We report direct observations of a fast magnetosonic forward–reverse shock pair observed by Solar Orbiter on 2022 March 8 at the short heliocentric distance of 0.5 au. The structure, sharing some features with fully-formed stream interaction regions, is due to the interaction between two successive coronal mass ejections (CMEs), never previously observed to give rise to a forward–reverse shock pair. The scenario is supported by remote observations from extreme ultraviolet cameras and coronagraphs, where two candidate eruptions compatible with the in situ signatures have been found. In the interaction region, we find enhanced energetic particle activity, strong nonradial flow deflections, and evidence of magnetic reconnection. At 1 au, well radially aligned Wind observations reveal a complex event, with characteristic observational signatures of both stream interaction region and CME–CME interaction, thus demonstrating the importance of investigating the complex dynamics governing solar eruptive phenomena.

Collisionless shock waves, ubiquitous in the Universe, are crucial for particle acceleration in various astrophysical systems. Currently, the heliosphere is the only natural environment available for their in situ study. In this work, we showcase the collective acceleration of electrons and ions by one of the fastest in situ shocks ever recorded, observed by the pioneering Parker Solar Probe at only 34.5 million km from the Sun. Our analysis of this unprecedented, near-parallel shock shows electron acceleration up to 6 MeV amidst intense multiscale electromagnetic wave emissions. We also present evidence of a variable shock structure capable of injecting and accelerating ions from the solar wind to high energies through a self-consistent process. The exceptional capability of the probe’s instruments to measure electromagnetic fields in a shock traveling at 1% the speed of light has enabled us, for the first time, to confirm that the structure of a strong heliospheric shock aligns with theoretical models of strong shocks observed in astrophysical environments. This alignment offers viable avenues for understanding astrophysical shock processes and the self-consistent acceleration of charged particles.

Solar energetic particles (SEPs) are considered a serious radiation threat to space technologies and humans in space. SEPs are accelerated to high energies by solar explosive phenomena such as solar flares and in particular by shocks driven by coronal mass ejections (CMEs). We aim to better understand the effects of magnetic field gradient-induced adiabatic focusing on the coronal acceleration of SEPs and to test whether free-escape boundaries produce the same effects as focusing. We present results from a one-dimensional oblique shock model with a mean free path similar to Bell’s (1978) theory using Monte Carlo simulations. We show that the momentum spectrum at a shock and far upstream will attain a steady state in a model with adiabatic focusing, whereas it does not in a non-focusing model. However, the effects of focusing can be mimicked in a non-focused simulation by introducing a free-escape boundary ahead of the shock close to the position where the particles will escape from the shock by focusing in a focused transport simulation. This provides a promising avenue for constructing computationally efficient codes that can model the particle emission from shocks.

There were about a 4.1million homeless people in the European Union [1]. In the European Union, 20-30 per cent of homeless people are young people between the ages of 18-29 years [2]. Homelessness is a concern for policymakers and society as a whole. Recent literature on social workers’ experiences with homeless people has mainly focused on working with the general homeless population and not specifically on social work with homeless youth. A qualitative research method was used to analyze the cause and consequences of youth homelessness, and identify skills needed for social work with young homeless people and inspiration of social workers motivation to help young homeless people. Five social workers working with young homeless people from a city in Finland participated in research. The semi-structured interview data were analysed using the content analysis method. The study revealed – causes and consequences of youth homelessness; skills needed for social work with young homeless people and social workers driving force working with homeless youths.

The Parker Solar Probe (PSP) and Solar Orbiter (SolO) missions opened a new observational window in the inner heliosphere, which is finally accessible to direct measurements. On 2022 September 5, a coronal mass ejection (CME)-driven interplanetary (IP) shock was observed as close as 0.07 au by PSP. The CME then reached SolO, which was radially well-aligned at 0.7 au, thus providing us with the opportunity to study the shock properties at different heliocentric distances. We characterize the shock, investigate its typical parameters, and compare its small-scale features at both locations. Using the PSP observations, we investigate how magnetic switchbacks and ion cyclotron waves are processed upon shock crossing. We find that switchbacks preserve their V–B correlation while compressed upon the shock passage, and that the signature of ion cyclotron waves disappears downstream of the shock. By contrast, the SolO observations reveal a very structured shock transition, with a population of shock-accelerated protons of up to about 2 MeV, showing irregularities in the shock downstream, which we correlate with solar wind structures propagating across the shock. At SolO, we also report the presence of low-energy (∼100 eV) electrons scattering due to upstream shocklets. This study elucidates how the local features of IP shocks and their environments can be very different as they propagate through the heliosphere.

Undesirable behaviors of dogs and cats may reduce their quality of life and may cause harm to their owners. Such behaviors have been treated with medications as well as behavioral training and environmental modifications. Finnish veterinarians answered a web-based questionnaire to characterize the treatment of undesirable behaviors in dogs and cats by medications. Fourteen indications related to undesirable behaviors were defined in the questionnaire. Most psychoactive medications authorized for veterinary or human use in Finland and allowed to be prescribed for animal use according to the national legislation were listed. In addition, some sedative and analgesic agents were included. Canine and feline undesirable behaviors were treated by the respondents with a wide variety of medications. In many cases, none of the remedies used could be demonstrated to be a clear favorite for a certain indication. Off-label use of psychoactive medications was common. Many medications were used without research-based evidence of their efficacy for the indication in those species in question. Treatment of dogs was more often associated with advice for behavioral training in addition to medications than treatment of cats. Both the common off-label use of medications and the wide variety of substances used for the particular behavioral problem reveal the need for further clinical evidence of the efficacy of medications to treat various canine and feline undesirable behaviors. • Undesirable behaviors of dogs and cats were treated with a wide variety of medicines. • Off-label use of psychoactive medicinal substances was common. • Some drugs were used with no evidence of their efficacy for the indication. • Dog owners were advised for behavioural training more often than cat owners. [ABSTRACT FROM AUTHOR]

In Nordic countries, Heterobasidion root rot is known as a widespread and severe disease affecting conifer trees on mineral soils, while our understanding of its occurrence in peatland forests is more limited. This study investigated the prevalence of Heterobasidion parviporum and H. annosum , along with common coexisting fungi in disease centers, in six Norway spruce-dominated and two Scots pine-dominated drained peatland forests in southern Finland. Among the 590 trees examined, Heterobasidion species were the most common fungi responsible for root rot in both spruce and pine stands. In mature spruce stands, Heterobasidion sp. had infected an average of 5.4 trees per hectare, and in pine stands, 4.5 trees per hectare. However, our results showed that compared to mineral soils in the same region, Heterobasidion sp. was neither as frequent nor as dominant in Norway spruce stands on peat soil. Furthermore, the absence of large multi-tree Heterobasidion genets in peatland forests indicated restricted progression of Heterobasidion infections. Instead of Heterobasidion sp., Armillaria sp. was the predominant decay fungus in three spruce stands and one pine stand, while Resinicium bicolor was dominant in one spruce stand. Interestingly, Armillaria cepistipes , less pathogenic than A. borealis and rarely causing decay on spruce on mineral soil, was the most common Armillaria species at peatland sites. Further in-vitro -tests revealed that certain fungal isolates from the disease centers were highly competitive against H. parviporum. These isolates included both basidiomycetes, such as Stereum sanquinolentum and Amylostereum aerolatum , as well as the ascomycetes, Acocoryne sp., Leptodontidium elatius , and Rutstroemia calopus. Our findings led us to speculate that the competitive ability of Heterobasidion sp. against coexisting fungi might be lower in peatland conditions compared to mineral soils. Moreover, the potential risks and benefits of continuous cover forestry (CCF) regarding Heterobasidion root rot are discussed. Considering the relatively low prevalence of the pathogen in peatland forests and the more beneficial environmental effects of CCF compared to clear-cut-based rotation forestry, CCF appears to be a viable management option in spruce-dominated stands on drained peat soil. However, to ensure the health of peatland forests in the future, controlling Heterobasidion root rot is as crucial on peatland as it is on mineral sites. • Heterobasidion sp. are less prevalent on peat soils than on mineral soils. • Coexisting fungi in disease centers compete effectively with Heterobasidion sp. • Armillaria cepistipes is a significant pathogen in boreal peatland forests. • The health of continuous cover forests is less threatened on peat than on mineral soil. [ABSTRACT FROM AUTHOR]

A shift from fossil fuels to biofuels is becoming an increasingly important part of national and corporate climate strategies, but the biodiversity impacts of biofuels are often ignored and remain poorly understood. Here we developed a novel eight-step general framework for the assessment of consumption-based biodiversity impacts of biofuels and applied the framework to assess the biodiversity impacts of peat and wood-fired district heating in Finland. We utilize the habitat hectare approach for which information about the ecosystem condition before and after the impact is needed. The habitat hectare approach has not yet been used on assessments of consumption-based biodiversity impacts. Of the different fuel types used in peat and wood-fired district heating in Finland, peat had the highest biodiversity impact per unit area, followed by chips from roundwood and logging residue chips. By-products from sawmill industry are argued to have no additional biodiversity impacts. Interestingly, however, when we consider the biodiversity impacts per unit energy, chips from roundwood had the highest and peat the lowest biodiversity impact. Our results suggest there is a truly substantial trade-off between the climate and biodiversity impacts of wood and peat firing. We conclude that the habitat hectare approach combined with the presented general assessment framework is a promising approach to be used in the assessment of consumption-based biodiversity impacts in different land use contexts, such as biodiversity offsetting, around the globe. This protocol should be further developed and refined in different systems and with different bio-based materials and land use contexts. • The biodiversity impacts of biofuel use are poorly known. • A framework for biodiversity impact assessment of district heating was developed. • Habitat hectares can be used for measuring biodiversity impacts of consumption. • Land use biodiversity impact of wood firing is 4–28 times greater than that of peat. • A trade-off exists between climate and biodiversity impacts of wood and peat firing. [ABSTRACT FROM AUTHOR]

1. Self-repair is an invisible, but important part of the circular economy. 2. Consumers' self-evaluated repair skills and willingness to develop them are higher for low complexity goods. 3. Frugality, past experience, egoistic and biospheric environmental concerns explain the willingness to develop skills. 4. A balanced approach to supporting repair in CE is needed, facilitating both self-repair and repair services. 5. Expanding education on repair in schools and through repair cafe initiatives is key for enabling circular consumption. Supporting repair is among the key strategies for achieving circular economy by 2050. Although consumers are generally positive towards repair, they often lack self-repair skills. This calls for a better understanding of consumers' current self-repair activities, repair skills, and willingness to develop them further. Our nationally representative survey (N = 1,000) from Finland showed that consumers felt most confident about repairing textiles and bicycles. Although they did not consider themselves to be skilled in repair, they showed a willingness to develop their skills further. The willingness to develop repair skills was positively associated with the level of education, self-evaluated repair skills, previous repair experience, frugality, and minimalism, as well as egoistic and biospheric environmental concerns, and negatively with older age. These findings underscore the importance of developing product design, policy measures and educational initiatives that reinforce (rather than undermine) the good will of citizens to update their repair skills. [ABSTRACT FROM AUTHOR]

The European spruce bark beetle, Ips typographus is the economically most important biotic damaging agent of Norway spruce. Efforts to delimit beetle populations by trapping, application of chemical insecticides, or mechanically excluding the beetles from their breeding substrates are often expensive and mostly inadequate. The use of natural enemies and viruses is receiving increased research interest as a potential environmentally healthy approach to control pest insect populations, but practical biocontrol methods against I. typographus are still lacking. To learn more about putative enemies of this pest species, we used high-throughput sequencing to determine its viral community using beetles collected at a Finnish forest site. The analysis revealed a diverse community of RNA viruses associated with I. typographus , including novel viruses that could be affiliated with the classified families Benyviridae, Metaviridae, Narnaviridae, Partitiviridae, Phenuiviridae, Solemoviridae, Virgaviridae, Tombusviridae , and proposed family Spiciviridae, as well as unclassified "quenyaviruses". Based on phylogenetic analysis, the viruses were distinct from, but resembled, unclassified viruses originating from other arthropods, and many of them were distantly related to previously described viruses. The possibility that the viruses could be hosted by other organisms than the beetle itself (associated fungi, nematodes and protozoa) was addressed by bioinformatic and phylogenetic analyses and is discussed. • Virome of the European spruce bark beetle was surveyed by high-throughput sequencing of total RNA. • A diverse community of previously unknown RNA viruses was discovered. • Most viruses resembled unclassified viruses originating from other arthropods. • The results enhance understanding of the putative enemies and associates of this pest species. [ABSTRACT FROM AUTHOR]

The tall cell subtype (TC-PTC) is an aggressive subtype of papillary thyroid carcinoma (PTC). The TC-PTC is defined as a PTC comprising at least 30% epithelial cells that are three times as tall as they are wide. In practice, this definition is difficult to adhere to, resulting in high inter-observer variability. In this multicenter study, we validated a previously trained deep learning (DL)-based algorithm for detection of tall cells on 160 externally collected hematoxylin and eosin (HE)-stained PTC whole-slide images. In a test set of 360 manual annotations of regions of interest from 18 separate tissue sections in the external dataset, the DL-based algorithm detected TCs with a sensitivity of 90.6% and a specificity of 88.5%. The DL algorithm detected non-TC areas with a sensitivity of 81.6% and a specificity of 92.9%. In the validation datasets, 20% and 30% TC thresholds correlated with a significantly shorter relapse-free survival. In conclusion, the DL algorithm detected TCs in unseen, external scanned HE tissue slides with high sensitivity and specificity without any retraining., Competing Interests: Johan Lundin is a co-founder and board member, and Mikael Lundin is a co-founder and director of concept design at Aiforia Technologies Oy, Helsinki Finland., (© 2024 The Authors.)

Background: Hypoxia inducible factors, HIF-1α and HIF-2α, and their main regulators, the prolyl hydroxylase domain proteins (PHDs), mediate cellular response to hypoxia and contribute to tumor progression in clear cell renal cell carcinoma (ccRCC). These biomarkers may improve the value of traditional histopathological features in predicting disease progression after nephrectomy for localized ccRCC and guide patient selection for adjuvant treatments., Patients and Methods: In this study, we analyzed the associations of PHD2 and PHD3 with histopathological tumor features and recurrence-free survival (RFS) in a retrospective cohort of 173 patients who had undergone surgery for localized ccRCC at Helsinki University Hospital (HUH), Finland. An external validation cohort of 191 patients was obtained from Turku University Hospital (TUH), Finland. Tissue-microarrays (TMA) were constructed using the primary tumor samples. Clinical parameters and follow-up information from 2006 to 2019 were obtained from electronic medical records. The cytoplasmic and nuclear expression of PHD2, and PHD3 were scored based on immunohistochemical staining and their associations with histopathological features and RFS were evaluated., Results: Nuclear PHD2 and PHD3 expression in cancer cells were associated with lower pT-stage and Fuhrman grade compared with negative nuclei. Patients with positive nuclear expression of PHD2 and PHD3 in cancer cells had favorable RFS compared with patients having negative tumors. The nuclear expression of PHD2 was independently associated with a decreased risk of disease recurrence or death from RCC in multivariable analysis. These results were observed in both cohorts., Conclusions: The absence of nuclear PHD2 and PHD3 expression in ccRCC was associated with poor RFS and the nuclear expression of PHD2 predicted RFS regardless of other known histopathological prognostic factors. Nuclear PHD2 and PHD3 are potential prognostic biomarkers in patients with localized ccRCC and should be further investigated and validated in prospective studies., (© 2024 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)