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Deleterious variants in the transcription factor early B-cell factor 3 (EBF3) are known to cause a neurodevelopmental disorder (EBF3-NDD). We report eleven individuals with EBF3 variants, including an individual with a duplication/triplication mosaicism of a region encompassing EBF3 and a phenotype consistent with EBF3-NDD, which may reflect the importance of EBF3 gene-dosage for neurodevelopment. The phenotype of individuals in this cohort was quite mild compared to the core phenotype of previously described individuals. Although ataxia tended to wane with age, we show that cognitive difficulties may increase, and we recommend that individuals with EBF3-NDD have systematic neuropsychological follow-up. • Individuals with EBF3 variants may have mild phenotypes without intellectual disability. • Copy number gain of EBF3 is associated with a neurodevelopmental phenotype. • Cognitive difficulties in individuals with EBF3 variants may increase with age. • EBF3 variants may be associated with cortical malformations. [ABSTRACT FROM AUTHOR]

• All studied rheumatic diseases impose an elevated risk for cardiovascular (CV) comorbidities with highest risks observed in patients with SLE and gout. • Risk of CV diseases is highest within one year before and/or after the diagnosis of a rheumatic disease. • Among CV comorbidities, the risk for venous thromboembolism was most evident in several rheumatic diseases. To elucidate the risk and temporal relationship of cardiovascular (CV) comorbidities in rheumatic diseases. Patients in the FinnGen study diagnosed between 2000 and 2014 with seropositive (n = 2368) or seronegative (n = 916) rheumatoid arthritis (RA), ankylosing spondylitis (AS, n = 715), psoriatic arthritis (PsA, n = 923), systemic lupus erythematosus (SLE, n = 190), primary Sjogren's syndrome (pSS, n = 412) or gout (n = 2034) were identified from healthcare registries. Each patient was matched based on age, sex, and birth region with twenty controls without any rheumatic conditions. Overall risk ratios (RR) were calculated by comparing the prevalence of seven CV diseases between patients and controls. Logistic regression models were used for estimating odds ratios (OR) for CV comorbidities before and after the onset of rheumatic diseases. The RR for 'any CVD' varied from 1.14 (95 % confidence interval [CI] 1.02–1.26) in PsA to 2.05 (95 % CI 1.67–2.52) in SLE. Patients with SLE or gout demonstrated over two-fold risks for several CV comorbidities. Among CV comorbidities, venous thromboembolism (VTE) showed the highest effect sizes in several rheumatic diseases. The ORs for CV comorbidities were highest within one year before and/or after the onset of the rheumatic disease. However, in gout the excess risk of CV disease was especially high before gout diagnosis. The risk of CV comorbidities was elevated in all studied rheumatic diseases, with highest risks observed in SLE and gout. The risk for CV diseases was highest immediately before and/or after rheumatic disease diagnosis, highlighting the increased risk for CV comorbidities across all rheumatic diseases very early on the disease course. [Display omitted] [ABSTRACT FROM AUTHOR]

Scedosporium species are fungal opportunistic pathogens frequently seen in chronic lung diseases such as in cystic fibrosis (CF). They can cause a wide spectrum of diseases mainly in immunodeficient patients. Invasive, disseminated infections with poor prognosis have been described after lung transplantation. We present a CF-patient with disseminated Scedosporium apiospermum infection after lung transplantation. The patient had skin, surgical wound, spinal cord, and brain involvements. She recovered fully after prolonged course of voriconazole treatment. [ABSTRACT FROM AUTHOR]

• Place-based prioritization model based on frequency of use and the perceived quality places was developed. • Development priority -category places found most often in transportation settings and in continuous urban fabric. • High share of the Development priority places was associated with lower quality of life of individuals. • The development priority areas overlapped with the existing planning areas of the city of Espoo. Prioritization of knowledge produced in participatory planning has been approached mainly from the perspective of whose perspectives are most in need of consideration. We ask, whether it is also possible to consider which locations , based on the knowledge from participants, should be prioritized. We developed a place-based approach to inform spatial decision making especially when the prioritization of limited resources is necessary. In the place-based prioritization model frequency of use and perceived quality of everyday places were used to identify various priority categories. We argued that especially places that are perceived negatively but used often in daily life pose a risk to wellbeing and the quality of life and should thus be prioritized in development. Such places belonged to the Development priority category, but also three other categories, Development potential, Management potential and Management priority were identified. The prioritization model was tested empirically by using place-based knowledge about inhabitants everyday and quality networks collected in the Finnish city of Espoo. According to the results, the Development priority category was represented only in about 5% of places, most often in land associated with road and rail networks as well as in continuous urban fabric. As hypothesized, high share of the Development priority places in everyday networks reduced individual's quality of life. We also found that a rather high share of these places was located within existing planning areas of the city. [ABSTRACT FROM AUTHOR]

Recently, increased attention has been drawn to the greenhouse gas emissions of the Land use, Land use Change and Forestry (LULUCF) sector. In the Finnish LULUCF sector, the soil-originated emissions from the after-use of cutover peatland have become a more relevant question. This is due to the rapid increase in the number of former peat-harvesting sites, caused by the decline in the combustion of energy peat due to its high CO 2 emissions. We conducted a nationally representative survey to study which after-use options of cutover peatlands are preferred by landowners. Based on the preferred after-use options, we estimated their impact on the national greenhouse gas emissions in the Finnish regions in 2035, and what factors influence the landowners' choice of after-use options. We found that the four most popular after-use options for landowners were afforestation (71%), agriculture (24%), production of wind and solar power (22%) and rewetting (18%) when the respondent chose the three most attractive options. However, there were clear regional differences in the preferred after-use options, which might lead, if realized, to different soil-originated emissions at the regional level. The preferred after-use options could produce emissions of 0.35 million tonnes of carbon dioxide equivalent a year (Mt CO 2 eq y−1) by 2035 in Finland. Most of these emissions (30.1%) would come from South Ostrobothnia in western Finland, mainly due to the indicated high interest in agricultural after-use. Most landowners prefer financially profitable after-use options, such as forestry, agriculture, as well as wind and solar energy production in cutover peatlands. However, environmentally oriented landowners favour many kinds of actions to support biodiversity, carbon sequestration, and water protection in cutover peatlands. It is crucial that economic productivity and the greenhouse gas sinks of cutover peatlands be considered simultaneously to meet the climate targets of the LULUCF sector in Finland. • The landowners' perspective of using cutover peatland was studied. • The landowners prefer financially profitable after-use options. • Forestry, agriculture, and wind and solar energy were the most popular options. • Landowners' choices would increase the soil originated GHG emissions nationally. • Strengthening the dialogue between the landowners and climate policy is needed. [ABSTRACT FROM AUTHOR]

To determine whether dissociative experiences moderate online problem gambling treatment effectiveness, and to characterize the temporal persistence of the relationship between dissociation and problem gambling. Repeatedly measured self-report data on a guided online cognitive behavioral therapy for problem gambling collected on four occasions: before treatment, after treatment, and at 6- and 12-month follow-ups. The data (N = 1243, 59.2% males) were collected in Finland between 2019 and 2021. The primary outcome variable was the self-reported level of problem gambling. The predictors were the treatment phase and dissociative experiences, their interaction, and the demographic covariates of age, education, income, and gender. Problem gambling scores and dissociative experiences declined significantly following treatment and remained low through the follow-ups (retention rates: 52.6% [post-treatment], 26.3% [at the 6-month follow-up], and 16.1% [at the 12-month follow-up]). However, the treatment was significantly less effective in reducing problem gambling for individuals who kept experiencing dissociation after the treatment. Dissociation is an integral sign of problem gambling severity and sustained dissociative experiences may significantly reduce the long-term effectiveness of online problem gambling treatments. Treatment efforts should be customized to account for individual differences in dissociative tendencies, and future research should broaden the study of dissociative experiences to other behavioral addictions. • The Finnish "Peli poikki" online treatment for problem gambling is very effective. • Persistent dissociative experiences reduced long-term treatment effectiveness. • Dissociation is sometimes a persistent sign of problem gambling severity. [ABSTRACT FROM AUTHOR]

Hypolimnetic oxygenation by pumping oxygen-rich surface water to the hypolimnion (HLO) is a commonly used tool for the restoration of nutrient-loaded dimictic lakes. However, in recent years its effectiveness has been questioned. In this case study we evaluated monitoring data covering a period of 23-years to show that, although experimental cessation of HLO drastically changed the lake's temperature and dissolved oxygen regimes, it did not significantly affect its trophic status. Thus, we recommend that the limited financial resources available are better directed towards further lowering the lake's external phosphorus load than continuing HLO. [ABSTRACT FROM AUTHOR]

• The overall childbirth experience in planned vaginal twin birth was positive. • Twin mothers felt less often able to choose their birthing position. • Intrapartum CS was a risk factor of a negative birth experience. Twin birth is a special setting for women giving birth, and the experience of childbirth can be different from singleton birth. The objective of this study was to evaluate and compare the childbirth experiences of twin mothers and singleton mothers. We also aimed to identify the risk factors of a negative childbirth experience in the whole study population. All live diamniotic twin deliveries in the study hospital of at least 35+0 weeks of gestation with a plan of vaginal birth were included in this matched groups study from August 2015 to August 2019. For every twin birth, two singleton birth controls were selected and matched with parity, the actual mode of birth, and gestational weeks at birth. Six weeks after birth, a Childbirth Experience Questionnaire (CEQ) was sent to mothers, and 72 twin mothers and 126 singleton mothers returned the questionnaire. The twin mothers' overall childbirth experience was positive. They reported a significantly lower opportunity to choose the birthing position (p < 0.001). Otherwise, there were no differences in the CEQ mean total scores between the study groups. Intrapartum cesarean section raised the risk of a negative childbirth experience and there was a high level of satisfaction with midwifery care among the whole study population. The overall maternal experience in planned vaginal twin birth was positive. Twin mothers felt less often able to choose their birthing position, otherwise the childbirth experience did not differ from that of singleton mothers. [ABSTRACT FROM AUTHOR]

Abstract: An emergency situation brings together individuals belonging to many different organizations, representing different organizational cultures including different usage of language. In this paper we propose that a common understanding is vital in managing emergency situations. Firstly, a simple emergency situation is presented where one of the causes for increased damage was simply due to a misunderstanding of language. Secondly, we propose a theoretical framework of how different organization cultures with their different uses of language can be integrated on the terminological level where the communication takes place. Thirdly, the presented example is reviewed. We show how situations such as the one in our example can be analyzed by means of the theoretical framework. Finally, we present the findings from a Delphi study conducted in Finland, which support the central thesis, i.e. the importance of a common understanding in emergency situations, and we propose using the Delphi method to find the critical domains in the flow of information between the different actors involved in disaster management. [Copyright &y& Elsevier]

OBJECTIVE: to describe the experiences of maternity-care professionals using an Internet-based network service, called Net Clinic, and the opportunities and obstacles they encountered in Net Clinic while organising their work and developing their know-how. DESIGN: qualitative information gathered from semi-structured thematic interviews. SETTING: four maternity care units in Eastern Finland (one antenatal ward in a university hospital, one antenatal ward in a central hospital, two maternity clinics in the community). PARTICIPANTS: five midwives, two public health nurses and three doctors. FINDINGS: all participants considered adequate privacy protection a prerequisite for development. They anticipated that because of their computer skills, young people would be able to use information and communication technology (ICT) as part of maternity-care services naturally. Managerial support, such as allocation of time and equipment, was extremely important during the introductory phase. The participants were divided into three groups based on their experiences of implementing Net Clinic: (1) 'doubters' did not believe in their own ICT competence and were afraid of using Net Clinic. They also showed resistance to Net Clinic. Doubters wanted versatile and personal guidance in ICT skills; (2) 'accepters' agreed that progress in ICT would inevitably affect their work. Development was considered difficult without awareness of the benefits of ICT, and Net Clinic was expected to increase their workload. Accepters preferred to have one-to-one ICT training; (3) 'future confidents' saw ICT as a useful tool for developing maternity care. They recognised the opportunities implicit in network collaboration and wanted versatile user training in ICT. They wanted successful network service models and were eager to develop them. IMPLICATIONS FOR THE FUTURE: families will increase their knowledge levels, as those who will be future parents are learning to use public network services at school. The increasing diversity of family structure will be a challenge to maternity care. Changes in maternity services can be accomplished with new e-Working models developed through diversified co-operation and with managerial support. The crucial question will be the attitude of maternity-care professionals towards Internet-based network service in their work. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To analyse the risk of coronary heart disease (CHD) events and total mortality among patients who had coronary artery bypass graft (CABG) surgery during 1988–1992. Methods: A population-based myocardial infarction (MI) register included data on invasive cardiac procedures among residents of the study area. The subjects aged 35–64 years were followed-up for 12 years for non-fatal and fatal CHD events and all-cause mortality, excluding events within 30 days of the CABG operation. CABG was performed on 1158 men and 215 women. Results: The overall survival of men who underwent CABG was similar to the survival of the corresponding background population for about ten years but started to worsen after that. At twelve years of follow-up, 23% (n =266, 95% CI 234–298) of the men who had undergone the operation had died, while the expected proportion, based on mortality in the background population, was 20% (n =231, 95% CI 226–237). The CHD mortality of men who had undergone the operation was clearly higher than in the background population. Among women, the mortality after CABG was about twice the expected mortality in the corresponding background population. In Cox proportional hazards models age, smoking, history of MI, body mass index and diabetes were significant predictors of mortality. Conclusions: The prognosis of male CABG patients did not differ from the prognosis of the corresponding background population for about ten years, but started to deteriorate after that. History of MI prior to CABG and major cardiovascular risk factors was a predictor of an adverse outcome. [Copyright &y& Elsevier]