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Objectives: We studied the short- and long-term effects of imatinib in hospitalized COVID-19 patients., Methods: Participants were randomized to receive standard of care (SoC) or SoC with imatinib. Imatinib dosage was 400 mg daily until discharge (max 14 days). Primary outcomes were mortality at 30 days and 1 year. Secondary outcomes included recovery, quality of life and long COVID symptoms at 1 year. We also performed a systematic review and meta-analysis of randomized trials studying imatinib for 30-day mortality in hospitalized COVID-19 patients., Results: We randomized 156 patients (73 in SoC and 83 in imatinib). Among patients on imatinib, 7.2% had died at 30 days and 13.3% at 1 year, and in SoC, 4.1% and 8.2% (adjusted HR 1.35, 95% CI 0.47-3.90). At 1 year, self-reported recovery occurred in 79.0% in imatinib and in 88.5% in SoC (RR 0.91, 0.78-1.06). We found no convincing difference in quality of life or symptoms. Fatigue (24%) and sleep issues (20%) frequently bothered patients at one year. In the meta-analysis, imatinib was associated with a mortality risk ratio of 0.73 (0.32-1.63; low certainty evidence)., Conclusions: The evidence raises doubts regarding benefit of imatinib in reducing mortality, improving recovery and preventing long COVID symptoms in hospitalized COVID-19 patients., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Hanna-Riikka Kreivi is a consultant for Pfizer and Roche and received lecture honoraria from Pfizer. Tiina Mattila is an advisory board member for GSK and received lecture honoraria from AstraZeneca, Boehringer-Ingelheim, Chiesi, GSK, and Orion. All other authors declare no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

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., (© 2022. The Author(s).)

The study examines the history of strategic decision-making concerning water protection in Helsinki, 1850-2000. We identified five major strategic decisions that occurred during the study period. The results indicate that strategic decision-making evolves in long-term policy cycles that last on average 20-30 years. New policy cycles are caused by paradigm shifts. Paradigms are shared and predominant ways of understanding reality that help when groups must act to solve common and complex environmental problems. However the internal structure and external dynamics of paradigms are contradictory. Although paradigms serve initially as means to redefine problems and find creative solutions, as time goes by each paradigm seems to become also a barrier that restricts the introduction of new ways of thinking and acting. The power of paradigms lies in the fact that they can be defined as scientific but also social, political, or cultural agreements depending on the context.

The postwar development of water protection legislation and wastewater discharges is poorly known for the Baltic Sea region as a whole. This article presents national efforts to govern wastewater discharges in Poland using legal tools over the twentieth century with an emphasis on the postwar period, 1945-2003. The study also attempts to evaluate how the state authority responded to changing legal demands in terms of urban and industrial wastewater discharges in the postwar period. It outlines the main changes during the socialist regime in Poland and after it regained independence. Also the implications of Poland's integration into the European Union are briefly discussed. Mathematical calculations are used to illustrate some changes in legal requirements over time.

The Convention on the Protection of the Marine Environment of the Baltic Sea Area signed in 1974 in Helsinki is probably the most important environmental agreement consummated in the Baltic Sea region. This article is the first study that explores the history of this agreement, also known as the Helsinki Convention, by using primary archival sources. The principal sources are the archives of the Ministry for Foreign Affairs of Finland. We examine the role of Finland in the process that led to the signing of the Helsinki Convention from the perspective of international politics. The study focuses primarily on Finnish, Swedish, and Soviet state-level parties from the end of the 1960s to 1974. We show that Cold War politics affected in several ways negotiations and contents of the Helsinki Convention. We also argue that the Soviet Union used the emerging international environmental issues as a new tool of power politics.

The aim of this study is to present a historical continuum of nearly 100 years of environmental investigations and changes in trophic levels in the sea area of Helsinki. The survey is based on a re-examination of original planktological and meteorological data; the principle being that eutrophication can be detected in plankton assemblages despite changes in methodology. The bays around Helsinki were found to be moderately eutrophic to hypereutrophic at the beginning of the 20th century. There were considerable differences in the development of the bays both in terms of degradation and recovery. The efficiency of wastewater treatment and especially the introduction of sea outfall have played an important role in decreasing eutrophication in the bay area of Helsinki.