Increasing trend of antimicrobial resistance among methicillin-resistant Staphylococcus aureus strains in Southwest Finland, 2007-2016: An analysis of shifting strain dynamics and emerging risk factors.

Objective: Substantial rise in the annual incidence of methicillin-resistant Staphylococcus aureus (MRSA) was reported in Southwest Finland (12.4-24.9/100,000 people) between 2007 and 2016.

From thaw till fall: Interacting hydrology, carbon cycle, and greenhouse gas dynamics in a subarctic stream-lake continuum.

Carbon-water interaction studies between aquatic and terrestrial ecosystems are especially needed today in Arctic and Boreal regions, as they are facing drastic warming and precipitation shifts. Despite the importance of streams in the carbon cycle, northern stream-based studies are scarce, owing to a lack of measurements throughout the north, and possibly skewing global greenhouse gas estimates. We used a combination of multiscale measurements to quantify water sources (HO isotope proxies), carbon availability (dissolved in/organic carbon concentrations) and quality (water absorbance, SUVA -index), microbial community structure (16S rRNA sequencing), and carbon dioxide (CO) and methane (CH) fluxes and concentrations.

Inline Raman Spectroscopy Provides Versatile Molecular Monitoring for Platelet Extracellular Vesicle Purification with Anion-Exchange Chromatography.

Extracellular vesicles (EVs) are relatively recently discovered biological nanoparticles that mediate intercellular communication. The development of new methods for the isolation and characterization of EVs is crucial to support further studies on these small and structurally heterogenous vesicles. New scalable production methods are also needed to meet the needs of future therapeutic applications.

Three-Year Outcomes of Oral Antibiotics vs Intravenous and Oral Antibiotics for Uncomplicated Acute Appendicitis: A Secondary Analysis of the APPAC II Randomized Clinical Trial.

Importance: Current short-term evidence has shown that uncomplicated acute appendicitis can be treated successfully with oral antibiotics alone, but longer-term results are lacking.

Objective: To assess the treatment effectiveness of oral antibiotic monotherapy compared with combined intravenous (IV) and oral antibiotics in computed tomography-confirmed uncomplicated acute appendicitis at a longer-term follow-up.

Design, Setting, And Participants: This secondary analysis of a predefined year 3 follow-up of the Appendicitis Acuta II (APPAC II) noninferiority, multicenter randomized clinical trial compared oral moxifloxacin with combined IV ertapenem plus oral levofloxacin and metronidazole for the treatment of uncomplicated acute appendicitis.

Nordic socio-recreational ecosystem services in a hydropeaked river.

Fluctuating energy prices call for short-term river flow regulation at hydropower plants (HPPs), which can lead to hydropeaking - the pulsating water flow downstream from a HPP. Hydropeaking can affect land use areas of regulated rivers and subsequently their socio-recreational ecosystem services (SRESs). These areas often offer a range of services, such as swimming, boating, fishing, hiking, cycling, and berry picking.

Leaching of nitrogen, phosphorus and other solutes from a controlled drainage cultivated peatland in Ruukki, Finland.

Cultivated peatlands are important for grass production in Northern Europe, but the potential impact of nutrients leaching to surface waters is a major concern. Due to a lack of data on nitrogen (N), phosphorus (P) and organic carbon leaching, a monitoring programme was established at Ruukki (Siikajoki, Finland), an agricultural, subsurface drained peat site with a peat thickness of 20-80 cm. Concentrations and loading of N, P, and total organic carbon (TOC) were monitored, along with other water quality parameters for the field discharge, in 2018-2021.

Development of tandem cation exchange chromatography for high purity extracellular vesicle isolation: The effect of ligand steric availability.

Purification of extracellular vesicles for research and therapeutic applications requires updated methodology to address the limitations of traditional ultracentrifugation and other size-based separation techniques. Their downfalls include induced extracellular vesicle aggregation, low yields, poor scalability and one-dimensionality of the separation process, as the size or sedimentation speed of extracellular vesicles is often the only selection criterion. Ion exchange chromatography is a promising alternative or supplementary method candidate, as it offers a different approach for extracellular vesicle separation, which is surface charge.

Impacts on water quality in the peatland dominated catchment due to foreseen changes in Nordic Bioeconomy Pathways.

The Nordic Bioeconomy Pathways (NBPs), conceptualized subsets of Shared Socioeconomic Pathways varying from environmentally friendly to open-market competition scenarios, can lead to plausible stressors in future for using bioresources. This study analysed the impacts of NBPs on hydrology and water quality based on two different land system management attributes: management strategy and a combination of reduced stand management and biomass removal at a catchment-scale projection. To understand the potential impacts of NBPs, the Simojoki catchment in northern Finland was chosen, as the catchment mainly covered peatland forestry.

Whole genome sequencing reveals new links between spa t172/CC59 methicillin-resistant Staphylococcus aureus cases in low-endemicity region of Southwest Finland, 2007‒2016.

Methicillin-resistant Staphylococcus aureus (MRSA) rates have remained relatively low in Finland. In Southwest Finland, however, annual MRSA incidence increased from 12 to 25/100,000 between 2007 and 2016 with spa t172 strain causing one fourth (237/983) of all cases. This provoked us to study the molecular epidemiology of t172-MRSA, aiming to better understand the transmission of this strain type.

Blood culture positivity in patients with acute appendicitis: A propensity score-matched prospective cohort study.

Background And Objective: The prevalence of bacteremia in acute appendicitis is unknown. We aimed to assess prevalence and predictive factors of bacteremia in adult patients with appendicitis.

Methods: In this prospective propensity score-matched cohort study, patients were recruited as part of one single-center prospective observational study assessing appendicitis microbiology in concurrence with two randomized controlled trials on non-operative treatment of uncomplicated acute appendicitis.

Early administration of tocilizumab in hospitalized COVID-19 patients with elevated inflammatory markers; COVIDSTORM-a prospective, randomized, single-centre, open-label study.

Objectives: Severe COVID-19 is associated with an imbalanced immune response. We hypothesized that patients with enhanced inflammation, as demonstrated by increased levels of certain inflammatory biomarkers, would benefit from interleukin-6 blockage.

Methods: Patients hospitalized with COVID-19, hypoxemia, and at least two of four markedly elevated markers of inflammation (interleukin-6, C-reactive protein, ferritin, and/or D-dimer) were randomized for tocilizumab (TCZ) plus standard of care (SoC) or SoC alone.

Stable water isotopes as a tool for assessing groundwater infiltration in sewage networks in cold climate conditions.

Effective identification and quantification of groundwater (GW) infiltration into sewage collection networks represents an important step towards sustainable urban water management. In many countries, including northern regions, sewage networks are aging to the point where renovation is needed. This study focused on the utilization of stable water isotopes as tracer substances for GW infiltration detection.

Thickness of peat influences the leaching of substances and greenhouse gas emissions from a cultivated organic soil.

The off-site effects of agricultural organic soils include the leaching of N, P, and organic carbon (OC) to watercourses and CO, CH, and NO emissions into the atmosphere. The aim of this study was to quantify how the thickness of organic layers affects these loads. A 19.

Iron in boreal river catchments: Biogeochemical, ecological and management implications.

Iron (Fe) is an important element in aquatic ecosystems worldwide because it is intimately tied with multiple abiotic and biotic phenomena. Here, we give a survey of manifold influences of Fe, and the key factors affecting it in the boreal catchments and their waters. It includes the perspectives of biogeochemistry, hydrology, ecology, and river basin management.

Combined use of satellite image analysis, land-use statistics, and land-use-specific export coefficients to predict nutrients in drained peatland catchment.

Maintaining and improving surface water quality requires knowledge of nutrient and sediment loads due to past and future land-use practices, but historical data on land cover and its changes are often lacking. In this study, we tested whether land-use-specific export coefficients can be used together with satellite images (Landsat) and/or regional land-use statistics to estimate riverine nutrient loads and concentrations of total nitrogen (TN), total phosphorus (TP), and suspended solids (SS). The study area, Simojoki (3160 km) in northern Finland, has been intensively drained for peatland forestry since the 1960s.

Effect of Oral Moxifloxacin vs Intravenous Ertapenem Plus Oral Levofloxacin for Treatment of Uncomplicated Acute Appendicitis: The APPAC II Randomized Clinical Trial.

Importance: Antibiotics are an effective and safe alternative to appendectomy for managing uncomplicated acute appendicitis, but the optimal antibiotic regimen is not known.

Objective: To compare oral antibiotics with combined intravenous followed by oral antibiotics in the management of computed tomography-confirmed uncomplicated acute appendicitis.

Design, Setting, And Participants: The Appendicitis Acuta (APPAC) II multicenter, open-label, noninferiority randomized clinical trial was conducted from April 2017 until November 2018 in 9 Finnish hospitals.

IL-6 and other biomarkers as predictors of severity in COVID-19.

Objective: Cytokine release syndrome is suggested to be the most important mechanism triggering acute respiratory distress syndrome and end organ damage in COVID-19. The severity of disease may be measured by different biomarkers.

Methods: We studied markers of inflammation and coagulation as recorded in 29 patients on admission to the hospital in order to identify markers of severe COVID-19 and need of ICU.

Potential impacts of a future Nordic bioeconomy on surface water quality.

Nordic water bodies face multiple stressors due to human activities, generating diffuse loading and climate change. The 'green shift' towards a bio-based economy poses new demands and increased pressure on the environment. Bioeconomy-related pressures consist primarily of more intensive land management to maximise production of biomass.

Performance of the Check-Direct ESBL Screen for BD MAX for detection of asymptomatic faecal carriage of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae.

Objectives: Accurte diagnostic methods are crucial for the detection of extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E). Besides culture-based gold-standard methods, new molecular gene detection tests are reaching the market. The aim of this study was to investigate the performance of the direct quantitative PCR (qPCR)-based methods Check-Direct ESBL and CPE Screen for BD MAX in relation to traditional culture-based methods for detection of ESBL-E faecal carriage.

Changing epidemiology of methicillin-resistant Staphylococcus aureus in a low endemicity area-new challenges for MRSA control.

The incidence of methicillin-resistant Staphylococcus aureus (MRSA) has increased sharply in Hospital District of Southwest Finland (HD). To understand reasons behind this, a retrospective, population-based study covering 10 years was conducted. All new 983 MRSA cases in HD from January 2007 to December 2016 were analysed.

Predicting iron transport in boreal agriculture-dominated catchments under a changing climate.

Increases in iron (Fe) concentration have been reported in boreal regions in recent decades, raising concerns about the fate of ecosystems along water courses. In this study, the SWAT (Soil and Water Assessment Tool) model was applied to the river Mustijoki catchment in southern Finland to determine the current state of Fe transport and to evaluate possible effects of ongoing environmental change in this agriculture-dominated catchment. The model was calibrated using five-year discharge, suspended solids, and Fe data, and validated with a three-year dataset of the same parameters.

Prospective multicentre cohort trial on acute appendicitis and microbiota, aetiology and effects of antimicrobial treatment: study protocol for the MAPPAC (Microbiology APPendicitis ACuta) trial.

Introduction: Based on the epidemiological and clinical data, acute appendicitis can present either as uncomplicated or complicated. The aetiology of these different appendicitis forms remains unknown. Antibiotic therapy has been shown to be safe, efficient and cost-effective for CT-confirmed uncomplicated acute appendicitis.

Optimising the antibiotic treatment of uncomplicated acute appendicitis: a protocol for a multicentre randomised clinical trial (APPAC II trial).

Background: Based on epidemiological and clinical data acute appendicitis can present either as uncomplicated (70-80%) or complicated (20-30%) disease. Recent studies have shown that antibiotic therapy is both safe and cost-effective for a CT-scan confirmed uncomplicated acute appendicitis. However, based on the study protocols to ensure patient safety, these randomised studies used mainly broad-spectrum intravenous antibiotics requiring additional hospital resources and prolonged hospital stay.