Julkaisuarkisto

This systematic review examines the decontamination techniques used to clean titanium (Ti) implant surfaces covered with in vitro bacterial biofilms. The selected studies were gathered from the PubMed and Web of Science databases. These include in vitro studies investigating decontamination methods used to clean Ti implant surfaces coated with bacterial biofilms until January 2024. The determined studies were filtered according to the PRISMA guidelines, and the Science in Risk Assessment and Policy (SciRAP) was used to assess the reporting and methodological quality of the included studies. A total of 634 full-length peer-reviewed articles were identified. After excluding duplicate papers between the databases and screening according to the predefined inclusion and exclusion criteria, 13 studies were included. The decontamination methods investigated included mechanical, chemical, and physical methods, either as a single or in a combined approach. Significant variability was observed among the included studies. Combining the mechanical and physical methods with a chemical yielded the most significant reduction in both single- and multiple-species biofilms. The current results do not indicate that any single decontamination technique is more effective than others in eradicating bacterial biofilm from Ti surfaces; the combined approach was more advantageous than the single ones.

Prolongation of the QT interval is a known precursor to serious arrhythmias and sudden cardiac death, often triggered by medication use. Current medication risk evaluation platforms rely on literature-based synthesis and may lag behind real-world developments. We aimed to evaluate whether a machine learning (ML) model trained on real-world genomic and medication data can identify associations between drug use and QTc duration, potentially enabling automated risk detection in clinical workflows. We included 10,208 individuals from the FinnGen biobank Expansion Area 3 substudy, integrating prescription records, clinical variables, and genetic information. We applied a nested-cross-validation approach to develop an ML framework to predict QTc duration using clinical characteristics, recent medication purchases, and polygenic score for QTc duration. We performed conventional linear regression analyses to estimate the robustness of the findings. Only a minority of ML-detected drug–QTc associations aligned with known effects listed in expert-curated reference. Several apparent false positives were observed, and effect sizes for true positives, such as amiodarone, were small and likely interpreted as clinically not meaningful (+1 ms in ML vs. +49 ms in linear regression). These findings highlight challenges in using ML to detect meaningful drug effects on ECG. ML models did not reliably identify medications associated with QT-interval prolongation. Consequently, risk quantification using QTc as an intermediate marker of electrophysiological vulnerability was limited in this framework. While new approaches continue to develop in medication safety assessment, a systematic evidence review conducted by clinical pharmacology experts is unlikely to be supplanted in the foreseeable future.

Background Tentorial dural arteriovenous fistulas (TDAVFs) are rare but high risk vascular lesions. Although endovascular embolization is often the preferred treatment, large scale data on efficacy and safety are limited.

Objective To investigate the efficacy and safety of endovascular treatment for TDAVFs in a large, retrospective, multicenter cohort, and to analyze lesion characteristics and outcomes according to TDAVF location.

Methods Clinical, radiological, and interventional data from 585 patients treated in 32 international centers in 758 endovascular treatment sessions between 2012 and 2022 were analyzed. Patient demographics, fistula characteristics, endovascular treatment techniques, complications, and outcomes were assessed. Efficacy was measured by occlusion rates, safety by symptomatic complications, and modified Rankin Scale (mRS) scores.

Results In 31.3% of cases TDAVFs initially presented with hemorrhage, including 12.8% in low grade TDAVFs (absence of cortical venous reflux). Transarterial embolization was the primary approach in 84.7% of sessions. Complete occlusion was achieved in 74.2% of cases after the last treatment and 85.7% at the last imaging follow-up (mean 20.9 months). Symptomatic complications occurred in 9.4% of patients, with 2.6% permanent deficits and 1.0% mortality. At the last clinical follow-up (mean 30.6 months), 89.2% of patients had good functional outcome (mRS score 0–2). Location was significantly associated with fistula grade (eg, galenic and tentorial sinus TDAVFs being more often high grade, and torcular TDAVFs being more often low-grade).

Conclusions This large multicenter series demonstrated high occlusion rates, favorable functional outcomes, and acceptable complication rates, supporting endovascular therapy as a treatment of choice for TDAVFs. Considerable hemorrhage rates in low grade TDAVFs support the treatment even in the absence of cortical venous reflux.

This study examines teachers’ views concerning multilingualism in Finnish-language and Swedish-language schools in Finland. Using the concepts of linguistically responsive teaching and sustainable translanguaging, the following research questions were posed: 1. How do teachers in Finnish-language and Swedish-language schools perceive multilingualism as reflected in their language use? 2. How do teachers in Finnish-language and Swedish-language schools perceive multilingualism as reflected in their guidance of the students’ language use? The data were collected through an online survey (N = 2 865) conducted in schools located in 291 municipalities across Finland, covering the entire country. Participants included primary school teachers, subject teachers, and special needs teachers. Almost a third of the participating schools reported no students with home languages other than Finnish, Swedish, or Saami. Both quantitative and qualitative methods were adopted. The results reveal that the teachers in Finnish-language schools relate the concept of linguistic diversity to all languages, whereas the teachers in Swedish-language schools often embrace the national languages within that concept. Furthermore, the results confirm the outcomes of previous research, reporting that Swedish-language schools have a dual role: to safeguard the use of the school language, which has a minority position in the Finnish society, and to acknowledge growing linguistic diversity. Teachers in both school types partially embrace multilingualism but need further support to implement linguistically responsive teaching. The results also suggest that to help teachers develop strategies for linguistically responsive teaching, the connection between teachers’ orientations and pedagogical knowledge needs to be further emphasised.