Browsing by Subject "DISCHARGE"

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  • Ojansuu, Ilkka; Putkonen, Hanna; Tiihonen, Jari (2018)
    Purpose: To analyze the causes of mortality among patients committed to compulsory forensic psychiatric hospital treatment in Finland during 1980-2009 by categorizing the causes of mortality into somatic diseases, suicides and other unnatural deaths.Materials and methods: The causes of mortality were analyzed among 351 patients who died during the follow-up. Standardized mortality ratio (SMR) was calculated as the ratio of observed and expected number of deaths by using the subject-years methods with 95% confidence intervals, assuming a Poisson distribution. The expected number of deaths was calculated on the basis of sex-, age- and calendar-period-specific mortality rates for the Finnish population.Results: The vast majority (249/351) of deaths were due to a somatic disease with SMR of 2.6 (mean age at death 61 years). Fifty nine patients committed suicide with a SMR of 7.1 (mean age at death 40 years). Four patients were homicide victims (mean age at death 40 years) and 32 deaths were accidental (mean age at death 52 years). The combined homicides and accidental deaths resulted in a SMR of 1.7.Conclusions: The results of this study point out that the high risk for suicide should receive attention when the hospital treatment and the outpatient care is being organized for forensic psychiatric patients. In addition, the risk of accidents should be evaluated and it should be assured that the patients receive proper somatic healthcare during the forensic psychiatric treatment and that it continues also in the outpatient setting.
  • Zhou, Zhipeng; Kyritsakis, Andreas; Wang, Zhenxing; Li, Yi; Geng, Yingsan; Djurabekova, Flyura (2019)
    Sufficiently high voltage applied between two metal electrodes, even in ultra high vacuum conditions, results in an inevitable discharge that lights up the entire gap, opening a conductive channel through the vacuum and parasitically consuming large amounts of energy. Despite many efforts to understand the processes that lead to this phenomenon, known as vacuum arc, there is still no consensus regarding the role of each electrode in the evolution of such a momentous process as lightning. Employing a high-speed camera, we capture the entire lightning process step-by-step with a nanosecond resolution and find which of the two electrodes holds the main responsibility for igniting the arc. The light that gradually expands from the positively charged electrode (anode), often is assumed to play the main role in the formation of a vacuum arc. However, both the nanosecond-resolution images of vacuum arc evolution and the corresponding theoretical calculations agree that the conductive channel between the electrodes is built in the form of cathodic plasma long before any significant activity develops in the anode. We show evidently that the anode illumination is weaker and plays a minor role in igniting and maintaining the conductive channel.
  • Jakobsson, Martin; O'Regan, Matt; Morth, Carl-Magnus; Stranne, Christian; Weidner, Elizabeth; Hansson, Jim; Gyllencreutz, Richard; Humborg, Christoph; Elfwing, Tina; Norkko, Alf; Norkko, Joanna; Nilsson, Bjorn; Sjöström, Arne (2020)
    Submarine groundwater discharge (SGD) influences ocean chemistry, circulation, and the spreading of nutrients and pollutants; it also shapes sea floor morphology. In the Baltic Sea, SGD was linked to the development of terraces and semicircular depressions mapped in an area of the southern Stockholm archipelago, Sweden, in the 1990s. We mapped additional parts of the Stockholm archipelago, areas in Blekinge, southern Sweden, and southern Finland using high-resolution multibeam sonars and sub-bottom profilers to investigate if the sea floor morphological features discovered in the 1990s are widespread and to further address the hypothesis linking their formation to SGD. Sediment coring and sea floor photography conducted with a remotely operated vehicle (ROV) and divers add additional information to the geophysical mapping results. We find that terraces, with general bathymetric expressions of about 1 m and lateral extents of sometimes > 100 m, are widespread in the surveyed areas of the Baltic Sea and are consistently formed in glacial clay. Semicircular depressions, however, are only found in a limited part of a surveyed area east of the island of Asko, southern Stockholm archipelago. While submarine terraces can be produced by several processes, we interpret our results to be in support of the basic hypothesis of terrace formation initially proposed in the 1990s; i.e. groundwater flows through siltier, more permeable layers in glacial clay to discharge at the sea floor, leading to the formation of a sharp terrace when the clay layers above seepage zones are undermined enough to collapse. By linking the terraces to a specific geologic setting, our study further refines the formation hypothesis and thereby forms the foundation for a future assessment of SGD in the Baltic Sea that may use marine geological mapping as a starting point. We propose that SGD through the submarine sea floor terraces is plausible and could be intermittent and linked to periods of higher groundwater levels, implying that to quantify the contribution of freshwater to the Baltic Sea through this potential mechanism, more complex hydrogeological studies are required.
  • Aaltonen, Kari I.; Isometsä, Erkki; Sund, Reijo; Pirkola, Sami (2019)
    Objective To examine longitudinally risk factors for suicide in depression, and gender differences in risk factors and suicide methods. Method We linked data from (i) The Finnish Hospital Discharge Register, (ii) the Census Register of Statistics Finland, and (iii) Statistics Finland's register on causes of deaths. All 56 826 first-hospitalized patients (25 188 men, 31 638 women) in Finland in 1991-2011 with a principal diagnosis of depressive disorder were followed up until death (2587 suicides) or end of the year 2014 (maximum 24 years). Results Clinical characteristics (severe depression adjusted hazard ratio [AHR] 1.19 [95% CI 1.08-1.30]; psychotic depression AHR 1.45 [1.30-1.62]; and comorbid alcohol dependence AHR 1.26 [1.13-1.41]), male gender (AHR 2.07 [1.91-2.24]), higher socioeconomic status and living alone at first hospitalization were long-term predictors of suicide deaths. Highest risk was associated with previous suicide attempts (cumulative probability 15.4% [13.7-17.3%] in men, 8.5% [7.3-9.7%] in women). Gender differences in risk factors were modest, but in lethal methods prominent. Conclusion Sociodemographic and clinical characteristics at first hospitalization predict suicide in the long term. Inpatients with previous suicide attempts constitute a high-risk group. Despite some gender differences in risk factors, those in lethal methods may better explain gender disparity in risk.
  • Salo, Heidi; Warsta, Lassi; Turunen, Mika; Nurminen, Jyrki; Myllys, Merja; Paasonen-Kivekäs, Maija; Alakukku, Laura; Koivusalo, Harri (2017)
    Subsurface drain trenches are important pathways for water movement from the field surface to subsurface drains in low permeability clayey soils. The hydrological effects of trenches installed with well conducting backfill material and gravel inlet patches are difficult to study with only experimental methods. Computational three-dimensional soil water models provide additional tools to assess spatial processes of such drainage system. The objective was to simulate water flow pathways with 3-D FLUSH model in drain spacing and trench depth scale with two model configurations: (1) the total pore space of soil was treated as a single continuous pore system and (2) the total pore space was divided into mobile soil matrix and macropore systems. Both model configurations were parameterized almost solely with field data without calibration. Data on soil hydraulic properties and drain discharge measurements were available from a clayey subsurface drained agricultural field in southern Finland. The effect of soil hydraulic variability on water flow pathways was assessed by generating computational grids in which the hydraulic properties were sampled randomly from five measured soil sets. Both model configurations were suitable to describe the recorded drain discharge, when model was parameterized in finer scale than drain spacing and the parameterization described highly conductive subdomains such as macropores in a dual-permeability model or the trench in a single pore system model. Models produced similar hourly discharge and water balance results with randomly sampled soil hydraulic properties. The results provide a new view on consequences of soil heterogeneity on subsurface drainage. The practical implication of the results from different drainage scenarios is that gravel trench appears to be important only in soils with a poorly conductive subsoil layers without direct macropore connections to subsurface drains. Solely drain discharge data was not sufficient to determine the differences in water flow pathways between the two model configurations and more output variables, such as groundwater level, should be taken into account in making assessments on the effects of different drainage practices on field drainage capacity. (C) 2016 Elsevier B.V. All rights reserved.
  • Zhou, Zhipeng; Kyritsakis, Andreas; Wang, Zhenxing; Li, Yi; Geng, Yingsan; Djurabekova, Flyura (2020)
    Vacuum breakdown (also known as arc or discharge) occurs when a sufficiently high electric field is applied between two electrodes in vacuum. The discharge is driven by the formation of an intensively glowing plasma at the cathode, which is followed by the ignition of an anode flare that gradually expands and fills the gap. Although it has been shown that the anode electrode does not play a significant role in the breakdown initiation, the nature of the anodic glow is of paramount importance for understanding the breakdown evolution. In this work, we use time- and space-resolved spectroscopy to study the anode flare. By using different anode and cathode materials, we find that excitations from both anode and cathode ions and neutrals contribute to the anodic glow. This implies that the cathodic plasma expands towards the anode without emitting any detectable light and starts glowing only when it reaches and interacts with the anode electrode. This interaction causes the introduction of anodic species in the plasma. The latter starts producing an expanding glow which contains spectra from both the cathode and anode materials and gradually fills the gap as the plasma equilibrates. Finally, we observe that after a breakdown, cathode material deposits on the anode electrode, gradually coating it. After hundreds of breakdowns, this coating covers the anode, resulting in the decay and possible elimination of the anode material signal in the spectra.
  • Pulkkinen, Maria; Jousela, Irma; Engblom, Janne; Salanterä, Sanna; Junttila, Kristiina (2020)
    Background: The shortened length of hospital stays (LOS) requires efficient and patient-participatory perioperative nursing approaches to enable early and safe discharge from hospitals for patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). The primary aim of this study was to explore the effect comparative to standard perioperative care of a new perioperative practice model (NPPM) on the LOS and the time points of the surgical care process in patients undergoing THA and TKA under spinal anesthesia. The secondary aim was to find out if any subgroups with different response could be found. Methods: Patients scheduled for elective, primary THA and TKA were assessed for eligibility. A two-group parallel randomized clinical trial was conducted with an intervention group (n = 230) and control group (n = 220), totaling 450 patients. The patients in the intervention group were each designated with one named anesthesia nurse, who took care of the patient during the entire perioperative process and visited the patient postoperatively. The patients in the control group received standard perioperative care from different nurses during their perioperative processes and without postoperative visits. The surgical care process time points for each study patient were gathered from the operating room management software and hospital information system until hospital discharge. Results: We did not find any statistically significant differences between the intervention and control groups regarding to LOS. Only slight differences in the time points of the surgical care process could be detected. The subgroup examination revealed that higher age, type of arthroplasty and ASA score 3-4 all separately caused prolonged LOS. Conclusion: We did not find the new perioperative practice model to shorten either length of hospital stays or the surgical care process in patients undergoing THA and TKA. Further studies at the subgroup level (gender, old age, and ASA score 3 and 4) are needed to recognize the patients who might benefit most from the NPPM.
  • Kyritsakis, A.; Veske, M.; Eimre, K.; Zadin, V.; Djurabekova, F. (2018)
    When an electron emitting tip is subjected to very high electric fields, plasma forms even under ultra high vacuum conditions. This phenomenon, known as vacuum arc, causes catastrophic surface modifications and constitutes a major limiting factor not only for modern electron sources, but also for many large-scale applications such as particle accelerators, fusion reactors etc. Although vacuum arcs have been studied thoroughly, the physical mechanisms that lead from intense electron emission to plasma ignition are still unclear. In this article, we give insights to the atomic scale processes taking place in metal nanotips under intense field emission conditions. We use multi-scale atomistic simulations that concurrently include field-induced forces, electron emission with finite-size and space-charge effects, Nottingham and Joule heating. We find that when a sufficiently high electric field is applied to the tip, the emission-generated heat partially melts it and the field-induced force elongates and sharpens it. This initiates a positive feedback thermal runaway process, which eventually causes evaporation of large fractions of the tip. The reported mechanism can explain the origin of neutral atoms necessary to initiate plasma, a missing key process required to explain the ignition of a vacuum arc. Our simulations provide a quantitative description of in the conditions leading to runaway, which shall be valuable for both field emission applications and vacuum arc studies.
  • Rautio, A.; Kivimäki, A.-L.; Korkka-Niemi, K.; Nygård, M.; Salonen, V.-P.; Lahti, K.; Vahtera, H. (2015)
    A low-altitude aerial infrared (AIR) survey was conducted to identify hydraulic connections between aquifers and rivers and to map spatial surface temperature patterns along boreal rivers. In addition, the stable isotopic compositions (delta O-18, delta D), dissolved silica (DSi) concentrations and electrical conductivity of water in combination with AIR data were used as tracers to verify the observed groundwater discharge into the river system in a boreal catchment. Based on low temperature anomalies in the AIR survey, around 370 groundwater discharge sites were located along the main river channel and its tributaries (203 km altogether). On the basis of the AIR survey, the longitudinal temperature patterns of the studied rivers differed noticeably. The stable isotopes and DSi composition revealed major differences between the studied rivers. The groundwater discharge locations identified in the proximity of 12 municipal water intake plants during the low-flow seasons should be considered as potential risk areas for water intake plants during flood periods (groundwater quality deterioration due to bank infiltration), and should be taken under consideration in river basin management under changing climatic situations.