Purpose
In this prospective study, we aim to determine surgical outcomes in patients with lumbar spinal stenosis (LSS) 10 years after surgery.
Methods
The study population consisted of 96 LSS ...patients who underwent decompressive surgery, 72 of whom participated in the 10-year follow-up. The patients completed a questionnaire preoperatively and 3 months, 5 years, and 10 years postoperatively. Outcome measures were satisfaction with the surgical outcomes, the Oswestry Disability Index (ODI), the visual analog scale (VAS), the numeric rating scale (NRS-11), and walking ability quantified in meters. Postoperative improvements at 5 and 10 years were analyzed using linear mixed models. Furthermore, comparisons between postoperative time points were made for clinical courses of pain, disability, and walking ability.
Results
At the 10-year follow-up, 68% of the patients were satisfied with the surgical outcomes. All the measured outcomes showed statistically significant improvement from baseline to the 5- and 10-year follow-up. The mean VAS score was 9.8 mm higher at the 5-year follow-up and 7.8 mm at the 10-year follow-up compared to the 3-month follow-up point. Similarly, the mean ODI was 4.8% higher at the 10-year follow-up compared to the 3-month follow-up point.
Conclusion
This study reports the clinical course of pain, disability, and walking distance after LSS surgery with the 10-year follow-up. Based on our study results, patients with LSS could expect to have positive effects of their back surgery up to 10 years. However, minor worsening in pain and disability may occur and one-fourth of the patients may need a reoperation during the 10-year follow-up period.
Mental disorders in young adulthood Suvisaari, J; Aalto-Setälä, T; Tuulio-Henriksson, A ...
Psychological medicine,
02/2009, Letnik:
39, Številka:
2
Journal Article
Recenzirano
The effect of mental disorders may be particularly detrimental in early adulthood, and information on mental disorders and their correlates in this age group is important.
A questionnaire focusing on ...mental health was sent to a nationally representative two-stage cluster sample of 1863 Finns aged 19 to 34 years. Based on a mental health screen, all screen-positives and a random sample of screen-negatives were asked to participate in a mental health assessment, consisting of the Structured Clinical Interview for DSM-IV (SCID-I) interview and neuropsychological assessment. We also obtained case-notes from all lifetime mental health treatments. This paper presents prevalences, sociodemographic associations and treatment contacts for current and lifetime mental disorders.
Forty percent of these young Finnish adults had at least one lifetime DSM-IV Axis I disorder, and 15% had a current disorder. The most common lifetime disorders were depressive disorders (17.7%) followed by substance abuse or dependence (14.2%) and anxiety disorders (12.6%). Of persons with any lifetime Axis I disorder, 59.2% had more than one disorder. Lower education and unemployment were strongly associated with current and lifetime disorders, particularly involving substance use. Although 58.3% of persons with a current Axis I disorder had received treatment at some point, only 24.2% had current treatment contact. However, 77.1% of persons with a current Axis I disorder who felt in need of treatment for mental health problems had current treatment contact.
Mental disorders in young adulthood are common and often co-morbid, and they may be particularly harmful for education and employment in this age group.
Droughts can have an impact on forest functioning and production, and even lead to tree mortality. However, drought is an elusive phenomenon that is difficult to quantify and define universally. In ...this study, we assessed the performance of a set of indicators that have been used to describe drought conditions in the summer months (June, July, August) over a 30-year period (1981–2010) in Finland. Those indicators include the Standardized Precipitation Index (SPI), the Standardized Precipitation–Evapotranspiration Index (SPEI), the Soil Moisture Index (SMI), and the Soil Moisture Anomaly (SMA). Herein, regional soil moisture was produced by the land surface model JSBACH of the Max Planck Institute for Meteorology Earth System Model (MPI-ESM). Results show that the buffering effect of soil moisture and the associated soil moisture memory can impact on the onset and duration of drought as indicated by the SMI and SMA, while the SPI and SPEI are directly controlled by meteorological conditions. In particular, we investigated whether the SMI, SMA and SPEI are able to indicate the Extreme Drought affecting Forest health (EDF), which we defined according to the extreme drought that caused severe forest damages in Finland in 2006. The EDF thresholds for the aforementioned indicators are suggested, based on the reported statistics of forest damages in Finland in 2006. SMI was found to be the best indicator in capturing the spatial extent of forest damage induced by the extreme drought in 2006. In addition, through the application of the EDF thresholds over the summer months of the 30-year study period, the SPEI and SMA tended to show more frequent EDF events and a higher fraction of influenced area than SMI. This is because the SPEI and SMA are standardized indicators that show the degree of anomalies from statistical means over the aggregation period of climate conditions and soil moisture, respectively. However, in boreal forests in Finland, the high initial soil moisture or existence of peat often prevent the EDFs indicated by the SPEI and SMA to produce very low soil moisture that could be indicated as EDFs by the SMI. Therefore, we consider SMI is more appropriate for indicating EDFs in boreal forests. The selected EDF thresholds for those indicators could be calibrated when there are more forest health observation data available. Furthermore, in the context of future climate scenarios, assessments of EDF risks in northern areas should, in addition to climate data, rely on a land surface model capable of reliable prediction of soil moisture.
Objective
To study whether pre‐eclampsia and hypertension without proteinuria during pregnancy are associated with adaptive functioning, and psychiatric and psychological problems, of older ...offspring.
Design
Retrospective longitudinal cohort study.
Setting
Participants in the Helsinki Birth Cohort 1934–44 Study.
Population
A cohort of 778 participants born after normotensive, pre‐eclamptic, or hypertensive pregnancies, defined based on the mother's blood pressure and urinary protein measurements at maternity clinics and birth hospitals.
Methods
Pearson's chi‐squared tests and multivariable logistic regression.
Main outcome measures
Achenbach System of Empirically Based Assessment Older Adult Self‐Report scores, completed at age 69.3 years (SD 3.1 years).
Results
Compared with offspring born after normotensive pregnancies, offspring born after pre‐eclamptic pregnancies had increased odds of reporting total problems (aOR 4.00, 95%CI 1.64–9.77) and problems of particular concern to clinicians (critical items; aOR 5.28, 95%CI 1.87–14.96), as well as: anxious/depressed, functional impairment, memory, thought, and irritable/disinhibited problems on syndrome scales; depressive, somatic, and psychotic problems on Diagnostic and Statistical Manual of Mental Disorders scales; and adjustment problems in relationship satisfaction with spouse/partner. Maternal hypertension without proteinuria was not consistently associated with adjustment and problems (total problems, aOR 1.08, 95%CI 0.75–1.57; critical items, aOR 1.58, 95%CI 0.91–2.72).
Conclusions
Maternal hypertensive disorders in pregnancy, during a period of expectant treatment, carry an increased risk of problems in adaptive functioning and mental wellbeing in the offspring seven decades later. Being the longest follow‐up on transgenerational consequences of maternal hypertensive disorders reported thus far, our study points to the life‐time increased risk of an adverse intrauterine environment.
Two types of low-loss converters between different optical waveguides on silicon-on-insulator are demonstrated. A vertical taper between 9.4- and 3.8-μm-thick single-moded rib waveguides gives an ...excess loss of 0.7/spl plusmn/0.2 dB with negligible polarization dependency. The second structure converts a 9.7-μm-thick rib waveguide into an equally thick and highly multimoded strip waveguide with a negligible loss (<0.07 dB) for the fundamental mode. The fabrication of both structures is based on a simple two-step etch process with a relaxed mask alignment tolerance and no need for epitaxy.
The effect of the 2018 extreme meteorological conditions in Europe on methane (CH
) emissions is examined using estimates from four atmospheric inversions calculated for the period 2005-2018. For ...most of Europe, we find no anomaly in 2018 compared to the 2005-2018 mean. However, we find a positive anomaly for the Netherlands in April, which coincided with positive temperature and soil moisture anomalies suggesting an increase in biogenic sources. We also find a negative anomaly for the Netherlands for September-October, which coincided with a negative anomaly in soil moisture, suggesting a decrease in soil sources. In addition, we find a positive anomaly for Serbia in spring, summer and autumn, which coincided with increases in temperature and soil moisture, again suggestive of changes in biogenic sources, and the annual emission for 2018 was 33 ± 38% higher than the 2005-2017 mean. These results indicate that CH
emissions from areas where the natural source is thought to be relatively small can still vary due to meteorological conditions. At the European scale though, the degree of variability over 2005-2018 was small, and there was negligible impact on the annual CH
emissions in 2018 despite the extreme meteorological conditions. This article is part of a discussion meeting issue 'Rising methane: is warming feeding warming? (part 2)'.
European CH 4 and N 2 O emissions are estimated for 2006 and 2007 using four inverse modelling systems, based on different global and regional Eulerian and La-grangian transport models. This ensemble ...approach is designed to provide more realistic estimates of the overall uncertainties in the derived emissions, which is particularly important for verifying bottom-up emission inventories. We use continuous observations from 10 European stations (including 5 tall towers) for CH 4 and 9 continuous stations for N 2 O, complemented by additional European and global discrete air sampling sites. The available observations mainly constrain CH 4 and N 2 O emissions from northwestern and eastern Europe. The inversions are strongly driven by the observations and the derived total emissions of larger countries show little dependence on the emission inventories used a priori. Three inverse models yield 26-56 % higher total CH 4 emissions from northwestern and eastern Europe compared Published by Copernicus Publications on behalf of the European Geosciences Union. 716 P. Bergamaschi et al.: Top-down estimates of European CH 4 and N 2 O emissions to bottom-up emissions reported to the UNFCCC, while one model is close to the UNFCCC values. In contrast, the inverse modelling estimates of European N 2 O emissions are in general close to the UNFCCC values, with the overall range from all models being much smaller than the UNFCCC uncertainty range for most countries. Our analysis suggests that the reported uncertainties for CH 4 emissions might be underestimated , while those for N 2 O emissions are likely overestimated .
This paper documents a global Bayesian variational inversion of CO2 surface fluxes during the period 1988–2008. Weekly fluxes are estimated on a 3.75° × 2.5° (longitude‐latitude) grid throughout the ...21 years. The assimilated observations include 128 station records from three large data sets of surface CO2 mixing ratio measurements. A Monte Carlo approach rigorously quantifies the theoretical uncertainty of the inverted fluxes at various space and time scales, which is particularly important for proper interpretation of the inverted fluxes. Fluxes are evaluated indirectly against two independent CO2 vertical profile data sets constructed from aircraft measurements in the boundary layer and in the free troposphere. The skill of the inversion is evaluated by the improvement brought over a simple benchmark flux estimation based on the observed atmospheric growth rate. Our error analysis indicates that the carbon budget from the inversion should be more accurate than the a priori carbon budget by 20% to 60% for terrestrial fluxes aggregated at the scale of subcontinental regions in the Northern Hemisphere and over a year, but the inversion cannot clearly distinguish between the regional carbon budgets within a continent. On the basis of the independent observations, the inversion is seen to improve the fluxes compared to the benchmark: the atmospheric simulation of CO2 with the Bayesian inversion method is better by about 1 ppm than the benchmark in the free troposphere, despite possible systematic transport errors. The inversion achieves this improvement by changing the regional fluxes over land at the seasonal and at the interannual time scales.
Psychiatric co-morbidity is often inadequately controlled for in studies on cognitive functioning in depression. Our recent study established no major deficits in cognition among young adults with a ...history of pure unipolar depression. The present study extends our previous work by examining the effects of psychiatric co-morbidity and other disorder characteristics on depression-related cognitive functioning.
Performance in verbal and visual short-term memory, verbal long-term memory and learning, attention, processing speed, and executive functioning was compared between a population-based sample aged 21-35 years with a lifetime history of unipolar depressive disorders (n=126) and a random sample of healthy controls derived from the same population (n=71). Cognitive functioning was also compared between the subgroups of pure (n=69) and co-morbid (n=57) depression.
The subgroups of pure and co-morbid depression did not differ in any of the cognitive measures assessed. Only mildly compromised verbal learning was found among depressed young adults in total, but no other cognitive deficits occurred. Received treatment was associated with more impaired verbal memory and executive functioning, and younger age at first disorder onset with more impaired executive functioning.
Psychiatric co-morbidity may not aggravate cognitive functioning among depressed young adults. Regardless of co-morbidity, treatment seeking is associated with cognitive deficits, suggesting that these deficits relate to more distress.
We present an estimate of net ecosystem exchange (NEE) of CO₂ in Europe for the years 2001-2007. It is derived with a data assimilation that uses a large set of atmospheric CO₂ mole fraction ...observations (~70 000) to guide relatively simple descriptions of terrestrial and oceanic net exchange, while fossil fuel and fire emissions are prescribed. Weekly terrestrial sources and sinks are optimized (i.e., a flux inversion) for a set of 18 large ecosystems across Europe in which prescribed climate, weather, and surface characteristics introduce finer scale gradients. We find that the terrestrial biosphere in Europe absorbed a net average of -165 Tg C yr⁻¹ over the period considered. This uptake is predominantly in non-EU countries, and is found in the northern coniferous (-94 Tg C yr⁻¹) and mixed forests (-30 Tg C yr⁻¹) as well as the forest/field complexes of eastern Europe (-85 Tg C yr⁻¹). An optimistic uncertainty estimate derived using three biosphere models suggests the uptake to be in a range of -122 to -258 Tg C yr⁻¹, while a more conservative estimate derived from the a-posteriori covariance estimates is -165±437 Tg C yr⁻¹. Note, however, that uncertainties are hard to estimate given the nature of the system and are likely to be significantly larger than this. Interannual variability in NEE includes a reduction in uptake due to the 2003 drought followed by 3 years of more than average uptake. The largest anomaly of NEE occurred in 2005 concurrent with increased seasonal cycles of observed CO₂. We speculate these changes to result from the strong negative phase of the North Atlantic Oscillation in 2005 that lead to favorable summer growth conditions, and altered horizontal and vertical mixing in the atmosphere. All our results are available through http://www.carbontracker.eu
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