The Ethics of Representation in the Fiction of Amitav Ghosh

Siirretty Doriast

Convolutional Recurrent Neural Networks for Polyphonic Sound Event Detection

Sound events often occur in unstructured environments where they exhibit wide variations in their frequency content and temporal structure. Convolutional neural networks (CNN) are able to extract higher level features that are invariant to local spectral and temporal variations. Recurrent neural networks (RNNs) are powerful in learning the longer term temporal context in the audio signals. CNNs and RNNs as classifiers have recently shown improved performances over established methods in various sound recognition tasks. We combine these two approaches in a Convolutional Recurrent Neural Network (CRNN) and apply it on a polyphonic sound event detection task. We compare the performance of the proposed CRNN method with CNN, RNN, and other established methods, and observe a considerable improvement for four different datasets consisting of everyday sound events.Comment: Accepted for IEEE Transactions on Audio, Speech and Language Processing, Special Issue on Sound Scene and Event Analysi

Gestational diabetes mellitus and labor analgesia : nationwide register-based analysis in Finland

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Lost boys? : Secondary education and crime

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Ultrasonic scissors decrease postoperative bleeding complications in mastectomy : A retrospective multicenter cohort study on 728 patients

Introduction: The aim of this study was to evaluate the rate of postoperative bleeding complications (primary outcome) and any other surgical complications (secondary outcome) in mastectomy between two surgical instruments, ultrasonic SonoSurg (R) scissors (US) and traditional electrocautery (EC). Materials and methods: In total 728 patients undergoing mastectomy in two adjacent university hospitals were retrospectively evaluated in terms of postoperative bleeding episodes, surgical site infections, skin flap necrosis, and any reoperations for 30 postoperative days. A propensity score matching was performed to acquire balanced groups. Patients consuming medications affecting hemostasis were excluded from the study. A multivariable logistic regression analysis was conducted to define the odds ratio (OR) for each complication separately. A cost analysis was performed. Results: The rate of postoperative bleeding complications was significantly lower in patients operated with US (0.3% vs 11.5%, OR 0.020, 95% CI 0.034-0.14) when compared to EC. The rate of surgical site infections (OR 0.65, 95% CI 0.35-1.23) was similar with both instruments, but there were less skin flap necroses (OR 0.35, 95% CI 0.13-0.98) in US group. For any reoperation, the OR for US was 0.13 (95% CI 0.046-0.39), mainly due to the lower number of acute bleeding complications. Even though the US instrument is more expensive than EC, the total cost of the treatment is lower in patients operated with US (3419 vs. 3475 euro). Conclusions: US seems to be associated with a lower risk of bleeding complications in mastectomy.(c) 2022 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).Peer reviewe

Paying Moms to Stay Home: Short and Long Run Effects on Parents and Children

We study the impacts of a policy designed to reward mothers who stay at home rather than join the labor force when their children are under age three. We use regional and over time variation in child home care allowance to show that home care allowance decreases maternal employment in both the short and long term, with almost three-quarters of the supplement amount offset by lost labor income. The effects are large enough for the existence of home care benefit system to explain the higher child penalty in Finland than comparable nations. Home care benefits also negatively affect the early childhood cognitive test results of children at the age of five, increase the likelihood of choosing vocational rather than academic secondary education track, and increase youth crimes. We confirm that the mechanism of action is changing work/home care arrangements by studying a a day care fee (DCF) reform had the opposite effect of raising incentives to work. We find that this policy increased the labor force participation of mothers and participation of children to day care, and improved child early test and schooling outcomes. This parallel set of findings suggests that on average in Finland, shifting child care from the home to the market increases labor force participation and improves child outcomes.nonPeerReviewe

Hormonaalisesti aktiivisen lisämunuaiskasvaimen diagnostiikka ja perioperatiivinen hoito

Lisämunuaiskasvaimen poistoa harkitaan, jos se erittää hormoneja tai sen hyvänlaatuista luonnetta ei pystytä kuvantamalla varmistamaan. Yleensä leikataan myös yli 4 cm:n kokoiset kasvaimet. Hormonaalisesti aktiiviset lisämunuaiskasvaimet voivat erittää adrenaliinia, noradrenaliinia, kortisolia tai aldosteronia. Primaarinen lisämunuaisen kuorikerroksen adrenokortikaalinen karsinooma voi erittää kortisolia tai aldosteronia sekä harvinaisissa tapauksissa myös androgeeneja ja estrogeeneja. Hormonaalisesti aktiivisten lisämunuaiskasvainten leikkaushoitoon liittyy lisääntynyt kirurgisten komplikaatioiden vaara hormonierityksen aiheuttamien hemodynaamisten muutosten ja liitännäissairauksien vuoksi. Lisämunuaiskasvainten huolellinen leikkausta edeltävä selvittely, hormonierityksen vaikutusten hallinta, anestesian aikainen seuranta ja hoito sekä siirtyminen laparo- tai retroperitoneoskooppisiin leikkausmenetelmiin vähentää perioperatiivisia komplikaatioita. Hormonaalisesti aktiivisten lisämunuaiskasvainten leikkaamisesta päätetään moniammatillisessa kokouksessa, ja leikkaukset tekee perioperatiiviseen hoitoon perehtynyt tiimi. Hoidon laatua tulee seurata ja raportoida.publishedVersionPeer reviewe

Delay in the initiation of adjuvant chemotherapy in patients with breast cancer with mastectomy with or without immediate breast reconstruction

Background Patients with breast cancer undergoing mastectomy should be offered the option of immediate breast reconstruction (IBR). The aim of this retrospective study was to assess whether there is a delay in the initiation of adjuvant chemotherapy in patients undergoing mastectomy with or without IBR. Method The study included patients aged 70 years or younger with clinically node-negative breast cancer who underwent unilateral mastectomy with IBR (IBR group) or mastectomy alone (no-IBR group) followed by adjuvant chemotherapy at the Helsinki University Hospital between January 2012 to July 2018. Results A total of 645 patients were included; 186 in the IBR group and 459 in the no-IBR group. Sixty-six (35.5 per cent) patients in the IBR group and 102 (22.2 per cent) patients in the no-IBR group received their first chemotherapy cycle later than 6 weeks after surgery (P < 0.001). The respective numbers for later than 8 weeks were 17 (9.1 per cent) and 14 (3.1 per cent) (P = 0.001). Among all 645 patients, postoperative complications were a significant risk factor for a delay in the initiation of chemotherapy. Sixty-seven (39.9 per cent) patients with and 101 (21.2 per cent) patients without complications had a delay in chemotherapy (P < 0.001). The delay in chemotherapy was due to complications in 39 (59.1 per cent) in the IBR group and in 28 (27.5 per cent) in the no-IBR group (P < 0.001). Conclusion Patients undergoing mastectomy alone were more likely to receive adjuvant chemotherapy within 6 weeks after surgery compared with the IBR patients. IBR significantly increased the risk of postoperative complications in comparison with mastectomy alone. The complications, in turn, were a significant risk factor for delay in adjuvant chemotherapy. The aim of this retrospective study was to see whether immediate breast reconstruction (IBR) is linked to a delay in initiation of adjuvant chemotherapy. The study shows that patients undergoing mastectomy alone were more likely to receive adjuvant chemotherapy within the recommended 6 weeks after surgery when compared with IBR patients. IBR significantly increased the risk of postoperative complications and the complications, in turn, were a significant risk factor for delay in adjuvant chemotherapy.Peer reviewe