Primary and metastatic ovarian cancer: Characterization by 3.0T diffusion-weighted MRI

OBJECTIVES We aimed to investigate whether apparent diffusion coefficients (ADCs) measured by 3.0T diffusion-weighted magnetic resonance imaging (DWI) associate with histological aggressiveness of ovarian cancer (OC) or predict the clinical outcome. This prospective study enrolled 40 patients with primary OC, treated 2011-2014. METHODS DWI was performed prior to surgery. Two observers used whole lesion single plane region of interest (WLsp-ROI) and five small ROIs (S-ROI) to analyze ADCs. Samples from tumours and metastases were collected during surgery. Immunohistochemistry and quantitative reverse transcription polymerase chain reaction (qRT-PCR) were used to measure the expression of vascular endothelial growth factor (VEGF) and its receptors. RESULTS The interobserver reliability of ADC measurements was excellent for primary tumours ICC 0.912 (WLsp-ROI). Low ADCs significantly associated with poorly differentiated OC (WLsp-ROI P = 0.035). In primary tumours, lower ADCs significantly associated with high Ki-67 (P = 0.001) and low VEGF (P = 0.001) expression. In metastases, lower ADCs (WLsp-ROI) significantly correlated with low VEGF receptors mRNA levels. ADCs had predictive value; 3-year overall survival was poorer in patients with lower ADCs (WLsp-ROI P = 0.023, S-ROI P = 0.038). CONCLUSION Reduced ADCs are associated with histological severity and worse outcome in OC. ADCs measured with WLsp-ROI may serve as a prognostic biomarker of OC. KEY POINTS • Reduced ADCs correlate with prognostic markers: poor differentiation and high Ki-67 expression • ADCs also significantly correlated with VEGF protein expression in primary tumours • Lower ADC values are associated with poorer survival in ovarian cancer • Whole lesion single plane-ROI ADCs may be used as a prognostic biomarker in OC

Handbook for Moving towards Multiprofessional Work

This handbook was supposed to be a choral artwork and the result is a very choral and artistic patchwork. In the process of building up the project ‘MOMU – Moving towards Multiprofessional Work’, we sewed, we combined patterns to define new ones. We knew our shapes were different as were our fabrics but we learned to measure and cut in order to create a larger design. The results of this is what you can see in this handbook. We hope you’ll agree that the whole is greater than the sum of the parts. It has not been easy to piece this together. These types of processes bring with them discussions, arguments, discoveries, hopes, despair and bureaucratic requirements; all inevitable parts of such a complex process. However, it is honest to say that the process has been exciting and paves the way for future and productive collaborations. Along the way some of the participants left us: Carola Boehm and Esther Mercado; some others joined us: Pedro de la Paz. Some changes took place in our universities, new roles were assumed. This is also part of the richness of the tapestry. We are very thankful to all of them for their contribution. We thank the European Union for funding this project. For all of us it was the first time we had developed an Erasmus+ KA2 project and we had to apply the ‘learning by doing formula’, but we managed. We are very thankful to teachers who volunteered to participate in the training sessions, to practitioners who gave us important input and feedback and showed us how to improve and make our teaching more practical. Thanks also to our national steering groups for their clarity and recommendations. Importantly, our gratitude extends to our students: social work and art students, who were open to new perspectives and ways of exploring their place in the world and the job market. Youth unemployment in Europe continues to be an issue, but projects like MOMU aim to address this challenge in creative ways. However, we are at the very starting point and further steps are needed to make the new competence framework we have created a reality. This handbook intends to suggest and inspire instead of guiding the reader. It offers training packages to be adapted depending on contexts, whilst highlighting our successes and failures. We suggest it is read, considered and adapted. In other words, each person willing to put it into practice will have to assume that they will have to make their own patchwork

Long-term tracking and population characteristics of lipoprotein (a) in the Cardiovascular Risk in Young Finns Study

Background and aimsLipoprotein (a) (Lp(a)) is a causal risk factor for cardiovascular diseases and its levels are under strict genetic control. Therefore, it is hypothesized that the concentration of Lp(a) remains stable throughout life. Finns have lower Lp(a) levels than central Europeans, but it is unknown whether there are differences within Finland, especially between the eastern and western parts of the country with known genetic duality and persistent differences in cardiovascular disease rates. We have examined the long-term stability of Lp(a) levels over 25 years in the Cardiovascular Risk in Young Finns Study (YFS), and the characteristics of individuals with different Lp(a) levels, including their geographical origin within Finland.MethodsIn YFS, the first large baseline examination was conducted in 1980 (baseline age, 3–18 years). Several follow-ups during the past 40 years have been conducted to investigate the determinants of cardiometabolic health. Lp(a) levels have been measured in study years 1986 (N = 2464, ages 9–24 years), 2001 (N = 2281, ages 24–39 years), 2007 (N = 2204, ages 35–45 years) and 2011 (N = 2044, ages 39–49 years). Tracking of Lp(a) was estimated by calculating Spearman's rank order correlations between the study years, and by cross-tabulating how many individuals diagnosed with either elevated or non-elevated Lp(a) levels in 1986, 2001 and 2007 remained in the same category in the latest follow-up in 2011.ResultsSpearman's correlation coefficients varied between r = 0.84–0.96. Most individuals (87–94%) who had a high Lp(a) level (>30 mg/dl) in any of the previous study years had a high level also in 2011. On average, the median Lp(a) levels were consistently ∼20% higher in the individuals originating from eastern Finland compared to those from western Finland, but there were no differences in the distribution of known genetic determinants between eastern and western Finns that would have explained the observed difference.ConclusionsThese data confirm that Lp(a) levels remain very stable over the life-course. In line with the genetic duality between eastern and western parts of Finland, we observed about 20% higher Lp(a) levels in individuals originating from eastern Finland compared to those originating from western Finland.</p

Long-term tracking and population characteristics of lipoprotein (a) in the Cardiovascular Risk in Young Finns Study

Background and aims: Lipoprotein (a) (Lp(a)) is a causal risk factor for cardiovascular diseases and its levels are under strict genetic control. Therefore, it is hypothesized that the concentration of Lp(a) remains stable throughout life. Finns have lower Lp(a) levels than central Europeans, but it is unknown whether there are differences within Finland, especially between the eastern and western parts of the country with known genetic duality and persistent differences in cardiovascular disease rates. We have examined the long-term stability of Lp(a) levels over 25 years in the Cardiovascular Risk in Young Finns Study (YFS), and the characteristics of individuals with different Lp(a) levels, including their geographical origin within Finland. Methods: In YFS, the first large baseline examination was conducted in 1980 (baseline age, 3–18 years). Several follow-ups during the past 40 years have been conducted to investigate the determinants of cardiometabolic health. Lp(a) levels have been measured in study years 1986 (N = 2464, ages 9–24 years), 2001 (N = 2281, ages 24–39 years), 2007 (N = 2204, ages 35–45 years) and 2011 (N = 2044, ages 39–49 years). Tracking of Lp(a) was estimated by calculating Spearman's rank order correlations between the study years, and by cross-tabulating how many individuals diagnosed with either elevated or non-elevated Lp(a) levels in 1986, 2001 and 2007 remained in the same category in the latest follow-up in 2011. Results: Spearman's correlation coefficients varied between r = 0.84–0.96. Most individuals (87–94%) who had a high Lp(a) level (>30 mg/dl) in any of the previous study years had a high level also in 2011. On average, the median Lp(a) levels were consistently ∼20% higher in the individuals originating from eastern Finland compared to those from western Finland, but there were no differences in the distribution of known genetic determinants between eastern and western Finns that would have explained the observed difference. Conclusions: These data confirm that Lp(a) levels remain very stable over the life-course. In line with the genetic duality between eastern and western parts of Finland, we observed about 20% higher Lp(a) levels in individuals originating from eastern Finland compared to those originating from western Finland.publishedVersionPeer reviewe

Sosiaalinen yhteenkuuluvuus koulukiusaamisen ehkäisijänä liikuntatunneilla : interventiotutkimus 7-9 luokkalaisille oppilaille

Tämän pro gradu- tutkielman tarkoituksena oli selvittää, voiko sosiaalista yhteenkuuluvuutta tukevilla harjoitteilla vähentää koulukiusaamista sekä parantaa sosiaalista yhteenkuuluvuutta liikunnanopetuksessa. Kyseessä on interventiotutkimus, jonka tavoitteena oli määrittää, millainen yhteys näillä kahdella tekijällä on toisiinsa. Suoritimme interventiokoulussa kahdeksan (8) viikon interventiojakson, jossa jokaiselle liikuntatunnille lisättiin kaksi sosiaalista yhteenkuuluvuutta palvelevaa harjoitetta. Tutkimuksessa oli mukana myös verrokkikoulu. Verrokkikoulun tarkoituksena oli verrata interventioharjoitusten yhteyttä sosiaaliseen yhteenkuuluvuuteen sekä koulukiusaamisen kokemuksiin. Sosiaalisesta yhteenkuuluvuudesta ja koulukiusaamisesta kerättiin tietoja keväällä 2023 kyselylomakkeella, joka sisälsi strukturoituja kysymyksiä. Tutkimustulokset analysoitiin kvantitatiivisin menetelmin. Väittämistä muodostettiin faktorianalyysin avulla neljä summamuuttujaa, jossa vertailtiin alku- ja loppumittausten keskiarvoja. Aineisto analysoitiin käyttämällä nonparametrisia menetelmiä. Tutkimustulokset osoittivat, että kiusaaminen vähentyi interventiokoulun oppilailla (7.–8. ja 9.luokka) interventiojakson aikana. Intervention alussa oppilaiden kokema kiusaaminen kaikkien luokkien osalta (7.- 8. ja 9.-luokka) oli keskiarvoltaan 1,30. Toisella mittauskerralla intervention jälkeen keskiarvo oli 1,20, tulos on tilastollisesti merkitsevä (p=0,007). Intervention alussa oppilaiden kokema sosiaalinen yhteenkuuluvuus kaikkien luokkien osalta oli keskiarvoltaan 3,84. Toisella mittauskerralla intervention lopussa vastaava arvo oli 3,80. Eroa sosiaalisen yhteenkuuluvuuden kokemisessa intervention alussa ja lopussa ei voida kuitenkaan pitää tilastollisesti merkitsevänä (p=0,176). Näin ollen voidaan todeta, että sosiaalisen yhteenkuuluvuuden kokemisessa ei tapahtunut juurikaan muutosta intervention aikana. Koetun sosiaalisen yhteenkuuluvuuden ja koetun koulukiusaamisen välisten yhteyksien tarkastelu osoitti, että ne korreloivat tilastollisesti erittäin merkitsevästi keskenään sekä intervention alussa, että lopussa (p<0,001). Verrokkikoulussamme, jossa sosiaalista yhteenkuuluvuutta palvelevia harjoitteita ei suoritettu, ei tapahtunut tilastollisesti merkittävää muutosta sosiaalisen yhteenkuuluvuuden tai koulukiusaamisen kokemuksissa. Tämän pro-gradu tutkielman perusteella voidaan todeta, että sosiaalisella yhteenkuuluvuudella ja koulukiusaamisella on yhteys. Sosiaalista yhteenkuuluvuutta palvelevien harjoitteiden avulla saatiin laskettua koulukiusaamisen määrää. Koulukiusaaminen laski eniten sillä luokkatasolla, jossa sitä myös esiintyi määrällisesti eniten. Näin ollen voidaan todeta, että sosiaalisen yhteenkuuluvuuden harjoitteisiin on syytä kiinnittää huomiota liikunnanopetuksessa.The purpose of this study was to investigate how pupils (7th, 8th and 9th grades) experience social cohesion in association with school bullying and enjoyment in Physical Education (PE) lessons. Our goal was to find out how secondary school pupils enjoy PE lessons, have social cohesion. This is an intervention investigation which goal was to determine what kind of association these two factors have with each other. We had an eight (8) week long intervention in the intervention school where these cooperative games were included in PE lessons. We also had a comparison school, so we could compare the impacts of the intervention. We collected information about social cohesion and school bullying in spring 2023 with a questionnaire which included structured questions. The data was analysed using quantitative methods. Four sum variables were formed by using factor analysis. Mean values of the first and the last measurement were compared. The data was analysed by using non- parametric tests. The study findings showed that school bullying decreased in the intervention school (7th, 8th and 9th grades) during the intervention. At the beginning of the intervention the mean value of the experience of school bullying was 1.30. After the intervention the mean value was 1.20. We can consider the difference in these mean values are significant (p=.007). At the beginning of the intervention pupils’ mean value in experiencing social cohesion was 3.84. After the intervention the mean value was 3.80. The difference between these two mean values in experiencing social cohesion can’t be seen significant (p=.176). Therefore we found out that there was not much change in the experience of social cohesion during the intervention and after that. Examining the experience of social cohesion and school bullying we can see that there is a strong statistical correlation (p<.001). There were no statistically significant changes in experiencing social cohesion and school bullying in comparison school that wasn’t using intervention practises. Based on this master's thesis, it can be stated that there is a strong statistical correlation between experience of social cohesion and school bullying. By using social cohesion practises we can decrease school bullying. School bullying decreased the most in that grade where that was already in high level. To conclude, we suggest that it is important to focus on social cohesion practices in PE lessons

Risk factors for mortality and end-colostomy in patients with sigmoid volvulus managed by sigmoid resection

BACKGROUND: The traditional operative treatment of sigmoid volvulus is sigmoid resection. The risks involved in its timing are not clear. This study evaluates the impact of timing of surgery and demographic factors on surgical outcome and the risk of mortality and end colostomy in patients with sigmoid volvulus.METHODS: Medical records of 100 patients with sigmoid volvulus treated with sigmoid resection were studied retrospectively. Patients were divided into three groups. Group 1 (N.=48): emergency sigmoid resection, group 2 (N.=14): emergency endoscopic detorsion and planned sigmoid resection during same hospitalization, group3 (N=38): emergency endoscopic detorsion and readmission for elective sigmoid resection. Uni-and multivariate regression analyses were performed to assess the risk of end colostomy and mortality. RESULTS: There was no statistical difference in the duration of hospital stay, the risk of end colostomy or rate of reoperation between groups (P=0.140, P=0.062 and P=0.432 respectively). Regression analysis showed ASA-Classification >= 4 to associate with an increased risk of end colostomy (P=0.012). Thirty-day mortality was 4% and there was no difference between the groups (P=0.660). One year mortality varied significantly between the groups (P=0.008) and the regression analysis showed surgery in an emergency setting (group 1) and living at a nursing home (P=0.027 and P<0.001) to independently predict increased risk for 1-year mortality.CONCLUSIONS: Emergency surgery increases 1-year mortality after sigmoid resection for sigmoid volvulus. Frailty associates with both 1-year mortality and the risk for end colostomy. Elective surgery is preferred, but its timing does not affect surgical outcome or survival.Peer reviewe