Something Old, Something New: Excursions into Finnish Sacrifical Carins

The article approaches the archaeological phenomenon known in Finland as 'sacrificial cairns' by examining the scholarly history and by placing these cairns in the context of the recent theoretical discussion concerning the essence of ritual and secular in prehistoric socities. 'Sacrificial cairns' are traditionally considered to have been Iron-Age altar-like constructions for the worship of various supernatural powers. This view started to develop already in writings on the Finnish 'ancient religion' (Fi. muinaisusko), and was made explicit in antiquarian and then archaeological scholarship. The grounds for identifying sacrificial cairns were sometimes very slight, but they nevertheless influenced future research. Later, secualr perspectives were added to ritual ones. I argue that the scholarly tradition and the consequent archaeological attributes of sacrificial cairns are an over-simplification, and that there is thus reason to re-examine the old interpretations. Although the existence of prehistoric cairns as places of sacrifice is implied by the ethnographic record, the same evidence also suggests that the relationship between cairns with sacral and secular functions is far less straightforward than has previously been thought. Following the recent discussion, some of the cairns traditionally identified as sacrificial might perhaps better be defined as structured depositions, possibly resulting from practices in which the ritual and the secular were inseparable

Pelvic sentinel lymph nodes have minimal impact on survival in melanoma patients

Publisher Copyright: © The Author(s) 2021. Published by Oxford University Press on behalf of BJS Society Ltd.BACKGROUND: Lower limb or trunk melanoma often presents with femoral and pelvic sentinel lymph nodes (SLNs). The benefits of harvesting pelvic lymph nodes remain controversial. In this retrospective study, the frequency and predictors of pelvic SLNs (PSLNs), and the impact of PSLNs on survival and staging was investigated. METHODS: Altogether 285 patients with cutaneous melanoma located in the lower limb or trunk underwent sentinel lymph node biopsy of the inguinal/iliac lymph node basin at Helsinki University Hospital from 2009-2013. Patient characteristics, detailed pathology reports and follow-up data were retrieved from hospital files. Subgroups of patients categorized by presence of PSLNs were compared for outcome parameters including progression-free survival, melanoma-specific survival and groin recurrence. RESULTS: Superficial femoral/inguinal SLNs were present in all patients and 199 (69.8 per cent) also had PSLNs removed. Median number of SLNs per patient was five and median number of PSLNs was two. Sixty-three patients (22.1 per cent) had metastases in their SLNs and seven (2.5 per cent) had metastases in PSLNs. A single patient had metastases solely in PSLNs, while superficial SLNs remained negative. Harvesting PSLNs or the number of PSLNs retrieved had no impact on progression-free survival or overall survival. The removal of PSLNs did not affect the risk of postoperative seroma or lymphoedema. The only predictor of positive PSLNs was radioactivity count equal to or more than that of the hottest superficial SLNs. CONCLUSION: Pelvic SLNs have minimal clinical impact on the outcome of melanoma patients especially in cases with negative superficial femoral/inguinal SLNs. Removal of PSLNs should be considered when they are the most radioactive nodes or equal to the hottest superficial femoral/inguinal SLNs in lymphoscintigraphy or during surgery.Preliminary results were presented in part at the International Sentinel Node Society Biennial Meeting, Tokyo, Japan, 11-13 October 2018.Peer reviewe

Prospective Longitudinal Health-related Quality of Life Analysis of the Finnish Arm of the PRIAS Active Surveillance Cohort : 11 Years of Follow-up

Publisher Copyright: © 2021Background: Living with an untreated cancer may alter quality of life (QoL) in the long term. Objective: To prospectively study long-term changes in general, mental, and physical QoL in a contemporary active surveillance (AS) patient cohort with low-risk prostate cancer (PCa). Design, setting, and participants: The study population consisted of patients enrolled in the PRIAS trial in Helsinki University Hospital (n = 348). The RAND-36 questionnaire was used to assess general QoL at the start of AS and at 1, 3, 5, 7, 9, and 11 years during follow-up. Patients who had undergone robot-assisted laparoscopic prostatectomy (RALP; n = 88) also received the questionnaire after treatment. Outcome measurements and statistical analysis: Changes over time were analysed using multilevel mixed-effects regression models, and reported as the mean and95% confidence interval. A rule of 0.5 × standard deviation was used to estimate changes of clinical importance. Results and limitations: Median follow-up until the end of AS or last follow-up was 7.2 (range 0.3−12.7) yr. A decrease was observed in six of eight QoL subdomains at 7 yr. However, all scores were above age-stratified reference values. There was no difference between the group who continued AS throughout the study period and the group who discontinued AS and underwent RALP. More than half of the study cohort discontinued AS (n = 198; 57%), 135 men (68%) because of events specified in the protocol and only seven (3.5%) because of anxiety. Metastatic disease developed in six patients (1.7%), and two cases (0.6%) of PCa-related death were recorded among 348 patients in more than 12 yr of overall follow-up. The lack of a randomised control population is a limitation of the study. Conclusions: Contemporary protocolised AS does not impair general QoL. Men undergoing a treatment change (RALP) did not experience a decrease in QoL before or after their treatment change. Patient summary: Active surveillance is a safe treatment option for men with low-risk prostate cancer. We show that this follow-up strategy does not cause a decline in patients’ general quality of life.Peer reviewe

Evaluation of operating cost management models for selection cutting in Scandinavian continuous cover forestry

The importance of continuous cover forestry (CCF) is increasing, yet there is lack of data and understanding about many aspects of this management, including the operational costs. Our objectives were to retrieve available harvesting cost models from published studies on selection cutting in Norway-spruce-dominated stands in Scandinavian countries and to evaluate them against real case studies. First, we retrieved three recently published harvesting cost models which provided explicit cost functions. Models 1 and 2, based on rotation forestry (RF) data and adapted for CCF, had separate sub-models for cutting and hauling costs. Model 3 was based on CCF data and produced total harvesting costs, including the cutting and hauling costs combined. Second, we measured cutting costs for 29 harvesting operations on stands with different stages of CCF structure. We then compared the observations with the simulations of Models 1 and 2 cutting cost sub-models for those cases. Third, we expanded the dataset, including a further 34 harvesting operations in stands with more advanced CCF structures (without measured costs). We then simulated the total harvesting costs for all three models in this dataset to investigate their general behaviour. On average, Models 1 and 2 cutting cost sub-models had relatively good and consistent predictions compared with the observed values. However, they differed in total costs due to different estimates for the hauling cost sub-models. Model 3 had predictions comparable to Models 1 and 2 in the more advanced stages of CCF, but much higher in the less advanced. This study provides important data regarding cutting costs in CCF and demonstrates the feasibility of using existing harvesting cost models