An investigation into children's agency : children's initiatives and practitioners' responses in Finnish early childhood education

This paper investigates adult–child interaction in the early years of education. The intention is to understand how children's initiatives and practitioners’ responses support and/or hinder children's agency. Our ethnographic data include 150 h of video data supplemented by observational field notes from a Finnish Early Childhood Education (ECE) centre with eight five-year-old children and two ECE practitioners. The video data were analysed abductively by using an Interaction Analysis method. The children's initiatives were found to manifest in several modes, namely asking a question, suggesting, challenging, refusing and ideating. The responses to these initiatives by the ECE practitioners included accepting, accepting after a rejection, adapting, rejecting or ignoring. The analysis points to ways in which adult–child relationships are negotiated in everyday activities, showing the relational nature of agency and suggesting that the ways in which adult engages in the child's initiations are an intricate part of children's agency.Peer reviewe

Fast and accurate Slicewise OutLIer Detection (SOLID) with informed model estimation for diffusion MRI data

The accurate characterization of the diffusion process in tissue using diffusion MRI is greatly challenged by the presence of artefacts. Subject motion causes not only spatial misalignments between diffusion weighted images, but often also slicewise signal intensity errors. Voxelwise robust model estimation is commonly used to exclude intensity errors as outliers. Slicewise outliers, however, become distributed over multiple adjacent slices after image registration and transformation. This challenges outlier detection with voxelwise procedures due to partial volume effects. Detecting the outlier slices before any transformations are applied to diffusion weighted images is therefore required. In this work, we present i) an automated tool coined SOLID for slicewise outlier detection prior to geometrical image transformation, and ii) a framework to naturally interpret data uncertainty information from SOLID and include it as such in model estimators. SOLID uses a straightforward intensity metric, is independent of the choice of the diffusion MRI model, and can handle datasets with a few or irregularly distributed gradient directions. The SOLID-informed estimation framework prevents the need to completely reject diffusion weighted images or individual voxel measurements by downweighting measurements with their degree of uncertainty, thereby supporting convergence and well-conditioning of iterative estimation algorithms. In comprehensive simulation experiments, SOLID detects outliers with a high sensitivity and specificity, and can achieve higher or at least similar sensitivity and specificity compared to other tools that are based on more complex and time-consuming procedures for the scenarios investigated. SOLID was further validated on data from 54 neonatal subjects which were visually inspected for outlier slices with the interactive tool developed as part of this study, showing its potential to quickly highlight problematic volumes and slices in large population studies. The informed model estimation framework was evaluated both in simulations and in vivo human data.Peer reviewe

CMC is more than a measure of corticospinal tract integrity in acute stroke patients

In healthy subjects, motor cortex activity and electromyographic (EMG) signals from contracting contralateral muscle show coherence in the beta (15-30 Hz) range. Corticomuscular coherence (CMC) is considered a sign of functional coupling between muscle and brain. Based on prior studies, CMC is altered in stroke, but functional significance of this finding has remained unclear. Here, we examined CMC in acute stroke patients and correlated the results with clinical outcome measures and corticospinal tract (CST) integrity estimated with diffusion tensor imaging (DTI). During isometric contraction of the extensor carpi radialis muscle, EMG and magneto encephalographic oscillatory signals were recorded from 29 patients with paresis of the upper extremity due to ischemic stroke and 22 control subjects. CMC amplitudes and peak frequencies at 13-30 Hz were compared between the two groups. In the patients, the peak frequency in both the affected and the unaffected hemisphere was significantly (p < 0.01) lower and the strength of CMC was significantly (p < 0.05) weaker in the affected hemisphere compared to the control subjects. The strength of CMC in the patients correlated with the level of tactile sensitivity and clinical test results of hand function. In contrast, no correlation between measures of CST integrity and CMC was found. The results confirm the earlier findings that CMC is altered in acute stroke and demonstrate that CMC is bidirectional and not solely a measure of integrity of the efferent corticospinal tract.Peer reviewe

Prediction of neo-adjuvant chemotherapy response in bladder cancer : the impact of clinical parameters and routine biomarkers

Purpose To investigate the role of clinical parameters and immunohistochemical (IHC) biomarkers in their feasibility to predict the effect of neo-adjuvant chemotherapy (NAC) in patients with muscle-invasive urothelial bladder cancer (MIBC). Materials and methods The first 76 consecutive patients with MIBC treated with NAC and radical cystectomy in two University hospitals in Finland between 2008 and 2013 were chosen for this study. After excluding patients with non-urothelial cancer, less than two cycles of chemotherapy, no tissue material for IHC analysis or non-muscle-invasive bladder cancer in re-review, 59 patients were included in the final analysis. A tissue microarray block was constructed from the transurethral resection samples and IHC stainings of Ki-67, p53, Her-2 and EGFR were made. The correlations between histological features in transurethral resection samples and immune-histochemical stainings were calculated. The associations of clinicopathological parameters and IHC stainings with NAC response were evaluated. Factors affecting survival were estimated. Results The complete response rate after NAC was 44%. A higher number of chemotherapy cycles was associated with better response to neo-adjuvant chemotherapy. No response to neo-adjuvant chemotherapy and female gender was associated with decreased cancer-specific survival. The IHC stainings used failed to show an association with neo-adjuvant chemotherapy response and overall or cancer specific survival. Conclusions Patients who do not respond to neo-adjuvant chemotherapy do significantly worse than responders. This study could not find clinical tools to distinguish responders from non-responders. Further studies preferably with larger cohorts addressing this issue are warranted to improve the selection of patients for neo-adjuvant chemotherapy.Peer reviewe

Yield, Quality and Nitrogen Use of Forage Maize under Different Nitrogen Application Rates in Two Boreal Locations

Research focusing on the nitrogen (N) application and N use of forage maize (Zea mays L.) in the boreal region is either limited or non-existent. The aim of this study was to investigate the response of yield, quality and N recovery efficiency (NRE) of forage maize to an increase in the N application rate and different climatic conditions in two locations in Finland. The field experiment was conducted in southern (Helsinki; 60° N) and central (Maaninka; 63° N) Finland in 2019 and 2020. Dry matter (DM) yield, forage quality and NRE were determined for N application rates of 100, 150 and 200 N kg ha−1. The DM yield was similar to all studied N application rates. Moreover, there were no marked differences in the studied forage quality traits or the NRE following the N application rates. However, the NRE of maize was generally low at 45%. The current study recommends a N application rate of 100–150 N kg ha−1 for forage maize in the boreal region. There is no need to increase the N application from current recommendations since climate conditions seem to limit the growth, development and NRE of forage maize. The observed low NRE of forage maize warrants further research in the future

Yield, Quality and Nitrogen Use of Forage Maize under Different Nitrogen Application Rates in Two Boreal Locations

Research focusing on the nitrogen (N) application and N use of forage maize (Zea mays L.) in the boreal region is either limited or non-existent. The aim of this study was to investigate the response of yield, quality and N recovery efficiency (NRE) of forage maize to an increase in the N application rate and different climatic conditions in two locations in Finland. The field experiment was conducted in southern (Helsinki; 60° N) and central (Maaninka; 63° N) Finland in 2019 and 2020. Dry matter (DM) yield, forage quality and NRE were determined for N application rates of 100, 150 and 200 N kg ha−1. The DM yield was similar to all studied N application rates. Moreover, there were no marked differences in the studied forage quality traits or the NRE following the N application rates. However, the NRE of maize was generally low at 45%. The current study recommends a N application rate of 100–150 N kg ha−1 for forage maize in the boreal region. There is no need to increase the N application from current recommendations since climate conditions seem to limit the growth, development and NRE of forage maize. The observed low NRE of forage maize warrants further research in the future

Interstitial cystitis: a rare manifestation of primary Sjögren’s syndrome, successfully treated with low dose cyclosporine

Chronic interstitial cystitis (IC), mostly affecting middle-aged women, is a very rare manifestation of primary Sjögren’s syndrome (pSS). Hereby, we report a 42-year-old woman with pSS, presenting with dysuria, urinary frequency, and suprapubic pain. She was diagnosed to have chronic IC, based upon the cystoscopic biopsy finding of chronic inflammation in the bladder wall. Systemic corticosteroid and azathioprine treatments together with local intravesical therapies were not effective. Therefore, cyclosporine (CSA) therapy was initiated. Initial low dose of CSA (1.5 mg/kg/d) improved the symptoms of the patient, with no requirement for dose increment. After 4 months of therapy, control cystoscopic biopsy showed that bladder inflammation regressed and IC improved. This case suggests that even low doses of CSA may be beneficial for treating chronic IC associated with pSS syndrome

Evaluation of Circulating Cardiovascular Biomarker Levels for Early Detection of Congenital Heart Disease in Newborns in Sweden

Congenital heart disease (CHD) is the most common congenital malformation in humans worldwide. Circulating cardiovascular biomarkers could potentially improve the early detection of CHD, even in asymptomatic newborns.\nTo assess the performance of a dried blood spot (DBS) test to measure the cardiovascular biomarker amino terminal fragment of the prohormone brain-type natriuretic peptide (NT-proBNP) levels in newborns and to compare DBS with standard EDTA analysis in control newborns during the first week of life.\nThis diagnostic study was conducted in a single regional pediatric service in southern Sweden. Healthy, term neonates born between July 1, 2018, and May 31, 2019, were prospectively enrolled and compared against retrospectively identified newborns with CHD born between September 1, 2003, and September 30, 2019. Neonates who required inpatient treatment beyond the standard postnatal care were excluded.\nNew DBS test for NT-proBNP quantification in newborns that used 3 μL of blood vs the current screening standard.\nPerformance of the new test and when combined with pulse oximetry screening was measured by receiver operating characteristic curve analysis. Performance of the new test and EDTA screening was compared using Pearson linear correlation analysis.\nThe DBS samples of 115 neonates (81 control newborns and 34 newborns with CHD, of whom 63 were boys [55%] and the mean [SD] gestational age was 39.6 [1.4] weeks) were analyzed. The new NT-proBNP test alone identified 71% (n = 24 of 34) of all CHD cases and 68% (n = 13 of 19) of critical CHD cases as soon as 2 days after birth. Detection of any CHD type improved to 82% (n = 28 of 34 newborns) and detection of critical CHD improved to 89% (n = 17 of 19 newborns) when combined pulse oximetry screening and NT-proBNP test results were used. Performance of the NT-proBNP test was excellent when control newborns were matched to newborns with CHD born between July 1, 2018, and May 31, 2019 (area under the curve, 0.96; SE, 0.027; 95% CI, 0.908-1.0; asymptotic P < .05).\nThis study found that NT-proBNP assay using minimal DBS samples appears to be timely and accurate in detecting CHD in newborns and to discriminate well between healthy newborns and newborns with various types of CHD. This finding warrants further studies in larger cohorts and highlights the potential of NT-proBNP to improve neonatal CHD screening.\nImportance\nObjectives\nDesign, Setting, and Participants\nExposure\nMain Outcomes and Measures\nResults\nConclusions and Relevanc

Perusopetuksen oppimisympäristöjen digitalisaation nykytilanne ja opettajien valmiudet hyödyntää digitaalisia oppimisympäristöjä

Tällä selvityksellä esitetään yleiskuva siitä, millainen on oppimisympäristöjen digitalisaation nykytilanne ja minkälaiset ovat opettajien valmiudet niiden hyödyntämiseen perusasteella. Selvitys toteutettiin verkkopohjaista Opeka-työkalua käyttäen ja saatua aineistoa täydennettiin kohderyhmien haastatteluilla. Kohdennettu haastattelu suoritettiin valituille sivistystoimenjohtajille, rehtoreille ja opettajille. Koulujen digitaalisuudessa ei ole suuria alueellisia eroja eri puolilla Suomea ja opettajat suhtautuvat pääosin (75 %) myönteisesti tieto- ja viestintäteknologian (TVT) käytön lisäämiseen omassa työssään. Opettajista noin puolet arvioi omaavansa perustason TVT:n käyttötaidot, viidenneksen kokiessa taitojensa olevan perustasoa paremmat. Selvityksen mukaan omien taitojen kehittämistäkin tarvitaan, noin 20 % vastaajista kokee osaamisessaan merkittäviä puutteita. Käytössä olevien laitteistojen tai välineistön määrä koetaan riittämättömäksi ja käytössä olevien laitteistojen laadussa nähdään olevan puutteita (60 %). Puolet vastaajista koki käytössään olevan internetyhteyden riittäväksi. Joka kolmannes vastaajista koki tyytymättömyyttä käytössään olevaan langattomaan verkkoon, osasta kouluja langaton verkko puuttuu edelleen. Uusi teknologia aiheuttaa myös stressiä lähes puolelle opettajista. Joustavat, innovatiiviset täydennyskoulutusratkaisut sekä teknisen ja pedagogisen tuen kehittäminen nousevat esiin tässäkin selvityksessä. Digitaalisuus ei ole itseisarvo, vaan väline kehittää koulutusta ja tarjota lapsille ja nuorille taitoja hyödyntää digitaalisuuden suomia mahdollisuuksia niin opiskelussa, työssä kuin vapaa-ajalla. Tätä raporttia täydentävät liite 1 haastatteluraportti sekä liite 2 raporttiin liittyviä taulukoita ja kuvioita

Lypsylehmien ruokinnan järjestäminen – pitkän aikavälin taloustarkastelu

Maatilan toimintaa kehitettäessä toimintavaihtoehtojen määrä kytkeytyy suunnittelun aikajänteeseen. Pitkälläaikavälillä on mahdollista tehdä paljon ja suuria muutoksia, mutta lyhyellä aikavälillä vaihtoehtojenmäärä voi olla hyvinkin rajoitettu. Kummallakin aikavälillä maatalousyrittäjän tavoitteena on tuottojen jakustannusten erotuksen maksimointi.Ruokinta vaikuttaa tuottojen suuruuteen, sillä eri rehuyhdistelmät muuttavat maitotuotoksen määrääja laatua. Lisäksi niillä on vaikutusta eläinten terveyteen. Maidontuotannossa ruokinta muodostaa keskeisenkustannuserän, joka vaihtelee ruokintavaihtoehdoittain. Kustannukset muodostuvat rehujen hankinnasta,käsittelystä ja eläinten ruokinnasta. Vaihtoehtoiset ruokintateknologiat muuttavat myös kustannussuhteita.Lehmän ruokinnan ja maitotuotoksen välisen yhteyden selvittäminen on haasteellinen tehtävä, sillävaihtoehtoisten ruokintakombinaatioiden määrä on suuri ja niiden ravitsemusfysiologiset vaikutuksetpoikkeavat toisistaan. Haasteellisuutta lisää myös se, että tarkasteluun on otettava mukaan maitotilan omienrehujen tuotanto ja siihen liittyvät prosessit (kasvifysiologia, maatalousteknologia jne.) ja niiden määräämätreunaehdot. Tutkimus on rajattu siten, että siinä tarkastellaan muutamia keskeisimpiä rehuja. Sisäruokintakaudenaikana karkearehuna käytetään tilalla tuotettua säilörehua, jota täydennetään väkirehulla(ohra-rypsirouheseos). Kasvukauden aikana kokoaikaisen sisäruokinnan lisäksi vaihtoehtoina on laidunnustai osittainen laidunnus, sillä laidun on lypsylehmälle luonnollista rehua.Tässä tutkimuksessa lypsylehmien ruokintaa tarkastellaan pitkän aikavälin taloudellisena optimointiongelmana.Tutkimuksessa luodaan lineaarinen optimointimalli, joka tekee mahdolliseksi tarkastellarehuntuotannon eri osatekijöitä talouden näkökulmasta. Mallilla verrataan eri toimintavaihtoehdoista saatavientuottojen ja kustannusten erotusta. Optimointimallin pohjana on Seppälän ym. (2002) laatima sisäruokintakaudenoptimointimalli, joka on päivitetty vastaamaan nykyistä tuotantoteknologiaa ja jota onlaajennettu kattamaan myös laidunkausi.Eri rehuyhdistelmien tuotosvaikutus on määritetty MTT:n tuotantokokeiden pohjalta, kuten mm.vähenevät rajatuotokset ja rehujen väliset korvautuvuussuhteet ja niihin liittyvät rajoitukset. MTT:n koetulostenpohjalta on määritetty säilörehun laadun (D-arvo) ja sadon (kg ka/ha) muutokset kasvukauden edetessäsekä kevätkorjuun ajoittumisen vaikutus syyssadon laatuun ja määrään. Teknologiset mahdollisuudetja rajoitteet perustuvat pääosin Työtehoseuran tutkimustuloksiin. Laidunkauden osalta responssit perustuvatMTT:n laidunkokeisiin ja TTS:n työnmenekkitutkimusten tuloksiin