"Dinosaurusperhosen hullut päivät" : Päiväkodin arkea lasten näkökulmasta

Opinnäytetyömme on toiminnallinen projekti, joka keskittyy leikki-ikäisten lasten mielipiteiden, ajatusten ja kokemusten esille tuomiseen. Rajasimme käsiteltäväksi aiheeksi päivähoidon, mutta sen puitteissa lapset saivat vapaasti tuottaa mitä halusivat. Näkemyksemme mukaan lapsella päivähoidon ensisijaisena asiakkaana on oikeus saada äänensä kuuluviin päivähoitokeskusteluissa. Opinnäytetyömme teoreettisena viitekehyksenä on Leena Kurjen sosiokulttuurinen innostaminen, jossa painottuu yksilön oma aktiivisuus yhteisönsä toiminnassa. Innostamisen teoriaan perustuu myös toimintamme taustalla oleva lapsilähtöinen ajattelu. Opinnäytetyömme ensimmäisenä tavoitteena oli lasten ajatusten ja mielipiteiden esille tuominen ja huomioiminen lasten osallisuutta tukevan toiminnan avulla. Opinnäytetyömme toinen tavoite oli lasten maailman esille tuominen lasten kuvakirjan kautta. Käytimme toiminnassa työmenetelminämme sovellettua sadutusta, kuvallista ilmaisua ja leikkiä, mitkä tukevat lasten mielikuvitusta ja luovuutta. Kuvakirja antaa mahdollisuuden päivähoitotoiminnan kehittämiseen, kun lasten mielipiteet voidaan ottaa huomioon päivähoitoa suunniteltaessa. Toteutimme opinnäytetyömme toiminnan päiväkoti Meripirtissä neljä – viisivuotiaiden kanssa. Lapset pääsivät kertomaan omista päivähoitokokemuksistaan omalle ikä- ja kehitysvaiheelleen ominaisella tavalla: sadun kerronnan, maalaamisen, muovailun, piirtämisen ja leikkimisen kautta. Kuvakirjan teksteinä ovat lasten omat sadut, ja lasten dokumentoidusta leikistä poimitut keskustelut on koostettu tarinoiden muotoon. Kirjan kuvat ovat valokuvia lasten maalauksista, piirroksista ja muovailuhahmoista sekä lasten aidoista leikkitilanteista. Kuvakirja on kirjoitettu lasten kielellä, me kirjan kokoajat olemme kirjoittaneet ainoastaan esipuheen. Oivalsimme, että lasten kuvakirjan paras asiantuntija on lapsi itse ja että lasten kirjoittama kirja voi koskettaa lapsilukijoita tai -kuulijoita lähemmin. Kuvakirjaa lukeva aikuinen saa myös mahdollisuuden kurkistaa lapsen maailmaan uudella tavalla. ”Dinosaurusperhosen hullut päivät ja muita kertomuksia päiväkodista” – kirjassa lapset kertovat päiväkodista, siellä olevista ihmisistä ja muista hahmoista sekä päiväkodin arjen tilanteista. Kirjan kautta voi ymmärtää lasten ajatuksia, tunteita, kokemuksia, toiveita ja odotuksia päivähoidosta. Kuvakirjan raakaversio on osa opinnäytetyötämme. Opinnäytetyöprosessin aikana pääsimme käytännössä toteuttamaan lapsilähtöistä päivähoitotoimintaa. Saamamme palautteen perusteella toiminta oli lapsille mielekästä ja merkityksellistä. Tällaisen luovan projektin kautta on mahdollista antaa lasten äänen kuulua laajemminkin ja ottaa heidät mukaan päätöksentekoon aikuisten rinnalle.“Dinobutterfly’s Crazy Days” – Everyday life at a day-care centre from children’s perspective This thesis was an activity-oriented project that focused on making visible the viewpoints, thoughts and experiences of pre-school children concerning day care. The children were given the freedom to express themselves freely in terms of this subject matter. The thesis was based on the belief that as the key client of the day care system, the child has the right to be heard on matters regarding day care. The theoretical frame of reference of the thesis project was based on Leena Kurki’s sociocultural animation whereby a functioning society is based on an individual's personal initiative. As a part of such sociocultural animation, the thesis project placed emphasis on child-oriented philosophy. The main purpose of the thesis was to make visible and acknowledge the opinions and thoughts of the children with the help of such activities that promote children’s participation. Our secondary objective was to reveal the "child’s world" with the aid of a picture book the children themselves had made. In practice, this meant applying storycrafting, visual expression, and play – all of which support and promote child’s imagination and creativity. The picture book provides an opportunity to develop day care services, as it provides a chance to take into consideration childrens' perspectives when planning a day care system. The project took place at the day care centre Meripirtti, with 4- to 5-year-old children. The children had the opportunity to recall their own day care experiences with methods based on their specific age and developmental phase, namely by means of storytelling, painting, claymodeling, drawing, and play. The stories written in the picture book are by the children themselves. The book also contains documented dialogues of the children at play that have then been compiled into stories. The illustrations in the picture book are photographs of children’s paintings, drawings and clay models as well as genuine scenarios of children’s playtime. In essence, the picture book has been written in the language of children, and we, the compilers of the book, have only written the foreword. We realized that the best expert on a children’s picture book are the children themselves, and a book written by a child can reach other children on a more personal level. An adult reading the picture book can also get a fresh glimpse of the world according to a child. In the book “Dinobutterfly's Crazy Days and Other Tales from the Daycare” the children recall the people, other characters, and day-today situations at a day care centre. This picture book provides a means by which to appreciate childrens' thoughts, emotions, experiences, hopes, and expectations of day care. The first draft of the picture book is included as a part of our thesis. During this project, we were able to put into practice child-oriented day care activities. According to the feedback received, children found the activities enjoyable and meaningful. Through this kind of creative project, it is possible to allow children to be heard on a broader scale and include them in decision making alongside adults.Opinnäytetyön osana on lasten kuvakirjan raakaversio "Dinosaurusperhosen hullut päivät ja muita kertomuksia päiväkodista"

Applications of reprogrammability in algorithm acceleration

This doctoral thesis consists of an introductory part and eight appended publications, which deal with hardware-based reprogrammability in algorithm acceleration with a specific emphasis on the possibilities offered by modern large-scale Field Programmable Gate Arrays (FPGAs) in computationally demanding applications. The historical evolution of both the theoretical and technological paths culminating in the introduction of reprogrammable logic devices is first outlined. This is followed by defining the commonly used terms in the thesis. The reprogrammable logic market is surveyed, and the architectural structures and the technological reasonings behind them are described in detail. As reprogrammable logic lies between Application Specific Integrated Circuits (ASICs) and general-purpose microprocessors in the implementation spectrum of electronics systems, special attention has been paid to differentiate these three implementation approaches. This has been done to emphasize, that reprogrammable logic offers much more than just a low-volume replacement for ASICs. Design systems for reprogrammable logic are investigated, as the learning curve associated with them is the main hurdle for software-oriented designers for using reprogrammable logic devices. The theoretically important topic of partial reprogrammability is described in detail, but it is concluded, that the practical problems in designing viable development platforms for partially reprogrammable systems will hinder its wide-spread adoption. The main technical, design-oriented, and economic applicability factors of reprogrammable logic are laid out. The main advantages of reprogrammable logic are their suitability for fine-grained bit-level parallelizable computing with a short time-to-market and low upfront costs. It is also concluded, that the main opportunities for reprogrammable logic lie in the potential of high-level design systems, and the ever-growing ASIC design gap. On the other hand, most power-conscious mass-market portable products do not seem to offer major new market potential for reprogrammable logic. The appended publications are examined and compared to contemporaneous research at other research institutions. The conclusion is that for relatively wide classes of well-defined computation problems, reprogrammable logic offers a more efficient solution than a software-centered approach, with a much shorter production cycle than is the case with ASICs.reviewe

Chronic Subdural Hematoma : Epidemiology, Mortality and Risk of Recurrence

Chronic subdural hematoma (CSDH) is a common neurosurgically treated disorder. CSDH is typically initiated by a minor head trauma which leads to a collection of blood between the dura mater and arachnoid mater. Symptomatic CSDHs are operatively treated. The first study of this thesis is a retrospective observational study. We aimed to assess whether the postoperative use of a subdural drain had reduced the rate of reoperation. The second and third study are nationwide register-based analyses. In the second study, we assessed one-year case-fatality after CSDH surgery in older patients with a pre-existing diagnosis of dementia. We searched controls matched for age, sex, and year of dementia diagnosis but without a diagnosis of CSDH. In the third study, we assessed the incidence of CSDH surgeries in adult patients in Finland during 1997–2014. When patients were treated without a subdural drain, recurrence occurred in 18% of patients. When a subdural drain was used, 6% of patients had a recurrence. Dementia was independently associated with one-year case-fatality among older patients. One-year mortality was 26% for those undergoing CSDH surgery with pre-existing dementia, whereas mortality was 16% for those having dementia but no CSDH. The age-standardized incidence of CSDH surgery increased from 12.2. to 16.5 per 100,000 person-years from 1997 to 2014. The age- and sex-adjusted incidence increased by 30%, and the incidence increased more in the older age groups. The incorporation of subdural drain use resulted in lower recurrence rates with no difference in functional outcome or complications. For older patients, dementia is a risk factor for one-year mortality after CSDH surgery. The age- and sex-adjusted incidence of CSDH surgery increased significantly in Finland during the past two decades. We expect the increase to continue as the population ages. Furthermore, we planned and executed a national multicenter randomized controlled trial. In this study, we assess the impact of intraoperative irrigation during a CSDH surgery on reoperation rates. The recruitment was finished in August 2022, and the results will be published in 2023. The protocol article of the study is included in this thesis.Krooninen subduraalihematooma on yleinen neurokirurgisesti hoidettava sairaus. Taustalla on usein trauma, joka johtaa kovakalvon ja lukinkalvon väliseen verikertymään. Mikäli hematooma aiheuttaa oireita, hoitona on leikkaus. Tämän väitöskirjan ensimmäinen osatyö on takautuva havaintotutkimus. Tavoitteena oli selvittää, kuinka leikkauksessa asetettavan subduraalidreenin kliininen käyttö oli vaikuttanut uusintaleikkausten määrään. Toinen ja kolmas osatyö ovat kansallisia rekisteriperustaisia tutkimuksia. Toisessa osatyössä tutkimme kuolleisuutta vuoden aikana leikkauksen jälkeen yli 60-vuotiailla potilailla, joilla oli dementia. Haimme dementiaa sairastaville tapauksille iän, sukupuolen ja dementiadiagnoosin vuoden perusteella kaltaistetut verrokit, joilla ei ollut kroonista subduraalihematoomaa. Kolmannessa osatyössä tutkimme kroonisen subduraalihematooman leikkauksen ilmaantuvuutta Suomessa vuosina 1997–2014. Ilman subduraalidreeniä hoidettaessa uusintaleikkaukseen joutui 18 % potilaista, kun taas dreenin kanssa uusiutumisia oli 6 %. Dementia oli iäkkäillä potilailla itsenäisesti yhteydessä yhden vuoden kuolleisuuteen. Iäkkäillä potilailla, joilla oli aikaisempi dementiadiagnoosi, kuolleisuus oli kroonisen subduraalihematooman leikkaushoidon jälkeen 26 %. Kaltaistettujen verrokkien kuolleisuus oli 16 %. Kroonisen subduraalihematooman leikkauksen ikävakioitu ilmaantuvuus nousi 12,2:sta 16,5:een 100 000 henkilövuotta kohden vuosien 1997–2014 aikana. Ikä- ja sukupuolivakioitu ilmaantuvuus nousi 30 % ja ilmaantuvuus nousi enemmän iäkkäimmillä potilailla. Tutkimuksen perusteella subduraalidreenin käyttöönotto johti uusintaleikkausten määrän vähenemiseen, mutta ei vaikuttanut toimintakykyyn tai komplikaatioihin. Dementia on iäkkäillä potilailla riskitekijä kuolleisuudelle kroonisen subduraalihematooman leikkaushoidon jälkeen. Kroonisen subduraalihematooman leikkauksen ikä- ja sukupuolivakioitu ilmaantuvuus on noussut Suomessa viimeisten kahden vuosikymmenen aikana. Väestön ikääntyessä odotamme taudin ilmaantuvuuden kasvavan edelleen. Lisäksi suunnittelimme ja toteutimme kansallisen satunnaistetun yhdenveroisuustutkimuksen, jossa arvioimme leikkauksessa tehtävän huuhtelun vaikutusta uusintaleikkausten määrään. Tutkimuksen rekrytointi päättyi elokuussa 2022 ja julkaisemme tulokset vuonna 2023. Tutkimuksen protokolla-artikkeli on osa tätä väitöskirjaa

A fully pipelined memoryless 17.8 Gbps AES-128 encryptor

A fully pipelined implementation of the Advanced Encryption Stan-dard encryption algorithm with 128-bit input and key length (AES-128) was implemented on Xilinx ’ Virtex-E and Virtex-II devices. The design is called SIG-AES-E and it implements the S-boxes combinatorially and thus requires no internal memory. It is con-cluded, that SIG-AES-E is faster than other published FPGA-based implementations of the AES-128 encryption algorithm. Categories and Subject Descriptor

Geenit ATM, RAD50 ja p53 rintasyövässä

Breast cancer is the most commonly occurring cancer among women, and its incidence is increasing worldwide. Positive family history is a well established risk factor for breast cancer, and it is suggested that the proportion of breast cancer that can be attributed to genetic factors may be as high as 30%. However, all the currently known breast cancer susceptibility genes are estimated to account for 20-30% of familial breast cancer, and only 5% of the total breast cancer incidence. It is thus likely that there are still other breast cancer susceptibility genes to be found. Cellular responses to DNA damage are crucial for maintaining genomic integrity and preventing the development of cancer. The genes operating in DNA damage response signaling network are thus good candidates for breast cancer susceptibility genes. The aim of this study was to evaluate the role of three DNA damage response associated genes, ATM, RAD50, and p53, in breast cancer. ATM, a gene causative for ataxia telangiectasia (A-T), has long been a strong candidate for a breast cancer susceptibility gene because of its function as a key DNA damage signal transducer. We analyzed the prevalence of known Finnish A-T related ATM mutations in large series of familial and unselected breast cancer cases from different geographical regions in Finland. Of the seven A-T related mutations, two were observed in the studied familial breast cancer patients. Additionally, a third mutation previously associated with breast cancer susceptibility was also detected. These founder mutations may be responsible for excess familial breast cancer regionally in Northern and Central Finland, but in Southern Finland our results suggest only a minor effect, if any, of any ATM genetic variants on familial breast cancer. We also screened the entire coding region of the ATM gene in 47 familial breast cancer patients from Southern Finland, and evaluated the identified variants in additional cases and controls. All the identified variants were too rare to significantly contribute to breast cancer susceptibility. However, the role of ATM in cancer development and progression was supported by the results of the immunohistochemical studies of ATM expression, as reduced ATM expression in breast carcinomas was found to correlate with tumor differentiation and hormone receptor status. Aberrant ATM expression was also a feature shared by the BRCA1/2 and the difficult-to-treat ER/PR/ERBB2-triple-negative breast carcinomas. From the clinical point of view, identification of phenotypic and genetic similarities between the BRCA1/2 and the triple-negative breast tumors could have an implication in designing novel targeted therapies to which both of these classes of breast cancer might be exceptionally sensitive. Mutations of another plausible breast cancer susceptibility gene, RAD50, were found to be very rare, and RAD50 can only be making a minor contribution to familial breast cancer predisposition in UK and Southern Finland. The Finnish founder mutation RAD50 687delT seems to be a null allele and may carry a small increased risk of breast cancer. RAD50 is not acting as a classical tumor suppressor gene, but it is possible that RAD50 haploinsufficiency is contributing to cancer. In addition to relatively rare breast cancer susceptibility alleles, common polymorphisms may also be associated with increased breast cancer risk. Furthermore, these polymorphisms may have an impact on the progression and outcome of the disease. Our results suggest no effect of the common p53 R72P polymorphism on familial breast cancer risk or breast cancer risk in the population, but R72P seems to be associated with histopathologic features of the tumors and survival of the patients; 72P homozygous genotype was an independent prognostic factor among the unselected breast cancer patients, with a two-fold increased risk of death. These results present important novel findings also with clinical significance, as codon 72 genotype could be a useful additional prognostic marker in breast cancer, especially among the subgroup of patients with wild-type p53 in their tumors.Rintasyöpä on naisten yleisin syöpä teollistuneissa maissa: Suomessa jopa joka yhdeksäs nainen sairastuu elinaikanaan rintasyöpään. Yksi suurimpia rintasyövän riskitekijöitä on rintasyövän esiintyminen suvussa. Jopa kolmanneksen kaikista rintasyövistä uskotaan syntyvän perinnöllisen alttiuden seurauksena, mutta nykyisin tunnetut alttiusgeenit kattavat kuitenkin vain noin 5 % rintasyövistä. Koska suurin osa näistä geeneistä toimii DNA:n korjauksessa, myös uusia alttiusgeenejä on perusteltua etsiä DNA:n korjausgeenien joukosta. Näiden geenien muutoksilla voi olla vaikutusta paitsi sairastumisriskiin myös syövän etenemiseen ja potilaan ennusteeseen. Tässä työssä tutkittiin kolmen DNA:n vauriokorjaukseen liittyvän geenin, ATM:n, RAD50:n ja p53:n, osuutta rintasyövässä. ATM, jonka mutaatiot aiheuttavat harvinaisen taudin, ataxia telangiectasian (A-T), on pitkään ollut vahva ehdokas rintasyöpäalttiusgeeniksi, sillä se on DNA:n korjausmekanismien keskeinen säätelijä. Tutkimme suomalaisten A-T-mutaatioiden esiintyvyyttä suomalaisissa rintasyöpäsuvuissa ja valikoimattomilla rintasyöpäpotilailla. Lisäksi etsimme muita ATM-geenin muutoksia eteläsuomalaisilta rintasyöpäpotilailta. Sekä A-T-mutaatiot että muut ATM-geenin muutokset olivat hyvin harvinaisia (kunkin esiintyvyys alle 1 %). Kolmea A-T-mutaatiota esiintyi pohjois- ja keskisuomalaisissa rintasyöpäsuvuissa, ja nämä alueelliset mutaatiot saattavat vaikuttaa suvuittaisen rintasyövän esiintymiseen näillä alueilla, mutta Etelä-Suomessa ATM-geenin muutoksilla ei näytä olevan juurikaan vaikutusta rintasyövän esiintymiseen. Tutkimme myös ATM-geenin ilmentymistä rintasyöpäkasvaimissa, ja havaitsimme, että geenin ilmentyminen on alentunut etenkin hormonireseptorinegatiivisissa ja huonommin erilaistuneissa kasvaimissa. Lisäksi ATM:n ilmenemisen alentuminen on yleisempää BRCA1- ja BRCA2-geenien ituratamutaatioiden kantajien kasvaimissa kuin muissa rintasyövissä, samoin vaikeahoitoisissa reseptorinegatiivisissa rintasyövissä. Tällä havainnolla voi olla kliinistä merkitystä uusia rintasyövän hoitomuotoja kehitettäessä. Tutkimme myös toisen DNA:n korjausgeenin, RAD50:n, muutosten esiintymistä englantilaisissa ja suomalaisissa rintasyöpäsuvuissa. Kaikkiaan RAD50-geenin muutokset olivat hyvin harvinaisia sekä englantilaisissa että suomalaisissa suvuissa ja niiden vaikutus perinnölliseen rintasyöpäalttiuteen jää hyvin pieneksi kummassakin väestössä. p53-geenin yleisellä polymorfismilla (p53 R72P) ei tulostemme mukaan ole vaikutusta rintasyöpäriskiin, mutta eri genotyypit yhdistyivät kasvainten erilaiseen histologiaan ja erilaistumiseen. Havaitsimme myös, että genotyypiltään PP-homotsygooteilla rintasyöpäpotilailla on merkitsevästi huonompi eloonjäämisennuste verrattuna muihin genotyyppeihin. PP-genotyyppi oli monimuuttuja-analyysissa itsenäinen ennustetekijä ja riippumaton myös p53-geenin ilmentymisestä kasvaimissa: PP-genotyyppiin liittyi muihin genotyyppeihin nähden kaksinkertainen riski kuolla rintasyöpään. Jos havaintomme voidaan vahvistaa myöhemmissä tutkimuksissa, sillä voi olla myös kliinistä merkitystä potilaiden ennustetta laadittaessa ja hoitoa suunniteltaessa

Transition of a Clinical Practice to Use of Subdural Drains after Burr Hole Evacuation of Chronic Subdural Hematoma : The Helsinki Experience

BACKGROUND: A number of randomized controlled trials have shown the benefit of drain placement in the operative treatment of chronic subdural hematoma (CSDH); however, few reports have described real-life results after adoption of drain placement into clinical practice. We report the results following a change in practice at Helsinki University Hospital from no drain to subdural drain (SD) placement after burr hole craniostomy for CSDH. METHODS: We conducted a retrospective observational study of consecutive patients undergoing burr hole craniostomy for CSDH. We compared outcomes between a 6-month period when SD placement was arbitrary (Julye December 2015) and a period when SD placement for 48 hours was routine (July-December 2017). Our primary outcome of interest was recurrence of CSDH necessitating reoperation within 6 months. Patient outcomes, infections, and other complications were assessed as well. RESULTS: A total of 161 patients were included, comprising 71 (44%) in the drain group and 90 (56%) in the non-drain group. There were no significant differences in age, comorbidities, history of trauma, or use of antithrombotic agents between the 2 groups (P > 0.05 for all). Recurrence within 6 months occurred in 18% of patients in the non-drain group, compared with 6% in the drain group (odds ratio, 0.28; 95% confidence interval, 0.09-0.87; P = 0.028). There were no differences in neurologic outcomes (P = 0.72), mortality (P = 0.55), infection rate (P = 0.96), or other complications (P = 0.20). CONCLUSIONS: The change in practice from no drain to use of an SD after burr hole craniostomy for CSDH effectively reduced the 6-month recurrence rate with no effect on patient outcomes, infections, or other complications.Peer reviewe

An efficient hardware architecture for a neural network activation function generator

This paper proposes an efficient hardware architecture for a function generator suitable for an artificial neural network (ANN). A spline-based approximation function is designed that provides a good trade-off between accuracy and silicon area, whilst also being inherently scalable and adaptable for numerous activation functions. This has been achieved by using a minimax polynomial and through optimal placement of the approximating polynomials based on the results of a genetic algorithm. The approximation error of the proposed method compares favourably to all related research in this field. Efficient hardware multiplication circuitry is used in the implementation, which reduces the area overhead and increases the throughput

FEM-simulations of Tailored 3D Pressure Fields for US-assisted Oleogel Crystallization

Due to their high content of unsaturated fatty acids and controllable mechanical properties, oleogels show promise as a replacement for traditional fats in food products. Controlling the oleogel formation with ultrasound makes it possible to tune the mechanical properties of oleogels, e.g., improving their structural stability and/or mouthfeel. We previously demonstrated tuning of mechanical properties of oleo gels by ultrasonic standing waves (USW) in a closed chamber. Our previous USW chamber only allowed 1D control of the pressure field. To properly tailor the oleogel properties, a more sophisticated chamber design and pressure field control technique is required. A new design for USW chamber and the frequency-domain time-reversal technique for field control were studied via simulations. We show that the proposed technique can create tailored USW fields inside a chamber filled with oil. Further, we show results of particle tracing simulations, and compare the idealized model with realistic phased arrays of transducers, to determine the requirements for the arrays to achieve a suitable resolution for shaping the field.Peer reviewe

Preterm birth, neonatal therapies and the risk of childhood cancer

Our aim was to study the impact of preterm birth and neonatal therapies on the risk of childhood cancer using a nationwide, registry-based, case-control design. Combining population-based data from Finnish Medical Birth Registry (MBR) and Finnish Cancer Registry, we identified a total of 2029 patients diagnosed with cancer under the age of 20 years and 10 103 age- and sex-matched controls over the years 1996 to 2014. Information on the prenatal and perinatal conditions was obtained from the MBR. Gestational age was categorized into early (= 37 weeks). Cancer risk among the preterm compared to term neonates was evaluated using conditional logistic regression. We identified 141 cancers among the preterm (20.8% of 678) vs 1888 cancers in the term children (16.5% of 11 454). The risk of any cancer was increased for the preterm (odds ratio [OR] 1.28, 95% confidence interval [CI] 1.06-1.57), especially for the early preterm (OR 1.84, 95% CI 1.16-2.92). The risk of acute myeloid leukemia (AML; OR 2.33, 95% CI 1.25-4.37), retinoblastoma (OR 3.21, 95% CI 1.22-8.41) and germ cell tumors (OR 5.89, 95% CI 2.29-15.18) was increased among the preterm compared to term. Germ cell tumors were diagnosed at a significantly younger age among the preterm. Neonatal therapies, for example, mechanical ventilation, were associated with an increased risk of childhood cancer independent of gestational age. Preterm, especially early preterm birth, is associated with an increased risk of childhood cancer, especially germ cell tumors and AML. Respiratory distress requiring neonatal intervention also appears to be associated with an increased risk.Peer reviewe