Hospital admissions and surgical treatment of children with lower-limb deficiency in Finland

Background and Aims: There are no population-based studies about hospital admissions and need for surgical treatment of congenital lower-limb deficiencies. The aim is to assess the impact children with lower-limb deficiencies pose to national hospital level health-care system. Materials and Methods: A population-based study was conducted using the national Register of Congenital Malformations and Care Register for Health Care. All 185 live births with lower-limb deficiency (1993-2008) were included. Data on hospital care were collected until 31 December 2009 and compared to data on the whole pediatric population (0.9 million) live born in 1993-2008. Results: The whole pediatric population had annually on average 0.10 hospital admissions and the mean length of in-patient care of 0.3 days per child. The respective figures were 1.5 and 5.6 in terminal lower-limb amputations (n = 7), 1.1 and 3.9 in long-bone deficiencies (n = 53), 0.6 and 1.9 in foot deficiencies (n = 26) and 0.4 and 2.6 in toe deficiencies (n = 101). Orthopedic surgery was performed in 72% (5/7) of patients with terminal amputations, in 62% (33/53) of patients with long bone, in 58% (14/24) of patients with foot and in 25% (25/101) of patients in toe deficiencies. Half (54%) of all procedures were orthopedic operations. Conclusion: In congenital lower-limb deficiencies the need of hospital care and the number of orthopedic procedures is multiple-fold compared to whole pediatric population. The burden to the patient and to the families is markedly increased, especially in children with terminal amputations and long-bone deficiencies of lower limbs.Peer reviewe

Challenges in context-aware mobile language learning: the MASELTOV approach

Smartphones, as highly portable networked computing devices with embedded sensors including GPS receivers, are ideal platforms to support context-aware language learning. They can enable learning when the user is en-gaged in everyday activities while out and about, complementing formal language classes. A significant challenge, however, has been the practical implementation of services that can accurately identify and make use of context, particularly location, to offer meaningful language learning recommendations to users. In this paper we review a range of approaches to identifying context to support mobile language learning. We consider how dynamically changing aspects of context may influence the quality of recommendations presented to a user. We introduce the MASELTOV project’s use of context awareness combined with a rules-based recommendation engine to present suitable learning content to recent immigrants in urban areas; a group that may benefit from contextual support and can use the city as a learning environment

Association of NCF2, IKZF1, IRF8, IFIH1, and TYK2 with Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) is a complex trait characterised by the production of a range of auto-antibodies and a diverse set of clinical phenotypes. Currently, ∼8% of the genetic contribution to SLE in Europeans is known, following publication of several moderate-sized genome-wide (GW) association studies, which identified loci with a strong effect (OR>1.3). In order to identify additional genes contributing to SLE susceptibility, we conducted a replication study in a UK dataset (870 cases, 5,551 controls) of 23 variants that showed moderate-risk for lupus in previous studies. Association analysis in the UK dataset and subsequent meta-analysis with the published data identified five SLE susceptibility genes reaching genome-wide levels of significance (Pcomb<5×10−8): NCF2 (Pcomb = 2.87×10−11), IKZF1 (Pcomb = 2.33×10−9), IRF8 (Pcomb = 1.24×10−8), IFIH1 (Pcomb = 1.63×10−8), and TYK2 (Pcomb = 3.88×10−8). Each of the five new loci identified here can be mapped into interferon signalling pathways, which are known to play a key role in the pathogenesis of SLE. These results increase the number of established susceptibility genes for lupus to ∼30 and validate the importance of using large datasets to confirm associations of loci which moderately increase the risk for disease

Gastroschisis in Finland 1993 to 2014-Increasing Prevalence, High Rates of Abortion, and Survival: A Population-Based Study

Introduction The study aims to assess the changes in prevalence and mortality of gastroschisis, and to identify associated anomalies.Materials and Methods It is a population-based nationwide study. All gastroschisis cases were identified in the Finnish Register of Congenital Malformations and the Care Register for Health Care from 1993 to 2014 including live births, stillbirths, and terminations of pregnancy due to fetal anomalies. Associated anomalies were recorded, and analyzed, and prevalence and infant mortality were calculated.Results There were 320 cases of gastroschisis; 235 (73%) live births, 16 (5%) stillbirths, and 69 (22%) terminations of pregnancy. Live birth prevalence of gastroschisis in Finland was lower than generally reported (1.73 in 10,000). However, due to relatively high rates of abortion, our total prevalence of 2.57/10,000 was similar with other reports. The most common risk factor was young maternal age. Babies with gastroschisis were born prematurely, on average on the 36th week and most are delivered by caesarean section. There was a significant increasing trend in live birth prevalence (p = 0.0018). Overall infant mortality was 7.7% (18/235), 7.2% (16/222) in simple gastroschisis and 15% (2/13) in complex gastroschisis. Associated anomalies were rare both in aborted fetuses and neonates, and there was only one case with a chromosomal abnormality.Conclusion Gastroschisis is usually an isolated anomaly with increasing birth prevalence and excellent survival rates. Regardless of the good prognosis, the abortion rates in Finland are higher than previously reported, and we hypothesize this to be due to lack of appropriate antenatal counselling.</p

Reduced Number of Pediatric Orthopedic Trauma Requiring Operative Treatment during COVID-19 Restrictions: A Nationwide Cohort Study

Cited by: 28; All Open Access, Green Open AccessPeer reviewe

Reduced Number of Pediatric Orthopedic Trauma Requiring Operative Treatment during COVID-19 Restrictions: A Nationwide Cohort Study

Cited by: 28; All Open Access, Green Open AccessPeer reviewe

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

[11C]Flumazenil brain uptake is influenced by the blood-brain barrier efflux transporter P-glycoprotein

Background:

Omphalocele in Finland from 1993 to 2014: Trends, Prevalence, Mortality, and Associated Malformations-A Population-Based Study

Introduction The aim of this study is to assess the changes in prevalence, mortality and termination pregnancy of omphalocele, and to identify associated anomalies.Materials and Methods A population-based nationwide register study. All cases with omphalocele were identified in the Finnish Register of Congenital Malformations and the Care Register for Health Care from 1993 to 2014 including live births, stillbirths, and terminations of pregnancy due to fetal anomalies. Associated anomalies were recorded and analyzed, and perinatal and infant mortality and prevalence were calculated.Results There were 600 cases with omphalocele including 229 live births, 39 stillbirths, and 332 (55%) abortions. Birth prevalence in Finland was 1.96 per 10,000 births with no consistent trend over time. However, total prevalence was much higher (4.71/10,000) because more than half of these families chose option for the termination of pregnancy. Omphalocele is often complicated with other anomalies; most commonly chromosomal abnormalities (9.3%), heart defects (6.3%), central nervous system anomalies (3.0%), gastrointestinal, and urogenital malformations (both 2.0%). Proportion of chromosomal and central nervous system abnormalities were even higher in terminated pregnancies. Overall infant mortality was 22%. Total 1-year survival rates for isolated omphalocele, cases with multiple anomalies and neonates with chromosomal defects were 80, 88, and 17%, respectively.Conclusion Omphalocele is a rare congenital anomaly, often associated with other malformations. Our data suggest that isolated cases may be more common than previously thought. In the absence of chromosomal defects, survival is reasonably good. Regardless, more than half of these pregnancies are often terminated.</p

Maternal risk factors for gastroschisis: A population‐based case–control study

BackgroundGastroschisis is an open abdominal wall defect with low mortality but significant morbidity. The prevalence has been increasing worldwide for the past decades. Several risk factors for gastroschisis have been identified, but no clear reason for increasing prevalence has been found. In our study, we aimed to assess and identify maternal risk factors for gastroschisis.MethodsIn our nationwide register‐based case–control study, we identified all gastroschisis cases in the Finnish Register of Congenital Malformations from 2004 to 2014. Information on drug prescriptions and purchases was received from Drugs and Pregnancy database. Five healthy age‐matched controls from the same geographical region were randomly selected for each case. Conditional logistic regression was used to evaluate different risk factors.ResultsOne‐hundred‐eighty‐eight cases of gastroschisis were identified and compared with 910 matched controls. Nulliparity was a significant risk factor for gastroschisis, aOR 2.00 (95% CI 1.29–3.11) whereas obesity was protective, aOR 0.35 (95% CI 0.15–0.83). Smoking appeared to increase the risk for gastroschisis, aOR 1.32 (95% CI 0.88–1.97). The mean maternal age of newborns with gastroschisis was significantly lower than average (p  ConclusionAs in previous studies, nulliparity and young maternal age were significant risk factors for gastroschisis. Maternal obesity significantly reduced the risk of gastroschisis regardless of maternal age and gestational diabetes.</p