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Enhancing pediatric robotic pyeloplasty with a no-touch urothelium approach : a case series
No full textBackgroundRobotic-assisted laparoscopic surgery has advanced minimally invasive urology. However, the absence of haptic feedback may increase the risk of tissue trauma. This case series evaluates a no-touch technique in robotic-assisted pyeloplasty to minimize urothelial handling and assess its feasibility and short-term outcomes.MethodsThis retrospective case series reviewed 20 pediatric patients with ureteropelvic junction obstruction treated with robotic-assisted pyeloplasty between 2019 and 2022. In 10 cases, a no-touch urothelium approach was applied to minimize direct tissue handling. Patient selection, surgical details, perioperative outcomes, and follow-up at 6 and 12 months were documented.ResultsThe no-touch approach was successfully implemented in all cases without intraoperative complications. Median console time was 98 min (IQR: 81-131). Postoperative outcomes were favorable, with significant improvement or resolution of hydronephrosis in all cases. No major complications occurred, and no anastomotic strictures were observed during follow-up.ConclusionsThe no-touch technique in robotic-assisted pyeloplasty is a feasible approach that maintains surgical efficiency while minimizing direct urothelial handling. Further studies with larger sample sizes and longer follow-up are needed to validate its potential benefits.Trial registrationThis study was approved by the Institutional Review Board of New Children's Hospital, Helsinki University Hospital (permit nr 5485), Finland.Peer reviewe
Influence of bark beetle infestation on stem diameter dynamics
No full textBark beetle epidemics have increased globally due to drought and a warming climate, impairing forest ecosystem services by inducing severe forest disturbances. Bark beetle infestation monitoring is urgently needed for pre-emptive forest management. However, we have a lack of thorough understanding of the physiological responses that occur on trees after a bark beetle infestation. More specifically, we need insights into how quickly trees decline post-infestation and how the rate of tree decline relates to the bark beetle brood development. To increase understanding of trees’ physiological responses to bark beetle infestation, we monitored stem diameter variations at 15-minute intervals across 31 healthy and 26 infested mature Norway spruces affected by the European spruce bark beetle (Ips typographus L.) in Southern Finland. We observed that the infestation led to reduced or negligible growth, followed by a sudden decline in stem diameter. Using dendrometer data, we also established a point of ceased stem expansion for trees affected by bark beetle infestation, serving as a proxy for the tree's physiological response. This allowed us to explore the duration between the infestation date and the onset of tree decline. We observed considerable temporal variation in the physiological response of trees to the bark beetle infestation. The timing of the point of ceased stem expansion ranged from 15 to 81 days after the onset of the simulated infestation date, with a mean of 46.8 days. Only 58 % of the trees showed a point of ceased stem expansion before the bark beetle brood development was completed. This suggests that trees may take longer to respond to the infestation than it takes for the bark beetle brood to develop. Considerable temporal variation in tree response to the bark beetle infestation was observed, which calls for more research to understand the temporal dynamics of the tree's response to bark beetle infestations.Peer reviewe
Development of a Mathematics Vocabulary Test: Evidence of Validity and Reliability in a Multilingual Context
No full textThe aim of this study was to develop the Mathematics Vocabulary Test (MVT)-an instrument to identify young children with a limited mathematics vocabulary-in a multilingual majority country-South Africa. This study consists of two substudies with children aged 3-8.5 years (N = 988, n(girls) = 429). In Study 1, a 26-item MVT was developed by multiprofessional expert panels and piloted in four languages, isiZulu (n = 229), Sesotho (n = 83), English (n = 89), and Afrikaans (n = 216). Study 1 provided evidence of content validity, and the MVT was further revised based on the results. In Study 2, additional samples were assessed with the revised version of the MVT in English (Stage 1, n = 270) and isiZulu (Stage 2, n = 101) to provide further evidence of reliability and validity for these two language versions of the test. Confirmatory factor analyses supported structural validity of a unidimensional structure, including 20 items in the English version and 16 items in the isiZulu version. The structure of the English MVT showed stability across time (T2 5 months after T1). Both versions showed good reliability in terms of internal consistency. Our findings also provided evidence of concurrent and known-group validity for both language versions, as well as predictive validity of the English version of the test. The English and isiZulu MVT can be used as a measure of mathematics vocabulary in educational practice and research with young children.Peer reviewe
Liikesalaisuuden suoja ja aineellisen totuuden selvittäminen – ristiriita ja punninta siviiliasian oikeudenkäynnissä
No full textLiikesalaisuus määritellään liikesalaisuuslain 2 §:ssä, jonka mukaan liikesalaisuutena suojatun tiedon tulee olla salaista, tiedon haltijan on tullut tehdä kohtuullisia toimenpiteitä sen salassa pitämiseksi, ja tiedolla tulee olla taloudellista arvoa. Oikeudenkäynnissä voi syntyä ristiriita liikesalaisuuden suojan ja aineellisen totuuden selvittämistä koskevan tavoitteen välillä, sillä aineellisen totuuden tavoitteen saavuttaminen edellyttää usein laajaa ja kattavaa todistelua, mikä taas voi johtaa siihen, että liikesalaisuus tulee paljastaa oikeudenkäynnin aikana.
Tutkielmassa tarkastellaan tätä ristiriitaa ja tasapainottelua siviiliasian oikeudenkäynnissä kolmen keskeisen tutkimuskysymyksen kautta. Ensiksi vastataan kysymykseen siitä, kenelle oikeudenkäymiskaaren 17 luvun 19 § antaa päätösvallan todistamista koskevassa asiassa. Toiseksi vastataan edellisen pohjalta kysymykseen siitä, onko todistajan todistamista liikesalaisuudesta koskevasta tiedosta pidettävä liikesalaisuuden oikeudettomana ilmaisemisena. Kolmantena ja tutkielman kokoavana kysymyksenä vastataan siihen, voidaanko tutkielman kaksi keskeistä tavoitetta, liikesalaisuuksien suoja ja aineellisen totuuden tavoite, sovittaa yhteen siten, että molemmat toteutuvat tasapainoisesti.
Tässä kontekstissa erityisesti Suomen oikeusjärjestelmän säädökset, kuten oikeudenkäymiskaaren 17 luvun 19 §:n mukainen vaitiolo-oikeus liikesalaisuudesta herättävät kysymyksiä liikesalaisuuden suojaamisen ja oikeudenkäynnin tavoitteiden tasapainottamisesta. Myös uusi lainsäädäntö, kuten EU:n liikesalaisuusdirektiivi (EU) 2016/943) ja sen pohjalta säädetty liikesalaisuuslaki (595/2018), ovat tuoneet uusia mekanismeja, mutta niiden soveltaminen oikeudenkäynneissä on jäänyt käytännön tasolla vielä epäselväksi.
Tutkielmassa hyödynnetään metodista pluralismia, yhdistäen oikeusdogmaattista eli lainopillista menetelmää sekä vertailevaa oikeustutkimusta. Oikeusvertailun avulla tarkastellaan muiden EU-jäsenvaltioiden ja Yhdysvaltojen lainsäädäntöä ja käytäntöjä liikesalaisuuksien suojaamisessa, tunnistaen eroja ja yhtäläisyyksiä Suomen lainsäädäntöön nähden. Näiden metodien avulla tutkielmassa esitetään kannanottoja de lege ferenda lainsäädännön kehittämiseksi.
Tutkimustulosten valossa päätösvalta todistamisesta on aina todistajalla, mutta todistaminen ilman tuomioistuimen velvoitetta aiheuttaa todistajalle riskin vastuun syntymisestä ja todistaminen voi tulla arvioiduksi liikesalaisuuslain 4 §:n mukaisena liikesalaisuuden oikeudettomana ilmaisemisena. Esitöistä ilmenevä lainsäätäjän tarkoitus on ollut, että todistajan päätösvalta olisi itsenäinen. Tämä ei kuitenkaan ilmene voimassa olevasta OK 17:19:sta. Tämän vuoksi tutkielmassa ehdotetaan de lege ferenda, että OK 17:19:ää tulisi jatkaa siten, että "todistajan päätösvalta todistamisesta on itsenäinen, eikä sitä voida rajoittaa yksityisoikeudellisilla järjestelyillä”. Tutkielmassa lopulta tullaan kuitenkin siihen johtopäätökseen, että tosiasiallisesti päätösvalta on tavallaan jaettu todistajan, tuomioistuimen ja liikesalaisuuden haltijan kesken.
Tutkielmassa ehdotetaan käyttökelpoisimpana ratkaisuna liikesalaisuuden suojan ja aineellisen totuuden tavoittamisen tasapainottamiseen Yhdysvalloissa käytettyä Special Master -järjestelyä, jossa tuomioistuin nimittää riippumattoman asiantuntijan arvioimaan liikesalaisuuksia koskevia kysymyksiä. Ehdotettu järjestely voitaisiin ottaa käyttöön olemassa olevan lainsäädännön pohjalta, erityisesti OK 17 luvun 24 §:n edellytysten mukaisesti, jolloin asiantuntijan käyttö olisi mahdollista, mikäli osapuolet niin sopivat tai tuomioistuin sen erityisestä syystä sallii
Niche exploitation profiles predict the palaeoclimate of tropical mammal communities
No full textPeer reviewe
Exploring microscale heterogeneity as a driver of biogeochemical transformations and gas transport in peat
No full textPeer reviewe
Social support and online interaction and their links to psychosocial well-being among Nordic adolescents: Integrating variable-centered and person-centered approaches
No full textThe Nordic countries are among the most digitally advanced societies in the world. Past research suggests that both social support offline and interaction online are linked to adolescent psychological adjustment. However, less is known regarding the complex implications of distinctive sources of social support offline and online interaction for a broader range of indices of adolescent psychosocial well-being, including its contemporary forms such as social media addiction. This study utilized two methodological approaches to examine the social components and determinants of psychosocial well-being (psychosomatic complaints and problematic social media use) among 22,384 Nordic adolescents aged between 11 and 15 years. A variable-centered approach focused on examining perceived support from four sources (family, peers, teachers, and classmates), preference for online interaction, and intensity of online interaction as predictors of psychosocial well-being. Concurrently, a person-centered approach was utilized to explore the subgroups at risk of psychosocial ill-being. In the variable-centered analysis, lower support from family, teachers, and classmates, higher preference for online interaction, and higher intensity of online interaction with “online contacts” (i.e., interaction partners met online) were linked to higher levels of psychosomatic complaints and more problematic social media use. Additionally, lower peer support was associated with increased psychosomatic complaints, while greater intensity of online interaction with “offline contacts” (e.g., close friends, parents) was related to more problematic social media use. The person-centered analysis identified five profiles of adolescents: (1) “Multiply supported online users” (56%), (2) “Primarily (family-peer) supported high online users” (22%), (3) “Non-supported online users” (13%), (4) “Primarily non-supported online users” (5%), and (5) “Non-supported high online users” (4%). Adolescents reporting higher support from multiple sources and moderate online interaction with offline contacts experienced the lowest levels of psychosomatic complaints and the least problematic social media use, while the other profiles exhibited more complex and less optimal psychosocial well-being. In conclusion, these findings suggest that adolescents benefit most from robust social support offline across multiple social networks, but strong support from certain sources (teachers, classmates) can somewhat mitigate the adverse effects of low support from other sources (family, peers). The relationship between online interaction and psychosocial well-being is contingent on the level of social support.Peer reviewe
Individual and parental housing tenure and mental healthcare use among Finnish men and women in early mid-adulthood
No full textHomeownership is a valuable status associated with better mental health outcomes than being a tenant. However, research has yet to investigate the role of duration and past experiences of homeownership, particularly in a context where homeownership is getting harder to achieve, especially for younger working-age adults. We estimate how individual and parental housing tenure is associated with mental healthcare use based on random-effect logit models using Finnish National Registers for residents born in 1972–1975. Mental healthcare use is measured through medication purchases and hospital visits for mental health reasons at ages 35 to 41. Parental housing tenure is observed at age 15, and individual housing tenure is measured annually from age 35 to 41. Analyses also address previous mental healthcare use (observed at age 20 to 35) and various health-related, demographic and socioeconomic covariates that are either time-varying (observed at ages 35–41) or time-constant (age 35). Results show that individual homeownership is associated with lower mental healthcare use independently of other socioeconomic factors (education, income and occupational status), even for individuals without previous mental healthcare use. Results stratified by parental housing tenure show that those who grew up as homeowners –– who might value homeownership more than those who grew up as tenants –– and those with separated or lone parents –– who might be more socioeconomically deprived and benefit more from family wealth in the future –– profited most from homeownership. The role of homeownership duration is minimal compared to the gap between owners and tenants. Parental homeownership is also associated with less mental healthcare use in the early mid-adulthood net of individual social characteristics. The results highlight the role of past and present homeownership histories and intergenerational continuities as a central mental health determinant that is independent of other socioeconomic and demographic factors.Peer reviewe