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Objective: MEN1 is associated with an increased risk of developing tumors in different endocrine organs. Neuroendocrine tumors of the thymus (TNETs) are very rare but often have an aggressive nature. We evaluated patients with MEN1 and TNET in three university hospitals in Finland. Design/Methods: We evaluated patient records of 183 MEN1-patients from three university hospitals between the years 1985–2019 with TNETs. Thymus tumor specimens were classified according to the new WHO 2021 classification of TNET. We collected data on treatments and outcomes of these patients. Results: There were six patients (3.3%) with MEN1 and TNET. Five of them had the same common gene mutation occurring in Finland. They originated from common ancestors encompassing two pairs of brothers from sequential generations. The mean age at presentation of TNET was 44.7 ± 11.9 years. TNET was classified as atypical carcinoid (AC) in five out of six patients. One patient had a largely necrotic main tumor with very few mitoses and another nodule with 25 mitoses per 2 mm2, qualifying for the 2021 WHO diagnosis of large cell neuroendocrine carcinoma (LCNEC). In our patients, the 5-year survival of the TNET patients was 62.5% and 10-year survival 31.3%. Conclusion: In this study, TNETs were observed in one large MEN1 founder pedigree, where an anticipation-like earlier disease onset was observed in the most recent generation. TNET in MEN1 patients is an aggressive disease. The prognosis can be better by systematic screening. We also show that LCNEC can be associated with TNET in MEN1 patients.

Hierarchical surfaces that aid in the droplet nucleation, growth, and removal is highly desirable for fog and moisture harvesting applications. Taking inspiration from the unique architecture of leaf skeletons, we present a multiscale surface capable of rapidly nucleating, growing, and directional transport of the water droplets. Copper oxide microtufts were fabricated onto the Ficus religiosaleaf skeletons via electroplating and chemical oxidation techniques. The fabricated surfaces with microtufts had high wettability and very good fog harvesting ability. CuO surfaces tend to become hydrophobic over time because of the adsorption of the airborne species. The surfaces were efficient in fog harvesting even when the hydrophobic coating is present. The overall water collection efficiencies were determined, and the role of the microtufts, fractal structures, and the orientation of leaf veins was investigated. Compared to the planar control surfaces, the noncoated and hydrophobic layer-coated copper oxide microtufts on the leaf skeletons displayed a significant increase in the fog harvesting efficiency. For superhydrophilic skeleton surfaces, the water collection rate was also observed to slightly vary with the vein orientation. The CuO microtufts along with high surface area fractals allowed an effective and sustainable way to capture and transport water. The study is expected to provide valuable insights into the design and fabrication of sustainable and efficient fog harvesting systems.

Purpose: Ectopic ACTH syndrome (EAS) is rare. We established a national cohort to increase awareness and address unmet needs. Methods: The Finnish national EAS cohort includes 60 patients diagnosed in 1997–2016. We assessed clinical features, diagnostic work-ups, treatments, incidence, and outcomes of subgroups occult tumor (OT), well-differentiated neuroendocrine tumor G1/G2 (NETG1/G2) and NET G3/neuroendocrine carcinoma (NETG3/NEC). Results: The distribution of OT, NETG1/G2, and NETG3/NEC was 10 (17%), 20 (33%), and 30 (50%), respectively; and median follow-up 22 months (0–249). Annual incidence (0.20–0.93 per million inhabitants) and tumor subgroups (OT vs. NEC) varied across the country. The longest diagnostic delay from EAS onset to radiological tumor identification was 48 months. In NET/NEC, 6/50 (12%) were diagnosed 1–24 years before EAS onset. Osteoporotic fractures (32%) and severe infections (55%) were common. The CRH stimulation test accurately diagnosed EAS in 25/31 (81%). Metyrapone (≤6 g daily, prescribed in 88%) was well tolerated. In NETG1/G2, 13/20 (65%) underwent curative resection of the primary tumor; four experienced recurrence within 2–12 years. In OT, 70% underwent bilateral adrenalectomy. Five-year overall survival in OT, NETG1/G2, and NETG3/NEC was 90%, 55%, and 0%, respectively (P< 0.001). Morning cortisol, hypokalemia, infections, metastatic disease, and acute onset were negative, whereas resection of the primary tumor and bilateral adrenalectomy were positive predictors of survival. Conclusions: NET/NEC may precede EAS onset by several years. In NETG1/G2, recurrences may occur > 10 years after successful primary surgery. Tumor subgroup (OT, NETG1/G2, NEC) was an independent predictor of survival.

• 99% yield of HCHO from CH 3 OH and CH 3 SH was achieved over vanadia–alumina catalyst. • Vanadium impregnation improved the selectivity towards formaldehyde production. • V5+ was more active oxidation state of vanadium than V4+ in formaldehyde production. • While being less active ZrV 2 O 7 and HfV 2 O 7 were more stable in presence of sulphur. • Lower VO x surface density leads to higher activity but lower stability. In this study, activity, selectivity and stability of vanadium catalysts supported on zirconia, hafnia, and alumina were examined in the oxidation of methanethiol and methanol to formaldehyde. The 3 wt-% vanadia–alumina catalyst with low VO x surface density showed the highest activity in the formaldehyde production. However, during the stability test, this catalyst deactivated due to the change in the oxidation state of vanadium from V5+ to V4+, decrease the amount of surface vanadium species and the formation of sulphates on the material surface. Zirconia and hafnia supported catalysts with high VO x surface density demonstrated better stability in the reaction conditions, but their activity in the formaldehyde production was lower. One reason for the lower activity might be the formation of metal-mixed oxide phases between vanadia and the support, which could also explain the decreased sulphur deposition on zirconia and hafnia after vanadium impregnation. [ABSTRACT FROM AUTHOR]

ABSTRACTFreud’s drive theory has been questioned since the 1940s when Fairbairn created a metaphor of the mind that is not based on the tripartite model and drive theory. His work inspired others to elaborate on the significance of internal object relationships. According to the object relation theory, internal object relations are dynamic structures capable of generating meanings and action. Consequently, two distinct metapsychologies were created.The aim of this article is to show how the interaction of theories has initiated revisions of classic drive theory. Freud’s concept of drive and three synthesizing viewpoints between the two perspectives are discussed. Otto Kernberg addresses affects as a primary motivational system; the mother–infant relationship organizes affects to drives. Joseph Sandler adheres to classic drive theory but proposes that the ego’s attempt to protect the mind against psychic pain is as important as drive derivatives in motivating the mind. Laplanche proposes that the unconscious of the care-giving adult is the crucial factor for the constitution of an infant’s unconscious and drives. For Freud and Klein, drive is inherent. Contemporary writers, like Loewald and Laplanche, conceive drive as a function of the mind that is born out of the same matrix of interaction with the other elements of the mind.

Craniosynostosis may lead to reduced intracranial volume (ICV) and disturb normal brain growth and development. Thus, ICV is an important parameter with respect to the surgical outcome. Current methods for ICV determination from computed tomography (CT) images have drawbacks. The aim of this study was to investigate the performance of the novel mesh-based method (MBM) for ICV determination with craniosynostosis patients.Twenty-two patients operated on for scaphocephaly were included in this study. ICVs from preoperative, one-week postoperative, and one-year postoperative CT images were measured with MBM. The level of agreement with the manual segmentation method (MSM) was determined for the measurements of preoperative and one-year postoperative datasets. Repeatability was determined with re-measurements of six datasets. Measurement time was recorded for MBM.Mean $$(\pm \text{ SD})$$preoperative ICV values were 895.0 $$\pm $$153.1 $$\text{ cm}^{3}$$and 896.4 $$\pm $$147.2 $$\text{ cm}^{3}$$as measured with MBM and MSM, respectively. Corresponding one-year postoperative values were 1,238.3 $$\pm $$118.7 $$\text{ cm}^{3}$$and 1,250.1 $$\pm $$117.5 $$\text{ cm}^{3}$$. The MBM allowed ICV determination from one-week postoperative datasets. Measurement time with MBM was 4MBM is an efficient method for determining the ICV of craniosynostosis patients, allowing the measurement of skulls with bony defects. The repeatability and short measurement time of MBM are attributable to the user interference and assessment of the measurement process.

The objective of this study was to investigate the effects of botulinum toxin A (BTXA) treatment on impairment and function of the upper limb during a 2-year follow-up period. A prospective longitudinal study design with assessments before and after intervention was utilized, involving six patients with cerebral palsy (three boys and three girls) aged 3 years 4 months to 11 years 11 months at commencement of study. The outcome measures were spasticity (modified Ashworth, MAS), active and passive range of movement (ROM), grips (pinch, key grip, 3-finger grip, narrow cylinder grip, wide cylinder grip, pen grip and diagonal grip; grasping, releasing; pronation-supination), bimanual functions, fine motor functions (Melbourne Assessment of Unilateral Upper Limb Function), movement pattern (Upper Limb Physician's Rating Scale, ULPRS), functional skills and self-care capability (Paediatric Evaluation of Disability Inventory, PEDI), upper extremity use (House Classification) and cosmetic appearance. The assessments were repeated by the same examiners at baseline and at 1, 3 and 6 months after each BTXA treatment and then every 6 months until 24 months. One subject received a total of four injections (at 0, 6, 12 and 18 months), one two injections (at 0 and 12 months) and four one injection at the beginning of the study period. Upper extremity surgery was performed on two subjects during the study and one was operated on 2 months after completion of the study. All children benefited from the BTXA treatment in terms of reduction in muscle tone and increase in active and passive ROM. By 6 months, spasticity returned, but in four children passive and especially active ROM remained better than at baseline. No significant changes in grips, bimanual tasks or Melbourne Assessment scores were detected. The change in movement pattern (ULPRS) was maintained for 3 months in two children and beyond this in four, thus extending beyond the pharmacologic effects of botulinum toxin A. All but one child showed improvement in PEDI functional skill and caregiver assistance scale scores during the 2-year period. The House classification showed a one-grade improvement in one child at 1 month and in one child at 3 months and a three-grade improvement in one child at 3 months after BTXA treatment. After each treatment, the parents reported at least a one-grade improvement in cosmetic appearance in all children at 1 month and in four children maintained at least until 6 months. In two subjects operated during the study period, a distinct improvement in active and passive ROM and a two-grade improvement in the House classification were observed after the operation. In this limited series, the reduction in muscle tone after BTXA treatment did not translate into better gripping or quality of fine motor functions (Melbourne Assessment) of the affected hand, but seemed to have a positive effect on upper limb movement pattern (ULPRS), upper extremity use (House Classification) and cosmetic appearance. Assessment of upper limb function in a child with cerebral palsy demands a variety of measures.

This study was conducted to assess occurrence and distribution of burst fractures as well as common accident mechanisms and the associated neurologic deficit. Using picture archiving and communications system, all emergency multidetector computed tomography studies over 34 months were retrieved and evaluated for burst fractures by two radiologists by consensus. Initial neurological findings were retrieved from patients’ medical records. One hundred fifty-two patients (112 male) with a total of 169 burst fractures were found. In both genders, the incidence of burst fractures peaked at the thoracolumbar junction and between levels T5 and T8. In 10% of cases, more than one burst fracture was seen, thereof 53% on noncontiguous levels. Main accident mechanisms were falls, traffic, and sports. Neurological deficit was highest in patients with burst fractures of the cervical spine, independent of accident mechanism, and lowest in thoracolumbar junction fractures. Burst fractures occur frequently in high energy traumas and are most commonly associated with falling and traffic accidents. Multiple burst fractures occur in 10% of cases, half thereof on noncontiguous levels.This study was conducted to assess occurrence and distribution of burst fractures as well as common accident mechanisms and the associated neurologic deficit. Using picture archiving and communications system, all emergency multidetector computed tomography studies over 34 months were retrieved and evaluated for burst fractures by two radiologists by consensus. Initial neurological findings were retrieved from patients’ medical records. One hundred fifty-two patients (112 male) with a total of 169 burst fractures were found. In both genders, the incidence of burst fractures peaked at the thoracolumbar junction and between levels T5 and T8. In 10% of cases, more than one burst fracture was seen, thereof 53% on noncontiguous levels. Main accident mechanisms were falls, traffic, and sports. Neurological deficit was highest in patients with burst fractures of the cervical spine, independent of accident mechanism, and lowest in thoracolumbar junction fractures. Burst fractures occur frequently in high energy traumas and are most commonly associated with falling and traffic accidents. Multiple burst fractures occur in 10% of cases, half thereof on noncontiguous levels.

Abstract Phlorotannins are ubiquitous secondary metabolites in brown algae that are phenotypically plastic and suggested to have multiple ecological roles. Traditionally, phlorotannins have been quantified as total soluble phlorotannins. Here, we modify a quantification procedure to measure, for the first time, the amount of cell-wall-bound phlorotannins. We also optimize the quantification of soluble phlorotannins. We use these methods to study the responses of soluble and cell-wall-bound phlorotannin to nutrient enrichment in growing and nongrowing parts of the brown alga Fucus vesiculosus . We also examine the effects of nutrient shortage and herbivory on the rate of phlorotannin exudation. Concentrations of cell-wall-bound phlorotannins were much lower than concentrations of soluble phlorotannins; we also found that nutrient treatment over a period of 41 days affected only soluble phlorotannins. Concentrations of each phlorotannin type correlated positively between growing and nongrowing parts of individual seaweeds. However, within nongrowing thalli, soluble and cell-wall-bound phlorotannins were negatively correlated, whereas within growing thalli there was no correlation. Phlorotannins were exuded from the thallus in all treatments. Herbivory increased exudation, while a lack of nutrients had no effect on exudation. Because the amount of cell-wall-bound phlorotannins is much smaller than the amount of soluble phlorotannins, the major function of phlorotannins appears to be a secondary one.

In type-II fractures of the odontoid process, the treatment is either conservative in a halo vest or primary surgical stabilisation. Since nonunion, requiring prolonged immobilisation or late surgery, is common in patients treated in a halo vest, the identification of those in whom this treatment is likely to fail is important.We reviewed the data of 69 patients with acute type-II fractures of the odontoid process treated in a halo vest. The mean follow-up was 12 months. Conservative treatment was successful, resulting in bony union in 32 (46%) patients. Anterior dislocation, gender and age were unrelated to nonunion. However, nonunion did correlate with a fracture gap (> 1 mm), posterior displacement (> 5 mm), delayed start of treatment (> 4 days) and posterior redisplacement (> 2 mm).We conclude that patients presenting with these risk factors are unlikely to achieve bony union by treatment in a halo vest. They deserve careful attention during the follow-up period and should also be considered as candidates for primary surgical stabilisation.

The aim of the study was to assess acute-phase multidetector CT (MDCT) findings in wrist injuries. We retrieved all emergency room MDCT requests processed in the period from August 2000 to May 2003. All patients with a wrist injury who underwent MDCT initially were included. Imaging studies were evaluated in relation to injury mechanism, fracture location, and fracture type. A total of 6422 MDCT examinations were performed during this 34-month period, and 38 patients (24 male, 14 female, age range 21–73 years, mean age 40 years) met the inclusion criteria. MDCT revealed 56 fractures and 7 dislocations in 29 patients. In 9 patients (24%) MDCT findings were normal. Eleven patients (29%) underwent surgical procedures. The main injury mechanism was a fall (58%). In 33 cases the primary radiograph was available. Compared to primary radiographs, MDCT revealed 9 occult fractures, mainly in small carpal bones. In 14 cases a suspected fracture (of the scaphoid in 7 cases) was ruled out by MDCT. Due to high-quality two-dimensional reformatting, MDCT examinations were not dependent on the wrist’s position in the CT gantry. In the comparison with radiography, MDCT detected occult fractures and ruled out suspected fractures, both mainly in the small carpal bones. High-quality two-dimensional reformats gave significant information about the fracture anatomy. MDCT provides fast and valuable information in assessing complex wrist fractures or when the primary radiograph is equivocal.

Abstract.: Purpose: To assess acute phase multi-slice CT findings in horse-riding accidents in patients referred to a level one trauma center. Methods: Using PACS, we retrieved all CT requests during a time period of 19 months. Patients who had a horse-riding accident and were examined with multi-slice CT were included. The imaging findings of multi-slice CT were retrospectively evaluated by location and injury mechanism. Results: Forty-six patients (3 male, 43 female, age 16–55 years, mean age 30) were assessed. The injuries we found were five head, three facial, 13 spine, five body, two pelvic, and three lower extremity trauma. Multiple injuries were seen in five (11%) patients. In 21 patients (46%) the initial multi-slice CT examination(s) was normal. Three main injury mechanisms were established; falling off a horse (72%), a horse kick (11%), and crushing injury caused by a falling horse (13%). Fifteen (33%) patients had serious injuries, one lethal and they were associated more frequently with falling off a horse. Conclusion: Serious injuries with horse riding accidents are not uncommon. In two thirds of patients, the injury mechanism was falling off a horse. Multiple injuries were seen in 11% of cases. In the acute phase, multi-slice CT provided fast and valuable information in assessing these injuries.

For several years we have been following patients with intractable, childhood‐onset idiopathic generalised epilepsies with ≥ 3 Hz spike‐wave discharges. Our need to find explanations for their intractability was the starting point for this study. We were interested in identifying characteristics, which would predict intractability; evaluating how these patients were treated and whether polytherapy was useful. We identified patients with ≥ 3 Hz spike‐wave discharges by reviewing EEG reports recorded between 1983 and 1992. Data were collected from medical records and through personal interviews. We identified 82 patients with tentative idiopathic generalised epilepsy. Eleven were excluded. Thirty‐eight patients had childhood absence epilepsy, 18 had juvenile absence epilepsy, 13 had juvenile myoclonic epilepsy and two had eyelid myoclonia with absences: 89.5, 78, 38 and 0% of the patients in each group, respectively, had been seizure free for more than 2 years. Twenty percent of the patients had intractable seizures. All intractable patients with juvenile absence epilepsy had rhythmic, random eyelid blinking and generalised tonic‐clonic seizures. A history of more than ten generalised tonic‐clonic seizures was associated with intractability in juvenile myoclonic patients. Monotherapy with ethosuximide or valproate resulted in seizure control in 65% of patients. Seventeen patients (24%) were treated with polytherapy, six achieved remission. These six patients had childhood absence epilepsy and juvenile absence epilepsy. Positive outcome was found in childhood absence epilepsy and juvenile absence epilepsy. Intractable seizures were more frequent among patients with juvenile myoclonic epilepsy. None of them benefited from polytherapy with conventional anti‐epileptic drugs.

Background:Children with allergic rhinitis are likely to develop asthma. Objective:The purpose of this investigation was to determine whether specific immunotherapy can prevent the development of asthma and reduce bronchial hyperresponsiveness in children with seasonal allergic rhinoconjunctivitis. Methods:From 6 pediatric allergy centers, 205 children aged 6 to 14 years (mean age, 10.7 years) with grass and/or birch pollen allergy but without any other clinically important allergy were randomized either to receive specific immunotherapy for 3 years or to an open control group. All subjects had moderate to severe hay fever symptoms, but at inclusion none reported asthma with need of daily treatment. Symptomatic treatment was limited to loratadine, levocabastine, sodium cromoglycate, and nasal budesonide. Asthma was evaluated clinically and by peak flow. Methacholine bronchial provocation tests were carried out during the season(s) and during the winter. Results:Before the start of immunotherapy, 20% of the children had mild asthma symptoms during the pollen season(s). Among those without asthma, the actively treated children had significantly fewer asthma symptoms after 3 years as evaluated by clinical diagnosis (odds ratio, 2.52; P< .05). Methacholine bronchial provocation test results improved significant in the active group (P< .05). Conclusion:Immunotherapy can reduce the development of asthma in children with seasonal rhinoconjunctivitis. (J Allergy Clin Immunol 2002;109:251-6.)

Two-dimensional maps of the atomic-hydrogen concentration distribution were acquired with two-photon laser-induced fluorescence. The environment was a hot-filament chemical-vapor-deposition reactor used for polycrystalline diamond-film deposition. The maps were measured in situ under diamond-deposition conditions with variation of the growth parameters. The parameters investigated were filament temperature, input methane concentration, and total pressure.

The hypothesis that dyslexics show prolonged audible persistence was tested by an event-related brain response technique and rejected in favour of an attentional explanation.

The aim of this study was to find out how the occurrence of subjective daytime sleepiness (SDS) in schoolchildren had changed after 2 years follow-up and which were the predictors associated with persistence and appearance of SDS.

The increased awareness of the benefits of rehabilitation technology will lead to an increased demand for services and may lead to discrepancies between needs and resources available. The present study was a regional follow-up of the use of 1278 technical aids. In this study the satisfaction with aids was high and quite near the optimum, but unsatisfactory areas were also identified. A better follow-up of the use of technical aids should be part of rehabilitation practice. Careful assessment of functional and psychosocial needs, goal attainment and environmental factors, and a good system of selection with available alternatives and proper instructions are the basic considerations for satisfactory technical aids.

The entomophilous Taraxacum and Leucanthemum are not generally regarded as harmful allergy causing plants because their pollen grains are normally not present in the air. However, walking through Taraxacum and Leucanthemum vegetation causes an increase in the atmospheric pollen frequencies. The increase was studied with rotorod traps 0.25, 1 and 1.5 m above the ground. The controls were obtained 1 and 0.5 h before, and immediately after a 30 min walking through the vegetation. The collections were made on four days in Taraxacum and two days in Leucanthemum meadows with four trappings each day. Walking in the vegetation increased the pollen frequencies, especially at the 0.25 m level from 24 to 1404 pollen grains • m-3 (Taraxacum) and from 32 to 4424 grains • m-3 (Leucanthemum) but less at the 1.5 m height (from 14 to 59 of Taraxacum and from 12 to 235 of Leucanthemum). Thus small children playing on the ground, are subjected more to pollen than adults. The importance of the entomophilous pollen frequencies at various heights as an allergy causing factor should be studied further.

The objective of the study was to investigate the features of cardiovascular and respiratory autonomic nervous regulation in asthmatic and control children. Cardiorespiratory reactivity was studied by continuous and non-invasive recording of the electrocardiogram, finger systolic arterial pressure (SAP) and flow-volume spirometry in supine and upright positions and during a deep breathing test in 19 children with bronchial asthma and 10 healthy control children (age 8-11 years). The periodic variability components of R-R intervals (the time between successive heart beats) and SAP in relation to respiration were assessed using spectral analysis techniques. Nine asthmatic children without beta,-agonist medication had a lower respiratory rate and larger high frequency (HF) variability of SAP than the controls, and 10 asthmatic children with beta2-agonist medication had greater low-frequency (LF) variability of SAP and LF/HF ratio of R-R intervals, but their respiratory rate did not differ from the controls. No intergroup differences were found in the postural change of variables. Stable bronchial asthma appears to increase respiratory-induced alterations in systolic blood pressure in children. Beta2-agonist medication, on the other hand, increases sympathetic cardiovascular activity in children with asthma.

In this study, we criticize the notion of bradyphreniaand argue that "slowness of thought" in Parkinson"s disease (PD) must be analyzed as slowness of different information-processing stages and that unselected patients should not be used in experimental studies. We selected 32 patients with a long history of PD and 50 control subjects. Sixteen patients had mild cognitive deterioration (not dementia) and 16 patients had preserved cognitive capacities; otherwise the groups were matched. By using computerized tests, we investigated three separate stages: automatic and controlled processing and motor programming. The results indicate that patients with mild cognitive deterioration are slower than patients with preserved cognitive capacities or controls in automatic visual and in controlled processing but not in motor programming. We conclude that the slowing of controlled processing reflects the disruption of central neural networks, that a long history of PD does not necessitate cognitiveslowing, and that PD is not a neuropsychologicallyserviceable category.

The incidence of asthma, hay fever and atopic dermatitis was assessed in three generations in 2820 families by a questionnaire. 35% of the families were atopic when the histories of parents and grandparents were included. 64% of atopic children had atopy in probands and the corresponding figure for non-atopic individuals was 31%. The highest prevalence of atopy was found in the parents' generation (13.5%) but it did not differ significantly from that of the children (10.8%) when compared with grandparents (7.6%). The results suggested an increasing prevalence of children's atopic dermatitis in Finland since the 1950s. The influence of heredity was apparent. Few geographical differences were observed.

The effect of extrinsic asthma on periodontal conditions was studied in a group of 30 asthmatic children. Clinical examination revealed that asthmatic children had more gingivitis than their healthy controls. The asthmatic children who received an inhaled corticosteroid as treatment had more severe gingivitis compared with asthmatic children on disodium cromoglycate treatment. The amount of plaque was not altered.The peroxidase activity was assessed from whole saliva. The results revealed that this defense mechanism was not altered in asthma. An enzyme group which is involved in inflammation, the arginine aminopeptidases, was found to be slightly elevated in the gingival fluid of asthmatic children. The results indicate that gingival inflammation is increased in asthma.

Normalization, which underlines mainstreaming, is widely accepted in paediatric rehabilitation, but its success depends on the availability of special services, including proper technical aids for day care and school. This study aimed to evaluate the need for and use of technical aids in various forms of day care and education. Handicapped children used basic technical aids. In day care children needed more technical aids to promote independent mobility and playing, and in school they needed more computers and adaptations and software for these computers. The arrangement of technical aids for handicapped children requires good cooperation between the children's parents and various professionals.

Grasping is one of the key tasks for robots. Gripping fragile and complex three-dimensional (3D) objects without applying excessive contact forces has been a challenge for traditional rigid robot grippers. To solve this challenge, soft robotic grippers have been recently proposed for applying small forces and for conforming to complex 3D object shapes passively and easily. However, rigid grippers are still able to exert larger forces, necessary for picking heavy objects. Therefore, in this study, we propose a magnetically switchable soft suction gripper (diameter: 20 mm) to be able to apply both small and large forces. The suction gripper is in its soft state during approach and attachment while it is switched to its rigid state during picking. Such stiffness switching is enabled by filling the soft suction cup with a magnetorheological fluid (MR fluid), which is switched between low-viscosity (soft) and high-viscosity (rigid) states using a strong magnetic field. We characterized the gripper by measuring the force required to pull the gripper from a smooth glass surface. The force was up to 90% larger when the magnetic field was applied (7.1 N vs. 3.8 N). We also demonstrated picking of curved, rough, and wet 3D objects, and thin and delicate films. The proposed stiffness-switchable gripper can also carry heavy objects and still be delicate while handling fragile objects, which is very beneficial for future potential industrial part pick-and-place applications.

Factors contributing to the duration of a single convulsive seizure >5 minutes were analyzed in 157 children. The medically treated episodes were compared with seizure episodes resolving without treatment (n 27). Major differences were in age (p0.016) and etiology (p0.003), and the association between treatment delay and response became significant after 30 minutes when this was analyzed as a single variable (p0.003) in Cox regression analysis.

The classification of odontoid process fractures introduced by Anderson and D'Alonzo in 1974 has gained wide acceptance among researchers and clinicians. In type II fractures the injury is located in the base of the odontoid process. In 1988 Hadley et al. introduced a comminuted subtype of this fracture, type IIA. Since then several authors have recommended a more aggressive surgical approach in treatment of this subtype. However, only a few cases of comminuted type II fractures have been reported. The objective of this study is to assess the occurrence of comminution in type II fractures. Twenty-six type II fractures imaged by multislice CT were reviewed. Subtle comminution of the fracture was observed in 12 of the cases. We conclude that, when imaged by multislice CT, subtle comminution in type II odontoid fractures is seen more commonly than previously reported in the literature.

AbstractTwo children with rotavirus gastroenteritis are presented. The first case developed a fatal Reye's syndrome and the other one encephalitis with slow recovery. The rotavirus diagnosis was made in both cases by electron microscopy and a significant rise in antibody titres to Nebraska calf diarrhea virus was seen in one of the two patients.

Fifteen hundred randomly chosen Finnish children aged 0–15 years were studied by a questionnaire about their sauna habits and possible abnormal symptoms during or immediately after the sauna. A total of 1247 families (83%) answered. Almost all children visited the sauna (98.5%), most of them “with pleasure” (83%). Nearly half of the children were in the sauna as often as 2–3 times a week, and over 90% at least once a week. The children's sauna visits began quite early, in 70% during infancy. The time spent in a hot steam bath increased with age. Symptoms were rare and were not serious. Transient symptoms (dizziness, nausea etc.) were the most common. Of the children, 17% had some chronic or recurring disorder, most commonly atopic dermatitis or middle ear infections. In half of the cases of atopic dermatitis it became worse in the sauna. Sauna is a very common practice in Finland, also among children. It does not seem to cause any significant immediate harm to healthy children.

The oxygen consumption of resting lambs in from 8 to 13 ml/min/kg during the 1st week of life. Assuming a cardiac output of 300 ml/min/kg and a hemoglobin of 13 g/100 ml, it may be seen that about one-third of the oxygen transport capacity is used at rest. In the present study lambs 2–7 days old were subjected to shivering during hypothermia. The animals were breathing 100% oxygen and were anesthetized with chloralose. Oxygen consumption, dye dilution curves, pressures of the central arteries, and arterial SO2and acid-base balance values were registered. The oxygen consumption of the lambs increasd to a maximum of 35 ml/min/kg during shivering. Cardiac outputs increased from about 300 ml/min/kg to 500–700 ml/min/kg in the lambs with the highest values of oxygen consumption. The arterial oxygen saturation did not change at the cardiac output values. These results were also observed when the body temperature had been lowered to about 30°. About one-third of the oxygen carried by the arterial blood was extracted by the organism. Decreasing values of standard bicarbonate were often associated with lowered cardiac outputs. Correction of metabolic acidosis increased cardiac outputs but did not influence the oxygen consumptions. It may be concluded that shivering increases the oxygen consumption and cardiac output in the neonatal lambs. Metabolic acidosis conteracts teh cardiac response but does not influence the rate of oxygen consumption.