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Vuonna 2015 Eurooppaan pyrki Lähi-idästä ja Pohjois-Afrikasta historiallisen suuri joukko turvapaikanhakijoita, pakolaisia ja siirtolaisia. Osa heistä päätyi suuntaamaan Suomeen Pohjois-Ruotsin ja Venäjän rajojen yli. Lapin sodan aikaan, vuonna 1944, pakolaisvirta kulki toiseen suuntaan: Suomesta Ruotsiin. Artikkeli tarkastelee taideteosta, jossa rinnastetaan nämä kaksi aikatasoa ja tapahtumakulkua.Minna Rainion ja Mark Robertsin lyhytelokuva They Came in Crowded Boats and Trains (2017 Suomi) kuvaa ”pohjoista” osin uudesta näkökulmasta. Elokuvan päähenkilöt, reaalielämässään itse turvapaikanhakijoita, ovat lukuisten mediaesitysten kehyksessä tunnistettavasti ”eteläisiä” hahmoja pohjoisessa maisemassa. Teoksen kertojaääni taas lukee otteita pohjoissuomalaisten pakolaisten kirjeistä ja päiväkirjoista seitsemänkymmenen vuoden takaa.Teoksessa menneisyyden ja nykyisyyden tapahtumat asettuvat ajan ja paikan ylittävään dialogiin. Kysymme artikkelissa, millainen kulttuurinen muisti ja kuvasto on rakentunut evakkouden ympärille ja miten Rainion ja Robertsin teos asettuu suhteessa siihen. Onko kahden aikakauden pakolaiskuvien välillä löydettävissä samanlaisuutta tai eroja? Analysoimme teoksessa rakentuvia suhteita ja asetelmia, kuten eri ajassa matkaavien pakolaisten eroja, erilaisuutta ja vertaisuutta, mutta myös elokuvassa rakentuvaa tietoisuutta suhteessa pakolaisuutta määrittäviin valtarakenteisiin ja historiallisiin rinnastuksiin.Escape from the North and to the North: Two Temporal Levels of Exile in the short film They Came in Crowded Boats and TrainsIn 2015 a historically vast number of refugees, asylum seekers and immigrants strived towards Europe from the Middle East and North Africa. Some of them ended up arriving in Finland, crossing the borders from either Northern Sweden or Russia. During the Lapland War, in 1944, the stream of refugees went to the opposite direction: from Finland to Sweden. In our article, we discuss a work of art, which draws a parallel between these two temporal levels and historical events. Minna Rainio and Mark Roberts’s short film They Came in Crowded Boats and Trains (2017 Finland) describes “the North” partly from a new perspective. The protagonists of the film, asylum seekers in their personal life, are in the framework of countless media representations recognizable as “southern” figures in a northern landscape. The voiceover in the film, however, reads excerpts from letters and diaries of northern Finnish refugees or evacuees from 70 years ago.In the film the events of past and present are situated in a dialogue, which transgresses both time and place. In the article we ask what kind of cultural memory and imagery has been constructed around being evacuated in 1944, and how Rainio and Roberts’ film situates itself in connection with this memory and imagery. How are the refugees represented in the film, and what kinds of similarities and differences are there to be found between the refugee representations of the two different eras? What kinds of associations, insights, and maybe even objections or criticisms the film evokes? Our article analyzes relations constructed in the narration: differences and similarities represented between refugees traveling in different times, but also the consciousness built in the film in relation to existing power structures and historical parallels defining what it means to be a refugee.

Purpose Surface guided radiotherapy (SGRT) is reported as a feasible setup technique for whole‐breast radiotherapy in deep inspiration breath hold (DIBH), but position errors of bony structures related to deeper parts of the target are not fully known. The aim of this study was to estimate patient setup accuracy and margins obtained with two different SGRT workflows with and without daily kV‐ and/or MV‐based image guidance (IGRT). Methods A total of 50 breast cancer patients were treated in DIBH, using SGRT for the patient setup, and IGRT for isocenter corrections. The patients were treated at two different departments, one using AlignRT® (25 patients) and the other using Catalyst™ (25 patients). Inter‐fractional position errors were analyzed retrospectively in orthogonal and tangential setup images, and analyzed with and without IGRT. Results In the orthogonal kV‐kV images, the systematic residual errors of the bony structures were ≤ 3 mm in both groups with SGRT‐only. When fine‐adjusted by daily IGRT, the errors decreased to ≤ 2 mm; except for the shoulder joint. The residual errors of the ribs in tangential images were between 1 and 2 mm with both workflows. The heart planning margins were between 3 and 7 mm. Conclusions The frequency of IGRT may be considerably reduced with a well‐planned SGRT‐workflow for whole‐breast DIBH with residual errors ≤ 3 mm. This accuracy can be further improved with an IGRT scheme.

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Background: Setup accuracy within adjuvant radiotherapy of breast cancer treated in free breathing is well studied, but a comparison of the typical regions of interest (ROI) used in surface guided radiation therapy (SGRT) does not exist. The aim of this study was to estimate the setup accuracy obtained with differently shaped ROIs in SGRT. Materials and methods: A total of 573 orthogonal image pairs were analyzed from free breathing breast patients in two groups: positioning using AlignRT® surface guidance system (Group A, n = 20), and setup using conventional laser and tattoo setup (Group L, n = 20). For SGRT, three different setup ROIs were used: a Breast-shaped, O-shaped and T-shaped (B-O and T-ROI). We evaluated the isocenter-, rotation-, pitch and arm position accuracy and residual errors for the chest wall and shoulder joint in kV orthogonal and tangential setup images with laser or SGRT-based setup. Results: Less isocenter variance was found in Group A than in Group L. Rotations and posture errors were larger in group L than in Group A (p ≤ 0.05). Rotation error was smaller with T-shaped ROI than with O-or B-shape (p = 0.01–0.04). Conclusion: Setup with AlignRT® improves reproducibility compared to laser setup. Between the different ROI shapes only small differences were found in the patient posture or the isocenter position in the images. The T-ROI is recommended to set up the chest wall bony structure and an additional B-ROI may be used to fine-tune the soft tissue accuracy publishedVersion

To investigate the near-surface doses and target coverage in modulated arc radiotherapy (RT) of the breast or chest wall in two treatment planning systems (TPS) in the presence of soft tissue deformations. This retrospective study consisted of 10 breast cancer patients with axillary lymph node inclusion. For each case, five RT plans were created: (1) tangential 3D conformal field-in-field (FinF) technique; (2) 200° to 240° arcs with optimization bolus (OB) in Eclipse (EB); (3) 243° to 250° arcs with an 8-mm OB in Monaco (MB); (4) 243° to 250° arcs with automatic skin flash tool (ASF) in Monaco TPS (MA); (5) 243° to 250° arcs with both ASF and OB in Monaco (MAB). Soft tissue deformation was simulated by editing CT-images with 4-, 8-, and 12-mm swelling and recalculating the dose. The increasing swelling from 0 to 12 mm caused the coverage (V95%) in clinical target volume to decrease from 96% ± 2% to 90% ± 6% for the FinF plans. For volumetric-modulated arc therapy (VMAT), the coverage decreased from 99% ± 1% to 92% ± 4% in the EB plans, and from 97% ± 1% to 68% ± 8%, 85% ± 6%, and 86% ± 5% for MA, MB, and MAB, respectively. The mean dose in the surface extending from 0 to 3 mm from the skin decreased on average 5%, 17%, 20%, 15%, and 8% in FinF, EB, MA, MB, and MAB, respectively. In the Monaco plans, the use of an OB(+ASF) provided better target coverage and lower dose maxima despite of tissue swelling than the ASF alone. With modulated arc therapy, we recommend the use of an OB instead of or in addition to the ASF. The use of 8 mm OB with VMAT plans is robust to account deformations extending outside up to 8mm. If soft tissue deformation is larger than 8 mm, the need for replanning should be evaluated.

In this article, identity politics is understood as a form of politics stressing collective but malleable group identities as the basis of political action. This notion of identity politics also allows thinking of identity as intersectional. The focus of this article, and a problem related to identity politics, is that when discussed in the context of the neoliberal order, identity politics has a tendency to become harnessed by the ethos of vulnerability. Some implications of the 'vulnerabilizisation' are considered in the field of education, which is a field currently thoroughly affected by neoliberalism. Therefore, it is also important to look closer at the relationship between identity politics and the ethos of vulnerability. In addition, we re-consider poststructuralist thinking as a theoretical and political approach to see what it can offer in terms of re-thinking identity politics and in analyzing the ethos of vulnerability. When categories of vulnerability keep expanding into various psycho-emotional vulnerabilities defining subjects that can be known and spoken about, it is crucial to ask whether we regard these changes as educationally and politically progressive. The article discusses some problematic policies in educational environments and the phenomenon of trigger warnings.

Intersectionality has been a debated concept in recent critical studies. It has been both hailed as the most important contribution to gender studies, and criticized for being an academic buzzword. In our chapter, however, we aim to focus on the potential productive power intersectionality might still have, for example, when critically applied to the narratives of cultural homogeneity and the ‘ordinariness’ of the majority. The narrative of Nordic societal homogeneity is often constructed as unitary and unchanging – the sphere of the ordinary. The white Nordic majority has become the norm against which the other, presented as in need of emancipation, is defined, read and interpreted. In such thinking, both ‘the majority’ and ‘the margin’ are stabilized constructs, even though they both remain inherently multifaceted and ambivalent. We turn the intersectional lens to the ‘homogenous commonplace’ by discussing on which conditions intersectionality could be turned towards the majority, or ‘the ordinary’. After that, we discuss intersectionality ‘in commonplace action’, by outlining a case study: the explicitly intersectional politics of the Feminist Party in Finland, founded in 2016.

Gendered and sexualized abuse and other forms of violence are visibly present in the culture of the third millennium. Especially bodies that are gendered as female are – both dead and alive – objects of multiple forms of abuse and violence in the texts and imageries of contemporary culture. Men, on the other hand, are often represented as abusive towards women and as the violent gender or, as targets of other men’s violence. Structural violence has also an impact on many areas of everyday life, and it is materialized in, for example discrimination and inequality.Gender and Violence: The Ethics and Politics of Reading scrutinizes gendered violence as a complex phenomenon of contemporary culture. The authors study the ways in which ways representations of violence can be read, viewed and received. They also discuss what kind of politics the violent representations implement and actualize, and how they affect their audience.Gender and Violence takes a critical stance on the intersections of gender, power, and violence in literature, film, television and the internet. The analysis focuses on, for example, sci-fi, Nordic Noir and North American comedy series, poems, young adult literature (YA) and nationalist blog texts. The book presents both Finnish and international academic discussions, in which researchers in the fields of gender studies, arts and literature, and cultural studies challenge contemporary English abstract 279 understanding of gender, sexuality, power, and violence. Moreover, Gender and Violence provides tools for critical discussions on violence and in-depth scrutiny about its cost on all of us. Gender and Violence is an anthology of academic research articles. It works well as an academic textbook, but it also provides timely and new knowledge for everyone interested in questions of gender and violence – phenomena that touch upon all of us.

Rationale and Objectives The aim of this study was to examine changes of brain iron content and diffusion patterns longitudinally in early-stage Parkinson's disease (PD) patients using T2- and T2*-based magnetic resonance imaging (MRI) over 2-year follow-up. Materials and Methods We imaged 32 PD patients with tremor and 19 healthy controls. A follow-up study (median 25 months, range 22–31 months) was accomplished for 25 patients (men:women = 11:14; age range 44–87 years, median 73 years). All patients and healthy volunteers underwent clinical, neuropsychological, and MRI examinations on the same day. Three different MRI sequences were used and their results were compared: T2-weighted imaging, susceptibility-weighted imaging, and T2* mapping. Additionally, we evaluated diffusion tensor data between groups using tract-based spatial statistics. Results Over the 2-year follow-up, the iron-related relaxation increased in the globus pallidus anterior and the caudate nucleus and slightly in the substantia nigra pars compacta (SNc). In the globus pallidus anterior and medial SNc, the change was associated with mild cognitive impairment. In the caudate nucleus, the increase was pronounced in patients with disease onset at 67 years or older. In the SNc, medial transverse relaxation was increased, and in the thalamus, it was decreased, in patients with PD compared with healthy volunteers at 2-year follow-up. Tract-based spatial statistical data did not differ between groups based on gender or Unified Parkinson's Disease Rating Scale, but a slight tendency to decreasing fractional anisotropy ( P Conclusions PD-related changes were found in putative iron content over 2 years. Although mild in the initial stages, these changes were consistent over MRI sequences. Rather than correlating with disease duration, the rate of changes was associated with individual characters, such as cognitive decline and age.

The purpose of this study was to analyze the lesion brightness (image contrast) in multiple MRI sequences in patients with relapsing-remitting MS (RRMS), secondary progressive MS (SPMS), primary progressive MS (PPMS), and clinically isolated syndrome (CIS); and to correlate the lesion contrast with lesion volumes and neurological disability. MRI ex- amination at 1.5 T was performed on 80 patients with RRMS, SPMS, PPMS, or CIS. The protocol included T1- and T2-weighted spin echo (SE), fluid attenuated inversion recovery (FLAIR), T1-weighted SE with magnetization transfer preparation, and diffusion weighted imaging (DWI). Contrast was measured between MS lesions and normal appearing white matter. Lesion volume was calculated in T1-weighted- and FLAIR-images. All patients were examined neurologically including evaluation of expanded disability status scale (EDSS) score. Lesion contrast correlated with total brain lesion volume (p = 0.000 - 0.040). In patients with low EDSS, three sequences were able to differentiate between CIS and RRMS. SPMS and PPMS were separated by DWI. Lesion contrast correlated with EDSS score on T1-weighted imaging, with or without magnetization transfer preparation. Patient age correlated with lesion contrasts. Contrast measurements seem limited in radiological and clinical diagnosis of MS in reference to disease course, its activity and progression. The differentiation between MS subgroups might improve at 3 T and could help in leading to earlier treatment of the disease.

Rationale and Objectives Early-stage diagnosis of Parkinson’s disease (PD) is essential in making decisions related to treatment and prognosis. However, there is no specific diagnostic test for the diagnosis of PD. The aim of this study was to evaluate the role of texture analysis (TA) of magnetic resonance images in detecting subtle changes between the hemispheres in various brain structures in patients with early symptoms of parkinsonism. In addition, functional TA parameters for detecting textural changes are presented. Materials and Methods Fifty-one patients with symptoms of PD and 20 healthy controls were imaged using a 3-T magnetic resonance device. Co-occurrence matrix–based TA was applied to detect changes in textures between the hemispheres in the following clinically interesting areas: dentate nucleus, basilar pons, substantia nigra, globus pallidus, thalamus, putamen, caudate nucleus, corona radiata, and centrum semiovale. The TA results were statistically evaluated using the Mann-Whitney U test. Results The results showed interhemispheric textural differences among the patients, especially in the area of basilar pons and midbrain. Concentrating on this clinically interesting area, the four most discriminant parameters were defined: co-occurrence matrix correlation, contrast, difference variance, and sum variance. With these parameters, differences were also detected in the dentate nucleus, globus pallidus, and corona radiata. Conclusions On the basis of this study, interhemispheric differences in the magnetic resonance images of patients with PD can be identified by the means of co-occurrence matrix–based TA. The detected areas correlate with the current pathophysiologic and neuroanatomic knowledge of PD.

The aim of this study was to evaluate diffusion tensor imaging (DTI) indices in the corpus callosum and pyramidal tract in normal-appearing white matter (NAWM) and the caudate nucleus and thalamus in deep grey matter (NADGM) in all MS subtypes and clinically isolated syndrome (CIS). Furthermore, it was determined whether these metrics are associated with clinical measures and the serum levels of candidate immune biomarkers. Apparent diffusion coefficients (ADC) values were significantly higher than in controls in all six studied NAWM regions in SPMS, 4/6 regions in RRMS and PPMS and 2/6 regions in CIS. In contrast, decreased fractional anisotropy (FA) values in comparison to controls were detected in 2/6 NAWM regions in SPMS and 1/6 in RRMS and PPMS. In RRMS, the level of neurological disability correlated with thalamic FA values (r=0.479,P=0.004). In chronic progressive subtypes and CIS, ADC values of NAWM and NADGM were associated with the levels of MIF, sFas, and sTNF-α. Our data indicate that DTI may be useful in detecting pathological changes in NAWM and NADGM in MS patients and that these changes are related to neurological disability.

Early-stage diagnosis of Parkinson's disease (PD) is essential in making decisions related to treatment and prognosis. However, there is no specific diagnostic test for the diagnosis of PD. The aim of this study was to evaluate the role of texture analysis (TA) of magnetic resonance images in detecting subtle changes between the hemispheres in various brain structures in patients with early symptoms of parkinsonism. In addition, functional TA parameters for detecting textural changes are presented.Fifty-one patients with symptoms of PD and 20 healthy controls were imaged using a 3-T magnetic resonance device. Co-occurrence matrix-based TA was applied to detect changes in textures between the hemispheres in the following clinically interesting areas: dentate nucleus, basilar pons, substantia nigra, globus pallidus, thalamus, putamen, caudate nucleus, corona radiata, and centrum semiovale. The TA results were statistically evaluated using the Mann-Whitney U test.The results showed interhemispheric textural differences among the patients, especially in the area of basilar pons and midbrain. Concentrating on this clinically interesting area, the four most discriminant parameters were defined: co-occurrence matrix correlation, contrast, difference variance, and sum variance. With these parameters, differences were also detected in the dentate nucleus, globus pallidus, and corona radiata.On the basis of this study, interhemispheric differences in the magnetic resonance images of patients with PD can be identified by the means of co-occurrence matrix-based TA. The detected areas correlate with the current pathophysiologic and neuroanatomic knowledge of PD.

Background Both a large lesion volume and abnormalities in diffusion tensor imaging are independently associated with a poor prognosis after cerebral infarctions. Therefore, we assume that they are associated. This study assessed the associations between lesion volumes and diffusion tensor imaging in patients with a right-sided cerebral infarction. Methods The lesion volumes of 33 patients (age 65.9 ± 8.7, 26 males and 7 females) were imaged using computed tomography (CT) in the acute phase (within 3-4 hours) and magnetic resonance imaging (MRI) in the chronic phase (follow-up at 12 months, with a range of 8-27 months). The chronic-phase fractional anisotropy (FA) and mean diffusivity (MD) values were measured at the site of the infarct and selected white matter tracts. Neurological tests in both the acute and chronic phases, and DTI lateralization were assessed with the Wilcoxon signed-rank test. The effects of thrombolytic therapy (n = 10) were assessed with the Mann-Whitney U test. The correlations between the measured parameters were analysed with Spearman's rho correlation. Bonferroni post-hoc correction was used to compensate for the familywise error rate in multiple comparisons. Results Several MD values in the right hemisphere correlated positively and FA values negatively with the lesion volumes. These correlations included both lesion area and healthy tissue. The results of the mini-mental state examination and the National Institutes of Health Stroke Scale also correlated with the lesion volume. Conclusions A larger infarct volume is associated with more pronounced tissue modifications in the chronic stage as observed with the MD and FA alterations.

Artikkeli tarkastelee queeria ajallisena ilmiönä ja kysyy mitä queer-ajattelu ja aktivismi ovat yhteiskunnallisesti ja kulttuurisesti ”parantaneet” tai korjanneet. Läpikäydyt esimerkit paikantuvat yhdysvaltalaiseen ja suomalaiseen lähihistoriaan sekä muutoksiin sukupuoli- ja seksuaalivähemmistöjen asemassa. Kirjoittaja kysyy miten reilu neljännesvuosisata, jonka voi sanoa pitäneen sisällään normaaliutta queeriyttäneitä aikoja, on vaikuttanut esimerkiksi kulttuurisiin representaatioihin ja joihinkin oikeuksiin mainituissa konteksteissa. Entä onko queer-keskustelussa itsessään näiden aikojen jälkeen korjaamisen varaa? Teoreettisesti artikkeli keskustelee erityisesti Eve Kosofsky Sedgwickin ja Sara Ahmedin ajattelun kanssa. Sedgwick näyttäytyy tekstissä yhtäältä queerin ajallisuuden, toisaalta reparatiivisuuden tai korjaavuuden teoreetikkona, Ahmed puolestaan pervon affektiivisuuden ja queerin potentiaalin haurauden ajattelijana. Kirjoittaja kyseenalaistaa myös queerin ulossulkevuuden ja ”oikeanlaisten” queer-subjektien ja objektien määrittymisen sekä homo–hetero-vastakkainasettelun hedelmällisyyden queerin ajattelun ja toiminnan lähtökohtana. Ylpeyden, häpeän takaisinottamisen ja enemmistöltä saadun tunnustuksen jälkeen artikkeli perää queerin tai pervouden parantumattomuutta ja parantumatonta määrittelemättömyyttä.

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The aim of this study was to find optimal planning approach for large planning targets with complicated geometry requiring wide field openings. The study presents a novel approach for arc geometry design for pelvic targets with extensive nodal involvement. A total of 15 patients with anorectal carcinoma or vulvar cancer were selected retrospectively. For each patient, one seven-field IMRT plan and three VMAT plans were calculated: one with two 360° arcs with no limitations for the field size (VMATw); one with two asymmetrically field-size-restricted 360° arcs (VMATr); and the proposed novel approach which consisted of one 360° arc with the field size restricted to the central PTV, and another arc divided into two 180° arcs, restricting the field sizes with the focus on the lymph nodes. The techniques were compared in terms of PTV coverage (VPTV(95%)), dose maximum (D(max)), dose conformity index (CI), homogeneity index (HI), and organs at risk doses. The proposed novel approach with one full and two half arcs tended to have better PTV coverage (VPTV(95%) = 97% ± 2%, compared to 95% ± 3%, 95% ± 3%, and 97% ± 2% in VMATw, VMATr, and 7f-IMRT, respectively) and lower maxima (D(max) = 107% ± 1%, compared to 110% ± 3%, 110% ± 4%, and 110% ± 4% in VMATw, VMATr, and 7f-IMRT, respectively); and lower or equal organs at risk doses. The superiority of the proposed technique (CI = 1.16 ± 0.05, HI = 9 ± 2) was more pronounced compared with the VMATw plans (CI = 1.41 ± 0.10, paired t-test p < 0.001; HI = 12 ± 2, p < 0.001), but the proposed technique was slightly better also in comparison with the VMATr plans (CI = 1.21 ± 0.07, p < 0.001; HI= 11 ± 4, p = 0.015) and 7f-IMRT plans (CI = 1.18 ± 0.03, p = 0.016; HI = 10 ± 2, p = 0.215). Radiotherapy treatment planning for large and complicated treatment volumes benefits not only from restricting the field size but also from careful field design that considers PTV geometry. This optimizes multileaf collimator movements, leading to better dose conformity and homogeneity.