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Purpose Obesity is the most important risk factor for obstructive sleep apnea (OSA); however, the exact underlying mechanisms are still not fully understood. The aim of this study was to examine the morphology of upper airways in overweight habitual snorers and in mild OSA patients. Furthermore, the associations between weight loss, parapharyngeal fat pad area and OSA were assessed in a 1-year randomised, controlled follow-up study originally conducted to determine the effects of lifestyle changes with weight reduction as a treatment of OSA. Methods Thirty-six overweight adult patients with mild OSA [apnea–hypopnea index (AHI) 5–15 events/h] and 24 weight-matched habitual snorers (AHI < 5 events/h) were included in the study. All patients underwent nocturnal cardiorespiratory recordings and multislice computed tomography (CT) of parapharyngeal fat pad area, the smallest diameter and area in naso-, oro- and hypopharynx, the smallest diameter and area of the whole pharyngeal airway, the distance from the hyoid bone to the mandibular plane and to cervical tangent as well as the distance between mandibular symphysis and cervical spine. In addition, OSA patients were further randomised to receive either an active 1-year lifestyle intervention with an early weight loss programme or routine lifestyle counselling. After 1 year, the cardiorespiratory recordings and CT scans were repeated. Results The pharyngeal fat pad area was significantly larger, and the distance from the hyoid bone to cervical spine was longer in patients with OSA than in habitual snorers ( p  = 0.002 and p  = 0.018, respectively). The multiple regression analysis showed that besides a large pharyngeal fat pad area and a long distance from the cervical spine to hyoid bone, also a short distance from the mandibular symphysis to cervical tangent increased a risk to OSA. During the 1-year follow-up in OSA patients, the pharyngeal fat pad area and AHI decreased significantly in the intervention group ( p  = 0.003 and p  < 0.001, respectively). Conclusions In the early stages of OSA, the pharyngeal fat pad seems to play an important role in the development of disease in overweight patients. Furthermore, weight reduction by lifestyle intervention-based programme reduces both central obesity and pharyngeal fat pads, resulting in an improvement of OSA.

Background: Heat sensitivity and cognitive deficits are typical manifestations of multiple sclerosis (MS). Although cognitive deficits are quite well characterized, practically no data exist on the effects of heat on cognitive performances in MS. Objective: To assess the effects of short-term heat stress on cognitive functioning in subjects with MS. Methods: A total of 23 heat-sensitive MS and 19 healthy control (HC) subjects participated. Moderate heat exposure took place in a Finnish sauna. Cognitive functioning was measured with tests of sustained attention and processing speed, the Paced Auditory Serial Addition Test (PASAT 3” and 2”) and the computerized visual vigilance test, before, during and after heat exposure. Results: During the heat exposure, the core body temperature of the MS group rose significantly more (p = 0.002) than that of the HC group. The heat stress worsened the performance of the MS group in the PASAT 3” (p = 0.025) but not in the other cognitive measures. The performance in the PASAT 3” was reversed almost to the baseline level only 1- h after the heat exposure. Conclusions: A significant increase in core body temperature during heat stress is associated with a mild and reversible worsening of the PASAT 3” performance, while visual vigilance performance seems to remain almost unaffected.

OBJECTIVE To assess the dynamic changes in left atrial volume by transthoracic three dimensional echocardiography and compare the results with those obtained by magnetic resonance imaging (MRI). DESIGN AND PATIENTS 30 healthy children (15 boys and 15 girls, aged 8 to 13 years) underwent examination by three dimensional echocardiography and MRI. METHODS Three dimensional echocardiography of the left atrium was performed using rotational acquisition of planes at 18° intervals from the parasternal window with ECG gating and without respiratory gating. Volume estimation by MRI was performed with a slice thickness of 4–8 mm and ECG triggering during breath holding in deep inspiration. A left atrial time–volume curve was reconstructed in each child. RESULTS Left atrial maximum and minimum volumes averaged 24.0 ml/m2 and 7.6 ml/m2 by three dimensional echocardiography, and 22.1 ml/m2 and 11.9 ml/m2 by MRI. The greater left atrial minimum volume in the latter was at least in part a result of breath holding. Dynamic changes in left atrial volume during the heart cycle were detectable by both methods. The higher temporal resolution of three dimensional echocardiography allowed a more precise evaluation of different phases. CONCLUSIONS Three dimensional echocardiography and MRI were both useful methods for studying the physiological volume changes in the left atrium in children. These methods may be used for further study of the systolic and diastolic function of the heart.

ObjectiveTo assess if arthroscopic partial meniscectomy (APM) is superior to placebo surgery in the treatment of patients with degenerative tear of the medial meniscus.MethodsIn this multicentre, randomised, participant-blinded and outcome assessor-blinded, placebo-surgery controlled trial, 146 adults, aged 35–65 years, with knee symptoms consistent with degenerative medial meniscus tear and no knee osteoarthritis were randomised to APM or placebo surgery. The primary outcome was the between-group difference in the change from baseline in the Western Ontario Meniscal Evaluation Tool (WOMET) and Lysholm knee scores and knee pain after exercise at 24 months after surgery. Secondary outcomes included the frequency of unblinding of the treatment-group allocation, participants' satisfaction, impression of change, return to normal activities, the incidence of serious adverse events and the presence of meniscal symptoms in clinical examination. Two subgroup analyses, assessing the outcome on those with mechanical symptoms and those with unstable meniscus tears, were also carried out.ResultsIn the intention-to-treat analysis, there were no significant between-group differences in the mean changes from baseline to 24 months in WOMET score: 27.3 in the APM group as compared with 31.6 in the placebo-surgery group (between-group difference, −4.3; 95% CI, −11.3 to 2.6); Lysholm knee score: 23.1 and 26.3, respectively (−3.2; −8.9 to 2.4) or knee pain after exercise, 3.5 and 3.9, respectively (−0.4; −1.3 to 0.5). There were no statistically significant differences between the two groups in any of the secondary outcomes or within the analysed subgroups.ConclusionsIn this 2-year follow-up of patients without knee osteoarthritis but with symptoms of a degenerative medial meniscus tear, the outcomes after APM were no better than those after placebo surgery. No evidence could be found to support the prevailing ideas that patients with presence of mechanical symptoms or certain meniscus tear characteristics or those who have failed initial conservative treatment are more likely to benefit from APM.

In Finland, Olkiluoto Island has been selected for constructing a spent nuclear fuel disposal facility. With the approaching licensing step, submitting the application for nuclear construction licence in 2012, all components of the safety case are becoming more site-specific. In order to assess compliance with regulatory requirements, a prospective deterministic dose assessment methodology based on the ICRP concept of assessing doses to the representative person was developed and implemented in the interim safety case 2009, to be further refined for the safety case 2012. To facilitate the assessment of doses to the most exposed people and other people at the evolving site, full dose distributions are derived, comprising the dose to each potentially exposed person in each generation.

In Finland, Olkiluoto Island on the western coast has been selected as a repository site for spent nuclear fuel disposal. A safety criterion is that typical exposures (dose rates) to flora and fauna should be demonstrated to be lower than those that according to best available knowledge could cause detrimental effect. To increase the confidence of dose assessment to flora, some selected plant species were measured in field conditions. This paper presents the results of the field campaign and discusses on the realism of the common assumption of ellipsoidal geometry applied to the plants in dose assessments of the other biota.

In Finland, Olkiluoto Island on the western coast has been selected as a repository site for spent nuclear fuel disposal. With approaching licensing steps, the biosphere assessment demonstrating the long-term safety of the repository is developed into more and more site specific. As the literature data on site-relevant crops and garden products on site-relevant soils are sparse or in some cases lacking for the elements of a high relevance to the biosphere assessment of the Olkiluoto spent fuel repository, crops and garden products were collected from farms nearby the site. The samples were then analysed for stable elements for initial contribution to the site-specific database in respect of these edibles.

In Finland, Olkiluoto Island on the western coast has been selected as a repository site for spent nuclear fuel disposal. With the approaching licensing steps (application for the nuclear construction licence in 2012), the biosphere assessment demonstrating the long-term safety of the repository is developed into more and more site specific. At the present coastal site, lakes will form in the future millennia due to the post-glacial crustal rebound, i.e. land uplift, which at least eventually will outrun the anthropogenic sea level rise. Both the brackish bays of Baltic Sea and the future lakes can be primary recipients of releases from the deep underground repository, and the aquatic plants can form a major pool of radionuclides with a rather rapid turnover. In some cases the aquatic plants are a relevant part of wildlife food web and possibly also a resource to human. To provide the biosphere assessment models with site-relevant input parameter data, samples of typical aquatic plants were collected from the sea area at the site and from two nearby lakes analogous to those expected to form at the site during the future millennia. This contribution presents water-to-plant concentration ratios of stable elements of high relevance to the biosphere assessment of the Olkiluoto spent fuel repository.

In Finland, Olkiluoto Island on the western coast has been selected as a repository site for spent nuclear fuel. Due to the shallow sea areas around the island, the postglacial land uplift is going to change the landscape within the next millennia. For instance, new lakes and mires will develop on the present offshore areas. Concerning radionuclide transport models, the properties of the future ecosystems surrounding Olkiluoto Island can be forecast based on the properties of present lakes and mires. Due to the lack of site-specific data, lakes and mires of various successional stages were selected within a larger geographical area as analogues of the future ones. Here we present an example of a systematic process for selection of appropriate analogue sites.

A programme of work, commissioned within the BIOPROTA collaborative forum, has recently been undertaken to assess the quantitative and qualitative elements of uncertainty associated with non-human biota (NHB) dose assessment in relation to the potential long-term release of radionuclides from a geological disposal facility (GDF). This was achieved through combining quantitative sensitivity and qualitative knowledge quality analyses based on the EC ERICA assessment approach and default assessment parameters. The results of the project demonstrate that this combination of approaches may be used to identify important parameters that could be significant in assessments of the impacts of any radionuclide release from a GDF on NHB, and for which there is low confidence. The output is intended to provide information on those parameters that may need to be considered in more detail for site-specific assessments. Such information should help users to enhance the quality of their assessments and build greater confidence in the results.