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(2024)Acute coronary syndrome incidence and case fatality have declined in the past decades, but some studies have suggested a potential stagnation in this decline. Therefore, we examined how the burden of the acute coronary syndrome has evolved among persons aged 35-74 in Finland from 1996 to 2021. We gathered data linking Finnish country-wide Hospital Discharge- and Causes of Death- Registers together with the help of unique personal identification number. With this our data contains all the first non-fatal and fatal acute coronary syndrome events happened in Finland during our study period. Altogether, the data consisted of 186 489 non-fatal and 72 907 fatal acute coronary syndrome events. We analysed incidence, mortality, and 28-day case fatality, and their trends and trend changes using negative binomial, Poisson, segmented, and logistic regression adjusting for age and sex. The acute coronary syndrome incidence declined in all age groups of men and in older women, age groups 55- 64 and 65-74. However, the incidence decline slowed down over the last decade. In women’s age groups of 35-44 and 45-54, the incidence was unchanged during the study period. The acute coronary syndrome mortality decline was fast in men and women and the rate of decline was quite similar in all age groups. Also, case fatality declined in all age groups of men and women. The decline in case fatality was most significant in the youngest age group which consisted of people aged 35-¬54 years. Our study shows that the acute coronary syndrome mortality and case fatality has declined in all groups, but the decline in the acute coronary syndrome incidence slowed down and even halted in women in the 2010s. In women aged 35-54, the incidence was unchanged between 1996 and 2021. These results emphasize the need for intensified cardiovascular prevention, particularly in women.
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(2016)Because sustained physical activity is important for a healthy life, this paper examined whether a greater diversity of sport activities during adolescence predicts higher levels of leisure-time physical activity (LTPA) in adulthood. From sport activity participation reported by 17-year-old twins, we formed five groups: 1, 2, 3, 4, and 5+ different sport activities. At follow-up in their mid-thirties, twins were divided into four activity classes based on LTPA, including active commuting. Multinomial regression analyses, adjusted for several confounders, were conducted separately for male (N=1288) and female (N=1770) participants. Further, conditional logistic regression analysis included 23 twin pairs discordant for both diversity of sport activities in adolescence and LTPA in adulthood. The diversity of leisure-time sport activities in adolescence had a significant positive association with adulthood LTPA among females. Membership in the most active adult quartile, compared to the least active quartile, was predicted by participation in 2, 3, 4, and 5+ sport activities in adolescence with odds ratios: 1.52 (p=0.11), 1.86 (p=0.02), 1.29 (p=0.39), and 3.12 (p=5.4e-05), respectively. Within-pair analyses, limited by the small sample of twins discordant for both adolescent activities and adult outcomes (N=23), did not replicate the association. A greater diversity of leisure-time sport activities in adolescence predicts higher levels of LTPA in adulthood in females, but the causal nature of this association remains unresolved.
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(2018)The need to sleep is physiologically regulated and lack of sleep results in impaired daily performance and feeling of tiredness. If sleep disturbance persists for a long time, the risk of many somatic and mental disorders increases. The study of the key molecular processes triggered by insufficient sleep could foster the assessment and enhance the methods of prevention and cure of these long-term health risks. Both insufficient and mistimed sleep have been shown to strongly affect cell transcriptome in animal models and in the studies of selected human cohorts. However, our understanding of the epigenetic modifications, particularly DNA methylation, triggered by the sleep loss remains limited. Here, we performed an epigenome-wide association study in the whole blood samples of men from the general population reporting lack of sleep and of men diagnosed with a shift work disorder. We combined the results from the two independent samples and identified a set of differentially methylated positions (DMPs) common for both cohorts. We further analyzed this set of DMPs by various computational tools, in order to explore altered biological pathways in individuals suffering from lack of sleep. As a result, we discovered a neurological pathway enriched for genes with DMPs, suggesting that curtailed sleep may result in the changes in processes related to synaptic plasticity. We also observed the loss of methylation in the majority of DMPs, in agreement with an earlier observation on the night shift workers. In order to investigate the effect of DNA methylation on gene expression, we performed correlational analyses of M values of the DMPs and the levels of corresponding gene expression. Since methylation levels might fluctuate according to the time of the blood sampling, we also studied the correlation of the DMPs with the time of the sampling. The analysis of genomic locations of the DMPs revealed enrichment of genomic loci involved in syndromes with symptoms of disturbances in visual processing and regulation of circadian rhythm. Our findings suggest that there is a distinctive pattern of genes showing diversity of epigenetic modifications in relation to insufficient sleep in men. The molecular mechanisms behind the observed associations require further investigation, both in general population based samples comprising both genders or occupational cohorts, and in experimental data.
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(2019)Sleep difficulties have been on the rise for the past decade. Insomnia and sleep difficulties have associations with an increased risk of overall mortality, as well as with a diverse array of complex diseases, such as coronary heart disease, major depressive disorder, fibromyalgia and Alzheimer’s disease. Epigenomics provides information on how environmental factors influence the genome via epigenetic mechanisms, such as DNA methylation. Thus far, epigenome-wide association studies looking at the effects of sleep disturbances on the methylome have provided evidence of distinctive methylation patterns in insufficient sleep, involving biological processes related to neuroplasticity and neurodegeneration. However, more knowledge is needed to determine how the severity of sleeping difficulties influence the methylome. This thesis investigates the effects of increasing sleep difficulties on DNA methylation with an epigenome-wide association study. The study sample is derived from the Health 2000 general population survey. Subjects were divided into three different groups by their self-reported level of sleeping difficulty, and methylation measurements performed from whole blood samples utilizing the Illumina Infinium MethylationEPIC kit, encompassing >850,000 CpG sites. To identify differentially methylated sites, a multivariable regression model was used with age, gender, smoking, alcohol use, cell type distribution and plate and array data as covariates. None of the differentially methylated CpG sites identified remained significant after multiple testing correction. To gain more information regarding which biological processes the methylated sites may be part of, those CpG sites with an uncorrected p-value of <0.0005 were subjected to pathway analysis. Notable significant pathways included oxytocin- and serotonin receptor-mediated signalling pathways and Alzheimer’s disease-amyloid secretase pathway. Altogether, six pathways remained significant after multiple testing correction, with a total of 12 different genes appearing in them. Furthermore, a post-hoc regression analysis was conducted between these 12 genes and their corresponding CpG sites, and health-related quality of life questionnaire responses. Significant results included associations between sleep, and discomfort and symptoms (including pain). As an additional analysis, a database search was conducted to learn more about the genes’ functionality at the level of phenotype. Results included some variant trait associations to sleep, Alzheimer’s disease and cognitive performance. The associations to Alzheimer’s disease and cognitive performance warrant further research with a similar additive model, perhaps with a larger sample.
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(2024)Objectives: Mental health problems as well as chronic stress and worries have been shown to have an established connection to sleep quality, but the individual effects of acute, stressful situations encountered in everyday life have received less attention. Rapid eye movement (REM) sleep has a hypothesized role in the processing of emotional memories and may therefore be affected by daytime acute stress. In experimental animal models and non-experimental human studies on healthy subjects acute stress has been associated with increases in REM sleep spectral power in the theta and beta ranges. The aim of this study was to investigate in an experimental setting utilizing virtual reality, whether an acute stress experience influences REM spectral power at these frequency ranges. Methods: Two groups of healthy young adults (N=31, 61 % female, mean age 25.5 years, SD = 3.46) underwent stress inducing or neutral virtual reality scenarios after which they spent the night at a sleep laboratory where their brain activity during sleep was measured with electroencephalography (EEG). To analyse the differences in theta and beta frequency activity during REM sleep, the EEG signal was Fourier transformed to yield power spectral density (PSD) values. Results: Statistical analysis of PSD values revealed that participants in the stress condition exhibited higher REM sleep theta power than controls when controlling for the effects of sex and age. Additionally, sex was found to have a statistically significant effect on REM sleep theta and beta power, with females exhibiting higher power. Age had a negative relationship with spectral power at the theta range, as well as with central low and high beta power. Conclusions: The finding that experimentally manipulated acute stress increases REM sleep theta power during the following night indicates the importance of REM sleep theta activity in the adaptive processing of acute stress, possibly due to the emotional processing of the stressful memory. This study also underlines the importance of sex and age in understanding the relationship between acute stress and REM sleep.
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(2017)Goals. The goal of this research was to find out, how the use of the non-identifying dynamic algorithm would affect fairness experience; and through it, behavioral intentions, in rebating context. Besides that, it was assessed how the provision of detailed information on algorithm's logic affects the fairness experience. Dynamic pricing, especially based on identification, has been shown to negatively affect fairness. The dynamic algorithms are better to companies due to their profitability potential. It is of vital importance to find out the conditions, on which they might be employed, while taking into account the possible reactions of the customers. A differential assessment of entity and event fairness through the lens of fairness heuristic theory is chosen as a backbone of this research to extend the mosaic empirical evidence of their mutual interaction paths. The fairness experience is also closely connected to affects; incidental affects and integral emotions, which are evoked by the fairness experience itself. Because of this close relationship, to complement general picture, the affects were assessed as well. Methods. The manipulations were performed on two levels. The first level, the exposure to dynamic algorithm or seeing the human-set pre-determined rebate rates, happened on the company's site when the algorithm trial was run. The second manipulation level, the amount of the available information, was performed during the gathering of the survey data. There were three conditions in the information manipulation: no information (the control), bare information about the ongoing trial and trial information including a detailed algorithm's logic description. The size of the final sample, used for the analysis, consisted of 404 participants. The main analysing technique employed was SEM. Results and conclusions. Effect paths between entity and event fairness areas were in accordance with the fairness heuristic theory - event fairness mediated the change in entity fairness partially. The subjects that were exposed to the algorithm, event fairness was affected negatively by the bare trial information as expected. The provision of the detailed information did not affect fairness. Entity fairness was connected to both, incidental affects and integral emotions. There were no analogous connection between event fairness, and affects and emotions. Fairness mediated only partially the change from incidental affects to integral emotions. Integral emotions were not connected to the behavioral intentions. Entity fairness mediated fully the effect of event fairness on the behavioral intentions. The provision of the detailed information affected directly positively on pro-active behavioral intentions without a mediation of fairness. None of the manipulations affected directly complaining intentions. The results provide important information about the dynamic algorithm exposure in real life, outside the laboratories. Despite the dynamic pricing being seen as unfair in principle, the exposure to the detailed information might have positive effects on the outcomes. There was only a limited support for the role of affects in the pricing fairness context.
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(2023)Antiepileptic drugs (AED) are vital for treating epilepsy, but their use in pregnancy carries significant risks. Prenatal exposure to some AEDs like valproic acid increases the risk of teratogenicity and deficits in cognitive development in children. The impact of AEDs at different ages has been studied but their effect on the trajectory of cognitive development remains unknown. This study assessed the cognitive performance of children with prenatal AED exposure and unexposed controls using Bayley scales of infant and toddler development III (BSID-III) at 2 years and Weschler intelligence scales for children (WISC-IV) at 6 years of age. The association between 2- and 6-year outcomes was analyzed with separate ANCOVA models for each WISC-IV subscale. BSID-III subscales were used as the covariates and the models were adjusted for confounding factors. BSID-III scores in cognitive (B=6.70, p=0.01) and language (B=6.92, p=0.008) subscales were significantly associated with the WISC-IV working memory scores in controls but not in the exposed group. The groups were also found to differ in their intercorrelations between BSID-III subscale scores. Scores at 2 years were not associated with later results in exposed children as they were in controls. This may suggest that the cognitive development trajectory of AED-exposed children differs from that of unexposed controls, possibly following an alternate projection. Developmental trajectories should be considered when investigating the cognitive effects of prenatal AED exposure. The finding of lacking correlations of BSID-III subscales also raises cause for future investigation of the structure of cognition in AED exposed children.
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Does securin expression have significance in prognostication of oral tongue cancer? : A pilot study (2018)Johdanto: : Sekuriini on proteiini, jolla on tärkeä merkitys solujen jakautumisessa. Sen pääasiallinen tehtävä on estää mitoosin aikana sisarkromatidien ennenaikainen irtoaminen toisistaan ennen kuin tumasukkulan muodostuminen on valmis. Sekuriini säätelee myös M-faasiin siirtymistä ja p53 proteiinin toimintaa, sekä osallistuu DNA:n korjausprosessiin. Sekuriinilla on todettu olevan merkittävä rooli myös useiden syöpien kehittymisessä. Tässä tutkimuksessa analysoimme sekuriinin tuotannon yhteyttä liikkuvan kielen levyepiteelikarsinoomapotilaiden ennusteeseen. Menetelmät: Tutkimusaineisto koostui 93 kielisyöpäpotilaasta, joiden diagnoosi sekä hoito toteutettiin Helsingin yliopistollisessa keskussairaalassa sekä Oulun yliopistollisessa sairaalassa vuosina 1981-2005. Sekuriinituotannon määrää ja sijaintia syöpäkudoksessa tutkittiin immunohistokemiallisesti siten, että 52 potilaan tissue microarray (TMA) ja 41 potilaan kasvainresekaattien histologiset leikkeet värjättiin monoklonaalisella sekuriini vasta-aineella. Sekuriinin määrää arvioitiin prosentuaalisena osuutena positiivisesti sekuriinivasta-aineella värjäytyneistä syöpäsoluista suhteessa kaikkiin kentässä näkyviin syöpäsoluihin. Tilastollisista analyyseistä khiin neliö -testiä käytettiin eri muuttujien välisten riippuvuuksien vertailussa. Kaplan-Meier kuvaajaa, log-rank testiä ja Coxin suhteellisen vaaran mallia sovellettiin elinaika-analyysissä. Tilastolliset analyysit tehtiin IBM SPSS (versio 20.0) tilastoanalyysiohjelmistolla. Tulokset: Sekuriinin yliekspressio liittyi merkittävästi syövän erilaistumisasteeseen (P=0.03). Sekuriinia oli enemmän levinneisyysasteeltaan pidemmälle edenneissä syövissä (asteet III ja IV), mutta tämä yhteys ei ollut tilastollisesti merkitsevä. Assosiaatiota ei myöskään löytynyt sekuriinin määrän ja kielisyöpäkuolleisuuden tai kielisyövän uusiutumisen välillä (P > 0.05). Johtopäätökset: Löydöksemme viittaavat siihen, että sekuriinin yliekspressiolla saattaa olla merkitystä kielisyövän etenemisessä, mutta sekuriini ei ennusta kielisyöpäpotilaan kuolleisuutta tautiin tai taudin uusiutumistaipumusta.
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(2019)Suomessa tehdään vuosittain noin 240 munuaissiirtoa ja siirtojen määrä on kasvamassa. Verrattuna dialyysihoitoon munuaisensiirto antaa potilaalle pidemmän elinajanennusteen sekä paremman elämänlaadun. Munuaisensiirto on lisäksi kustannustehokasta dialyysihoitoon verrattuna. Suomessa suurin osa (85%) munuaissiirteistä tulee aivokuolleelta elinluovuttajalta. Loput siirteet tulevat eläviltä luovuttajilta, mutta maailmalla käytetään myös verenkierron pysähtymiseen menehtyneitä elinluovuttajia. Aivokuolema aiheuttaa elinluovuttajalle verenkierronsäätelyn häiriöitä sekä muutoksia immuuni- ja hyytymisjärjestelmiin. Lisäksi munuaissiirteen kylmä- ja lämminsäilytys sekä verenkierron palauttaminen aiheuttavat siirteelle iskemia-reperfuusio vaurion. Tämä voi aiheuttaa munuaissiirteen hidastuneen käynnistymisen (delayed graft function, DGF) aiheuttaen dialyysihoidon tarpeen. Munuaissiirteen hidastuneen käynnistymisen yleisyys Suomessa on tällä hetkellä noin 25%. Tässä tutkielmassa on analysoitu 100 munuaissiirtopotilaan muodostama aineisto. 89 munuaissiirteistä oli Suomesta ja 11 munuaissiirrettä saatiin Pohjoismaisen jakeluverkoston kautta. Munuaissiirrot on tehty vuosina 2015-2016. Tutkimuksen tavoitteena on selvittää, mitkä elinluovuttajaan liittyvät tekijät vaikuttavat DGF:n kehittymiseen. 30%:lle aineiston potilaista kehittyi DGF. Tilastollisesti merkittäviä tekijöitä DGF:n kehittymiselle olivat elinluovuttajan BMI ja verenpainetauti. Tutkimus tuo vahvistusta jo aikaisemmin tiedossa olleille DGF:n riskitekijöille suomalaisessa aineistossa. DGF lisää munuaissiirtoon liittyviä kustannuksia ja huonontaa siirteen pitkäaikaisennustetta. DGF:lle altistavat tekijät ovat suurelta osin elinluovuttajaan liittyviä (64%). Tämä puoltaa ajantasaisten ja yhtenäisten elinluovuttajan hoito-ohjeiden käyttöä.
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(2016)Avhandlingen är en litteraturöversikt om bettfel och ortodontisk vård hos personer med Downs syndrom. Materialet är samlat från PubMed och tidskrifter inom pedodonti och ortodonti. Bettfelen hos personer med Downs syndrom är ett resultat av allmän muskelhypotoni, hypoplastisk maxilla och särdrag hos tänderna (hypodonti och taurodonti). De vanligaste bettfelen är Angle klass III-format bett och anteriort korsbett. Andra bettfel är anteriort öppet bett, posteriort korsbett och trångställning. På grund av muskelhypotonin skjuts tungan framåt och detta kallas "pseudomacroglossia". Den främsta ortodontiska vården går ut på att träna upp tungan att hållas vilande uppe mot gommen, följt av breddning av den hypoplastiska maxillan. Målet med vården är att förbättra tuggfunktionen, talet, sväljning och estetiken i det orala området. Hos patienter med mild sömnapné kan sömnkvalitén förbättras med en oral apparatur.
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(2017)Dry eye disease is one of the most common eye diseases and it deteriorates the life quality of a large number of patients. The etiopathological causes behind the dry eye disease are divided in two major classes, aqueous-deficient dry eye (ADDE) and evaporative dry eye (EDE). Naturally, the reasons behind dry eye symptoms of a certain patient may be a combination of both classes. Knowing the underlying cause behind the symptoms is crucial in finding the correct treatment. Properties of the human tear film have been studied to a great extent. One of the research methods that has been used is computer simulations, especially during the last decades as increases in computing power have made even rather sophisticated models accessible. This literature review first describes the dry eye syndrome as a medical condition and then discusses the pros and cons of computer simulations. Then, key findings from the literature are presented in three categories: macro-scale tear fluid simulations, models of the rupturing process of the thin precorneal tear film, and molecular simulations of the tear film lipid layer. A brief example of a simulation is also presented.
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(2020)Dilatoiva kardiomyopatia (DCM) on sydänlihassairaus, jolle on tyypillistä vasemman kammion laajeneminen ja supistuvuuden heikkeneminen, kun selittävänä tekijänä ei ole vakavaa sepelvaltimotautia tai poikkeavaa vasemman kammion kuormitusta. Titiini- ja lamiini A/C-geenit (TTN, LMNA) ovat merkittävimmät tautigeenit familiaalisen DCM:n taustalla. Aiemmin DSP:n variantit on yhdistetty arrytmogeeniseen oikean kammion kardiomyopatiaan (ARVC) ja vasta viime aikoina DCM:ään. Tutkimuksessa kuvataan DSP c.6310delA, p.(Thr2104Glnfs*12)-varianttiin liittyviä sydänilmentymiä. Tämä DSP-variantti havaittiin kymmenellä suomalaisella eri suvuista olevalla indeksihenkilöllä käyttämällä uuden sukupolven sekvensointia (NGS, next-generation sequencing). Indeksien sukulaisilta varmistettiin DSP-variantin esiintyminen käyttämällä Sanger-sekvensointia. Tutkittavien kliinisiä tietoja kerättiin vanhoista sairauskertomusteksteistä ja lisäksi osalle heistä tehtiin kliininen sydäntilanteen arviointi. Havaitsimme DSP c.6310delA, p.(Thr2104Glnfs*12) variantin 17 henkilöllä, joista 11 (65 %) täytti DCM:n diagnostiset kriteerit. Tämä patogeeninen variantti ilmenee vasemman kammion laajentumisena ja systolisen toiminnan häiriönä sekä vakavina kammioperäisinä rytmihäiriöinä. Kahdella potilaalla esiintyi sydämen magneettitutkimuksessa sydänlihaksen turvotusta ja jälkitehostumaa, jotka voivat viitata inflammatoriseen prosessiin sydänlihaksessa. Erityisesti niillä DSP-variantin kantajilla, joilla oli diagnosoitu DCM, esiintyi myös kammioperäisiä rytmihäiriöitä. Tämä löydös tukee uutta arrytmogeenisen kardiomyopatian käsitettä sekä DSP-varianttien merkitystä DCM:n taustalla. Tämän trunkoivan DSP-variantin penetranssi oli matala indeksien sukulaisilla ennen 40 vuoden ikää. Jatkossa tarvitaan vielä lisätutkimuksia selventämään patogeenisten DSP-varianttien ja sydänlihaksen inflammaation välistä mahdollista yhteyttä. (192 sanaa)
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(2019)Tavoitteet: D-vitamiinin on ehdotettu olevan yksi mahdollinen ympäristötekijä mielenterveyden häiriöiden kehittymisessä. D-vitamiini osallistuu aivoissa hermosolujen muodostumiseen ja erilaistumiseen sekä joidenkin geenien säätelyyn. Lisäksi mielenterveyden häiriöistä, kuten autismikirjon häiriöstä, kärsivillä lapsilla on havaittu olevan ikätovereitaan alhaisempi seerumin D-vitamiinitaso. Muutamassa tutkimuksessa on verrattu lasten D-vitamiinitasoja ja eksternalisoivia eli ulospäin suuntautuneita ja internalisoivia eli sisäänpäin suuntautuneita oireita, eivätkä tulokset ole olleet systemaattisia. Interventiotutkimuksissa esimerkiksi autismikirjon häiriön oireita on onnistuttu lieventämään ravitsemussuosituksia suuremmalla D-vitamiinilisän käytöllä. Aiempaa interventiotutkimusta ei-kliinisessä lapsipopulaatiossa D-vitamiinilisän vaikutuksista ei ole. Menetelmät: Tutkimuksen otos on osa suomalaisen VIDI (Vitamin D Intervention in Infants) -tutkimuksen aineistoa. Tutkimus oli satunnaistettu kontrolloitu kaksoissokkokoeasetelmallinen interventiotutkimus. Kontrolliryhmä sai kahden viikon ikäisestä kaksivuotiaaksi asti pohjoismaisten ravitsemussuositusten mukaisen annoksen (10 µg) D-vitamiinilisää päivittäin, interventioryhmän saadessa kolminkertaisen annoksen (30 µg). Lasten eksternalisoivia ja internalisoivia oireita kartoitettiin kaksivuotiaana vanhempien täyttämällä ITSEA (Infant-Toddler Social and Emotional Scale) -lomakkeella. Tarkoituksena oli tutkia eroavatko D-vitamiinilisää enemmän saaneitten lasten eksternalisoivien ja internalisoivien oireiden määrät kontrolliryhmästä. Ryhmien väliset tarkastelut tehtiin myös sukupuolille erikseen, sillä eksternalisoivissa ja internalisoivissa oireissa tiedetään ilmenevän eroja sukupuolten välillä. Tulokset ja johtopäätökset: Interventio- ja kontrolliryhmän lasten eksternalisoivien ja internalisoivien oireiden määrät eivät eronneet toisistaan kahden vuoden iässä. Tulos viittaa siihen, ettei tämänhetkisiä ravitsemussuosituksia suuremmalla D-vitamiinilisän määrällä saavuteta hyötyjä suhteessa kaksivuotiaiden lasten psykologisiin tekijöihin. Poikien kohdalla ilmeni heikko yhteys suuremman D-vitamiinilisän määrän ja korkeamman eksternalisoivien oireiden määrän välillä. Aikaisemmissa interventiotutkimuksissa D-vitamiinilisän vaikutus on ollut päinvastainen, mutta koehenkilöillä on ollut diagnosoidun autismikirjon häiriön lisäksi matala veren seerumin D-vitamiinitaso ennen D-vitamiini-interventiota. Korkeamman D-vitamiinilisän määrän mahdolliset haitalliset vaikutukset poikien eksternalisoiviin oireisiin kaipaavat lisäselvitystä.
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(2020)Taustaa: Pään ja kaulan alueen syövät ovat tiettyjen sijaintikohtien osalta melko huonoennusteisia. Hoitotuloksia yritetään parantaa kehittämällä hoitomuotoja sekä lyhentämällä sekä diagnostista että hoitoviivettä. Lisäksi pyritään vaikuttamaan muun muassa etiologisiin tekijöihin. Näiden syöpien tunnettuja riskitekijöitä ovat alkoholin suurkulutus, runsas tupakointi sekä ihmisen papilloomavirusinfektio. D-vitamiinitason on todettu aiemmissa havainnoivissa tutkimuksissa assosioituvan käänteisesti muun muassa yleisen syöpäriskin sekä suolistosyöpäriskin kanssa. Kirjallisuudessa on tähän liittyen tutkimuksia myös pään ja kaulan alueen syövän suhteen. Tavoitteet: Systemaattisen katsauksen tavoitteena oli selvittää nykyinen käsitys D-vitamiinin roolista pään ja kaulan alueen syövälle altistavana tekijänä sekä D-vitamiinipitoisuuden vaikutuksesta kyseisten syöpien hoitotulokseen. Systemaattinen katsaus tehtiin Ovid Medline -, Pubmed-, ja Scopus-tietokannoissa. Katsaukseen hyväksyttiin tutkimukset, joissa tutkittavat sairastivat pään ja kaulan alueen syöpää sekä heiltä oli mitattu 25-OH-D₂-pitoisuudet. Tutkimukset rajattiin englanninkielisiin julkaisuihin. Valikoitujen tutkimusten ulkopuolelle suljettiin syövän hoitoon sekä eläinkokeisiin keskittyvät ja solutason tutkimukset. Tulokset: Tarkasteltuja tutkimuksia oli 276, joista valikoitui lopulta 13 tutkimusta. Pään ja kaulan alueen syöpiä sairastavilla potilailla on selkeästi matalammat D-vitamiinipitoisuudet terveisiin verrokkeihin verrattuna. D-vitamiinin yhteydestä syöpäriskiin löytyi ristiriitaisia tuloksia, sekä D-vitamiinin roolia puoltavia että kumoavia tutkimuksia oli yhtä paljon. D-vitamiinilla ei havaittu yhteyttä kuolleisuuteen, mutta sen epäillään assosioituvan pidemmän hoidonjälkeisen elossaoloajan kanssa sekä suojaavan mukosiitilta ja lihaskadolta. Johtopäätelmät: Tulosten perusteella D-vitamiinin roolista on tähän mennessä hyvin ristiriitaisia tuloksia pään ja kaulan alueen syöpien altistavana tekijänä, eikä pelkkien havainnoivien tutkimusten perusteella voida päätellä syy-yhteyksiä. Tutkielman aiheesta tarvitaan satunnaistettuja kontrolloituja tutkimuksia, jotta saadaan vahvempaa näyttöä ja voidaan tarvittaessa luoda uusia ravintosuosituksia tämän alueen syöpäpotilaille.
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(2015)Målet med denna studie var att undersöka sambandet mellan D-vitaminhalten i blodet och riskfaktorer för det metabola syndromet. Dessa faktorer är hypertension, bukfetma, hyperglykemi och dyslipidemi. Det har i många studier framkommit ett samband mellan dessa och en D-vitaminhalt på under 50 nmol/l. I denna studie analyseras att material som består av en D-vitaminmätning från år 2007 och mätning av de olika riskfaktorerna från åren 2012-2013. Materialet är en del av Helsinki Birth Cohort Study (HBCS) materialet. Analysen av materialet visar att D-vitaminbrist med stor sannolikhet är kopplat till det metabola syndromets olika riskfaktorer.
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(2017)Detta arbete är en litteraturstudie vars syfte är att undersöka vetenskapliga artiklar för att ta reda på hur D-vitamin påverkar parodontala vävnaden och om det finns belägg för att D-vitamin har en positiv effekt på parodontala hälsan. D-vitamin är ett prohormon som reglerar immunförsvaret och kroppens absorption av kalcium och fosfor. Parodontit är en kronisk inflammatorisk sjukdom som bryter ner tänders stödjevävnad samt käkarnas alveolarben och ger upphov till tandlossning. Denna studie letar i den vetenskapliga litteraturen om det finns kausalitets samband mellan D-vitaminbrist och parodontit eftersom båda tillstånden är skelettala och inflammatoriska sjukdomar. Både parodontit och D-vitaminbrist är vanligt förekommande i den finska befolkningen. Detta arbete är baserat på litteratursökning i PubMed, Melinda, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews och internet hemsidan terveysportti.fi. Litteraturgranskningens resultat är att sambandet mellan D-vitamin halten i serum och parodontal infektion är svag. Populations studier visar att D-vitamin brist har försumbar gynnsam effekt på parodontal infektion. Däremot har D-vitamin i teorin positiv effekt på alveolarbenets mineraldensitet och immunförsvar. Denna studie visar att D-vitaminbrist kan vara orsaken till ett svagt parodontologiskt behandlingssvar om andra starkare parodontologiska riskfaktorer är uteslutna.
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(2023)Intestinal epithelium is capable of rapid regeneration, which is associated with transient changes in cellular identity. Some of these changes involve an enrichment of fetal-like gene expression and simultaneous suppression of adult stem cell signature. Interestingly, the upregulation of fetal-like marker Stem cell antigen 1 (Sca1) is modulated by extracellular matrix (ECM) which is known to guide epithelial cells during regeneration. Our recently published decellularized small intestinal ECM (iECM) system retains the composition and topology of natural ECM. This makes it an attractive system for ex vivo studies addressing regeneration. This thesis aimed to gain insight into the fetal-like identity and its dynamics using an ex vivo iECM system. Intriguingly, Sca1 expressing cells on iECM displayed migratory features, such as a leading edge and changes in nuclear morphology. Curiously, these features are typical for epithelial cells during development. Furthermore, based on marker gene expression during iECM re-epithelization, fetal-like state was upregulated while adult stem cell state was downregulated, revealing a gradually emerging inverse correlation. Additionally, data suggests that circadian rhythms may have a role in modulating the fetal-like state. iECM from an active-state mice indicated a reduced capability to induce fetal-like identity and overall re-epithelization compared to the rest-state iECM. The results of this thesis suggest further potential of iECM system in studying emergence of fetal-like state during re-epithelization and circadian rhythm impact on it.
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(2016)Background Constipation and dyspepsia are disturbing gastrointestinal symptoms that are often ignored in research on physical comorbidities of schizophrenia. Aims Our aim was to assess dyspepsia and constipation in a sample of outpatients with schizophrenia spectrum psychoses. Methods A general practitioner performed a thorough physical health check for 275 outpatients and diagnosed constipation and dyspepsia. We assessed the possible contribution of several sociodemographic, lifestyle, and clinical variables to constipation and dyspepsia using logistic regression analysis. We also assessed whether these symptoms were associated with abnormal laboratory findings. Results The prevalence of constipation was 31.3%, and of dyspepsia 23.6%. Paracetamol (OR=3.07, 95% CI 1.34–7.02) and clozapine use (OR=5.48, 95% CI 2.75–10.90), older age (OR=1.04, 95% CI 1.01–1.06), and living in sheltered housing (OR=2.49, 95% CI 1.16–5.33) were risk factors for constipation. For dyspepsia the risk factors were female sex (OR=2.10, 95% CI 1.15–3.83), non-steroidal anti-inflammatory drugs (OR=2.47, 95% CI 1.13–5.39), and diabetes medication (OR=2.42, 95% CI 1.12–5.25). Patients with dyspepsia had lower hemoglobin and hematocrit and higher glucose values than those without dyspepsia. Patients with constipation had lower thrombocyte values than patients without constipation. However, these findings were explained by factors predisposing to constipation and dyspepsia. Conclusions Clozapine use markedly increases the risk of constipation and may lead to life-threatening complications. In addition, analgesics and diabetes medication were related to gastrointestinal symptoms. These medications and their association to gastrointestinal symptoms should be kept in mind when treating patients with schizophrenia.
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(2019)Playing video games is a popular way to spend time and mobile gaming is one of the most growing entertainment industries in the world. Gaming is often associated with high level of motivation from the user as well as many negative and positive outcomes. Commitment towards games has invited countless of researches to examine what makes them so intriguing and motivating. This growing understanding gives developers more tools to design even better games and allows game-like features to be used in other contexts as well. This master’s thesis examines automatically gathered early log-data (n=100 000) from two free-to-play mobile games in order to create a model for retention. A model created using early log-data (first three days of play) creates opportunities to recognize potential players in an early phase and to evaluate early iterations of games that are in development. Furthermore, individual features are analyzed to study, what are the factors that influence coming back to the game at a later point (30 days after the installation of the game). The research questions in this thesis are: 1) Can commitment towards mobile games be modeled using early log-data? 2) How accurate predictions the created model can do? 3) What are the most important in-game features that predict retention? The model is created using a decision tree analysis, which was selected as a method due to its transparency and because it has been used before in earlier studies with similar designs. In both games, the rate of coming back to the game after 30 days of installation was 7.6%. A working model for retention was formulated which was able to predict coming back to the game with 33% accuracy. The most important in-game features that affect retention were the number of victories, the number of starts and the number of in-app-purchases during the three-day period after the game’s installation. Surprisingly, in-game rewards and achievements were the most insignificant features when predicting retention although they are often specifically designed to elevate user motivation. These results can influence design decisions made in game development by setting the focus on the factors that influence player commitment and behavior. Achievements and in-game rewards might feel too artificial and superficial compared to winning in game. If the system gives direct feedback of the effect of time and monetary sacrifice to the player’s performance, one might be able to reduce the number of players that decide to leave the game. The results also can be used to examine how game-like features are used in non-game systems where the goal is to tie together the high-level of motivation seen in games and socially impactful endeavors. Further studies of in-game behavior might also give new insights on game addiction and its negative effects on player well-being and business.
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(2018)Background: The etiology of type 1 diabetes (T1D) is largely unknown. Infections and microbial exposures are believed to play a role in the pathogenesis and in the development of islet autoimmunity in genetically susceptible individuals. Objective: To assess the relationships between early childhood infections, islet autoimmunity, and progression to T1D in genetically predisposed children. Methods: Children with HLA-conferred disease susceptibility (N=790; 51.5% males) from Finland (n=386), Estonia (n=322), and Russian Karelia (n=82) were observed from birth up to the age of 3 years. Children attended clinical visits at the age of 3, 6, 12, 18, 24, and 36 months. Serum samples for analyzing T1D-associated autoimmune markers were collected and health data recorded during the visits. Results: Children developing islet autoimmunity (n=46, 5.8%) had more infections during the first year of life (3.0 vs. 3.0, mean rank 439.1 vs. 336.2; p=0.001) and their first infection occurred earlier (3.6 vs. 5.0 months; p=0.005) than children with no islet autoimmunity. By May 2016, seven children (0.9%) had developed T1D (progressors). Compared to non-diabetic children, T1D progressors were younger at first infection (2.2 vs. 4.9 months; p=0.004) and had more infections during the first 2 years of life (during each year 6.0 vs. 3.0; p=0.001 and p=0.027, respectively). By 3 years of age, the T1D progressors had twice as many infections as the other children (17.5 vs. 9.0; p=0.006). Conclusions: Early childhood infections may play an important role in the pathogenesis of T1D. Current findings may reflect either differences in microbial exposures or early immunological aberrations making diabetes-prone children more susceptible to infections.
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