University of Turku
  • Turku, Finland
Recent publications
Background The privacy and security of a person’s health data is a human right protected by law in many countries. However, networked information systems that store and process health data may have security vulnerabilities and are attractive to attacks aimed to gain either unauthorized access to these data or compromise it. Compromising data of patients with chronic conditions like Diabetes Mellitus has potentially life-threatening consequences (e.g., from incorrect insulin dosing due to loss of glucose measurement data integrity). Consequently, privacy-preserving computing methods are called to mitigate the risk of a data breach. Methods In this paper, our aim is to apply homomorphic encryption to safeguard blood glucose management in the context of artificial pancreas device systems. Namely, we introduced and evaluated a proportional–integral–derivative controller using simulation tests. We compared a plaintext controller with the proposed privacy-preserving controller on two different food-intake profiles. Results Our results demonstrated that the time in range values by our system (the average time in range across 10 average food intake profiles and 10 extreme profiles were 85.9% and 86.0%, respectively) did not differ between the two implementations. Conclusion In the future, a cloud-based secure, and private Diabetes Mellitus management system of this kind could both regulate a given patient’s blood glucose and support remote patient monitoring continuously and conveniently at home.
Background Changes in the incidence of melanoma in children and adolescents have been reported in Europe and in the USA in the recent decades. Aims The aim of this study was to examine the incidence of paediatric and adolescent melanomas in Finland in 1990-2014, and the associated clinical and histopathological characteristics to reveal temporal trends, such as changes in diagnostic sensitivity of Spitzoid melanomas. Methods Information on 122 patients diagnosed with cutaneous melanoma at 0-19 years of age in Finland in 1990-2014 were retrieved from the Finnish Cancer Registry. 73 primary melanoma archival samples were re-evaluated by two dermatopathologists to allow comparability over time. Results A 5.6% annual increase was observed in the incidence of melanoma among children and adolescents during the study period. Fifty-six tumours were confirmed as malignant melanomas in the re-evaluation. After correction for tumour misclassification in the Cancer Registry, the age-adjusted annual incidence was estimated to have increased from 1.4/1 000 000 in 1990-1994 to 5.8/1 000 000 in 2010-2014. The change in incidence was most prominent among adolescents and in Spitzoid melanoma subtype. Melanomas diagnosed 1990-2002 and 2003-2014 did not differ in terms of their clinicopathological characteristics or prognosis (hazard ratio for melanoma-related death 1.53, 95% CI 0.30 to 7.88). Spitzoid melanomas were diagnosed at a younger age, were of higher stage and had higher Clark level than other melanomas, yet the hazard ratio for death was 0.52 (95% CI 0.10 to 2.58) for Spitzoid versus other melanomas. Conclusions The incidence of cutaneous melanoma has clearly increased among the young in Finland, especially among adolescents. No evidence for overdiagnosis of Spitzoid melanomas as the underlying cause of the increased incidence was observed. • Key message • A nationwide retrospective re-evaluation of the cutaneous melanomas recorded in the Finnish Cancer Registry among patients aged 0–19 years in Finland in 1990–2014 revealed an approximately 4-fold increase in the incidence. The increase in the incidence was most prominent among adolescents and in the Spitzoid melanoma subtype. Our results contrast those reported in other countries, where the incidence of melanoma among adolescents has declined.
Objective: The aim was to investigate the effect of different interfacial surface treatments on the shear bond strength (SBS) between a short fiber-reinforced flowable composite (SFRC) and a particulate-filled flowable composite (PFC). In addition, SBS between two successive layers of similar materials was evaluated. Materials and methods: One-hundred and forty-four specimens were prepared having either SFRC (everX Flow) as a substructure composite and PFC (G-aenial Flo X) as a surface composite or having one of the two materials as both substructure and surface layer. Eight groups of specimens were created (n = 18/per group) according to the interfacial surface protocol used. Group 1: no treatment; Group 2: ethanol one wipe; Group 3: ethanol three wipes; Group 4: phosphoric acid etching + bonding agent; Group 5: hydrofluoric acid etching + bonding agent; and Group 6: grinding + phosphoric acid etching. Group 7: only PFC layers and Group 8 (control) only SFRC layers without any surface treatment. After one-day storage (37 °C), SBS between surface and substructure composite layers was measured in a universal testing machine, and failure modes were visually analyzed. SEM was used to examine the bonding surface of the SFRC composite after surface treatment. SBS values were statistically analyzed with a one-way analysis of variance (ANOVA) followed by the Tukey HSD test (α = .05). Results: The SBS between successive SFRC layers (Group 8) was statistically (p < .05) the highest (43.7 MPa) among tested groups. Surface roughening by grinding followed by phosphoric acid etching (Group 6) resulted in a higher SBS (28.8 MPa) than the remaining surface treatments. Conclusion: Flowable composite with glass fibers (everX Flow) showed higher interlayer SBS compared to PFC flowable composite. Interfacial surface roughness increases the bonding of PFC to the substructure of SFRC.
ABSTRACT Long-term livestock grazing has shaped landscapes, biodiversity, societies, cultures, and economies in the North Atlantic over time. However, overgrazing has become a major environmental sustainability challenge for this region, covering the Faroe Islands, Greenland, Iceland, Norway, and Scotland. The objective of this study was to elicit narratives and spatial patterns of local people’s management preferences for sheep grazing in the Faroe Islands through a socio-cultural lens. We collected data via a Public Participation Geographic Information Systems (PPGIS) survey with an open question about hopes and concerns for sheep management in the Faroe Islands and a mapping exercise for expressing spatial preferences for sheep management. Four distinct narratives emerged from a qualitative analysis of responses to the open question (n = 184): (1) Sustainable sheep management, (2) Nature without sheep, (3) Sheep as part of Faroese culture, and (4) Sheep as nuisance. Visual inspection of narrative-specific maps with locations where either no or fewer sheep were preferred indicated that sheep management is not simply a ’sheep vs. no sheep’ issue but embedded in a more nuanced consideration of the place of sheep in the landscape and society. For example, for some residents sheep-farming is not a commercial enterprise but a social activity and local source of food. Our combined methodological approach using qualitative and spatial data can help researchers in other fields identify the interplay between place-specific areas of grazing management concern and socio-ultural values, enabling more targeted land-use management policies or plans.
Background: Prior evidence suggests that capsinoids ingestion may increase resting energy expenditure (EE) and fat oxidation (FATox), yet whether they can modulate those parameters during exercise conditions remains poorly understood. We hypothesized that dihydrocapsiate (DHC) ingestion would increase EE and specifically FATox during an acute bout of aerobic exercise at FATmax intensity (the intensity that elicits maximal fat oxidation during exercise [MFO]) in men with overweight/obesity. Since FATmax and MFO during aerobic exercise appear to be indicators of metabolic flexibility, whether DHC has an impact on FATox in this type of population is of clinical interest. Methods: A total of 24 sedentary men (age = 40.2 ± 9.2 years-old; body mass index = 31.6 ± 4.5 kg/m2 [n = 11 overweight, n = 13 obese]) participated in this randomized, triple-blinded, placebo-controlled, crossover trial (registered under ClinicalTrials.gov Identifier no. NCT05156697). On the first day, participants underwent a submaximal exercise test on a cycle ergometer to determine their MFO and FATmax intensity during exercise. After 72 hours had elapsed, the participants returned on 2 further days (≥ 72 hours apart) and performed a 60 min steady-state exercise bout (i.e. cycling at their FATmax, constant intensity) after ingesting either 12 mg of DHC or placebo; these conditions were randomized. Respiratory gas exchange was monitored by indirect calorimetry. Serum marker concentrations (i.e. glucose, triglycerides, non-esterified fatty acids (NEFAs), skin temperature, thermal perception, heart rate, and perceived fatigue) were assessed. Results: There were no significant differences (P > 0.05) between DHC and placebo conditions in the EE and FATox during exercise. Similarly, no significant changes were observed in glucose, triglycerides, or NEFAs serum levels, neither in the skin temperature nor thermal perception across conditions. Heart rate and perceived fatigue did not differ between conditions. Conclusions: DHC supplementation does not affect energy metabolism during exercise in men with overweight/obesity.
Alterations in the gut microbiota composition have been associated with a range of neurodevelopmental, neurodegenerative, and neuropsychiatric disorders. The gut microbes transform and metabolize dietary- and host-derived molecules generating a diverse group of metabolites with local and systemic effects. The bi-directional communication between brain and the microbes residing in the gut, the so-called gut-brain axis, consists of a network of immunological, neuronal, and endocrine signaling pathways. Although the full variety of mechanisms of the gut-brain crosstalk is yet to be established, the existing data demonstrates that a single metabolite or its derivatives are likely among the key inductors within the gut-brain axis communication. However, more research is needed to understand the molecular mechanisms underlying how gut microbiota associated metabolites alter brain functions, and to examine if different interventional approaches targeting the gut microbiota could be used in prevention and treatment of neurological disorders, as reviewed herein.Abbreviations:4-EPS 4-ethylphenylsulfate; 5-AVA(B) 5-aminovaleric acid (betaine); Aβ Amyloid beta protein; AhR Aryl hydrocarbon receptor; ASD Autism spectrum disorder; BBB Blood-brain barrier; BDNF Brain-derived neurotrophic factor; CNS Central nervous system; GABA ɣ-aminobutyric acid; GF Germ-free; MIA Maternal immune activation; SCFA Short-chain fatty acid; 3M-4-TMAB 3-methyl-4-(trimethylammonio)butanoate; 4-TMAP 4-(trimethylammonio)pentanoate; TMA(O) Trimethylamine(-N-oxide); TUDCA Tauroursodeoxycholic acid; ZO Zonula occludens proteins.
Background Prehospital medical problem reporting is essential in the management of helicopter emergency medical services (HEMS) operations. The consensus-based template for reporting and documenting in physician-staffed prehospital services exists and the classification of medical problems presented in the template is widely used in research and quality improvement. However, validation of the reported prehospital medical problem is lacking. This study aimed to describe the in-hospital diagnoses, patient characteristics and medical interventions in different categories of medical problems. Methods This retrospective, observational registry study examined the 10 most common in-hospital International Statistical Classification of Disease (ICD-10) diagnoseswithin different prehospital medical problem categories, defined by the HEMS physician/paramedic immediately after the mission was completed. Data were gathered from a national HEMS quality registry and a national hospital discharge registry. Patient characteristics and medical interventions related to different medical problem categories are also described. Results A total of 33,844 patients were included in the analyses. All the medical problem categories included a broad spectrum of ICD-10 diagnoses (the number of diagnosis classes per medical problem category ranged from 73 to 403). The most frequent diagnoses were mainly consistent with the reported medical problems. Overlapping of ICD-10 diagnoses was mostly seen in two medical problem categories: stroke and acute neurology excluding stroke. Additionally, typical patient characteristics and disturbances in vital signs were related to adequate medical problem categories. Conclusions Medical problems reported by HEMS personnel have adequate correspondence to hospital discharge diagnoses. However, the classification of cerebrovascular accidents remains challenging.
It is well known that green urban commons enhance mental and physical well-being and improve local biodiversity. We aim to investigate how these outcomes are related in an urban system and which variables are associated with better outcomes. We model the outcomes of an urban common—box gardening—by applying the Social-Ecological Systems (SES) framework. We expand the SES framework by analyzing it from the perspective of social evolution theory. The system was studied empirically through field inventories and questionnaires and modeled quantitatively by Structural Equation Modeling (SEM). This method offers powerful statistical models of complex social-ecological systems. Our results show that objectively evaluated ecological outcomes and self-perceived outcomes are decoupled: gardening groups that successfully govern the natural resource ecologically do not necessarily report many social, ecological, or individual benefits, and vice versa. Social capital, box location, gardener concerns, and starting year influenced the changes in the outcomes. In addition, the positive association of frequent interactions with higher self-perceived outcomes, and lack of such association with relatedness of group members suggests that reciprocity rather than kin selection explains cooperation. Our findings exemplify the importance of understanding natural resource systems at a very low “grassroot” level.
Purpose This study examines the relationship between birth order and length of hospitalization due to pediatric traumatic brain injury (TBI). Methods We prospectively followed 59,469 Finnish newborns from 1987 until age 18 years. Data on first diagnosis of TBI was recorded within the 1987 Finnish Birth Cohort (FBC). Hospitalization period was divided into two categories: 2 days or less and more than 2 days. The latter was considered in this study as longer hospitalization. Results Compared with first born siblings, later born siblings had an increased risk of a longer hospitalization for TBI (12.7% of fourth or higher born birth children diagnosed with TBI were hospitalized for 2 or more days, 11.3% of first born, 10.4% of third born and 9.0% of second born). Fourth or higher born children were more likely to experience a repeat TBI; 13.4% of fourth or higher born children diagnosed with TBI had 2–3 TBIs during the study period compared to 9% of third born, 7.8% of second born and 8.8% of the first born. Injuries in the traffic environment and falls were the most common contributors to pediatric TBI and occurred most frequently in the fourth or higher birth category; 29.3% of TBIs among fourth or higher birth order were due to transport accidents and 21% were due to falls. Conclusions This study revealed a significant increase in risk for longer hospitalization due to TBI among later born children within the same sibling group. The study provides epidemiological evidence on birth order as it relates to TBI, and its potential to help to explain some of the statistical variability in pediatric TBI hospitalization over time in this population.
This paper introduces and motivates the Radical Technology Inquirer (RTI) methodology for anticipation of technological breakthroughs and their combined cross-sectoral and social impacts. The primary use of the methodology is long-term policy evaluation and design. The first version of the methodology was published in 2013. This paper reports the current RTI 2018 version, which is based on systematic collection of scientific and technological news and grounded on theory. It combines societal functions with technological opportunities by conceptualising 20 "global value-producing networks" GVNs and 100 "anticipated radical technologies" ARTs. The RTI methodology is participa-tory, using continuous crowdsourcing and stakeholder evaluations. Each GVN is characterised by a need and an existing and a novel way of satisfying that need and organising the societal function. The methodology combines existing and new foresight methods and concepts to achieve a holistic and transparent approach for anticipating technology-enabled transformative socio-technical developments of the next 20 years. In this anticipation effort, the focus is more on recent weak signals of emerging technological capabilities than on past strong signals, e.g. the diffusion of various technologies.
Extrapyramidal (EP) symptoms such as tremor, rigidity, and bradykinesia are common side effects of most antipsychotics, and may associate with impaired performance in neurocognitive testing. We studied EP symptoms in first-episode psychosis (FEP; n = 113). Cognitive testing and EP symptoms (three items of the Simpson-Angus Scale) were assessed at baseline and follow-up (mean follow-up time 12 months). Mild EP symptoms were present at treatment onset in 40% of the participants. EP symptoms were related with lower performance in neurocognitive testing at baseline and at follow-up, especially among those with nonaffective psychotic disorder, and especially in tasks requiring speed of processing. No associations between EP symptoms and social cognition were detected. In linear regression models, when positive and negative symptom levels and chlorpromazine equivalents were accounted for, baseline EP symptoms were associated with worse baseline global neurocognition and visuomotor performance. Baseline EP symptoms also longitudinally predicted global, verbal, and visuomotor cognition. However, there were no cross-sectional associations between EP symptoms and cognitive performance at follow-up. In sum, we found both cross-sectional and longitudinal associations between EP symptoms and neurocognitive task performance in the early course of psychosis. Those without EP symptoms at the start of treatment had higher baseline and follow-up neurocognitive performance. Even mild EP symptoms may represent early markers of long-term neurocognitive impairment.
Species richness is a widely used proxy for patterns of biodiversity variation in metacommunities. However, deeper analyses require additional metrics, such as the occupancy-frequency distributions (SOFD) of different local communities. The SOFD patterns indicate the number of shared species between study sites; therefore, they can provide new insights into the current debate on how to create more biodiversity-friendly cities. Breeding birds were counted from 593 point-count stations located in five 500 m × 500 m squares in land-sharing (LSH; low-density built areas interspersed with green spaces) and five similar nearby squares in land-sparing (LSP; densely built-up with set-aside, large-sized, continuous green spaces) landscapes in nine cities across Europe. High beta-diversity (with over 42% of the 103 species detected being restricted to a single city and only 7% found in all studied cities) showed the uniqueness of cities at the continental scale. Urban bird metacommunities followed the unimodal-satellite SOFD pattern at the European continental scale but a bimodal symmetric or asymmetric distribution at the city-level scale, suggesting that many common species occur in cities on a smaller scale. The LSP urban areas followed a unimodal satellite SOFD pattern with numerous rare species. In contrast, the LSH areas fit several types of bimodal SOFD patterns equally well, where communities share several common species. The findings also highlight the need to use multi-scale approaches to analyze the effects of LSH-LSP urban designs on urban bird diversity.
The Northern pike (Esox lucius) is an important predator in freshwater and brackish water environments. In the Baltic Sea, Northern pike follows isolation by distance pattern across wide geographical scale. However, relatively little is known about the fine-scale population divergence and temporal genetic variation of Baltic pike, especially for populations inhabiting the eastern part of the Baltic Sea. Here, we characterize the population genetic structure of Northern pike and its temporal stability in six freshwater and one brackish water locations on the Island of Saaremaa (Estonia). To accomplish this, we collected 274 young-of-the-year (YOY) of two consecutive cohorts and 218 older specimens that were genotyped using ten microsatellite loci. Our results indicate a temporally stable population differentiation between geographically close locations and reduced diversity of the north-western Saaremaa populations. Furthermore, the correspondence analysis and a discriminant analysis of principal components showed a clear differentiation between north-western and the Gulf of Riga spawning grounds. Our findings support the idea that natal homing behavior, limited dispersal and facultative anadromy in Baltic pike likely promotes the existence of temporally stable genetic divergence among different populations at small geographical scale, representing an essential prerequisite for development of local adaptations. Thus, conservation, management and restoration efforts of coastal Baltic Sea pike should preserve the existing genetic differences between different populations and avoid actions, which potentially increase genetic homogenization.
Awareness that high-status adolescents can be targets of aggression has grown in recent years. However, questions remain about the associations of the confluence of victimization and popularity with adjustment. The current study fills this gap by examining the joint and unique effects of victimization and popularity on aggression and alcohol use. Participants were 804 Dutch adolescents (50.2% boys, Mage = 13.65) who were followed for one year. High-status victims were more aggressive and drank more alcohol than lower-status victims. High-status victims were also more proactively and indirectly aggressive and self-reported more bullying than high-status non-victims. Thus, the findings demonstrated a conjoined risk of victimization and popularity for some types of aggression.
Despite their importance little is known about how innovation ecosystems come into existence. We address this gap through an historical case study Herceptin, a revolutionary drug developed for the treatment of ovarian and breast cancer, and the innovation ecosystem that emerged around this drug between 1978 and 1998. Through qualitative content analysis of a broad scope of archival documents (2474 in total), we define a cast of roles and determine their timing of entry onto the stage of ecosystem emergence, and in turn describe the interaction of these roles that govern emergence. We find that the locus of ecosystem emergence shifts gradually from discovery, resource provision and commitment, to the formation of connections and trust, and finally to complementarity and value creation. These activities are facilitated by specific roles that gain significance at various points in time. We additionally witness shifts in interaction dynamics, from individual level interactions early on, to interactions across levels, and finally to interactions at the organisational level. We synthesize these findings to propose a framework of a processual understanding of how innovation ecosystems come into existence.
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Vesa Oikonen
  • Turku PET Centre
Anne Kovalainen
  • Turku School of Economics
Veli-Matti Kähäri
  • Department of Dermatology and Venereology
Ivan Jambor
  • Department of Diagnostic Radiology
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