Temporal Changes in Blood Biomarkers Associated with Sleep Apnea Severity: A Retrospective Cohort Study in Finland

Obstruktiivinen uniapnea on yleinen unihäiriö, johon liittyy unenaikaisia hengityskatkoksia, jotka usein johtavat happisaturaation laskuun ja unen häiriintymiseen. Uniapnean tiedetään vaikuttavan moniin fysiologisiin parametreihin, kuten hematologisiin ja lipidiarvoihin. Tämän tutkimuksen tavoitteena on tutkia CPAP-hoidon vaikutuksia uniapneapotilaiden laboratorioarvoihin. Toteutimme retrospektiivisen tutkimuksen, jossa käytimme Helsingin ja Uudenmaan sairaanhoitopiirin (HUS) aineistoa, joka kattoi 30 722 vuosina 2005–2020 hoidettua aikuista uniapneapotilasta. Tutkimuksessa hyödynsimme sanahakua, jonka avulla etsimme aineistosta tietoa potilaiden apnea-hypopnea-indeksistä (AHI), CPAP-hoidon käytöstä ja tunnistaaksemme hoidosta kieltäytyneet potilaat. Hematologiset ja metaboliset laboratorioarvot kerättiin kolme vuotta ennen potilaan ensimmäistä uniapneadiagnoosia ja kolme vuotta diagnoosin jälkeen. Kovarianssianalyysiä käytettiin vertailemaan parametrien vaihtelua uniapnean eri vaikeusasteiden välillä vakioituna iällä, sukupuolella ja BMI:llä. Parittaista T-testiä käytettiin analysoimaan eroja ennen ja jälkeen uniapneadiagnoosin. Uniapnean eri vaikeusasteita esiintyi aineistossa seuraavasti: 14,8 % lieväasteisia, 32,6 % keskivaikea-asteisia ja 52,6 % vaikea-asteisia. Keskimääräinen diagnosointi-ikä oli 55,0 ja keskimääräinen BMI 32,4. Kliinisesti merkittävimmät muutokset havaittiin veren lipidiarvoissa kolesteroli-, HDL- ja LDL-tasojen kohentumisena (P < 0,05) mitattuna ennen CPAP-hoidon aloitusta ja hoidon aloittamisen jälkeen. Glukoositasot sen sijaan nousivat seurantajakson aikana. Vastaavasti hematokriitti ja hemoglobiini laskivat merkitsevästi CPAP-hoidon aloituksen jälkeen. Sukupuolikohtaisissa analyyseissä merkittävää parantumista kolesteroli-, HDL- ja LDL-tasoissa havaittiin molemmilla sukupuolilla. Triglyseriditasot parantuivat miespotilailla, mutta naispotilailla ne päinvastoin nousivat seurantajakson aikana. CPAP-hoito kohentaa kolesteroli-, HDL- ja LDL-tasoja merkittävästi molemmilla sukupuolilla sekä alentaa hematokriitti- ja hemoglobiinitasoja. Tämä tutkimus korostaa uniapnean systeemisiä vaikutuksia ja alleviivaa hematologisen ja lipidiprofiilin arvioinnin tärkeyttä uniapnean hallinnassa.Obstructive sleep apnea (OSA) is a common sleep disorder associated with breathing interruptions during sleep, often leading to oxygen level drops and sleep disturbances. OSA is known to impact various physiological parameters, including hematological and lipid profiles. This study aims to investigate the effect of continuous positive airway pressure (CPAP) therapy on laboratory values in patients with OSA. We conducted a retrospective study using data from Finland's largest hospital district, including 30,722 adult OSA patients treated between 2005 and 2020. We implemented a text search algorithm within the patient chart data to extract the apnea-hypopnea index (AHI) and the usage of CPAP therapy, along with identifying patients who had declined treatment. Hematological and metabolic laboratory values were collected three years before and after the first OSA diagnosis. Analysis of covariance (ANCOVA) was employed to compare parameter variations across severity levels, adjusted for age, sex, and BMI. T-test for repeated measurements was used to analyze the differences between three years prior and three years after the first OSA diagnosis. Our study of 30,722 OSA patients showed varying severity levels in OSA patients: 14.8% mild, 32.6% moderate, and 52.6% severe, with an average diagnosis age of 55.0 years and a mean BMI of 32.4. The most clinically significant changes were observed in lipid profile markers, with improvements in cholesterol, HDL, and LDL levels (P < 0.05), measured before CPAP treatment initiation and after the treatment began. Conversely, glucose levels increased during the follow-up period. Similarly, hematocrit and hemoglobin decreased significantly after initiation of the CPAP treatment. In sex-specific analyses, significant improvements in cholesterol, HDL, and LDL levels were found in both sexes. Triglyceride levels improved in male patients, in contrast to female participants, whose triglyceride levels increased during the follow-up period. CPAP therapy significantly improves cholesterol, HDL, and LDL levels in both sexes and reduces hematocrit and hemoglobin levels. This study highlights the systemic effects of OSA and underscores the importance of evaluating hematological and lipid profiles in OSA management

Large‐scale ocean‐atmosphere interactions drive phytoplankton accumulation in the northern Antarctic Peninsula

The northern Antarctic Peninsula (NAP) region is a highly productive ecosystem that supports a large krill-based food web. In summer 2006, the NAP region had substantially elevated phytoplankton biomass, with surface chlorophyll-a concentrations that reached the greatest level during 2001–2023. Using the long-term in situ data from the U.S. Antarctic Marine Living Resources program, satellite observations, and ERA5 reanalysis products, the mechanisms of the elevated chlorophyll-a anomalies in summer 2006 were analyzed. The results suggest that the position of the Amundsen Sea Low (ASL) shifted considerably westward that summer, resulting in strong positive sea level pressure anomalies west of the NAP, which induced southerly wind anomalies and reduced the advection of moist airflow toward the NAP. This in turn reduced the cloud coverage and increased photosynthetically available radiation over this region, which directly increased the phytoplankton photosynthesis. The intensified radiation also increased the ocean temperature and strengthened stratification, which increased phytoplankton growth rates and allowed phytoplankton to accumulate in the upper euphotic zone. This work underlines the important role of coupled atmospheric-oceanic processes in generating large phytoplankton biomass in the NAP region

Selective separation of Am(iii)/Eu(iii) using heterocyclic bistriazolyl phosphonate grafted zirconia and titania solid phase extractants

Surface functionalization of metal oxides with phosphonic acid monolayers by covalent bonding enables the generation of robust hybrid materials with enhanced separation properties. Mesoporous crystalline zirconia and titania serve as applicable inorganic supports with high thermal stability and resistance to oxidation, acidity and radiolysis. We have fabricated selective solid phase extractants that efficiently separate americium and europium from each other, via straightforward grafting of the zirconia and titania surfaces with N- and S-donor complexing agents, namely 2,6-bis-triazolyl-pyridine derivatives. Separation factors (Am/Eu) up to 13 were obtained in binary solution at pH 2 and preference for Am over Eu was observed even in Eu excess solution. These stable hybrid materials can be utilized for separation purposes without substantial degradation, providing advantageous reusability and a greener option in comparison to commonly used solvent extraction methods.Peer reviewe

How the understanding of atmospheric new particle formation has evolved along with the development of measurement and analysis methods

The chain of chemical and physical processes leading to formation of new aerosol particles from gaseous precursors vapors is often called new particle formation (NPF). Although first observations of atmospheric NPF date back to more than a century ago, many aspects of the phenomenon and its importance on global climate remained unknown for a long time. Along with the development of more robust measurement techniques enabling continuous field measurements of particle size distributions down to the size of recently formed particles and their precursors vapors, NPF research has taken leaps forward in the past decades. In this article we review how the new measurement methods has enabled us to observe, analyze and classify atmospheric new particle formation events and how this has changed our understanding of the process and its significance in the atmosphere.Peer reviewe

Can a Universal Mindfulness Intervention in Schools Reduce ADHD Symptoms among Adolescents? : A Cluster Randomized Controlled Trial

Existing studies suggest that mindfulness-based interventions (MBIs) can reduce ADHD symptoms when delivered as targeted clinical programs to young people diagnosed with ADHD. However, there is currently a lack of research on whether MBIs are effective in reducing elevated ADHD symptoms when delivered as universal programs to whole classes in schools. This study investigated the effects of a universal nine-week MBI (.b program) on students' elevated ADHD symptoms using an cluster randomized controlled trial (RCT) design. The modifying effects of pupils' baseline characteristics (gender, age, and socioeconomic status) and home-practice intensity were examined. A total of 3519 adolescents aged 12 to 15 years from Finnish schools were randomized into an MBI group, a relaxation-based active-control group, and a passive-control group. ADHD symptoms were measured at baseline (T0), at nine weeks (T9), and at 26-weeks (T26, follow-up) using parent-reported assessments. The study found no positive intervention effects on parent-reported ADHD symptoms in the MBI group compared to the control groups. Neither boys nor girls benefited from the MBI. The same was true of different age groups and socioeconomic levels. Moreover, regular home practice during the follow-up period did not strengthen the intervention effects. The results do not support the use of brief, universal MBIs in whole school classes as part of the routine curriculum to reduce elevated ADHD symptoms in adolescents. Further research is essential to identify optimal content and delivery methods for MBIs in schools. Particularly among adolescents with elevated ADHD symptoms, targeted MBIs, adapted to the unique needs of this subgroup, should be examined.Trial Registration: Healthy Learning Mind-a school-based mindfulness and relaxation program: a study protocol for a cluster randomized controlled trial (RCT) ISRCTN18642659 retrospectively registered on 13 October 2015. The full trial protocol can be accessed atPeer reviewe

Study protocol of the METAPANC trial - intensified treatment in patients with local operable but oligometastatic pancreatic cancer - multimodal surgical treatment versus chemotherapy alone: a randomized controlled trial

Abstract Background Based on current guidelines, surgical treatment of hepatic oligometastases in patients with pancreatic ductal adenocarcinoma (PDAC) is not primarily recommended. Systematic chemotherapy is the therapy of choice for these patients. The relevance of subsequent surgical resection after chemotherapy remains unclear. This multicentre, randomized, controlled phase III trial is planned to evaluate whether resection of the primary tumor and liver metastases can improve overall survival in patients with PDAC with hepatic oligometastases in a multimodal treatment setting. Methods After an induction therapy with eight cyles of mFOLFIRINOX and a response assessment after four and eight cycles, patients will be randomized to either Arm 1 (perioperative mFOFIRINOX plus resection of the primary tumor with resection or ablation of all hepatic metastases) or Arm 2 (continuation of 4 cycles of the standard-of-care mFOLFIRINOX chemotherapy). This clinical trial will focus on a well-defined patient group with metastatic disease limited to the liver as the target organ, with a maximum of three metastases. Discussion METAPANC is the first international, randomized, controlled, open-label, multicentre, phase III clinical trial for curative intended surgical therapy of oligometastatic pancreatic cancer in Europe and America. The multimodal surgical treatment of patients with oligometastatic pancreatic cancer could significantly extend the overall survival of this patient group. A possible recommendation of this multimodal treatment regimen outside of clinical trials requires data from randomized controlled trials first. To identify patient subgroups that might benefit from multimodal surgical therapy, additional information on tumor genetics could supplement valid parameters. Trial registration EU Clinical Trials No. 2023-503558-10-00

Vertailukoe 17/2023: Ekologinen kompensaatio, laskenta

Suomen ympäristökeskus (Syke) järjesti loppuvuodesta 2023 kansallisen vertailukokeen vapaaehtoiseen ekologiseen kompensaatioon liittyvästä laskennasta. Vertailukoe järjestettiin ensimmäistä kertaa ja toteutettiin kehittämishankkeena Ekologisen kompensaation pilotointi -hankkeen ja Proftest Syken vertailumittaustoiminnan yhteistyönä. Vertailukokeessa tehtävänä oli ekologiseen kompensaatioon liittyvä heikennyksen ja hyvityksen arviointi ja laskenta luonnonsuojelulain sekä ympäristöministeriön ekologista kompensaatiota koskevan asetuksen linjausten mukaisesti esimerkkiaineiston pohjalta. Vertailukokeeseen ilmoittautui 26 toimijaa, joista 7 palautti tulokset. Osallistujien laskentatuloksia verrattiin saman aineiston ja ohjeistuksen pohjalta tehtyyn esimerkkilaskelmaan. Tuloksien arvioinnissa tunnistettiin mahdollisia syitä poikkeamiin esimerkkilaskelmasta. Tätä tietoa hyödynnetään laskentaohjeiden jatkokehityksessä. Hyväksyttäviä tuloksia oli 88 %. Kiitos vertailukokeen osallistujille.Intercomparison 17/2023: Biodiversity offsetting, calculating loss and gain Finnish environment institute (Syke) organized in November-December 2023 a national intercomparison of the calculations related to biodiversity offsetting. The intercomparison was organized as the first time and was carried out as development project in cooperation with the Ekologisen kompensaation pilotointi (Biodiversity offsetting pilot) project and Proftest Syke. In the intercomparison, the task was to evaluate and calculate the nature loss and gain related to biodiversity offsetting based on the given data. In total 26 parties registered in the intercomparison, out of which 7 reported results. The participants' results were compared to an example calculation based on the same data and instructions. The evaluation of the results identified possible reasons for deviations from the example calculation. In the intercomparison 88% of the results were satisfactory. Warm thanks to all the participants

A pilot study comparing three-dimensional models of tumor histopathology and magnetic resonance imaging

Three-dimensional (3D) modeling is often used to provide better visual understanding. This has become an everyday tool especially in medical imaging. However, modeling soft tissue histopathology in 3D is in its early stages, thus making 3D comparison between radiology and histopathology difficult. Here, we sought to create a model that combines a model based on histopathological tumor borders and a model reformatted from magnetic resonance image (MRI). The 3D models were constructed from an oral squamous cell carcinoma (OSCC) resection specimen and a preoperative MRI scan. Potential challenges were identified, and respective solutions proposed. The 3D model based on histopathological tumor borders was constructed by a method that uses a 3D table scanner and modeling software. The 3D MRI model was constructed using 3D Slicer software. The two models were fitted together by anatomical landmarks in each model. We compared the volume and dimensions between the two 3D models. As a result, we created an image fusion that presents the soft-tissue resection specimen, its histopathological findings, and the MRI findings combined in a digital 3D form. Presenting these two 3D models within the resection specimen can serve as a tool to improve the multidisciplinary discussion of patient management. To create these models, only a few additional steps to a normal protocol are required.Peer reviewe

Lähi-idän ja Afrikan sarven turvallisuuskompleksit muutoksessa? : Tapauksena Egyptin ja Yhdistyneiden arabiemiraattien toimet Afrikan sarvessa

Tutkielmassa tarkastellaan Lähi-idän valtioiden kasvavaa vaikutusta Afrikan sarvessa keskittyen kyseisten alueiden turvallisuuskompleksien suhteiden muutoksiin. Tapausesimerkkinä ovat Yhdistyneiden arabiemiraattien ja Egyptin toimet Afrikan sarvessa. Tutkimuksessa analysoidaan etenkin näiden valtioiden turvallisuuteen kytkeytyneitä intressejä alueella. Aihetta lähestytään sotilaallisten, kauppapoliittisten ja diplomaattisten toimien sekä humanitaarisen avun kautta tarkasteltuna. Tutkimuksessa vastataan kysymyksiin siitä, miten Lähi-idän ja Afrikan sarven väliset suhteet ovat muuttuneet, sekä voidaanko katsoa, että kaksi erillisenä pidettyä turvallisuuskompleksia ovat yhdistymässä. Tutkielman teoreettisena viitekehyksenä on alueellinen turvallisuuskompleksiteoria. Lisäksi kompleksiteoriaan yhdistetään ”raja-alueen” käsite (frontier/borderland), jota hyödynnetään työn analyysiosuudessa. Tutkimuksessa sovelletaan myös turvallistamisen (securitization) käsitettä, joka liittyy olennaisesti alueelliseen turvallisuuskompleksiteoriaan. Tutkielman menetelmänä on teorialähtöinen sisällönanalyysi. Aineistona käytetään muun muassa uutislähteitä, tutkimuslaitosten raportteja, valtion johdon lausuntoja sekä aiempaa tutkimusta. Tutkielmassa tullaan johtopäätelmään, jonka mukaan Lähi-idän valtioiden, tutkimuksessa rajatummin Yhdistyneiden arabiemiraattien ja Egyptin kiinnostus Afrikan sarvea kohtaan on vain voimistunut entisestään. Emiraattien kohdalla toimien taustalla on vaikuttanut etenkin Iranin, Qatarin ja Turkin vaikutusvallan vähentäminen alueella, kun taas Egyptin kohdalla toimien taustalla on vaikuttanut Etiopian GERD-projekti. Lisäksi analyysin tuloksena havaitaan, etteivät Lähi-idän ja Afrikan sarven turvallisuuskompleksit ole yhdistymässä. Vaikka kompleksien yhdistymistä ei ole tapahtunut, tutkimuksessa todetaan kuitenkin, että muun muassa laajentuneiden poliittisten vaikutuspyrkimysten vuoksi Afrikan sarvea voidaan pitää yhä enenevissä määrin Lähi-idän turvallisuuskompleksin ”rajavyöhykkeenä”

The Heisenberg-RIXS instrument at the European XFEL

Resonant inelastic X-ray scattering (RIXS) is an ideal X-ray spectroscopy method to push the combination of energy and time resolutions to the Fourier transform ultimate limit, because it is unaffected by the core-hole lifetime energy broadening. Also, in pump–probe experiments the interaction time is made very short by the same core-hole lifetime. RIXS is very photon hungry so it takes great advantage from high-repetition-rate pulsed X-ray sources like the European XFEL. The Heisenberg RIXS instrument is designed for RIXS experiments in the soft X-ray range with energy resolution approaching the Fourier and the Heisenberg limits. It is based on a spherical grating with variable line spacing and a position-sensitive 2D detector. Initially, two gratings were installed to adequately cover the whole photon energy range. With optimized spot size on the sample and small pixel detector the energy resolution can be better than 40 meV (90 meV) at any photon energy below 1000 eV with the high-resolution (high-transmission) grating. At the SCS instrument of the European XFEL the spectrometer can be easily positioned thanks to air pads on a high-quality floor, allowing the scattering angle to be continuously adjusted over the 65–145° range. It can be coupled to two different sample interaction chambers, one for liquid jets and one for solids, each state-of-the-art equipped and compatible for optical laser pumping in collinear geometry. The measured performances, in terms of energy resolution and count rate on the detector, closely match design expectations. The Heisenberg RIXS instrument has been open to public users since the summer of 2022.Peer reviewe