Relative and absolute cancer risks among Nordic kidney transplant recipients-a population-based study

Kidney transplant recipients (KTRs) have an increased cancer risk compared to the general population, but absolute risks that better reflect the clinical impact of cancer are seldom estimated. All KTRs in Sweden, Norway, Denmark, and Finland, with a first transplantation between 1995 and 2011, were identified through national registries. Post-transplantation cancer occurrence was assessed through linkage with cancer registries. We estimated standardized incidence ratios (SIR), absolute excess risks (AER), and cumulative incidence of cancer in the presence of competing risks. Overall, 12 984 KTRs developed 2215 cancers. The incidence rate of cancer overall was threefold increased (SIR 3.3, 95% confidence interval [CI]: 3.2-3.4). The AER of any cancer was 1560 cases (95% CI: 1468-1656) per 100 000 person-years. The highest AERs were observed for nonmelanoma skin cancer (838, 95% CI: 778-901), non-Hodgkin lymphoma (145, 95% CI: 119-174), lung cancer (126, 95% CI: 98.2-149), and kidney cancer (122, 95% CI: 98.0-149). The five- and ten-year cumulative incidence of any cancer was 8.1% (95% CI: 7.6-8.6%) and 16.8% (95% CI: 16.0-17.6%), respectively. Excess cancer risks were observed among Nordic KTRs for a wide range of cancers. Overall, 1 in 6 patients developed cancer within ten years, supporting extensive post-transplantation cancer vigilance.Peer reviewe

A 2 year physical activity and dietary intervention attenuates the increase in insulin resistance in a general population of children: the PANIC study

Funder: The NIHR Biomedical Research Centre in CambridgeFunder: Finnish Innovation Fund SitraFunder: Foundation for Paediatric ResearchFunder: Ministry of Social Affairs and Health of FinlandFunder: Yrjö Jahnsson FoundationFunder: Research Committee of the Kuopio University Hospital Catchment Area (State Research Funding)Funder: The city of KuopioFunder: The UK Medical Research CouncilFunder: Finnish Cultural FoundationFunder: Ministry of Education and Culture of FinlandFunder: Juho Vainio FoundationFunder: Paavo Nurmi FoundationFunder: Diabetes Research Foundation in FinlandFunder: Finnish Foundation for Cardiovascular ResearchFunder: Social Insurance Institution of FinlandAbstract: Aims/hypothesis: We studied for the first time the long-term effects of a combined physical activity and dietary intervention on insulin resistance and fasting plasma glucose in a general population of predominantly normal-weight children. Methods: We carried out a 2 year non-randomised controlled trial in a population sample of 504 children aged 6–9 years at baseline. The children were allocated to a combined physical activity and dietary intervention group (306 children at baseline, 261 children at 2-year follow-up) or a control group (198 children, 177 children) without blinding. We measured fasting insulin and fasting glucose, calculated HOMA-IR, assessed physical activity and sedentary time by combined heart rate and body movement monitoring, assessed dietary factors by a 4 day food record, used the Finnish Children Healthy Eating Index (FCHEI) as a measure of overall diet quality, and measured body fat percentage (BF%) and lean body mass by dual-energy x-ray absorptiometry. The intervention effects on insulin, glucose and HOMA-IR were analysed using the intention-to-treat principle and linear mixed-effects models after adjustment for sex, age at baseline, and pubertal status at baseline and 2 year follow-up. The measures of physical activity, sedentary time, diet and body composition at baseline and 2 year follow-up were entered one-by-one as covariates into the models to study whether changes in these variables might partly explain the observed intervention effects. Results: Compared with the control group, fasting insulin increased 4.65 pmol/l less (absolute change +8.96 vs +13.61 pmol/l) and HOMA-IR increased 0.18 units less (+0.31 vs +0.49 units) over 2 years in the combined physical activity and dietary intervention group. The intervention effects on fasting insulin (regression coefficient β for intervention effect −0.33 [95% CI −0.62, −0.04], p = 0.026) and HOMA-IR (β for intervention effect −0.084 [95% CI −0.156, −0.012], p = 0.023) were statistically significant after adjustment for sex, age at baseline, and pubertal status at baseline and 2 year follow-up. The intervention had no effect on fasting glucose, BF% or lean body mass. Changes in total physical activity energy expenditure, light physical activity, moderate-to-vigorous physical activity, total sedentary time, the reported consumption of high-fat (≥60%) vegetable oil-based spreads, and FCHEI, but not a change in BF% or lean body mass, partly explained the intervention effects on fasting insulin and HOMA-IR. Conclusions/interpretation: The combined physical activity and dietary intervention attenuated the increase in insulin resistance over 2 years in a general population of predominantly normal-weight children. This beneficial effect was partly mediated by changes in physical activity, sedentary time and diet but not changes in body composition. Trial registration: ClinicalTrials.gov NCT01803776 Graphical abstrac

The effects of a 2-year physical activity and dietary intervention on plasma lipid concentrations in children: the PANIC Study

Funder: Opetus- ja Kulttuuriministeriö; doi: http://dx.doi.org/10.13039/501100003126Funder: Sosiaali- ja Terveysministeriö; doi: http://dx.doi.org/10.13039/501100008487Abstract: Purpose: We studied the effects of a physical activity and dietary intervention on plasma lipids in a general population of children. We also investigated how lifestyle changes contributed to the intervention effects. Methods: We carried out a 2-year controlled, non-randomized lifestyle intervention study among 504 mainly prepubertal children aged 6–9 years at baseline. We assigned 306 children to the intervention group and 198 children to the control group. We assessed plasma concentrations of total, LDL, HDL, and VLDL cholesterol, triglycerides, HDL triglycerides, and VLDL triglycerides. We evaluated the consumption of foods using 4-day food records and physical activity using a movement and heart rate sensor. We analyzed data using linear mixed-effect models adjusted for age at baseline, sex, and pubertal stage at both time points. Furthermore, specific lifestyle variables were entered in these models. Results: Plasma LDL cholesterol decreased in the intervention group but did not change in the control group ( − 0.05 vs. 0.00 mmol/L, regression coefficient (β) = − 0.0385, p = 0.040 for group*time interaction). This effect was mainly explained by the changes in the consumption of high-fat vegetable oil-based spreads (β = − 0.0203, + 47% change in β) and butter-based spreads (β = − 0.0294, + 30% change in β), moderate-to-vigorous physical activity (β = − 0.0268, + 30% change in β), light physical activity (β = − 0.0274, + 29% change in β) and sedentary time (β = − 0.0270, + 30% change in β). The intervention had no effect on other plasma lipids. Conclusion: Lifestyle intervention resulted a small decrease in plasma LDL cholesterol concentration in children. The effect was explained by changes in quality and quantity of dietary fat and physical activity. Clinical Trial Registry Number: NCT01803776, ClinicalTrials.go

Kartoitus Suomen ohjelmistotuotealan kehityksestä vuosina 2000-2005

Ohjelmistotuotetoimiala on yksi nopeimmin kasvavia toimialoja maailmassa. Suomen ohjelmistotuoteala on määritelty yhdeksi Suomen tulevaisuuden avainklustereista, ja sen uskotaan olevan kansallisesti merkittävä toimiala tulevaisuudessa. Suomen ohjelmistotuoteteollisuuden osuus maailman markkinoista on noin 0,5 % ja sen odotetaan moninkertaistuvan lähivuosina. Ohjelmistotuotetoimialan kasvua on pyritty vauhdittamaan useilla yhteiskunnallisilla kehittämistoimilla 90-luvun loppupuolelta lähtien. Suomen ohjelmistotuotealan kasvu on kuluneella vuosikymmenellä kuitenkin ollut selkeästi odotettua hitaampaa, eikä se ole yltänyt sille asetettuihin tavoitteisiinsa. Tämän diplomityön tavoitteena on tarkastella Suomen ohjelmistotuotealan kehitystä vuosituhannen vaihteen jälkeen vuosina 2000-2005 toimialan keskeisimpien kehittämiskohteiden näkökulmasta. Tutkimusongelmana on selvittää, mitä yhteiskunnallisia kehittämistoimia näille kehittämiskohteille on tehty ja miten ne ovat vaikuttaneet toimialan kasvuun. Työn kirjallisuuskatsauksessa käydään läpi viimeaikaisia toimialojen kehittämiseen liittyviä kansantaloustieteellisiä teorioita sekä niiden sovelluksia ohjelmistoalan kehittämiseen. Varsinainen tutkimus on toteutettu analysoimalla kaikki merkittävimmät tutkimusajanjakson selvitykset Suomen ohjelmistotuotealan kehittämisestä, sekä vertaamalla näitä eri toimialan tilaa ja kasvua mittaaviin tutkimuksiin. Lisäksi asiantuntijoiden mielipiteet toimialan kehitystoimien onnistumisesta on kartoitettu erillisellä kyselyllä. Tarkastelun kohteeksi on valittu viisi vuosituhannen vaihteessa tunnistettua keskeisintä toimialan kehittämiskohdetta: työvoiman saatavuus, kansainvälinen liiketoiminta, innovaatiot, kärkihankkeet sekä pääomarahoitus. Tutkimuksen tuloksina todetaan, että kaikilla keskeisillä toimialan kehittämisalueilla on tehty laajoja yhteiskunnallisia kehittämistoimia ja pääosin ne ovat olleet tavoitteidensa mukaisesti onnistuneita. Tutkimuksen merkittävimpänä löydöksenä kuitenkin todetaan, että keskeisimpien kehittämiskohteiden kehitys tutkimusajanjaksolla on kehittämistoimista huolimatta ollut joko neutraalia tai negatiivista. Kuvaavana tutkimuksena tässä diplomityössä ei varsinaisesti pyritä esittämään selityksiä kehittämiskohteiden heikolle kehitykselle, mutta tutkimuksen pohdintaosassa käydään läpi sekä asiantuntijoiden esittämiä mielipiteitä asiasta, että pohditaan kulttuurillisten arvojen ja toimialan viimeaikaisen rakenteellisen muutoksen vaikutusta Suomalaisen ohjelmistotuotetoimialan kehityksessä

On systelogical design of information systems

Developing information systems is basically a model ling process from several perspectives. One of those perspectives is the systelogical one, which sometimes seems to be overlooked by computer specialists. The consequence is then very often an efficient data processing system which howeve r does not meet requirements regarding effectiveness . In this paper the term systelogical design and the importance of this de sign step wll l be elucidated. Thereafter, several approaches, which are available today, wi 11 be discussed