Immigrants’ use of healthcare in their country of origin: the role of social integration, discrimination and parallel use of healthcare systems.

AimsThe objective of this study was to elucidate the utilisation of Russian health care by immigrants of Russian origin living in Finland (cross-border health care). The study examined the association of cross-border health care with social integration and discrimination. Moreover, it studied whether cross-border health care was used as an alternative to the host-country's healthcare system.MethodsData from the Finnish Migrant Health and Wellbeing Survey (Maamu) were utilised. The number of respondents of Russian origin was 545. The main analytical method was logistic regression. The outcome variable was based on a survey item on seeking physician's treatment or help abroad during the last 12 months. Social integration was measured multi-dimensionally, and the indicator was extracted by multiple correspondence analysis. Ethical approval for the study was obtained from the Ethical Committee of the Uusimaa Hospital Region.ResultsWe found that 15.4% of the respondents had visited a physician in Russia during the last 12 months. 10.4% had experienced discrimination in Finnish health services during their stay in Finland. Stronger social integration predicted less frequent utilisation of cross-border health care. Experiences of discrimination or unfairness were associated with higher odds for seeking cross-border health care. Cross-border health care was typically used in parallel to the Finnish services.ConclusionsOur findings on integration and discrimination emphasise the importance of general integration policy as well as cultural competence in health care. Parallel use of healthcare systems entails both risks (e.g double medication, problems of follow-up) and opportunities (e.g. sense of agency), which should be further investigated.<br /

Distribution of Airborne Particles from Multi-Emission Source

The purpose of this work was to study the distribution of airborne particles in the surroundings of an iron and steel factory in southern Finland. Several sources of particulate emissions are lying side by side, causing heavy dust loading to the environment. This complicated multi-pollutant situation was studied mainly by SEM/EDX methodology. Particles accumulated on Scots pine bark were identified and quantitatively measured according to their element content, size and shape. As a result, distribution maps of particulate elements were drawn and the amount of different particle types along the study lines was plotted. Particulate emissions from the industrial or energy production processes were not the main dust source. Most emissions were produced from the clinker crusher. Numerous stockpiles of the industrial wastes and raw materials also gave rise to particulate emissions as a result of wind erosion. It was concluded that SEM/EDXmethodology is a useful tool for studying the distribution of particulate pollutants

The pore size of polycaprolactone scaffolds has limited influence on bone regeneration in an in vivo model

Bone tissue engineering scaffolds should be designed to optimize mass transport, cell migration, and mechanical integrity to facilitate and enhance new bone growth. Although many scaffold parameters could be modified to fulfill these requirements, pore size is an important scaffold characteristic that can be rigorously controlled with indirect solid freeform fabrication. We explored the effect of pore size on bone regeneration and scaffold mechanical properties using polycaprolactone (PCL) scaffolds designed with interconnected, cylindrical orthogonal pores. Three scaffold designs with unique microarchitectures were fabricated, having pore sizes of 350, 550, or 800 Μm. Bone morphogenetic protein-7 transduced human gingival fibroblasts were suspended in fibrin gel, seeded into scaffolds, and implanted subcutaneously in immuno-compromised mice for 4 or 8 weeks. We found that (1) modulus and peak stress of the scaffold/bone constructs depended on pore size and porosity at 4 weeks but not at 8 weeks, (2) bone growth inside pores depended on pore size at 4 weeks but not at 8 weeks, and (3) the length of implantation time had a limited effect on scaffold/bone construct properties. In conclusion, pore sizes between 350 and 800 Μm play a limited role in bone regeneration in this tissue engineering model. Therefore, it may be advantageous to explore the effects of other scaffold structural properties, such as pore shape, pore interconnectivity, or scaffold permeability, on bone regeneration when designing PCL scaffolds for bone tissue engineering. © 2009 Wiley Periodicals, Inc. J Biomed Mater Res, 2010Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/64538/1/32381_ftp.pd

Eturauhassyövän entsyymikuvantaminen PET-menetelmällä

Eturauhassyövän PET-kuvantamisessa on käytetty eri merkkiaineita. Uusi prostataspesifinen merkkiaine (PSMA) on korvannut lähes kaikki aiemmin käytetyt PET-merkkiaineet. PSMA tarjoaa uusia mahdollisuuksia taudin levinneisyyden selvittelyyn ja uusiutumien toteamiseen hyvin pienillä PSA-arvoilla. Näiden lisäksi PSMA:n sopivia käyttöaiheita ovat esimerkiksi oligometastaattisen taudin tunnistaminen ja systeemihoidon tehon seuranta. Menetelmän haasteena ovat usein esiintyvät hyvin pienet luustokertymät (maxSUV </em

Muscle Free Fatty-Acid Uptake Associates to Mechanical Efficiency During Exercise in Humans

Intrinsic factors related to muscle metabolism may explain the differences in mechanical efficiency (ME) during exercise. Therefore, this study aimed to investigate the relationship between muscle metabolism and ME. Totally 17 healthy recreationally active male participants were recruited and divided into efficient (EF; n = 8) and inefficient (IE; n = 9) groups, which were matched for age (mean +/- SD 24 +/- 2 vs. 23 +/- 2 years), BMI (23 +/- 1 vs. 23 +/- 2 kg m(-2)), physical activity levels (3.4 +/- 1.0 vs. 4.1 +/- 1.0 sessions/week), and (V)over dotO(2)peak (53 +/- 3 vs. 52 +/- 3 mL kg(-1) min(-1)), respectively, but differed for ME at 45% of (V)over dotO(2)peak intensity during submaximal bicycle ergometer test (EF 20.5 +/- 3.5 vs. IE 15.4 +/- 0.8%, P < 0.001). Using positron emission tomography, muscle blood flow (BF) and uptakes of oxygen (m(V)over dotO(2)), fatty acids (FAU) and glucose (GU) were measured during dynamic submaximal knee-extension exercise. Workload-normalized BF (EF 35 +/- 14 vs. IE 34 +/- 11 mL 100 g(-1) min(-1), P = 0.896), m(V)over dotO(2) (EF 4.1 +/- 1.2 vs. IE 3.9 +/- 1.2 mL 100 g(-1) min(-1), P = 0.808), and GU (EF 3.1 +/- 1.8 vs. IE 2.6 +/- 2.3 m mol 100 g(-1) min(-1), P = 0.641) as well as the delivery of oxygen, glucose, and FAU, as well as respiratory quotient were not different between the groups. However, FAU was significantly higher in EF than IE (3.1 +/- 1.7 vs. 1.7 +/- 0.6 m mol 100 g(-1) min(-1), P = 0.047) and it also correlated with ME (r = 0.56, P = 0.024) in the entire study group. EF group also demonstrated higher use of plasma FAU than IE, but no differences in use of plasma glucose and intramuscular energy sources were observed between the groups. These findings suggest that the effective use of plasma FAU is an important determinant of ME during exercise

Upregulated but insufficient generation of activated protein C is associated with development of multiorgan failure in severe acute pancreatitis

INTRODUCTION: Disturbed protein C (PC) pathway homeostasis might contribute to the development of multiple organ failure (MOF) in acute pancreatitis (AP). We therefore evaluated circulating levels of PC and activated protein C (APC), evaluated monocyte deactivation in AP patients, and determined the relationship of these parameters to MOF. PATIENTS AND METHODS: Thirty-one patients in the intensive care unit were categorized as cases (n = 13, severe AP with MOF) or controls (n = 18, severe AP without MOF). Blood samples were drawn every second day to determine the platelet count, the levels of APC, PC, and D-dimer, and the monocyte HLA-DR expression using flow cytometry. The APC/PC ratio was used to evaluate turnover of PC to APC. RESULTS: During the initial two weeks of hospitalization, low PC levels (<70% of the adult mean) occurred in 92% of cases and 44% of controls (P = 0.008). The minimum APC level was lower in cases than in controls (median 85% versus 97%, P = 0.009). Using 87% as the cut-off value, 8/13 (62%) cases and 3/18 (17%) controls showed reduced APC levels (P = 0.021). A total of 92% of cases and 50% of controls had APC/PC ratios exceeding the upper normal limit (P = 0.013). Plasma samples drawn before MOF showed low PC levels and high APC/PC ratios. HLA-DR-positive monocytes correlated with PC levels (r = 0.38, P < 0.001) and APC levels (r = 0.27, P < 0.001), indicating that the PC pathway was associated with systemic inflammation-triggered immune suppression. CONCLUSION: PC deficiency and decreased APC generation in severe AP probably contributed to a compromised anticoagulant and anti-inflammatory defence. The PC pathway defects were associated with the development of MOF. The data support feasibility of testing the use of APC or PC to improve the clinical outcome in AP

Experience of a Preventive Experiment : Spatial Social Mixing in Post-World War II Housing Estates in Helsinki, Finland

The contingent of large housing estates built in the 1960s and 1970s accounts for almost a half of all high-rises in Finland. The primary ideology in their genesis was to combine industrially prefabricated urban housing development with the surrounding forest landscape—together with a policy of spatial social mixing—to prevent social disorder and segregation. These policies seemed to work as intended until the early 1990s, but have since proved to be insufficient. With Western integration and new information and communication-based economic growth, new trends of population differentiation have emerged. As new wealth has moved out to the fringes of cities, the large housing estates have declined socio-economically—and have been enriched ethnically. This differentiation is structurally produced, works through the regional housing market and, as such, is beyond the scope of the preventive policies pursued. Recent attempts at controlling the regional markets and new forms of spatial social mixing have so far proved difficult.The contingent of large housing estates built in the 1960s and 1970s accounts for almost a half of all high-rises in Finland. The primary ideology in their genesis was to combine industrially prefabricated urban housing development with the surrounding forest landscape—together with a policy of spatial social mixing—to prevent social disorder and segregation. These policies seemed to work as intended until the early 1990s, but have since proved to be insufficient. With Western integration and new information and communication-based economic growth, new trends of population differentiation have emerged. As new wealth has moved out to the fringes of cities, the large housing estates have declined socio-economically—and have been enriched ethnically. This differentiation is structurally produced, works through the regional housing market and, as such, is beyond the scope of the preventive policies pursued. Recent attempts at controlling the regional markets and new forms of spatial social mixing have so far proved difficult.Peer reviewe

Relationship of faecal calprotectin and long-term outcomes in Finnish patients with Crohn's disease : retrospective multi-centre chart review study

Background and Aims: A retrospective non-interventional, multi-centre patient chart review study was conducted to investigate the association of faecal calprotectin (FC) 1 year (+/- 2 months) after biological therapy initiation with composite event-free survival (CEFS) consisting of surgical procedures, corticosteroid initiation, treatment failure or dose increase in patients with Crohn's disease (CD). In addition, the correlations of FC and other tests of disease activity were assessed. Materials and methods: Data on Finnish CD patients initiating a biological therapy between 2010 and 2016, were collected. The association of FC and CEFS was analysed with Kaplan-Meier and Cox proportional hazard modelling. The correlations were tested with Pearson's test. Results: Biological therapy was initiated in 186 patients, of which 87 (46.8%) had FC results available at 1 year and 80 had follow-up exceeding 14 months. The characteristics of patients with and without FC results were similar. Patients with elevated FC (>250 mu g/g) had a significantly increased risk of experiencing composite event (HR 3.4, 95% CI: 1.3-8.9; p = .013) when compared to patients with normal FC (FCPeer reviewe

Alternative oxidase confers nutritional limitation on Drosophila development

The mitochondrial alternative oxidase, AOX, present in most eukaryotes apart from vertebrates and insects, catalyzes the direct oxidation of ubiquinol by oxygen, by‐passing the terminal proton‐motive steps of the respiratory chain. Its physiological role is not fully understood, but it is proposed to buffer stresses in the respiratory chain similar to those encountered in mitochondrial diseases in humans. Previously, we found that the ubiquitous expression of AOX from Ciona intestinalis in Drosophila perturbs the development of flies cultured under low‐nutrient conditions (media containing only glucose and yeast). Here we tested the effects of a wide range of nutritional supplements on Drosophila development, to gain insight into the physiological mechanism underlying this developmental failure. On low‐nutrient medium, larvae contained decreased amounts of triglycerides, lactate, and pyruvate, irrespective of AOX expression. Complex food supplements, including treacle (molasses), restored normal development to AOX‐expressing flies, but many individual additives did not. Inhibition of AOX by treacle extract was excluded as a mechanism, since the supplement did not alter the enzymatic activity of AOX in vitro. Furthermore, antibiotics did not influence the organismal phenotype, indicating that commensal microbes were not involved. Fractionation of treacle identified a water‐soluble fraction with low solubility in ethanol, rich in lactate and tricarboxylic acid cycle intermediates, which contained the critical activity. We propose that the partial activation of AOX during metamorphosis impairs the efficient use of stored metabolites, resulting in developmental failure.</p

Human α2β1HI CD133+VE epithelial prostate stem cells express low levels of active androgen receptor

Stem cells are thought to be the cell of origin in malignant transformation in many tissues, but their role in human prostate carcinogenesis continues to be debated. One of the conflicts with this model is that cancer stem cells have been described to lack androgen receptor (AR) expression, which is of established importance in prostate cancer initiation and progression. We re-examined the expression patterns of AR within adult prostate epithelial differentiation using an optimised sensitive and specific approach examining transcript, protein and AR regulated gene expression. Highly enriched populations were isolated consisting of stem (α(2)β(1)(HI) CD133(+VE)), transiently amplifying (α(2)β(1)(HI) CD133(-VE)) and terminally differentiated (α(2)β(1)(LOW) CD133(-VE)) cells. AR transcript and protein expression was confirmed in α(2)β(1)(HI) CD133(+VE) and CD133(-VE) progenitor cells. Flow cytometry confirmed that median (±SD) fraction of cells expressing AR were 77% (±6%) in α(2)β(1)(HI) CD133(+VE) stem cells and 68% (±12%) in α(2)β(1)(HI) CD133(-VE) transiently amplifying cells. However, 3-fold lower levels of total AR protein expression (peak and median immunofluorescence) were present in α(2)β(1)(HI) CD133(+VE) stem cells compared with differentiated cells. This finding was confirmed with dual immunostaining of prostate sections for AR and CD133, which again demonstrated low levels of AR within basal CD133(+VE) cells. Activity of the AR was confirmed in prostate progenitor cells by the expression of low levels of the AR regulated genes PSA, KLK2 and TMPRSS2. The confirmation of AR expression in prostate progenitor cells allows integration of the cancer stem cell theory with the established models of prostate cancer initiation based on a functional AR. Further study of specific AR functions in prostate stem and differentiated cells may highlight novel mechanisms of prostate homeostasis and insights into tumourigenesis