Vertaistuki ja asiantuntija-apu vulvodyniapotilaiden hoidossa

Vulvodynialla tarkoitetaan pitkäaikaista yli kolme kuukautta kestänyttä kiputilaa, jonka taustalla ei ole mikään tunnettu sairaus, eikä siihen aina liity ulkosynnyttimien alueen ihomuutoksia. Vulvodyniapotilaiden hoidossa käytetään erilaisia algoritmeja. Hoidon kulmakivenä on moniammatillinen hoito, joka käsittää lääkärin tekemän gynekologisen tutkimuksen, seksuaalineuvonnan tai -terapian ja usein lantionpohjan fysioterapian. Valitettavasti monet potilaista käyvät läpi koko hoitopolun saamatta apua sen eri vaiheissa. Turun yliopistollisen keskussairaalan seksuaaliterveyspoliklinikan moniammatillinen hoitotiimi kehitti ohjatun vertaistukiryhmähoidon hoitopolkunsa viimeiseksi askelmaksi. Ajatus vertaistukiryhmästä pohjautui tutkimustietoon psykoedukaation ja vertaistukiryhmän tehosta kroonisen sairauden hoidossa. Ryhmän tavoitteena on tukea kustannusvaikuttavasti potilasta pärjäämään kroonisen kivun kanssa arjessa ja siirtymään erikoissairaanhoidosta avohoidon palvelujen piiriin.</p

Simulated seasonal impact on middle atmospheric ozone from high-energy electron precipitation related to pulsating aurorae

Recent simulation studies have provided evidence that a pulsating aurora (PsA) associated with high-energy electron precipitation is having a clear local impact on ozone chemistry in the polar middle mesosphere. However, it is not clear if the PsA is frequent enough to cause longer-term effects of measurable magnitude. There is also an open question of the relative contribution of PsA-related energetic electron precipitation (PsA EEP) to the total atmospheric forcing by solar energetic particle precipitation (EPP). Here we investigate the PsA-EEP impact on stratospheric and mesospheric odd hydrogen, odd nitrogen, and ozone concentrations. We make use of the Whole Atmosphere Community Climate Model and recent understanding on PsA frequency, latitudinal and magnetic local time extent, and energy-flux spectra. Analysing an 18-month time period covering all seasons, we particularly look at PsA-EEP impacts at two polar observation stations located at opposite hemispheres: Tromsø in the Northern Hemisphere (NH) and Halley Research Station in the Southern Hemisphere (SH). We find that PsA EEP can have a measurable impact on ozone concentration above 30 km altitude, with ozone depletion by up to 8 % seen in winter periods due to PsA-EEP-driven NOx enhancement. We also find that direct mesospheric NOx production by high-energy electrons (E> 100 keV) accounts for about half of the PsA-EEP-driven upper stratospheric ozone depletion. A larger PsA-EEP impact is seen in the SH where the background dynamical variability is weaker than in the NH. Clearly indicated from our results, consideration of polar vortex dynamics is required to understand PsA-EEP impacts seen at ground observation stations, especially in the NH. We conclude that PsA-EEP has the potential to make an important contribution to the total EPP forcing; thus, it should be considered in atmospheric and climate simulations.publishedVersio

Interferon-gamma and IL-5 associated cell-mediated immune responses to HPV16 E2 and E6 distinguish between persistent oral HPV16 infections and noninfected mucosa

Objectives: Natural history of human papillomavirus (HPV) infection in the head and neck region is poorly understood, and their impact on collective HPV-specific immunity is not known. Materials and methods: In this study, we have performed a systematic analysis of HPV16-specific cell-mediated immunity (CMI) in 21 women with known oral and genital HPV DNA status and HPV serology (Ab) based on 6-year follow-up data. These women being a subgroup from the Finnish Family HPV Study were recalled for blood sampling to be tested for their CMI-responses to HPV16 E2, E6, and E7 peptides. Results: The results showed that HPV16 E2-specific lymphocyte proliferation was more prevalent in women who tested HPV16 DNA negative in oral mucosa and were either HPV16 seropositive or negative than in HPV16 DNA+/Ab+ women (p = 0.046 and p = 0.035). In addition, the HPV16 DNA-/Ab- women most often displayed E6-specific proliferation (p = 0.020). Proportional cytokine profiles indicated that oral HPV16-negative women were characterized by prominent IFN-gamma and IL-5 secretion not found in women with persisting oral HPV16 (p = 0.014 and p = 0.040, respectively). Conclusions: Our results indicate that the naturally arising immune response induced by oral HPV infections displays a mixed Th1/Th2/Th17 cytokine profile while women with persisting oral HPV16 might have an impaired HPV16-specific CMI, shifted partly toward a Th2 profile, similarly as seen earlier among patients with high-grade genital HPV lesions. Thus, the lack of HPV 16 E2 and E6 specific T memory cells and Th2 cytokines might also predispose women for persistent oral HPV16 infection which might be related to the risk of cancer.Peer reviewe

Broadband Meter-Wavelength Observations of Ionospheric Scintillation

Intensity scintillations of cosmic radio sources are used to study astrophysical plasmas like the ionosphere, the solar wind, and the interstellar medium. Normally these observations are relatively narrow band. With Low Frequency Array (LOFAR) technology at the Kilpisj\"arvi Atmospheric Imaging Receiver Array (KAIRA) station in northern Finland we have observed scintillations over a 3 octave bandwidth. ``Parabolic arcs'', which were discovered in interstellar scintillations of pulsars, can provide precise estimates of the distance and velocity of the scattering plasma. Here we report the first observations of such arcs in the ionosphere and the first broad-band observations of arcs anywhere, raising hopes that study of the phenomenon may similarly improve the analysis of ionospheric scintillations. These observations were made of the strong natural radio source Cygnus-A and covered the entire 30-250\,MHz band of KAIRA. Well-defined parabolic arcs were seen early in the observations, before transit, and disappeared after transit although scintillations continued to be obvious during the entire observation. We show that this can be attributed to the structure of Cygnus-A. Initial results from modeling these scintillation arcs are consistent with simultaneous ionospheric soundings taken with other instruments, and indicate that scattering is most likely to be associated more with the topside ionosphere than the F-region peak altitude. Further modeling and possible extension to interferometric observations, using international LOFAR stations, are discussed.Comment: 11 pages, 17 figure

Modeling the efficient access of full-text information

The title of this paper describes a research goal set by many offices within US DOE. This paper reviews efficient full-text searching techniques being developed to better understand and meet this goal. Classical computer human interaction (CHI) approaches provided by commercial information retrieval (IR) engines fail to contextualize information in ways that facilitate timely decision making. Use of advanced CHI techniques (eg, visualization) in combination with deductive database technology augment the weaknesses found in presentation capabilities of IR engines and are discussed. Various techniques employed in a Web-based prototype system currently under development are presented

Procedural recommendations of cardiac PET/CT imaging: standardization in inflammatory-, infective-, infiltrative-, and innervation (4Is)-related cardiovascular diseases: a joint collaboration of the EACVI and the EANM

With this document, we provide a standard for PET/(diagnostic) CT imaging procedures in cardiovascular diseases that are inflammatory, infective, infiltrative, or associated with dysfunctional innervation (4Is). This standard should be applied in clinical practice and integrated in clinical (multicenter) trials for optimal procedural standardization. A major focus is put on procedures using [18F]FDG, but 4Is PET radiopharmaceuticals beyond [18F]FDG are also described in this document. Whilst these novel tracers are currently mainly applied in early clinical trials, some multicenter trials are underway and we foresee in the near future their use in clinical care and inclusion in the clinical guidelines. Finally, PET/MR applications in 4Is cardiovascular diseases are also briefly described. Diagnosis and management of 4Is-related cardiovascular diseases are generally complex and often require a multidisciplinary approach by a team of experts. The new standards described herein should be applied when using PET/CT and PET/MR, within a multimodality imaging framework both in clinical practice and in clinical trials for 4Is cardiovascular indications

Loss of microRNA-7a2 induces hypogonadotropic hypogonadism and infertility

MicroRNAs (miRNAs) are negative modulators of gene expression that fine-tune numerous biological processes. miRNA loss-of-function rarely results in highly penetrant phenotypes, but rather, influences cellular responses to physiologic and pathophysiologic stresses. Here, we have reported that a single member of the evolutionarily conserved miR-7 family, miR7a2, is essential for normal pituitary development and hypothalamic-pituitary-gonadal (HPG) function in adulthood. Genetic deletion of mir-7a2 causes infertility, with low levels of gonadotropic and sex steroid hormones, small testes or ovaries, impaired spermatogenesis, and lack of ovulation in male and female mice, respectively. We found that miR-7a2 is highly expressed in the pituitary, where it suppresses golgi glycoprotein 1 (GLG1) expression and downstream bone morphogenetic protein 4 (BMP4) signaling and also reduces expression of the prostaglandin F2a receptor negative regulator (PTGFRN), an inhibitor of prostaglandin signaling and follicle-stimulating hormone (FSH) and luteinizing hormone (LH) secretion. Our results reveal that miR-7a2 critically regulates sexual maturation and reproductive function by interconnecting miR-7 genomic circuits that regulate FSH and LH synthesis and secretion through their effects on pituitary prostaglandin and BMP4 signaling

Gene fusions and oncogenic mutations in MLH1 deficient and BRAFV600E wild-type colorectal cancers

Gene fusions can act as oncogenic drivers and offer targets for cancer therapy. Since fusions are rare in colorectal cancer (CRC), their universal screening seems impractical. Our aim was to investigate gene fusions in 62 CRC cases with deficient MLH1 (dMLH1) and BRAFV600E wild-type (wt) status from a consecutive real-life series of 2079 CRCs. First, gene fusions were analysed using a novel FusionPlex Lung v2 RNA-based next-generation sequencing (NGS) panel, and these results were compared to a novel Idylla GeneFusion assay and pan-TRK immunohistochemistry (IHC). NGS detected seven (7/62, 11%) NTRK1 fusions (TPM3::NTRK1, PLEKHA6::NTRK1 and LMNA::NTRK1, each in two cases, and IRF2BP2::NTRK1 in one case). In addition, two ALK, four RET and seven BRAF fusions were identified. Idylla detected seven NTRK1 expression imbalances, in line with the NGS results (overall agreement 100%). Furthermore, Idylla detected the two NGS-identified ALK rearrangements as one specific ALK fusion and one ALK expression imbalance, whilst only two of the four RET fusions were discovered. However, Idylla detected several expression imbalances of ALK (n = 7) and RET (n = 1) that were found to be fusion negative with the NGS. Pan-TRK IHC showed clearly detectable, fusion partner-dependent staining patterns in the seven NTRK1 fusion cases. Overall agreement for pan-TRK antibody clone EPR17341 was 98% and for A7H6R 100% when compared to the NGS. Of the 62 CRCs, 43 were MLH1 promoter hypermethylated (MLH1ph) and 39 were RASwt. All fusion cases were both MLH1ph and RASwt. Our results show that kinase fusions (20/30, 67%) and most importantly targetable NTRK1 fusions (7/30, 23%) are frequent in CRCs with dMLH1/BRAFV600Ewt/MLH1ph/RASwt. NGS was the most comprehensive method in finding the fusions, of which a subset can be screened by Idylla or IHC, provided that the result is confirmed by NGS

Relativistic electron microbursts and pulsating aurora

第6回極域科学シンポジウム[OS] 宙空圏11月16日（月）　国立極地研究所 2階 大会議