Web-sivuston suunnittelu ja toteutus WordPress-julkaisujärjestelmällä

Opinnäytetyön toimeksiantajana toimi Suomen Joogaliitto ry. Joogaliitto järjestää ympäri vuoden erilaisia joogakursseja ja kouluttaa uusia joogan ohjaajia. Tehtävänä oli suunnitella ja toteuttaa Joogaliitolle uudet verkkosivut, jotka korvaavat vanhat. Tavoitteena oli saada verkkosivuista helposti päivitettävät ja nykyaikaisemmat. Verkkosivuille tehtiin muun muassa kurssikalenteri sekä oma intranet. Verkkosivut tehtiin responsiivisiksi eli laitemukautuviksi Bootstrap frameworkin avulla. Sivut rakennettiin WordPress-julkaisujärjestelmän päälle ja niissä käytettiin eri WordPressin lisäosia. Julkaisujärjestelmän avulla Joogaliiton ihmiset pystyvät päivittämään sivuja helposti itse. Verkkosivujen kurssikalenteria ja kirjatilauksia varten WordPressiin luotiin kaksi uutta sisältötyyppiä ja tähän kustomoituja kenttiä. Sivuilta pystyy suoraan ilmoittautumaan kurssille ja tilaamaan kirjoja. Intranetiin luotiin erilaisia käyttäjäryhmiä, joilla on vaihtelevia oikeuksia intranetin sivuille. Intranetissä käytetään WordPressissä tehtyjä käyttäjiä ja kirjautumiseen käytetään WordPressin kirjautumislomaketta. Sivuille luotiin myös Joogaliiton käyttämiä lomakkeita sähköisessä muodossa. Lomakkeiden tiedot lähetetään sähköpostilla Joogaliitolle. Tehtävän tuloksena syntyi rakenteeltaan ja ulkoasultaan uudistuneet verkkosivut. Toimeksiantaja pystyy helposti päivittämään sivujen sisältöä ilman suurempia teknisiä taitoja. Uudet sivut ovat responsiiviset, mikä helpottaa ja tulee todennäköisesti lisäämään mobiilikäyttöä. Lomakkeita ei tarvitse enää tulostaa, vaan ne voi lähettää suoraan sivujen kautta. Lisäksi verkkosivujen tulokset hakukoneissa parantuvat sivujen hakukoneoptimoinnin ansiosta.The client of this Bachelor's Thesis was The Yoga Federation of Finland. The Yoga Federation organizes yoga courses and trains new yoga instructors around the year. The task was to design and implement a new website for The Yoga Federation to replace the old one. The objective was to make the website more modern and easily updatable. Among other things, the website included a course calendar and an intranet. With the help of the Bootstrap framework, the website was made responsive, or in other words, device-adaptive. The website was built using the WordPress content management system and its various plugins. With the help of the content management system, the people of The Yoga Federation can update the pages easily by themselves. For the course calendar and the book orders, two new post types were created for WordPress, and new custom fields were added to them. From the website, one can directly sign up for courses or order books. Various user groups with different rights to the intranet pages were created on the intranet. The WordPress users are utilized as users within the intranet users and the WordPress login form is used for logging in. The Yoga Federation uses various kinds of forms, which were created as online forms. The information submitted through the online forms is sent to The Yoga Federation by e-mail. As the result, a new website with an improved structure and layout was created. The client can easily update the content of the pages without advanced technical skills. The new website is responsive, which makes it easier to use and is likely to increase mobile usage. The forms do not need to be printed out anymore and they can be sent directly through the website. In addition, because of the search engine optimization of the website, the website's results in search engines will improve

Levinneisyyden selvittäminen uusilla kuvantamismenetelmillä korkean riskin eturauhassyövässä, kirjallisuuskatsaus.

Levinneisyyden arviointi on oleellinen osa eturauhassyövän hoitolinjaa valittaessa. Perinteisesti levinneisyyden arviointiin käytetyissä kuvantamismenetelmissä on omat vajaavaisuutensa, jotka selittävät osittain hoidetun eturauhassyövän korkeaa uusiutumistaipumusta. Uutta kuvantamismenetelmää edustaa PSMA-PET-TT, joka hyödyntää eturauhassolun pinnalla olevaa antigeenia (PSMA, prostate spesific membrane antigen), jonka ilmeneminen suurenee huomattavasti eturauhasen kasvainsoluissa. Tutkimustulokset sen hyödyntämisestä on kuitenkin toistaiseksi vähäisiä, joskin lupaavia, ja tehokas käyttö kliinisessä työssä vaatii vielä enemmän näyttöä

Prostate MRI added to CAPRA, MSKCC and Partin cancer nomograms significantly enhances the prediction of adverse findings and biochemical recurrence after radical prostatectomy

Background To determine the added value of preoperative prostate multiparametric MRI (mpMRI) supplementary to clinical variables and their role in predicting post prostatectomy adverse findings and biochemically recurrent cancer (BCR). Methods All consecutive patients treated at HUS Helsinki University Hospital with robot assisted radical prostatectomy (RALP) between 2014 and 2015 were included in the analysis. The mpMRI data, clinical variables, histopathological characteristics, and follow-up information were collected. Study end-points were adverse RALP findings: extraprostatic extension, seminal vesicle invasion, lymph node involvement, and BCR. The Memorial Sloan Kettering Cancer Center (MSKCC) nomogram, Cancer of the Prostate Risk Assessment (CAPRA) score and the Partin score were combined with any adverse findings at mpMRI. Predictive accuracy for adverse RALP findings by the regression models was estimated before and after the addition of MRI results. Logistic regression, area under curve (AUC), decision curve analyses, Kaplan-Meier survival curves and Cox proportional hazard models were used. Results Preoperative mpMRI data from 387 patients were available for analysis. Clinical variables alone, MSKCC nomogram or Partin tables were outperformed by models with mpMRI for the prediction of any adverse finding at RP. AUC for clinical parameters versus clinical parameters and mpMRI variables were 0.77 versus 0.82 for any adverse finding. For MSKCC nomogram versus MSKCC nomogram and mpMRI variables the AUCs were 0.71 and 0.78 for any adverse finding. For Partin tables versus Partin tables and mpMRI variables the AUCs were 0.62 and 0.73 for any adverse finding. In survival analysis, mpMRI-projected adverse RP findings stratify CAPRA and MSKCC high-risk patients into groups with distinct probability for BCR. Conclusions Preoperative mpMRI improves the predictive value of commonly used clinical variables for pathological stage at RP and time to BCR. mpMRI is available for risk stratification prebiopsy, and should be considered as additional source of information to the standard predictive nomograms.Peer reviewe

Associations of PTEN and ERG with Magnetic Resonance Imaging Visibility and Assessment of Non–organ-confined Pathology and Biochemical Recurrence After Radical Prostatectomy

Background: Diagnosing clinically significant prostate cancer (PCa) is challenging, but may be facilitated by biomarkers and multiparametric magnetic resonance imaging (MRI). Objective: To determine the association between biomarkers phosphatase and tensin homolog (PTEN) and ETS-related gene (ERG) with visible and invisible PCa lesions in MRI, and to predict biochemical recurrence (BCR) and non-organ-confined (non-OC) PCa by integrating clinical, MRI, and biomarker-related data. Design, setting, and participants: A retrospective analysis of a population-based cohort of men with PCa, who underwent preoperative MRI followed by radical prostatectomy (RP) during 2014-2015 in Helsinki University Hospital (n = 346), was conducted. A tissue microarray corresponding to the MRI-visible and MRI-invisible lesions in RP specimens was constructed and stained for PTEN and ERG. Outcome measurements and statistical analysis: Associations of PTEN and ERG with MRI-visible and MRI-invisible lesions were examined (Pearson's chi 2 test), and predictions of non-OC disease together with clinical and MRI parameters were determined (area under the receiver operating characteristic curve and logistic regression analyses). BCR prediction was analyzed by Kaplan-Meier and Cox proportional hazard analyses. Results and limitations: Patients with MRI-invisible lesions (n = 35) had less PTEN loss and ERG-positive expression compared with patients (n = 90) with MRI-visible lesions (17.2% vs 43.3% [p = 0.006]; 8.6% vs 20.0% [p = 0.125]). Patients with invisible lesions had better, but not statistically significantly improved, BCR-free survival probability in Kaplan-Meier analyses (p = 0.055). Rates of BCR (5.7% vs 21.1%; p = 0.039), extraprostatic extension (11.4% vs 44.6%; p < 0.001), seminal vesicle invasion (0% vs 21.1%; p = 0.003), and lymph node metastasis (0% vs 12.2%; p = 0.033) differed between the groups in favor of patients with MRI-invisible lesions. Biomarkers had no independent role in predicting non-OC disease or BCR. The short follow-up period was a limitation. Conclusions: PTEN loss, BCR, and non-OC RP findings were more often encountered with MRI-visible lesions. Patient summary: Magnetic resonance imaging (MRI) of the prostate misses some cancer lesions. MRI-invisible lesions seem to be less aggressive than MRI-visible lesions. (C) 2020 European Association of Urology. Published by Elsevier B.V. All rights reserved.Peer reviewe

Climate impacts of peat fuel utilization chains – a critical review of the Finnish and Swedish life cycle assessments

In recent years there has been a lively debate in Finland and Sweden on the climate impact of peat fuel utilization. The aim of this study was to clarify the contradictions between the Finnish and Swedish studies and provide a better basis for energy policy decision-making by summarizing the recent scientific knowledge about the climate impacts of peat fuel utilization chains based on the life cycle assessment (LCA) methodology. A starting point for this study was to carry out a critical review of Finnish and Swedish life cycle studies of the climate impacts of peat fuel utilization chains. The critical review was conducted according to the recommendations of international standards and its aim was to ensure that the methods, data and interpretation of results were carried out in a scientifically and technically valid way. During the review the available data (mostly published) on the greenhouse gas (GHG) balances and the radiative forcing impacts of GHGs were gathered and updated.  The re-calculations showed that the climate impact of "Pristine mire – afforestation" utilization chain is similar to the climate impact of coal utilization, whereas the result of the peat utilization chain "Pristine mire – restoration" is slightly worse than for the coal utilization chain. The results were similar in the reviewed studies. The peat utilization chain "Forestry-drained peatlands – afforestration" causes a slightly higher climate impact on average than the coal utilization chain does. From the viewpoint of peat utilization the result was similar to the result of Finnish study. According to the reviewed studies the use of cultivated peatlands causes the lowest climate impact compared to the climate impacts of the other peatlands. However, cultivated peatlands do not play important role as an extraction area for peat utilization. From the viewpoint of peat utilization the result of cultivated peatland was worse compared to the result produced by the Finnish and Swedish studies. The climate impacts of peat fuel utilization chains are mostly caused by the carbon dioxide released by peat combustion. These emissions are known quite  well. However, the emission assessments of different peat types include large uncertainty before, during and after peat extraction. In spite of that it can be said that land change options related to peat extraction and after-treatments have very limited effects on the climate impacts of peat utilization chain

Oncolytic Adenovirus Type 3 Coding for CD40L Facilitates Dendritic Cell Therapy of Prostate Cancer in Humanized Mice and Patient Samples

Dendritic cell (DC)-based vaccines have shown some degree of success for the treatment of prostate cancer (PC). However, the highly immunosuppressive tumor microenvironment leads to DC dysfunction, which has limited the effectiveness of these vaccines. We hypothesized that use of a fully serotype 3 oncolytic adenovirus (Ad3-hTERT-CMV-hCD40L; TILT-234) could stimulate DCs in the prostate tumor microenvironment by expressing CD40L. Activated DCs would then activate cytotoxic T cells against the tumor, resulting in therapeutic immune responses. Oncolytic cell killing due to cancer cell-specific virus replication adds to antitumor effects but also enhances the immunological effect by releasing tumor epitopes for sampling by DC, in the presence of danger signals. In this study, we evaluated the companion effect of Ad3-hTERT-CMV-hCD40L and DC-therapy in a humanized mouse model and PC histocultures. Treatment with Ad3-hTERT-CMV-hCD40L and DC resulted in enhanced antitumor responses in vivo. Treatment of established histocultures with Ad3-hTERT-CMV-hCD40L induced DC maturation and notable increase in proinflammatory cytokines. In conclusion, Ad3-hTERT-CMV-hCD40L is able to modulate an immunosuppressive prostate tumor microenvironment and improve the effectiveness of DC vaccination in PC models and patient histocultures, setting the stage for clinical translation.Peer reviewe

A Prospective Comparison of F-18-prostate-specific Membrane Antigen-1007 Positron Emission Tomography Computed Tomography, Whole-body 1.5 T Magnetic Resonance Imaging with Diffusion-weighted Imaging, and Single-photon Emission Computed Tomography/Computed Tomography with Traditional Imaging in Primary Distant Metastasis Staging of Prostate Cancer (PROSTAGE)

Background: Computed tomography (CT) and bone scintigraphy (BS) are the imaging modalities currently used for distant metastasis staging of prostate cancer (PCa). Objective: To compare standard staging modalities with newer and potentially more accurate imaging modalities. Design, setting, and participants: This prospective, single-centre trial (NCT03537391) enrolled 80 patients with newly diagnosed high-risk PCa (International Society of Urological Pathology grade group >= 3 and/or prostate-specific antigen [PSA] >= 20 and/or cT >= T3; March 2018-June 2019) to undergo primary metastasis staging with two standard and three advanced imaging modalities. Outcome measurements and statistical analysis: The participants underwent the following five imaging examinations within 2 wk of enrolment and without a prespecified sequence: BS, CT, Tc-99m-hydroxymethylene diphosphonate (Tc-99m-HMDP) single-photon emission computed tomography (SPECT)-CT, 1.5 T whole-body magnetic resonance imaging (WBMRI) using diffusion-weighted imaging, and F-18-prostate-specific membrane antigen-1007 (F-18-PSMA-1007) positron emission tomography(PET)-CT. Each modality was reviewed by two independent experts blinded to the results of the prior studies, who classified lesions as benign, equivocal, or malignant. Pessimistic and optimistic analyses were performed to resolve each equivocal diagnosis. The reference standard diagnosis was defined using all available information accrued during at least 12 mo of clinical follow-up. Patients with equivocal reference standard diagnoses underwent MRI and/or CT to search for the development of anatomical correspondence. PSMA PET-avid lesions without histopathological verification were rated to be malignant only if there was a corresponding anatomical finding suspicious for malignancy at the primary or follow-up imaging. Results and limitations: Seventy-nine men underwent all imaging modalities except for one case of interrupted MRI. The median interval per patient between the first and the last imaging study was 8 d (interquartile range [IQR]: 6-9). The mean age was 70 yr (standard deviation: 7) and median PSA 12 ng/mL (IQR:7-23). The median follow-up was 435 d (IQR: 378-557). Metastatic disease was detected in 20 (25%) patients. The imaging modality F-18-PSMA-1007 PET-CT had superior sensitivity and highest inter-reader agreement. The area under the receiver-operating characteristic curve (AUC) values for bone metastasis detection with PSMA PET-CT were 0.90 (95% confidence interval [CI]: 0.85-0.95) and 0.91 (95% CI: 0.87-0.96) for readers 1 and 2, respectively, while the AUC values for BS, CT, SPECT-CT, and WBMRI were 0.71 (95% CI: 0.58-0.84) and 0.8 (95% CI: 0.67-0.92), 0.53 (95% CI: 0.39-0.67) and 0.66 (95% CI: 0.54-0.77), 0.77 (95% CI: 0.65-0.89) and 0.75 (95% CI: 0.62-0.88), and 0.85 (95% CI: 0.74-0.96) and 0.67 (95% CI: 0.54-0.80), respectively, for the other four pairs of readers. The imaging method F-18-PSMA-1007 PET-CT detected metastatic disease in 11/20 patients in whom standard imaging was negative and influenced clinical decision making in 14/79 (18%) patients. In 12/79 cases, false positive bone disease was reported only by PSMA PET-CT. Limitations included a nonrandomised study setting and few histopathologically validated suspicious lesions. Conclusions: Despite the risk of false positive bone lesions, F-18-PSMA-1007 PET-CT outperformed all other imaging methods studied for the detection of primary distant metastasis in high-risk PCa. Patient summary: In this report, we compared the diagnostic performance of conventional and advanced imaging. It was found that F-18-prostate-specific membrane antigen-1007 positron emission tomography/computed tomography (F-18-PSMA-1007 PET-CT) was superior to the other imaging modalities studied for the detection of distant metastasis at the time of initial diagnosis of high-risk prostate cancer. PSMA PET-CT also appears to detect some nonmetastatic bone lesions. (C) 2020 The Author(s). Published by Elsevier B.V. on behalf of European Association of Urology.Peer reviewe

Response to letter on use of functional imaging by 11C-metomidate PET for primary aldosteronism subtyping

Non peer reviewe

A Prospective Comparison of 18F-prostate-specific Membrane Antigen-1007 Positron Emission Tomography Computed Tomography, Whole-body 1.5 T Magnetic Resonance Imaging with Diffusion-weighted Imaging, and Single-photon Emission Computed Tomography/Computed Tomography with Traditional Imaging in Primary Distant Metastasis Staging of Prostate Cancer (PROSTAGE)

Background: Computed tomography (CT) and bone scintigraphy (BS) are the imaging modalities currently used for distant metastasis staging of prostate cancer (PCa).Objective: To compare standard staging modalities with newer and potentially more accurate imaging modalities.Design, setting, and participants: This prospective, single-centre trial (NCT03537391) enrolled 80 patients with newly diagnosed high-risk PCa (International Society of Urological Pathology grade group ≥3 and/or prostate-specific antigen [PSA] ≥20 and/or cT ≥ T3; March 2018-June 2019) to undergo primary metastasis staging with two standard and three advanced imaging modalities.Outcome measurements and statistical analysis: The participants underwent the following five imaging examinations within 2 wk of enrolment and without a prespecified sequence: BS, CT, 99mTc-hydroxymethylene diphosphonate (99mTc-HMDP) single-photon emission computed tomography (SPECT)-CT, 1.5 T whole-body magnetic resonance imaging (WBMRI) using diffusion-weighted imaging, and 18F-prostate-specific membrane antigen-1007 (18F-PSMA-1007) positron emission tomography(PET)-CT. Each modality was reviewed by two independent experts blinded to the results of the prior studies, who classified lesions as benign, equivocal, or malignant. Pessimistic and optimistic analyses were performed to resolve each equivocal diagnosis. The reference standard diagnosis was defined using all available information accrued during at least 12 mo of clinical follow-up. Patients with equivocal reference standard diagnoses underwent MRI and/or CT to search for the development of anatomical correspondence. PSMA PET-avid lesions without histopathological verification were rated to be malignant only if there was a corresponding anatomical finding suspicious for malignancy at the primary or follow-up imaging.Results and limitations: Seventy-nine men underwent all imaging modalities except for one case of interrupted MRI. The median interval per patient between the first and the last imaging study was 8 d (interquartile range [IQR]: 6-9). The mean age was 70 yr (standard deviation: 7) and median PSA 12 ng/mL (IQR:7-23). The median follow-up was 435 d (IQR: 378-557). Metastatic disease was detected in 20 (25%) patients. The imaging modality 18F-PSMA-1007 PET-CT had superior sensitivity and highest inter-reader agreement. The area under the receiver-operating characteristic curve (AUC) values for bone metastasis detection with PSMA PET-CT were 0.90 (95% confidence interval [CI]: 0.85-0.95) and 0.91 (95% CI: 0.87-0.96) for readers 1 and 2, respectively, while the AUC values for BS, CT, SPECT-CT, and WBMRI were 0.71 (95% CI: 0.58-0.84) and 0.8 (95% CI: 0.67-0.92), 0.53 (95% CI: 0.39-0.67) and 0.66 (95% CI: 0.54-0.77), 0.77 (95% CI: 0.65-0.89) and 0.75 (95% CI: 0.62-0.88), and 0.85 (95% CI: 0.74-0.96) and 0.67 (95% CI: 0.54-0.80), respectively, for the other four pairs of readers. The imaging method 18F-PSMA-1007 PET-CT detected metastatic disease in 11/20 patients in whom standard imaging was negative and influenced clinical decision making in 14/79 (18%) patients. In 12/79 cases, false positive bone disease was reported only by PSMA PET-CT. Limitations included a nonrandomised study setting and few histopathologically validated suspicious lesions.Conclusions: Despite the risk of false positive bone lesions, 18F-PSMA-1007 PET-CT outperformed all other imaging methods studied for the detection of primary distant metastasis in high-risk PCa.Patient summary: In this report, we compared the diagnostic performance of conventional and advanced imaging. It was found that 18F-prostate-specific membrane antigen-1007 positron emission tomography/computed tomography (18F-PSMA-1007 PET-CT) was superior to the other imaging modalities studied for the detection of distant metastasis at the time of initial diagnosis of high-risk prostate cancer. PSMA PET-CT also appears to detect some nonmetastatic bone lesions.</p