Mismatch, empowerment, fatigue or balance? Four scenarios of physical activity up to 2030 in Finland

Sedentary lifestyles and the lack of physical activity (PA) are a major concern among all age groups, and current generations tend to be less fit than the previous ones in the Western World. At the same time, there is an urgent need to cut transport-related carbon dioxide (CO2) emissions. Major gains can be foreseen if current car-centred lifestyles and sedentary behaviour are addressed from an integrated perspective. In this study, we explore future scenarios in the intersections of PA and active lifestyles as well as related environmental and health benefits in Finland. We used a disaggregative Delphi approach to examine the topic. Although frequently used in health-related research, Delphi has rarely been used in exploring alternative futures or non-consensus. The study design was based on a mixed-methods approach where we combined both qualitative and quantitative data analysis. Building on the experts’ perceptions on alternative futures, we formulated four scenarios for PA up to 2030, which we named Mismatch, Empowerment, Fatigue and Balance. The scenarios may be utilised as guides in developing future policies and decision-making, and to build better futures. Our scenarios demonstrate that alternatives do exist, and actions can be realigned with the positive scenarios of Empowerment and Balance. The physically inactive scenarios of Mismatch and Fatigue represent avoidable scenarios.</p

Human Protoparvovirus DNA and IgG in Children and Adults with and without Respiratory or Gastrointestinal Infections

Abstract: Three human protoparvoviruses, bufavirus (BuV), tusavirus (TuV) and cutavirus (CuV), have recently been discovered in diarrheal stool. BuV has been associated with diarrhea and CuV with cutaneous T-cell lymphoma, but there are hardly any data for TuV or CuV in stool or respiratory samples. Hence, using qPCR and IgG enzyme immunoassays, we analyzed 1072 stool, 316 respiratory and 445 serum or plasma samples from 1098 patients with and without gastroenteritis (GE) or respiratory-tract infections (RTI) from Finland, Latvia and Malawi. The overall CuV-DNA prevalences in stool samples ranged between 0–6.1% among our six patient cohorts. In Finland, CuV DNA was significantly more prevalent in GE patients above rather than below 60 years of age (5.1% vs 0.2%). CuV DNA was more prevalent in stools among Latvian and Malawian children compared with Finnish children. In 10/11 CuV DNA-positive adults and 4/6 CuV DNA-positive children with GE, no known causal pathogens were detected. Interestingly, for the first time, CuV DNA was observed in two nasopharyngeal aspirates from children with RTI and the rare TuV in diarrheal stools of two adults. Our results provide new insights on the occurrence of human protoparvoviruses in GE and RTI in different countries.Peer reviewe

Human Protoparvovirus DNA and IgG in Children and Adults with and without Respiratory or Gastrointestinal Infections

Abstract: Three human protoparvoviruses, bufavirus (BuV), tusavirus (TuV) and cutavirus (CuV), have recently been discovered in diarrheal stool. BuV has been associated with diarrhea and CuV with cutaneous T-cell lymphoma, but there are hardly any data for TuV or CuV in stool or respiratory samples. Hence, using qPCR and IgG enzyme immunoassays, we analyzed 1072 stool, 316 respiratory and 445 serum or plasma samples from 1098 patients with and without gastroenteritis (GE) or respiratory-tract infections (RTI) from Finland, Latvia and Malawi. The overall CuV-DNA prevalences in stool samples ranged between 0–6.1% among our six patient cohorts. In Finland, CuV DNA was significantly more prevalent in GE patients above rather than below 60 years of age (5.1% vs 0.2%). CuV DNA was more prevalent in stools among Latvian and Malawian children compared with Finnish children. In 10/11 CuV DNA-positive adults and 4/6 CuV DNA-positive children with GE, no known causal pathogens were detected. Interestingly, for the first time, CuV DNA was observed in two nasopharyngeal aspirates from children with RTI and the rare TuV in diarrheal stools of two adults. Our results provide new insights on the occurrence of human protoparvoviruses in GE and RTI in different countries.Peer reviewe

Epidemiology of two human protoparvoviruses, bufavirus and tusavirus

Two human parvoviruses were recently discovered by metagenomics in Africa, bufavirus (BuV) in 2012 and tusavirus (TuV) in 2014. These viruses have been studied exclusively by PCR in stool and detected only in patients with diarrhoea, although at low prevalence. Three genotypes of BuV have been identified. We detected, by in-house EIA, BuV1-3 IgG antibodies in 7/228 children (3.1%) and 10/180 adults (5.6%), whereas TuV IgG was found in one child (0.4%). All children and 91% of the adults were Finnish, yet interestingly 3/6 adults of Indian origin were BuV-IgG positive. By competition EIA, no cross-reactivity between the BuVs was detected, indicating that the BuV genotypes represent distinct serotypes. Furthermore, we analysed by BuV qPCR stool and nasal swab samples from 955 children with gastroenteritis, respiratory illness, or both, and found BuV DNA in three stools (0.3%) and for the first time in a nasal swab (0.1%). This is the first study documenting the presence of BuV and TuV antibodies in humans. Although the seroprevalences of both viruses were low in Finland, our results indicate that BuV infections might be widespread in Asia. The BuV-specific humoral immune responses appeared to be strong and long-lasting, pointing to systemic infection in humans.Peer reviewe

Human Protoparvovirus DNA and IgG in Children and Adults with and without Respiratory or Gastrointestinal Infections

Three human protoparvoviruses, bufavirus (BuV), tusavirus (TuV) and cutavirus (CuV), have recently been discovered in diarrheal stool. BuV has been associated with diarrhea and CuV with cutaneous T-cell lymphoma, but there are hardly any data for TuV or CuV in stool or respiratory samples. Hence, using qPCR and IgG enzyme immunoassays, we analyzed 1072 stool, 316 respiratory and 445 serum or plasma samples from 1098 patients with and without gastroenteritis (GE) or respiratory-tract infections (RTI) from Finland, Latvia and Malawi. The overall CuV-DNA prevalences in stool samples ranged between 0-6.1% among our six patient cohorts. In Finland, CuV DNA was significantly more prevalent in GE patients above rather than below 60 years of age (5.1% vs 0.2%). CuV DNA was more prevalent in stools among Latvian and Malawian children compared with Finnish children. In 10/11 CuV DNA-positive adults and 4/6 CuV DNA-positive children with GE, no known causal pathogens were detected. Interestingly, for the first time, CuV DNA was observed in two nasopharyngeal aspirates from children with RTI and the rare TuV in diarrheal stools of two adults. Our results provide new insights on the occurrence of human protoparvoviruses in GE and RTI in different countries

A computationally designed antigen eliciting broad humoral responses against SARS-CoV-2 and related sarbecoviruses

The threat of spillovers of coronaviruses associated with the severe acute respiratory syndrome (SARS) from animals to humans necessitates vaccines that offer broader protection from sarbecoviruses. By leveraging a viral-genome-informed computational method for selecting immune-optimized and structurally engineered antigens, here we show that a single antigen based on the receptor binding domain of the spike protein of sarbecoviruses elicits broad humoral responses against SARS-CoV-1, SARS-CoV-2, WIV16 and RaTG13 in mice, rabbits and guinea pigs. When administered as a DNA immunogen or by a vector based on a modified vaccinia virus Ankara, the optimized antigen induced vaccine protection from the Delta variant of SARS-CoV-2 in mice genetically engineered to express angiotensin-converting enzyme 2 and primed by a viral-vector vaccine (AZD1222) against SARS-CoV-2. A vaccine formulation incorporating mRNA coding for the optimized antigen further validated its broad immunogenicity. Vaccines that elicit broad immune responses across subgroups of coronaviruses may counteract the threat of zoonotic spillovers of betacoronaviruses

Analysis of Serological Biomarkers of SARS-CoV-2 Infection in Convalescent Samples From Severe, Moderate and Mild COVID-19 Cases.

Precision monitoring of antibody responses during the COVID-19 pandemic is increasingly important during large scale vaccine rollout and rise in prevalence of Severe Acute Respiratory Syndrome-related Coronavirus-2 (SARS-CoV-2) variants of concern (VOC). Equally important is defining Correlates of Protection (CoP) for SARS-CoV-2 infection and COVID-19 disease. Data from epidemiological studies and vaccine trials identified virus neutralising antibodies (Nab) and SARS-CoV-2 antigen-specific (notably RBD and S) binding antibodies as candidate CoP. In this study, we used the World Health Organisation (WHO) international standard to benchmark neutralising antibody responses and a large panel of binding antibody assays to compare convalescent sera obtained from: a) COVID-19 patients; b) SARS-CoV-2 seropositive healthcare workers (HCW) and c) seronegative HCW. The ultimate aim of this study is to identify biomarkers of humoral immunity that could be used to differentiate severe from mild or asymptomatic SARS-CoV-2 infections. Some of these biomarkers could be used to define CoP in further serological studies using samples from vaccination breakthrough and/or re-infection cases. Whenever suitable, the antibody levels of the samples studied were expressed in International Units (IU) for virus neutralisation assays or in Binding Antibody Units (BAU) for ELISA tests. In this work we used commercial and non-commercial antibody binding assays; a lateral flow test for detection of SARS-CoV-2-specific IgG/IgM; a high throughput multiplexed particle flow cytometry assay for SARS-CoV-2 Spike (S), Nucleocapsid (N) and Receptor Binding Domain (RBD) proteins); a multiplex antigen semi-automated immuno-blotting assay measuring IgM, IgA and IgG; a pseudotyped microneutralisation test (pMN) and an electroporation-dependent neutralisation assay (EDNA). Our results indicate that overall, severe COVID-19 patients showed statistically significantly higher levels of SARS-CoV-2-specific neutralising antibodies (average 1029 IU/ml) than those observed in seropositive HCW with mild or asymptomatic infections (379 IU/ml) and that clinical severity scoring, based on WHO guidelines was tightly correlated with neutralisation and RBD/S antibodies. In addition, there was a positive correlation between severity, N-antibody assays and intracellular virus neutralisation

Applying the European Framework of Reference for Languages in German teaching

Eurooppalaisen viitekehyksen pääajatuksena on ammatillisen kieltenopiskelun yhtenäistäminenEuroopassa. Viitekehyksessä kuvataan kielenhallinnan eri alueet, kielitaidon osaamisalueet ja -tasot sekä niiden luokittelu eri tasoille. Common European Framework of Reference for Languages: Learning, Teatching, Assessment -teos ilmestyi 90-luvun alussa ja sitä on siitä lähtien päivitetty useaan otteeseen. Ammattikorkeakoulujen kieltenopetus palvelee erityisesti työelämän ja ammatin tarpeita. Tämän vuoksi on tärkeää, että eri alojen kieltenopetukseen laaditaan omat viitekehyksensä. Olen laatinut Keski-Pohjanmaan ammattikorkeakoulun Kokkolan liiketalouden yksikön saksan kielen opetusta varten viitekehyksen. Viitekehys on kolmiosainen liiketalouden saksan opetuksen kuvaus, johon kuuluvat työelämän viestintätaidon kuvaus, alan viestintätilanteiden kuvaus, kieltenopetuksen- ja oppimisen kuvaus, kielitaidon tavoitteet, arviointi ja arviointikriteerit. Kehittämishankkeessani kokeilin viitekehystä yhteen saksan valinnaiseen opintojaksoon. Opintojakso "Wiederholung und Sprechübungen" oli laajuudeltaan kolme opintopistettä ja se oli tarkoitettu vähintään ammattikorkeakoulumme liiketalouden alan neljän aiemman samanpituisen opintojakson tai lukion saksan oppimäärän suorittaneille. Tavoitteenani oli yhtenäistää kieltenopetusta myös valinnaisen kielen osalta. Viitekehystyö Suomessa on tähän mennessä keskittynyt pääasiassa pakollisiin kieliin eli ruotsiin ja saksaan. Hankkeessani keskityin viitekehyksen kielikohtaisenkuvauksen kielenkäyttötilanteiden ydinainekseen: opintojakson tai -kokonaisuuden keskeisten sisältöjen ja tavoitteisen määrittelyyn ja niiden toteutumisen arviointiin.The European Framework of Reference for Languages: Learning, Teaching, Assessment was written in the beginning of 90s. Its main idea is to co-ordinate professional language studies in Europe. The language teaching at Polytechnics especially serves the needs of the working life and profession and they are very subject specific. I have made a framework of referencefor German language teaching in the business department. This framework describes the various parts of professional language teaching: communication skills at work, communication situations, language teaching and learning, the aims of the language skills, evaluation and evaluation criteria. The main idea of this studywas to apply the Common European Framework of Reference for Languages to one language course in German. The extent of this course "Wiederholung und Sprechübungen" is three ects and it is meant for the students who have already taken part in the previous four courses (three ects each) in German in the business department of our Polytechnic or who have studied German in high school. The European Framework of Reference has until now mainly focused on the obligatory languages Swedish and English and the other aim of this development project was toapply it also in a non - obligatory language

Ihmisen koronavirusten ja bokavirusten esiintyvyys ja merkitys lasten gastroenteriittien yhteydessä

Akuutti gastroenteriitti eli äkillinen maha-suolitulehdus on edelleen tärkeimpiä syitä lasten sairaalahoitoon Suomessa, vaikka rotavirusrokotteen otto kansalliseen rokotusohjelmaan on enemmän kuin puolittanut sairaalahoitojen määrän. Rotavirusten eliminoinnin jälkeen norovirukset ovat tulleet tärkeimmiksi lasten virusperäisen gastroenteriitin aiheuttajiksi Suomessa. Diagnostiikan kehittymisestä huolimatta kuitenkin osassa lasten gastroenteriittitapauksista taudinaiheuttaja jää tunnistamatta. Viime vuosina on löydetty useita uusia viruksia, kuten ihmisen bokavirukset ja ihmisen koronavirustyypit NL63 ja HKU1. Näitä uusia viruksia on löydetty myös ulostenäytteistä. Tässä väitöskirjatyössä selvitettiin ihmisen koronavirusten ja ihmisen bokavirusten esiintymistä sairaalahoitoon joutuneiden lasten ulosteissa sekä näiden virusten yhteyttä akuuttiin gastroenteriittiin. Tutkimuksessa käytettiin kahta Tampereen yliopistollisessa sairaalassa vuosina 2006-2008 ja 2009-2011 kerättyä aineistoa, joista ensimmäinen sisälsi vain ulostenäytteitä, ja toinen ulostenäytteitä, hengitystienäytteitä ja verinäytteitä. Ihmisen koronavirusten yhteyttä gastroenteriitteihin tutkittiin käänteiskopiointi polymeraasi ketjureaktio (RT-PCR) – menetelmällä, joka suunniteltiin tunnistamaan kaikki tunnetut ihmisen koronavirustyypit. Ennen tätä tutkimusta ainoastaan SARS-koronaviruksen esiintymistä ulosteissa oli tutkittu systemaattisesti. Ensimmäisessä osatyössä ilmeni, että kaikkia yleisesti kiertäviä koronavirustyyppejä, OC43, 229E, NL63 ja HKU1, löytyi gastroenteriittiin sairastuneiden lasten ulosteista, mutta koronaviruspositiivisten näytteiden osuus tautitapauksista oli pieni, kokonaisuudessaan vain 2,5 %. Lisäksi joillakin kontrolliryhmän lapsilla, joilla ei ollut gastroenteriittiä, löytyi koronavirus-positiivisia ulostenäytteitä ja osalla gastroenteriittiä sairastavista koronavirus-positiivisista lapsista oli myös hengitystieinfektion oireita. Toisessa osatyössä koronavirusten esiintymistä tutkittiin ulostenäytteiden lisäksi saman tautiepisodin aikana nenän limakalvolta otetuista tikkunäytteistä. Näytteitä tutkittiin sekä gastroenteriitin että hengitystieinfektion takia sairaalahoitoon joutuneilta lapsilta. Osalla lapsista esiintyi yhtä aikaa sekä hengitystieinfektion että gastroenteriitin oireita. Toisessa osatyössä selvisi, että koronaviruksen löytyessä ulosteesta myös hengitystienäyte oli 90 % tapauksista positiivinen. Koronaviruksia löytyi sekä hengitystieinfektiopotilaiden että gastroenteriittiin sairastuneiden potilaiden ulosteista ja gastroenteriittitapauksissa ulosteesta löytyi yleensä myös jokin tunnettu gastroenteriittia aiheuttava virus, kuten rotavirus tai norovirus. Näiden kahden osatyön perusteella vaikuttaa siltä etteivät yleisesti kiertävät koronavirustyypit OC43, 229E, NL63 ja HKU1 ole lasten sairaalahoitoa vaativien gastroenteriittien aiheuttajia vaan positiivinen ulostenäyte liittyy viruksen läsnäoloon hengitysteissä ja on siten pikemminkin merkki akuutista tai aiemmin sairastetusta hengitystieinfektiosta kuin gastroenteriitistä. Ihmisen bokavirusten tutkimiseen käytettiin PCR-menetelmää ja neljännessä osatyössä myös ihmisen bokaviruksille spesifien vasta-aineiden tunnistamiseen EIA- menetelmää. Väitöskirjan kolmannessa osatyössä todettiin bokavirustyyppien 1, 2 ja 3 esiintyvän gastroenteriittiin sairastuneiden lasten ulostenäytteissä, mutta useimmiten yhdessä jonkin tunnetun gastroenteriittiviruksen kanssa. Lisäksi myös osalla kontrolliryhmän lapsista löytyi bokaviruspositiivisia ulostenäytteitä. Neljännessä osatyössä bokaviruksia tutkittiin koronavirusten tapaan ulostenäytteiden lisäksi myös hengitystienäytteistä ja voitiin todeta, että bokavirustyypit 2 ja 3 löytyvät pääasiassa ulostenäytteistä, kun taas tyyppi 1 esiintyy ulostenäytteiden lisäksi myös hengitystienäytteissä. Eri tutkimusryhmiä vertailemalla voitiin todeta, että ihmisen bokavirus 1:n esiintyminen näytteissä liittyy hengitystieinfektioihin, mutta ihmisen bokavirus 2:n ja ihmisen bokavirus 3:n esiintyminen ei eronnut tutkimusryhmien välillä merkittävästi. Lisäksi gastroenteriittitapauksissa ulosteesta löytyi yli 90% tapauksista bokaviruksen lisäksi jokin tunnettu gastroenteriittiä aiheuttava virus, joka todennäköisimmin oli oireiden aiheuttaja. Väitöskirjatyön perusteella mikään tutkituista viruksista ei lunastanut paikkaansa lasten sairaalahoitoa vaativan gastroenteriitin aiheuttajana. Koronavirukset ovat ensisijaisesti hengitystieinfektioita aiheuttavia viruksia ja ulostelöydökset liittyvät yleensä viruksen samanaikaiseen esiintymiseen hengitysteissä. Bokaviruksista tyypit 2 ja 3 ovat pääasiassa suolistossa viihtyviä viruksia, mutta niiden yhteyttä lasten sairaalahoitoiseen gastroenteriittiin ei pystytty osoittamaan.Acute gastroenteritis (AGE) remains an important cause of child hospitalization in Finland, although rotavirus vaccination has reduced the number of AGE hospitalizations significantly. After the elimination of rotaviruses, noroviruses – and to a smaller extent adenoviruses – are the leading viral causes of the AGE in children. Despite the use of comprehensive diagnostic methods, there are still cases of AGE in children without a known causative pathogen. In recent years, new viruses, such as human bocaviruses (HBoVs) and human coronavirus (HCoV) types NL63 and HKU1, have been discovered. There has been suggestive evidence that these new viruses might be associated with AGE, warranting further studies. The aim of this dissertation was to investigate the occurrence of HCoVs and HBoVs in children hospitalized for AGE and to see if the virus detections in stools are associated with AGE. Two large datasets of prospectively collected patient materials were studied; they were collected at Tampere University Hospital in 2006-2008 and 2009-2011. Stool samples were available from the first group, and stool, nasal swab, and serum samples were available from the second group. A reverse transcription-polymerase chain reaction (RT-PCR) method designed to detect all known HCoV types was set up. Before this study, only SARS (severe acute respiratory syndrome) CoV had been studied systematically from stool samples by molecular techniques. In the first study, we found that all non-SARS HCoVs – including OC43, 229E, and the new types NL63 and HKU1 – were present in some stool samples of children hospitalized for AGE, but the overall detection rate was low, 2.5%. In addition, 1.8% of the control children without gastroenteritis harbored HCoVs in their stools, and several of the HCoV positive children with AGE also had respiratory symptoms. In the second study, we studied both the stool and nasal swab samples of children with AGE and also the stool and nasal swab samples of children hospitalized for acute respiratory tract infection (ARTI). Some of the children had symptoms of both AGE and ARTI. This second study revealed that in addition to children with AGE, children with ARTI – and children with symptoms of both AGE and ARTI – also harbored HCoVs in their stools. Furthermore, if HCoV was found in the stool sample, in 90% of the cases it was found in the nasal swab sample as well. In addition, if an HCoV was found in children with AGE, in most cases there was a known gastroenteritis virus, usually rotavirus or norovirus, in the same stool sample. Combining the results of these two studies, it was concluded that commonly circulating HCoVs (OC43, 229E, NL63, and HKU1) are not significant causes of AGE in hospitalized children. Instead, it seems that a positive stool sample is associated with positivity in the nasal swab sample, and thus a finding of HCoV in the stool is rather a consequence of acute or recent respiratory tract infection. HBoVs were studied by PCR, and in the third study, it was found that HBoV types 1, 2, and 3 were found in 5.6%, 3.3% and 0.9% of the stool samples of children with AGE respectively, but they were usually found together with known gastroenteritis viruses. In addition, some of the control children without symptoms of AGE harbored HBoVs. In the fourth study, both PCR and enzyme immunoassays (EIAs) were used to detect HBoV DNA and HBoV specific antibodies, respectively. HBoVs from both stool and nasal swab samples were studied in a similar way to the HCoVs, and it was found that HBoV2 and 3 were mainly detected in stools, whereas HBoV1 was commonly found in both stool and nasal swab samples. HBoV1 findings were associated with symptoms of respiratory tract infections, in line with being a respiratory virus, while HBoV2 and HBoV3 were found at similar rates in children with and without AGE. In over 90% of the HBoV positive stool samples of children with AGE, a well established gastroenteritis virus was detected in the same sample. Even in the cases of acute HBoV2 infections, norovirus was simultaneously detected in the stools, thus being the most probable reason for the symptoms. In conclusion, neither HCoVs nor HBoVs were associated with the children’s AGE in this study. HCoVs are principally respiratory viruses and findings in stools are probably remnants of the infection in the respiratory tract. HBoV2 and 3 are mainly found in stool samples, and may be regarded as enteric viruses, but no association with AGE in the hospitalized children was found