869 research outputs found
Liikunta kuntoutuksen tukena neurologista sairautta sairastavilla : Kelan vaativaan lÀÀkinnÀlliseen kuntoutukseen osallistuneiden liikuntatottumukset ja avoterapiastandardiin liittyvÀ liikuntakokeilu
Tausta: VÀestön fyysisen aktiivisuuden ja liikunnan vÀhÀisyys aiheuttaa haasteita suomalaiselle yhteiskunnalle. Liikkumaton elÀmÀntapa lisÀÀ monia kansansairauksia ja kansantalouden kustannuksia ja on yhteydessÀ vÀestöryhmien vÀlisiin terveys- ja hyvinvointieroihin. Neurologista sairautta sairastaville kuntoutujille arjen fyysinen aktiivisuus ja liikunnan harrastaminen saattaa olla ongelmallista. Kun fyysisen aktiivisuuden ja liikunnan toteuttamisen edellytykset ovat kunnossa, edistetÀÀn terveyttÀ ja hyvinvointia, vÀhennetÀÀn eriarvoisuutta sekÀ tuetaan ihmisten vastuuta omasta terveydentilasta ja elÀmÀntavoista. Tutkimuksessa Liikunta kuntoutuksen tukena selvitettiin Kelan vaativan lÀÀkinnÀllisen kuntoutuksen fysioterapiaa saavien kuntoutujien liikunnan harrastamista edistÀviÀ ja rajoittavia tekijöitÀ sekÀ Kelan avoterapiastandardin sisÀltÀmÀÀ liikuntakokeilumahdollisuuden kÀyttöÀ.
MenetelmÀt: Tutkimuksen kohderyhmÀnÀ olivat Kelan vaativan lÀÀkinnÀllisen kuntoutuksen fysioterapiaa saavat neurologista sairautta sairastavat suomen- ja ruotsinkieliset kuntoutujat Varsinais-Suomen alueella (N = 564), Kelan jÀrjestÀmÀn fysioterapian palveluntuottajat, joilla on vaikeavammaisia neurologisia kuntoutujia (Loimaa, Paimio, Turku ja Uusikaupunki) (n = 59) sekÀ nÀiden kuntien erityisliikunnasta vastaavat työntekijÀt (n = 4). Kuntoutujien aineisto poimittiin Kelan rekisteristÀ. Tutkimukseen vastasi 219 kuntoutujaa (38,8 %), 22 fysioterapeuttia (37,2 %) ja 2 kahden kunnan erityisliikunnasta vastaavaa työntekijÀÀ. Tutkimus toteutettiin kyselynÀ kuntoutujille sekÀ puhelinhaastatteluna ja sÀhköpostikyselynÀ fysioterapeuteille ja kunnan liikuntatoimen työntekijöille.
Tulokset: Kyselyyn vastanneet kuntoutujat harrastivat eniten kÀvelyÀ tai juoksua, uintia tai vesijuoksua, luonnossa liikkumista ja kuntosaliharjoittelua. Luonnossa liikkumista, uintia tai vesijuoksua, kuntosaliharjoittelua ja tanssia sekÀ keilailua ja ratsastusta halusivat harrastaa myös ne kuntoutujat, jotka eivÀt aikaisemmin olleet harrastaneet nÀitÀ lajeja. Avoterapiastandardiin kuuluvaa liikuntakokeilumahdollisuutta oli hyödynnetty 58 vastaajan (26,7 %) fysioterapiassa. NykyistÀ liikunnan harrastamista kohtalaisesti edistivÀt vastaajan tietÀmys liikunnan ja terveyden vÀlisistÀ yhteyksistÀ sekÀ perheenjÀsenten asenteet ja rajoitti merkittÀvÀsti neurologinen oire. Liikunnan harrastamista lievÀsti edistÀvÀt oma motivaatio liikkua ja oma asenne, avustaja, asiantuntijoiden ohjaus, kuljetusjÀrjestelyt ja liikuntakaveri. LievÀsti nykyistÀ liikunnan harrastamista rajoittivat vastaajan liikunnalliset taidot sekÀ taloudellinen tilanne. Fysioterapeutit ja liikuntatoimi halusivat kehittÀÀ neurologista sairautta sairastavien kuntoutujien liikuntamahdollisuuksia ja toivoivat lisÀÀ tiedottamista kunnan liikuntapalveluista ja Kelan avoterapiastandardin kÀytöstÀ.
JohtopÀÀtökset: Neurologista sairautta sairastavat kuntoutujat, fysioterapeutit ja kunnan erityisliikunnan työntekijÀt kannattivat avoterapiastandardin liikuntakokeilumahdollisuuden kÀyttöÀ, mikÀli liikuntatoiminnan edellytykset ovat kunnossa. Hyvin toteutettuna liikunta tukee kuntoutumista
Counter Machines and Distributed Automata: A Story about Exchanging Space and Time
We prove the equivalence of two classes of counter machines and one class of
distributed automata. Our counter machines operate on finite words, which they
read from left to right while incrementing or decrementing a fixed number of
counters. The two classes differ in the extra features they offer: one allows
to copy counter values, whereas the other allows to compute copyless sums of
counters. Our distributed automata, on the other hand, operate on directed path
graphs that represent words. All nodes of a path synchronously execute the same
finite-state machine, whose state diagram must be acyclic except for
self-loops, and each node receives as input the state of its direct
predecessor. These devices form a subclass of linear-time one-way cellular
automata.Comment: 15 pages (+ 13 pages of appendices), 5 figures; To appear in the
proceedings of AUTOMATA 2018
The ATF6-Met [67] Val substitution is associated with increased plasma cholesterol levels
Objectiveâ Activating transcription factor 6 (ATF6) is a sensor of the endoplasmic reticulum stress response and regulates expression of several key lipogenic genes. We used a 2-stage design to investigate whether ATF6 polymorphisms are associated with lipids in subjects at increased risk for cardiovascular disease (CVD). Methods and Resultsâ In stage 1, 13 tag-SNPs were tested for association in Dutch samples ascertained for familial combined hyperlipidemia (FCHL) or increased risk for CVD (CVR). In stage 2, we further investigated the SNP with the strongest association from stage 1, a Methionine/Valine substitution at amino-acid 67, in Finnish FCHL families and in subjects with CVR from METSIM, a Finnish population-based cohort. The combined analysis of both stages reached region-wide significance (P=9x10â4), but this association was not seen in the entire METSIM cohort. Our functional analysis demonstrated that Valine at position 67 augments ATF6 protein and its targets Grp78 and Grp94 as well as increases luciferase expression through Grp78 promoter. Conclusionsâ A common nonsynonymous variant in ATF6 increases ATF6 protein levels and is associated with cholesterol levels in subjects at increased risk for CVD, but this association was not seen in a population-based cohort. Further replication is needed to confirm the role of this variant in lipids. We report the association of the ATF6-methionine [67]valine amino-acid substitution with plasma cholesterol levels. Association analyses in 2674 subjects and functional data suggest that the ATF6 gene may influence cholesterol levels in subjects at increased risk to develop cardiovascular disease
Can processes make relationships work? The Triple Helix between structure and action
This contribution seeks to explore how complex adaptive theory can be applied at the conceptual level to unpack Triple Helix models. We use two cases to examine this issue â the Finnish Strategic Centres for Science, Technology & Innovation (SHOKs) and the Canadian Business-led Networks of Centres of Excellence (BL-NCE). Both types of centres are organisational structures that aspire to be business-led, with a considerable portion of their activities driven by (industrial) usersâ interests and requirements. Reflecting on the centresâ activities along three dimensions â knowledge generation, consensus building and innovation â we contend that conceptualising the Triple Helix from a process perspective will improve the dialogue between stakeholders and shareholders
Cardiac Involvement in Fabry Disease: JACC Review Topic of the Week
Fabry disease (FD) is a rare X-linked inherited lysosomal storage disorder caused by deficient α-galactosidase A activity that leads to an accumulation of globotriasylceramide (Gb3) in affected tissues, including the heart. Cardiovascular involvement usually manifests as left ventricular hypertrophy, myocardial fibrosis, heart failure, and arrhythmias, which limit quality of life and represent the most common causes of death. Following the introduction of enzyme replacement therapy, early diagnosis and treatment have become essential to slow disease progression and prevent major cardiac complications. Recent advances in the understanding of FD pathophysiology suggest that in addition to Gb3 accumulation, other mechanisms contribute to the development of Fabry cardiomyopathy. Progress in imaging techniques have improved diagnosis and staging of FD-related cardiac disease, suggesting a central role for myocardial inflammation and setting the stage for further research. In addition, with the recent approval of oral chaperone therapy and new treatment developments, the FD-specific treatment landscape is rapidly evolving
Polyteam Semantics
Team semantics is the mathematical framework of modern logics of dependence and independence in which formulae are interpreted by sets of assignments (teams) instead of single assignments as in first-order logic. In order to deepen the fruitful interplay between team semantics and database dependency theory, we define "Polyteam Semantics" in which formulae are evaluated over a family of teams. We begin by defining a novel polyteam variant of dependence atoms and give a finite axiomatisation for the associated implication problem. We also characterise the expressive power of poly-dependence logic by properties of polyteams that are downward closed and definable in existential second-order logic (ESO). The analogous result is shown to hold for poly-independence logic and all ESO-definable properties.Peer reviewe
Common Variants at 10 Genomic Loci Influence Hemoglobin A(1C) Levels via Glycemic and Nonglycemic Pathways
OBJECTIVE Glycated hemoglobin (HbA1c), used to monitor and diagnose diabetes, is influenced by average glycemia over a 2- to 3-month period. Genetic factors affecting expression, turnover, and abnormal glycation of hemoglobin could also be associated with increased levels of HbA1c. We aimed to identify such genetic factors and investigate the extent to which they influence diabetes classification based on HbA1c levels.
RESEARCH DESIGN AND METHODS We studied associations with HbA1c in up to 46,368 nondiabetic adults of European descent from 23 genome-wide association studies (GWAS) and 8 cohorts with de novo genotyped single nucleotide polymorphisms (SNPs). We combined studies using inverse-variance meta-analysis and tested mediation by glycemia using conditional analyses. We estimated the global effect of HbA1c loci using a multilocus risk score, and used net reclassification to estimate genetic effects on diabetes screening.
RESULTS Ten loci reached genome-wide significant association with HbA1c, including six new loci near FN3K (lead SNP/P value, rs1046896/P = 1.6 Ă 10â26), HFE (rs1800562/P = 2.6 Ă 10â20), TMPRSS6 (rs855791/P = 2.7 Ă 10â14), ANK1 (rs4737009/P = 6.1 Ă 10â12), SPTA1 (rs2779116/P = 2.8 Ă 10â9) and ATP11A/TUBGCP3 (rs7998202/P = 5.2 Ă 10â9), and four known HbA1c loci: HK1 (rs16926246/P = 3.1 Ă 10â54), MTNR1B (rs1387153/P = 4.0 Ă 10â11), GCK (rs1799884/P = 1.5 Ă 10â20) and G6PC2/ABCB11 (rs552976/P = 8.2 Ă 10â18). We show that associations with HbA1c are partly a function of hyperglycemia associated with 3 of the 10 loci (GCK, G6PC2 and MTNR1B). The seven nonglycemic loci accounted for a 0.19 (% HbA1c) difference between the extreme 10% tails of the risk score, and would reclassify âŒ2% of a general white population screened for diabetes with HbA1c.
CONCLUSIONS GWAS identified 10 genetic loci reproducibly associated with HbA1c. Six are novel and seven map to loci where rarer variants cause hereditary anemias and iron storage disorders. Common variants at these loci likely influence HbA1c levels via erythrocyte biology, and confer a small but detectable reclassification of diabetes diagnosis by HbA1c
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