Women with polycystic ovary syndrome have poorer work ability and higher disability retirement rate at midlife : a Northern Finland Birth Cohort 1966 study

Objective: Polycystic ovary syndrome (PCOS) presents with multiple comorbidities potentially affecting function. This was the first general population-based study to evaluate work ability, participation in working life, and disability retirement in middle-aged women with and without PCOS. Design: This is a cohort study. Methods: Women with PCOS (n = 280) and women without PCOS symptoms or diagnosis (n = 1573) were identified in the Northern Finland Birth Cohort in 1966 and were evaluated for self-rated work ability and potential confounders at age 46. Next, incidence rate ratios (IRRs) for disability and unemployment days were extracted from national registers during a prospective 2-year follow-up. Lastly, we assessed hazard ratios (HRs) for disability retirement between 16 and 52 years of age from national registers. Results: The women with PCOS reported poorer ability to work at age 46, especially due to poorer health. During the 2-year follow-up period, the affected women gained on average an additional month of disability and unemployment days, corresponding to an approximately 25% higher risk for both disability (IRR (95% CI): 1.25 (1.22-1.27)) and unemployment days (IRR (95% CI): 1.26 (1.23-1.28)) in models adjusted for health and socioeconomic factors. Lastly, we found a two-fold higher cumulative risk for disability retirement by age 52 compared to non-PCOS women (HR (95% CI): 1.98 (1.40-2.80)), which remained after adjusting for confounding factors (aHR (95% CI): 1.55 (1.01-2.38)). Conclusions: PCOS is associated with lower participation in working life already in midlife. Acknowledging PCOS-related multimorbidity, concerted efforts are needed to support sustainable careers for women with PCOS.Peer reviewe

Gln27Glu variant of Beta2-adrenoceptor gene affects male type fat accumulation in women

<p>Abstract</p> <p>Background</p> <p>The β₂-adrenergic receptor (BAR2) is the main lipolytic receptor in white human adipose tissue. There is a functional glutamine 27 glutamic acid (Gln27Glu, rs 1042714) polymorphism in its gene, which has been variably associated with body mass index. This gene variant may be associated with male-type adiposity in women and thus increased cardiovascular risk. We investigated whether the BAR2 Gln27Glu polymorphism is associated with visceral fat and coronary intima thickness in women.</p> <p>Methods</p> <p>The amount of mesenteric and omental fat was directly measured and anthropometric measurements were done from 112 forensic autopsy cases of women aged 15 to 49 years. The thickness of the coronary intima, which reflects the severity of atherosclerosis, was measured by computerized image analysis. The BAR2 Gln27Glu polymorphism was determined by polymerase chain reaction.</p> <p>Results</p> <p>We found that the amount of visceral fat was significantly higher in women with the Glu allele (689 ± 555 g) compared to Gln/Gln homozygotes (481 ± 392 g, P = 0.023). The waist-hip ratio also tended to be higher in women with the Glu allele compared to Gln/Gln homozygotes (p = 0.050). There were no statistically significant differences between the genotype groups in BMI or the thickness of coronary intima.</p> <p>Conclusion</p> <p>The Glu allele of the BAR2 gene may be a risk factor for visceral fat accumulation in young to middle-aged women. However, this polymorphism was not associated with preclinical atherosclerosis.</p

Lymphatic vessels are present in human saccular intracranial aneurysms

Saccular intracranial aneurysm (sIA) rupture leads to subarachnoid haemorrhage and is preceded by chronic inflammation and atherosclerotic changes of the sIA wall. Increased lymphangiogenesis has been detected in atherosclerotic extracranial arteries and in abdominal aortic aneurysms, but the presence of lymphatic vessels in sIAs has remained unexplored. Here we studied the presence of lymphatic vessels in 36 intraoperatively resected sIAs (16 unruptured and 20 ruptured), using immunohistochemical and immunofluorescence stainings for lymphatic endothelial cell (LEC) markers. Of these LEC-markers, both extracellular and intracellular LYVE-1-, podoplanin-, VEGFR-3-, and Prox1-positive stainings were detected in 83%, 94%, 100%, and 72% of the 36 sIA walls, respectively. Lymphatic vessels were identified as ring-shaped structures positive for one or more of the LEC markers. Of the sIAs, 78% contained lymphatic vessels positive for at least one LEC marker. The presence of LECs and lymphatic vessels were associated with the number of CD68+ and CD163+ cells in the sIA walls, and with the expression of inflammation indicators such as serum amyloid A, myeloperoxidase, and cyclo-oxygenase 2, with the presence of a thrombus, and with the sIA wall rupture. Large areas of VEGFR-3 and alpha-smooth muscle actin (alpha SMA) double-positive cells were detected in medial parts of the sIA walls. Also, a few podoplanin and alpha SMA double-positive cells were discovered. In addition, LYVE-1 and CD68 double-positive cells were detected in the sIA walls and in the thrombus revealing that certain CD68+ macrophages are capable of expressing LEC markers. This study demonstrates for the first time the presence of lymphatic vessels in human sIA walls. Further studies are needed to understand the role of lymphatic vessels in the pathogenesis of sIA.Peer reviewe

Myeloperoxidase Associates With Degenerative Remodeling and Rupture of the Saccular Intracranial Aneurysm Wall

Rupture of a saccular intracranial aneurysm (sIA) is often fatal. Thus, early detection of rupture-prone sIAs is vital. Myeloperoxidase (MPO), derived mainly from neutrophils, associates with sIA rupture, and therefore its role in sIA pathogenesis warrants further studies. We analyzed MPO and its association with other histological markers in 36 (16 unruptured and 20 ruptured) sIA samples by immunohistochemistry. MPO was present in all studied sIAs, and its expression associated with wall inflammatory cell infiltrations (r = 0.50, 0.63, and 0.75, all p <0.002), degenerative remodeling (p = 0.002) and rupture (p = 0.003). MPO associated strongly with the presence of organized luminal thrombi (p <0.001), which also stained positive for MPO. Polymorphonuclear MPO+ cells were detected in the sIA walls, indicating neutrophils as MPO-source. MPO correlated strongly with accumulation of oxidized lipids (r = 0.67, p <0.001) and loss of smooth muscle cells (r = -0.68, p <0.001), suggesting that MPO is a relevant source of oxidative stress leading to cell death in the sIA wall. Furthermore, MPO associated with erythrocyte fragmentation (r = 0.74, p <0.001) and iron deposition (p = 0.041), 2 outcomes known to amplify MPO-dependent oxidative stress. Taken together, these results suggest that MPO associates with degenerative remodeling predisposing to sIA wall rupture and may serve as a biomarker of a rupture-prone sIA wall.Peer reviewe

Impaired WNT signaling and the spine-Heterozygous WNT1 mutation causes severe age-related spinal pathology

Background: WNT signaling plays a major role in bone and cartilage metabolism. Impaired WNT/beta-catenin signaling leads to early-onset osteoporosis, but specific features in bone and other tissues remain inadequately characterized. We have identified two large Finnish families with early-onset osteoporosis due to a heterozygous WNT1 mutation c.652T>G, p.C218G. This study evaluated the impact of impaired WNT/beta-catenin signaling on spinal structures. Methods: Altogether 18 WNT1 mutation-positive (age range 11-76 years, median 49 years) and 14 mutation negative subjects (10-77 years, median 43 years) underwent magnetic resonance imaging (MRI) of the spine. The images were reviewed for spinal alignment, vertebral compression fractures, intervertebral disc changes and possible endplate deterioration. The findings were correlated with clinical data. Results: Vertebral compression fractures were present in 78% (7/9) of those aged over 50 years but were not seen in younger mutation-positive subjects. All those with fractures had several severely compressed vertebrae. Altogether spinal compression fractures were present in 39% of those with a WNT1 mutation. Only 14% (2/14) mutation -negative subjects had one mild compressed vertebra each. The mutation-positive subjects had a higher mean spinal deformity index (4.0 +/- 7.3 vs 0.0 +/- 0.4) and more often increased thoracic kyphosis (Z-score > + 2.0 in 33% vs 0%). Further, they had more often Schmorl nodes (61% vs 36%), already in adolescence, and their intervertebral discs were enlarged. Conclusion: Compromised WNT signaling introduces severe and progressive changes to the spinal structures. Schmorl nodes are prevalent even at an early age and increased thoracic kyphosis and compression fractures become evident after the age of 50 years. Therapies targeting the WNT pathway may be an effective way to prevent spinal pathology not only in those harboring a mutation but also in the general population with similar pathology. (C) 2017 Elsevier Inc. All rights reserved.Peer reviewe

Merialueemme vieraslajien seurannan, varhaisvaroitus-järjestelmän (VVJ) ja riskin-arvioinnin kehittäminen

Liitteessä 1 Suomessa (Itämeressä) ns. vakiintuneet vieraslajit (useammin kuin kerran havaitut). VISEVARIS-projektin yhteydessä toimineen työryhmän ehdottamat uudet/muutetut suomenkieliset lajinimet lihavoitu. (Työryhmän vetäjänä toimi Erkki Leppäkoski).VISEVARIS-hankkeen tavoitteena oli kehittää rannikkovesiemme vieraslajien seuranta- ja varhaisvaroitusjärjestelmä (VVJ), mihin kuuluu mm. tietoisuuden lisääminen, vieraslajien aikainen havainnointi, tiedonkulun nopea välittäminen haitallisten lajien havaitsemisen jälkeen sekä kansalaisten valistaminen lajien levittämisen estämiseksi. Hankkeessa tutkittiin miltä osin ja miksi nykyseuranta ei pysty havaitsemaan uusia vieraslajeja, etsittiin tehokkaampia menetelmiä vieraslajien havaitsemiseksi ja niiden elinympäristöjen ja alueiden kartoittamiseksi, selvitettiin ja kuvattiin merialueemme keskeiset biologiset seurannat sekä niiden tuottama tieto tavattujen vieraslajien levinneisyydestä ja runsaudesta. Työssä todettiin, etteivät seurannat tavoita suurinta osaa nykyisistäkään vieraslajeista. Havaituista lajeista vain parista saadaan riittävä kuva runsauden ja levinneisyyden suhteen. Matalat rannikkovedet ovat heikoimmin seuratut elinympäristöt. Niiden seurantaa pitäisi lisätä. Hankkeessa tuotettiin ehdotus tehostetun seurannan toteuttamisesta, sen keskittämisestä eri elinympäristöihin sekä velvoiteseurannan toteuttamisesta satamissa. Hanke tuotti nettipohjaisen tunnistus-oppaan suurimmasta osasta Suomen merialueella esiintyvistä ja mahdollisesti tänne saapuvista vieraslajeista helpottamaan niiden havaitsemista ja tunnistamista. Hankkeessa selvitettiin myös vieraslajien riskinarviointiin tarjolla olevia kansainvälisiä työkaluja, joista testattaviksi valittiin makeanveden selkärangattomille kehitetty Fi-ISK ja kaloille käytetty FISK riskinarviointi-työkalu. Niiden avulla saadaan numeerisia arvoja eri lajien haitallisuudelle, mikä auttaa ryhmittelemään vieraslajeja niiden torjunnan kannalta. Kehittämällä työkaluja paremmin murtovesiolosuhteet huomioiviksi riskinarviointeja voidaan toteuttaa Itämeren alueella. Varhais-varoitus- ja informaatiojärjestelmän kehittämiseen tuotetuista osista voidaan rakentaa raamiversio, jonka kehysten sisälle tarvittava lisätieto voidaan helposti koota. Hanke auttaa kehittämään ja monipuolistamaan nykyisiä seurantoja ottamaan huomioon myös vieraslajit. Suomen kansallinen VVJ voi toimia esimerkkinä muille Itämeren maille ja se voi toimia yhteydenpitoväylänä Itämeren valtioiden kesken. Hankkeessa kehitetyllä nettilomakkeella parannetaan vieraslajihavaintojen ilmoittamismahdollisuuksia. Lomakkeen avulla niin tutkijat, konsultit, hallintoviranomaiset kuin kansalaisetkin voivat helposti ilmoittaa havaitsemansa vieraslajit sekä tarkistaa jo tehdyt vieraslajiilmoitukset. Hankkeessa saatuja tuloksia hyödynnetään EU:n meristrategia-direktiivin hyvän tilan indikaattoreita kehitettäessä sekä direktiivin toimeenpanoa tukevien seurantojen kehityksessä. Hankkeen aktiviteettien ansiosta monen vieraslajin havainnot moninkertaistuivat ja levinneisyys osoittautui oletettua laajemmaksi.Maa- ja metsätalousministeri

Face masks to prevent transmission of respiratory infections : Systematic review and meta-analysis of randomized controlled trials on face mask use

Funding Information: The Strategic Research Council, Academy of Finland, 340551, LL. The Strategic Research Council, Academy of Finland, 340539, HMO. Publisher Copyright: Copyright: © 2022 Ollila et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Objectives To examine the use of face mask intervention in mitigating the risk of spreading respiratory infections and whether the effect of face mask intervention differs in different exposure settings and age groups. Design Systematic review and meta-analysis. We evaluated the risk of bias using the Cochrane Risk of Bias 2 tool (ROB2). Data sources We searched PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science were searched for randomized controlled trials investigating the effect of face masks on respiratory infections published between 1981 and February 9, 2022. We followed the PRISMA 2020 guidelines. Eligibility criteria for selecting studies We included randomized controlled trials investigating the use of face mask intervention in mitigating the risk of spreading respiratory infections across different exposure settings. Results We identified 2,400 articles for screening. 18 articles passed the inclusion criteria for both evidence synthesis and meta-analysis. There were N = 189,145 individuals in the face mask intervention arm and N = 173,536 in the control arm, and the follow-up times ranged from 4 days to 19 months. Our results showed between-study heterogeneity (p < 0.0001). While there was no statistically significant association over all studies when the covariate unadjusted intervention effect estimates were used (RR = 0.977 [0.858–1.113], p = 0.728), our subgroup analyses revealed that a face mask intervention reduced respiratory infections in the adult subgroup (RR = 0.8795 [0.7861–0.9839], p = 0.0249) and in a community setting (RR = 0.890 [0.812–0.975], p = 0.0125). Furthermore, our leave-one-out analysis found that one study biased the results towards a null effect. Consequently, when using covariate adjusted odds ratio estimates to have a more precise effect estimates of the intervention effect to account for differences at the baseline, the results showed that a face mask intervention did reduce respiratory infections when the biasing study was excluded from the analysis (OR = 0.8892 [0.8061–0.9810], p = 0.0192). Conclusion Our findings support the use of face masks particularly in a community setting and for adults. We also observed substantial between-study heterogeneity and varying adherence to protocol. Notably, many studies were subject to contamination bias thus affecting the efficacy of the intervention, that is when also some controls used masks or when the intervention group did not comply with mask use leading to a downward biased effect of treatment receipt and efficacy.Peer reviewe

Serum Amyloid A Is Present in Human Saccular Intracranial Aneurysm Walls and Associates With Aneurysm Rupture

Saccular intracranial aneurysm (sIA) rupture leads to a disabling subarachnoid hemorrhage. Chronic inflammation and lipid accumulation in the sIA wall contribute to wall degenerative remodeling that precedes its rupture. A better understanding of the pathobiological process is essential for improved future treatment of patients carrying sIAs. Serum amyloid A (SAA) is an acute-phase protein produced in response to acute and chronic inflammation and tissue damage. Here, we studied the presence and the potential role of SAA in 36 intraoperatively resected sIAs (16 unruptured and 20 ruptured), that had previously been studied by histology and immunohistochemistry. SAA was present in all sIAs, but the extent of immunopositivity varied greatly. SAA immunopositivity correlated with wall degeneration (p=0.028) and rupture (p=0.004), with numbers of CD163-positive and CD68-positive macrophages and CD3-positive T lymphocytes (all pPeer reviewe

Interactions between the Aggregatibacter actinomycetemcomitans secretin HofQ and host cytokines indicate a link between natural competence and interleukin-8 uptake

Naturally competent bacteria acquire DNA from their surroundings to survive in nutrient-poor environments and incorporate DNA into their genomes as new genes for improved survival. The secretin HofQ from the oral pathogen Aggregatibacter actinomycetemcomitans has been associated with DNA uptake. Cytokine sequestering is a potential virulence mechanism in various bacteria and may modulate both host defense and bacterial physiology. The objective of this study was to elucidate a possible connection between natural competence and cytokine uptake in A. actinomycetemcomitans. The extramembranous domain of HofQ (emHofQ) was shown to interact with various cytokines, of which IL-8 exhibited the strongest interaction. The dissociation constant between emHofQ and IL-8 was 43nM in static settings and 2.4M in dynamic settings. The moderate binding affinity is consistent with the hypothesis that emHofQ recognizes cytokines before transporting them into the cells. The interaction site was identified via crosslinking and mutational analysis. By structural comparison, relateda type I KH domain with a similar interaction site was detected in the Neisseria meningitidis secretin PilQ, which has been shown to participate in IL-8 uptake. Deletion of hofQ from the A. actinomycetemcomitans genome decreased the overall biofilm formation of this organism, abolished the response to cytokines, i.e., decreased eDNA levels in the presence of cytokines, and increased the susceptibility of the biofilm to tested -lactams. Moreover, we showed that recombinant IL-8 interacted with DNA. These results can be used in further studies on the specific role of cytokine uptake in bacterial virulence without interfering with natural-competence-related DNA uptake.Peer reviewe

Liikunnan oppilasarvioinnin käytänteet:kyselytutkimus Kainuun alakouluissa

Tiivistelmä. Tutkimus käsittelee liikuntaa alakoulussa opettavien opettajien liikunnan oppilasarvioinnissa käyttämiä menetelmiä ja osa-alueita. Tavoitteena oli selvittää mitkä asiat vaikuttavat liikunnan oppilasarviointiin alakoulussa, minkä painoarvon opettajat antavat millekin liikunnan arvioinnin osa-alueelle ja mitä menetelmiä opettajat käyttävät arviointitietoa kerätessään. Tutkimuksen kohteena olivat myös selvittää opettajien mielipiteitä arvioinnin haastavuudesta. Tutkimuksessa pyrittiin selvittämään myös onko opetuskokemuksella ja koulutustaustalla vaikutusta arviointiin. Lisäksi tutkimuksessa selvitettiin, miten opettajat kokevat mahdollisen lisäkoulutuksen tarpeen arvioinnin kokemiseen liittyen. Oppimiskäsityksen muuttuessa behavioristisesta kohti kognitiivista myös arvioinnin luonne on muuttunut. Arviointi nähdään prosessina, joka on osana kaikkia oppimisen ja opettamisen vaiheita. Sillä nähdään olevan vaikutusta oppilaan oppimiseen ja oppimisprosessin kulkuun. Liikunnan opetuksen keskeinen tavoite on liikunnalliseen elämäntapaan kasvattaminen ja tässä myös arvioinnin merkitys korostuu. Kokonaisuudessaan arvioinnin tavoitteena on tukea oppilaan kasvua ja kehitystä. Opettaja tekee arviointiaan oman persoonansa myötä, jolloin opettajan arvot, ihmiskäsitys ja oppimiskäsitys vaikuttavat työskentelyn taustalla. Tutkimuksen kohdejoukkona olivat Kainuun alueen alakoulujen liikuntaa opettavat opettajat. Kyselyn vastaajajoukon koko oli 86 kappaletta kahdeltakymmeneltäyhdeksältä koululta. Kyselyyn vastasi 53 naista ja 33 miestä. Tutkimus toteutettiin kvantitatiivisesti, jota laajennettiin avoimilla kysymyksillä. Kyselylomakkeessa oli yhteensä kymmenen kysymystä, joista seitsemän oli monivalinta- tai suljettuja kysymyksiä ja kolme avoimia kysymyksiä. Aineisto kerättiin keväällä 2012 postikyselynä. Analysointimenetelminä tutkimusongelmiin vastattaessa käytettiin frekvenssianalyysia, keskiarvoa, keskihajontaa sekä Spearmanin järjestyskorrelaatiokerrointa. Avoimia kysymyksiä luokiteltiin aihealueittain, joista etsittiin täydennyksiä opettajien antamiin vastauksiin kvantitatiivisten kysymysten lisäksi. Tutkimuksen tuloksista kävi ilmi, että tutkimuksessa esitetyistä liikunnan oppilasarvioinnin osa-alueista opettajat painottivat eniten kiinnostusta ja asennetta sekä liikuntataitoja. Pienin painoarvo oli puolestaan liikuntatiedoilla. Arviointimenetelminä opettajat käyttivät eniten selkeästi eniten havainnointia ja tarkkailua. Arviointimenetelmistä vähiten opettajat käyttivät työssään portfoliota, kirjallisia liikuntatietoja mittaavia kokeita ja toveriarviointia. Tutkittaessa opettajan työkokemuksen ja koulutustaustan mahdollista yhteyttä arvioinnin kokemisen helppouteen ja haastavuuteen ei löytynyt yhteyttä. Suurin osa opettajista koki, ettei lisäkoulutukselle ole tarvetta. Tutkimuksesta kävi ilmi, että opettajat toivoisivat arvioinnin olevan tasapuolista niin paikkakuntakohtaisesti kuin valtakunnallisella tasolla