Investigations of Noise-Related Tinnitus

Tinnitus is a frequent consequence of noise trauma. Usually, however, the main focus regarding the consequences of noise trauma is placed on hearing loss, instead of tinnitus. The objectives of the present study were to assess various aspects of noise-related tinnitus in Finland, such as to determine the main causes of conscript acute acoustic traumas (AAT) in the military, assess tinnitus prevalence after noise trauma, characterize long-term AAT-related tinnitus prevalence and characteristics, assess occupational tinnitus, and evaluate the efficacy of hearing protection regulations in preventing hearing loss and tinnitus. The study comprised several independent noise-exposed groups: conscripts performing their military duty, former conscripts who suffered an AAT over a decade earlier, bomb explosion victims, and retired army personnel. Tinnitus questionnaires were used to assess tinnitus prevalence and characteristics. For occupational tinnitus, occupational noise-induced hearing loss (NIHL) reports to the Finnish Institute of Occupational Health were reviewed. Tinnitus is a common result of AAT, blast exposure and long-term noise exposure. Despite hearing protection regulations, up to hundreds of AATs occur annually among conscripts in the Finnish Defence Forces (FDF). The most common cause is an accidental shot, accounting for approximately half of the cases. Conscript AATs are mainly due to accidental shots, while the ear is unprotected. Only seldom is an AAT due to negligence. The most common causative weapon of conscript AATs is the assault rifle, accounting for 81% of conscript AATs. After AAT, the majority of tinnitus cases resolve during military service and become asymptomatic. However, in one-fifth of the cases, tinnitus persists, causing problems such as sleeping and concentration difficulties in many. In Finland, occupational tinnitus often remains unreported in conjunction with NIHL reports. In a survey of occupational NIHL cases, tinnitus was mentioned in only four per cent. However, a subsequent inquiry revealed that almost 90% in fact had tinnitus, indicating that most cases remained undetected and unreported. The best way to prevent noise-related tinnitus is prevention of noise trauma. In the military, hearing protection guidelines have been revised several times over the years. These regulations have been effective in reducing hearing loss of professional soldiers. There has also been a reduction in cases with tinnitus, but the decrease was not significant. However, with improved hearing protection regulations, a significant reduction in the risk of more serious, disturbing tinnitus was observed.

Studies on Causes of Multiple Sclerosis : From Genes to Transcriptome

Multiple sclerosis (MS) is the most common cause of neurological disability in young adults, affecting more than two million people worldwide. It manifests as a chronic inflammation in the central nervous system (CNS) and causes demyelination and neurodegeneration. Depending on the location of the demyelinated plaques and axonal loss, a variety of symptoms can be observed including deficits in vision, coordination, balance and movement. With a typical age of onset at 20-40 years, the social and economic impacts of MS on lives of the patients and their families are considerable. Unfortunately the current treatments are relatively inefficient and the development of more effective treatments has been impeded by our limited understanding of the causes and pathogenesis of MS. Risk of MS is higher in biological relatives of MS patients than in the general population. Twin and adoption studies have shown that familial clustering of MS is explained by shared genetic factors rather than by shared familial environment. While the involvement of the human leukocyte antigen (HLA) genes was first discovered four decades ago, additional genetic risk factors have only recently been identified through genome-wide association studies (GWAS). Current evidence suggests that MS is a highly polygenic disease with perhaps hundreds of common variants with relatively modest effects contributing to susceptibility. Despite extensive research, the majority of these risk factors still remain to be identified. In this thesis the aim was to identify novel genes and pathways involved in MS. Using genome-wide microarray technology, gene expression levels in peripheral blood mononuclear cells (PBMC) from 12 MS patients and 15 controls were profiled and more than 600 genes with altered expression in MS were identified. Three of five selected findings, DEFA1A3, LILRA4 and TNFRSF25, were successfully replicated in an independent sample. Increased expression of DEFA1A3 in MS is a particularly interesting observation, because its elevated levels have previously been reported also in several other autoimmune diseases. A systematic review of seven microarray studies was then performed leading to identification of 229 genes, in which either decreased or increased expression in MS had been reported in at least two studies. In general there was relatively little overlap across the experiments: 11 of the 229 genes had been reported in three studies and only HSPA1A in four studies. Nevertheless, these 229 genes were associated with several immunological pathways including interleukin pathways related to type 2 and type 17 helper T cells and regulatory T cells. However, whether these pathways are involved in causing MS or related to secondary processes activated after disease onset remains to be investigated. The 229 genes were also compared with loci identified in published MS GWASs. Single nucleotide polymorphisms (SNP) in 17 of the 229 loci had been reported to be associated with MS with P-value less than 0.0001 including variants in CXCR4 and SAPS2, which were the only loci where evidence for correlation between the associated variant and gene expression was found. The CXCR4 variant was further tested for association with MS in a large case-control sample and the previously reported suggestive association was replicated (P-value is 0.0004). Finally, common genetic variants in candidate genes, which had been selected on the basis of showing association with other autoimmune diseases (MYO9B) or showing differential expression in MS in our study (DEFA1A3, LILRA4 and TNFRSF25), were tested for association with MS, but no evidence of association was found. In conclusion, through a systematic review of genome-wide expression studies in MS we have identified several promising candidate genes and pathways for future studies. In addition, we have replicated a previously suggested association of a SNP variant upstream of CXCR4 with MS. Keywords: autoimmune disease, common variant, CXCR4, DEFA1A3, HSPA1A,gene expression, genetic association, GWAS, MS, multiple sclerosis, systematic review

Factors affecting perceptions of corporate social responsibility implementation: an emphasis on values

This dissertation is a broad study of factors affecting perceptions of CSR issues in multiple stakeholder realms, the main purpose being to determine the effects of the values of individuals on their perceptions regarding CSR. It examines perceptions of CSR both at the emic (observing individuals and stakeholders) and etic levels (conducting cross-cultural comparison) through a descriptive-empirical research strategy. The dissertation is based on quantitative interview data among Chinese, Finnish and US stakeholder groups of industry companies (with an emphasis on the forest industries) and consists of four published articles and two submitted manuscripts. Theoretically, this dissertation provides a valuable and unique philosophical and intellectual perspective on the contemporary study of CSR `The Harmony Approach to CSR'. Empirically, this dissertation does values assessment and CSR evaluation of a wide variety of business activities covering CSR reporting, business ethics, and three dimensions of CSR performance. From the multi-stakeholder perspective, this dissertation use survey methods to examine the perceptions and stakeholder salience in the context of CSR by describing, comparing the differences between demographic factors as well as hypothetical drivers behind perceptions. The results of study suggest that the CSR objective of a corporation's top management should be to manage the divergent and conflicting interests of multiple stakeholders, taking others than key stakeholders into account as well. The importance of values as a driver of ethical behaviour and decision-making has been generally recognized. This dissertation provides more empirical proof of this theory by highlighting the effects of values on CSR perceptions. It suggests that since the way to encourage responsible behaviour and develop CSR is to develop individual values and cultivate their virtues, it is time to invoke the critical role of moral (ethics) education. The specific studies of China and comparison between Finland and the US contribute to a common understanding of the emerging CSR issues, problems and opportunities for the future of sustainability. The similarities among these countries can enhance international cooperation, while the differences will open up opportunities and diversified solutions for CSR in local conditions.

Photosynthesis of ground vegetation in boreal Scots pine forests

Research on carbon uptake in boreal forests has mainly focused on mature trees, even though ground vegetation species are effective assimilators and can substantially contribute to the CO2 uptake of forests. Here, I examine the photosynthesis of the most common species of ground vegetation in a series of differently aged Scots pine stands, and at two clear-cut sites with substantial differences in fertility. In general, the biomass of evergreen species was highest at poor sites and below canopies, whereas grasses and herbs predominated at fertile sites and open areas. Unlike mosses, the measured vascular species showed clear annual cycles in their photosynthetic activity, which increased earlier and decreased later in evergreen vascular species than in deciduous species. However, intraspecific variation and self-shading create differences in the overall level of photosynthesis. Light, temperature history, soil moisture and recent possible frosts could explain the changes in photosynthesis of low shrubs and partially also some changes in deciduous species. Light and the occurrence of rain events explained most of the variation in the photosynthesis of mosses. The photosynthetic production of ground vegetation was first upscaled, using species-specific and mass-based photosynthetic activities and average biomass of the site, and then integrated over the growing season, using changes in environmental factors. Leaf mass-based photosynthesis was highest in deciduous species, resulting in notably higher photosynthetic production at fertile sites than at poor clear-cut sites. The photosynthetic production decreased with stand age, because flora changed towards evergreen species, and light levels diminished below the canopy. In addition, the leaf mass-based photosynthetic activity of some low shrubs declined with the age of the surrounding trees. Different measuring methods led to different momentary rate of photosynthesis. Therefore, the choice of measuring method needs special attention.

Field intercomparison of four methane gas analysers suitable for eddy covariance flux measurements

Eddy covariance (EC)-flux measurement technique is based on measurement of turbulent motions of air with accurate and fast measurement devices. For instance, in order to measure methane flux a fast methane gas analyser is needed which measures methane concentration at least ten times in a second in addition to a sonic anemometer, which measures the three wind components with the same sampling interval. Previously measurement of methane flux was almost impossible to carry out with EC-technique due to lack of fast enough gas analysers. However during the last decade new instruments have been developed and thus methane EC-flux measurements have become more common. Performance of four methane gas analysers suitable for eddy covariance measurements are assessed in this thesis. The assessment and comparison was performed by analysing EC-data obtained during summer 2010 (1.4.-26.10.) at Siikaneva fen. The four participating methane gas analysers are TGA-100A (Campbell Scientific Inc., USA), RMT-200 (Los Gatos Research, USA), G1301-f (Picarro Inc., USA) and Prototype-7700 (LI-COR Biosciences, USA). RMT-200 functioned most reliably throughout the measurement campaign and the corresponding methane flux data had the smallest random error. In addition, methane fluxes calculated from data obtained from G1301-f and RMT-200 agree remarkably well throughout the measurement campaign. The calculated cospectra and power spectra agree well with corresponding temperature spectra. Prototype-7700 functioned only slightly over one month in the beginning of the measurement campaign and thus its accuracy and long-term performance is difficult to assess.

Dissection of the genetic background of childhood onset progressive myoclonic epilepsies

The progressive myoclonic epilepsies (PMEs) are a clinically and etiologically heterogeneous group of symptomatic epilepsies characterized by myoclonus, tonic-clonic seizures, psychomotor regression and ataxia. Different disorders have been classified as PMEs. Of these, the group of neuronal ceroid lipofuscinoses (NCLs) comprise an entity that has onset in childhood, being the most common cause of neurodegeneration in children. The primary aim of this thesis was to dissect the molecular genetic background of patients with childhood onset PME by studying candidate genes and attempting to identify novel PME-associated genes. Another specific aim was to study the primary protein properties of the most recently identified member of the NCL-causing proteins, MFSD8. To dissect the genetic background of a cohort of Turkish patients with childhood onset PME, a screen of the NCL-associated genes PPT1, TPP1, CLN3, CLN5, CLN6, MFSD8, CLN8 and CTSD was performed. Altogether 49 novel mutations were identified, which together with 56 mutations found by collaborators raised the total number of known NCL mutations to 364. Fourteen of the novel mutations affect the recently identified MFSD8 gene, which had originally been identified in a subset of mainly Turkish patients as the underlying cause of CLN7 disease. To investigate the distribution of MFSD8 defects, a total of 211 patients of different ethnic origins were evaluated for mutations in the gene. Altogether 45 patients from nine different countries were provided with a CLN7 molecular diagnosis, denoting the wide geographical occurrence of MFSD8 defects. The mutations are private with only one having been established by a founder-effect in the Roma population from the former Czechoslovakia. All mutations identified except one are associated with the typical clinical picture of variant late-infantile NCL. To address the trafficking properties of MFSD8, lysosomal targeting of the protein was confirmed in both neuronal and non-neuronal cells. The major determinant for this lysosomal sorting was identified to be an N-terminal dileucine based signal (9-EQEPLL-14), recognized by heterotetrameric AP-1 adaptor proteins, suggesting that MFSD8 takes the direct trafficking pathway en route to the lysosomes. Expression studies revealed the neurons as the primary cell-type and the hippocampus and cerebellar granular cell layer as the predominant regions in which MFSD8 is expressed. To identify novel genes associated with childhood onset PME, a single nucleotide polymorphism (SNP) genomewide scan was performed in three small families and 18 sporadic patients followed by homozygosity mapping to determine the candidate loci. One of the families and a sporadic patient were positive for mutations in PLA2G6, a gene that had previously been shown to cause infantile neuroaxonal dystrophy. Application of next-generation sequencing of candidate regions in the remaining two families led to identification of a homozygous missense mutation in USP19 for the first and TXNDC6 for the second family. Analysis of the 18 sporadic cases mapped the best candidate interval in a 1.5 Mb region on chromosome 7q21. Screening of the positional candidate KCTD7 revealed six mutations in seven unrelated families. All patients with mutations in KCTD7 were reported to have early onset PME, rapid disease progression leading to dementia and no pathologic hallmarks. The identification of KCTD7 mutations in nine patients and the clinical delineation of their phenotype establish KCTD7 as a gene for early onset PME. The findings presented in this thesis denote MFSD8 and KCTD7 as genes commonly associated with childhood onset symptomatic epilepsy. The disease-associated role of TXNDC6 awaits verification through identification of additional mutations in patients with similar phenotypes. Completion of the genetic spectrum underlying childhood onset PMEs and understanding of the gene products functions will comprise important steps towards understanding the underlying pathogenetic mechanisms, and will possibly shed light on the general processes of neurodegeneration and nervous system regulation, facilitating the diagnosis, classification and possibly treatment of the affected cases.

Interruption and Uncooperativeness in Academic ELF Group Work : An Application of Linear Unit Grammar

This study addresses the challenge of analyzing interruption in spoken interaction. It begins with my observation of eight hours of academic group work among speakers of English as a lingua franca (ELF) in a university course. Unlike the common findings of ELF research which underscore the cooperative orientation of ELF users, this particular group gave strong impressions of interruption and uncooperativeness as they prepared a scientific group presentation. In the effort to investigate these impressions, I found that no satisfactory method exists for systematically identifying and analyzing interruptions. A useful tool was found in Linear Unit Grammar or LUG (Sinclair & Mauranen 2006), which analyzes spoken interaction prospectively as linear text. In the course of transcribing one of the early group work meetings, I developed a model of LUG-based criteria for identifying individual instances of interruption. With this system in place, I was then able to evaluate the aggregate occurrences of interruption in the group work and identify co-occurring interactive features which further influenced the perception of uncooperativeness. Finally, these aggregate statistics directed a return to the data and a contextually sensitive, qualitative analysis. This research cycle illuminates the interactive features which contributed to my own impressions of uncooperativeness, as well as the group members orientations to their own interruptive practice.

Role of CIP2A in carcinogenesis

Worldwide and notably in the developed countries, cancer is an increasing cause of morbidity and mortality, being the second most common cause of death after ischemic heart disease. Now and in the future new cancer cases need to be diagnosed earlier. Prognostic factors may be helpful in recognizing and handling those patients who need more aggressive therapy, and it is also desirable to predict treatment response accurately. Cancerous inhibitor of protein phosphatase 2A (CIP2A) is an oncoprotein predominantly expressed in malignant tissues and inhibiting protein phosphatase 2A (PP2A) activity; it is a promising target for cancer therapy. The aim of this thesis was to evaluate the prognostic role of CIP2A in solid cancers, and for this purpose to explore expression of CIP2A, and investigating regulation of CIP2A in order to gain insight into signalling pathways leading to alteration in prognosis. Patients diagnosed with gastric, serous ovarian, tongue, or colorectal cancer at Helsinki University Central Hospital were included. Tumour tissue microarrays assembled from specimens from these patients were prepared and stained immunohistochemically for CIP2A protein expression. Associations with clinicopathologic parameters and other biomarkers were explored, and survival analyses were done according to the Kaplan-Meier method. Study of the role of CIP2A in intracellular signalling in vitro involved gastric, ovarian, and tongue cancer cell lines. We found CIP2A to be highly expressed in gastric, ovarian, tongue, and colorectal cancer specimens. CIP2A was associated with clinicopathologic parameters characterizing an aggressive disease, namely advanced stage, high grade, p53 immunopositivity, and high proliferation index. CIP2A led to recognition of gastric, ovarian, and tongue cancer patients with poor prognosis, however, with a cancer type-specific cut-off level for prognostic significance. In tongue cancer, it served as an independent prognostic marker. In contrast, in colorectal cancer, CIP2A provided no prognostic value. In cancer cell lines, CIP2A was highly expressed at both protein and mRNA levels, and promoted cell proliferation and anchorage-independent growth. In gastric cancer, we demonstrated with a MYCER construct in mouse embryo fibroblasts that activation of MYC led to increased CIP2A mRNA expression, and hence we suggested that a positive feedback mechanism between CIP2A and MYC may potentiate and prolong the oncogenic activity of these proteins. We demonstrated in ovarian cancer an association between CIP2A and EGFR protein overexpression and EGFR gene amplification. In ovarian and tongue cancer cells we showed that depletion of EGFR downregulates CIP2A expression. In conclusion, high CIP2A expression occurred frequently among patients with aggressive disease. CIP2A may serve as a prognostic marker in gastric, ovarian, and tongue cancer and thus may help in tailoring therapy for cancer patients. The positive feedback mechanism between CIP2A and MYC, as well as the positive regulation of CIP2A by EGFR, are a few signalling pathways regulating and regulated by CIP2A. These and other mechanisms need to be studied further, however. CIP2A is a potential target for therapy, and its potential role as predictive marker and as a tumour marker in serum requires exploration.