Human papillomavirus (HPV) in mothers before and after delivery – a three year follow-up study.

Human papillomavirus (HPV) infections in mothers are important to consider since pregnancy may affect the outcome of the infection and the mother may transmit HPV to the child. This thesis is part of the 3-year Finnish Family HPV Study on HPV infection dynamics within 329 families. The presence of maternal HPV antibodies and HPV DNA in placenta, umbilical cord blood and breast milk was examined. In addition, genital and oral HR-HPV carriage was studied among mothers with one or two pregnancies. At enrollment, seropositivity to HPV 6, 11, 16, 18 and 45 was recorded in 53 %, 21 %, 35 %, 21 % and 9 % of the mothers, respectively. Age at sexual debut, number of sexual partners, a history of genital warts and antibodies to LR/HR-HPV predicted HR/LR-HPV-seropositivity. During follow-up 27 %, 14 %, 17 %, 17 % and 7 % of the mothers seroconverted to the tested HPV-types, respectively. Decay of HPV-antibodies was rare. The mother’s new pregnancy was of minor impact in the outcome of oral and cervical HR-HPV infections. HPV-DNA was present in 4.2 % and 3.5 % of the placentas and umbilical cord blood samples, and in 4.5 % and 19.7 % of the breast milk samples collected at day 3 and month 2 postpartum, respectively. HPV-positivity in placenta/cord blood was related to a history of abnormal pap-smears or genital warts, and raised the risk of the neonate being HPV-positive at birth. The mode of delivery did not predict the HPVstatus of neonate, placenta, or cord blood. HPV DNA in breast milk was associated with oral HPV status of the father, but not with HPV status of the neonate. The results indicate that exposure to HPV is common and that part of the exposure might take place already early in life. Contrary to the common claim, pregnancy is not a risk factor for HPV.

Characterisation of Human Neutral and Lysosomal alpha-Mannosidases

Neutral alpha-mannosidase and lysosomal MAN2B1 alpha-mannosidase belong to glycoside hydrolase family 38, which contains essential enzymes required for the modification and catabolism of asparagine-linked glycans on proteins. MAN2B1 catalyses lysosomal glycan degradation, while neutral α-mannosidase is most likely involved in the catabolism of cytosolic free oligosaccharides. These mannose containing saccharides are generated during glycosylation or released from misfolded glycoproteins, which are detected by quality control in the endoplasmic reticulum. To characterise the biological function of human neutral α-mannosidase, I cloned the alpha-mannosidase cDNA and recombinantly expressed the enzyme. The purified enzyme trimmed the putative natural substrate Man9GlcNAc to Man5GlcNAc, whereas the reducing end GlcNAc2 limited trimming to Man8GlcNAc2. Neutral α-mannosidase showed highest enzyme activity at neutral pH and was activated by the cations Fe₂+, Co2+ and Mn₂+, Cu2+ in turn had a strong inhibitory effect on alpha-mannosidase activity. Analysis of its intracellular localisation revealed that neutral alpha-mannosidase is cytosolic and colocalises with proteasomes. Further work showed that the overexpression of neutral alpha-mannosidase affected the cytosolic free oligosaccharide content and led to enhanced endoplasmic reticulum associated degradation and underglycosylation of secreted proteins. The second part of the study focused on MAN2B1 and the inherited lysosomal storage disorder α-mannosidosis. In this disorder, deficient MAN2B1 activity is associated with mutations in the MAN2B1 gene. The thesis reports the molecular consequences of 35 alpha-mannosidosis associated mutations, including 29 novel missense mutations. According to experimental analyses, the mutations fall into four groups: Mutations, which prevent transport to lysosomes are accompanied with a lack of proteolytic processing of the enzyme (groups 1 and 3). Although the rest of the mutations (groups 2 and 4) allow transport to lysosomes, the mutated proteins are less efficiently processed to their mature form than is wild type MAN2B1. Analysis of the effect of the mutations on the model structure of human lysosomal alpha-mannosidase provides insights on their structural consequences. Mutations, which affect amino acids important for folding (prolines, glycines, cysteines) or domain interface interactions (arginines), arrest the enzyme in the endoplasmic reticulum. Surface mutations and changes, which do not drastically alter residue volume, are tolerated better. Descriptions of the mutations and clinical data are compiled in an α-mannosidosis database, which will be available for the scientific community. This thesis provides a detailed insight into two ubiquitous human alpha-mannosidases. It demonstrates that neutral alpha-mannosidase is involved in the degradation of cytosolic oligosaccharides and suggests that the regulation of this α-mannosidase is important for maintaining the cellular homeostasis of N-glycosylation and glycan degradation. The study on alpha-mannosidosis associated mutations identifies multiple mechanisms for how these mutations are detrimental for MAN2B1 activity. The α-mannosidosis database will benefit both clinicians and scientific research on lysosomal alpha‑mannosidosis.

Application of Computational Fluid Dynamics in Modeling Blood Flow in Human Thoracic Aorta

The aim of this study was to simulate blood flow in thoracic human aorta and understand the role of flow dynamics in the initialization and localization of atherosclerotic plaque in human thoracic aorta. The blood flow dynamics in idealized and realistic models of human thoracic aorta were numerically simulated in three idealized and two realistic thoracic aorta models. The idealized models of thoracic aorta were reconstructed with measurements available from literature, and the realistic models of thoracic aorta were constructed by image processing Computed Tomographic (CT) images. The CT images were made available by South Karelia Central Hospital in Lappeenranta. The reconstruction of thoracic aorta consisted of operations, such as contrast adjustment, image segmentations, and 3D surface rendering. Additional design operations were performed to make the aorta model compatible for the numerical method based computer code. The image processing and design operations were performed with specialized medical image processing software. Pulsatile pressure and velocity boundary conditions were deployed as inlet boundary conditions. The blood flow was assumed homogeneous and incompressible. The blood was assumed to be a Newtonian fluid. The simulations with idealized models of thoracic aorta were carried out with Finite Element Method based computer code, while the simulations with realistic models of thoracic aorta were carried out with Finite Volume Method based computer code. Simulations were carried out for four cardiac cycles. The distribution of flow, pressure and Wall Shear Stress (WSS) observed during the fourth cardiac cycle were extensively analyzed. The aim of carrying out the simulations with idealized model was to get an estimate of flow dynamics in a realistic aorta model. The motive behind the choice of three aorta models with distinct features was to understand the dependence of flow dynamics on aorta anatomy. Highly disturbed and nonuniform distribution of velocity and WSS was observed in aortic arch, near brachiocephalic, left common artery, and left subclavian artery. On the other hand, the WSS profiles at the roots of branches show significant differences with geometry variation of aorta and branches. The comparison of instantaneous WSS profiles revealed that the model with straight branching arteries had relatively lower WSS compared to that in the aorta model with curved branches. In addition to this, significant differences were observed in the spatial and temporal profiles of WSS, flow, and pressure. The study with idealized model was extended to study blood flow in thoracic aorta under the effects of hypertension and hypotension. One of the idealized aorta models was modified along with the boundary conditions to mimic the thoracic aorta under the effects of hypertension and hypotension. The results of simulations with realistic models extracted from CT scans demonstrated more realistic flow dynamics than that in the idealized models. During systole, the velocity in ascending aorta was skewed towards the outer wall of aortic arch. The flow develops secondary flow patterns as it moves downstream towards aortic arch. Unlike idealized models, the distribution of flow was nonplanar and heavily guided by the artery anatomy. Flow cavitation was observed in the aorta model which was imaged giving longer branches. This could not be properly observed in the model with imaging containing a shorter length for aortic branches. The flow circulation was also observed in the inner wall of the aortic arch. However, during the diastole, the flow profiles were almost flat and regular due the acceleration of flow at the inlet. The flow profiles were weakly turbulent during the flow reversal. The complex flow patterns caused a non-uniform distribution of WSS. High WSS was distributed at the junction of branches and aortic arch. Low WSS was distributed at the proximal part of the junction, while intermedium WSS was distributed in the distal part of the junction. The pulsatile nature of the inflow caused oscillating WSS at the branch entry region and inner curvature of aortic arch. Based on the WSS distribution in the realistic model, one of the aorta models was altered to induce artificial atherosclerotic plaque at the branch entry region and inner curvature of aortic arch. Atherosclerotic plaque causing 50% blockage of lumen was introduced in brachiocephalic artery, common carotid artery, left subclavian artery, and aortic arch. The aim of this part of the study was first to study the effect of stenosis on flow and WSS distribution, understand the effect of shape of atherosclerotic plaque on flow and WSS distribution, and finally to investigate the effect of lumen blockage severity on flow and WSS distributions. The results revealed that the distribution of WSS is significantly affected by plaque with mere 50% stenosis. The asymmetric shape of stenosis causes higher WSS in branching arteries than in the cases with symmetric plaque. The flow dynamics within thoracic aorta models has been extensively studied and reported here. The effects of pressure and arterial anatomy on the flow dynamic were investigated. The distribution of complex flow and WSS is correlated with the localization of atherosclerosis. With the available results we can conclude that the thoracic aorta, with complex anatomy is the most vulnerable artery for the localization and development of atherosclerosis. The flow dynamics and arterial anatomy play a role in the localization of atherosclerosis. The patient specific image based models can be used to diagnose the locations in the aorta vulnerable to the development of arterial diseases such as atherosclerosis.

Liminal Monster and the Conflict Between Human and Machine: The Shrike in Dan Simmons’ Hyperion and The Fall of Hyperion

Tarkastelen tutkielmassani Dan Simmonsin kaksiosaista tieteisfiktioteosta, joka koostuu romaaneista Hyperion ja The Fall of Hyperion. Keskityn teoksissa esiintyvään Shrike-hirviöön, joka edustaa ihmiskunnan pelkäämää potentiaalista konfliktia ihmisten ja koneiden välillä. Pelko ja konflikti ovat keskeisiä teemoja paitsi tieteisfiktiossa, myös hirviöteoksissa yleensä, ja näiden kahden käyttö samassa kertomuksessa luo otolliset edellytykset nyky-yhteiskunnan ahdistusten kuvaamiseen. Hirviöitä ja tieteisfiktiota on tätä nykyä tutkittu melko laajalti, mutta Shrike on aiemmin jäänyt vähälle huomiolle. Lähtökohtaisen teoreettisen viitekehyksen tutkimukselleni ovat luoneet Jeffrey Cohenin Monster Theory: Reading Culture, Stephen Asman On Monsters: An Unnatural History of Our Worst Fears sekä Holly Lynn Baumgartnerin ja Roger Davisin At the Interface: Hosting the Monster. Teoksista kokoamani hirviöteorian kautta tarkastelen sitä, miten Shriken puoliksi orgaaninen ja puoliksi keinotekoinen keho heijastaa niitä romaaneissa esiintyviä osa-alueita, joista tulevaisuudenpelko ja ihmisten ja koneiden väliseen konfliktin uhka koostuu. Koska Shrike on puoliksi orgaaninen ja puoliksi keinotekoinen, se on näiden ominaisuuksien kynnyksellä; tässä risteytyneessä kehossa yhdistyvät molemmat ääripäät, jolloin tämä keho myös symboloi osapuolten välistä konfliktia. Konfliktin lisäksi Shrike ilmentää niitä vastakkaisuuksia, joista ihmisten ja koneiden välisen konfliktin pelko rakentuu: itseyttä ja toiseutta, houkuttelevuutta ja luotaantyöntävyyttä, menneisyyttä ja tulevaisuutta sekä utopiaa ja dystopiaa.

Outcome of human papillomavirus infection among men in the Finnish Family HPV Study

Ihmisen papilloomaviruksen taudinkuva suomalaisperheiden seurantatutkimuksen mieskohortissa Tieto ihmisen papilloomaviruksen (HPV) yhteydestä eri anatomisten alueiden sairauksien syntyyn on lisännyt mielenkiintoa miehen papilloomavirustulehduksen taudinkulun selvittämiseksi. Tämä väitöskirjatyö on osa suomalaista seurantatutkimusta, jossa tutkitaan HPVinfektioiden tartuntareittejä 329 perheessä. Väitöstyössä keskitytään tutkimukseen osallistuneiden 131 miehen aineistoon. Suun limakalvonäytteet otettiin seitsemässä aikapisteessä. Lisäksi otettiin sukuelinalueen näytteet kahdella seurantakäynnillä. Riskitekijöitä kartoittava kyselytutkimus teetettiin tutkimuksen alkutilanteessa sekä viimeisellä seurantakäynnillä. Oireettomat HPV infektiot olivat alkutilanteessa yleisiä molemmilla sukupuolilla (miesten suu 18,3 % ja sukuelinalue 35,9 %, naisten suu 17,2 % ja kohdunsuu 18,8 %), mutta HPV:n genotyyppien vastaavuus partnerien välillä oli vähäinen. Naisen, mutta ei miehen, seksuaalinen riskikäyttäytyminen oli yhteydessä pariskunnan HPV tyyppien vastaavuuteen. Partnerin ja siviilisäädyn vaihtaminen lisäsivät miehen riskiä saada uusia HPV infektioita. Miehen suun limakalvonäytteistä löytyi kaikkiaan 17 eri HPV tyyppiä. Suun HPV-tulehduksen esiintyvyys vaihteli eri aikapisteissä 15 %:sta 31 %:iin. Uusien HPV tulehdusten ilmaantumisaika vaihteli 3,9 ja 25,7 kuukauden välillä. Suun HPV infektio parani valtaosalla miehistä. Suun krooninen HPV-infektio todettiin 14 %:lla miehistä. Näiden infektioiden keskimääräinen kesto vaihteli 6.0:sta 30.7:ään kuukauteen. Tupakointi lisäsi korkean riskin HPV tyyppien aiheuttamien suun kroonisten infektioiden riskiä, kun taas aikaisemmin sairastetut sukuelinten kondyloomat suojasivat siltä. Tuloksemme osoittavat, että miehen oireeton HPV tulehdus on yleinen suussa ja sukuelinten alueella. Vakaa parisuhde suojaa uusilta HPV tulehduksilta. Tupakoinnilla on keskeinen merkitys suun HPV-infektion kroonistumisessa.

Trust Embedded Open Innovation: Human-Centricity in the Financial

Globalization and interconnectedness in the worldwide sphere have changed the existing and prevailing modus operandi of organizations around the globe and have challenged existing practices along with the business as usual mindset. There are no rules in terms of creating a competitive advantage and positioning within an unstable, constantly changing and volatile globalized business environment. The financial industry, the locomotive or the flagship industry of global economy, especially, within the aftermath of the financial crisis, has reached a certain point trying to recover and redefine its strategic orientation and positioning within the global business arena. Innovation has always been a trend and a buzzword and by many has been considered as the ultimate answer to any kind of problem. The mantra Innovate or Die has been prevailing in any organizational entity in a, sometimes, ruthless endeavour to develop cutting-edge products and services and capture a landmark position in the market. The emerging shift from a closed to an open innovation paradigm has been considered as new operational mechanism within the management and leadership of the company of the future. To that respect, open innovation has been experiencing a tremendous growth research trajectory by putting forward a new way of exchanging and using surplus knowledge in order to sustain innovation within organizations and in the level of industry. In the abovementioned reality, there seems to be something missing: the human element. This research, by going beyond the traditional narratives for open innovation, aims at making an innovative theoretical and managerial contribution developed and grounded on the on-going discussion regarding the individual and organizational barriers to open innovation within the financial industry. By functioning across disciplines and researching out to primary data, it debunks the myth that open innovation is solely a knowledge inflow and outflow mechanism and sheds light to the understanding on the why and the how organizational open innovation works by enlightening the broader dynamics and underlying principles of this fascinating paradigm. Little attention has been given to the role of the human element, the foundational pre-requisite of trust encapsulated within the precise and fundamental nature of organizing for open innovation, the organizational capabilities, the individual profiles of open innovation leaders, the definition of open innovation in the realms of the financial industry, the strategic intent of the financial industry and the need for nurturing a societal impact for human development. To that respect, this research introduces the trust-embedded approach to open innovation as a new insightful way of organizing for open innovation. It unveils the peculiarities of the corporate and individual spheres that act as a catalyst towards the creation of productive open innovation activities. The incentive of this research captures the fundamental question revolving around the need for financial institutions to recognise the importance for organizing for open innovation. The overarching question is why and how to create a corporate culture of openness in the financial industry, an organizational environment that can help open innovation excel. This research shares novel and cutting edge outcomes and propositions both under the prism of theory and practice. The trust-embedded open innovation paradigm captures the norms and narratives around the way of leading open innovation within the 21st century by cultivating a human-centricity mindset that leads to the creation of human organizations, leaving behind the dehumanization mindset currently prevailing within the financial industry.

Carriage of herpes simplex virus and human papillomavirus in oral mucosa is rare in young women: a long-term prospective follow-up

Herpes simplex -virus 1 (HSV-1) ja ihmisen papilloomavirus (HPV) infektoivat suun epiteelisoluja. Useimmissa tapauksissa näiden virusten infektio on kliinisesti oireeton. Suun limakalvojen oireeton HPV-infektio on aikuisilla yleinen, ja valtaosa näistä infektioista ovat ohimeneviä ja vain pieni osa johtaa krooniseen HPV-infektioon. Krooninen HPV-infektio lisää riskiä epiteelisolujen transformoitumiseen kohti syöpäsolua. HPV infektio ei ole yksinään riittävä aiheuttamaan syöpäsolun, vaan siihen tarvitaan myös muita riskitekijöitä.. Muut infektiot, kuten esimerkiksi HSV-1-infektio saattaa olla yksi näistä riskitekijöistä. Tämän syventävän opinnäytetyön tutkimuksen tavoitteena oli selvittää HSV-1-infektion esiintymistä naisten suun limakalvonäytteissä kuuden vuoden seurannassa. Toinen tavoitteemme oli selvittää HSV-1 ja HPV -yhteisinfektion esiintymistä suun epiteelisoluissa, erityisesti naisilla joilla havaittiin suun krooninen HPV-infektio. Tämä tutkimus on osa kuusivuotista seurantatutkimusta (Finnish Family HPV -tutkimus), joka suunniteltiin selvittämään HPV-infektioiden dynamiikkaa ja riskitekijöitä 329 suomalaisperheessä. Suun limakalvoilta otettiin harjausnäyte ennen synnytystä ja kuusi kertaa synnytyksen jälkeen kuuden vuoden aikana. Näytteistä eristettyä DNA:ta oli saatavilla riittävästi HSV-1-analyysiä varten yhteensä 304 naiselta (keski-ikä 25.6 vuotta). Kaikkiaan tutkittavia näytteitä oli 1,873, joista HSV-1:n esiintyminen tutkittiin käyttäen kvantitatiivista PCR:ää. Lisäksi epävarmat PCR-tulokset varmistettiin PCR-tuotteen Southern Blot hybridisaatiolla. HSV-1 tuloksia verrattiin aikaisemmin saatuihin HPV-tuloksiin. Suun limakalvonäytteistä 2.2% oli HSV-1-positiivisia ja 19.6% oli HPV-positiivisia. Yhteensä 11.8%:lla äideistä suunäyte oli HSV-1-DNA -positiivinen ainakin kerran seurannan aikana. HSV-1 ja HPV -yhteisinfektio löydettiin vain neljältä äidiltä. Suurin osa äideistä, jotka olivat HSV-1-positiivisia ennen syntymää, pysyivät HSV-1-positiivisina myös synnytyksen jälkeen. Kolmella naisella todettiin persistentti HPV-16 infektio ja kahdella heistä oli samanaikainen HSV-1 infektio. Tuloksemme osoittaa, että HSV-1:n ja HPV:n esiintyminen yhtä aikaa nuorten naisten suun limakalvolla on harvinaista. On suositeltavaa, että yhteisinfektion omaavia äitejä seurataan myös tulevaisuudessa, sillä HSV-1-infektio saattaa olla yksi riskitekijä suun limakalvon malignissa muutoksessa kroonisen HPV-infektion yhteydessä.