CYP17A1 Enzyme activity is linked to ambulatory blood pressure in a family-based population study.

BACKGROUND: Genome-wide association studies have linked CYP17A1 coding for the steroid hormone synthesizing enzyme 17α-hydroxylase (CYP17A1) to blood pressure (BP). We hypothesized that the genetic signal may translate into a correlation of ambulatory BP (ABP) with apparent CYP17A1 activity in a family-based population study and estimated the heritability of CYP17A1 activity. METHODS: In the Swiss Kidney Project on Genes in Hypertension, day and night urinary excretions of steroid hormone metabolites were measured in 518 participants (220 men, 298 women), randomly selected from the general population. CYP17A1 activity was assessed by 2 ratios of urinary steroid metabolites: one estimating the combined 17α-hydroxylase/17,20-lyase activity (ratio 1) and the other predominantly 17α-hydroxylase activity (ratio 2). A mixed linear model was used to investigate the association of ABP with log-transformed CYP17A1 activities exploring effect modification by urinary sodium excretion. RESULTS: Daytime ABP was positively associated with ratio 1 under conditions of high, but not low urinary sodium excretion (P interaction <0.05). Ratio 2 was not associated with ABP. Heritability estimates (SE) for day and night CYP17A1 activities were 0.39 (0.10) and 0.40 (0.09) for ratio 1, and 0.71 (0.09) and 0.55 (0.09) for ratio 2 (P values <0.001). CYP17A1 activities, assessed with ratio 1, were lower in older participants. CONCLUSIONS: Low apparent CYP17A1 activity (assessed with ratio 1) is associated with elevated daytime ABP when salt intake is high. CYP17A1 activity is heritable and diminished in the elderly. These observations highlight the modifying effect of salt intake on the association of CYP17A1 with BP.

Epidemiology of masked and white-coat hypertension : the family-based SKIPOGH study

Un enregistrement de la tension artérielle ambulatoire (couvrant 24 heures) ainsi que plusieurs mesures en cabinet ont permis de classer chaque participant dans 4 catégories : normotension (tension artérielle normale au cabinet et en ambulatoire), hypertension artérielle soutenue (tension artérielle élevée au cabinet et en ambulatoire), hypertension de la blouse blanche (tension artérielle élevée au cabinet mais normale en ambulatoire) et hypertension artérielle masquée (tension artérielle élevée en ambulatoire mais normale au cabinet). Dans la littérature, la prévalence de l'hypertension artérielle masquée varie entre 8% et 48% selon la méthodologie utilisée et la population étudiée. Les personnes présentant une hypertension artérielle masquée ou une hypertension de la blouse blanche pourraient avoir un risque cardiovasculaire plus élevé que des personnes normotendues. Il est utile de déterminer les facteurs cliniques associés à l'hypertension artérielle masquée et à l'hypertension de la blouse blanche afin d'identifier les personnes à risque de développer ces conditions. Peu d'études ont examiné la proportion et les facteurs associés à l'hypertension artérielle masquée et à l'hypertension de la blouse blanche en Suisse, et aucune étude n'a été faite au niveau populationnel. Dans cette étude, nous investiguons les facteurs associés à l'hypertension masquée et à l'hypertension de la blouse blanche dans une étude populationnelle Suisse. Le Swiss Kidney Project on Genes in Hypertension (SKIPOGH) est une étude familiale transversale. La tension artérielle au cabinet et la tension artérielle ambulatoire sont mesurées par des appareils validés. Dans cette étude, nous avons défini l'hypertension artérielle masquée comme une tension artérielle au cabinet < 140/90 mmHg et une tension ambulatoire (jour) s 135/85 mmHg ; l'hypertension de la blouse blanche comme une tension artérielle au cabinet s 140/90 mmHg et une tension ambulatoire < 135/85 mmHg ; et enfin la tension artérielle à la limite supérieure de la norme au cabinet comme une tension systolique entre 130 et 139 mmHg et/ou une tension artérielle diastolique entre 85 et 89 mmHg lors de la mesure au cabinet. Nous avons utilisé une régression logistique multiple pour examiner la relation entre l'hypertension masquée et l'hypertension de la blouse blanche, d'une part, et les facteurs associés, d'autre part, en prenant en compte les corrélations familiales. Parmi les 652 participants inclus dans cette analyse, 51% sont des femmes. L'âge moyen (± écart type) est de 48 ans (± 18 ans). Les proportions de participants avec une hypertension masquée et une hypertension de la blouse blanche sont de 15.8% et de 2.6% respectivement. L'hypertension masquée est associée à l'âge (odds ratio (OR) = 1.02, p = 0.012), à une tension artérielle au cabinet à la limite supérieure de la norme (OR = 6.68, p, 0.001) et à l'obésité (OR = 3.63, p = 0.001). L'hypertension de la blouse blanche est associée à l'âge (OR = 1.07, p, 0.001) mais pas au niveau d'éducation, à l'anamnése familiale d'hypertension ou à l'activité physique. Nos données suggèrent que les médecins doivent envisager d'effectuer un enregistrement de la tension artérielle ambulatoire chez les personnes âgées avec une tension au cabinet à la limite supérieure de la norme et/ou chez les patients obèses afin de déterminer si ces individus présentent une hypertension artérielle en ambulatoire.

A feasability study of the analysis of the economic outcomes of specialized nutrition in obesity and weight management in Switzerland

The increasing prevalence of obesity and its associated complications requires specialized care to improve outcomes and control health care costs. Obesity is associated with numerous serious and costly medical problems requiring specialized care in managing health. The economic burden of obesity includes increased inpatient and outpatient medical expenditures as well as employer-related issues of absenteeism and associate costs. The objectives of this study are: - To describe the health consequences and the economic burden of obesity, - To review the existing treatment - To argue in favor of a specialized nutritional intervention that has shown to improve health and reduce obesity related health care costs. Therefore, expose the possibility of introducing the specialized nutrition in Switzerland and the feasibility of this project considering the medical trends and reimbursement system in Switzerland The benefits and outcomes for the patients will be the significant weight loss which reduces the severity and risk factors for complications and the improved health and quality of life. Weight loss will be a combination of a diet, exercise and behavioral interventions which are the basic recommendations for obesity treatment in addition to the specialized nutritional support. By nutritional support, we mean products that are intended to provide nutritional support in the dietary management of people with specific diseases and conditions when adequate intake of regular foods is compromised. These products are called, Food for special medical purposes FSMP. They are not intended to treat, cure, prevent, mitigate or have a direct impact on disease in a manner similar to drugs or other medical treatments and should be used under medical supervision. They also provide a low cost alternative to surgery. From a health care system perspective, the specialized nutrition will drive its advantage by reducing the utilization of medical services for obesity associated complications like medication, physician's consultations and surgical interventions arriving to a cost effective care for the hospitals, the health care organizations and the third party payers which are the health insurances. [Author, p. 4]

Diffantom: Whole-Brain Diffusion MRI Phantoms Derived from Real Datasets of the Human Connectome Project.

Food allergies are believed to be on the rise and currently management relies on the avoidance of the food. Hen's egg allergy is after cow's milk allergy the most common food allergy; eggs are used in many food products and thus difficult to avoid. A technological process using a combination of enzymatic hydrolysis and heat treatment was designed to produce modified hen's egg with reduced allergenic potential. Biochemical (SDS-PAGE, Size exclusion chromatography and LC-MS/MS) and immunological (ELISA, immunoblot, RBL-assays, animal model) analysis showed a clear decrease in intact proteins as well as a strong decrease of allergenicity. In a clinical study, 22 of the 24 patients with a confirmed egg allergy who underwent a double blind food challenge with the hydrolysed egg remained completely free of symptoms. Hydrolysed egg products may be beneficial as low allergenic foods for egg allergic patients to extent their diet. This article is protected by copyright. All rights reserved.

The unfathomable secret remains: a reverse engineering study of SEO factors on Google's search engine

The vast majority of users don’t seek results beyond the second page offered by the search engine, so if a site fails to be among the top 20 (second page), it says that this page does not have good SEO and, therefore, is not visible to the user. The overall objective of this project is to conduct a study to discover the factors that determine (or not) the positioning of websites in a search engine.

Supplier's position in project marketing networks

The present study explores relationships between project marketers and their customers in project marketing context. The purpose of the study is to increase the understanding on supplier’s position in project marketing networks. Project marketing is representing a high volume in the international business, and the industrial network approach and the project marketing research cannot fully explain a supplier’s position in project marketing networks. Increased knowledge on project networks can also contribute to industrial marketing research more generally. Data for the present study was collected firstly during the pilot case study from project buyers in the paper and the steel industry in interviews. Secondly an entire project marketing case concerning a steel industry case was used as a data source. The data included interviews, correspondence between the supplier and the buyer, and project documents. The data of the pilot case was analysed with contents analysis, and in the case a deeper analysis based on the developed Stage Dimension framework was used. Supplier’s position in project marketing networks is a hierarchical and dynamic concept including a supplier’s position on the highest level. The dimensions of the position concept are the intermediate level, and the dimensions are based on the underlying components. Supplier’s position is composed from four organization related dimensions, and two individual actor related dimensions. The composition of the supplier’s position varies during the project marketing process, and consequently the relative importance of the dimensions is changing over the process. Supplier’s position in project marketing networks is shaped by incremental and radical changes. Radical changes are initiated by critical events. The study contributes to the research of industrial networks and project marketing. The theoretical contribution of the study is threefold: firstly it proposes a structure of the position concept in project marketing networks, secondly it proposes the Position Stage Dimension Component (PSDC) model for the development of supplier’s position during the project marketing process, and thirdly the study widens the critical event concept to cover the project marketing process both on the organizational and individual level. In addition to the theoretical contributions there are several managerial implications for planning and implementing marketing strategies in the project context.

Managing virtual project teams

The purpose of the Master’s Thesis is to study the best practices to virtual project management from the project manager’ point of view. The best practices are divided according to a five-phase virtual project life cycle model. Each phase include concrete suggestions for actions. Research’s theoretical background is wide because of the broad subject matter. In the theoretical part topics such as virtual working, virtual project management challenges are examined and some concrete actions to tackle these challenges are introduced. Thesis’ approach is constructive, where a known problem is solved piece by piece after creating a pre-understanding of the topic. Existing research work is utilized when creating a model for virtual project team management. The basis of the model comes from various best practices read from literature and from the interviews conducted on experienced virtual project managers in the case organization. As a result the model combines both previous research and the organizations empirical experience. As an output of the thesis a model for virtual project team management is developed, which can be used as a guideline by the virtual project managers in their work. The model includes actions and practices what can be used to overcome the challenges of virtual project management.

Factors of customer project profitability in an engineering industrial enterprise

The purpose of the study is to find factors affecting projects' profitability in project business. The issue is approached from customer profitability and project management point of view. The study has been made for a big Finnish company acting in a global market place. The research method is quantitative. Research hypotheses are based on the literature. The used database is originated from the company's ERP- (enterprise resource planning) and project financial follow-up —system. The findings of the study supported the hypotheses weakly. Obviously profitability fluctuated depending on a customer and a project manager. The reasons could not be justified with the variables used in the research.

Enhancement of R&D project management system

Stora Enso has research centres in Finland, Sweden and Germany. The research centres use PIMS as a research project invoicing and monitoring system. Possible reorganization and new financing model for R&D functions have been considered and the project management system should be developed to support the new operation model. The objective of this thesis is to find a model for R&D project management, and to present the project management system of Stora Enso, and to discuss if the current system could be developed to respond to the new needs or should it be replaced with another system. The theoretical part of the study describes challenges in R&D project management, and presents different project characteristics, and methods for managing R&D project portfolio. It is also described how the project management system can support project monitoring and controlling, and how inter-project learning can be enhanced. The empirical part of the study presents the current project management system of Stora Enso and how the system should be developed to support Stora Enso’s R&D functions better. In conclusion, it is stated that there is no relevant reason to replace PIMS with another system, because PIMS can be developed to support R&D project management better with a hybrid system. It is also suggested that the new financing model should not be implemented before more comprehensive analysis of its effects is conducted.

Assessment of an information product project success: case business blueprint

The objective of this study was to find out how project success can be measured in a case where the output of a project is an intangible information product, what kind of framework can be used to evaluate the project success, and how the project assessment can be done in practice. As a case example, the success of a business blueprint project was assessed from the product point of view. A framework for assessing business blueprint project success was made based on a literature review. Furthermore, separate frameworks for measuring information product quality and project costs were developed. The theory of business blueprinting was discovered not to be firmly institutionalized and it is briefly covered in the thesis. The possible net benefits from the strategic business process harmonization were noted to be much more significant than the costs of the business blueprint project. The project was seen as a sufficient success from the viewpoint of the created output.

Management of Nitrogen Oxides Reduction Project in a Cement Plant

The main aim of this study was to develop the project management framework model which would serve as the new model to follow for upcoming projects at the Lappeenranta cement plant. The other goal was to execute the SNCR (selective non catalytic reduction) project successfully so that the nitrogen oxides emissions are below the stated emission limit when the new emission limit comes into effect beginning in July, 2008. Nitrogen oxides, project management aspects, SNCR and the invested system are explained in the theory part. In the practical part of the study, the SNCR project in the Lappeenranta cement plant was executed and the findings were documented. In order to reach the aim of this study, a framework of project management was made. The framework is based on the executed SNCR project, previous projects in the cement plant and on the available literature relating to the subject matter. The developed project turned out to be successful.

Feasibility Study and Market Review of Small Scale Bioenergy Heating Plants in North-West Russia

The paper is focused on feasibility study and market review of small scale bioenergy heating plants in the Russian North-West region. The main focus is effective and competitive usage of low-grade wood for heating purposes in the region. As example of economical feasibility estimation it was chosen the project of reconstruction of small scale boiler plant in Leningrad region that Brofta Oy is planning to implement the nearest time. It includes calculation the payback time with and without interest, the estimation of probable investments, the evaluation of possible risks and research on the potential of small scale heating plants projects. Calculations show that the profitability of this kind of projects is high, but payback time is not very short, because of high level of initial investments. Though, the development of small scale bioenergy heating plants in the region is considered to be the best way to solve the problems of heat supply in small settlements using own biomass resources.

Survival of European patients diagnosed with lymphoid neoplasms in 2000-2002: results of the HAEMACARE project

The European Cancer Registry-based project on hematologic malignancies (HAEMACARE), setup to improve the availability and standardization of data on hematologic malignancies in Europe, used the European Cancer Registry-based project on survival and care of cancer patients (EUROCARE-4) database to produce a new grouping of hematologic neoplasma(defined by the International Classification of Diseases for Oncology, Third Edition and the 2001/2008 World Health Organization classifications) for epidemiological and public healthpurposes. We analyzed survival for lymphoid neoplasms in Europe by disease group, comparing survival between different European regions by age and sex. Design and Methods Incident neoplasms recorded between 1995 to 2002 in 48 population-based cancer registries in 20 countries participating in EUROCARE-4 were analyzed. The period approach was used to estimate 5-year relative survival rates for patients diagnosed in 2000-2002, who did not have 5years of follow up. Results: The 5-year relative survival rate was 57% overall but varied markedly between the definedgroups. Variation in survival within the groups was relatively limited across European regions and less than in previous years. Survival differences between men and women were small. The relative survival for patients with all lymphoid neoplasms decreased substantially after the age of 50. The proportion of ‘not otherwise specified’ diagnoses increased with advancing age.Conclusions: This is the first study to analyze survival of patients with lymphoid neoplasms, divided into groups characterized by similar epidemiological and clinical characteristics, providing a benchmarkfor more detailed analyses. This Europe-wide study suggests that previously noted differences in survival between regions have tended to decrease. The survival of patients with all neoplasms decreased markedly with age, while the proportion of ‘not otherwise specified’ diagnoses increased with advancing age. Thus the quality of diagnostic work-up and care decreased with age, suggesting that older patients may not be receiving optimal treatment

Improving interMediAte Risk management. MARK study

Background: Cardiovascular risk functions fail to identify more than 50% of patients who develop cardiovascular disease. This is especially evident in the intermediate-risk patients in which clinical management becomes difficult. Our purpose is to analyze if ankle-brachial index (ABI), measures of arterial stiffness, postprandial glucose, glycosylated hemoglobin, self-measured blood pressure and presence of comorbidity are independently associated to incidence of vascular events and whether they can improve the predictive capacity of current risk equations in the intermediate-risk population. Methods/Design: This project involves 3 groups belonging to REDIAPP (RETICS RD06/0018) from 3 Spanish regions. We will recruit a multicenter cohort of 2688 patients at intermediate risk (coronary risk between 5 and 15% or vascular death risk between 3-5% over 10 years) and no history of atherosclerotic disease, selected at random. We will record socio-demographic data, information on diet, physical activity, comorbidity and intermittent claudication. We will measure ABI, pulse wave velocity and cardio ankle vascular index at rest and after a light intensity exercise. Blood pressure and anthropometric data will be also recorded. We will also quantify lipids, glucose and glycosylated hemoglobin in a fasting blood sample and postprandial capillary glucose. Eighteen months after the recruitment, patients will be followed up to determine the incidence of vascular events (later follow-ups are planned at 5 and 10 years). We will analyze whether the new proposed risk factors contribute to improve the risk functions based on classic risk factors. Discussion: Primary prevention of cardiovascular diseases is a priority in public health policy of developed and developing countries. The fundamental strategy consists in identifying people in a high risk situation in which preventive measures are effective and efficient. Improvement of these predictions in our country will have an immediate, clinical and welfare impact and a short term public health effect

Exposure to Tobacco Smoke and Markers of Subclinical Atherosclerosis in Children and Adolescents. The STRIP Study.

Background: Measurement of serum cotinine, a major metabolite of nicotine, provides a valid marker for quantifying exposure to tobacco smoke. Exposure to tobacco smoke causes vascular damage by multiple mechanisms, and it has been acknowledged as a risk factor for atherosclerosis. Multifactorial atherosclerosis begins in childhood, but the relationship between exposure to tobacco smoke and arterial changes related to early atherosclerosis have not been studied in children. Aims: The aim of the present study was to evaluate exposure to tobacco smoke with a biomarker, serum cotinine concentration, and its associations with markers of subclinical atherosclerosis and lipid profile in school-aged children and adolescents. Subjects and Methods: Serum cotinine concentration was measured using a gas chromatographic method annually between the ages 8 and 13 years in 538-625 children participating since infancy in a randomized, prospective atherosclerosis prevention trial STRIP (Special Turku coronary Risk factor Intervention Project). Conventional atherosclerosis risk factors were measured repeatedly. Vascular ultrasound studies were performed among 402 healthy 11-year-old children and among 494 adolescents aged 13 years. Results: According to serum cotinine measurements, a notable number of the school aged children and adolescents were exposed to tobacco smoke, but the exposure levels were only moderate. Exposure to tobacco smoke was associated with decreased endothelial function as measured with flow-mediated dilation of the brachial artery, decreased elasticity of the aorta, and increased carotid and aortic intima-media thickness. Longitudinal exposure to tobacco smoke was also related with increased apolipoprotein B and triglyceride levels in 13-year-old adolescents, whose body mass index and nutrient intakes did not differ. Conclusions: These findings suggest that exposure to tobacco smoke in childhood may play a significant role in the development of early atherosclerosis. Key Words: arterial elasticity, atherosclerosis, children, cotinine, endothelial function, environmental tobacco smoke, intima-media thickness, risk factors, ultrasound