Reduced visual function and its association with physical functioning in the Finnish adult population : Prevalence, causes, and need for eye care services

The purpose of this study was to estimate the prevalence and distribution of reduced visual acuity, major chronic eye diseases, and subsequent need for eye care services in the Finnish adult population comprising persons aged 30 years and older. In addition, we analyzed the effect of decreased vision on functioning and need for assistance using the World Health Organization’s (WHO) International Classification of Functioning, Disability, and Health (ICF) as a framework. The study was based on the Health 2000 health examination survey, a nationally representative population-based comprehensive survey of health and functional capacity carried out in 2000 to 2001 in Finland. The study sample representing the Finnish population aged 30 years and older was drawn by a two-stage stratified cluster sampling. The Health 2000 survey included a home interview and a comprehensive health examination conducted at a nearby screening center. If the invited participants did not attend, an abridged examination was conducted at home or in an institution. Based on our finding in participants, the great majority (96%) of Finnish adults had at least moderate visual acuity (VA ≥ 0.5) with current refraction correction, if any. However, in the age group 75–84 years the prevalence decreased to 81%, and after 85 years to 46%. In the population aged 30 years and older, the prevalence of habitual visual impairment (VA ≤ 0.25) was 1.6%, and 0.5% were blind (VA < 0.1). The prevalence of visual impairment increased significantly with age (p < 0.001), and after the age of 65 years the increase was sharp. Visual impairment was equally common for both sexes (OR 1.20, 95% CI 0.82 – 1.74). Based on self-reported and/or register-based data, the estimated total prevalences of cataract, glaucoma, age-related maculopathy (ARM), and diabetic retinopathy (DR) in the study population were 10%, 5%, 4%, and 1%, respectively. The prevalence of all of these chronic eye diseases increased with age (p < 0.001). Cataract and glaucoma were more common in women than in men (OR 1.55, 95% CI 1.26 – 1.91 and OR 1.57, 95% CI 1.24 – 1.98, respectively). The most prevalent eye diseases in people with visual impairment (VA ≤ 0.25) were ARM (37%), unoperated cataract (27%), glaucoma (22%), and DR (7%). One-half (58%) of visually impaired people had had a vision examination during the past five years, and 79% had received some vision rehabilitation services, mainly in the form of spectacles (70%). Only one-third (31%) had received formal low vision rehabilitation (i.e., fitting of low vision aids, receiving patient education, training for orientation and mobility, training for activities of daily living (ADL), or consultation with a social worker). People with low vision (VA 0.1 – 0.25) were less likely to have received formal low vision rehabilitation, magnifying glasses, or other low vision aids than blind people (VA < 0.1). Furthermore, low cognitive capacity and living in an institution were associated with limited use of vision rehabilitation services. Of the visually impaired living in the community, 71% reported a need for assistance and 24% had an unmet need for assistance in everyday activities. Prevalence of ADL, instrumental activities of daily living (IADL), and mobility increased with decreasing VA (p < 0.001). Visually impaired persons (VA ≤ 0.25) were four times more likely to have ADL disabilities than those with good VA (VA ≥ 0.8) after adjustment for sociodemographic and behavioral factors and chronic conditions (OR 4.36, 95% CI 2.44 – 7.78). Limitations in IADL and measured mobility were five times as likely (OR 4.82, 95% CI 2.38 – 9.76 and OR 5.37, 95% CI 2.44 – 7.78, respectively) and self-reported mobility limitations were three times as likely (OR 3.07, 95% CI 1.67 – 9.63) as in persons with good VA. The high prevalence of age-related eye diseases and subsequent visual impairment in the fastest growing segment of the population will result in a substantial increase in the demand for eye care services in the future. Many of the visually impaired, especially older persons with decreased cognitive capacity or living in an institution, have not had a recent vision examination and lack adequate low vision rehabilitation. This highlights the need for regular evaluation of visual function in the elderly and an active dissemination of information about rehabilitation services. Decreased VA is strongly associated with functional limitations, and even a slight decrease in VA was found to be associated with limited functioning. Thus, continuous efforts are needed to identify and treat eye diseases to maintain patients’ quality of life and to alleviate the social and economic burden of serious eye diseases.

Pathological changes at the target tissue level in Sjögren's syndrome and their effect on the exocrine function of the salivary glands

Sjögren s syndrome (SS) is a common autoimmune disease affecting the lacrimal and salivary glands. SS is characterized by a considerable female predominance and a late age of onset, commonly at the time of adreno- and menopause. The levels of the androgen prohormone dehydroepiandrosterone-sulphate (DHEA-S) in the serum are lower in patients with SS than in age- and sex-matched healthy control subjects. The eventual systemic effects of low androgen levels in SS are not currently well understood. Basement membranes (BM) are specialized layers of extracellular matrix and are composed of laminin (LM) and type IV collagen matrix networks. BMs deliver messages to epithelial cells via cellular LM-receptors including integrins (Int) and Lutheran blood group antigen (Lu). The composition of BMs and distribution of LM-receptors in labial salivary glands (LSGs) of normal healthy controls and patients with SS was assessed. LMs have complex and highly regulated distribution in LSGs. LMs seem to have specific tasks in the dynamic regulation of acinar cell function. LM-111 is important for the normal acinar cell differentiation and its expression is diminished in SS. Also LM-211 and -411 seem to have some acinar specific functional tasks in LSGs. LM-311, -332 and -511 seem to have more general structure maintaining and supporting roles in LSGs and are relatively intact also in SS. Ints α3β1, α6β1, α6β4 and Lu seem to supply structural basis for the firm attachment of epithelial cells to the BM in LSGs. The expression of Ints α1β1 and α2β1 differed clearly from other LM-receptors in that they were found almost exclusively around the acini and intercalated duct cells in salivons suggesting some type of acinar cell compartment-specific or dominant function. Expression of these integrins was lower in SS compared to healthy controls suggesting that the LM-111 and -211-to-Int α1β1 and α2β1 interactions are defective in SS and are crucial to the maintenance of the acini in LSGs. DHEA/DHEA-S concentration in serum and locally in saliva of patients with SS seems to have effects on the salivary glands. These effects were first detected using the androgen-dependent CRISP-3 protein, the production and secretion of which were clearly diminished in SS. This might be due to the impaired function of the intracrine DHEA prohormone metabolizing machinery, which fails to successfully convert DHEA into its active metabolites in LSGs. The progenitor epithelial cells from the intercalated ductal area of LSGs migrate to the acinar compartment and then undergo a phenotype change into secretory acinar cells. This migration and phenotype change seem to be regulated by the LM-111-to-Int α1β1/Int α2β1 interactions. Lack of these interactions could be one factor limiting the normal remodelling process. Androgens are effective stimulators of Int α1β1 and α2β1 expression in physiologic concentrations. Addition of DHEA to the culture medium had effective stimulating effect on the Int α1β1 and α2β1 expression and its effect may be deficient in the LSGs of patients with SS.

The Rocky Road of Social Sustainability : The Impact of Integrated Biodiversity Conservation and Development on the Local Realities in Ranomafana National Park, Madagascar

The objective of this study is to examine the social impacts of the integrated conservation and development project (ICDP) aimed at biodiversity conservation and local socio-economic development in the Ranomafana National Park (RNP), Madagascar. Furthermore, the study explores social sustainability and justice of the ICDP in Ranomafana. This ethnographically informed impact study uses of various field methods. The research material used consists of observation, interviews (key-person and focus group), school children's writings, official statistics and project documents. Fieldwork was conducted in three phases in 2001, 2002 and 2004 in twelve villages around the park, as well as in neighbouring areas of Ranomafana. However, four of those twelve villages were chosen for closer study. This study consists of five independent articles and a concluding chapter. Social impacts were studied through reproductive health indicators as well as a life security approach. Equity and distribution of benefits and drawbacks of ICDP were analysed and the actors related to the conservation in Ranomafana were identified. The children and adolescents' environmental views were also examined. The reproductive health indicators studied showed a poor state of reproductive health in the park area. Moreover, the existing social capital in the villages seemed to be fragmented due to economic difficulties that were partly caused by the conservation regulations. The ICDP in Ranomafana did not pay attention to the heterogeneity of the affected communities even though the local beneficiaries of the ICDP varied according to their ethnicity, living place, wealth, social position and gender. In addition, various conservation actors (local people in various groups, local authorities, tourist business owners, conservation NGOs and scientists) contest their interests over the forest, conservation and its related activities. This study corroborates the same type of evidence and conclusions discussed in other similar cases elsewhere: so called social conservation programmes still cannot meet the needs of the people living near the protected areas; on the contrary, they even have a reverse impact on the people's lives. A fundamental misunderstood assumption in the conservation process in Ranomafana was to consider the local people as a problem for biodiversity conservation. Major reasons for the failure of the ICDP in Ranomafana include a lack of local institutions that would have been able to communicate as equals with the conservation NGOs as well as to transfer the tradition of the authoritarian governance in conservation management together with the over-appreciation of scientific biodiversity, and lack of will to understand the local people's rights to use the forest for their livelihoods.

Consent Practices and Biomedical Knowledge Production in Tissue Economies

The use of human tissue sample collections has become an important tool in biomedical research. The collection, use and distribution of human tissue samples, which include blood and diagnostic tissue samples, from which DNA can be extracted and analyzed has also become a major bio-political preoccupation, not only in national contexts, but also at the transnational level. The foundation of medical research rests on the relationship between the doctor and the research subject. This relationship is a social one, in that it is based on informed consent, privacy and autonomy, where research subjects are made aware of what they are getting involved in and are then able to make an informed decision as to whether or not to participate. Within the post-genomic era, however, our understanding of what constitutes informed consent, privacy and autonomy is changing in relation to the needs of researchers, but also as a reflection of policy aspirations. This reflects a change in the power relations between the rights of the individual in relation to the interests of science and society. Using the notions of tissue economies and biovalue (Waldby, 2002) this research explores the changing relationship between sources and users of samples in biomedical research by examining the contexts under which human tissue samples and the information that is extracted from them are acquired, circulated and exchanged in Finland. The research examines how individual rights, particularly informed consent, are being configured in relation to the production of scientific knowledge in tissue economies in Finland from the 1990s to the present. The research examines the production of biovalue through the organization of scientific knowledge production by examining the policy context of knowledge production as well as three case studies (Tampere Research Tissue Bank, Hereditary Non-polyposis Colorectal Cancer and the Finnish Genome Information Center) in which tissues are acquired, circulated and exchanged in Finland. The research shows how interpretations of informed consent have become divergent and the elements and processes that have contributed to these differences. This inquiry shows how the relationship between the interests of individuals is re-configured in relation to the interests of science and society. It indicates how the boundary between interpretations of informed consent, on the one hand, and social and scientific interests, on the other, are being re-drawn and that this process is underscored, in part, by the economic, commercial and preventive potential that research using tissue samples are believed to produce. This can be said to fundamentally challenge the western notion that the rights of the individual are absolute and inalienable within biomedical legislation.

Alternative News Sources as 'Collaboratory' Journalism. A case study of Helsingin Sanomat and its relation with the Youth Voice Editorial Board

The new paradigm of connectedness and empowerment brought by the interactivity feature of the Web 2.0 has been challenging the traditional centralized performance of mainstream media. The corporation has been able to survive the strong winds by transforming itself into a global multimedia business network embedded in the network society. By establishing networks, e.g. networks of production and distribution, the global multimedia business network has been able to sight potential solutions by opening the doors to innovation in a decentralized and flexible manner. Under this emerging context of re-organization, traditional practices like sourcing need to be re- explained and that is precisely what this thesis attempts to tackle. Based on ICT and on the network society, the study seeks to explain within the Finnish context the particular case of Helsingin Sanomat (HS) and its relations with the youth news agency, Youth Voice Editorial Board (NÄT). In that sense, the study can be regarded as an explanatory embedded single case study, where HS is the principal unit of analysis and NÄT its embedded unit of analysis. The thesis was able to reach explanations through interrelated steps. First, it determined the role of ICT in HS’s sourcing practices. Then it mapped an overview of the HS’s sourcing relations and provided a context in which NÄT was located. And finally, it established conceptualized institutional relational data between HS and NÄT for their posterior measurement through social network analysis. The data set was collected via qualitative interviews addressed to online and offline editors of HS as well as interviews addressed to NÄT’s personnel. The study concluded that ICT’s interactivity and User Generated Content (UGC) are not sourcing tools as such but mechanism used by HS for getting ideas that could turn into potential news stories. However, when it comes to visual communication, some exemptions were found. The lack of official sources amidst the immediacy leads HS to rely on ICT’s interaction and UGC. More than meets the eye, ICT’s input into the sourcing practice may be more noticeable if the interaction and UGC is well organized and coordinated into proper and innovative networks of alternative content collaboration. Currently, HS performs this sourcing practice via two projects that differ, precisely, by the mode they are coordinated. The first project found, Omakaupunki, is coordinated internally by Sanoma Group’s owned media houses HS, Vartti and Metro. The second project found is coordinated externally. The external alternative sourcing network, as it was labeled, consists of three actors, namely HS, NÄT (professionals in charge) and the youth. This network is a balanced and complete triad in which the actors connect themselves in relations of feedback, recognition, creativity and filtering. However, as innovation is approached very reluctantly, this content collaboration is a laboratory of experiments; a ‘COLLABORATORY’.

Synthesis and characterization of metal substituted AlxCr1-x(acetylacetonate)(3) single-source precursors for their application to MOCVD of thin films

A detailed study, involving the synthesis of a single-source precursor containing two metal ions sharing the same crystallographic site, has been undertaken to elucidate the use of such a single-source precursor in a CVD process for growing thin films of oxides comprising these two metals, ensuring a uniform composition and distribution of metal ions. The substituted complexes Cr1-xAlx(acac)(3), where acac = acetyl-acetonate, have been prepared by a co-synthesis method, and characterized using UV-Vis spectroscopy. TGA/DTA measurements, and single crystal X-ray diffraction at low temperature. All the studied compositions crystallize in the monoclinic space group P2(1)/c with Z = 4 in the unit cell. It was observed that the ratio (Al:Cr) of the site occupancy for the metal ions, obtained from single crystal refinement, is in agreement with the results obtained from complexometric titrations. All the solid state structures have the metal in an octahedral environment forming six-membered chelate rings. M-O acac bond lengths and disorder in the terminal carbon have been studied in detail for these substituted metal-organic complexes. One composition among these was chosen to evaluate their suitability as a single-source precursor in a LPMOCVD process (low-pressure metal-organic chemical vapour deposition) for the deposition of a substituted binary metal oxide thin film. The resulting thin films were characterized by X-ray diffraction, scanning electron microscopy, and infrared spectroscopy. (C) 2010 Elsevier Ltd. All rights reserved.

Role of indenter angle on the plastic deformation underneath a sharp indenter and on representative strains: An experimental and numerical study

The subsurface microhardness mapping technique of Chaudhri was utilized to determine the shape, size and distribution of plastic strain underneath conical indenters of varying semi-apex angles, alpha (55 degrees, 65 degrees and 75 degrees). Results show that the elastic-plastic boundary under the indenters is elliptical in nature, contradicting the expanding cavity model, and the ellipticity increases with alpha. The maximum plastic strain immediately under the indenter was found to decrease with increasing alpha. Complementary finite-element analysis was conducted to examine the ability of simulations to capture the experimental observations. A comparison of computational and experimental results indicates that the plastic strain distributions as well as the maximum strains immediately beneath the indenter do not match, suggesting that simulation of sharp indentation requires further detailed studies for complete comprehension. Representative strains, epsilon(r), evaluated as the volume-average strains within the elastic-plastic boundary, decrease with increasing alpha and are in agreement with those estimated by using the dimensional analysis. (C) 2011 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

A GIS (geographical information system)-based spatial data mining approach for optimal location and capacity planning of distributed biomass power generation facilities: A case study of Tumkur district, India

This paper primarily intends to develop a GIS (geographical information system)-based data mining approach for optimally selecting the locations and determining installed capacities for setting up distributed biomass power generation systems in the context of decentralized energy planning for rural regions. The optimal locations within a cluster of villages are obtained by matching the installed capacity needed with the demand for power, minimizing the cost of transportation of biomass from dispersed sources to power generation system, and cost of distribution of electricity from the power generation system to demand centers or villages. The methodology was validated by using it for developing an optimal plan for implementing distributed biomass-based power systems for meeting the rural electricity needs of Tumkur district in India consisting of 2700 villages. The approach uses a k-medoid clustering algorithm to divide the total region into clusters of villages and locate biomass power generation systems at the medoids. The optimal value of k is determined iteratively by running the algorithm for the entire search space for different values of k along with demand-supply matching constraints. The optimal value of the k is chosen such that it minimizes the total cost of system installation, costs of transportation of biomass, and transmission and distribution. A smaller region, consisting of 293 villages was selected to study the sensitivity of the results to varying demand and supply parameters. The results of clustering are represented on a GIS map for the region.

Probing disorder and transport properties in polypyrrole thin-film devices by impedance and Raman spectroscopy

In the present study, impedance and Raman spectroscopy are adopted to probe the nature and extent of disorder to correlate with transport properties in doped polypyrrole (PPy) thin-film devices, synthesized electrochemically at different temperatures. A comparative study of the impedance spectroscopy is performed on PPy devices by both experimental and simulation approach with varying extent of disorder. The impedance measurements of PPy devices are well described by introducing a constant phase element (CPE) (Q) in modified RQ circuit, which accounts for frequency dependence of dielectric response. However, for the PPy grown at lower temperature, an equivalent circuit consisting of two such RQ elements in series is used for successful modelling of the impedance results, which accounts for the depletion region near the electrode. Raman spectroscopy and the de-convoluted spectra are successfully studied to probe the variation in C=C bond stretching and distribution of conjugation length, which relates to disorder in PPy films and the interpretation is well correlated to the impedance results.

Formation and Thermal Stability of Gold-Silica Nanohybrids: Insight into the Mechanism and Morphology by Electron Tomography

Gold-silica hybrids are appealing in different fields of applications like catalysis, sensorics, drug delivery, and biotechnology. In most cases, the morphology and distribution of the heterounits play significant roles in their functional behavior. Methods of synthesizing these hybrids, with variable ordering of the heterounits, are replete; however, a complete characterization in three dimensions could not be achieved yet. A simple route to the synthesis of Au-decorated SiO2 spheres is demonstrated and a study on the 3D ordering of the heterounits by scanning transmission electron microscopy (STEM) tomography is presentedat the final stage, intermediate stages of formation, and after heating the hybrid. The final hybrid evolves from a soft self-assembled structure of Au nanoparticles. The hybrid shows good thermal stability up to 400 degrees C, beyond which the Au particles start migrating inside the SiO2 matrix. This study provides an insight in the formation mechanism and thermal stability of the structures which are crucial factors for designing and applying such hybrids in fields of catalysis and biotechnology. As the method is general, it can be applied to make similar hybrids based on SiO2 by tuning the reaction chemistry as needed.

Seismotectonics of the April-May 2015 Nepal earthquakes: An assessment based on the aftershock patterns, surface effects and deformational characteristics

Occurrence of the April 25, 2015 (Mw 7.8) earthquake near Gorkha, central Nepal, and another one that followed on May 12 (Mw 7.3), located similar to 140 km to its east, provides an exceptional opportunity to understand some new facets of Himalayan earthquakes. Here we attempt to assess the seismotectonics of these earthquakes based on the deformational field generated by these events, along with the spatial and temporal characteristics of their aftershocks. When integrated with some of the post-earthquake field observations, including the localization of damage and surface deformation, it became obvious that although the mainshock slip was mostly limited to the Main Himalayan Thrust (MHT), the rupture did not propagate to the Main Frontal Thrust (MFT). Field evidence, supported by the available InSAR imagery of the deformation field, suggests that a component of slip could have emerged through a previously identified out-of-sequence thrust/active thrust in the region that parallels the Main Central Thrust (MCT), known in the literature as a co-linear physiographic transitional zone called PT2. Termination of the first rupture, triggering of the second large earthquake, and distribution of aftershocks are also spatially constrained by the eastern extremity of PT2. Mechanism of the 2015 sequence demonstrates that the out-of-sequence thrusts may accommodate part of the slip, an aspect that needs to be considered in the current understanding of the mechanism of earthquakes originating on the MHT. (c) 2015 Elsevier Ltd. All rights reserved.

Life-cycle analysis of energy and greenhouse gas emissions of automotive fuels in India: Part 2-Well-to-wheels analysis

In this second of the two-part study, the results of the Tank-to-Wheels study reported in the first part are combined with Well-to-Tank results in this paper to provide a comprehensive Well-to-Wheels energy consumption and greenhouse gas emissions evaluation of automotive fuels in India. The results indicate that liquid fuels derived from petroleum have Well-to-Tank efficiencies in the range of 75-85% with liquefied petroleum gas being the most efficient fuel in the Well-to-Tank stage with 85% efficiency. Electricity has the lowest efficiency of 20% which is mainly attributed due to its dependence on coal and 25.4% losses during transmission and distribution. The complete Well-to-Wheels results show diesel vehicles to be the most efficient among all configurations, specifically the diesel-powered split hybrid electric vehicle. Hydrogen engine configurations are the least efficient due to low efficiency of production of hydrogen from natural gas. Hybridizing electric vehicles reduces the Well-to-Wheels greenhouse gas emissions substantially with split hybrid configuration being the most efficient. Electric vehicles do not offer any significant improvement over gasoline-powered configurations; however a shift towards renewable sources for power generation and reduction in losses during transmission and distribution can make it a feasible option in the future. (C) 2015 Elsevier Ltd. All rights reserved.

Toxicity and imaging of multi-walled carbon nanotubes in human macrophage cells.

Multi-walled carbon nanotubes (MWNTs) have been proposed for use in many applications and concerns about their potential effect on human health have led to the interest in understanding the interactions between MWNTs and human cells. One important technique is the visualisation of the intracellular distribution of MWNTs. We exposed human macrophage cells to unpurified MWNTs and found that a decrease in cell viability was correlated with uptake of MWNTs due to mainly necrosis. Cells treated with purified MWNTs and the main contaminant Fe(2)O(3) itself yielded toxicity only from the nanotubes and not from the Fe(2)O(3). We used 3-D dark-field scanning transmission electron microscopy (DF-STEM) tomography of freeze-dried whole cells as well as confocal and scanning electron microscopy (SEM) to image the cellular uptake and distribution of unpurified MWNTs. We observed that unpurified MWNTs entered the cell both actively and passively frequently inserting through the plasma membrane into the cytoplasm and the nucleus. These suggest that MWNTs may cause incomplete phagocytosis or mechanically pierce through the plasma membrane and result in oxidative stress and cell death.

A Simulation Model for Unified Interrill Erosion and Rill Erosion on Hillslopes

A mathematical model was developed for simulating runoff generation and soil erosion on hillslopes. The model is comprised of three modules: one for overland flow, one for soil infiltration, and one for soil erosion including rill erosion and interrill er

Spread of Salmonella enterica in the body during systemic infection: unravelling host and pathogen determinants.

Salmonella enterica causes a range of life-threatening diseases in humans and animals worldwide. Current treatments for S. enterica infections are not sufficiently effective, and there is a need to develop new vaccines and therapeutics. An understanding of how S. enterica spreads in tissues has very important implications for targeting bacteria with vaccine-induced immune responses and antimicrobial drugs. Development of new control strategies would benefit from a more sophisticated evaluation of bacterial location, spatiotemporal patterns of spread and distribution in the tissues, and sites of microbial persistence. We review here recent studies of S. enterica serovar Typhimurium (S. Typhimurium) infections in mice, an established model of systemic typhoid fever in humans, which suggest that continuous bacterial spread to new infection foci and host phagocytes is an essential trait in the virulence of S. enterica during systemic infections. We further highlight how infections within host tissues are truly heterogeneous processes despite the fact that they are caused by the expansion of a genetically homogeneous microbial population. We conclude by discussing how understanding the within-host quantitative, spatial and temporal dynamics of S. enterica infections might aid the development of novel targeted preventative measures and drug regimens.