A Possible and Necessary Consistency Proof

After Gödel's incompleteness theorems and the collapse of Hilbert's programme Gerhard Gentzen continued the quest for consistency proofs of Peano arithmetic. He considered a finitistic or constructive proof still possible and necessary for the foundations of mathematics. For a proof to be meaningful, the principles relied on should be considered more reliable than the doubtful elements of the theory concerned. He worked out a total of four proofs between 1934 and 1939. This thesis examines the consistency proofs for arithmetic by Gentzen from different angles. The consistency of Heyting arithmetic is shown both in a sequent calculus notation and in natural deduction. The former proof includes a cut elimination theorem for the calculus and a syntactical study of the purely arithmetical part of the system. The latter consistency proof in standard natural deduction has been an open problem since the publication of Gentzen's proofs. The solution to this problem for an intuitionistic calculus is based on a normalization proof by Howard. The proof is performed in the manner of Gentzen, by giving a reduction procedure for derivations of falsity. In contrast to Gentzen's proof, the procedure contains a vector assignment. The reduction reduces the first component of the vector and this component can be interpreted as an ordinal less than epsilon_0, thus ordering the derivations by complexity and proving termination of the process.

Interplay of Virulence Factors in Complement Resistance of Streptococcus pneumoniae

Streptococcus pneumoniae (pneumococcus) is a normal inhabitant of the human nasopharynx. Symptoms occur in only a small proportion of those who become carriers, but the ubiquity of the organism in the human population results in a large burden of disease. S. pneumoniae is the leading bacterial cause of pneumonia, sepsis, and meningitis worldwide, causing the death of a million children each year. Middle-ear infection is the most common clinical manifestation of mucosal pneumococcal infections. In invasive disease, S. pneumoniae gains access to the bloodstream and spreads to normally sterile parts of the body. The progression from asymptomatic colonization to disease depends on factors characteristic of specific pneumococcal strains as well as the status of host defenses. The polysaccharide capsule surrounding the bacterium is considered to be the most important factor affecting the virulence of pneumococci. It protects pneumococci from phagocytosis and also may determine its affinity to the respiratory epithelium. S. pneumoniae as a species comprises more than 90 different capsular serotypes, but not all of them are equally prevalent in human diseases. Invasive serotypes are rarely isolated from healthy carriers, but relatively often cause invasive disease. Serotypes that are carried asymptomatically for a long time behave like opportunistic pathogens, causing disease in patients who have impaired immune defenses. The complement system is a collection of blood and cell surface proteins that act as a major primary defense against invading microbes. Phagocytic cells with receptors for complement proteins can engulf and destroy pneumococcal cells opsonized with these proteins. S. pneumoniae has evolved a number of ways to subvert mechanisms of innate immunity, and this is likely to contribute to its pathogenicity. The capsular serotype, proteins essential for virulence, as well the genotype, may all influence the ability of pneumococcus to resist complement and its potential to cause disease. Immunization with conjugate vaccines produces opsonic antibodies, which enhance complement deposition and clearance of the bacteria. The pneumococcal vaccine included in the Finnish national immunization program in 2010 contains the most common serotypes causing invasive disease. Clinical data suggest that protection from middle-ear infection and possibly also from invasive disease depends largely on the capsular serotype, for reasons hitherto unknown. The general aim of this thesis is to assess the relative roles of the pneumococcal capsule and virulence proteins in complement evasion and subsequent opsonophagocytic killing. The main question is whether differences between serotypes to resist complement explain the different abilities of serotypes to cause disease. The importance of particular virulence factors to the complement resistance of a strain may vary depending on its genotype. Prior studies have evaluated the effect of the capsule and virulence proteins on complement resistance of S. pneumoniae by comparing only a few strains. In this thesis, the role of pneumococcal virulence factors in the complement resistance of the bacterium was studied in several genotypically different strains. The ability of pneumococci to inhibit deposition of the complement protein C3 on the bacterial surface was found to depend on the capsular serotype as well as on other features of the bacteria. The results suggest that pneumococcal histidine triad (Pht) proteins may play a role in complement inhibition, but their contribution depends on the bacterial genotype. The capsular serotype was found to influence complement resistance more than the bacterial genotype. A higher concentration of anticapsular antibodies was required for the opsonophagocytic killing of serotypes resistant to C3 deposition. The invasive serotypes were more resistant to C3 deposition than the opportunistic serotypes, suggesting that the former are better adapted to resist immune mechanisms controlling the development of invasive disease. The different susceptibilities of serotypes to complement deposition, opsonophagocytosis, and resultant antibody-mediated protection should be taken into account when guidelines for serological correlates for vaccine efficacy evaluations are made. The results of this thesis suggest that antibodies in higher quantity or quality are needed for efficient protection against the invasive serotypes.

Epidemiology of candidemia in Finland

Candida species are an important cause of nosocomial bloodstream infections in hospitalized patients worldwide, with associated high mortality, excess length of stay and costs. Main contributors to candidemias is profound immunosuppression due to serious underlying condition or intensive treatments leading to an increasing number of susceptible patients. The rank order of causative Candida species varies over time and in different geographic locations. The aim of this study was to obtain information on epidemiology of candidemia in Finland, to identify trends in incidence, causative species, and patient populations at risk. In order to reveal possible outbreaks and assess the value of one molecular typing method, restriction enzyme analysis (REA), in epidemiological study, we analyzed C. albicans bloodstream isolates in Uusimaa region in Southern Finland during eight years. The data from the National Infectious Disease Register were used to assess the incidence and epidemiological features of candidemia cases. In Helsinki University Central Hospital (HUCH) all patients with blood culture yielding any Candida spp. were identified from laboratory log-books and from Finnish Hospital Infection Program. All the patients with a stored blood culture isolate of C. albicans were identified through microbiology laboratory logbooks, and stored isolates were genotyped with REA in the National Institute for Health and Welfare (former KTL). The incidence of candidemia in Finland is globally relatively low, but increased between between 1990s and 2000s. The incidence was highest in males >65 years of age, but incidence rates for patients <1-15 years were lower during 2000s than during 1990s. In HUCH the incidence of candidemia remained low and constant during our 18 years of observation, but a significant shift in patient-populations at risk was observed, associated with patients treated in intensive care units, such as premature neonates and surgical patients. The predominating causative species in Finland and in HUCH is C. albicans, but the proportion of C. glabrata increased considerably. The crude one-month case fatality was constantly high between 28-33%. REA differentiated efficiently between C. albicans blood culture isolates and no clusters were observed in the hospitals involved, despite of abundant transfer of patients among them. Candida spp. are an important cause of nosocomial blood stream infections in Finland, and continued surveillance is necessary to determine the overall trends and patient groups at risk, and reduce the impact of these infections in the future. Molecular methods provide an efficient tool for investigation of suspected outbreak and should be available in the future in Finland, also.

Identification of TGFβ signaling, p53, and actin stress fibers as targets of LKB1 tumor suppressor activity

Tumorigenesis is a consequence of inactivating mutations of tumor suppressor genes and activating mutations of proto-oncogenes. Most of the mutations compromise cell autonomous and non-autonomous restrains on cell proliferation by modulating kinase signal transduction pathways. LKB1 is a tumor suppressor kinase whose sporadic mutations are frequently found in non-small cell lung cancer and cervical cancer. Germ-line mutations in the LKB1 gene lead to Peutz-Jeghers syndrome with an increased risk of cancer and development of benign gastrointestinal hamartomatous polyps consisting of hyperproliferative epithelia and prominent stromal stalk composed of smooth muscle cell lineage cells. The tumor suppressive function of LKB1 is possibly mediated by 14 identified LKB1 substrate kinases, whose activation is dependent on the LKB1 kinase complex. The aim of my thesis was to identify cell signaling pathways crucial for tumor suppression by LKB1. Re-introduction of LKB1 expression in the melanoma cell line G361 induces cell cycle arrest. Here we demonstrated that restoring the cytoplasmic LKB1 was sufficient to induce the cell cycle arrest in a tumor suppressor p53 dependent manner. To address the role of LKB1 in gastrointestinal tumor suppression, Lkb1 was deleted specifically in SMC lineage in vivo, which was sufficient to cause Peutz-Jeghers syndrome type polyposis. Studies on primary myofibroblasts lacking Lkb1 suggest that the regulation of TGFβ signaling, actin stress fibers and smooth muscle cell lineage differentiation are candidate mechanisms for tumor suppression by LKB1 in the gastrointestinal stroma. Further studies with LKB1 substrate kinase NUAK2 in HeLa cells indicate that NUAK2 is part of a positive feedback loop by which NUAK2 expression promotes actin stress fiber formation and, reciprocally the induction of actin stress fibers promote NUAK2 expression. Findings in this thesis suggest that p53 and TGFβ signaling pathways are potential mediators of tumor suppression by LKB1. An indication of NUAK2 in the promotion of actin stress fibers suggests that NUAK2 is one possible mediator of LKB1 dependent TGFβ signaling and smooth muscle cell lineage differentiation.

Variation i kvinnors namnfraser i officiella dokument i Helsingfors 1780-1930 : Socioonomastiska synvinklar på makt och identitet

This dissertation is an onomastic study of variation in women s name phrases in official documents in Finland during the period 1780−1930. The aim is to discuss from a socio-onomastic perspective both the changeover from patronymics to inherited family names and the use of surnames after marriage (i.e. whether women adopted their husbands family names or retained their maiden names), before new laws in this area entered into force in Finland in the early 20th century. In 1920, a law on family names that required fixed names put an end to the use of the patronymic as a person s only surname. After 1929, it was no longer possible for a married woman to retain her maiden name. Methodologically, to explain this development from a socio-onomastic perspective, I have based my study on a syntactic-semantic analysis of the actual name phrases. To be able to demonstrate the extensive material, I have elaborated a scheme to divide the 115 different types of name phrases into 13 main categories. The analysis of the material for Helsinki is based on frequency calculations of the different types of name phrases every thirtieth year, as well as on describing variation in the structure and semantic content of the name phrases, e.g. social variation in the use of titles and epithets. In addition to this, by applying a biographic-genealogical method, I have conducted two case studies of the usage of women s name phrases in the two chosen families. The study is based on parish registers from the period 1780−1929, estate inventory documents from the period 1780−1928, registration forms for liberty of trade from the period 1880−1908, family announcements on newspapers from the period 1829−1888, gravestones from the period 1796−1929 and diaries from the periods 1799−1801 and 1818−1820 providing a corpus of 5 950 name phrases. The syntactic-semantic analysis has revealed the overall picture of various ways of denoting women in official documents. In Helsinki, towards the end of the 19th century, the use of inherited family names seems to be almost fully developed in official contexts. At the late 19th century, a patronymic still appears as the only surname of some working-class women whereas in the early 20th century patronymics were only entered in the parish register as a kind of middle name. In the beginning of the 19th century, most married women were still registered under their maiden names, with a few exceptions among the bourgeoisie and upper class. The comparative analysis of name phrases in diaries, however, indicates that the use of the husband s family name by married women was a much earlier phenomenon in private contexts than in official documents. Keywords: socio-onomastics, syntactic-semantic analysis, name phrase, patronymic, maiden name, husband s family name