Epigenetic phenotypes distinguish microsatellite-stable and -unstable colorectal cancers

Aberrant DNA methylation is a common phenomenon in human cancer, but its patterns, causes, and consequences are poorly defined. Promoter methylation of the DNA mismatch repair gene MutL homologue (MLH1) has been implicated in the subset of colorectal cancers that shows microsatellite instability (MSI). The present analysis of four MspI/HpaII sites at the MLH1 promoter region in a series of 89 sporadic colorectal cancers revealed two main methylation patterns that closely correlated with the MSI status of the tumors. These sites were hypermethylated in tumor tissue relative to normal mucosa in most MSI(+) cases (31/51, 61%). By contrast, in the majority of MSI(−) cases (20/38, 53%) the same sites showed methylation in normal mucosa and hypomethylation in tumor tissue. Hypermethylation displayed a direct correlation with increasing age and proximal location in the bowel and was accompanied by immunohistochemically documented loss of MLH1 protein both in tumors and in normal tissue. Similar patterns of methylation were observed in the promoter region of the calcitonin gene that does not have a known functional role in tumorigenesis. We propose a model of carcinogenesis where different epigenetic phenotypes distinguish the colonic mucosa in individuals who develop MSI(+) and MSI(−) tumors. These phenotypes may underlie the different developmental pathways that are known to occur in these tumors.

Urinary Biomarkers Indicative of Apoptosis and Acute Kidney Injury in the Critically Ill.

BACKGROUND Apoptosis is a key mechanism involved in ischemic acute kidney injury (AKI), but its role in septic AKI is controversial. Biomarkers indicative of apoptosis could potentially detect developing AKI prior to its clinical diagnosis. METHODS As a part of the multicenter, observational FINNAKI study, we performed a pilot study among critically ill patients who developed AKI (n = 30) matched to critically ill patients without AKI (n = 30). We explored the urine and plasma levels of cytokeratin-18 neoepitope M30 (CK-18 M30), cell-free DNA, and heat shock protein 70 (HSP70) at intensive care unit (ICU) admission and 24h thereafter, before the clinical diagnosis of AKI defined by the Kidney Disease: Improving Global Outcomes -creatinine and urine output criteria. Furthermore, we performed a validation study in 197 consecutive patients in the FINNAKI cohort and analyzed the urine sample at ICU admission for CK-18 M30 levels. RESULTS In the pilot study, the urine or plasma levels of measured biomarkers at ICU admission, at 24h, or their maximum value did not differ significantly between AKI and non-AKI patients. Among 20 AKI patients without severe sepsis, the urine CK-18 M30 levels were significantly higher at 24h (median 116.0, IQR [32.3-233.0] U/L) than among those 20 patients who did not develop AKI (46.0 [0.0-54.0] U/L), P = 0.020. Neither urine cell-free DNA nor HSP70 levels significantly differed between AKI and non-AKI patients regardless of the presence of severe sepsis. In the validation study, urine CK-18 M30 level at ICU admission was not significantly higher among patients developing AKI compared to non-AKI patients regardless of the presence of severe sepsis or CKD. CONCLUSIONS Our findings do not support that apoptosis detected with CK-18 M30 level would be useful in assessing the development of AKI in the critically ill. Urine HSP or cell-free DNA levels did not differ between AKI and non-AKI patients.

Plasma Heme Oxygenase-1 in Patients Resuscitated from out-of-Hospital Cardiac Arrest

Heme oxygenase-1 (HO-1) is an enzyme induced by hypoxia and reperfusion injury, and is associated with organ dysfunction in critically ill patients. Patients resuscitated from out-of-hospital cardiac arrest (OHCA) are subjected to hypoxemia, brain injury, and organ dysfunction. Accordingly, we studied HO-1 among these patients. A total of 143 OHCA patients resuscitated from a shockable initial rhythm and admitted to an ICU were included, with plasma HO-1 measured at ICU admission and at 24 h. We analyzed the associations between plasma HO-1 and time to return of spontaneous circulation (ROSC), 90-day mortality, and 12-month Cerebral Performance Category (CPC). HO-1 plasma concentrations were higher after OHCA compared with controls. HO-1 concentrations at admission and on day 1 associated with ROSC (P = 0.002 to P = 0.003). Admission and day 1 HO-1 plasma concentrations were higher in 90-day non-survivors than in survivors (P = 0.017, 0.026). In addition, poor neurological outcome (CPC 3-5) was associated with higher HO-1 plasma levels at admission (P = 0.024). Admission plasma HO-1 levels had an AUC of 0.623 to predict 90-day mortality and an AUC of 0.611 to predict CPC 3 to 5. In conclusion, we found that higher HO-1 plasma levels are associated with longer ROSC and poor long-term outcome.

(Table 1) Stable oxygen and carbon isotopic ratios of tree rings, and tree ring width of white spruce (Picea glauca), Ennadai Lake

Stable isotope ratios from tree rings and peatland mosses have become important proxies of past climate variations. We here compare recent stable carbon and oxygen isotope ratios in cellulose of tree rings from white spruce (Picea glauca), growing near the arctic tree line; and cellulose of Sphagnum fuscum stems, growing in a hummock of a subarctic peatland, in west-central Canada. Results show that carbon isotopes in S. fuscum correlate significantly with July temperatures over the past ~20 yr. The oxygen isotopes correlate with both summer temperature and precipitation. Analyses of the tree-ring isotopes revealed summer temperatures to be the main controlling factor for carbon isotope variations, whereas tree-ring oxygen isotope ratios are controlled by a combination of spring temperatures and precipitation totals. We also explore the potential of combining high-frequency (annual) climate signals derived from long tree-ring series with low-frequency (decadal to centennial) climate signals derived from the moss remains in peat deposits. This cross-archive comparison revealed no association between the oxygen isotopes, which likely results from the varying sensitivity of the archives to different seasons. For the carbon isotopes, common variance could be achieved through adjustments of the Sphagnum age model within dating error.

Teiskon maiseman- ja luonnonhoidon yleissuunnitelma

Perinteisen karjatalouden muovaamat perinnebiotoopit, kuten kedot, niityt, hakamaat ja metsälaitumet, ovat monimuotoisimpia luontoympäristöjämme. Hoidon myötä arvokkaat maisemat säilyvät avoimina. Härkää sarvista on ylimaakunnallinen hanke, jonka tavoitteena on arvokkaiden kohteiden laidunnushoidon järjestäminen. Tampereen Teisko on valittu yhdeksi hankkeen kohdealueista, joille on laadittu maiseman- ja luonnonhoidon yleissuunnitelma. Yleissuunnitelmassa ovat mukana arvokkaat perinnebiotoopit, jotka on inventoitu 1990-luvulla. Lisäksi mukaan on valittu kohteita, jotka ovat lajistoltaan monimuotoisia, riittävän suuria laidunnuskohteiksi tai sijaitsevat maisemallisesti keskeisillä paikoilla. Suunnitelma sisältää tietoa hoitomenetelmistä ja rahoitusmahdollisuuksista, ja niistä on myös tiedotettu suunnittelun aikana. Tavoitteena on saada kohteita hoidon piiriin, innostaa maanomistajia ja löytää kohteille hoitajiksi karjatilallisia ja paikallisia yhdistyksiä. Mahdolliset hoitotoimenpiteet perustuvat täysin vapaaehtoisuuteen. Hankkeen puitteissa voidaan avustaa kohteiden hoidon suunnittelussa ja rahoitusten hakemisessa. Yleissuunnittelun maastotyöt ja tiedotus toteutettiin kesän ja syksyn 2010 aikana. Härkää sarvista- hankkeen toiminta-aika on 1.6.2009–31.5.2012. Hanketta toteuttavat Keski-Suomen, Pirkanmaan, Etelä-Pohjanmaan ja Etelä-Savon ELY-keskukset sekä alueelliset ProAgriat.

Permanent Public Access for Citizens - Finnish Government Publications on a Repository Platform

Poster presented at Open Repositories 2016 in Dublin, Ireland, June 14, 2016

Seksuaalivähemmistöihin kuuluvat opettajat heteronormatiivisuutta murtamassa

Tämän tutkimuksen tarkoituksena oli ottaa selvää seksuaalivähemmistöihin kuuluvien opettajien kokemuksista kouluyhteisöissä. Keskeisimpiä tutkittavia asioita olivat, ovatko seksuaalivähemmistöihin kuuluvat opettajat avoimia seksuaalisesta suuntautumisestaan, miten kollegat, esimiehet, oppilaat ja vanhemmat ovat haastateltavien mielestä asiaan suhtautuneet ja pyrkivätkö seksuaalivähemmistöihin kuuluvat opettajat horjuttamaan heteronormatiivista koulumaailmaa. Tutkimus on luonteeltaan laadullinen, ja sen aineisto hankittiin teemahaastattelujen avulla. Haastattelujoukko koostuu 11 eri-ikäisestä ja eri puolella Suomea opettavista seksuaalivähemmistöihin kuuluvista opettajista. Tutkimusaineisto analysoitiin sisällönanalyysin keinoin teemoittelemalla. Tutkimuksen kaikki haastateltavat olivat avoimia seksuaalisesta suuntautumisestaan kollegoilleen. Rehtorille kertomista harkittiin enemmän, ja vain muutama opettaja oli kertonut asiasta oppilailleen. Pääosin opettajat olivat kohdanneet neutraaleja tai positiivisia reaktioita asian kertomisen yhteydessä. Suurin syy, miksi oppilaille haluttiin olla avoimia tai ainakin mietittiin avoimempaa linjaa, oli heteronormatiivisuuden murtaminen sekä halu tarjota roolimalli seksuaalivähemmistöihin kuuluville nuorille. Tutkimuksen tavoitteena on nostaa aihe tietoisen pohdinnan alaisuuteen ja sitä kautta parantaa seksuaalivähemmistöihin kuuluvien opettajien ja oppilaiden hyvinvointia. Vastauksissa nousi esille, että opettajankoulutus ei tarjoa tietoa asian käsittelemiseen. Tuloksia voidaankin hyödyntää myös opettajankoulutuksen sisältöjen päivittämisessä.

Development of business processes and sales reporting - Case recovered paper

The purpose of this research is to discover development points for business processes and sales reporting in the recovered paper sourcing organization. The processes under development are both sales and sourcing processes that were determined by the commissioning company. All of these processes have in common that there are used sales orders to organize the money flows correctly. Although the main objective is to source only recovered paper, the sourcing also brings by-products that cannot be utilized and are thus sold. As the purpose of the sales function is to only support the sourcing strategy, it should be organized as efficiently as possible. Investigating the current status of the processes and finding development points help in building proposals for enhanced process descriptions. In order that sales function could be analyzed, should the sales reporting be accurate and present the needed key figures. The current status of the processes as well as the possible problems and development ideas were researched with the help of interviews. Best practices could also be brought from other business lines in the commissioning company. The theory part was build according to relevant literature and scientific articles. The research indicates, that processes have shaped differently in sourcing organization’s business units. Local infrastructure and legislation sets certain limitations to the sourcing of recovered paper, and these circumstances cannot be changed. Customer-supplier power relations also affect to the formulation of business processes. In order to steer the processes, there has to be more internal controls. Still, the enterprise resource planning system also sets boundaries how the processes can be made more efficient.

Kommunala riktlinjer för anhöriganställningar : En kvalitativ innehållsanalys med feministisk teoriansats

Det övergripande syftet var att undersöka kommunala riktlinjer för anhöriganställningar tillgängliga på kommunernas hemsidor, dvs regeldokument gällande situationer där en anhörig anställs för att vårda en närstående. Det övergripande syftet har byggts upp utifrån följande tre frågeställningar angående hur kommunerna i Sverige beskriver: 1) vilka situationer som berättigar anhöriganställning, 2) hur det säkerställs att den äldre personen skall få sina behov tillgodosedda samt 3) hur säkerställs den anhöriganställdes rättigheter/välmående? Det saknas lagstöd för anhöriganställningar som rättighet, och det kommunala självstyret avgör om kommunen erbjuder denna omsorgsform. På senare tid har anhöriganställningar begränsats och förbjudits i flera svenska kommuner, och enligt uppgifter är det cirka 55–65 % av Sveriges kommuner som tillåter anhöriganställningar. Det är mestadels kvinnor med utländsk bakgrund som är anhöriganställda numera, och feministisk omsorgsforskning och media lyfter fram anhöriganställningar som en kvinnofälla och som en risk för integration av invandrare. I studien inkluderas riktlinjer från totalt 21 kommuner, vilka analyserades med kvalitativ innehållsanalys enligt Elo & Kyngäs (2007). De undersökta riktlinjerna hittades från hemsidorna för Sveriges 121 medelstora och stora kommuner (mer än 20 000 invånare). Resultatet har bearbetats med hjälp av feministisk teori (Hirdman 2012). Resultatet visar att det överlag finns få riktlinjer tillgängliga i Sveriges kommuner och att regelverken skiljer sig åt i de olika kommunerna.  I de riktlinjer som finns är ofta innehållet allmänna eller oklara beskrivningar. En slutsats är därför att många kommuner säkerställer sitt eget handlingsutrymme och ett tolkningsföreträde genom otydliga och allmänt hållna regler i sina riktlinjer. Utifrån ett feministiskt perspektiv kan dessa tolkningsföreträden skapa orättvisa strukturer och skillnader i förutsättningar och villkor för de äldre och för deras anhörigvårdare avseende anhöriganställningar. Slutligen visar resultatet på att de få detaljerade beskrivningarna prioriterar de äldres rättigheter framför de anhöriganställdas. Säkerställandet av de anhöriganställdas rättigheter beskrivs huvudsakligen att ske genom att kontrollera och styra de anhöriganställda. De anhöriganställda är ofta osynliga i riktlinjerna, betraktas som pseudoanställda och hamnar därför mellan stolarna vad gäller stödbehovet (Sand 2010).

Analysis of Needs and Resources

The initial aim of the CareMan project was to develop a joint degree programme that combined and utilised the strengths of the five collaborating universities that were already involved in delivering social and health care management education. Because the project was to be implemented in collaboration between education- al institutions, the collaboration had to be based on a detailed understanding of the national and institutional specifics of each of the individual academic enti- ties. During this process it was recognised that, due to a number of regulation issues, achieving the original aim would not be possible; ultimately, following a series of analytical works, which are presented below, it was decided that a set of three master’s level modules should be developed. One of the reasons was that the Finnish law on master’s degrees at universities of applied sciences (UAS) stated that the requirement for entry to a UAS master’s programme was a bachelor degree from a UAS or equivalent, plus a minimum of three years of work experience in an appropriate field. The three years’ work experience is also required from international students. In practice this meant that the participating Finnish UASs, Lahti and HAMK, could not award a diploma for foreign students without this work experience. The other European universities do not have the work experience requirement, although some take it as a bonus for admission (FHS UK). There were also other differences in law (e.g., requirements for mini - mum standards in Social Work education at FHS UK) that could not have been overcome during the period of project realisation. Consequently, the outcome was the development of only three common educational modules, each for 10 ECTS, which were developed, delivered and assessed during the lifetime of the project. The intention was that these would be integrated into the current masters’ level provision in each of the universities