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Sustainable work aims at improving working conditions to allow workers to effectively extend their working life. In this context, occupational safety and well-being are major concerns, especially in labor-intensive fields, such as construction-related work. Internet of Things and wearable sensors provide for unobtrusive technology that could enhance safety using human activity recognition techniques, and has the potential of improving work conditions and health. However, the research community lacks commonly used standard datasets that provide for realistic and variating activities from multiple users. In this article, our contributions are threefold. First, we present VTT-ConIoT, a new publicly available dataset for the evaluation of HAR from inertial sensors in professional construction settings. The dataset, which contains data from 13 users and 16 different activities, is collected from three different wearable sensor locations. Second, we provide a benchmark baseline for human activity recognition that shows a classification accuracy of up to 89% for a six class setup and up to 78% for a sixteen class more granular one. Finally, we show an analysis of the representativity and usefulness of the dataset by comparing it with data collected in a pilot study made in a real construction environment with real workers.

Recombinant sequences of the SARS-CoV-2 Omicron variant were detected in surveillance samples collected in north-western Finland in January 2022. We detected 191 samples with an identical genome arrangement in weeks 3 to 11, indicating sustained community transmission. The recombinant lineage has a 5’-end of BA.1, a recombination breakpoint between orf1a and orf1b (nucleotide position 13,296–15,240) and a 3’-end of BA.2 including the S gene. We describe the available genomic and epidemiological data about this currently circulating recombinant XJ lineage.

The current epidemics of cardiovascular and metabolic noncommunicable diseases have emerged alongside dramatic modifications in lifestyle and living environments. These correspond to changes in our ”modern” postwar societies globally characterized by rural-to-urban migration, modernization of agricultural practices, and transportation, climate change, and aging. Evidence suggests that these changes are related to each other, although the social and biological mechanisms as well as their interactions have yet to be uncovered. LongITools, as one of the 9 projects included in the European Human Exposome Network, will tackle this environmental health equation linking multidimensional environmental exposures to the occurrence of cardiovascular and metabolic noncommunicable diseases.

Objective: Telomeres are DNA–protein complexes that protect chromosome ends from DNA damage and are surrogate biomarkers of cellular aging. Current evidence, almost entirely from cross-sectional observations, supports negative associations between leukocyte telomere length (LTL) and adverse lifestyle factors and cardiometabolic risk factors. Polycystic ovary syndrome (PCOS), the most common gynecological endocrine disorder, is associated with inflammation and oxidative stress, both factors associated with accelerated telomere attrition. We therefore hypothesized that LTL would be shorter and decrease more rapidly in women with PCOS in comparison to a control population. Design: This is a population-based cohort study comprising women of Northern Finland Birth Cohort 1966, with clinical examinations at ages 31 and 46. The sample included self-reported PCOS (age 31, n = 190; age 46, n = 207) and referent women (age 31, n = 1054; age 46, n = 1324) with data on LTL. Methods: The association between LTL and PCOS at ages 31 and 46 was analyzed by linear regression models adjusted for BMI, smoking, alcohol consumption and socioeconomic status at the corresponding age. Results: Women with PCOS had similar mean LTL at ages 31 and 46 (P > 0.4 for both). The mean LTL change between ages 31 and 46 did not differ between groups (P = 0.19). However, we observed a significant LTL attrition between ages 31 and 46 in the reference population (P

Idiopathic Pulmonary Fibrosis (IPF) is a rare disease with poor prognosis. By contrast, cancer is common in any elderly population and a leading killer, but is now often curable. Of note, whereas IPF is driven by cellular senescence, cancer is characterized by uncontrolled cell division.Using data available from two large biobank-based studies (Finnish FinnGen study and UK biobank), we conducted a comprehensive analysis of the shared genetic background of IPF and cancer. In a population sample of 218,792 Finns with complete longitudinal health histories, we estimated the effect of individual genetic variants to the lifetime risk of IPF and cancer. We extend the analysis from IPF-GWAS to pan-cancer meta-analysis over FinnGen and UK Biobank and finally to the identification of genetic drivers of somatic chromosomal alterations.We detected six loci (SPDL1, MAD1L1, MAP2K1, RTEL1-STMN3, TERC-ACTRT3, OBFC1) associated with both IPF and cancer, all closely related to cellular division. However, each individual signal is found with opposite effects over the two diseases, termed as antagonistic pleiotropy. Several of these loci (TERC-ACTRT3, RTEL1-STMN3, OBFC1) are among the strongest inherited factors for constitutive telomere length variation and consistently indicate that shorter telomere length would increase the risk for IPF but protect from malignancy. However, a Finnish enriched SPDL1 missense variant and a common MAD1L1 intronic variant had no effect on telomere length but were shown to protect individuals from accumulation of somatic mutations.The decreased risk of cancer in SPDL1 and MAD1L1 variant carriers might result from a lower number of chromosomal alterations accumulated over time, conversely leading to fibrosis in the lung due to cellular senescence-induced inflammation. We hypothesize that the SPDL1 missense variant functions as gain-of-function mutation, leading to cellular senescence, a barrier to cancer and a driver of fibrosis in IPF. If translated to therapy, these findings might not only be able to offer relief to individuals with IPF, but also to protect from onset of cancer.

Background/Aim: Prompted by the increasing demand of non-invasive diagnostic tools for screening of gastric cancer (GC) risk conditions, i.e., atrophic gastritis (AG) and Helicobacter pylori (Hp) infection, the GastroPanel® test (GP: biomarker panel of PGI, PGII, G‐17, Hp IgG ELISA) that was developed in the early 2000’s, was recently updated to a new-generation (unified GP) test version. This clinical validation study evaluated the diagnostic accuracy of the new-generation GP test in detection of AG and Hp among gastroscopy referral patients in a University Clinic. Patients and Methods: Altogether, 522 patients were enrolled among the patients referred for gastroscopy at the Gastro Center, Oulu University Hospital (OUH). All patients underwent gastroscopy with biopsies classified using the Updated Sydney System (USS), and blood sampling for GP testing. Results: Biopsy-confirmed AG was found in 10.2% (53/511) of the patients. The overall agreement between the GP and the USS classification was 92.4% (95%CI=90.0‐94.6%), with the weighted kappa (κw) of 0.861 (95%CI=0.834‐0.883). In ROC analysis using moderate/severe AG of the corpus (AGC2+) as the endpoint, AUC=0.952 (95%CI=0.891‐1.000) and AUC=0.998 (95%CI=0.996‐1.000) for PGI and PGI/PGII, respectively. Hp IgG antibody ELISA detected biopsy-confirmed Hp-infection with AUC=0.993 (95%CI=0.987‐0.999). Conclusion: The new generation GastroPanel® is a precise test for non-invasive diagnosis of atrophic gastritis and Hp-infection in dyspeptic patients referred for diagnostic gastroscopy.

Background: It is uncertain if functional dyspepsia (FD) or irritable bowel syndrome (IBS) are linked to smoking, and smoking cessation is not part of the routine advice provided to these patients. Aim: To assess if smoking is an independent risk factor for FD and IBS. Methods: Three population-based endoscopy studies in Sweden with 2560 community individuals in total (mean age 51.5 years, 46% male). IBS (14.9%), FD (33.5%), and associated symptoms were assessed using the validated abdominal symptom questionnaire, and smoking (17.9%) was obtained from standardised questions during a clinic visit. The effect of smoking on symptom status was analysed in an individual person data meta-analysis using mixed effect logistic regression, adjusted for snuffing, age and sex. Results: Individuals smoking cigarettes reported significantly higher odds of postprandial distress syndrome (FD-PDS) (OR 10–19 cig/day = 1.42, 95% CI 1.04–1.98 P = 0.027, OR ≥20 cig/day = 2.16, 95% CI 1.38–3.38, P = 0.001) but not epigastric pain. Individuals smoking 20 or more cigarettes per day reported significantly higher odds of IBS-diarrhoea (OR = 2.40, 95% CI 1.12–5.16, P = 0.025), diarrhoea (OR = 2.01, 95%CI 1.28–3.16, P = 0.003), urgency (OR = 2.21, 95%CI 1.41–3.47, P = 0.001) and flatus (OR = 1.77, 95%CI 1.14–2.76, P = 0.012) than non-smokers. Smoking was not associated with IBS-constipation or IBS-mixed. Conclusions: Smoking is an important environmental risk factor for postprandial distress syndrome, the most common FD subgroup, with over a twofold increased odds of PDS in heavy smokers. The role of smoking in IBS-diarrhoea, but not constipation, is also likely important.

Motivation: Ageing is a biological and psychosocial process related to diseases and mortality. It correlates with changes in DNA methylation (DNAm) in all human tissues. Therefore, epigenetic markers can be used to estimate biological age using DNAm profiling across tissues. Results: We developed a Bioconductor package that allows computation of several existing DNAm adult/childhood and gestational age clocks. Functions to visualize the DNAm age prediction versus chronological age and the correlation between DNAm clocks are also available as well as other features, such as missing data imputation of cell types’ estimates, that are required for DNAm age clocks. Availability and implementation: https://github.com/isglobal-brge/methylclock

Introduction: The concept of gut-to-brain communication via microbial or inflammatory pathways is gaining increased attention but genuine pathology directly linking gut perturbation to anxiety is lacking. We hypothesized that duodenal eosinophilia, as known to occur in functional dyspepsia (FD), may be an underlying cause of anxiety and may help explain the striking association between FD and anxiety. Methods: Randomly selected subjects from the national population register of Sweden completed the validated Abdominal Symptom Questionnaire; 1000 completed esophagogastroduodenoscopy and the Hospital Anxiety and Depression Scale questionnaire. Duodenal biopsies were obtained from 1st (D1) and 2nd portion (D2). Eligible subjects who underwent endoscopy (n = 887) were invited to participate in a 10-year follow-up study with the same questionnaires. Among endoscopy normal subjects, FD was identified by Rome criteria, and controls were symptom free. Duodenal eosinophilia was based on pre-defined cut-offs. Finding are reported as odds ratios (ORs) with 95% confidence interval and p-value. Results: The study population comprised 89 cases with FD and 124 healthy controls (mean age 62 years, SD 12, 34% male). Clinical anxiety at follow-up was elevated in those with D1 eosinophilia at baseline considering either new-onset anxiety (OR = 4.5, 95% CI 0.8, 23.8; p = 0.08) or follow-up anxiety adjusting for baseline anxiety (OR = 4.51 (95% CI 1.03, 19.81; p = 0.046). Conclusions: Duodenal eosinophilia may potentially be a mechanism linked to anxiety independent of FD.

Whilst intraepithelial lymphocytes (IELs) are considered normal within the distal esophageal mucosa, they have an increasingly recognised role in the pathogenesis of reflux esophagitis, and IEL quantification establishes the diagnosis of lymphocytic esophagitis. Knowledge regarding the upper limit of a normal IEL count in health is lacking. We studied 117 non-healthcare seeking adult volunteers from a random community sample (the Kalixanda study) with esophageal biopsies 2 cm above the gastroesophageal junction. Subjects were divided into four groups based on the presence or absence of gastro-esophageal reflux symptoms and/or esophagitis on endoscopy. Asymptomatic subjects with no endoscopic esophagitis were selected as controls, and the cell counts in this group were used to define the upper limit of normal of IELs, eosinophils and neutrophils. The entire sample was used to identify independent predictors of increased cellular counts by logistic regression analysis. None of the healthy controls had an IEL count of more than three per five high power fields (HPF), and therefore this was considered as the upper limit of normal; no controls had eosinophils or neutrophils in esophageal biopsies. Independent predictors of an elevated IEL count were spongiosis on histology (OR 11.17, 95% CI 3.32–37.58, P < 0.01) and current smoking (OR 4.84, 95% CI 1.13–2.71, P = 0.03). A receiver operating characteristics analysis concluded that a threshold of 3 IELs/5HPFs performs best in predicting reflux symptoms when a normal esophageal mucosa is visualized on endoscopy (sensitivity = 100.0%, specificity = 35.2%). The healthy esophageal mucosa does not contain more than three IELs per five HPF in the distal esophagus.

Background: It is unexplained why functional dyspepsia and gastro‐oesophageal reflux disease (GERD) overlap more often than expected by chance. Post‐prandial distress syndrome has been linked to impaired gastric fundic accommodation which may induce increased transient lower oesophageal sphincter relaxations and consequent GERD. Duodenal eosinophilia has been linked to functional dyspepsia and post‐prandial distress syndrome. Aim: To identify if there is an association between duodenal eosinophilia in functional dyspepsia and symptoms of GERD and whether post‐prandial distress syndrome or epigastric pain syndrome are associated with new onset GERD. Methods: Participants (n = 1000) were randomly selected from the national Swedish population register and surveyed by questionnaires and oesophagogastroduodenoscopy in 1999‐2001. All eligible subjects (n = 887) were invited to a follow‐up study in 2010 (response rate 79%). In a case‐control study of 213 subjects (functional dyspepsia vs healthy controls), histology from the duodenum was evaluated at baseline and the possible association of eosinophilia to new onset GERD symptoms was analysed. Results: Functional dyspepsia (OR 7.6; 95% CI 2.93‐19.4, P < 0.001) and post‐prandial distress syndrome at baseline (OR 9.0, 95% CI 3.36‐24.0, P < 0.001) were associated with an increased risk of GERD at follow‐up. Eosinophilia in the second part of duodenum only was independently associated with an increased risk of GERD amongst those with functional dyspepsia (OR 4.2; 95% CI 1.2‐4.77, P = 0.024) and post‐prandial distress syndrome at baseline (OR 6.0; 95% CI 1.50‐23.6, P = 0.011), respectively. Conclusions: Duodenal eosinophilia is associated with increased risk of GERD at 10‐year follow‐up in those with functional dyspepsia and post‐prandial distress syndrome at baseline. Duodenal eosinophilia may explain the link between GERD and functional dyspepsia, suggesting subsets of functional dyspepsia and GERD may be part of the same disease spectrum.

Tutkimuksessa selvitettiin Oulun teknisen liikelaitoksen Konepalveluiden korjaamon ja metallirakennetoiminnan nykytilaa ja toimintaa. Vuoteen 2020 asetetut tavoitteet liikelaitoksen toiminnalle supistaa omaa osuutta palveluntuottamisessa. Tämä vähentää liikelaitoksen henkilöstön ja tilojen määrää sekä muuttaa toimintatapoja. Tutkimuksessa kartoitettiin liikelaitoksen käytössä oleva ajoneuvo- ja työkonekalusto sekä sen määrä ja laatu. Suunniteltujen huoltotilojen ja -toiminnan tulee vastata kaluston tarpeita. Huoltotilojen toiminta tuli suunnitella jäljelle jääviin tukikohtiin missä olemassa olevat kiinteistöt varustellaan käyttöön. Kirjallisuustutkimuksessa perehdyttiin kunnossapidon sisältämään toimintaan ja layout suunnitteluun liittyviin asioihin. Kirjallisuustutkimuksessa lisäksi haastateltiin liikelaitoksen henkilöstöä heidän yksikkönsä toiminnasta ja näkemyksestä Konepalveluiden toiminnasta. Tutkimuksen aikana kartoitettiin huollettavaa kalustoa ja huoltotehtävissä tarvittavaa laitteistoa, työskentelyn ohessa. Olemassa oleva kalustokanta on laaja ja monimerkkinen sekä osaltaan ikääntynyt. Kaluston huolto-, korjaus- ja muutostöiden osalta dokumentointi on ollut vajavaista ja tiedon löytäminen on vaikeaa. Huolto- ja korjaustöiden tekeminen omana työnä toimii, mutta huoltojen ajoittaminen, ajanvaraus ja tarviketilaukset ovat puutteellisia. Tutkimuksen tuloksena laadittiin layoutsuunnitelmat Kiilletielle sijoitetusta ajoneuvojen ja raskaan kaluston huoltotiloista sekä Poratie–Sorvitielle sijoittuvasta pienkonehuoltotiloista. Huolto- ja korjaustöihin liittyviin ongelmakohtiin on esitetty ratkaisuja mitä käyttämällä voidaan helpottaa ja tehostaa töiden suorittamista sekä dokumentointia. In this study the present conditions and operations of the Oulu Technical Services Public Utility of Machine Service unit workshop and metallurgical operations were researched. The goals set to be reached by 2020 for the operation of the Oulu Technical Services Public Utility will reduce their share of service delivery. This reduces the number of staff and facilities, as well as changes the way it operates. One part of the study was to determine the number of vehicles and construction machinery utilized by Oulu Technical Services Public Utility as well as the quality of vehicles. Planned maintenance facilities and operations should meet the needs of the vehicles. The operation of the maintenance facilities had to be planned for the remaining locations where existing properties were equipped for the specific need. In the literature study were the studied issues concerning the maintenance activities and layout design. In addition to the study the staffs of Oulu Technical Services Public Utility were interviewed about their unit’s operations and their views on the operation of Machine Service unit. During the research were surveyed the maintenance equipment and the equipment needed for maintenance work. The existing assortment of machinery is broad and consists of large number of brands. Parts of the vehicles are also aging. The documentation concerning maintenance, repair and modification actions has been incomplete and it finding information has proved to be difficult. Maintenance and repair tasks work out run independently, but task scheduling as well as booking and supply order systems are inadequate. As a result, layout plans for Kiilletie vehicle and heavy duty maintenance facilities and small machine maintenance facilities located in Poratie–Sorvitie are provided. Solutions for problems related to maintenance and repair work are also presented. Using these solutions the execution of the tasks and documentation will be easier and more efficient.

Introduction: Eosinophilic esophagitis (EoE) is one of the most prevalent esophageal diseases and the leading cause of dysphagia and food impaction in children and young adults. This underlines the importance of optimizing diagnosys and treatment of the condition, especially after the increasing amount of knowledge on EoE recently published. Therefore, the UEG, EAACI ESPGHAN, and EUREOS deemed it necessary to update the current guidelines regarding conceptual and epidemiological aspects, diagnosis, and treatment of EoE. Methods: General methodology according to the Appraisal of Guidelines for Research and Evaluation (AGREE) II and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used in order to comply with current standards of evidence assessment in formulation of recommendations. An extensive literature search was conducted up to August 2015 and periodically updated. The working group consisted of gastroenterologists, allergists, pediatricians, otolaryngologists, pathologists, and epidemiologists. Systematic evidence-based reviews were performed based upon relevant clinical questions with respect to patient-important outcomes. Results: The guidelines include updated concept of EoE, evaluated information on disease epidemiology, risk factors, associated conditions, and natural history of EoE in children and adults. Diagnostic conditions and criteria, the yield of diagnostic and disease monitoring procedures, and evidence-based statements and recommendation on the utility of the several treatment options for patients EoE are provided. Recommendations on how to choose and implement treatment and long-term management are provided based on expert opinion and best clinical practice. Conclusion: Evidence-based recommendations for EoE diagnosis, treatment modalities, and patients’ follow up are proposed in the guideline. © 2017, © Author(s) 2017.

Obesity is associated with greater risk of several diseases, such as type 2 diabetes and metabolic syndrome. Single nucleotide polymorphisms (SNP) within the fat mass- and obesity-associated gene FTO are robustly associated with increased body mass index (BMI) in several age and ethnic groups. Studies with transgenic mice support a mechanistic role for FTO protein in energy metabolism. Fto-deficient mice are leaner than wild-type and overexpression of Fto leads to obese phenotype; however, the precise mechanism of FTO action in the control of BMI has remained obscure. Fto mRNA is most abundant in the brain while high expression is present also in white and brown adipose tissues (WAT and BAT, respectively). WAT stores the nutritional energy and BAT dissipates it to produce heat. Furthermore, these organs participate in a complex endocrine network affecting the whole body metabolism, which is more or less disrupted in obesity. In the browning process, white adipocytes begin to manifest brown characteristics. MicroRNAs (miRNA) are small RNA molecules, which fine-tune post-transcriptionally the expression of genes important in several cellular processes, including WAT and BAT differentiation and browning of WAT. FTO has been shown to participate in these processes as well as miRNA regulation. The current study used a new Fto-deficient mouse model to reveal deeper insights into the role of Fto on genes affecting WAT and BAT differentiation and function, as well as WAT browning. Furthermore, the effects of Fto on the miRNA regulation in WAT browning and BAT were investigated. Our results supported a role for Fto in adipose tissue. Fto-deficient mice were resistant to diet-induced obesity and their WAT and BAT adipocytes did not become hypertrophic similar to wild-type on high-fat diet. Furthermore, the expression of genes affecting adipose tissue differentiation and function was altered in Fto-deficient WAT and BAT, especially after high-fat diet, and the changes may be mediated via altered miRNA expression. Fto-deficient WAT was more susceptible to browning, which in part contributed to the lean phenotype of these mice. Current study supported a role for Fto in whole body metabolism and adaptation of adipose tissue to changes in dietary environment. Tiivistelmä Lihavuus on toistuvasti yhdistetty useisiin liitännäissairauksiin, kuten tyypin 2 diabetekseen ja metaboliseen oireyhtymään. FTO-geenissä (fat mass- and obesity-associated) esiintyvien yhden nukleotidin muutoksien (single nucleotide polymorphia, SNP) on useissa ikä- ja etnisissä ryhmissä raportoitu liittyvän korkeampaan painoindeksiin ihmisillä. Muuntogeenisillä hiirillä tehdyt tutkimukset tukevat FTO:n mekanistista roolia energia-aineenvaihdunnassa, sillä Fto-poistogeeniset hiiret ovat villityypin hiiriä laihempia ja sen yliekspressio johtaa ylipainoon. FTO:n tarkka rooli painon säätelyssä on kuitenkin vielä epäselvä. Fto:ta tuotetaan eniten aivoissa, mutta myös valkoisessa ja ruskeassa rasvassa. Valkoinen rasva varastoi ravinnosta saatavan energian ja ruskea hajottaa sitä lämmöntuotantoon. Näillä kudoksilla on lisäksi tärkeä rooli energia-aineenvaihdunnan monimutkaisessa verkostossa. Valkoisen rasvakudoksen ruskettumisprosessissa valkoiset rasvasolut alkavat muistuttaa ruskeita rasvasoluja. Mikro-RNA:t (miRNA) ovat pieniä RNA-juosteita, jotka hienosäätävät geenien ekspressiota transkription jälkeen ja vaikuttavat useisiin solun tärkeisiin tapahtumiin, myös valkoisen ja ruskean rasvasolun erilaistumiseen ja ruskettumiseen. FTO osallistuu näihin prosesseihin sekä miRNA-säätelyyn. Tämän tutkimuksen tavoitteena oli selventää Fto:n roolia valkoisen ja ruskean rasvakudoksen erilaistumisessa ja toiminnassa Fto-poistogeenisen hiirimallin avulla. Lisäksi selvitettiin Fto:n vaikutuksia valkoisen rasvan ruskettumiseen ja ruskean rasvan toimintaan osallistuvien miRNA:iden säätelyyn. Tulokset tukivat FTO:n roolia rasvakudoksessa. Fto-poistogeeniset hiiret eivät lihoneet rasvaisella ruokavaliolla eivätkä niiden rasvasolut varastoineet rasvaa yhtä paljon kuin villityypin hiirillä rasvaisen ruokavalion jälkeen. Lisäksi Fto-poistogeenisen rasvakudoksen erilaistumiseen ja toimintaan liittyvien geenien esiintyvyys muuttui erityisesti rasvaisella ruokavaliolla. Nämä muutokset voivat osittain selittyä muuttuneella miRNA-säätelyllä. Tulokset viittasivat siihen, että Fto-poistogeeninen valkoinen rasvakudos oli alttiimpaa ruskettumiselle, mikä osaltaan vaikutti Fto-poistogeenisten hiirten laihuuteen. Tutkimus tuki Fto-geenin roolia energia-aineenvaihdunnan säätelyssä sekä rasvakudoksen mukautumisessa ruokavalion muutoksiin.

Tässä opinnäytetyössä tarkastellaan matkailualan yritysyhteistyötä periferian näkökulmasta. Tarkoitus on tutkia yhteistyöhön liittyviä vaikutuksia sekä sitä millaisia esteitä periferian ja ytimen matkailuyritysten välillä mahdollisesti on. Esimerkkitapauksena käytetään kuusamolaisia yrityksiä Rukan matkailukeskuksen ulkopuolelta. Työssä selvitetään niin matkailusta välillisesti hyötyvien yritysten kuin varsinaisten matkailuyritystenkin näkemyksiä yhteistyöstä matkailun ydinalueen kanssa. Työn teoreettinen viitekehys pohjautuu matkailukehityksen teoriaan ja sen suhteeseen etenkin alueelliseen talouskehitykseen. Matkailupalvelujen klusteroituminen alueellisesti luo osaltaan matkailun ydinalueita, jotka kehittyvät periferiasta erillään. Aluetaloudessa matkailu voidaan nähdä tärkeänä voimavarana, mutta sen tuomat positiiviset vaikutukset voivat jäädä pelkästään ydinalueelle. Sekä matkailutoimialan sisäistä että matkailun ja eri elinkeinojen välistä yhteistyötä tarkastellaan keinona levittää matkailun vaikutuksia laajemmalle ytimen ulkopuolelle. Yritysyhteistyön kautta on mahdollista lisätä matkailun aluetaloudellisia vaikutuksia periferiassa. Tutkimuksen aineisto koostuu kahdesta osasta. Ensimmäinen aineisto on kvalitatiivinen ja siihen sisältyy kahdeksan matkailusta välillisesti hyötyvän poro-, kala- ja luonnontuotealan yrityksen haastattelua. Fenomenografista tutkimusotetta hyödyntäen haastattelut analysoitiin muun muassa teemoittelun avulla. Toisena aineistona on kvantitatiivinen kyselyaineisto. Postikyselyyn vastasi 41 matkailusta välittömästi hyötyvää majoitus- ja ravitsemusalan sekä ohjelma- ja liikennepalvelualan yritystä. Tätä aineistoa analysoitiin tilastollisin menetelmin. Tutkimustulosten perusteella Kuusamossa uskotaan yritysyhteistyön hyötyihin. Paikallisella yhteistyöllä voidaan lisätä matkailutuotteiden arvoa. Tämän hetkinen yritysten välinen yhteistyö on useimmiten mainontaan ja markkinointiin, tai ostoihin ja myyntiin liittyvää. Yhteistä tuotekehitystä paikallisten tuottajien ja matkailuyritysten kesken on vielä suhteellisen vähän. Esteinä yhteistyössä ovat niin yritysten sisäiset tekijät, kuten yrittäjän tiedon tai ajan puute tai korkea ikä, kuin ulkoisetkin, kuten ketjuyritysten lisääntyminen, logistiset ongelmat tai negatiivinen asenneilmapiiri. Myös hintataso, palvelun heikko laatu tai toimijoiden pirstaleinen sijoittuminen voivat olla esteenä yhteistyössä. Tällä hetkellä yleisin periferian matkailuyritysten yhteistyökumppani Rukalla ovat ohjelmapalvelut. Tulevaisuudessa periferiassa halutaan lisätä yhteistyötä Rukan ohjelmapalvelujen lisäksi etenkin liikennepalvelujen sekä hoito- ja hyvinvointipalvelujen kanssa. Myös tuotekehitysyhteistyötä toivotaan lisättävän jatkossa. Linkittämällä eri toimialoja voidaan tulevaisuudessa hyödyntää laaja-alaisemmin Kuusamon eri alueita ja palvelutarjontaa matkailussa ja näin tukea koko seudun talouskehitystä.

Accurate measurements of the 8B neutrino spectrum are important for the interpretation of solar neutrino data. Experimentally, the 8B neutrino spectrum can be obtained from the measurement of the β-delayed α spectrum. We report on an α-α coincidence measurement performed at the IGISOL facility in Jyväskylä, Finland. Our measurement allows extensive cross-checks to be performed and gives a more intense neutrino spectrum at high energies compared to the present standard. The deviation reaches 4% at the end point of the spectrum. Below 11 MeV, the deviation is less than 1%.

The beta feeding probability of Tc-102,Tc- 104,Tc- 105,Tc- 106,Tc- 107, Mo-105, and Nb-101 nuclei, which are important contributors to the decay heat in nuclear reactors, has been measured using the total absorption technique. We have coupled for the first time a total absorption spectrometer to a Penning trap in order to obtain sources of very high isobaric purity. Our results solve a significant part of a long-standing discrepancy in the gamma component of the decay heat for Pu-239 in the 4-3000 s range., This work was supported by the following projects: Spanish FPA 2005-03993 and FPA2008-06419-C02-01; Hungarian OTKA K72566; the EC Contract No. MERG-CT-2004-506849; the Finnish Center of Excellence Programme 2006-2011, the EU 6th Framework Programme (Contract No. 506065 (EURONS), and the Hungarian-Spanish collaboration program.

The aim of this work was to evaluate the outcome of childhood Henoch-Schönlein purpura (HSP), the effectiveness of Cyclosporine A (CyA) for treating severe HSP nephritis (HSN), and more particularly the possibility for influencing the course of HSP disease by early prednisone treatment. A total of 47 adults who had had childhood HSP were evaluated after a mean of 24.1 years (16.4–35.6). The outcome was highly dependent on the renal symptoms at onset, since 7 out of 20 adults (20%) who had severe renal symptoms at onset had renal impairment as adults, compared with 2 out of 27 (7%) with mild or no renal symptoms at onset (relative risk 4.7; 95% CI 1.3–18.7). 70% of pregnancies in women after childhood HSN were complicated by hypertension or proteinuria. The annual incidence of HSN with nephrotic-range proteinuria was 2 per million children under 15 years. After a mean follow-up of 4.6 years, only three patients out of 19 were in complete remission. Kidney biopsy did not predict the outcome in these patients. CyA seemed to be promising for the treatment of severe HSN with nephrotic-range proteinuria, since four out of seven patients treated with CyA achieved stable remission and three had preserved their renal function after a mean follow-up of 6.0 years. Treatment at an early stage in the disease was associated with stable remission. The efficacy of early prednisone treatment was evaluated in a randomized double-blind trial involving 171 patients (84 prednisone, 87 placebo). Prednisone, given at a dose of 1 mg/kg/day for 2 weeks, with weaning over the next two weeks, was effective in reducing the intensity of abdominal pain (pain score 2.5 vs. 4.8; t-test p = 0.029) and shortening its duration (1.5 days vs. 2.7 days; t-test p = 0.028) compared with the placebo. The mean scores for joint pain were lower in the prednisone group (4.6 vs. 7.3; t-test p = 0.030) and the improvement from joint symptoms was faster (log rank p = 0.007). Prednisone did not prevent the development of renal symptoms but it was effective in treating them, since renal symptoms resolved in 61% of the prednisone patients after treatment compared with 34% of the placebo patients (difference 27%, 95% CI 3–47%, p = 0.024). Prednisone was most effective for children aged 6 or more with renal symptoms at onset, since only two patients needed to be treated in order to save one from renal involvement (95% CI’s for NNT 2–6). The long-term outcome of HSP is dependent on renal symptoms. Severe renal symptoms indicate early immunosuppressive treatment for HSN, and patients with renal involvement at the acute phase need long-term follow-up, especially women during and after pregnancy. Early treatment with prednisone is effective in reducing the abdominal and joint symptoms involved in HSP and is also effective in altering, but not preventing, the course of renal involvement. Tiivistelmä Väitöskirjatyön tarkoituksena oli selvittää lapsuusiän Henoch-Schönleinin purppuran (HSP) pitkäaikaisennustetta, Siklosporiini-A:n (CyA) tehoa vaikean HSP-nefriitin hoidossa ja tutkia varhain aloitetun prednisonihoidon hyötyä HSP-taudin oireisiin. HSP:n pitkäaikaisennustetta selvitettiin tarkastamalla 47:n lapsena HSP-taudin sairastaneen aikuisen terveystilanne keskimäärin 24.1 vuoden (16.4-–35.6) seuranta-ajan jälkeen. HSP-taudin ennuste oli vahvasti riippuvainen munuaisoireen vaikeusasteesta: 20 % niistä, joilla taudin alussa oli vaikeat munuaisoireet, kärsi vielä aikuisiällä munuaisoireista; vastaava luku munuaisoireettomilla ja niillä, joilla oli ollut vain lievää veri- tai valkuaisvirtsaisuutta, oli 7 %, (RR 4.7; 95 % CI 1.3–18.7). Raskauskomplikaatiot olivat yleisiä lapsuusiällä HSP-taudin sairastaneilla naisilla, sillä 70 % raskauksista komplisoi korkea verenpaine tai valkuaisvirtsaisuus. Vuosittain 2 lasta miljoonasta sairastuu vaikeaan nefroottistasoiseen HSP-nefriittiin Suomessa. Vain kolme nefroottistasoiseen HSP-nefriittiin sairastuneesta 19 lapsesta oli 4.6 vuoden seurannan jälkeen parantunut oireettomaksi. Ensimmäisen munuaisbiopsian vaikeusaste ei ennakoinut selviytymistä. CyA näytti olevan lupaavan tehokas lääke vaikean HSP-nefriitin hoidossa, sillä neljä seitsemästä CyA-hoitoa saaneesta lapsesta, oli oireeton 6.0 vuoden seurannan jälkeen. Mitä aikaisemmin vaikean nefriitin hoito oli aloitettu, sen parempi hoitotulos oli. Varhain aloitetun prednisonihoidon hyötyä HSP-taudin oireisiin selvitettiin satunnaistetulla kaksoissokkotutkimuksella, johon satunnaistettiin 171 lasta (84 prednisoni, 87 lumelääke) saamaan joko prednisonia 1 mg/kg/päivä 2 viikon ajan tai lumelääkettä. Prednisoni vähensi tehokkaasti vatsa- ja nivelkipuja ja se lyhensi merkitsevästi myös niiden kestoa. Prednisoni ei estänyt munuaisoireen kehittymistä lapselle, mutta niiltä, joille se kehittyi, oireet hävisivät merkitsevästi nopeammin lumelääkitykseen verrattuna (61 % versus 34 %, 95 % CI 3–47 %, p = 0.024). Kaikkein tehokkainta prednisoni oli yli 6 vuotiaille lapsille, joilla oli munuaisoire heti taudin alussa (NNT 2, 95 % CI 2–6). Tutkimuksen perusteella voidaan sanoa, että lapsuusiällä HSP-nefriitin sairastaneet lapset tarvitsevat seurantaa aikuisiällä, erityisesti naiset raskauden aikana. HSP-nefriitin varhainen hoitaminen on tärkeää. Varhainen prednisonihoito ei estä munuaisoiretta, mutta hoitaa jo kehittynyttä nefriittiä ja vähentää vatsa- ja nivelkipuja tehokkaasti.

Agile software development methods have caught the attention of software engineers and researchers worldwide. Scientific research is yet scarce. This paper reports results from a study, which aims to organize, analyze and make sense out of the dispersed field of agile software development methods. The comparative analysis is performed using the method’s life-cycle coverage, project management support, type of practical guidance, fitness-for-use and empirical evidence as the analytical lenses. The results show that agile software development methods, without rationalization, cover certain/different phases of the software development life-cycle and most of them do not offer adequate support for project management. Yet, many methods still attempt to strive for universal solutions (as opposed to situation appropriate) and the empirical evidence is still very limited. Based on the results, new directions are suggested. In principal, it is suggested to place emphasis on methodological quality - not method quantity.