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  • 1
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    Development of a healthy lifestyle index within a multidomain intervention aimed at prevention of cognitive impairment and dementia, and its association with cognition: Results from the FINGER trial
    Wiley ; 2021
    In:  Alzheimer's & Dementia Vol. 17, No. S10 ( 2021-12)
    Details
    In: Alzheimer's & Dementia, Wiley, Vol. 17, No. S10 ( 2021-12)
    Abstract: Given the complex and multi‐factorial aetiology of dementia, preventive interventions targeting several risk‐factors simultaneously and tailored on specific risk‐profiles are likely to be most beneficial. To date, trials testing lifestyle‐ and vascular‐based multidomain interventions for dementia and cognitive decline prevention have shown inconsistent results. In particular, achieving sufficient level of intervention intensity, accurately assessing adherence, and identifying the optimal target population have been highlighted among the key challenges. Within FINGER, the first large trial showing the efficacy of a multidomain intervention in preventing cognitive decline, we aimed to develop a Healthy Lifestyle Index (HLI) as a potential easy‐access indicator of adherence, and to assess its association with cognition. Method The HLI (score 0‐24) was developed based on a brief set of self‐reported questions collected at baseline, 12, and 24 months within the FINGER trial (N=1260) and across four lifestyle components: physical activity, diet, smoking and alcohol, and social and cognitive activity. The FINGER cognitive outcomes were the overall z‐score from a Neuropsychological Test Battery (NTB, 14 tests, primary outcome) and the z‐scores of the NTB cognitive domains (secondary outcomes). Linear mixed‐models repeated‐measures with maximum likelihood estimation were used to assess the effect of the intervention on change in the HLI and associations between HLI and cognition over the 2‐year study period. Result The intervention led to an increase in HLI (P 〈 0.001). At baseline, the HLI was directly associated with the overall NTB z‐score (b=0.024; 95% CI: 0.014‐0.033; P 〈 0.001) and individual cognitive domains. Baseline HLI was significantly associated with 2‐year changes in the NTB z‐score (0.006; 95% CI: 0.003‐0.010; P 〈 0.001), as well as the memory domain. Changes in HLI were not significantly associated with 2‐year changes in cognitive outcomes. Conclusion The FINGER HLI may potentially help measure and monitor adherence to multidomain interventions aimed at prevention of cognitive decline. Being developed as an easy‐access tool, its application could be especially relevant for those settings where more complex assessments are not feasible, such as implementation trials in clinical practice, and primary care in particular. More evidence is needed to determine its efficacy in predicting response to such interventions.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    URL: Article
    DOI: 10.1002/alz.v17.S10
    DOI: 10.1002/alz.053388
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2201940-6
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  • 2
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    The Extension of Surgery Predicts Acute Postoperative Pain, While Persistent Postoperative Pain Is Related to the Spinal Pathology in Adolescents Undergoing Posterior Spinal Fusion
    MDPI AG ; 2022
    In:  Children Vol. 9, No. 11 ( 2022-11-10), p. 1729-
    Details
    In: Children, MDPI AG, Vol. 9, No. 11 ( 2022-11-10), p. 1729-
    Abstract: Persistent pain after posterior spinal fusion affects 12 to 42% of patients with adolescent idiopathic scoliosis. The incidence of persistent pain among surgically treated children with Scheuermann kyphosis and spondylolisthesis is not known. The aim of our study was to determine the predictors and incidence of acute and chronic postoperative pain in adolescents undergoing posterior spinal fusion surgery. The study was a retrospective analysis of a prospectively collected pediatric spine register data. The study included 213 consecutive patients (158 AIS, 19 Scheuermann kyphosis, and 36 spondylolisthesis), aged 10–21 years undergoing posterior spinal fusion at a university hospital between March 2010 and March 2020. The mean (SD) daily postoperative opioid consumption per kilogram was significantly lower in the spondylolisthesis patients 0.36 mg/kg/day (0.17) compared to adolescent idiopathic scoliosis 0.51 mg/kg/day (0.25), and Scheuermann kyphosis 0.52 mg/kg/day (0.25) patients after surgery (p = 0.0004). Number of levels fused correlated with the daily opioid consumption (rs = 0.20, p = 0.0082). The SRS-24 pain domain scores showed a statistically significant improvement from preoperative levels to two-year follow-up in all three groups (p ≤ 0.03 for all comparisons). The spondylolisthesis patients had the lowest SRS pain domain scores (mean 4.04, SD 0.94), reporting more pain two years after surgery, in comparison to AIS (mean 4.31, SD 0.60) (p = 0.043) and SK (mean 4.43, SD 0.48) patients (p = 0.049). Persistent postoperative pain in adolescents undergoing posterior spinal fusion is related to disease pathology while higher acute postoperative pain is associated with a more extensive surgery. Spondylolisthesis patients report more chronic pain after surgery compared to AIS and SK patients.
    Type of Medium: Online Resource
    ISSN: 2227-9067
    URL: Article
    DOI: 10.3390/children9111729
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2732685-8
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  • 3
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    Long-term prognostic significance of the ST level and ST slope in the 12‑lead ECG in the general population
    Elsevier BV ; 2020
    In:  Journal of Electrocardiology Vol. 58 ( 2020-01), p. 176-183
    Details
    In: Journal of Electrocardiology, Elsevier BV, Vol. 58 ( 2020-01), p. 176-183
    Type of Medium: Online Resource
    ISSN: 0022-0736
    URL: Article
    DOI: 10.1016/j.jelectrocard.2019.12.010
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2020
    detail.hit.zdb_id: 2048912-2
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  • 4
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    Radiological outcome of hallux valgus deformity correction with metatarsal osteotomy from a single-center cohort – Best results achieved by foot and ankle surgeons
    Elsevier BV ; 2024
    In:  Foot and Ankle Surgery Vol. 30, No. 1 ( 2024-01), p. 32-36
    Details
    In: Foot and Ankle Surgery, Elsevier BV, Vol. 30, No. 1 ( 2024-01), p. 32-36
    Type of Medium: Online Resource
    ISSN: 1268-7731
    URL: Article
    DOI: 10.1016/j.fas.2023.08.004
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2024
    detail.hit.zdb_id: 2006229-1
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  • 5
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    Brain amyloid load and its associations with cognition and vascular risk factors in FINGER Study
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Neurology Vol. 90, No. 3 ( 2018-01-16), p. e206-e213
    Details
    In: Neurology, Ovid Technologies (Wolters Kluwer Health), Vol. 90, No. 3 ( 2018-01-16), p. e206-e213
    Abstract: To investigate brain amyloid pathology in a dementia-risk population defined as cardiovascular risk factors, aging, and dementia risk (CAIDE) score of at least 6 but with normal cognition and to examine associations between brain amyloid load and cognitive performance and vascular risk factors. Methods A subgroup of 48 individuals from the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) main study participated in brain 11 C-Pittsburgh compound B (PiB)-PET imaging, brain MRI, and neuropsychological assessment at the beginning of the study. Lifestyle/vascular risk factors were determined as body mass index, blood pressure, total and low-density lipoprotein cholesterol, and glucose homeostasis model assessment. White matter lesions were visually rated from MRIs by a semiquantitative Fazekas score. Results Twenty participants (42%) had a positive PiB-PET on visual analysis. The PiB-positive group performed worse in executive functioning tests, included more participants with APOE ε4 allele (50%), and showed slightly better glucose homeostasis compared to PiB-negative participants. PiB-positive and -negative participants did not differ significantly in other cognitive domain scores or other vascular risk factors. There was no significant difference in Fazekas score between the PiB groups. Conclusions The high percentage of PiB-positive participants provides evidence of a successful recruitment process of the at-risk population in the main FINGER intervention trial. The results suggest a possible association between early brain amyloid accumulation and decline in executive functions. APOE ε4 was clearly associated with amyloid positivity, but no other risk factor was found to be associated with positive PiB-PET.
    Type of Medium: Online Resource
    ISSN: 0028-3878 , 1526-632X
    URL: Article
    DOI: 10.1212/WNL.0000000000004827
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
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  • 6
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    The prognostic significance of T‐wave inversion according to ECG lead group during long‐term follow‐up in the general population
    Wiley ; 2021
    In:  Annals of Noninvasive Electrocardiology Vol. 26, No. 1 ( 2021-01)
    Details
    In: Annals of Noninvasive Electrocardiology, Wiley, Vol. 26, No. 1 ( 2021-01)
    Abstract: Inverted T waves in the electrocardiogram (ECG) have been associated with coronary heart disease (CHD) and mortality. The pathophysiology and prognostic significance of T‐wave inversion may differ between different anatomical lead groups, but scientific data related to this issue is scarce. Methods A representative sample of Finnish subjects ( n  = 6,354) aged over 30 years underwent a health examination including a 12‐lead ECG in the Health 2000 survey. ECGs with T‐wave inversions were divided into three anatomical lead groups (anterior, lateral, and inferior) and were compared to ECGs with no pathological T‐wave inversions in multivariable‐adjusted Fine–Gray and Cox regression hazard models using CHD and mortality as endpoints. Results The follow‐up for both CHD and mortality lasted approximately fifteen years (median value with interquartile ranges between 14.9 and 15.3). In multivariate‐adjusted models, anterior and lateral (but not inferior) T‐wave inversions associated with increased risk of CHD (HR: 2.37 [95% confidence interval 1.20–4.68] and 1.65 [1.27–2.15] , respectively). In multivariable analyses, only lateral T‐wave inversions associated with increased risk of mortality in the entire study population (HR 1.51 [1.26–1.81]) as well as among individuals with no CHD at baseline (HR 1.59 [1.29–1.96] ). Conclusions The prognostic information of inverted T waves differs between anatomical lead groups. T‐wave inversion in the anterior and lateral lead groups is independently associated with the risk of CHD, and lateral T‐wave inversion is also associated with increased risk of mortality. Inverted T wave in the inferior lead group proved to be a benign phenomenon.
    Type of Medium: Online Resource
    ISSN: 1082-720X , 1542-474X
    URL: Issue
    URL: Article
    DOI: 10.1111/anec.v26.1
    DOI: 10.1111/anec.12799
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2111515-1
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  • 7
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    The role of ions in new particle formation in the CLOUD chamber
    Copernicus GmbH ; 2017
    In:  Atmospheric Chemistry and Physics Vol. 17, No. 24 ( 2017-12-21), p. 15181-15197
    Details
    In: Atmospheric Chemistry and Physics, Copernicus GmbH, Vol. 17, No. 24 ( 2017-12-21), p. 15181-15197
    Abstract: Abstract. The formation of secondary particles in the atmosphere accounts for more than half of global cloud condensation nuclei. Experiments at the CERN CLOUD (Cosmics Leaving OUtdoor Droplets) chamber have underlined the importance of ions for new particle formation, but quantifying their effect in the atmosphere remains challenging. By using a novel instrument setup consisting of two nanoparticle counters, one of them equipped with an ion filter, we were able to further investigate the ion-related mechanisms of new particle formation. In autumn 2015, we carried out experiments at CLOUD on four systems of different chemical compositions involving monoterpenes, sulfuric acid, nitrogen oxides, and ammonia. We measured the influence of ions on the nucleation rates under precisely controlled and atmospherically relevant conditions. Our results indicate that ions enhance the nucleation process when the charge is necessary to stabilize newly formed clusters, i.e., in conditions in which neutral clusters are unstable. For charged clusters that were formed by ion-induced nucleation, we were able to measure, for the first time, their progressive neutralization due to recombination with oppositely charged ions. A large fraction of the clusters carried a charge at 1.5 nm diameter. However, depending on particle growth rates and ion concentrations, charged clusters were largely neutralized by ion–ion recombination before they grew to 2.5 nm. At this size, more than 90 % of particles were neutral. In other words, particles may originate from ion-induced nucleation, although they are neutral upon detection at diameters larger than 2.5 nm. Observations at Hyytiälä, Finland, showed lower ion concentrations and a lower contribution of ion-induced nucleation than measured at CLOUD under similar conditions. Although this can be partly explained by the observation that ion-induced fractions decrease towards lower ion concentrations, further investigations are needed to resolve the origin of the discrepancy.
    Type of Medium: Online Resource
    ISSN: 1680-7324
    URL: Article
    DOI: 10.5194/acp-17-15181-2017
    Language: English
    Publisher: Copernicus GmbH
    Publication Date: 2017
    detail.hit.zdb_id: 2092549-9
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  • 8
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    Molecular understanding of the suppression of new-particle formation by isoprene
    Copernicus GmbH ; 2020
    In:  Atmospheric Chemistry and Physics Vol. 20, No. 20 ( 2020-10-20), p. 11809-11821
    Details
    In: Atmospheric Chemistry and Physics, Copernicus GmbH, Vol. 20, No. 20 ( 2020-10-20), p. 11809-11821
    Abstract: Abstract. Nucleation of atmospheric vapours produces more than half of global cloud condensation nuclei and so has an important influence on climate. Recent studies show that monoterpene (C10H16) oxidation yields highly oxygenated products that can nucleate with or without sulfuric acid. Monoterpenes are emitted mainly by trees, frequently together with isoprene (C5H8), which has the highest global emission of all organic vapours. Previous studies have shown that isoprene suppresses new-particle formation from monoterpenes, but the cause of this suppression is under debate. Here, in experiments performed under atmospheric conditions in the CERN CLOUD chamber, we show that isoprene reduces the yield of highly oxygenated dimers with 19 or 20 carbon atoms – which drive particle nucleation and early growth – while increasing the production of dimers with 14 or 15 carbon atoms. The dimers (termed C20 and C15, respectively) are produced by termination reactions between pairs of peroxy radicals (RO2⚫) arising from monoterpenes or isoprene. Compared with pure monoterpene conditions, isoprene reduces nucleation rates at 1.7 nm (depending on the isoprene ∕ monoterpene ratio) and approximately halves particle growth rates between 1.3 and 3.2 nm. However, above 3.2 nm, C15 dimers contribute to secondary organic aerosol, and the growth rates are unaffected by isoprene. We further show that increased hydroxyl radical (OH⚫) reduces particle formation in our chemical system rather than enhances it as previously proposed, since it increases isoprene-derived RO2⚫ radicals that reduce C20 formation. RO2⚫ termination emerges as the critical step that determines the highly oxygenated organic molecule (HOM) distribution and the corresponding nucleation capability. Species that reduce the C20 yield, such as NO, HO2 and as we show isoprene, can thus effectively reduce biogenic nucleation and early growth. Therefore the formation rate of organic aerosol in a particular region of the atmosphere under study will vary according to the precise ambient conditions.
    Type of Medium: Online Resource
    ISSN: 1680-7324
    URL: Article
    URL: Article
    DOI: 10.5194/acp-20-11809-2020
    DOI: 10.5194/acp-20-11809-2020-supplement
    Language: English
    Publisher: Copernicus GmbH
    Publication Date: 2020
    detail.hit.zdb_id: 2092549-9
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  • 9
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    Increased lesion depth, higher body mass index and older age are risk factors for osteoarthritis during long-term follow-up in patients with osteochondritis dissecans of the knee
    Springer Science and Business Media LLC ; 2022
    In:  Archives of Orthopaedic and Trauma Surgery Vol. 143, No. 7 ( 2022-09-28), p. 3863-3869
    Details
    In: Archives of Orthopaedic and Trauma Surgery, Springer Science and Business Media LLC, Vol. 143, No. 7 ( 2022-09-28), p. 3863-3869
    Abstract: To report on the long-term prognosis of osteochondritis dissecans (OCD) patients regarding radiological and patient-reported outcomes and to analyze possible risk factors. Materials and methods All patients diagnosed with knee OCD between 2004 and 2014 with radiographic Kellgren–Lawrence (K–L) grades 0–2 at the time of diagnoses, ability to understand the language of the interview, and willingness to participate in the study were retrospectively reviewed. Current knee radiographs and the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire were prospectively collected between May 2020 and March 2021. The extent of osteoarthritis (OA) and KOOS questionnaire results were evaluated. Results 90 patients (103 knees) with a mean age of 21 years (range 6–60) were included. The mean follow-up time was 12 years (range 7–20). 24 knees (23%) were treated conservatively, and 79 knees (77%) operatively. At the time of diagnoses, 90% of the patients had K–L grades of 0–1; during the follow-up period, 45% of the patients showed radiological progression of OA. Patient body mass index (BMI) ( p  = 0.004; 95% CI 0.25–0.29), age ( p  = 0.003; 95% CI 0.18–0.30), operative treatment ( p  = 0.0075; 95% CI 0.41–0.65) and lesion depth ( p  = 0.0007) were statistically significantly connected to K–L grade change. Patients with no progression in joint space narrowing had statistically significantly better overall KOOS scores ( p  = 0.03; 95% CI 0.77–0.88) than patients whose K–L grades worsened. Conclusions During the long-term follow-up of 12 years, patients with knee OCD had good clinical results. Lac of radiological progression of cartilage degeneration was noted in 55% of the patients, regardless of treatment method. Lesion depth, higher BMI and older age were associated with the progression of OA. The progression of OA was related to a worsening of functional scores. Level of evidence IV.
    Type of Medium: Online Resource
    ISSN: 1434-3916
    URL: Article
    DOI: 10.1007/s00402-022-04638-4
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 1458452-9
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  • 10
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    Epidemiology and emm types among group A streptococcal pharyngitis in Finland: a prospective laboratory-based study
    Springer Science and Business Media LLC ; 2023
    In:  European Journal of Clinical Microbiology & Infectious Diseases
    Details
    In: European Journal of Clinical Microbiology & Infectious Diseases, Springer Science and Business Media LLC
    Abstract: Streptococcus pyogenes (mostly termed group A Streptococcus - GAS) is the most important bacterial causative of pharyngitis. However, epidemiology of GAS pharyngitis is not widely established. This study describes GAS pharyngitis cases and emm -type distribution in a prospective study covering over 2 years in two Hospital Districts in Finland. Methods A prospective, systematic collection of GAS pharyngitis isolates was conducted between March 2018 and December 2020 in two large Hospital Districts in Finland. Patient characteristics (age, gender) were included if available. All GAS isolates collected were emm typed. Results Altogether 1320 GAS pharyngitis strains were collected, 904 in the Hospital District 1 (HD1) and 416 in Hospital District 2 (HD2). In HD1, age and gender data were available. Females were overrepresented (58% of all cases). In addition, the age and gender distributions were noted to be significantly different ( p 〈 0.0001) with females having a more uniform distribution until age of 40. emm 28 was common among the age group of 20–29-year-olds and emm 89 in children under 10 years of age, respectively. In HD1, most of the isolates were collected during winter and autumn months. Significant differences by season in the frequency of emm 12, emm 89, emm 75 and group of “others” were observed. Conclusion Age distribution among GAS pharyngitis cases was significantly different between genders ( p 〈 0.0001). In addition, age group specific and seasonal variations in emm GAS types causing the disease were observed. These findings warrant further investigation, especially for understanding population-based spread of GAS even in more detail.
    Type of Medium: Online Resource
    ISSN: 0934-9723 , 1435-4373
    URL: Article
    DOI: 10.1007/s10096-023-04714-6
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 1459049-9
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