Eastern Finland Research Articles

Serum copper, copper-zinc ratio and the risk of sudden cardiac death and all-cause death: a prospective cohort study

Abstract Sudden cardiac death (SCD) constitutes a major global health burden, contributing to about 20% of deaths in Western countries. In addition to the associated economic and health impacts of SCD, the genetic predispositions to SCD-associated risk factors make identification of biomarkers for screening or therapeutic management of SCD to be crucial. Copper (Cu) and Zinc (Zn) are essential micronutrients and trace elements involved in various homeostatic mechanisms in humans, including inflammation, immunity, and oxidation-reduction reactions. However, the potential association of Cu and Cu/Zn ratio and risk of SCD in a prospective study is not established. We therefore examined the association between serum Cu levels, Cu/Zn ratio and the risk of SCD and all-cause death in Finnish men. Methods We used a prospective study from eastern Finland, comprising 1889 men aged 42–60 years without history of coronary heart disease at baseline ((1984–1989). The baseline serum Cu and Zn concentrations were determined using Atomic Absorption Spectrometer. Serum Cu/Zn ratio were categorized into quartiles: ≤1.03; >1.03 to ≤1.18; >1.18 to ≤1.34; and >1.34. Associations of serum Cu, Cu/Zn ratio and risk of SCD and all-cause death were analyzed using multivariable Cox models. Results After a median follow-up of 26 years, 147 SCD cases and 848 all-cause deaths were recorded. The hazard ratios (HR, and 95% CI) per unit increase in serum Cu levels for SCD and all-cause death were 2.51 (1.00–6.28) and 2.37 (1.60–3.51) respectively, after adjustment for age, C-reactive protein, total cholesterol, body mass index, systolic blood pressure, smoking status, and history of type 2 diabetes. Using the first quartile of Cu/Zn ratio as the referent, the HR and 95% CIs for SCD and all-cause death in the fourth quartiles were 1.32 (0.84–2.09) and 1.35 (1.11–1.64) respectively. Men in the highest quartile of Cu/Zn ratio, compared with those in the lowest quartile, had higher risk of all-cause death. Conclusion Serum Cu level, per unit increment, was directly associated with risk of SCD and all-cause death in middle-aged Finnish men. There was linear association between Cu/Zn ratio and risk of all-cause death. Serum Cu can possibly be a prognostic marker or risk factor for SCD and all-cause death, while Cu/Zn ratio may be a marker for all-cause death. However, the exact mechanisms need further exploration. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): North Savo Regional Fund

Impacts of rising, peak and receding phases of discharge events on erosion potential of a boreal meandering river

AbstractFlow features of a meandering river can vary seasonally and widely in the boreal zone, as seasonal variation in discharges affect the properties of meander bends and the spatial location of flow magnitudes. However, a better understanding of the impacts of consecutive high‐discharge events in the boreal zone requires further analyses. Thus, the impacts of the fluvial processes and their magnitudes on different types of meander bends (e.g., sinuosity, symmetricity) were analysed throughout an open‐channel flow period, using accurate flow measurements and hydrodynamic (two‐dimensional) modelling. In particular, the research compared the impacts of different discharge events in magnitude and length of river evolution, and whether there is a difference in the erosion forces of the rising and falling phases of discharge hydrographs, and which of the phases has the greatest relevance to erosion forces. A case study was carried out in a middle boreal zone meandering river (Koitajoki in eastern Finland) during the 2020 open water season from May to October. Five different types of meander bends were considered in the study area. Flow magnitudes and shear forces were at their strongest during the spring flood peak, which is normally considered as the highest flow event during the hydrological year. Exceptionally, the largest summer discharge event reached a level that was close to the spring floods' maximum erosional capabilities. Bed shear stress values indicated the falling phases of the flood hydrographs are more important to river evolution than during the ascent stage, as the long duration of the flood downstage contributes more strongly to meander bend erosion and development. The smaller the curvature and larger the sinuosity of the bends, the more variation in erosional forces occurs between discharge stages. The study provides new insights into seasonal fluvial processes in boreal river meander bends as well as reinforces results from earlier river studies.

Koli Calling 2022

We warmly invite you to attend the 22nd Koli Calling International Conference on Computing Education Research (Koli Calling 2022), to be held 17-20 November 2022 in the beautiful Koli National Forest in Eastern Finland. Koli Calling is one of the leading international conferences dedicated to the scholarship of teaching and learning and to education research in the computing disciplines. This year, we had a record number of submissions (up 20% from last year!) and are anticipating a strong slate of presentations.

Preservation of microscopic fur, feather, and bast fibers in the Mesolithic ochre grave of Majoonsuo, Eastern Finland.

The study of animal and plant fibers related to grave furnishing, garments, and grave goods in thousands-of-year-old burials provides new insights into these funerary practices. Their preservation presupposes favorable conditions, where bacterial and fungal activity is at a minimum, as in anaerobic, wet, salty, arid, or frozen environments. The extreme acidic-soil environments (i.e., podzols) of Finland pose a challenge when it comes to studying funerary deposits, as human remains are rarely found. However, its potential to preserve microparticles allows us to approach the funerary event from a totally different point of view. Here, we present the first multiproxy analyses of a Mesolithic deposit from Finland. A red-ochre burial of a child found in Majoonsuo is studied by analyzing 1) microscopic fibers, 2) fatty acids, and 3) physical-chemical (CIELab color, pH, grain size) properties of 60 soil samples and associated materials. The microscopic fibers evidenced the remains of waterfowl downy feathers, a falcon feather fragment, canid and small rodent hairs as well as bast fibers. These could have been used in furnishing the grave and as ornaments or clothes. Canid hairs could belong to a dog inhumation, or more likely to canid fur used as grave good/clothes. Samples with microparticles have more long-chain and unsaturated fatty acids, although animal species identification was not possible. Soil properties indicate that the burial was made in the local soil, adding homogeneous red ochre and removing the coarser material; no bioturbation was found. The highly acidic sandy soil, together with a slight increase in finer particles when ochre is abundant, probably resulted in micro-scale, anoxic conditions that prevented bacterial attack. This study reveals the first animal hairs and feathers from a Finnish Mesolithic funerary context, and provides clues about how their preservation was possible.

Forest Owners’ Perspectives Concerning Non-Timber Forest Products, Everyman’s Rights, and Organic Certification of Forests in Eastern Finland

Global trends towards the bioeconomy and multidimensional ecosystem-based approaches are transforming our understanding of forests and expanding access to forest management. The demand for non-timber forest products (NTFPs) is increasing due to the current trends in lifestyle and consumption. Forest owners play a key role in the supply of NTFPs. However, many forest owners are not committed to production or aware of the opportunities for production of their forests. Understanding better the family forest owners’ behaviour and decision making regarding NTFPs is needed to strengthen the role of NTFPs in the Finnish bioeconomy. In this study, forest owners’ perspectives concerning NTFPs, Everyman’s Rights, and organic certification of forests were identified. The survey data were collected by emailing the questionnaire to North Karelian forest owners and analysed by creating forest owner typologies based on their forest ownership motives and perspectives concerning NTFPs. Regarding forest ownership motives, four owner groups of relatively equal size were identified and named as recreationist, conservationists, timber producers, and resigning owners leaving the forest property to the next generation. Regarding their use of NTFPs and interest in producing NTFPs four groups of owners were identified: owners who 1) harvested NTFPs for household use or 2) sale, 3) would allow the harvesting of NTFPs not covered by everyman’s right, and 4) need more information on the joint production of timber and NTFPs not covered by Everyman’s Rights. Most owners were household users. The results can be utilised to promote NTFP production and advocate for the more effective organic certification of forests for different forest owner groups.

Service provider’s perspective on luxury tourism experiences in Finland – unconventional luxury tourism experience products

The following piece is based on the lectio praecursoria presented at the defense of the doctoral dissertation “The Challenge of Luxury Experience – Service Provider’s Perspective” which was publicly defended on December 3, 2021, at Joensuu, University of Eastern Finland. The full version of the dissertation can be found at https://erepo.uef.fi/handle/123456789/26447

Explore the Characteristics of Destination Image in the New Era of Information Technology, Case of Online Travel Reviews

The follwing piece is based on the Lectio praecursoria presented at the defense of the doctoral dissertation ‘The Nature of Destination Image Concept in Online Travel Reviews’, which was publicly discussed on March 4, 2022, at the University of Eastern Finland. The full version of the dissertation can be found at: http://urn.fi/URN:ISBN:978-952-61-4483-2

Associations of serum n–3 and n–6 polyunsaturated fatty acids with prevalence and incidence of nonalcoholic fatty liver disease

ABSTRACTBackgroundNonalcoholic fatty liver disease (NAFLD) is a major cause of liver diseases worldwide, and lifestyle and diet are significant factors in its development. Recent studies have suggested that dietary fat quality is associated with the development of NAFLD.ObjectivesOur purpose was to investigate the cross-sectional and longitudinal associations of serum n–3 (ω-3) and n–6 (ω-6) PUFAs with NAFLD among middle-aged and older men and women from eastern Finland. We also investigated the associations of estimated Δ5-desaturase and Δ6-desaturase activities, enzymes involved in PUFA metabolism, with NAFLD.MethodsAfter exclusions, the cross-sectional analyses included 1533 men examined in 1984–1989 and 674 men and 870 women examined in 1998–2001 in the Kuopio Ischaemic Heart Disease Risk Factor Study. The longitudinal analyses included 520 men examined in 1991–1993 and 301 men and 466 women examined in 2005–2008. Fatty liver index (FLI) was used as a surrogate for NAFLD. Hepatic steatosis was defined as FLI >60. ANCOVA and logistic regression were used for analyses.ResultsIn the longitudinal analyses, participants with higher serum concentrations of total n–6 PUFA and linoleic acid, the major n–6 PUFA, had markedly lower FLI and lower odds for hepatic steatosis (e.g., odds ratios for incident hepatic steatosis in the highest compared with lowest quartiles were ≤0.41), whereas serum γ-linolenic acid concentration was associated with a higher FLI and higher odds for hepatic steatosis. The associations with the other PUFAs were generally weaker and nonsignificant. In the cross-sectional analyses, also the long-chain n–3 PUFAs had inverse associations. In most analyses, high estimated Δ5-desaturase activity was associated with lower risk and high estimated Δ6-desaturase activity with higher risk for NAFLD.ConclusionsIn middle-aged and older Finnish adults, higher serum concentrations of total n–6 PUFAs and linoleic acid were associated with lower odds for future NAFLD.

Incidence of first-ever transient ischemic attack in Eastern Finland.

The incidence of stroke has been declining in Finland, as well as in Europe. However, it is unclear whether the incidence of transient ischemic attack (TIA) is also decreasing. In fact, the TIA incidence in the Finnish population has never been reported. Therefore, here we investigated the incidence of TIA in the Eastern Finnish population in 2017. All patients with suspected TIA, from a defined catchment area, were referred to a neurological emergency unit at Kuopio University Hospital (KUH) in the Northern Savonia region of Eastern Finland, which had a population of 246,653 in 2017. The original study population comprised TIA patients diagnosed based on the WHO TIA criteria in 2017. Incidence rates were calculated by dividing the number of TIA cases by the number of people in different age groups. Among 432 patients with a suspected TIA referred to the neurological emergency unit at Kuopio University Hospital in 2017, 293 were living in Northern Savonia and were ultimately diagnosed with TIA after neurological examinations. The number of first-ever TIAs was 211. The crude incidence of all TIA was 122/100,000 inhabitants, and of first-ever TIA was 86/100,000. The age-standardized incidence (European population 2010) of the first-ever TIA was calculated to be 64/100,000. The mean age of first-ever TIA patients was 70 years: 72 years for women versus 68 years for men. We found a high incidence of TIA in Eastern Finland.

The effect of antithrombotic therapy on the recurrence and outcome of chronic subdural hematoma after burr-hole craniostomy in a population-based cohort

PurposeTo study the effect of antithrombotic therapy (ATT) on the outcome of operatively treated chronic subdural hematomas (CSDH).MethodsA retrospective population-based cohort study from Eastern Finland including all adult patients who underwent a burr-hole craniostomy (BHC) for CSDH during 2016 and 2017. The follow-up time for recurrence was 6 months and for mortality 3 years.ResultsA total of 301 CSDH patients were included in the study. ATT (antithrombotic therapy; antiplatelet or anticoagulant medication) was used by 164 patients (54.5%) at the time of diagnosis. The hematoma was bilateral in 102 patients (33.9%). Forty-seven patients (15.8%) encountered hematoma recurrence. Bilateral CSDHs required reoperations more often than unilateral hematomas (12.6% vs. 22.0%; p = 0.036) regardless of the primary operation (uni- or bilateral). A bivariate logistic regression analysis showed that bilateral hematoma (OR 1.918; 95% CI 1.013–3.630; p = 0.045) and male gender (OR 2.363; 95% CI 1.089–5.128; p = 0.030) independently predicted hematoma recurrence. The overall three-year mortality was 27.9%. The use of ATT was not associated with CSDH recurrence, and the length of the temporary postoperative ATT discontinuation did not correlate with the rate of thromboembolic events.ConclusionsATT did not affect CSDH recurrence in our study population, and the duration of the temporary postoperative ATT discontinuation was not associated with the rate of thromboembolic complications. Male gender and bilateral hematomas were more frequently associated with recurrences.

Economic Recession and the Risk of Cancer: A Cohort Study From Eastern Finland.

BackgroundLittle is known about the role of economic recessions in the risk of cancer. Therefore, we evaluated the impact of the severe economic recession in Finland from 1991–1994 on the incidence of all cancers and cancer subtypes among a middle-age and older population.MethodsFrom the Kuopio Ischemic Heart Disease Risk Factor Study (KIHD), a population-based sample of 1,620 women and men aged 53–73 years were examined from 1998–2001. The cancer-free participants completed a questionnaire on the possible impact of the 1990s recession in Finland on their lives. Incident cases of cancer were obtained through record linkage with the Finnish Cancer Registry. Cox proportional hazards regression was used to estimate hazard ratios (HR) of incident cancer events after adjusting for possible confounders.ResultsA total of 1,096 cancer-free participants had experienced socioeconomic hardships due to the recession at the baseline. During 20 years of follow-up, 473 participants developed cancer. After adjustment for age, baseline socioeconomic position, and lifestyle factors, the risk of all cancers was 32% higher among men who experienced socioeconomic hardships compared to those who did not (HR 1.32; 95% confidence interval [CI], 1.00–1.74, P = 0.05). Prostate-genital cancer was 71% higher among men with hardships (n = 103, HR 1.71; 95% CI, 1.06–2.74, P = 0.02). No association was observed between socioeconomic hardships and subsequent risk of total or any subtype of cancer among women.ConclusionThe 1990s economic recession was associated with increased risk of all cancers, especially prostate-genital cancer among Finnish middle-age and older men, but no association with cancer was observed in women.

Geodynamic and Isotopic Constraints on the Genesis of Kimberlites, Lamproites and Related Magmas From the Finnish Segment of the Karelian Craton

AbstractDespite the scientific and economic significance of kimberlites and related magmas, their origin is unclear. Here, we address this issue using whole‐rock and perovskite‐derived Sr‐Nd‐Hf isotopes for the three occurrences of kimberlite, lamproites and ultramafic lamprophyres (UMLs) in Finland. Mesoproterozoic olivine lamproites at Lentiira‐Kuhmo and UMLs at Kuusamo have different isotopic signatures yet were emplaced contemporaneously at 1,200 Ma in response to an extensional regime linked to the Baltica‐Laurentia breakup. The low εNd(i) and εHf(i) values of the olivine lamproites are consistent with an enriched subcontinental lithospheric mantle (SCLM) source while UML compositions are intermediate between those of typical kimberlites and lamproites and are interpreted to reflect mixing of asthenospheric melts and ∼10%–15% of melts sourced from metasomatized SCLM. The ∼750 Ma Kuusamo kimberlites, are probably linked to the mantle plume activity that initiated Rodinia's break‐up, exhibiting homogenous isotopic compositions which mirror the prominent Geodynamic and Source Constraints for ∼1,200 Ma Olivine Lamproite and Ultramafic Lamprophyre Magmatism in Eastern Finland (PREMA)‐like signature of kimberlites globally. By contrast, ∼620–585 Ma Kaavi‐Kuopio kimberlites show limited range in εNd(i) and 87Sr/86Sr(i) but have remarkably heterogeneous εHf(i) (+6.5 to −6.3) with a temporal trend toward lower εHf(i) values. While the Kuusamo kimberlites erupted during the early stage of continental break‐up, the Kaavi‐Kuopio kimberlites were emplaced when Rodinia break‐up was completed, coeval with formation of the Central Iapetus large igneous province. Magmas forming the Kaavi‐Kupio kimberlites may have formed from an upwelling mantle source similar to PREMA modified by increasing incorporation (up to 10%) of recycled crustal material through time accounting for the trend toward lower εHf(i) in these kimberlites.

Long-term tracking and population characteristics of lipoprotein (a) in the Cardiovascular Risk in Young Finns Study

Background and aimsLipoprotein (a) (Lp(a)) is a causal risk factor for cardiovascular diseases and its levels are under strict genetic control. Therefore, it is hypothesized that the concentration of Lp(a) remains stable throughout life. Finns have lower Lp(a) levels than central Europeans, but it is unknown whether there are differences within Finland, especially between the eastern and western parts of the country with known genetic duality and persistent differences in cardiovascular disease rates. We have examined the long-term stability of Lp(a) levels over 25 years in the Cardiovascular Risk in Young Finns Study (YFS), and the characteristics of individuals with different Lp(a) levels, including their geographical origin within Finland. MethodsIn YFS, the first large baseline examination was conducted in 1980 (baseline age, 3–18 years). Several follow-ups during the past 40 years have been conducted to investigate the determinants of cardiometabolic health. Lp(a) levels have been measured in study years 1986 (N = 2464, ages 9–24 years), 2001 (N = 2281, ages 24–39 years), 2007 (N = 2204, ages 35–45 years) and 2011 (N = 2044, ages 39–49 years). Tracking of Lp(a) was estimated by calculating Spearman's rank order correlations between the study years, and by cross-tabulating how many individuals diagnosed with either elevated or non-elevated Lp(a) levels in 1986, 2001 and 2007 remained in the same category in the latest follow-up in 2011. ResultsSpearman's correlation coefficients varied between r = 0.84–0.96. Most individuals (87–94%) who had a high Lp(a) level (>30 mg/dl) in any of the previous study years had a high level also in 2011. On average, the median Lp(a) levels were consistently ∼20% higher in the individuals originating from eastern Finland compared to those from western Finland, but there were no differences in the distribution of known genetic determinants between eastern and western Finns that would have explained the observed difference. ConclusionsThese data confirm that Lp(a) levels remain very stable over the life-course. In line with the genetic duality between eastern and western parts of Finland, we observed about 20% higher Lp(a) levels in individuals originating from eastern Finland compared to those originating from western Finland.

Development and strengthening of educational potential in the field of fisheries at the K.I. Skryabin Kyrgyz national agrarian university

The Kyrgyz National Agrarian University named after K.I. Scriabin has created an educational and practical base for university, college students, as well as for training fish farmers from the private sector of aquaculture. The demonstration fishery is a place for scientific research and short-term courses for farmers. Teachers of KNAU together with teachers of the University of Eastern Finland have prepared educational and methodological complexes and other educational materials. The first stage of the FishEDU project was the training of teachers in fisheries disciplines. The training was conducted in Kyrgyzstan by international-level teachers, as well as foreign experts. All teachers and trainers have been trained in the fisheries of Kyrgyzstan and Finland. On the basis of KNAU, an electronic library, a laboratory for water research and a kitchen for making fish dishes are organized for students and farmers. At the second stage, a demonstration fish farm was built on the territory of KNAU, consisting of two blocks of trout and carp. Trout are grown in plastic pools, and 1 pond with a geomembrane is equipped for keeping carp. Water from the well enters the intake system, is degassed from underground nitrogen, and is saturated with oxygen. Having studied the local reservoirs of Kyrgyzstan, the stocking was carried out safely. Thus, the demonstration fish farm was built thanks to the hard work of KNAU employees and UVF representatives.

Eruption pattern of the maxillary canines: features indicating treatment needs as seen in PTG at the late mixed stage—Part II

AimTo describe features of maxillary permanent canines in the late mixed stage as seen in panoramic radiograph (PTG) that later needed treatment to erupt into the oral cavity and to compare them with naturally erupted canines.MethodsThe cross-sectional part of this retrospective register-based study consisted of 1454 PTGs of children (mean age 9.3 years) living in Eastern Finland, while the longitudinal part involved patient data on 184 treated maxillary canines. The variables examined were treatment needs, overlapping and inclination of the maxillary canines, the development stage of the canines and lateral incisors and dental age.ResultsOnly 11.6% of the maxillary canines needed treatment, including interceptive procedures. The treated canines significantly more often had overlapping (p < 0.001), larger inclination (p = 0.001) and incomplete lateral incisors (p = 0.002) than did the naturally erupted canines. The children treated significantly more often had a delayed dental age (p = 0.035). Clear overlapping was closely associated with all treatment modalities, whereas some overlapping and a large inclination angle (≥ 25°) were associated especially in cases of late treatment. An incomplete lateral incisor and delayed dental age were associated with treatment.ConclusionAn association with treatment needs was found especially in the case of overlapping and a large inclination angle of the maxillary canine a couple of years before eruption into the oral cavity. These features can be early signs and indications for instant or later treatment of a maxillary canine and underline the importance of monitoring space conditions and erupting canines.

Potential for increased connectivity between differentiated wolverine populations

Information on genetic population structure provides important knowledge for species conservation. Yet, few studies combine extensive genetic data to evaluate the structure and population dynamics of transboundary populations. Here we used single nucleotide polymorphisms (SNPs), microsatellites and mitochondrial haplotypes to analyze the genetic population structure of wolverines (Gulo gulo) across Fennoscandia using a long-term monitoring dataset of 1708 individuals. Clear population subdivision was detected between the Scandinavian and the eastern Finnish population with a steep cline in the contact zone. While the Scandinavian population showed isolation by distance, large swaths of this population were characterized by high connectivity. Areas with high resistance to gene flow are likely explained by a combination of factors, such as historical isolation and founder effects. From a conservation perspective, promoting gene flow from the population in eastern Finland to the northwest of Scandinavia could augment the less variable Scandinavian population, and increase the demographic resilience of all subpopulations. Overall, the large areas of low resistance to gene flow suggest that transboundary cooperation with aligned actions of harvest and conflict mitigation could improve genetic connectivity across Finland, Sweden, and Norway.

Defoliation-Induced Growth Reduction of Pinus sylvestris L. after a Prolonged Outbreak of Diprion pini L.—A Case Study from Eastern Finland

The frequency and intensity of insect outbreaks have increased in boreal forests, along with associated impacts on the growth and economic losses of host trees. In Finland, the common pine sawfly (Diprion pini L.) is a serious pest, causing declines in health and growth responses of Scots pine (Pinus sylvestris L.). We focused on investigating the species’ defoliating impact on tree radial and volume growth and estimated the economic value of the declined growth. Managed P. sylvestris forests in our study area in eastern Finland have suffered from extended defoliation by D. pini for 15 years since 1999 at varying intensity levels. We classified 184 trees into four defoliation classes and compared annual growth, expressed as growth indices between the classes. We modelled tree volume, estimated economic loss, and compared those to a reference period preceding the initial outbreak. We found significant differences in growth indices between the defoliation classes. Growth losses of 4.2%, 20.8%, and 40.4% were obtained for the mild, moderate, and high defoliation classes, with related economic impacts of 51 €, 272 €, and 734 € per ha for 11 years, respectively. Growth was slightly enhanced in the lowest defoliation class. We suggest that growth-related economic loss caused by D. pini may be significant and depend on defoliation intensity and outbreak duration.

Individually tailored nutritional guidance improved dietary intake of older family caregivers: a randomized controlled trial

PurposeOlder family caregivers (FCs) are vulnerable to insufficient dietary intake and risk of malnutrition. The aim of this study was to assess the impact of individually tailored nutritional guidance on the dietary intake and nutritional status of older FCs and their care recipients’ (CRs’) nutritional status.MethodsThis study was a randomized controlled 6-month nutrition intervention in Eastern Finland. The inclusion criteria for FCs were having a home-living CR aged 65 or above and a valid care allowance. The exclusion criterion was CR receiving end-of-life care at baseline. Participants were randomly assigned to an intervention (FCs n = 63, CRs n = 59) and a control (FCs n = 50, CRs n = 48) group. Individually tailored nutritional guidance targeted to FCs was given to an intervention group by a clinical nutritionist. The main outcomes were dietary intake (3-day food record).ResultsAfter the 6-month intervention, 63 FCs and 59 CRs in the intervention group and 50 FCs and 48 CRs in the control group were analyzed. In the intervention group of FCs, the intakes of protein, riboflavin, calcium, potassium, phosphorus, and iodine differed significantly (p < 0.05) compared to the control group. In addition, the intake of vitamin D supplementation improved in the intervention group of the FCs and CRs (p < 0.001).ConclusionIndividually tailored nutrition guidance improves the intake levels of crucial nutrients, such as the intake levels of protein, vitamin D, and calcium of the FCs. Further studies are warranted to optimize the methods to improve the nutrition of FCs.Registration number of Clinical Trials: ClinicalTrials.gov NCT04003493 (1 July 2019).

Serum copper-to-zinc ratio is associated with heart failure and improves risk prediction in middle-aged and older Caucasian men: A prospective study

Background and aimsSerum copper (Cu) and zinc (Zn) may play a role in the development of adverse cardiovascular outcomes including heart failure (HF). Serum Cu/Zn-ratio has been shown to be a risk indicator for cardiovascular disease, but its relationship with HF has not been previously investigated. We aimed to assess the association between Cu/Zn-ratio and incident HF risk using a prospective cohort study. Methods and resultsStudy participants were recruited in eastern Finland with baseline examinations carried out between March 1998 and December 2001. Serum levels of Cu and Zn were measured using atomic absorption spectrometry in 1866 men aged 42–61 years without a history of HF at baseline. Multivariable-adjusted hazard ratios (HRs) with confidence intervals (CIs) were calculated for incident HF. During 26.5 years median follow-up, 365 HF cases occurred. Restricted cubic splines suggested linear relationships of serum Cu/Zn-ratio, Cu and Zn with HF risk. A unit increase in Cu/Zn-ratio was associated with an increased HF risk in analysis adjusted for several potential confounders including nutritional factors such as total energy intake, intake of fruits, berries and vegetables, and red meat (HR 1.63; 95% CI 1.06–2.51). The corresponding multivariable-adjusted HRs (95% CIs) for serum Cu and Zn were 2.42 (1.32–4.44) and 1.34 (0.50–3.63), respectively. Addition of Cu/Zn-ratio to a HF risk prediction model was associated with improved risk prediction. ConclusionIn middle-aged and older Finnish men, increased serum Cu/Zn-ratio is associated with an increased risk of HF in a linear dose-response fashion and might improve HF risk assessment.

Hippocampal position and orientation as prognostic biomarkers for posttraumatic epileptogenesis: An experimental study in a rat lateral fluid percussion model.

ObjectiveThis study was undertaken to identify prognostic biomarkers for posttraumatic epileptogenesis derived from parameters related to the hippocampal position and orientation.MethodsData were derived from two preclinical magnetic resonance imaging (MRI) follow‐up studies: EPITARGET (156 rats) and Epilepsy Bioinformatics Study for Antiepileptogenic Therapy (EpiBioS4Rx; University of Eastern Finland cohort, 43 rats). Epileptogenesis was induced with lateral fluid percussion‐induced traumatic brain injury (TBI) in adult male Sprague Dawley rats. In the EPITARGET cohort, T2∗‐weighted MRI was performed at 2, 7, and 21 days and in the EpiBioS4Rx cohort at 2, 9, and 30 days and 5 months post‐TBI. Both hippocampi were segmented using convolutional neural networks. The extracted segmentation mask was used for a geometric construction, extracting 39 parameters that described the position and orientation of the left and right hippocampus. In each cohort, we assessed the parameters as prognostic biomarkers for posttraumatic epilepsy (PTE) both individually, using repeated measures analysis of variance, and in combination, using random forest classifiers.ResultsThe extracted parameters were highly effective in discriminating between sham‐operated and TBI rats in both the EPITARGET and EpiBioS4Rx cohorts at all timepoints (t; balanced accuracy > .9). The most discriminating parameter was the inclination of the hippocampus ipsilateral to the lesion at t = 2 days and the volumes at t ≥ 7 days after TBI. Furthermore, in the EpiBioS4Rx cohort, we could effectively discriminate epileptogenic from nonepileptogenic animals with a longer MRI follow‐up, at t = 150 days (area under the curve = .78, balanced accuracy = .80, p = .0050), based on the orientation of both hippocampi. We found that the ipsilateral hippocampus rotated outward on the horizontal plane, whereas the contralateral hippocampus rotated away from the vertical direction.SignificanceWe demonstrate that assessment of TBI‐induced hippocampal deformation by clinically translatable MRI methodologies detects subjects with prior TBI as well as those at high risk of PTE, paving the way toward subject stratification for antiepileptogenesis studies.