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Abstract The prevalence of the isolated ultrasonographic finding of polycystic ovaries (PCO) in the Finnish population and among women with a history of gestational diabetes (GDM) and changes in the present carbohydrate metabolism were investigated in the present study. One aim of this study was to investigate the prevalence of the recently discovered variant type LH (v-LH) in PCOS and to compare patient cohorts from Finland, the Netherlands, the United Kingdom and the United States of America. In addition, this study attempted to evaluate the nature of the ovarian streoidogenic response of women with PCOS to exogenously administered human chorionic gonadotrophin (hCG), human menotrophin (hMG) and follicle stimulating hormone (FSH). The effect of metformin on ovarian steroidogenesis was also studied. The prevalence of PCO was significantly higher in younger (≤ 35 years, 21.6%) than among older women (in ≥ 36 years, 7.8%). The overall prevalence of PCO in Finnish women was 14.2%. Women with previous GDM revealed a high prevalence of PCO (39.4%). The carrier frequency of the v-LHb allele in the entire study population was 18.5%. The frequency of the v-LH carrier was significantly lower in obese PCOS subjects in the Netherlands (2.0%) and Finland (4.5%). Women with previous GDM had impaired insulin sensitivity and β-cell function. They also had higher adrenal androgen secretion than the control women. Women with PCO and previous GDM had marked hyperinsulinemia which was not explained by obesity. Obese PCOS women achieved peak peripheral serum T concentrations at 48 hours after a hCG injection, preceded by peak levels of 17-OHP and E2 at 24 hours. In contrast, all steroids measured in the control women reached their maximum serum concentrations at 96 hours. HMG stimulated the production of ovarian androgens more efficiently than a urinary FSH after pituitary suppression with a gonadotrophin releasing hormone agonist (GnRHa). In conclusion, the prevalence of PCO is common in healthy Finnish women and even more common in women with a history of GDM. The ultrasonographic appearance of PCO may be a predictive factor with regards abnormal glucose tolerance during and after pregnancy and, these women should therefore be advised as to possible consequences. The high overall frequency of the v-LH allele in women in general and its low frequency in obese PCOS patients suggests that v-LH plays a role in reproductive functions and may counteract the pathogenesis of PCOS in obese individuals. The differences observed in steroid responses to hCG between normal and PCOS women might be explained by higher theca cell activity or mass in polycystic ovaries. Women with PCOS did not show a distinctly exaggerated steroidogenic response to hMG or FSH administration compared with control women. FSH administration also resulted in increased A and T production.

Transcription growth factor beta (TGFβ) mediated epithelial to mesenchymal transition (EMT) of lens epithelial cells (LEC) is known to cause posterior capsular opacification (PCO). In this work, I have focused on the TGFβ-induced EMT pathway governed by the cellular actin cytoskeleton dynamics. This study is the first to report the involvement of transcription co-factor myocardin related transcription factor-A (MRTF-A) in TGFβ-induced EMT in the lens. Using rat lens epithelial explants, I have conclusively established that in LECs, TGFβ induces nuclear migration of MRTF-A leading to induction of αSMA expression. Furthermore, I have manipulated the intracellular translocation of MRTF-A indirectly using actin binding drugs and established that inhibiting nuclear migration of MRTF-A reduces αSMA production by the cells. In addition, direct manipulation of MRTF-A using adenoviral vectors carrying modified gene constructs show that presence of functional MRTF-A construct in the nucleus is necessary to trigger αSMA expression by causing EMT. In order to understand the involvement of matrix metalloproteinase -9 (MMP-9) in this specific pathway, explants were treated with an MMP2/9 inhibitor and rhMMP9. I have established that rhMMP-9 does not significantly affect the intracellular migration of MRTF-A. Nevertheless, gene expression studies showed that MMP-9 induces the expression of MRTF-A. Taken together, I believe MMP-9 functions through a feedback mechanism controlling MRTF-A expression in the cell. However, the presence of MMP-9 is necessary but not sufficient for induction in MRTF-A nuclear translocation. Overall, the work presented in this thesis demonstrates for the first time the presence of MRTF-A in LECs and successfully shows that the intracellular translocation of MRTF-A as an integral part of TGFβ induced EMT. Therefore, in the future, MRTF-A may be used as a successful target molecule to inhibit in order to prevent EMT leading to PCO. / Thesis / Doctor of Philosophy (PhD)

With the increasing time people spend indoors, the indoor environment quality draws more and more attention. The concentration of indoor pollutants is usually much higher than outdoors, in which volatile organic compounds (VOCs) and mold/mildew are both major pollutants and cause many health problems to residents. Efforts devoted from academy and industry to protecting people from indoor environment problems are apparently not sufficient. Photocatalysts, such as TiO2, WO and ZnO, can absorb light photons and react with O2 and H2O to generate highly oxidative radicals, which can oxidize VOCs and disinfect microorganisms. Recently, this photocatalytic oxidation (PCO) technology has been intensively studied to reduce VOCs and disinfect bacteria in the indoor environment. Few papers address the indoor mold/mildew problem, and this research therefore endeavors to do so. The objectives are to evaluate the effectiveness of PCO technology to resist mold/mildew growth and prevent VOC emission from building materials under either UV or visible light irradiation. The models, including linear regression, logistic regression, and numerical model, are also built for interpreting experimental results and for predicting performance in application. The mold/mildew resistance of different PCO gels was examined using accelerated mold/mildew growth agar plate tests. These gels included TiO2 only and TiO2 in combination with H2O2 and with Ag. Without the application of PCO gels, no mold/mildew inhibition was observed from UV (365 nm) or visible light. Under UV light irradiation, the TiO2 gel achieved complete mold/mildew inhibition. Without light, a 12-day delay of mold growth was obtained using the Ag-TiO2/H2O2 gel. Under visible light irradiation, the Ag-TiO2/H2O2 gel was also the most effective PCO gel with a 8-day delay of mold growth, which, however, was shorter than the same gel in the condition of no light with a 10-day delay due to the light-induced deterioration of the Ag-TiO2. The reduction of VOC emission from PCO gel (TiO2 gel and Ag-TiO2/H2O2 gel) coated building materials under UV or visible light irradiation was also confirmed by small chamber tests (the Ag-TiO2/H2O2 gel with above 50% reduction of total VOC emission). A linear model was obtained for the Ag-TiO2/H2O2 gel in the condition of no light, with respect to the correlation between the delay of mold growth and the gel ingredients. A logistic model was created for predicting the probability of mold growth on different TiO2 gels with different UV light exposure time at different intensities. A numerical model was developed with better accuracy than the previous one for VOC emission from PCO gel coated building materials. This study showed that the PCO gel might be a promising multifunctional material in resisting mold/mildew growth and preventing VOC emission in the indoor environment (The TiO2 gel for complete mold/mildew inhibition and the Ag-TiO2/H2O2 gel for delay of mold growth in emergency situations and reduction of VOC emission from building materials). More stable Ag-TiO2 or other visible-light-driven photocatalysts are needed in future research because of the deterioration of the current one.

PCO(S) är ett tillstånd som påverkar äggstockarna. Tillståndet gör det lättare att gå upp i vikt och många som har diagnosen har en övervikt. Syftet med uppsatsen är att få en bild av hur personer med PCO(S) och övervikt bemöts i svensk hälso- och sjukvård. Den frågeställning som behandlas i uppsatsen är "Hur bemöts personer med PCO(S) och övervikt i svensk hälso- och sjukvård?". Undersökningen utfördes med hjälp av en webbenkät som delades i Facebook-gruppen "Vi med PCO(S) i Norden". 13 frågor utformades och de flesta baserades på tidigare forskning. 11 frågor hade fasta svarsalternativ och 2 frågor var öppna. 89 personer svarade på enkäten. Majoriteten av respondenterna upplevde ett dåligt bemötande i hälso- och sjukvården. En stor del upplevde att de själva behövde vara pålästa om PCO(S) för att få ett bra bemötande. Många av respondenterna efterfrågade mer påläst vårdpersonal och önskade att få bli behandlade med respekt och utan fördomar. Det framkom också att många föredrog om övervikt bara togs upp av vårdpersonal om det var relevant till vårdbesöket och många föredrog också att bli tillfrågade om ett samtycke att diskutera övervikt innan detta togs upp. Det framkom också att en del av deltagarna bytt vårdgivare till följd av dåligt bemötande samt att vissa undvikt att söka vård för att de varit rädda för ett dåligt bemötande relaterat till deras vikt. Patientgruppen verkar extra utsatt för dåligt bemötande och det antas att patientgruppen får lägga ner mycket extra tid på sin vård.

The meeting industry is a growing industry around the world, and the technological development in recent decades is one of the contributing factors to the increased travel opportunities and meeting industry's expansion. It can be assumed that the technology could replace some of the personal meetings, but humans have always had a need to meet in physical locations in work related purposes, therefore there is no evidence that personal meetings will disappear. Technological development should be seen as complementary rather than a substitute to the existing professional meetings. Public and private sectors within countries has drawn attention to meeting industry's potential, as favored destinations in terms of economic administration, image creation, expansion and acquisition of further market share in the global market. Meeting industry is complex precisely because there are so many different actors and stakeholders that integrate. For a destination to differentiate them and excel in the increasingly global world needed an elaborate marketing plan and effective cooperation between the various actors at the destination. Usually the largest professional meetings takes place in cities where there is capacity to receive large numbers of visitors. Essential elements for sustainable meeting industry are mutually dependent network relationships with strong organizational skills, and are of primary importance to a functioning whole. Among the various meeting actors, Convention Bureau occupy key role as the representative, the primary aim is to market the destination, display options, and finally bring together stakeholders with meeting participants. Lack of a Convention Bureau inhibit communication between meeting participants and stakeholders, also weakened the meeting related image because of incomplete representation.

The aim of the thesis named Decision criteria for the allocation of conferences and congresses in Prague is to analyse all the factors, which influence the choice of a particular congress or conference destination. The priority is to evaluate the congress tourism potential of the city of Prague and to suggest options for the innovation in order to increase the popularity of the destination. The thesis analyses the characteristics of the whole decision process of allocation a congress or a conference. Moreover, the activity of congress or conference organizers and destination organizations is described as well. The thesis is divided into four chapters. In the first and the second one, the substantial concepts of congress tourism, its organization and subjects are defined and characterized. The second target of this thesis is focused on the analysis of the decision criteria for the choice of the congress destination, the potential of Prague including SWOT analysis and the consequent summarization of impacts and possible innovations for Prague. The given interviews and materials from professionals in this field are the main sources for this thesis. In the end of the thesis, the overall situation in the congress tourism in Prague is evaluated and some suggestions for innovations for congresses or conference organization are proposed.

Polycystisktovarialsyndrom (PCOS) förekommer hos 5-10% av alla kvinnor och är den vanligaste orsaken till anovulatorisk infertilitet. Andra delar av syndromet är hyperandrogena och metabola symtom. Infertilitet behandlas med klomifencitrat. Akne och hirsutism behandlas i första hand med kombinerade p-piller med östrogenprofil. Förhöjda blodsockernivåer, hypertoni, dyslipidemi och övriga komplikationer till syndromet behandlas farmakologiskt vid behov. Hyperandrogenism och insulinresistens tycks spela en huvudroll i uppkomsten av sjukdomen. Då metformin förbättrar insulinkänsligheten, och tros kunna påverka patofysiologin, har det föreslagits som en alternativ förstahandsbehandling. Denna litteraturstudie syftade till att undersöka vilket vetenskapligt underlag som finns för att ändra behandlingsrekommendationerna vid PCOS. De studier som jämfört resultatet av metformin och klomifencitrat vid anovulatorisk infertilitet visar att klomifencitrat mer effektivt framkallar ovulation och graviditet hos kvinnor med PCOS och övervikt, men att metformin är lika effektivt hos normalviktiga kvinnor. Medan metforminbehandling är en välbeprövad och säker behandling med få biverkningar har klomifencitrat allvarliga biverkningar i form av risk för flerbörd och ovarialthyperstimuleringssyndrom. De få studier som undersökt metformins påverkan på fostret finner inga belägg för teratogena effekter. Metformin har positiva effekter på hyperandrogena symtom vid PCOS, och man har inte kunnat se någon signifikant skillnad i effekt mellan metformin och p-piller då det gäller att minska akne och hirsutism. Dessutom finns det belägg för att metformin kan ha en positiv påverkan på BMI och blodtryck, förbättra lipidprofilen genom att sänka nivåerna av LDL kolesterol, samt minskar risken hos denna patientgrupp att utveckla typ 2 diabetes. Sammantaget kan dock sägas att det vetenskapliga underlaget ännu är för svagt för att man ska ändra den rådande behandlingsrekommendationen. Det finns behov av större, blindade studier där man jämför metforminbehandling med klomifencitrat och tittar på en kombination av faktorer och utfall kopplade till symtombilden vid PCOS.

Indiana University-Purdue University Indianapolis (IUPUI) / Introduction: Endodontic treatment in teeth with pulp canal obliteration (PCO) is challenging. Guided Endodontic Access (GEA) combines information from a cone-beam computed tomography (CBCT) scan with an intra-oral scan to create a stent that can be used as a guide to treat teeth with PCO. GEA stents designed with traditional palatal accesses were shown to be successful in accurately negotiating these 3D printed teeth with simulated PCO, however, the difference in accuracy between the traditional palatal access compared to a conservative incisal access is not yet known. Objective: This in vitro study compares GEA stents designed with an incisal access approach to GEA stents designed with a traditional palatal access approach. The effect on the overall degree of deviation of the designed access path from the prepared path is evaluated by measuring the degree of angle of deviation and amount of deviation in millimeters. Materials and Methods: A 3-D printed maxillary model of an anonymous patient was used. PCO was simulated in a 3D printed natural #8 using the coDiagnostiX software tooth at two levels: coronal and mid-root. A GEA stent that extended from tooth #3 to tooth #14 with a guide sleeve over the simulated tooth #8 was accessed with a dedicated 1.0 mm diameter and 20 mm length drill that is designed to fit the access sleeve. 15 GEA stents had guides utilized for the incisal access approach, and 15 GEA stents had guides utilized for the traditional palatal access approach. Results: Angle, mesio-distal (base), and mesio-distal (tip) deviations were significantly lower for the incisal access compared to the traditional access. Inciso-apical (base) deviation was significantly more negative for incisal access compared to the traditional access. Bucco-lingual (base) deviation was significantly more negative for traditional access compared to the incisal access, while incisal and traditional accesses were not significantly different for bucco-lingual (tip) deviation. Coronal 1/3 calcification groups had significantly more mesio-distal (base) deviation than the middle 1/3 and no PCO groups. The no PCO group had significantly more negative inciso--apical (base) deviation than the coronal 1/3 calcification and middle 1/3 calcification groups, and the coronal 1/3 calcification group was significantly more negative than the middle 1/3 calcification group. The coronal 1/3 calcification group had significantly more mesio-distal (tip) deviation than the no PCO group. PCO level did not have a significant effect on angle, bucco-lingual (base), or bucco-lingual (tip) deviations. Conclusion: The utilization GEA via incisal access resulted in less degree and amount of drill deviation compared to the traditional access at all levels of calcification, however, the level of PCO did not influence the degree and amount of drill deviation between the incisal and traditional access approaches. It can be concluded that the use of a GEA stent that utilizes an incisal access approach in teeth with PCO will result in a more predictable outcome.

This thesis is focused on the congress tourism in Prague, which is the main congress destination of the Czech Republic. The first part aims to characterize and to map congress tourism in Prague with an emphasis on the potential of Prague as a congress destination. The thesis also describes the mechanisms of both domestic and foreign congress tourism market, including subjects, which operate on them. The subject of the next part is a comparison with selected congress destinations. The last part will focus on analysis of a company GUARANT International, which is representative of the professional congress organizer in Prague. The aim of the analysis is to assess the company's position in the domestic and foreign markets, for which competition analysis will be used. The last part will be a SWOT analysis and the results will be compared with the new company strategy.