芬兰健康与福利研究所

Advances in genotyping have heightened interest in using polygenic risk scores (PRS) to predict complex diseases such as type 2 diabetes (T2D) and coronary heart disease (CHD). However, the psychological effects of receiving a PRS have been examined only to a limited extent, with a notable absence of studies grounded in health psychology theory. The present study investigated whether incorporating PRS into risk communication influences health behaviors, drawing on a model inspired by the Health Action Process Approach (HAPA). The sample was collected in a randomized experimental design (N = 1494), in which 751 participants received a PRS result and 743 did not. Multigroup structural equation modeling was used to estimate HAPA-inspired path models and test whether the path coefficients differed between the study groups. The models examined how perceived risk, self-efficacy, and outcome expectancies were related to intentions to increase physical activity (PA) and fruit and vegetable intake (FVI), and how these intentions, in turn, were related to subsequent behavior. Multigroup analysis revealed small, non-significant differences between groups, suggesting that the inclusion of PRS did not substantially alter the functioning of the motivational pathways proposed by HAPA or the resulting health behaviors. Supplementing traditional disease risk information with PRS does not appear to significantly disrupt the motivational processes typically associated with health behavior change. These findings align with prior research on the HAPA model as well as with studies examining the psychological impact of receiving PRS.

Background:Tick-borne encephalitis (TBE), caused by tick-borne encephalitis virus (TBEV), is a zoonotic disease that can lead to severe neurological symptoms. Given the increasing number of reported human TBE cases in Europe, we developed a spatio-temporal predictive model to infer the year-to-year probability of human TBE occurrence across Europe at the regional and municipal administrative levels. Methods:We derived the distribution of human TBE cases at the regional level during 2017-2022 by using data provided by the European Centre for Disease Prevention and Control (ECDC), and at the municipal level by using data provided by Austria, Finland, Italy, Lithuania, and Slovakia. We modeled the probability of presence of human TBE cases at the regional and municipal levels for the period 2017-2025 with a boosted regression trees model, including covariates that affect both the natural hazard of virus circulation and human exposure to tick bites. Findings:Areas with the highest probability of human TBE infections are located in central-eastern Europe, the Baltic states, and along the coastline of Nordic countries. Our results highlight a statistically significant rising trend in human TBE risk not only in north-western, but also in south-western European countries. Such areas are characterised by the presence of key tick host species, forested areas, intense human activity in forests, steep drops in late summer temperatures and high precipitation amounts during the driest months. The model showed good predictive performance, with a mean AUC of 0.84 (SD = 0.03), sensitivity of 0.83 (SD = 0.01), and specificity of 0.80 (SD = 0.01) at the regional level, and a mean AUC of 0.82 (SD = 0.03), sensitivity of 0.83 (SD = 0.01), and specificity of 0.69 (SD = 0.01) at the municipal level. Interpretation:With ongoing climate and land use changes, the number of human TBE cases is likely to increase and spread into new areas. This highlights the importance of predictive models that can identify potential risk areas to support disease prevention and control efforts by public health authorities. The approach adopted, by fitting a One Health framework and leveraging lagged covaries, enables timely one-year-ahead predictions and enhances our current understanding of TBE risk under a global change scenario.

Longitudinal, nationwide register study. To identify independent predictors of clinical outcomes at 12 months for patients undergoing primary anterior cervical discectomy and fusion (ACDF) for degenerative cervical spine disease (DCSD). ACDF is an established surgical treatment for DCSD. Identifying factors that predict successful surgical outcomes can improve patient selection and inform decision-making. This study utilized data from the Finnish National Spine Register (FinSpine), covering all Finnish centers that perform ACDF surgery. Patients undergoing primary ACDF surgery for DCSD between June 2016 and February 2024 without prior cervical spine surgery were included (n=5517). Patients were grouped based on the patient symptom status (“improved” vs. “indifferent or worse”) at 12 months postsurgery. Predictive factors were identified using classification tree analysis followed by binary logistic regression. At 12 months, 76.8% (n=1799) of patients reported symptom improvement, while 23.2% (n=542) reported that symptoms were indifferent or worse. Loss to follow-up for the outcome variable was 57.6% at 12 months. The following factors were associated with better outcomes: shorter preoperative pain duration (≤1 yr, OR=1.95, P<0.001), lower preoperative Neck Disability Index (NDI) scores (≤42, OR=1.37, P=0.012), and nonsmoking (OR=1.37, P=0.030). The initial diagnosis also influenced outcomes: patients treated for herniated disks and nerve root stenosis were more likely to report improvement compared to those with central canal stenosis or myelopathy (P<0.001). Gender, age, BMI, working status, regular use of pain medication, perioperative complications, muscle weakness, levels fused, and use of plate versus stand-alone cage were not independently predictive of outcomes. Shorter preoperative pain duration, lower NDI scores, and nonsmoking status were significant predictors of good outcomes at 12 months after ACDF surgery for DCSD. These findings can help to guide preoperative patient counseling and enhance evidence-based decision-making for treating DCSD.

Cardiovascular Risk in Young Finns Study (YFS) is a prospective cohort of 3596 males and females (baseline age 3-18 years) that was established in 1980 to study cardiovascular risk factors in children and adolescents. The YFS has been instrumental in demonstrating the links between childhood risk factors and adult cardiovascular outcomes with implications on paediatric cardiovascular preventive practise. In the latest follow-up in 2018-2020, the study was expanded into a three-generation cohort, including the original cohort members, as well as their parents and offspring. Altogether 7341 individuals aged 3-92 years participated; 2127 original cohort members (now aged 40-58 years), 2452 parents (aged 58-92 years) and 2762 offspring (aged 3-37 years) of the original cohort members. The main aim was to establish a multigenerational population data base, sample biobank and links to national health registries that would offer a unique platform to study familial transmission of health-related traits. The field studies and data collections were conducted as part of the ERC funded MULTIEPIGEN project designed testing a specific hypothesis that epigenetic markers in the semen play a role in the transmission of intergenerational information in the paternal lineage. It is a first a priori designed epidemiologic study assessing the role of paternal life exposures, including chemical and psychosocial stress, in the development of cardio-metabolic, cognitive and psychosocial outcomes in their offspring. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The Young Finns Study has been financially supported by the Academy of Finland: grants 356405, 322098, 286284, 134309 (Eye), 126925, 121584, 124282, 129378 (Salve), 117797 (Gendi), and 141071 (Skidi); the Social Insurance Institution of Finland; Competitive State Research Financing of the Expert Responsibility area of Kuopio, Tampere and Turku University Hospitals (grant X51001); Juho Vainio Foundation; Paavo Nurmi Foundation; Finnish Foundation for Cardiovascular Research; Finnish Cultural Foundation; The Sigrid Juselius Foundation; Tampere Tuberculosis Foundation; Emil Aaltonen Foundation; Yrjo Jahnsson Foundation; Signe and Ane Gyllenberg Foundation; Diabetes Research Foundation of Finnish Diabetes Association; EU Horizon 2020 (grant 755320 for TAXINOMISIS and grant 848146 for To Aition); European Research Council (grant 742927 for MULTIEPIGEN project); Tampere University Hospital Supporting Foundation; Finnish Society of Clinical Chemistry; the Cancer Foundation Finland; pBETTER4U_EU (Preventing obesity through Biologically and bEhaviorally Tailored inTERventions for you; project number: 101080117); CVDLink (EU grant nro. 101137278) and the Jane and Aatos Erkko Foundation; Research Committee of the Kuopio University Hospital Catchment Area (State Research Funding, 5031364); Research Council of Finland Flagship InFLAMES (funding decision numbers 337530 and 357910). Pashupati P. Mishra was supported by the Academy of Finland (Grant number: 349708) and Emma Raitoharju (grants: 330809, 338395). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethical committees of the Hospital District of Southwest Finland and the European Research Council have approved the study. All individuals and/or legal guardians have signed a written informed consent to take part in the study. They had the right to refuse any part of the study protocol or discontinue at any time without the need to give any explanation. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Due to the local legal restrictions concerning the distribution of all personal information, allowance of open access to the YFS data is not possible. Therefore, data sharing outside the study group requires a data-sharing agreement. Investigators can submit an expression of interest to the YFS Steering Group / Data Sharing Committee (PI of the YFS, Prof. Olli Raitakari, olli.raitakari@utu.fi).

BACKGROUND AND OBJECTIVES The developmental trajectories and stability of delayed sleep phase (DSP) are poorly known. We investigated how behavioral and psychiatric characteristics, circadian thermoregulation, and the amount and intensity of physical activity (PA) were associated with the continuity of DSP from late adolescence to early adulthood. METHODS We created a population-based longitudinal study in which 1374 adolescents (mean age, 16.8 years; SD, 0.6; 66% girls) self-reported their sleep and psychiatric and behavioral symptoms at timepoint 1 (T1). A DSP-weighted subsample at T2 (7 months from T1; N = 315) and at T3 (19 months from T1; N = 207) provided sleep, PA (GENEActiv actigraphy, 8 days and nights), and skin temperature data (iButton 1922L thermologgers; 3 days and nights) twice. RESULTS Cluster analysis indicated 2 behavioral profiles underlying DSP: 1 pointing to game addiction alone and the other to widely spread behavioral challenges. The stability of DSP was 70%, such that poor self-control, attention-deficit hyperactivity disorder symptoms, and alcohol use together accounted for 18%. Alcohol use and poor self-control accounted for 16% of the emergence of DSP over time. Circadian thermoregulation or the duration or intensity of PA did not associate with the continuity of DSP. CONCLUSIONS DSP is a highly stable condition from late adolescence to early adulthood. Behavioral challenges related to self-control, attention-deficit hyperactivity disorder symptoms, and alcohol use underlie the trajectories of DSP over time. The outcomes emphasize behavioral over the potential physiological components of DSP measured in this study and give clear directions to develop new interventional targets to overcome DSP.