Revisión sistemática de la literatura : AINES en la disrupción ovulatoria y posible uso en anticoncepción de emergencia

La anticoncepción de emergencia a nivel mundial no ha mostrado el impacto esperado en disminuir la tasa de embarazo no deseados. El uso de nuevos medicamentos como los antiinflamatorios no esteroideos (AINES), al alterar el proceso ovulatorio, como una opción para la anticoncepción de emergencia, podría mejorar este resultado. Objetivo: Realizar una revisión sistemática de la literatura para determinar la efectividad de los AINES en alterar el proceso de la ovulación y posible uso en la anticoncepción de emergencia. Materiales y métodos: Se realizó una búsqueda sistemática y ampliada ensayos clínicos acerca de la efectividad de los AINES en la inhibición o retardo de la ovulación. Resultados: En total se encontraron 59 artículos, de los cuales siete cumplieron con los criterios de elegibilidad. Se evaluaron diferentes tipos de inhibidores de la Cicloxigenasa-COX (selectivos y no selectivos), encontrando tasas entre 75% hasta del 100% en la disrupción de la ovulación en las mujeres que recibieron COX-2 selectivos y un gradiente dosis-respuesta. Conclusiones: Los resultados de esta revisión sistemática de la literatura sugieren la efectividad de los AINES (específicamente los COX-2 selectivos) en la alteración de la ovulación y su potencial uso como medicamento para la anticoncepción de emergencia. Se requieren más ensayos clínicos con mayores tamaños de muestra que evalúen esta opción terapéutica.

Ain schön lied von ainem Ritter auß der Steyrmarck, genan[n]t Trinumitas, unnd von aines Künigs tochter auß Den[n]marck, genannt Floredebel : in Herzog Ernnsts ton

In Fraktur

Ioannis Lodovici Vivis Von Gebirlichê Thun und Lassen aines Ehermanns ain Buch verteuscht und erklärt durch Christophorum Brunonem ...

Sign.: a4, A-K6

Tyhjyyden reunalla, helvetin kannella : Yhtenäisen subjektin hajoaminen Saul Bellowin Herzogissa

The study shows that the reading paradigm derived from codes Roland Barthes presented in his S/Z exposes the postmodernic nature of Saul Bellow s Herzog (1964), and embodies in which way the novel is organized as a radical rewriting of modernism and its ideology. I explore how solid, compact and modernistic subject breaks down at every level of Herzog s narration. I actually argue that the heteroglossic novel is representative of an early American postmodern movement in literaure, and it should by no means be dissected narrowly as a realistic or naturalistic novel at all. The intertextual code verifies that the interpretation of Herzog remains inadequate if one doesn t take account of the novel s significant intertextual references to other texts. In fact, even the mind of Moses Herzog, the protagonist of the novel, is a mosaic of citations. It emerges from the dissertation that the figure of Don Quixote follows Moses Herzog as an ambiguous shadow while the professor of history struggles with his anxiety and anguish, and travels in a mentally confused state around the U.S. for five days in the early 1960s, encountering the impending atmosphere of transition as the country is on the threshold of a significant cultural and social change. There is a strong necessity for updated interpretation of Herzog partly because its centrality to Bellow s own career as a writer but mainly because it has been previously read trough modernistic lenses. I shall try to proof in my study that American Jewish Saul Bellow s (1915 2005) Herzog escapes any kind of simple, elemental or essentialistic construction or reading and in real terms it doesn t offer any comprehensive, total or coherent solution or system for those philosophical doctrines it criticizes and makes fun of. The philosophical, conceptual and cultural substance of Herzog does not constitute an independent or autonomous theoretical tract which would have a life of its own. Altough the novel reflects the continuity of Bellow s writing it is clearly some kind of conscious or unconscious experiment during his long career as a writer. He hasn t been so radical before or since the publication of Herzog. It is unarguably his most postmodern novel.The reading paradigm based on specific codes demonstrates how deep into the basic questions of his personal life and existence itself he must dive in oder to find his many ways towards authentic or primordial self in fragmented and shattered world which is constanly rewritten and which makes human being a tourist of his own life. In that ongoing process the protagonist has to accept the ultimate plurality of his mind and self. He must confront that the modernistic definition of identity as a solid, monolithic and stable entity has broken down into different, inconsistent and even contradictory possibilities of identification. Moses Herzog embodies obviously Stuart Hall s description of the postmodern self his identity has turn into a movable feast.

Temperature sensitivity of soil organic matter decomposition in boreal soils

The temperature sensitivity of decomposition of different soil organic matter (SOM) fractions was studied with laboratory incubations using 13C and 14C isotopes to differentiate between SOM of different age. The quality of SOM and the functionality and composition of microbial communities in soils formed under different climatic conditions were also studied. Transferring of organic layers from a colder to a warmer climate was used to assess how changing climate, litter input and soil biology will affect soil respiration and its temperature sensitivity. Together, these studies gave a consistent picture on how warming climate will affect the decomposition of different SOM fractions in Finnish forest soils: the most labile C was least temperature sensitive, indicating that it is utilized irrespective of temperature. The decomposition of intermediate C, with mean residence times from some years to decades, was found to be highly temperature sensitive. Even older, centennially cycling C was again less temperature sensitive, indicating that different stabilizing mechanisms were limiting its decomposition even at higher temperatures. Because the highly temperature sensitive, decadally cycling C, forms a major part of SOM stock in the organic layers of the studied forest soils, these results mean that these soils could lose more carbon during the coming years and decades than estimated earlier. SOM decomposition in boreal forest soils is likely to increase more in response to climate warming, compared to temperate or tropical soils, also because the Q10 is temperature dependent. In the northern soils the warming will occur at a lower temperature range, where Q10 is higher, and a similar increase in temperature causes a higher relative increase in respiration rates. The Q10 at low temperatures was found to be inversely related to SOM quality. At higher temperatures respiration was increasingly limited by low substrate availability.

Energiapuuharvennus osana metsänkasvatusta ja ilmastonmuutoksen hillitsemistä

The aim of this study was to compare the differences between forest management incorporating energy wood thinning and forest management based on silvicultural recommendations (baseline). Energy wood thinning was substituted for young stand thinning and the first commercial thinning of industrial wood. The study was based on the forest stand data from Southern Finland, which were simulated by the MOTTI-simulator. The main interest was to find out the climatic benefits resulting from carbon sequestration and energy substitution. The value of energy wood was set to substitute it for coal as an alternative energy fuel (emission trade). Other political instruments (Kemera subsidies) were also analysed. The largest carbon dioxide emission reductions were achieved as a combination of carbon sequestration and energy substitution (on average, a 26-90 % increase in discounted present value in the beginning of rotation) compared to the baseline. Energy substitution increased emission reductions more effectively than carbon sequestration, when maintaining dense young stands. According to the study, energy wood thinning as a part of forest management was more profitable than the baseline when the value of carbon dioxide averaged more than 15 €/CO2 and other political subsidies were unchanged. Alternatively, the price of energy wood should on average exceed 21 €/m3 on the roadside in order to be profitable in the absence of political instruments. The most cost-efficient employment of energy wood thinning occured when the dominant height was 12 meters, when energy substitution was taken into account. According to alternative forest management, thinning of sapling stands could be done earlier or less intensely than thinning based on silvicultural recommendations and the present criteria of subsidies. Consequently, the first commercial thinning could be profitable to carry out either as harvesting of industrial wood or energy wood, or as integrated harvesting depending on the costs of the harvesting methods available and the price level of small-size industrial wood compared to energy wood.

Langattoman peltotiedustelijan maanalainen toimintaympäristö ja laitesuunnittelu

Tässä väitöskirjassa esitellään langattomien maanalaisten peltotiedustelijoiden järjestelmän tavoitteet ja rajoitukset. Tarkoitus oli kehittää käytännön viljelyyn sovellettava pellon seurantajärjestelmä, sillä reaaliaikaisen kosteus- ja lämpötilatiedon keruulaitteiden puuttuminen haittaa viljelytoimenpiteiden suunnittelua. Mittaus-aineistosta voi tehdä sekä havaintoja pellon ominaisuuksista että muutoksista niissä. Tulevaisuudessa tiedustelijalla saatetaan voida mitata ravinteita tai kemikaaleja. Kun peltotiedustelijan 869 MHz:n radioaalto saavuttaa vastaanottoantennin, on 1) maa-aines vaimentanut sitä; 2) osa aallosta heijastunut rajapinnoilta; 3) pellosta ulos taittuva aalto hajaantunut ja; 4) aallon intensiteetti alentunut etäisyyden kasvaessa. Maan sähkökenttäkäyttäytymistä kuvaava permittiivisyys on kompleksinen suure, jonka reaaliosa kuvaa varautumiskykyä (polarisoitumista) ja imaginaariosa häviöllisyyttä (sähkönjohtavuutta). Pellon pinnassa aalto on pallomainen, joten heijastumisen lisäksi hajaannuttaa taittuminen suurilla taitekulmilla sen tehoa. Tiedustelijan prototyyppiä varten kehitettiin maa-aineksessa toimivat antennit, joiden taajuuskaistat kattoivat ne aallonpituudet, jotka 869 MHz:n radioaalto saa kuivassa ja märässä mullassa, sillä aallon etenemisnopeus ja pituus muuttuvat maan kosteudesta riippuen. Vaimennusmallin testausmittauksiin tehtiin discone-antenni, ja tiedustelijaa varten piirilevytekniikalla pienikokoinen elliptinen monopoliantenni, jonka piirikortille ladottiin myös tiedustelijan elektroniikka. Multalaatikkoon upotettujen antennien säteilyominaisuudet määritettiin piirianalysaattorilla heijastusvaimennusmittauksin. Elektroniikkasuunnittelun tavoitteita oli pieni koko ja pitkä toimintaikä. Näihin päästiin komponenttivalinnoilla sekä ohjelmoinnin keinoin. Tiedustelija teki mittaukset ja lähetti tulokset 10 min välein ja sen keskivirrankulutus oli 4,2 uA käytettäessä 3 V:n paristoa, jonka 1800 mAh kapasiteetti riittäisi huonollakin hyötysuhteella yli 10 vuodeksi. Vuoden mittaisen 12 prototyypin käytön perusteella voidaan kantamaa parantaa yli nykyisen 200 m:n ilman käyttöiän lyhentymistä 1) nostamalla laitteen lähetystehoa ja pariston käyttöastetta lisäkomponenteilla; 2) parantamalla vastaanottoantennin vahvistusta; 3) pidentämällä lähetysten jaksoa; 4) ohjelmoimalla tiedustelija suodattamaan mittaustietoja ja; 5) koodaamalla useita tuloksia samaan lähetteeseen. Järjestelmän ja mittaustulosten käytettävyyttä voidaan parantaa paikantamalla tiedustelijoiden syvyydet aaltoilevan lämpötilan vaihe-erojen perusteella ja ohjelmoimalla tiedustelijaan opastava asennustoiminto. Lisäksi maahan asennetun tiedustelijan toimintaparametrit tai jopa koko ohjelmisto voidaan vaihtaa langattomasti. Vastaanottoasemat matkapuhelinmastoissa voisivat vastaanottaa viestejä parin kilometrin säteeltä. Koostettu aineisto maaperäsimulaattoreihin yhdistettynä antaisi kuvan alueellisesta tilanteesta ja viljelijän omille lohkoille sijoitetut tiedustelijat korjauspisteitä keskiarvosta.

Degradation of lignin and other 14C-labelled compounds in compost and soil with an emphasis on white-rot fungi

Puu, ruohokasvit ja näistä tehdyt tuotteet kuten mekaanisesta massasta valmistettu sanomalehtipaperi sisältävät ligniiniä, joka hajoaa yleensä hyvin hitaasti luonnossa. Valkolahosienet hajottavat ligniiniä tehokkaimmin, ja koska niiden tuottamat entsyymit hajottavat myös muita vaikeasti hajoavia yhdisteitä, voidaan valkolahosienten avulla mahdollisesti puhdistaa saastuneita maita. Tässä työssä haluttiin selvittää, säilyttävätkö valkolahosienet (Abortiporus biennis, Bjerkandera adusta, Dichomitus squalens, Phanerochaete chrysosporium, Phanerochaete sordida, Phlebia radiata, Pleurotus ostreatus, Trametes hirsuta ja Trametes versicolor) aktiivisuutensa ja kasvavatko ne maassa. Aktiivisuutta mitattiin seuraamalla sienten synteettisen ligniinin (14C-DHP) hajotuskykyä. T. versicolor (silkkivyökääpä) osoittautui tehokkaimmaksi ligniinin hajottajaksi ja sen pentakloorifenolin (PCP) hajotuskykyä tutkittiin erillisessä kokeessa. Entiset tai pitkään käytössä olleet saha-alueet ovat yhä saastuneet puun käsittelyaineista peräisin olevilla kloorifenoleilla. Biohajoavien muovien kehitystyö sekä kompostoinnin yleistyminen jätteiden käsittelymenetelmänä ovat luoneet tarpeen materiaalien biohajoavuuden määrittämiseen. Euroopan standardisoimisjärjestön (CEN) kontrolloidussa kompostitestissä biohajoavuus määritetään materiaalin hajoamisen aikana muodostuvan hiilidioksidin perusteella. Hiilidioksidin tuotto mitataan sekä näytettä sisältävästä kompostista että kompostista ilman näytettä, ja tällöin oletetaan, että kompostin orgaaninen aines molemmissa komposteissa (tausta) tuottaa yhtä paljon hiilidioksidia. Testin puutteeksi saattaa osoittautua kompostissa tai maassa esiintyvä "priming effect". Tällä tarkoitetaan materiaalin lisäämisen jälkeen esiintyvää epänormaalin suurita tai pientä hiilidioksidin muodostusta, minkä seurauksena testin tulosksena saatava biohajoavuus on virheellinen. Ligniinin hajotessa muodostuu enemmän humusta kuin hiilidioksidia, koska ligniini on humuksen tärkein lähtöaine. Näin ollen ligniiniä sisältävät paperituotteet saattavat testin mukaan vaikuttaa biologisesti hajoamattomilta. Valkolahosienet hajottivat 4-23% ligniinistä hiilidioksidiksi ja T. versicolor 29% PCP:sta. Kompostissa ligniini hajosi hiilidioksidiksi 58°C:ssa huomattavasti vähemmän (8%) kuin lämpötiloissa 35°C ja 50°C (23-24%). Kompostin todennäköisesti tärkeimpien ligniinin hajottajien, termofiilisten sienten, tyypillinen optimilämpötila on 45°C, eivätkä ne ole enää aktiivisia 58°C:ssa. Sekä maassa että kompostissa ligniini sitoutui kuitenkin suurimmaksi osaksi humukseen. Valkolahosienet hajottivat sekä humukseen sitoutunutta ligniiniä että PCP:ia, mutta kompostin sekapopulaatio ei tähän pystynyt, ja ligniiniä sitoutui humukseen yhä enemmän kompostoinnin aikana. T. versicolor hajotti PCP:ia tehokkaasti, eikä se tuottanut myrkyllisiä kloorianisoleja, joita jotkut valkolahosienet saattavat muodostaa kloorifenoleista. Priming effect ilmiötä tutkittiin eri ikäisissä ja kypsyydeltään erilaisissa komposteissa. Kompostit erosvat toisistaan myös hajoamattoman jätteen määrän ja mikrobipopulaation suhteen. Negatiivinen priming effect havaittiin kaikissa epästabiileissa komposteissa (ikä enintään 6 kk), ja sen lisäksi yhdessä näistä komposteista positiivinen priming effect kokeen lopussa. Stabiileissa komposteissa (ikä vähintään 6 kk) ilmiötä ei sen sijaan havaittu. Epästabiileissa komposteissa biohajoavuudelle saadut tulokset eivät siis ole luotettavia. Työn tulosten perusteella valkolahosienet, ja erityisesti T. versicolor, ovat lupaavia saastuneen maan puhdistukseen, joskin sienirihmaston mahdollisuudet säilyä aktiivisena maan alkuperäisen mikrobipopulaation kanssa täytyy vielä selvittää. Kompostin sekapopulaatio, joka ei sisällä valkolahosieniä, hajotti ligniiniä yllättävän tehokkaasti termofiilisille sienille sopivissa lämpötiloissa, vaikka ligniini sitoutuikin pääasiallisesti humukseen. Kompostin kypsyys osoittautui tärkeäksi tekijäksi kontrolloidun kompostitestin onnistumisen kannalta. Priming effect ilmiön välttämiseksi on varmistettava, että testissä käytetty komposti on riittävän kypsä. Kompostien mikrobipopulaation koostumusta kompostoinnin eri vaiheissa tulisi tarkemmin selvittää, koska stabiilien ja epästabiilien kompostien ero aiheutui todennäköisesti populaatioiden rakenteessa vallitsevista eroista. Näin myös priming effect ilmiön syyt voitaisiin selittää paremmin.

Bayesian Inference for Retrospective Population Genetics Models Using Markov Chain Monte Carlo Methods

Genetics, the science of heredity and variation in living organisms, has a central role in medicine, in breeding crops and livestock, and in studying fundamental topics of biological sciences such as evolution and cell functioning. Currently the field of genetics is under a rapid development because of the recent advances in technologies by which molecular data can be obtained from living organisms. In order that most information from such data can be extracted, the analyses need to be carried out using statistical models that are tailored to take account of the particular genetic processes. In this thesis we formulate and analyze Bayesian models for genetic marker data of contemporary individuals. The major focus is on the modeling of the unobserved recent ancestry of the sampled individuals (say, for tens of generations or so), which is carried out by using explicit probabilistic reconstructions of the pedigree structures accompanied by the gene flows at the marker loci. For such a recent history, the recombination process is the major genetic force that shapes the genomes of the individuals, and it is included in the model by assuming that the recombination fractions between the adjacent markers are known. The posterior distribution of the unobserved history of the individuals is studied conditionally on the observed marker data by using a Markov chain Monte Carlo algorithm (MCMC). The example analyses consider estimation of the population structure, relatedness structure (both at the level of whole genomes as well as at each marker separately), and haplotype configurations. For situations where the pedigree structure is partially known, an algorithm to create an initial state for the MCMC algorithm is given. Furthermore, the thesis includes an extension of the model for the recent genetic history to situations where also a quantitative phenotype has been measured from the contemporary individuals. In that case the goal is to identify positions on the genome that affect the observed phenotypic values. This task is carried out within the Bayesian framework, where the number and the relative effects of the quantitative trait loci are treated as random variables whose posterior distribution is studied conditionally on the observed genetic and phenotypic data. In addition, the thesis contains an extension of a widely-used haplotyping method, the PHASE algorithm, to settings where genetic material from several individuals has been pooled together, and the allele frequencies of each pool are determined in a single genotyping.

Ideological notions in public health care rationing : Case studies from Oregon, New Zealand and Finland

The purpose of this dissertation is to analyze and explicate the ideological content, which is often implicit, in the health care rationing discussion. The phrase "ideological content" refers to viewpoints and assumptions expressed in the rationing discussion that may be widespread and accepted, but without clear evidential support. The study method is philosophical text analysis. The study begins by exploring the literature from the 1970s that affects the present-day rationing discussion. Since ideological contents may have different emphases in realm of health care, three representative cases were studied. The first was a case study of the first and best-known rationing experiment in the American state of Oregon, namely, an experimental rationing plan within the public health program Medicaid, which is designed to provide care for the poor and underprivileged. The second was a study of the only national-level public priority setting that has been conducted in New Zealand. The third examined the Finnish Care Guarantee plan introduced in March 2005. The findings show that several problematic and scientifically mostly unproven concepts have remained largely uncontested in the debate about public health care rationing. Some of these notions already originated decades ago in studies that relied on outdated data or research paradigms. The problematic ideological contents have also been taken up from one publication into another, thereby affecting the rationing debate. The study suggests that before any new public health care rationing experiments are undertaken, these ideological factors should be properly examined, especially in order to avoid repetitious research and perhaps erroneous rationing decisions.

Sediment resuspension as a water quality regulator in lakes

Sediment resuspension, the return of the bottom material into the water column, is an important process that can have various effects on a lake ecosystem. Resuspension caused by wind-induced wave disturbance, currents, turbulent fluctuations and bioturbation affects water quality characteristics such as turbidity, light conditions, and concentrations of suspended solids (SS) and nutrients. Resuspension-mediated increase in turbidity may favour the dominance of phytoplankton over macrophytes. The predator-prey interactions contributing to the trophic state of a lake may also be influenced by increasing turbidity. Directly, the trophic state of a lake can be influenced by the effect of sediment resuspension on nutrient cycling. Resuspension enhances especially the cycling of phosphorus by bringing the sedimentary nutrients back into the water column and may thereby induce switches between phosphorus and nitrogen limitation. The contribution of sediment resuspension to gross sedimentation, turbidity, and concentration of SS and nutrients was studied in a small, deep lake as well as in a multibasin lake with deep and shallow areas. The effect of ice cover on sediment resuspension and thereby on phosphorus concentrations was also studied. The rates of gross sedimentation and resuspen¬sion were estimated with sediment traps and the associations between SS and nutrients were considered. Sediment resuspension, caused by wind activity, comprised most of the gross sedimenta¬tion and strongly contributed to the concentration of SS and turbidity in the lakes studied. Additionally, via the influence on SS, resuspension affected the concentration of total phosphorus (TP) and soluble reactive phosphorus (SRP), as well as the total nitrogen to total phosphorus (TN:TP) ratio. Although contrasting results concerning the dependence between the SS and SRP concentrations were observed, it could be concluded that sediment resuspension during strong algal blooms (pH > 9) led to aerobic release of P. The main findings of this thesis were that in the course of the growing season, sediment resuspension coupled with phytoplankton succession led to liberation of P from resuspended particles, which in turn resulted in high TP concentrations and low TN:TP ratios. This development was likely a cause of strong cyanobacterial blooms in midsummer.

Molecular details of phage phi6 RNA-dependent RNA synthesis

For most RNA viruses RNA-dependent RNA polymerases (RdRPs) encoded by the virus are responsible for the entire RNA metabolism. Thus, RdRPs are critical components in the viral life cycle. However, it is not fully understood how these important enzymes function during viral replication. Double-stranded RNA (dsRNA) viruses perform the synthesis of their RNA genome within a proteinacous viral particle containing an RdRP as a minor constituent. The phi6 bacteriophage is the best-studied dsRNA virus, providing an excellent background for studies of its RNA synthesis. The purified recombinant phi6 RdRP is highly active in vitro and it possesses both RNA replication and transcription activities. The crystal structure of the phi6 polymerase, solved in complex with a number of ligands, provides a working model for detailed in vitro studies of RNA-dependent RNA polymerization. In this thesis, the primer-independent initiation of the phi6 RdRP was studied in vitro using biochemical and structural methods. A C-terminal, four-amino-acid-long loop protruding into the central cavity of the phi6 RdRP has been suggested to stabilize the incoming nucleotides of the initiation complex formation through stacking interactions. A similar structural element has been found from several other viral RdRPs. In this thesis, this so-called initiation platform loop was subjected to site-directed mutagenesis to address its role in the initiation. It was found that the initiation mode of the mutants is primer-dependent, requiring either an oligonucleotide primer or a back-priming initiation mechanism for the RNA synthesis. The crystal structure of a mutant RdRP with altered initiation platform revealed a set of contacts important for primer-independent initiation. Since phi6 RdRP is structurally and functionally homologous to several viral RdRPs, among them the hepatitis C virus RdRP, these results provide further general insight to understand primer-independent initiation. In this study it is demonstrated that manganese phasing could be used as a practical tool for solving structures of large proteins with a bound manganese ion. The phi6 RdRP was used as a case study to obtain phases for crystallographic analysis. Manganese ions are naturally bound to the phi6 RdRP at the palm domain of the enzyme. In a crystallographic experiment, X-ray diffraction data from a phi6 RdRP crystal were collected at a wavelength of 1.89 Å, which is the K edge of manganese. With this data an automatically built model of the core region of the protein could be obtained. Finally, in this work terminal nucleotidyl transferase (TNTase) activity of the phi6 RdRP was documented in the isolated polymerase as well as in the viral particle. This is the first time that such an activity has been reported in a polymerase of a dsRNA virus. The phi6 RdRP used uridine triphosphates as the sole substrate in a TNTase reaction but could accept several heterologous templates. The RdRP was able to add one or a few non-templated nucleotides to the 3' end of the single- or double-stranded RNA substrate. Based on the results on particle-mediated TNTase activity and previous structural information of the polymerase, a model for termination of the RNA-dependent RNA synthesis is suggested in this thesis.

Export of organic matter, sulphate and base cations from boreal headwater catchments downstream to the coast: impacts of land use and climate

The terrestrial export of dissolved organic matter (DOM) is associated with climate, vegetation and land use, and thus is under the influence of climatic variability and human interference with terrestrial ecosystems, their soils and hydrological cycles. The present study provides an assessment of spatial variation of DOM concentrations and export, and interactions between DOM, catchment characteristics, land use and climatic factors in boreal catchments. The influence of catchment characteristics, land use and climatic drivers on the concentrations and export of total organic carbon (TOC), total organic nitrogen (TON) and dissolved organic phosphorus (DOP) was estimated using stream water quality, forest inventory and climatic data from 42 Finnish pristine forested headwater catchments, and water quality monitoring, GIS land use, forest inventory and climatic data from the 36 main Finnish rivers (and their sub-catchments) flowing to the Baltic Sea. Moreover, the export of DOM in relation to land use along a European climatic gradient was studied using river water quality and land use data from four European areas. Additionally, the role of organic and minerogenic acidity in controlling pH levels in Finnish rivers and pristine streams was studied by measuring organic anion, sulphate (SO4) and base cation (Ca, Mg, K and Na) concentrations. In all study catchments, TOC was a major fraction of DOM, with much lower proportions of TON and DOP. Moreover, most of TOC and TON was in a dissolved form. The correlation between TOC and TON concentrations was strong and TOC concentrations explained 78% of the variation in TON concentrations in pristine headwater streams. In a subgroup of 20 headwater catchments with similar climatic conditions and low N deposition in eastern Finland, the proportion of peatlands in the catchment and the proportion of Norway spruce (Picea abies Karsten) of the tree stand had the strongest correlation with the TOC and TON concentrations and export. In Finnish river basins, TOC export increased with the increasing proportion of peatland in the catchment, whereas TON export increased with increasing extent of agricultural land. The highest DOP concentrations and export were recorded in river basins with a high extent of agricultural land and urban areas, reflecting the influence of human impact on DOP loads. However, the most important predictor for TOC, TON and DOP export in Finnish rivers was the proportion of upstream lakes in the catchment. The higher the upstream lake percentage, the lower the export indicating organic matter retention in lakes. Molar TOC:TON ratio decreased from headwater catchments covered by forests and peatlands to the large river basins with mixed land use, emphasising the effect of the land use gradient on the stoichiometry of rivers. This study also demonstrated that the land use of the catchments is related to both organic and minerogenic acidity in rivers and pristine headwater streams. Organic anion dominated in rivers and streams situated in northern Finland, reflecting the higher extent of peatlands in these areas, whereas SO4 dominated in southern Finland and on western coastal areas, where the extent of fertile areas, agricultural land, urban areas, acid sulphate soils, and sulphate deposition is highest. High TOC concentrations decreased pH values in the stream and river water, whereas no correlation between SO4 concentrations and pH was observed. This underlines the importance of organic acids in controlling pH levels in Finnish pristine headwater streams and main rivers. High SO4 concentrations were associated with high base cation concentrations and fertile areas, which buffered the effects of SO4 on pH.

Acute renal failure in critically ill patients : With special reference to prediction of outcome

Acute renal failure (ARF) is a clinical syndrome characterized by rapidly decreasing glomerular filtration rate, which results in disturbances in electrolyte- and acid-base homeostasis, derangement of extracellular fluid volume, and retention of nitrogenous waste products, and is often associated with decreased urine output. ARF affects about 5-25% of patients admitted to intensive care units (ICUs), and is linked to high mortality and morbidity rates. In this thesis outcome of critically ill patients with ARF and factors related to outcome were evaluated. A total of 1662 patients from two ICUs and one acute dialysis unit in Helsinki University Hospital were included. In study I the prevalence of ARF was calculated and classified according to two ARF-specific scoring methods, the RIFLE classification and the classification created by Bellomo et al. (2001). Study II evaluated monocyte human histocompatibility leukocyte antigen-DR (HLA-DR) expression and plasma levels of one proinflammatory (interleukin (IL) 6) and two anti-inflammatory (IL-8 and IL-10) cytokines in predicting survival of critically ill ARF patients. Study III investigated serum cystatin C as a marker of renal function in ARF and its power in predicting survival of critically ill ARF patients. Study IV evaluated the effect of intermittent hemodiafiltration (HDF) on myoglobin elimination from plasma in severe rhabdomyolysis. Study V assessed long-term survival and health-related quality of life (HRQoL) in ARF patients. Neither of the ARF-specific scoring methods presented good discriminative power regarding hospital mortality. The maximum RIFLE score for the first three days in the ICU was an independent predictor of hospital mortality. As a marker of renal dysfunction, serum cystatin C failed to show benefit compared with plasma creatinine in detecting ARF or predicting patient survival. Neither cystatin C nor plasma concentrations of IL-6, IL-8, and IL-10, nor monocyte HLA-DR expression were clinically useful in predicting mortality in ARF patients. HDF may be used to clear myoglobin from plasma in rhabdomyolysis, especially if the alkalization of diuresis does not succeed. The long-term survival of patients with ARF was found to be poor. The HRQoL of those who survive is lower than that of the age- and gender-matched general population.