Inpatient hospital care and its costs among type 1 diabetic patients in Finland : a nationwide longitudinal study

Background. In Finland, the incidence of type 1 diabetes mellitus (T1DM) is the highest in the world, and it continues to increase steadily. No effective preventative interventions exist either for individuals at high risk or for the population as a whole. In addition to problems with daily lifelong insulin replacement therapy, T1DM patients with long-lasting disease suffer from various diabetes related complications. The complications can lead to severe impairments and reductions in functional capacity and quality of life and in the worst case they can be fatal. Longitudinal studies on the costs of T1DM are extremely rare, especially in Finland. Typically, in these studies, distinctions between the various types of diabetes have not been made, and costs have not been calculated separately for the sexes. Aims. The aim of this study was to describe inpatient hospital care and costs of inpatient care in a cohort of 5,166 T1DM patients by sex during 1973-1998 in Finland. Inpatient care and costs of care due to T1DM without complications, due to T1DM with complications and due to other causes were calculated separately. Material and Methods. The study population consisted of all Finnish T1DM patients diagnosed before the age of 18 years between January 1st in 1965 and December 31st in 1979 and derived from the Finnish population based T1DM register (N=5,120 in 1979 and N=4,701 in 1997). Data on hospitalisations were obtained from the Finnish Hospital Discharge Register. Results. In the early stages of T1DM, the majority of the use of inpatient care was due to the treatment of T1DM without complications. There were enormous increases in the use of inpatient care for certain complications when T1DM lasted longer (from 9.5 years to 16.5 years). For women, the yearly number of bed-days for renal complications increased 4.8-fold, for peripheral vascular disease 4.3-fold and for ophthalmic complications 2.5-fold. For men, the corresponding increases were as follows: 5-fold, 6.9-fold and 2.5-fold. The yearly bed-days for glaucoma increased 8-fold, nephropathy 7-fold and microangiopathy 6-fold in the total population. During these 7 years, the yearly numbers of bed-days for T1DM without complications dropped dramatically. The length of stay in inpatient care decreased notably, but hospital visits became more frequent when the length of duration of T1DM increased from 9.5 years to 16.5 years. The costs of treatments due to complications increased when T1DM lasted longer. Costs due to inpatient care of complications in the cohort 2.5-folded as duration of T1DM increased from 9.5 years to 16.5 years, while the total costs of inpatient care in the cohort dropped by 22% due to an 80% decrease in the costs of care of T1DM without complications. Treating complications of female patients was more expensive than treating complications of men when T1DM had lasted 9.5 years; the mean annual costs for inpatient care of a female diabetic (any cause) were 1,642 , and the yearly costs of care of complications were 237 . The corresponding yearly mean costs for a male patient were 1,198 and 167 . Treating complications of female patients was more expensive than that of male patients also when the duration of diabetes was 16.5 years, although the difference in average annual costs between sexes was somewhat smaller. Conclusions. In the early phases of T1DM, the treatment of T1DM without complications causes a considerable amount of hospital bed-days. The use of inpatient care due to complications of T1DM strongly increases with ageing of patients. The economic burden of inpatient care of T1DM is substantial.

Valikoivan metsästyksen vaikutus hirven ikärakenteeseen ja vasatuottoon Savonrannan ja Sodankylän riistanhoitoyhdistysten alueilla

Suomen hirvenmetsästykseen omaksuttiin 1970-luvun alussa valikoivan metsästyksen periaatteet, joiden tavoitteena oli maksimoida vasatuotto hirvikannan ikärakennetta muuttamalla. Metsästysstrategiassa tapahtui huomattava muutos, kun hirvisaaliin vasaosuutta lisättiin selvästi. Tämän seurauksena naarashirvien keski-ikä ja vasatuotto kohosivat. Vasojen suuri osuus saaliissa oli keskeinen tekijä hirvikannan rajuun kasvuun. Tämän opinnäytetyön tavoitteena oli selvittää saaliin vasaosuuden vaikutusta hirven ikärakenteeseen ja vasatuottoon Savonrannan ja Sodankylän riistanhoitoyhdistysten alueilla. Tutkimusalueet valittiin hyvin erilaisten hirvisaaliin vasaosuuksien perusteella, sillä Savonrannan vuosien 1994-2003 saaliin vasaosuuden keskiarvo oli 50,1 % ja Sodankylän 19,6 %. Tutkimuksen ennakko-olettamuksena oli, että erilaisten saaliin vasaosuuksien pitäisi vaikuttaa aikuistuvan ikäluokan suhteellisen osuuden kautta hirvipopulaation keski-ikään ja sitä kautta vasatuottoon. Ikärakenteen osalta tutkittiin naaraiden, valtasonnien eli 6,5-9,5-vuotiaiden uroshirvien ja vähintään 8-piikkisten urosten ikärakennetta. Tutkimus rakentui hirven iänmääritysaineiston ympärille, joka kerättiin Savonrannan ja Sodankylän riistanhoitoyhdistysten hirvenmetsästäjien avustuksella vuosina 2003 ja 2004. Iänmääritysaineistossa oli yhteensä 244 hirveä. Näistä oli naaraita 152 ja uroksia 92 kpl. Hirven ikärakennetietojen saamiseksi suoritti tutkimuksen tekijä iänmäärityksen hammasnäytteistä. Iänmääritys tehtiin hammassementtikerroksiin perustuvaa menetelmää käyttäen, jota varten sahattiin poikittaisia hammasleikkeitä hirven ensimmäisestä etuhampaasta (I1). Tutkimuksen aineistoon kuuluivat myös Savonrannan ja Sodankylän hirvihavaintokorttien perusteella saadut vasatuottotiedot vuosilta 1995- 2004 ja Riistawebin saalistiedot vuosilta 1994-2003. Tutkimuksen perusteella hirvisaaliin vasaosuus vaikuttaa Savonrannan ja Sodankylän riistanhoitoyhdistysten naaraiden ikärakenteeseen. Kaksivuotisesta aineistosta saatiin Savonrannan naaraiden keski-iäksi 6,40 vuotta. Sodankylän naaraiden keski-ikä oli 5,09 vuotta. Myös naaraiden ikäjakaumat olivat hyvin erilaiset. Hirvisaaliin vasaosuus ei sen sijaan vaikuta Savonrannan ja Sodankylän valtasonnien ja vähintään 8-piikkisten urosten ikärakenteeseen. Savonrannan valtasonnien keski-ikä oli 7,21 vuotta ja Sodankylän 7,07 vuotta. Savonrannan vähintään 8-piikkisten urosten keski-ikä oli 5,82 vuotta ja Sodankylän 5,91 vuotta. Tutkimuksella saatiin selville saaliin ikärakenne, elävän hirvikannan ikärakenteen tutkiminen vaatii laajempia tutkimuksia. Hirvisaaliin vasaosuus vaikuttaa Savonrannan ja Sodankylän riistanhoitoyhdistysten vasatuottoon. Naaraiden ikärakenteen erot näkyivät osaltaan hirvihavaintokorttien ja näytenaaraiden perusteella lasketuissa vasatuottotiedoissa. Saaliin vasaosuus vaikuttaa välillisesti hirven vasatuottoon, sillä se vaikuttaa ensin naaraiden ikärakenteeseen, joka vaikuttaa edelleen vasatuottoon.

Measurements of the top-quark mass using charged particle tracking

We present three measurements of the top-quark mass in the lepton plus jets channel with approximately 1.9 fb-1 of integrated luminosity collected with the CDF II detector using quantities with minimal dependence on the jet energy scale. One measurement exploits the transverse decay length of b-tagged jets to determine a top-quark mass of 166.9+9.5-8.5 (stat) +/- 2.9 (syst) GeV/c2, and another the transverse momentum of electrons and muons from W-boson decays to determine a top-quark mass of 173.5+8.8-8.9 (stat) +/- 3.8 (syst) GeV/c2. These quantities are combined in a third, simultaneous mass measurement to determine a top-quark mass of 170.7 +/- 6.3 (stat) +/- 2.6 (syst) GeV/c2.

Two ex situ fungal technologies to treat contaminated soil

Wood-degrading fungi are able to degrade a large range of recalcitrant pollutants which resemble the lignin biopolymer. This ability is attributed to the production of lignin-modifying enzymes, which are extracellular and non-specific. Despite the potential of fungi in bioremediation, there is still an understanding gap in terms of the technology. In this thesis, the feasibility of two ex situ fungal bioremediation methods to treat contaminated soil was evaluated. Treatment of polycyclic aromatic hydrocarbons (PAHs)-contaminated marsh soil was studied in a stirred slurry-phase reactor. Due to the salt content in marsh soil, fungi were screened for their halotolerance, and the white-rot fungi Lentinus tigrinus, Irpex lacteus and Bjerkandera adusta were selected for further studies. These fungi degraded 40 - 60% of a PAH mixture (phenanthrene, fluoranthene, pyrene and chrysene) in a slurry-phase reactor (100 ml) during 30 days of incubation. Thereafter, B. adusta was selected to scale-up and optimize the process in a 5 L reactor. Maximum degradation of dibenzothiophene (93%), fluoranthene (82%), pyrene (81%) and chrysene (83%) was achieved with the free mycelium inoculum of the highest initial biomass (2.2 g/l). In autoclaved soil, MnP was the most important enzyme involved in PAH degradation. In non-sterile soil, endogenous soil microbes together with B. adusta also degraded the PAHs extensively, suggesting a synergic action between soil microbes and the fungus. A fungal solid-phase cultivation method to pretreat contaminated sawmill soil with high organic matter content was developed to enhance the effectiveness of the subsequent soil combustion. In a preliminary screening of 146 fungal strains, 28 out of 52 fungi, which extensively colonized non-sterile contaminated soil, were litter-decomposing fungi. The 18 strains further selected were characterized by their production of lignin-modifying and hydrolytic enzymes, of which MnP and endo-1,4-β-glucanase were the main enzymes during cultivation on Scots pine (Pinus sylvestris) bark. Of the six fungi selected for further tests, Gymnopilus luteofolius, Phanerochaete velutina, and Stropharia rugosoannulata were the most active soil organic matter degraders. The results showed that a six-month pretreatment of sawmill soil would result in a 3.5 - 9.5% loss of organic matter, depending on the fungus applied. The pretreatment process was scaled-up for a 0.56 m3 reactor, in which perforated plastic tubes filled with S. rugosoannulata growing on pine bark were introduced into the soil. The fungal pretreatment resulted in a soil mass loss of 30.5 kg, which represents 10% of the original soil mass (308 kg). Despite the fact that Scots pine bark contains several antimicrobial compounds, it was a suitable substrate for fungal growth and promoter of the production of oxidative enzymes, as well as an excellent and cheap natural carrier of fungal mycelium. This thesis successfully developed two novel fungal ex situ bioremediation technologies and introduce new insights for their further full-scale application. Ex situ slurry-phase fungal reactors might be applied in cases when the soil has a high water content or when the contaminant bioavailability is low; for example, in wastewater treatment plants to remove pharmaceutical residues. Fungal solid-phase bioremediation is a promising remediation technology to ex situ or in situ treat contaminated soil.

Search for the Higgs Boson Using Neural Networks in Events with Missing Energy and b-Quark Jets in pp̅ Collisions at √s=1.96 TeV

We report on a search for the standard model Higgs boson produced in association with a $W$ or $Z$ boson in $p\bar{p}$ collisions at $\sqrt{s} = 1.96$ TeV recorded by the CDF II experiment at the Tevatron in a data sample corresponding to an integrated luminosity of 2.1 fb$^{-1}$. We consider events which have no identified charged leptons, an imbalance in transverse momentum, and two or three jets where at least one jet is consistent with originating from the decay of a $b$ hadron. We find good agreement between data and predictions. We place 95% confidence level upper limits on the production cross section for several Higgs boson masses ranging from 110$\gevm$ to 150$\gevm$. For a mass of 115$\gevm$ the observed (expected) limit is 6.9 (5.6) times the standard model prediction.

Measurements of the top-quark mass using charged particle tracking

We present three measurements of the top-quark mass in the lepton plus jets channel with approximately 1.9 fb-1 of integrated luminosity collected with the CDF II detector using quantities with minimal dependence on the jet energy scale. One measurement exploits the transverse decay length of b-tagged jets to determine a top-quark mass of 166.9+9.5-8.5 (stat) +/- 2.9 (syst) GeV/c2, and another the transverse momentum of electrons and muons from W-boson decays to determine a top-quark mass of 173.5+8.8-8.9 (stat) +/- 3.8 (syst) GeV/c2. These quantities are combined in a third, simultaneous mass measurement to determine a top-quark mass of 170.7 +/- 6.3 (stat) +/- 2.6 (syst) GeV/c2.