Ventricular rate during acute atrial fibrillation and outcome of electrical cardioversion: The FinCV Study

The impact of ventricular rate (VR) on the outcome of electrical cardioversion (ECV) of acute atrial fibrillation (AF) is currently unknown. We aimed to determine the effect of VR during acute AF on the success of ECV, recurrence of AF and occurrence of post-cardioversion complications in 30 days follow-up. All ECVs performed in patients with acute atrial fibrillation lasting <48 hours in 2 Finnish university hospitals during 2003-2010 and 1 central hospital during 2010 were retrospectively identified. A total of 6,624 ECVs were performed in 2,821 consecutive patients. VR≤60 BPM was defined low and VR≥160 BPM high. The median VR before ECV was 109 BPM. The success rate of ECV was 94.2%. Bradycardia occurred in 62 (0.9%) and thromboembolic complications in 39 (0.6%) ECVs. Low VR was observed before 75 (1.1%) ECVs and male sex was its only independent predictor. High VR was observed in 165 (2.5%) ECVs. The independent predictors of high VR were younger age, <12 h episode duration, no previous history of AF and alcohol abuse. Low or high VR were not related to the success of ECV, incidence of thromboembolic or bradycardic complications, or recurrence of AF, although VR was significantly (p<0.001) lower in the patients in whom AF recurred. In conclusion, ECV of acute AF is an effective procedure and VR during AF does not affect its efficacy, the maintenance of sinus rhythm or the incidence of bradycardic, thromboembolic or other complications during 30 days follow-up after ECV. Low VR is predominately observed in male patients, while high VR was a feature related to a shorter history of AF and high alcohol-intake.

Internet-lähteistä haettujen uutisten ryhmittely

Tämän diplomityön tarkoituksena on tutkia, mitä vaaditaan uutisten samanlaisuuden automaattiseen tunnistamiseen. Uutiset ovat tekstipohjaisia uutisia, jotka on haettu eri uutislähteistä. Uutisista on tarkoitus tunnistaa ensinnäkin ne uutiset, jotka tarkoittavat samaa asiaa, sekä ne uutiset, jotka eivät ole aivan sama asia, mutta liittyvät kuitenkin toisiinsa. Tässä diplomityössä tutkitaan, millä algoritmeilla tämä tunnistus onnistuu tehokkaimmin sekä suomalaisessa, että englanninkielisessä tekstissä. Diplomityössä vertaillaan valmiita algoritmeja. Tavoitteena on valita sellainen algoritmiyhdistelmä, että 90 % vertailluista uutisista tunnistuu oikein. Tutkimuksessa käytetään 2 eri ryhmittelyalgoritmia, sekä 3 eri stemmaus-algoritmia. Näitä algoritmeja vertaillaan sekä uutisten tunnistustehokkuuden, että niiden suorituskyvyn suhteen. Parhaimmaksi stemmaus-algoritmiksi osoittautui sekä suomen-, että englanninkielisten uutisten vertailussa Porterin algoritmi. Ryhmittely-algoritmeista tehokkaammaksi osoittautui yksinkertaisempi erilaisiin tunnuslukuihin perustuva algoritmi.

Onnistunut yritysosto - henkilöstö- ja kulttuurinäkökohdat

Useat ”uuden” talouden piirteet, kuten ympäristön ennustamattomuus, globalisaatio, vapaa kauppa ja teknologian leviäminen, ovat lisänneet organisaatioiden muutospaineita. Yritysostoista on tullut resurssien ja markkinavoiman hankkimistyökalu, jonka avulla yritykset voivat kohdata ympäristön niille asettamat haasteet sekä hyödyntää markkinoiden tarjoamat mahdollisuudet. Yritysostojen onnistumisprosentit ovat kuitenkin olleet alhaiset, mahdollisesti siitä syystä, että yritysostoissa on keskitytty taloudellisiin ja oikeudellisiin asioihin henkilöstöprosessien kustannuksella. Tästä syystä henkilöstöjohtamista ja erityisesti integraatiojohtamista on enenevässä määrin pidetty tärkeänä yritysostojen onnistumisen kannalta. Tässä tutkimuksessa tarkasteltiin yritysostojen vaikutuksia yritysten henkilöstöön ja yrityskulttuureihin. Tutkimuksessa verrattiin kolmen eri yrityksen kohdalla suoritettuja yritysostoprojekteja, ja niissä esiin tulleita ongelmakohtia. Vertailut osoittivat yritysostojen merkitsevän henkilöstölle suurta epävarmuutta, jota voitiin vähentää muun muassa toimivalla sisäisellä viestinnällä ja suunnitelmallisella muutosjohtamisella. Suurimmiksi ongelmiksi koettiin ostokohteen maantieteellinen etäisyys ostavasta yrityksestä, pienen ja ison yrityksen kulttuurien yhteensovittaminen sekä henkilöstön huomiointi yritysostotilanteessa ja sen jälkeen.

Kansallisten immateriaalioikeuksien vaikutus lääkekeksintöihin Suomessa ja Ruotsissa 1980-90-luvulla

Pro gradu- tutkielman tarkoituksena oli tutkia lääkkeiden immateriaalioikeudellisia suojamuotoja Suomen ja Ruotsin osalta. Tutkimuksessa pyrittiin selvittämään lääkkeiden kansallisen patenttisuojan, lisäsuojatodistuksen ja dokumentaatiosuojan vaikutusta lääkekeksintöihin 1980–90-luvun Suomessa ja Ruotsissa. Lääkkeiden lisäsuojatodistuksella tarkoitetaan ainoastaan lääkeaineille tarkoitettua erillistä immateriaalioikeudellista lisäsuojamuotoa, joka pidentää suoja-aikaa enimmillään viidellä vuodella. Dokumentaatiosuojalla tarkoitetaan suojamuotoa, joka suojaa lääkkeiden kehittämisessä aikaan saatuja tutkimus- ja turvallisuustuloksia rinnakkaisvalmistajilta tietyn määritellyn ajan. Suomen ja Ruotsin kansallisessa lainsäädännössä oli tarkasteluajanjaksolla olennaisia eroja. Rinnakkaisongelmana tutkittiin innovaatio- ja patenttipolitiikan merkitystä lääkekeksintöjen määrään ja laatuun. Tutkimuskysymyksiä lähestyttiin virallislähteiden ja kirjallisuuden lisäksi myös teemahaastatteluin. Haastateltavat olivat alan asiantuntijoita. Tutkimus oli haasteellinen. Oli palkitsevaa saada asiaa koskeva ”hiljainen tieto” kansiin. Suomen ja Ruotsin poliittinen ja lainsäädännöllinen ilmapiiri poikkesivat toisistaan. Suomessa vallitsi protektionistinen ilmapiiri ja se näkyi politiikassa ja vaikutti lainsäädäntöön. Menetelmäpatentista ei haluttu luopua. Menetelmäpatentti on patentti, joka käsittää ainoastaan lääkeaineen valmistusmenetelmän, eikä lopputuotetta. Suomessa sallittiin lääkeaineiden tuotepatentti vasta 1995. Toisin oli Ruotsissa; siellä poliittinen ilmapiiri ja valtion sekä lääketeollisuuden näkemykset johtivat kehitystä niin, että tuotepatenttikielto poistettiin huomattavasti aiemmin kuin Suomessa. Ruotsi oli kaukonäköisempi myös muiden suojamuotojen kohdalla. Lopputuloksena tästä seurasi se, että Ruotsin lääketeollisuus on menestynyt huomattavasti paremmin kuin Suomen. Lääkekeksintöjä tehtiin enemmän. Ruotsin lääkekeksinnöistä suuri osa oli uusia molekyylejä; Suomen vastaava osuus oli selvästi pienempi. Myös Ruotsin lääkevienti oli ja on huomattavasti suurempaa kuin Suomen.

Management of interdependency in project portfolio

Project management has evolved in recent decades. Project portfolio management, together with multi project management, is an emerging area in the project management field in practice, and correspondingly in academic research and forums. In multi project management, projects cannot be handled isolated from each other, as they often have interdependencies that have to be taken into account. If the interdependencies between projects are evaluated during the selection process, the success rate of the project portfolio is increased. Interdependencies can be human resources, technological, and/or market based. Despite of the fact that interdependency as a phenomenon has roots in the 1960s and is related to famous management theories, it has not been much studied, although in practice most companies use it to great extent. There exists some research on interdependency, but prior publications have not emphasized the phenomenon per se, because a practical orientation practitioner techniques prevails in the literature. This research applies the method triangulation, electronic surveys and multiple case study. The research concentrates on small to large companies in Estonia and Finland, mainly in construction, engineering, ICT, and machinery industries. The literature review reveals that interdependencies are deeply involved in R&D and innovation. Survey analysis shows that companies are aware of interdependency issues in general, but they i have lack of detailed knowledge to use it thoroughly. Empirical evidence also indicates that interdependency techniques influence the success rate and other efficiency aspects to different extents. There are a lot of similarities in interdependency related managerial issues in companies of varying sizes and countries in Northern Europe. Differences found in the study are for instance the fact that smaller companies face more difficulties in implementing and evaluating interdependency procedures. Country differences between Estonia and Finland stem from working solutions to manage interdependencies on a daily basis.historical and cultural reasons, such as the special features of a transition country compared to a mature country. An overview of the dominant problems, best practices, and commonly used techniques associated with interdependency is provided in the study. Empirical findings show that many interdependency techniques are not used in practice. A multiple case study was performed in the study to find out how interdependencies are managed in real life on a daily basis. The results show that interdependencies are mostly managed in an informal manner. A description of managing the interdependencies and implementation procedures is given. Interdependency procedures are hard to implement, especially in smaller companies. Companies have difficulties in implementing interdependency procedures and evaluating them. The study contains detailed results on how companies have implemented working solutions to manage interdependencies on a daily basis

Computational modeling of stented coronary arteries

The application of computational fluid dynamics (CFD) and finite element analysis (FEA) has been growing rapidly in the various fields of science and technology. One of the areas of interest is in biomedical engineering. The altered hemodynamics inside the blood vessels plays a key role in the development of the arterial disease called atherosclerosis, which is the major cause of human death worldwide. Atherosclerosis is often treated with the stenting procedure to restore the normal blood flow. A stent is a tubular, flexible structure, usually made of metals, which is driven and expanded in the blocked arteries. Despite the success rate of the stenting procedure, it is often associated with the restenosis (re-narrowing of the artery) process. The presence of non-biological device in the artery causes inflammation or re-growth of atherosclerotic lesions in the treated vessels. Several factors including the design of stents, type of stent expansion, expansion pressure, morphology and composition of vessel wall influence the restenosis process. Therefore, the role of computational studies is crucial in the investigation and optimisation of the factors that influence post-stenting complications. This thesis focuses on the stent-vessel wall interactions followed by the blood flow in the post-stenting stage of stenosed human coronary artery. Hemodynamic and mechanical stresses were analysed in three separate stent-plaque-artery models. Plaque was modeled as a multi-layer (fibrous cap (FC), necrotic core (NC), and fibrosis (F)) and the arterial wall as a single layer domain. CFD/FEA simulations were performed using commercial software packages in several models mimicking the various stages and morphologies of atherosclerosis. The tissue prolapse (TP) of stented vessel wall, the distribution of von Mises stress (VMS) inside various layers of vessel wall, and the wall shear stress (WSS) along the luminal surface of the deformed vessel wall were measured and evaluated. The results revealed the role of the stenosis size, thickness of each layer of atherosclerotic wall, thickness of stent strut, pressure applied for stenosis expansion, and the flow condition in the distribution of stresses. The thicknesses of FC, and NC and the total thickness of plaque are critical in controlling the stresses inside the tissue. A small change in morphology of artery wall can significantly affect the distribution of stresses. In particular, FC is the most sensitive layer to TP and stresses, which could determine plaque’s vulnerability to rupture. The WSS is highly influenced by the deflection of artery, which in turn is dependent on the structural composition of arterial wall layers. Together with the stenosis size, their roles could play a decisive role in controlling the low values of WSS (<0.5 Pa) prone to restenosis. Moreover, the time dependent flow altered the percentage of luminal area with WSS values less than 0.5 Pa at different time instants. The non- Newtonian viscosity model of the blood properties significantly affects the prediction of WSS magnitude. The outcomes of this investigation will help to better understand the roles of the individual layers of atherosclerotic vessels and their risk to provoke restenosis at the post-stenting stage. As a consequence, the implementation of such an approach to assess the post-stented stresses will assist the engineers and clinicians in optimizing the stenting techniques to minimize the occurrence of restenosis.

Comparison and problems between Traditional and Agile software development methods

In today’s world because of the rapid advancement in the field of technology and business, the requirements are not clear, and they are changing continuously in the development process. Due to those changes in the requirements the software development becomes very difficult. Use of traditional software development methods such as waterfall method is not a good option, as the traditional software development methods are not flexible to requirements and the software can be late and over budget. For developing high quality software that satisfies the customer, the organizations can use software development methods, such as agile methods which are flexible to change requirements at any stage in the development process. The agile methods are iterative and incremental methods that can accelerate the delivery of the initial business values through the continuous planning and feedback, and there is close communication between the customer and developers. The main purpose of the current thesis is to find out the problems in traditional software development and to show how agile methods reduced those problems in software development. The study also focuses the different success factors of agile methods, the success rate of agile projects and comparison between traditional and agile software development.

An IP capable data link layer protocol for narrow band half-duplex packet data radio networks

The wide adaptation of Internet Protocol (IP) as de facto protocol for most communication networks has established a need for developing IP capable data link layer protocol solutions for Machine to machine (M2M) and Internet of Things (IoT) networks. However, the wireless networks used for M2M and IoT applications usually lack the resources commonly associated with modern wireless communication networks. The existing IP capable data link layer solutions for wireless IoT networks provide the necessary overhead minimising and frame optimising features, but are often built to be compatible only with IPv6 and specific radio platforms. The objective of this thesis is to design IPv4 compatible data link layer for Netcontrol Oy's narrow band half-duplex packet data radio system. Based on extensive literature research, system modelling and solution concept testing, this thesis proposes the usage of tunslip protocol as the basis for the system data link layer protocol development. In addition to the functionality of tunslip, this thesis discusses the additional network, routing, compression, security and collision avoidance changes required to be made to the radio platform in order for it to be IP compatible while still being able to maintain the point-to-multipoint and multi-hop network characteristics. The data link layer design consists of the radio application, dynamic Maximum Transmission Unit (MTU) optimisation daemon and the tunslip interface. The proposed design uses tunslip for creating an IP capable data link protocol interface. The radio application receives data from tunslip and compresses the packets and uses the IP addressing information for radio network addressing and routing before forwarding the message to radio network. The dynamic MTU size optimisation daemon controls the tunslip interface maximum MTU size according to the link quality assessment calculated from the radio network diagnostic data received from the radio application. For determining the usability of tunslip as the basis for data link layer protocol, testing of the tunslip interface is conducted with both IEEE 802.15.4 radios and packet data radios. The test cases measure the radio network usability for User Datagram Protocol (UDP) based applications without applying any header or content compression. The test results for the packet data radios reveal that the typical success rate for packet reception through a single-hop link is above 99% with a round-trip-delay of 0.315s for 63B packets.