Long-term outcomes of 118 patients with eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome) enrolled in two prospective trials.

The purpose of this study was to assess the outcomes of 118 patients with eosinophilic granulomatosis with polyangiitis (EGPA) enrolled in 2 prospective, randomized, open-label clinical trials (1994-2005), with or without Five-Factor Score (FFS)-defined poor-prognosis factors, focusing on survival, disease-free survival, relapses, clinical and laboratory findings, therapeutic responses, and factors predictive of relapse. Forty-four patients with FFS ≥ 1 were assigned to receive 6 or 12 cyclophosphamide pulses plus corticosteroids and the seventy-four with FFS = 0 received corticosteroids alone, with immunosuppressant adjunction when corticosteroids failed. Patients were followed (2005-2011) under routine clinical care in an extended study and data were recorded prospectively. Mean ± SD follow-up was 81.3 ± 39.6 months. Among the 118 patients studied, 29% achieved long-term remission and 10% died. Among the 115 patients achieving a first remission, 41% experienced ≥1 relapses, 26.1 ± 26.8 months after treatment onset, with 57% of relapses occurring when corticosteroid-tapering reached <10 mg/day. Treatment achieved new remissions in >90%, but relapses recurred in 38%. Overall survival was good, reaching 90% at 7 years, regardless of baseline severity. Age ≥65 years was the only factor associated with a higher risk of death during follow-up. The risk of relapse was higher for patients with anti-myeloperoxidase antibodies and lower for those with >3000 eosinophils/mm(3). Sequelae remained frequent, usually chronic asthma and peripheral neuropathy. In conclusion, EGPA patients' survival rate is very good when treatment is stratified according to the baseline FFS. Relapses are frequent, especially in patients with anti-myeloperoxidase antibodies and baseline eosinophilia <3000/mm(3).

Immunohistochemistry as a valuable tool to assess CD30 expression in peripheral T-cell lymphomas: high correlation with mRNA levels.

The extended use of brentuximab-vedotin was reported for CD30(+) nonanaplastic peripheral T-cell lymphomas (PTCLs) with promising efficacy. CD30 status assessment is thus a critical factor for therapeutic decision, but the reliability of immunohistochemistry (IHC) in evaluating its expression remains to be defined. This prompted us to investigate the correlation between semiquantitative CD30 protein assessment by IHC and messenger RNA (mRNA) assessment by microarrays in a cohort of 376 noncutaneous PTCLs representative of the main entities. By IHC, CD30 expression was heterogeneous across and within entities and significantly associated with large tumor cell size. In addition to 100% anaplastic large-cell lymphomas, 57% of other PTCL entities were CD30-positive at a 5% threshold. CD30 protein expression was highly correlated to mRNA levels. mRNA levels were bimodal, separating high from low CD30-expressing PTCL cases. We conclude that IHC is a valuable tool in clinical practice to assess CD30 expression in PTCLs.

The Persistence of Finnish Equity Fund Performance

Tutkimuksen tavoitteena on selvittää, esiintyykö suomeen sijoittavilla osakerahastoilla menestyksen pysyvyyttä. Tutkimusaineisto koostuu kaikista suomalaisista osakerahastoista, jotka toimivat ajanjaksolla 15.1.1998-13.1.2005. Aineisto on vapaa selviytymisvinoumasta. Suorituskyvyn mittareina käytetään CAPM-alfaa sekä kolmi- ja nelifaktori-alfaa. Empiirisessä osassa osakerahastojen menestyksen pysyvyyttä testataan Spearmanin järjestyskorrelaatiotestillä. Evidenssi menestyksen pysyvyydestä jäi vähäiseksi, vaikkakin sitä esiintyi satunnaisesti kaikilla menestysmittareilla joillakin ranking- ja sijoitusperiodin yhdistelmillä. CAPM-alfalla tarkasteltuna tilastollisesti merkitsevää menestyksen pysyvyyttä esiintyi selvästi useammin kuin muilla menestysmittareilla. Tulokset tukevat viimeaikaisia kansainvälisiä tutkimuksia, joiden mukaan menestyksen pysyvyys riippuu usein mittaustavasta. Menestysmittareina käytettyjen regressiomallien merkitsevyystestit osoittavat multifaktorimallien selittävän osakerahastojen tuottoja CAPM:a paremmin. Lisätyt muuttujat parantavat merkittävästi CAPM:n selitysvoimaa.

Spanish adaptation of the Expectancy Questionnaire (EQ) about alcohol effects in adolescents

Background: Alcohol-related expectancies are especially relevant in relation to alcohol consumption during adolescence. The main aim of this study was to adapt and translate into Spanish (Castilian) the Expectancy Questionnaire (EQ), and to study its psychometric properties in adolescents. Method: The sample was composed of 514 adolescents (57.20% female, mean age = 15.21; SD = .63) who completed the EQ and the alcohol consumption questionnaire AIS-UJI. Results: Confi rmatory factor analysis indicated that an eight-factor model, grouped into two general factors of positive and negative expectancies, had acceptable fi t indices. Cronbach’s alphas ranged from .75 to .96. Finally, the structural equation model showed that positive expectancies were positively related to alcohol use, whereas negative expectancies were negatively related to drinking. Conclusions: Results showed that the Spanish version of the EQ for adolescents is a valid and reliable questionnaire to measure expectancies about alcohol effects.

Translation and psychometric evaluation of a French version of the Readiness for Hospital Discharge Scale.

AIMS AND OBJECTIVES: To evaluate the reliability and the factor structure of the Readiness for Hospital Discharge Scale - French version. BACKGROUND: The patient's perspective is essential when assessing risk for adverse events at hospital discharge. Developed in the USA, the Readiness for Hospital Discharge Scale is the only instrument that measures an individual's self-perception of readiness before leaving the hospital. A French version of the Readiness for Hospital Discharge Scale was developed and validated. DESIGN: Cross-sectional study. METHODS: A convenience sample of 265 older inpatients from four medical units was selected. The translation and cultural adaptation of the scale involved experts in gerontology and the French language and included back translation. The items were semantically evaluated and pretested in 10 older inpatients. The scale's psychometric properties were internally validated by using confirmatory and exploratory factor analyses. Reliability was assessed by examining the internal consistency of its items. RESULTS: Goodness-of-fit indices of the confirmatory factor analyses were not adequate, but reliability was acceptable (Cronbach's α = 0·80). Exploratory factor analysis of the French version provided results close to those described for the English version, with three similar subscales (physical and emotional readiness, coping with medical treatment and personal care), whereas the initially described Expected Support subscale was not identified in the French version. CONCLUSION: The Readiness for Hospital Discharge Scale - French version appears to be partially consistent with its original English version, but requires additional adaptation to fully take into account the Swiss context and culture to achieve its original aim. RELEVANCE TO CLINICAL PRACTICE: Assessing patient readiness for hospital discharge before leaving hospital could help nurses to improve the discharge planning process and achieve better patient preparedness and care coordination.

Sähkönjakelun luotettavuusindeksit ja laskenta

Tässä kandidaatintyössä on käsitelty sähkönjakelun luotettavuusanalysointia, laskentaa sekä luotettavuusindeksejä. Työssä on esitelty luotettavuusanalysoinnin perusperiaatteet ja keskitytty sähkönjakelun luotettavuuden tarkasteluun analyyttisin menetelmin ja yksinkertaisin esimerkein. Lisäksi on esitelty yleisimmät käytössä olevat luotettavuusindeksit. Luotettavuusanalysoinnilla on kasvava merkitys verkkoliiketoiminnan, sen sääntelyn sekä verkoston suunnittelun ja kehittämisen kannalta nyky-yhteiskunnassa, jossa vaaditaan yhä luotettavampaa ja keskeytyksettömämpää sähkönjakelua. Suomessa sähkönjakeluverkon säteittäisen käyttöperiaatteen myötä luotettavuuslaskentaan tarvittavat yhtälöt yksinkertaistuvat muutamaan perusyhtälöön. Tällöin jo yksinkertaisilla laskutoimituksilla voidaan huomioida keskeytyskustannusten vaikutus verkoston optimoinnissa sekä hyödyntää luotettavuusindeksejä verkkoyhtiöiden sääntelymallissa laatukannustimena. Luotettavuusanalysoinnin ja sen osana suoritettavan laskennan tuloksena saatavien luotettavuutta eri tavoin kuvaavien indeksien laaja kirjo ja niiden kirjava soveltaminen eri maissa vaikeuttavat indeksien perusteella tehtävää keskinäistä vertailua. Suomessa viranomainen julkaisee tilastoitavat ja tarkasteltavat indeksit, jotka palvelevat näin ollen viranomaisen sääntelyn tarpeita kotimaisella tasolla sekä toimivat verkoston kehittämisen tukena.

Termodinâmica estatística de líquidos com o método de Monte Carlo. II. O líquido clorofórmio

Thermodynamic properties and radial distribution functions for liquid chloroform were calculated using the Monte Carlo method implemented with Metropolis algorithm in the NpT ensemble at 298 K and 1 atm. A five site model was developed to represent the chloroform molecules. A force field composed by Lennard-Jones and Coulomb potential functions was used to calculate the intermolecular energy. The partial charges needed to represent the Coulombic interactions were obtained from quantum chemical ab initio calculations. The Lennard-Jones parameters were adjusted to reproduce experimental values for density and enthalpy of vaporization for pure liquid. All thermodynamic results are in excelent agreement with experimental data. The correlation functions calculated are in good accordance with theoretical results avaliable in the literature. The free energy for solvating one chloroform molecule into its own liquid at 298 K and 1 atm was computed as an additional test of the potential model. The result obtained compares well with the experimental value. The medium effects on cis/trans convertion of a hypotetical solute in water TIP4P and chloroform solvents were also accomplished. The results obtained from this investigation are in agreement with estimates of the continuous theory of solvation.

Risk-Return Trade-Off for European Stock Markets

This paper adopts dynamic factor models with macro-finance predictors to test the intertemporal risk-return relation for 13 European stock markets. We identify country specific, euro area, and global macro-finance factors to determine the conditional risk and return. Empirically, the risk- return trade-off is generally negative. However, a Markov switching model documents that there is time-variation in this trade-off that is linked to the state of the economy. Keywords: Risk-return trade-off; Dynamic factor model; Macro-finance predictors; European stock markets; Markov switching model JEL Classifications: C22; G11; G12; G17

IT-alan pk-yrityksen liiketoimintaympäristön analyysi ja markkinointistrategia

Taloudellisen laman aikana monet yritykset pyrkivät tehostamaan omaa toimintaa tarkastelemalla uudelleen itselleen tärkeitä liiketoiminnan prosesseja. Tässä diplomityössä suoritetaan IT-alan pk-yrityksen liiketoimintaympäristön analyysi käyttäen SWOT- työkalua ja Porterin viiden voiman mallia. Tämän jälkeen selvitetään Yritys Oy:n asiakastarpeita sekä yrityksen tarjoomaa. Tämän jälkeen suoritetaan potentiaalisten asiakkaiden segmentointi. Jokaiselle segmentille muodostetaan oma tarjooma ja asemoidaan se. Asemointi tapahtuu muodostamalla jokaiselle segmentille omaa sanomaa, joka perustuu segmentin tarjoomaan. Segmentointi pyritään toteuttamaan asiakaslähtöisesti. Työn lopussa muodostetaan Yritys Oy:lle markkinointistrategia.

Kvantitatiivisen osakepisteytysmallin testaaminen Euroopan markkinoilla

Tutkielman tavoitteena on testata kvantitatiivisen osakepisteytysmallin tehokkuutta Euroopan osakemarkkinoilla. Osakepisteytysmalli järjestää osakkeet paremmuusjärjestykseen yrityskohtaisten tunnuslukujen avulla. Pisteytysmallin suositusten mukaan luodaan testisalkku ajanjaksolta 2002 2007. Testisalkun tuottoa mitataan pääomahyödykkeiden hinnoittelumallin sekä Faman ja Frenchin kolmen faktorin mallin avulla. Testisalkkua testataan markkina arvopainoisena sekä tasapainoisena. Tasapainoisessa salkussa jokaista osaketta painotetaan yhtäläisesti. Testisalkun rinnalle luodaan lisäksi vertailusalkku satunnaisista osakkeista. Tasapainotettu testisalkku tuotti tarkasteluajanjaksolla tilastollisesti merkitsevää markkinariskikorjattua ylituottoa 0,7 prosenttia kuukaudessa. Kolmen faktorin mallin avulla laskettu ylituotto ei ollut merkitsevä. Yrityskokofaktori sekä markkinatuotto näyttivät selittävän vahvasti testisalkun tuottoja. Yrityskoon vaikutus näkyi myös markkina arvopainotetussa salkussa, jonka tuotto ei päihittänyt markkinatuottoa. Vertailusalkku ei tuottanut tilastollisesti merkitsevää ylituottoa.

Distribution Patterns of Soil Properties in a Rural Mediterranean Area in Northeastern Spain

Soil properties on the Cap de Creus Peninsula, NE Spain depend primarily on scarce agricultural practices and early abandonment. In the study area, 90% of which is mainly covered by Cistus shrubs, 8 environments representing variations in land use/land cover and soil properties at different depths were identified. In each environment variously vegetated areas were selected and sampled. The soils, collected at different depths, were classified as Lithic Xerorthents according to the United States Department of Agriculture system of soil classification (USDA-NRCS 1975). Differences in soil properties were largely found according to the evolution of the plant canopy and the land use history. To identify underlying patterns in soil properties related to environmental evolution, factor analysis was performed and factor scores were used to determine how the factor patterns varied between soil variables, soil depths and selected environments. The three-factor model always accounted for 80% of the total variation in the data at the different soil depths. Organic matter was the more relevant soil property at 0–2 cm depth, whereas active minerals (silt and clay) were found to be the most relevant soil parameters controlling soil dynamics at the other depths investigated. Results showed that vineyards and olive tree soils are poorly developed and present worse conditions for mineral and organic compounds. Analysis of factor scores allowed independent assessment of soils, depth and plant cover and demonstrated that soils present the best physico-chemical characteristics under Erica arborea and meadows. In contrast, soils under Cistus monspeliensis were less nutrient rich and less well structured

Teknisen auringonsuojauksen tukikonseptin liiketoimintalähtöinen arviointi

Työssä tutkitaan erään tekniseen auringonsuojaukseen keskittyneen yrityksen päätöstä tuottaa aloittelevia yrityksiä palveleva tukikonsepti. Konsepti sisältää mitoitusohjelmia, kokoonpano-ohjeita sekä markkinointimateriaalia. Oleellista on selvittää kannattaako yrityksen keskittyä kyseisiin asiakkaisiin, sekä onko konsepti oikea ratkaisu tälle segmentille. Tätä varten työssä tutustuttiin toimiala-analyysiin, strategiaan, segmentointiin sekä differointiin. Työssä selvitettiin, että Porterin viiden voiman malli on yhä toimiva aloitus toimiala-analyysin laatimiseen. Strategiaan liittyviä koulukuntia löytyy kirjallisuudesta useita erilaisia, oleellista on löytää oikea lähestymistapa kuhunkin tilanteeseen. Segmentointi on tärkeä vaihe, koska sen avulla selvitetään yrityksen eri asiakasryhmiä. Differointi on usein suositeltu keino kilpailuedun tavoittelemiseen. Työtä varten laadittiin yritykselle toimiala-analyysi. Lisäksi yritykselle etsittiin segmenttejä sekä pohdittiin sen mahdollisuuksia differointiin. Segmenttejä löydettiin kolme erilaista. Samalla todettiin, että paras tapa differoida yrityksen tuotteita on keskittyä tuotteiden aineettomiin ominaisuuksiin. Toimiala-analyysin, segmenttien sekä differointimahdollisuuksien perusteella päädyttiin siihen, että yrityksen päätös keskittyä enemmän uusiin ja aloitteleviin asiakkaisiin vaikuttaa järkevältä. Konseptin ominaisuuksien perusteella myös konsepti vaikuttaa hyvältä tavalta palvella kyseistä asiakassegmenttiä.

Mikroyrittäjä ja yrityksen kasvu

Tämän tutkimuksen tarkoituksena on selvittää mitkä tekijät ovat mikroyrityksen kasvun edellytyksenä ja mitkä tekijät ovat kasvun esteinä. Tutkimuksen taustalla on mikroyritysten yleisesti vähäinen kasvuhalukkuus. Tässä tutkimuksessa yrittäjien kasvuaikomuksia tarkastellaan kasvun prosessimalliin tukeutuen ja mikroyritysten kasvuun vaikuttavia tekijöitä tarkastellaan Perrenin mikroyrityksen kasvuun vaikuttavien tekijöiden mallin avulla. Tutkimuksessa on käytetty kvalitatiivista tutkimusmenetelmää. Tutkimus on toteutettu haastattelututkimuksena, jossa on haastateltu mikroyrittäjiä Päijät-Hämeessä Lahden ja Hollolan alueilla. Tämän tutkimuksen mukaan mikroyritysten kasvuun vaikuttavat yrittäjän tahtotila ja kyky yrityksen kehittämiseen sekä yrittäjän riskinottokyky että suotuisat ympäristölliset olosuhteet. Näiden tekijöiden puuttuminen estää kasvun. Yrityksen kasvua estäviä muita tekijöitä ovat tutkimuksen mukaan mikroyritysten liiallinen paikallisuus, yhteistyön vähäisyys sekä yrittäjän liiallinen kietoutuminen liiketoimintaan että toiminnan liian vähäinen strateginen suunnittelu.

Classification, comorbidity, heredity, and risk factors of female sexual dysfunctions

Female sexual dysfunctions, including desire, arousal, orgasm and pain problems, have been shown to be highly prevalent among women around the world. The etiology of these dysfunctions is unclear but associations with health, age, psychological problems, and relationship factors have been identified. Genetic effects explain individual variation in orgasm function to some extent but until now quantitative behavior genetic analyses have not been applied to other sexual functions. In addition, behavior genetics can be applied to exploring the cause of any observed comorbidity between the dysfunctions. Discovering more about the etiology of the dysfunctions may further improve the classification systems which are currently under intense debate. The aims of the present thesis were to evaluate the psychometric properties of a Finnish-language version of a commonly used questionnaire for measuring female sexual function, the Female Sexual Function Index (FSFI), in order to investigate prevalence, comorbidity, and classification, and to explore the balance of genetic and environmental factors in the etiology as well as the associations of a number of biopsychosocial factors with female sexual functions. Female sexual functions were studied through survey methods in a population based sample of Finnish twins and their female siblings. There were two waves of data collection. The first data collection targeted 5,000 female twins aged 33–43 years and the second 7,680 female twins aged 18–33 and their over 18–year-old female siblings (n = 3,983). There was no overlap between the data collections. The combined overall response rate for both data collections was 53% (n = 8,868), with a better response rate in the second (57%) compared to the first (45%). In order to measure female sexual function, the FSFI was used. It includes 19 items which measure female sexual function during the previous four weeks in six subdomains; desire, subjective arousal, lubrication, orgasm, sexual satisfaction, and pain. In line with earlier research in clinical populations, a six factor solution of the Finnish-language version of the FSFI received supported. The internal consistencies of the scales were good to excellent. Some questions about how to avoid overestimating the prevalence of extreme dysfunctions due to women being allocated the score of zero if they had had no sexual activity during the preceding four weeks were raised. The prevalence of female sexual dysfunctions per se ranged from 11% for lubrication dysfunction to 55% for desire dysfunction. The prevalence rates for sexual dysfunction with concomitant sexual distress, in other words, sexual disorders were notably lower ranging from 7% for lubrication disorder to 23% for desire disorder. The comorbidity between the dysfunctions was substantial most notably between arousal and lubrication dysfunction even if these two dysfunctions showed distinct patterns of associations with the other dysfunctions. Genetic influences on individual variation in the six subdomains of FSFI were modest but significant ranging from 3–11% for additive genetic effects and 5–18% for nonadditive genetic effects. The rest of the variation in sexual functions was explained by nonshared environmental influences. A correlated factor model, including additive and nonadditive genetic effects and nonshared environmental effects had the best fit. All in all, every correlation between the genetic factors was significant except between lubrication and pain. All correlations between the nonshared environment factors were significant showing that there is a substantial overlap in genetic and nonshared environmental influences between the dysfunctions. In general, psychological problems, poor satisfaction with the relationship, sexual distress, and poor partner compatibility were associated with more sexual dysfunctions. Age was confounded with relationship length but had over and above relationship length a negative effect on desire and sexual satisfaction and a positive effect on orgasm and pain functions. Alcohol consumption in general was associated with better desire, arousal, lubrication, and orgasm function. Women pregnant with their first child had fewer pain problems than nulliparous nonpregnant women. Multiparous pregnant women had more orgasm problems compared to multiparous nonpregnant women. Having children was associated with less orgasm and pain problems. The conclusions were that desire, subjective arousal, lubrication, orgasm, sexual satisfaction, and pain are separate entities that have distinct associations with a number of different biopsychosocial factors. However, there is also considerable comorbidity between the dysfunctions which are explained by overlap in additive genetic, nonadditive genetic and nonshared environmental influences. Sexual dysfunctions are highly prevalent and are not always associated with sexual distress and this relationship might be moderated by a good relationship and compatibility with partner. Regarding classification, the results supports separate diagnoses for subjective arousal and genital arousal as well as the inclusion of pain under sexual dysfunctions.

Future trends of Finnish cement based construction

The construction material sector, as a capital intensive industry, is highly vulnerable to rapid fluctuations in the economic cycles. In Finland this was witnessed especially during the late 2000s, as in 2007 and 2008 the demand for several construction materials exceeded their supply and right after this, in 2009 the demand collapsed fast as a result of an international recession. These factors brought about the need to study the future trends of the market place of the commissioning company, Finnsementti Oy. As reliable short term market forecasts for the sector are difficult to compose, the study concentrates primarily in examining and identifying the trends that are likely to affect the Finnish cement industry, and as an extension, the concrete industry in a frame of 10 to 15 years. The study’s scope comprehends also the examination of the domestic construction sector, as it represents the end user industry of both cement and concrete. These motives for the study produce the research problem, which is to conduct a trend analysis for cement based building in the Finnish market area in the 2020s. The theoretical frame for composing a trend analysis in the case of this study is twofold. This is due to the fact that both, the macro and micro environments of the examined industries are studied. The main methods used are the PESTE-model (macro) and Porter’s five forces model (micro). The study applies a qualitative approach and the data is gathered by interviewing a group of experts from the cement, concrete and construction industries. The result of the paper is an overall trend analysis for the Finnish cement based building sector, which is based on ‘sub trend analyses’ concerning four identified sub-sectors of the Finnish construction industry. The results are a combination of findings from these sub-sectors and the analyzed data that deals with the studied sector’s macro and micro environment. The conclusions provide an overall picture of the examined sectors’ potential future as a whole and by defined sub-sectors of the construction industry. The recognition of future trends in different areas of the construction industry can be applied as a means for an industry actor’s decision making and in estimating the types of construction that are likely to grow or decline. Finally, based on the analyzed data and conclusions, the commissioning company is provided with a brief SWOT analysis, that provides additional tools for decision making and planning processes regarding the future.