Cardiac paraganglioma: diagnostic work up and review of the literature.

Paraganglioma of the heart are potentially invasive, highly vascularized tumors for which complete resection may be curative. Derived from the cardiac wall in most instances, resectability can be assessed after integration of the data provided by MRI in T2 sequence, and coronarography. A fully documented case of a large cardiac pheochromocytoma of the left atrium and AV groove is reported and the pertinent literature on the subject is here presented.

Sedimentological and palaeohydrological responses to tectonics and climate in a small, closed lacustrine system: Oligocene As Pontes Basin (Spain)

A small, closed, lacustrine system developed during the restraining overstep stages of the Oligocene As Pontes strike-slip basin (Spain). The increase in basin accommodation and the headward spread of the drainage, which increased the water input, triggered a change from shallow, holomictic to deeper, meromictic conditions.

Prominent use of distal 5' transcription start sites and discovery of a large number of additional exons in ENCODE regions.

This report presents systematic empirical annotation of transcript products from 399 annotated protein-coding loci across the 1% of the human genome targeted by the Encyclopedia of DNA elements (ENCODE) pilot project using a combination of 5' rapid amplification of cDNA ends (RACE) and high-density resolution tiling arrays. We identified previously unannotated and often tissue- or cell-line-specific transcribed fragments (RACEfrags), both 5' distal to the annotated 5' terminus and internal to the annotated gene bounds for the vast majority (81.5%) of the tested genes. Half of the distal RACEfrags span large segments of genomic sequences away from the main portion of the coding transcript and often overlap with the upstream-annotated gene(s). Notably, at least 20% of the resultant novel transcripts have changes in their open reading frames (ORFs), most of them fusing ORFs of adjacent transcripts. A significant fraction of distal RACEfrags show expression levels comparable to those of known exons of the same locus, suggesting that they are not part of very minority splice forms. These results have significant implications concerning (1) our current understanding of the architecture of protein-coding genes; (2) our views on locations of regulatory regions in the genome; and (3) the interpretation of sequence polymorphisms mapping to regions hitherto considered to be "noncoding," ultimately relating to the identification of disease-related sequence alterations.

Report on applying agreed-upon procedures to the Villisca Municipal Power Plant’s accounting procedures, cash and investment balances and compliance with Code of Iowa requirements for the period February 1, 2007 through December 31, 2010

Report on applying agreed-upon procedures to the Villisca Municipal Power Plant’s accounting procedures, cash and investment balances and compliance with Code of Iowa requirements for the period February 1, 2007 through December 31, 2010

Dynamic models of energy allocation and investment

In dynamic models of energy allocation, assimilated energy is allocated to reproduction, somatic growth, maintenance or storage, and the allocation pattern can change with age. The expected evolutionary outcome is an optimal allocation pattern, but this depends on the environment experienced during the evolutionary process and on the fitness costs and benefits incurred by allocating resources in different ways. Here we review existing treatments which encompass some of the possibilities as regards constant or variable environments and their predictability or unpredictability, and the ways in which production rates and mortality rates depend on body size and composition and age and on the pattern of energy allocation. The optimal policy is to allocate resources where selection pressures are highest, and simultaneous allocation to several body subsystems and reproduction can be optimal if these pressures are equal. This may explain balanced growth commonly observed during ontogeny. Growth ceases at maturity in many models; factors favouring growth after maturity include non-linear trade-offs, variable season length, and production and mortality rates both increasing (or decreasing) functions of body size. We cannot yet say whether these are sufficient to account for the many known cases of growth after maturity and not all reasonable models have yet been explored. Factors favouring storage are also reviewed.

The Caribbean-North America-Cocos Triple Junction and the dynamics of the Polochic-Motagua fault systems: Pull-up and zipper models

The Polochic-Motagua fault systems (PMFS) are part of the sinistral transform boundary between the North American and Caribbean plates. To the west, these systems interact with the subduction zone of the Cocos plate, forming a subduction-subduction-transform triple junction. The North American plate moves westward relative to the Caribbean plate. This movement does not affect the geometry of the subducted Cocos plate, which implies that deformation is accommodated entirely in the two overriding plates. Structural data, fault kinematic analysis, and geomorphic observations provide new elements that help to understand the late Cenozoic evolution of this triple junction. In the Miocene, extension and shortening occurred south and north of the Motagua fault, respectively. This strain regime migrated northward to the Polochic fault after the late Miocene. This shift is interpreted as a ``pull-up'' of North American blocks into the Caribbean realm. To the west, the PMFS interact with a trench-parallel fault zone that links the Tonala fault to the Jalpatagua fault. These faults bound a fore-arc sliver that is shared by the two overriding plates. We propose that the dextral Jalpatagua fault merges with the sinistral PMFS, leaving behind a suturing structure, the Tonala fault. This tectonic ``zipper'' allows the migration of the triple junction. As a result, the fore-arc sliver comes into contact with the North American plate and helps to maintain a linear subduction zone along the trailing edge of the Caribbean plate. All these processes currently make the triple junction increasingly diffuse as it propagates eastward and inland within both overriding plates.

Long-term effects of neonatal hypoglycemia on brain growth and psychomotor development in small-for-gestational-age preterm infants.

OBJECTIVE: To investigate the effects of neonatal hypoglycemia on physical growth and neurocognitive function.Study design: A systematic detection of hypoglycemia (<2.6 mmol/L or 47 mg/dL) was carried out in 85 small-for-gestational-age preterm neonates. Prospective serial evaluations of physical growth and psychomotor development were performed. Retrospectively, infants were grouped according to their glycemic status. RESULTS: The incidence of hypoglycemia was 72.9%. Infants with repeated episodes of hypoglycemia had significantly reduced head circumferences and lower scores in specific psychometric tests at 3.5 years of age. Hypoglycemia also caused reduced head circumferences at 18 months and lower psychometric scores at 5 years of age. Infants with moderate recurrent hypoglycemia had lower scores at 3.5 and 5 years of age compared with the group of infants who had 1 single severe hypoglycemic episode. CONCLUSION: Recurrent episodes of hypoglycemia were strongly correlated with persistent neurodevelopmental and physical growth deficits until 5 years of age. Recurrent hypoglycemia also was a more predictable factor for long-term effects than the severity of a single hypoglycemic episode. Therefore repetitive blood glucose monitoring and rapid treatment even for mild hypoglycemia are recommended for small-for-gestational-age infants in the neonatal period.

Centrality and investment strategies at the beginning of industrialisation in mid-nineteenth-century Catalonia

We apply social networks analysis to the study of an important database on investment and companies" share in the Catalonia (Spain) of the nineteenth century. In contrast with most of the existing related literature, usually addressing power relationships across administration boards, we focus on the structure of interactions among individual investors and firms. Centrality analysis uncovers interesting roles played by certain economic sectors (e.g. textile and financial). Furthermore, the diverse composition (in terms of economic activity) of communities in the network (subgroups more densely connected internally than with the rest of the network) reveals a high investment diversification, which nicely agrees with a known characteristic of traditional Catalan business strategies.

Role of brachytherapy in the treatment of cancers of the anal canal. Long-term follow-up and multivariate analysis of a large monocentric retrospective series.

BACKGROUND AND PURPOSE: There are few data on long-term clinical results and tolerance of brachytherapy in anal canal cancer. We present one of the largest retrospective analyses of anal canal cancers treated with external beam radiotherapy with/without (±) chemotherapy followed by a brachytherapy boost. MATERIALS AND METHODS: We performed a retrospective analysis of clinical results in terms of efficacy and toxicity. The impact of different clinical and therapeutic variables on these outcomes was studied. RESULTS: From May 1992 to December 2009, 209 patients received brachytherapy after external beam radiotherapy ± chemotherapy. Of these patients, 163 were stage II or stage IIIA (UICC 2002) and 58 were N1-3. According to age, ECOG performance status (PS), and comorbidities, patients received either radiotherapy alone (58/209) or radiochemotherapy (151/209). The median follow-up was 72.8 months. The 5- and 10-year local control rates were 78.6 and 73.9 %, respectively. Globally, severe acute and late G3-4 reactions (NCI-CTC scale v. 4.0) occurred in 11.2 and 6.3 % of patients, respectively. Univariate analysis showed the statistical impact of the pelvic treatment volume (p = 0.046) and of the total dose (p = 0.02) on the risk of severe acute and late toxicities, respectively. Only six patients required permanent colostomy because of severe late anorectal toxicities. CONCLUSION: After a long follow-up time, brachytherapy showed an acceptable toxicity profile and high local control rates in patients with anal canal cancer.

Software testing design and implementation in a small software company

Monet ohjelmistoyritykset ovat alkaneet kiinnittää yhä enemmän huomiota ohjelmistotuotteidensa laatuun. Tämä on johtanut siihen, että useimmat niistä ovat valinneet ohjelmistotestauksen välineeksi, jolla tätä laatua voidaan parantaa. Testausta ei pidä rajoittaa ainoastaan ohjelmistotuotteeseen itseensä, vaan sen tulisi kattaa koko ohjelmiston kehitysprosessi. Validaatiotestauksessa keskitytään varmistamaan, että lopputuote täyttää sille asetetut vaatimukset, kun taas verifikaatiotestausta käytetään ennaltaehkäisevänä testauksena, jolla pyritään poistamaan virheitä jo ennenkuin ne pääsevät lähdekoodiin asti. Työ, johon tämä diplomityö perustuu, tehtiin alkukevään ja kesän aikana vuonna 2003 Necsom Oy:n toimeksiannosta. Necsom on pieni suomalainen ohjelmistoyritys, jonka tutkimus- ja kehitysyksikkö toimii Lappeenrannassa.Tässä diplomityössä tutustutaan aluksi ohjelmistotestaukseen sekä eri tapoihin sen organisoimiseksi. Tämän lisäksi annetaan yleisiä ohjeita testisuunnitelmien ja testaustapausten tekoon, joita onnistunut ja tehokas testaus edellyttää. Kun tämä teoria on käyty läpi, esitetään esimerkkinä kuinka sisäinen ohjelmistotestaus toteutettiin Necsomilla. Lopuksi esitetään johtopäätökset, joihin päädyttiin käytännön testausprosessin seuraamisen jälkeen ja annetaan jatkotoimenpide-ehdotuksia.

Stereotactic body radiation therapy with helical tomotherapy for medical inoperable early-stage primary and second-primary non-small cell lung neoplasm : one-year outcome and toxicity analysis

Le cancer du poumon est la première cause de mortalité associée au cancer dans le monde. Le traitement curatif des tumeurs pulmonaires non-à-petites-cellules (NSCLC) diagnostiquées à un stade précoce se base sur une approche chirurgicale. Cependant, étant donné les comorbidités liées à la consommation de tabac, dont la bronchopneumopathie chronique occupe la première place, l'éligibilité chirurgicale pour ce type de cancer se trouve fréquemment limitée. Dans ce contexte, l'emploi de la radiothérapie stéréotaxique (SBRT) est une alternative valable chez les patients atteints d'un NSCLC primaire de stade précoce, et qui sont considérés inopérables à cause de leurs comorbidités. Depuis peu seulemement, le spectre de la SBRT a été élargi aux patients atteints d'un deuxième NSCLC primaire (SPLC), faisant suite à un premier NSCLC, traité avec un but curatif. Ils concernent donc des patients ayant déjà subits une intervention chirurgicale au préalable et qui présentent une réserve fonctionnelle pulmonaire extrêmement réduite. Le succès croissant de la SBRT résulte soit d'une efficacité thérapeutique comparables à la chirurgie, soit de sa toxicité qui semble limitée. À notre connaissance, seulement une étude a reporté des issues cliniques de patients affectés par des NSCLC primaires traités par SBRT. Cette dernière a utilisé la tomothérapie comme système d'irradiation (T-SBRT), sur un faible échantillon de patients (n = 27). Concernant l'irradiation des patients présentant des SPLC, la littérature disponible est pauvre et aucune publication a décrit l'utilisation de la T-SBRT. Ces éléments innovants ont donc motivé la rédaction d'un travail de thèse concernant les premières données cliniques de l'expérience faite au CHUV. Du point de vue des effets secondaires, si la pneumonie actinique précoce et tardive survenant au niveau du champ d'irradiation est désormais une complication iatrogène bien connue de la SBRT, une seule étude s'est intéressée à ce sujet dans le cadre de la T-SBRT. De plus, une entité bénigne et transitoire de pneumonie ( ?) a été reconnue depuis peu : la pneumonie organisée radio-induite (OP). Celle-ci semble se chevaucher comme un autre effet iatrogène à l'extérieur du champ d'irradiation. Originellement, cette dernière avait été rapportée dans les suites de la radiothérapie pour les cancer du sein. Elle a été décrite comme étant initialement limitée au champ d'irradiation et successivement pouvant s'étendre dynamiquement en dehors de celui-ci. Nous avons donc supposé que des infiltrats de OP peuvent être présents chez des patients asymptomatiques, et que ce dynamisme pourrait être identifié déjà au sein du champ d'irradiation. Notre étude a démontré que le traitement par T-SBRT garde des issues cliniques très encourageantes, aussi bien pour les tumeurs primaires que pour les SPLC. Entre autre, ce traitement semble avoir une toxicité limitée, et l'existence vraisemblable de la OP, déjà au sein du champ d'irradiation, peut aider les radiologues à différencier les infiltrats radio-induits d'une une récidive tumorale.

Technology Catching-up and the Role of Institutions

The aim of the paper is to investigate the role played by differences in Institutional Quality on the process of technology catch-up across countries. Empirical evidence shows how countries endowed with better institutions are those experiencing higher TFP growth rates, faster rates of technology adoption and hence being those more rapidly closing the gap with the frontier. Conversely, countries lacking some minimum institutional level are shown to diverge in the long run and not to catch-up. Some institutions, however, play an ambiguous role in the creation and adoption of technology. We find that the tightening of Intellectual Property Rights reduces the ability of followers to freely imitate technology slowing down their catchup rate. This negative effect is stronger the farther the countriesare found from the frontier. Other institutional categories such as openness to trade, instead, benefit both leaders and followers.

Competence Development and Capacity Building of Sawmill Enterprises in Kenya – A Human Resources Development Approach

The Kenyan forestry and sawmilling industry have been subject to a changing environment since 1999 when the industrial forest plantations were closed down. This has lowered raw material supply and it has affected and reduced the sawmill operations and the viability of the sawmill enterprises. The capacity of the 276 registered sawmills is not sufficient to fulfill sawn timber demand in Kenya. This is because of the technological degradation and lack of a qualified labor force, which were caused because of non-existent sawmilling education and further training in Kenya. Lack of competent sawmill workers has led to low raw material recovery, under utilization of resources and loss of employment. The objective of the work was to suggest models, methods and approaches for the competence and capacity development of the Kenyan sawmilling industry, sawmills and their workers. A nationwide field survey, interviews, questionnaire and literature review was used for data collection to find out the sawmills’ competence development areas and to suggest models and methods for their capacity building. The sampling frame included 22 sawmills that represented 72,5% of all the registered sawmills in Kenya. The results confirmed that the sawmills’ technological level was backwards, productivity low, raw material recovery unacceptable and workers’ professional education low. The future challenges will be how to establish the sawmills’ capacity building and workers’ competence development. Sawmilling industry development requires various actions through new development models and approaches. Activities should be started for technological development and workers’ competence development. This requires re-starting of vocational training in sawmilling and the establishment of more effective co-operation between the sawmills and their stakeholder groups. In competence development the Enterprise Competence Management Model of Nurminen (2007) can be used, whereas the best training model and approach would be a practically oriented learning at work model in which the short courses, technical assistance and extension services would be the key functions.