Inguinal hernias in patients of 50 years and above. Pattern and outcome

OBJECTIVE: to evaluate a one year experience with inguinal hernia repair, in patients of > 50years, with respect to the type of inguinal hernia, type of surgery, postoperative complications and recurrence. METHODS: a prospective descriptive study of patients (n=57) > 50 years operated for inguinal hernia during a one year period. Tension-free meshplasty and herniorrhaphy, using 3"x6" polypropylene mesh and 2-0 polypropylene suture, were performed in elective and emergency surgery respectively. Follow-up visits were scheduled at six weeks, three and six months postoperatively. RESULTS: the most representative age group was 61-70 years, and all patients were male. 52 (91.22%) patients had unilateral inguinal hernias, while five (8.77%) had bilateral hernias. In 50 (87.71%) patients, the hernia was uncomplicated, while seven (12.28%) patients presented with some complication such as obstruction or strangulation. Elective surgery was performed in 50 (87.71%) patients while seven (12.28%) patients were operated in emergency. Postoperatively, 50 (87.7%) patients had uneventful recovery, while seven (12.28%) patients developed some complications which were treated conservatively. Mean hospital stay was six days. One recurrence was observed and there was no peri/postoperative death. CONCLUSION: tension-free meshplasty and herniorrhaphy are safe, simple and applicable even in elderly patients after adequate pre-operative assessment and optimization. Although associated with longer hospital stay, the mortality rate is nil and complication as well as recurrence rate is low. Hence, timely repair is necessary in elderly patients even in those with comorbid conditions.

Spontaneous rupture of renal angiomyolipoma during pregnancy

Renal angiomyolipoma is a benign tumor, composed of adipocytes, smooth muscle cells and blood vessels. The association with pregnancy is rare and related with an increased risk of complications, including rupture with massive retroperitoneal hemorrhage. The follow-up is controversial because of the lack of known cases, but the priorities are: timely diagnosis in urgent cases and a conservative treatment when possible. The mode of delivery is not consensual and should be individualized to each case. We report a case of a pregnant woman with 18 weeks of gestation admitted in the emergency room with an acute right low back pain with no other symptoms. The diagnosis of rupture of renal angiomyolipoma was established by ultrasound and, due to hemodinamically stability, conservative treatment with imaging and clinical monitoring was chosen. At 35 weeks of gestation, it was performed elective cesarean section without complications for both mother and fetus.

Ensuring the efficient utilization of Business Intelligence

In recent years, chief information officers (CIOs) around the world have identified Business Intelligence (BI) as their top priority and as the best way to enhance their enterprises competitiveness. Yet, many enterprises are struggling to realize the business value that BI promises. This discrepancy causes important questions, for example: what are the critical success factors of Business Intelligence and, more importantly, how it can be ensured that a Business Intelligence program enhances enterprises competitiveness. The main objective of the study is to find out how it can be ensured that a BI program meets its goals in providing competitive advantage to an enterprise. The objective is approached with a literature review and a qualitative case study. For the literature review the main objective populates three research questions (RQs); RQ1: What is Business Intelligence and why is it important for modern enterprises? RQ2: What are the critical success factors of Business Intelligence programs? RQ3: How it can be ensured that CSFs are met? The qualitative case study covers the BI program of a Finnish global manufacturer company. The research questions for the case study are as follows; RQ4: What is the current state of the case company’s BI program and what are the key areas for improvement? RQ5: In what ways the case company’s Business Intelligence program could be improved? The case company’s BI program is researched using the following methods; action research, semi-structured interviews, maturity assessment and benchmarking. The literature review shows that Business Intelligence is a technology-based information process that contains a series of systematic activities, which are driven by the specific information needs of decision-makers. The objective of BI is to provide accurate, timely, fact-based information, which enables taking actions that lead to achieving competitive advantage. There are many reasons for the importance of Business Intelligence, two of the most important being; 1) It helps to bridge the gap between an enterprise’s current and its desired performance, and 2) It helps enterprises to be in alignment with key performance indicators meaning it helps an enterprise to align towards its key objectives. The literature review also shows that there are known critical success factors (CSFs) for Business Intelligence programs which have to be met if the above mentioned value is wanted to be achieved, for example; committed management support and sponsorship, business-driven development approach and sustainable data quality. The literature review shows that the most common challenges are related to these CSFs and, more importantly, that overcoming these challenges requires a more comprehensive form of BI, called Enterprise Performance Management (EPM). EPM links measurement to strategy by focusing on what is measured and why. The case study shows that many of the challenges faced in the case company’s BI program are related to the above-mentioned CSFs. The main challenges are; lack of support and sponsorship from business, lack of visibility to overall business performance, lack of rigid BI development process, lack of clear purpose for the BI program and poor data quality. To overcome these challenges the case company should define and design an enterprise metrics framework, make sure that BI development requirements are gathered and prioritized by business, focus on data quality and ownership, and finally define clear goals for the BI program and then support and sponsor these goals.

Initialism as a mechanism of weed interference: can a crop plant be blinded?

Initialism is a new word proposed to indicate the "shade-avoidance syndrome". Plants detect the presence of neighbor plants very early in the growing season through changes in light quality. They modify the allocation of photosynthesis products privileging shoot growth over the roots. One of the hypotheses of the authors is that, when weed management is timely scheduled, a "blind" crop could be more productive because it would avoid an imbalance on the shoot:root ratio (S:R). Two strategies were developed to test this hypothesis: a) to use the classical Yoda's Law to screen several crops for insensitivity to S:R imbalance; b) to evaluate several growth regulators to control the plant responses to crowding. Experimental results confirm that both strategies can yield insensitive plants. The possibilities of the use of this knowledge are discussed.

Building Dynamic Data Centers for Fast Delivery of New Data and Data Updates

Poster at Open Repositories 2014, Helsinki, Finland, June 9-13, 2014

Integrating CRIS and repository – an overview of the situation in Finland and in three other Nordic countries

Presentation at Open Repositories 2014, Helsinki, Finland, June 9-13, 2014

Gap junctions in cells of the immune system: structure, regulation and possible functional roles

Gap junction channels are sites of cytoplasmic communication between contacting cells. In vertebrates, they consist of protein subunits denoted connexins (Cxs) which are encoded by a gene family. According to their Cx composition, gap junction channels show different gating and permeability properties that define which ions and small molecules permeate them. Differences in Cx primary sequences suggest that channels composed of different Cxs are regulated differentially by intracellular pathways under specific physiological conditions. Functional roles of gap junction channels could be defined by the relative importance of permeant substances, resulting in coordination of electrical and/or metabolic cellular responses. Cells of the native and specific immune systems establish transient homo- and heterocellular contacts at various steps of the immune response. Morphological and functional studies reported during the last three decades have revealed that many intercellular contacts between cells in the immune response present gap junctions or "gap junction-like" structures. Partial characterization of the molecular composition of some of these plasma membrane structures and regulatory mechanisms that control them have been published recently. Studies designed to elucidate their physiological roles suggest that they might permit coordination of cellular events which favor the effective and timely response of the immune system.

Production planning and optimization of a pulp mill: introduction of the optimisation based scheduling software for pulp industry

The objective of this project was to introduce a new software product to pulp industry, a new market for case company. An optimization based scheduling tool has been developed to allow pulp operations to better control their production processes and improve both production efficiency and stability. Both the work here and earlier research indicates that there is a potential for savings around 1-5%. All the supporting data is available today coming from distributed control systems, data historians and other existing sources. The pulp mill model together with the scheduler, allows what-if analyses of the impacts and timely feasibility of various external actions such as planned maintenance of any particular mill operation. The visibility gained from the model proves also to be a real benefit. The aim is to satisfy demand and gain extra profit, while achieving the required customer service level. Research effort has been put both in understanding the minimum features needed to satisfy the scheduling requirements in the industry and the overall existence of the market. A qualitative study was constructed to both identify competitive situation and the requirements vs. gaps on the market. It becomes clear that there is no such system on the marketplace today and also that there is room to improve target market overall process efficiency through such planning tool. This thesis also provides better overall understanding of the different processes in this particular industry for the case company.

Operatiivisen tason suorituskyvyn mallimittariston kehittäminen logistiikkapalveluyritykselle

Tutkimuksen tavoitteena oli kehittää mallimittaristo logistiikkapalvelualalla toimivan yrityksen operatiivisen tason suorituskyvyn seurantaan ja toiminnanohjausta varten, päivittäisen johtamisen tueksi. Tutkimus suoritettiin pääosin toiminta-analyyttisena, yhden yrityksen empiirisenä tapaustutkimuksena. Tutkimuksen kohdeyrityksen toiminnanmittaus perustuu tällä hetkellä pääasiassa taloudellisiin mittareihin ja muutamaan kyselyyn. Toiminnanohjauksen ja – kehittämisen, päätöksenteon tueksi tarvitaan, taloudellisten mittareiden lisäksi, mittareita, joilla pystytään seuraamaan suorituskyvyn taustalla vaikuttavien tekijöiden kehittymistä. Tutkimuksen kohdeyrityksen operatiivisen tason suorituskyvyn mallimittariston suunnittelussa haluttiin varmistaa, että jatkossa mittaamisella vaikutettaisiin seuraustekijöiden lisäksi myös syytekijöihin, selkiyttää liiketoiminnan tavoitteet, operatiivisen tason näkökulmasta, ja mittaamisen tavoite. Tutkimuksessa esitelty mallimittaristo on suunniteltu, tasapainotetun mittariston viitekehyksen avulla. Mittariston näkökulmiksi valittiin: talous, sidosryhmä (asiakas), prosessi ja henkilöstö. Mittariston tuottaman tiedon tavoitteena on toiminnanohjauksen, -kehittämisen ja päätöksenteon tukeminen, kun mittaustulokset ja trendi ovat yhdessä paikassa, on tiedonhaku ja - hyödyntäminen helpompaa. Mallimittaristoa ei testattu eikä käyttöönotettu tutkimuksessa.

Esimies luottamuksen rakentajana muutoksessa

Tänä päivänä organisaatiot elävät lähestulkoon jatkuvan muutoksen aikaa. Jotta muutoksista selvitään menestyksekkäästi, tulisi työntekijöiden luottamus organisaatiota kohtaan säilyttää hyvänä myös muutosten keskellä. Muutosten läpivieminen on helpompaa, kun luottamus on vahvaa. Toisaalta muutokset haastavat luottamuksen. Tämän tutkielman tavoitteena on osallistua luottamuksen merkityksestä työyhteisössä käytävään tieteelliseen keskusteluun tuomalla esille lähiesimiehen roolia luottamuksen rakentajana sekä korostamalla muutostilanteiden tuomia erityispiirteitä luottamuksen rakentamiseen ja ylläpitämiseen. Tavoitteeseen pyrittiin analysoimalla Kelan Kymenlaakson vakuutuspiirin alueella työskentelevien 11 toimihenkilön ja 5 esimiehen teemahaastatteluista saatua laadullista aineistoa. Tutkimustulosten perusteella voidaan todeta, että luottamus työyhteisössä on tärkeää ja se korostuu entisestään muutostilanteissa. Lähiesimies on merkittävässä roolissa työyhteisön luottamuksen ylläpitäjänä ja rakentajana ja hän voi rakentaa työntekijän luottamusta paitsi itseään niin myös koko organisaatiota kohtaan. Muutostilanteissa esimies voi rakentaa luottamusta erityisesti oikea-aikaisella tiedottamisella ja viestinnällä, keskustelemalla, huomioimalla yksilön henkilökohtaiset tarpeet, avoimuudella sekä huolehtimalla työntekijän koulutuksesta ja osaamisen kehittämisestä. Avoin tiedottaminen ja keskusteluyhteys osapuolten välillä näyttävät siis olevan kaiken lähtökohta.

Remodeling in the ischemic heart: the stepwise progression for heart

Abstract Coronary artery disease is the leading cause of death in the developed world and in developing countries. Acute mortality from acute myocardial infarction (MI) has decreased in the last decades. However, the incidence of heart failure (HF) in patients with healed infarcted areas is increasing. Therefore, HF prevention is a major challenge to the health system in order to reduce healthcare costs and to provide a better quality of life. Animal models of ischemia and infarction have been essential in providing precise information regarding cardiac remodeling. Several of these changes are maladaptive, and they progressively lead to ventricular dilatation and predispose to the development of arrhythmias, HF and death. These events depend on cell death due to necrosis and apoptosis and on activation of the inflammatory response soon after MI. Systemic and local neurohumoral activation has also been associated with maladaptive cardiac remodeling, predisposing to HF. In this review, we provide a timely description of the cardiovascular alterations that occur after MI at the cellular, neurohumoral and electrical level and discuss the repercussions of these alterations on electrical, mechanical and structural dysfunction of the heart. We also identify several areas where insufficient knowledge limits the adoption of better strategies to prevent HF development in chronically infarcted individuals.

Securin, Cdc20 and Cdc27 in predicting the outcome of human breast cancer

Deregulated proliferation has been recognized among the most important factors promoting breast cancer development and progression. The aim of the project is to gain understanding of the role of specific cell cycle regulators of metaphase-anaphase transition and evaluate their potential in breast cancer prognostication and treatment decisions. Metaphase-anaphase transition is triggered by activation of anaphase promoting complex (APC) which is activated by a cascade of regulatory proteins, among them securin, Cdc20 and Cdc27. These proteins promote the metaphase–anaphase transition and participate in the timely separation of the chromatids. This study is based on a patient material of approximately 600 breast cancer patients and up to 22 years of follow-up. As the main observation, based on DNA cytometric and immunohistochemical methods, securin, Cdc20 and Cdc27 protein expressions were associated with abnormal DNA content and outcome of breast cancer. In the studied patient material, high securin expression alone and in combination with Cdc20 and Cdc27 predicted up to 9.8-fold odds for aneuploid DNA content in human breast cancer. In Kaplan–Meier analyses, high expression of securin systematically indicated decrease in breast cancer survival as compared to low expression cases. The adverse effect of high securin expression was further strengthened by combining it with Cdc20 or Cdc27 expressions, resulting in up to 6.8-fold risk of breast cancer death. High securin and Cdc20 expression was also associated with triple-negative breast cancer type with high statistical significance. Securin, Cdc20 or Cdc27 have not previously been investigated in a clinically relevant large breast cancer patient material or in association with DNA ploidy. The present findings suggest that the studied proteins may serve as potential biomarkers for identification of aggressive course of disease and unfavourable outcome of human breast cancer, and that they may provide a future research aim for understanding abnormal proliferation in malignant disease.

Depth sensors in augmented reality solutions. Literature review

The emergence of depth sensors has made it possible to track – not only monocular cues – but also the actual depth values of the environment. This is especially useful in augmented reality solutions, where the position and orientation (pose) of the observer need to be accurately determined. This allows virtual objects to be installed to the view of the user through, for example, a screen of a tablet or augmented reality glasses (e.g. Google glass, etc.). Although the early 3D sensors have been physically quite large, the size of these sensors is decreasing, and possibly – eventually – a 3D sensor could be embedded – for example – to augmented reality glasses. The wider subject area considered in this review is 3D SLAM methods, which take advantage of the 3D information available by modern RGB-D sensors, such as Microsoft Kinect. Thus the review for SLAM (Simultaneous Localization and Mapping) and 3D tracking in augmented reality is a timely subject. We also try to find out the limitations and possibilities of different tracking methods, and how they should be improved, in order to allow efficient integration of the methods to the augmented reality solutions of the future.

“Who is steering the ship and which constellation guides the way? Exploring transparency in the European Central Bank during the time of crisis”

This paper explores transparency in the decision-making of the European Central Bank (ECB). According to ECB´s definition, transparency means that the central bank provides the general public with all relevant information on its strategy, assessments and policy decisions as well as its procedures in an open, clear and timely manner. In this paper, however, the interpretation of transparency is somewhat broader: Information is freely available and directly accessible to those who will be affected by the decisions. Moreover, the individuals shall be able to master this material. ECB´s negative attitude towards publication of documents has demonstrated central bank´s reluctance to strive towards more extensive transparency. By virtue of the definition adopted by the ECB the bank itself is responsible for determining what is considered as relevant information. On the grounds of EU treaties, this paper assesses ECB`s accountability concentrating especially on transparency by employing principal-agent theory and constitutional approach. Traditionally, the definite mandate and the tenet of central bank independence have been used to justify the limited accountability. The de facto competence of the ECB has, however, considerably expanded as the central bank has decisively resorted to non-standard measures in order to combat the economic turbulences facing Europe. It is alleged that non-standard monetary policy constitutes a grey zone occasionally resembling economic policy or fiscal policy. Notwithstanding, the European Court of Justice has repeatedly approved these measures. This dynamic interpretation of the treaties seems to allow temporarily exceptions from the central bank´s primary objective during extraordinary times. Regardless, the paper suggests that the accountability nexus defined in the treaties is not sufficient in order to guarantee the accountability of the ECB after the adoption of the new, more active role. Enhanced transparency would help the ECB to maintain its credibility. Investing in the quality of monetary dialogue between the Parliament and the ECB appears to constitute the most adequate and practicable method to accomplish this intention. As a result of upgraded transparency the legitimacy of the central bank would not solely rest on its policy outputs.

Cross Listing of a Finnish Company on an Exchange in the United States of America

Finnish companies cross listing in the United States is an exceptional phenomenon. This study examines the cross listing decision, cross listing choice and cross listing process with associated challenges and critical factors. The aim is to create an in-depth understanding of the cross listing process and the required financial information. Based on that, the aim is to establish the process phases with the challenges and the critical factors that ought to be considered be- fore establishing the process plus re-evaluated and further considered at points in time during the process. The empirical part of this study is conducted as a qualitative study. The research data was collected through the adoption of two approaches, which are the interview approach and the textual data approach. The interviews were conducted with Finnish practitioners in the field of accounting and finance. The textual data was from publicly available publications of this phenomenon by the two BIG5 accounting companies worldwide. The results of this study demonstrate the benefits of cross listing in the U.S. are the better growth opportunities, the reduction of cost of capital and the production of higher quality financial information. In the decision making process companies should assess whether the benefits exceed the increased costs, the pressure for performance, the uncertainty of market recognition and the requirements of management. The exchange listing is seen as the most favourable cross listing choice for Finnish companies. The establishment of the processes for producing reliable, transparent and timely financial information was seen as both highly critical and very challenging. The critical success factors relating to the cross listing phases are the assessment and planning as well as the right mix of experiences and expertise. The timing plays important role in the process. The results mainly corroborate the literature concerning cross listing decision and choice. This study contributes to the literature on the cross listing process offering a useful model for the phases of the cross listing process.