Assessment of panobacumab as adjunctive immunotherapy for the treatment of nosocomial Pseudomonas aeruginosa pneumonia.

The fully human anti-lipopolysaccharide (LPS) immunoglobulin M (IgM) monoclonal antibody panobacumab was developed as an adjunctive immunotherapy for the treatment of O11 serotype Pseudomonas aeruginosa infections. We evaluated the potential clinical efficacy of panobacumab in the treatment of nosocomial pneumonia. We performed a post-hoc analysis of a multicenter phase IIa trial (NCT00851435) designed to prospectively evaluate the safety and pharmacokinetics of panobacumab. Patients treated with panobacumab (n = 17), including 13 patients receiving the full treatment (three doses of 1.2 mg/kg), were compared to 14 patients who did not receive the antibody. Overall, the 17 patients receiving panobacumab were more ill. They were an average of 72 years old [interquartile range (IQR): 64-79] versus an average of 50 years old (IQR: 30-73) (p = 0.024) and had Acute Physiology and Chronic Health Evaluation II (APACHE II) scores of 17 (IQR: 16-22) versus 15 (IQR: 10-19) (p = 0.043). Adjunctive immunotherapy resulted in an improved clinical outcome in the group receiving the full three-course panobacumab treatment, with a resolution rate of 85 % (11/13) versus 64 % (9/14) (p = 0.048). The Kaplan-Meier survival curve showed a statistically significantly shorter time to clinical resolution in this group of patients (8.0 [IQR: 7.0-11.5] versus 18.5 [IQR: 8-30] days in those who did not receive the antibody; p = 0.004). Panobacumab adjunctive immunotherapy may improve clinical outcome in a shorter time if patients receive the full treatment (three doses). These preliminary results suggest that passive immunotherapy targeting LPS may be a complementary strategy for the treatment of nosocomial O11 P. aeruginosa pneumonia.

Parhaat käyttökelpoiset tekniikat (BAT) perunankuorimoiden jätteiden käsittelyssä -käytäntöjä Euroopan maista

Yhä suurempi osa suurkeittiöistä ja ravintoloista käyttää ruuan valmistuksessa valmiiksi prosessoituja kasviksia, jotka hankitaan pääasiassa lähellä sijaitsevista tilakuorimoista. Kuorimoilla syntyy suuria määriä jätettä, enimmäkseen kuorijätteitä, multaa ja jätevettä. Tässä työssä tarkastellaan perunankuorimoiden kuorintamenetelmiä ja kuorintaprosessia, prosessissa syntyviä jätteitä ja niiden käsittelyä sekä ympäristöasioiden hallintamenetel-miä kuorimoilla Suomessa ja muissa EU-maissa. Työn tavoitteena oli selvittää, minkälainen on lainsäädäntö ja minkälaiset ovat kuorimotoimintaa koskevat lupakäytännöt Ruotsissa, Saksassa, Belgiassa ja Iso-Britanniassa. Lisäksi tavoitteena oli selvittää, onko näissä maissa määritelty, millainen on perunankuorimoille soveltuva paras käyttökelpoinen tekniikka (BAT) erityisesti jätteiden käsittelyssä. Euroopan yhteisön neuvoston direktiivi (96/61/EY) ympäristön pilaantumisen ehkäisemisen ja vähentämisen yhtenäistämiseksi edellyttää perunankuorimoilta toimintaansa ympäristöluvan. Laitosten koko, joilta ympäristölupa vaaditaan, vaihtelee suuresti eri maissa. Myös kuorimoiden jäteveden puhdistusvaatimukset vaihtelevat maittain. Belgi-assa ja Saksassa perunankuorimoilla syntyville jätevesille on asetettu päästöraja-arvot laissa. Kansallinen BAT-ohjeistus vihanneksia ja hedelmiä jatkojalostavalle teollisuudelleon tehty Belgiassa ja Iso-Britanniassa. Sen sijaan Saksassa ja Ruotsissa kansallista ohjeistusta ei ole tehty. Kansallisten BAT-ohjeistusten pohjalta Euroopan yhteisöjen komissio on julkaissut tammikuussa 2006 elintarviketeollisuudelle BAT-vertailuasiakirjan eli BREFin (BAT Referense Document), joissa kuvataan yleisellä tasolla BAT-tekniikoiksi sovitut tekniikat mm. perunan prosessoinnissa. Tässä työssä tuli ilmi, että kokoerot Suomen ja tässä työssä tarkasteltavien maiden kuo-rimoiden välillä ovat suuret. Voidaankin todeta, että tässä työssä tarkastelluissa BAT - ohjeistuksissa ja Euroopan komission BREF-dokumentissa esitetyt BAT-tekniikat etenkin jätevedenpuhdistuksessa eivät suoraan ole sovellettavissa Suomen olosuhteisiin kuorimoidemme pienestä koosta johtuen. Kiinteiden kuorintajätteiden käsittelyssä BAT-tekniikoiksi ulkomailla on määritelty lä-hinnä rehukäyttö, kompostointi ja peltoon levitys. Perunankuorimoiden jäteveden puhdistuksessa BAT-tekniikaksi Belgiassa on määritelty primääripuhdistus ja sekundääripuhdistus aerobisella menetelmällä. Iso-Britanniassapuolestaan BAT-tekniikkaa on primää-ripuhdistus, sekundääripuhdistus aerobisesti tai anaerobisesti ja tertiääripuhdistus, mikäli se on taloudellisesti mahdollista toteuttaa. Kuorijätteiden kompostointi on tällä hetkelläSuomessa melko harvinaista, sillä jätteiden suuri vesipitoisuus ja kylmä ilmastomme vaikeuttavat kompostointia. Kompostointimah-dollisuuksia ja kompostointiprosessin optimointia kuorintajätteille sopivaksi tulisikin tutkia tulevaisuudessa yhtenä jätteiden käsittelyvaihtoehtona. Kuorimoiden jätevesien puhdistuksessa tulevat Suomessa kysymykseen lähinnä yksinkertaiset kiinteistökohtaiset pienpuhdistamot, kuten panospuhdistamot. Pienpuhdistamolaitteistoihin liittyvää tutki-mus-ja kehitystyötä on viime vuosina tehty paljon ja sitä olisi tärkeää jatkaa edelleen, jotta löydettäisiin entistä kustannustehokkaampia ratkaisuja.

Spatial distribution of motor units recruited during electrical stimulation of the quadriceps muscle versus the femoral nerve.

INTRODUCTION: In this study we investigated differences in the spatial recruitment of motor units (MUs) in the quadriceps when electrical stimulation is applied over the quadriceps belly versus the femoral nerve. METHODS: M-waves and mechanical twitches were evoked using over-the-quadriceps and femoral nerve stimulation of gradually increasing intensity from 22 young, healthy subjects. Spatial recruitment was investigated using recruitment curves of M-waves recorded from the vastus medialis (VM) and vastus lateralis (VL) and of twitches recorded from the quadriceps. RESULTS: At maximal stimulation intensity (Imax), no differences were found between nerve and over-the-quadriceps stimulation. At submaximal intensities, VL M-wave amplitude was higher for over-the-quadriceps stimulation at 40% Imax, and peak twitch force was greater for nerve stimulation at 60% and 80% Imax. CONCLUSIONS: For the VM, MU spatial recruitment during nerve and over-the-quadriceps stimulation of increasing intensity occurred in a similar manner, whereas significant differences were observed for the VL. Muscle Nerve, 2013.

Power spectral changes of the superimposed M wave during isometric voluntary contractions of increasing strength.

INTRODUCTION: We examined the power spectral changes of the compound muscle action potential (M wave) evoked during isometric contractions of increasing strength. METHODS: Surface electromyography (sEMG) of the vastus lateralis and medialis was recorded from 20 volunteers who performed 4-s step-wise isometric contractions of different intensities. A maximal M wave was elicited by a single stimulus to the femoral nerve and superimposed on the voluntary contractions. The spectral characteristics (Fmean and Fmedian) of sEMG and M-wave signals were calculated. RESULTS: M-wave spectral indicators increased systematically with contraction intensity up to 60% MVC and then leveled off at higher forces. Over the 10-60% MVC range, the increase in spectral indicators was 3 times higher for M waves (36%) than for sEMG (12%). CONCLUSIONS: The consistent increase in M-wave spectral characteristics with force is due to the fact that the number of motor units recruited by the superimposed supramaximal stimulus is approximately stable.

Runa des Finlandois Planches de musique - 1

Paris : Chez Levrault, Schoell, et Compagnie 1804, Gravé par Richomme

Grande valse pour le piano : par Oskar Merikanto - [1]

Kansilehdellä omistus: Sally Ehnroth, jouluna 1885. - Oskar Merikannon Grande valse¿n tunnetumpi nimi on Kesäillan valssi.

Niin sinua katsoin, neiti - [1]

Ruovesi 1914

"Tula tuulan tei!" näytelmäkappaleesta "Tukkijoella" miesköörille, baryton soololle

Heikki Klemetti on kirjoittanut lyijykynällä nuottilehdelle huomautuksen.

Assessing Recent Selection and Functionality at Long Noncoding RNA Loci in the Mouse Genome.

Long noncoding RNAs (lncRNAs) are one of the most intensively studied groups of noncoding elements. Debate continues over what proportion of lncRNAs are functional or merely represent transcriptional noise. Although characterization of individual lncRNAs has identified approximately 200 functional loci across the Eukarya, general surveys have found only modest or no evidence of long-term evolutionary conservation. Although this lack of conservation suggests that most lncRNAs are nonfunctional, the possibility remains that some represent recent evolutionary innovations. We examine recent selection pressures acting on lncRNAs in mouse populations. We compare patterns of within-species nucleotide variation at approximately 10,000 lncRNA loci in a cohort of the wild house mouse, Mus musculus castaneus, with between-species nucleotide divergence from the rat (Rattus norvegicus). Loci under selective constraint are expected to show reduced nucleotide diversity and divergence. We find limited evidence of sequence conservation compared with putatively neutrally evolving ancestral repeats (ARs). Comparisons of sequence diversity and divergence between ARs, protein-coding (PC) exons and lncRNAs, and the associated flanking regions, show weak, but significantly lower levels of sequence diversity and divergence at lncRNAs compared with ARs. lncRNAs conserved deep in the vertebrate phylogeny show lower within-species sequence diversity than lncRNAs in general. A set of 74 functionally characterized lncRNAs show levels of diversity and divergence comparable to PC exons, suggesting that these lncRNAs are under substantial selective constraints. Our results suggest that, in mouse populations, most lncRNA loci evolve at rates similar to ARs, whereas older lncRNAs tend to show signals of selection similar to PC genes.

A qualitative study of adolescents with medically unexplained symptoms and their parents. Part 2: How is healthcare perceived?

Medically unexplained symptoms (MUS) are common among adolescents and an important cause of clinical visits. This study sought to understand the experiences with, and perceptions of, the healthcare of adolescents who have MUS and their parents. Using a qualitative approach, six focus groups and two individual interviews were conducted with a total of ten adolescents and sixteen parents. The participants were recruited in a university hospital in Switzerland. A thematic analysis was conducted in accordance with the Grounded Theory. Six main themes emerged: needing a label for the symptoms, seeking an etiology to explain the symptoms, negotiating the medical system, medication and treatments, interactions with doctors, and the inclusion of parents during consultations. Transcending these themes, however, was the need for good communication between the adolescents, their parents and the clinicians. When explaining the symptoms, clinicians should make sure to discuss the results, investigations and lack of organic origin.

A qualitative study of adolescents with medically unexplained symptoms and their parents. Part 1: Experiences and impact on daily life.

Medically unexplained symptoms (MUS) are common among adolescents and are frequently encountered in primary care. Our aim was to explore how these adolescents and their parents experience the condition and its impact on their daily lives and to provide recommendations for health professionals. Using a qualitative approach, six focus groups and two individual interviews were conducted. These involved a total of ten adolescents with different types of MUS and sixteen parents. The respondents were recruited in a university hospital in Switzerland. A thematic analysis was conducted according to the Grounded Theory. The analysis of the data highlighted four core themes: disbelief, being different, concealing symptoms, and priority to adolescent's health. Transcending these themes was a core issue regarding the discrepancy between the strategies that adolescents and their parents use to cope with the symptoms. Health professionals should be made aware of the emotional needs of these patients and their families.

A qualitative study of adolescents with medically unexplained symptoms and their parents

Il est fréquent en médecine de premier recours de rencontrer des adolescents exprimant des symptômes somatiques pour lesquels aucune des investigations entreprises n'a permis de rendre compte d'une pathologie organique. De tels symptômes sont retrouvés dans la littérature sous la terminologie de symptômes médicalement inexpliqués (MUS) ou des troubles fonctionnels. Bien que la prévalence des adolescents souffrant de MUS est fréquente, les médecins éprouvent encore beaucoup de difficultés à prendre en charge et communiquer avec ces patients, principalement en raison d'une incompréhension de leurs besoins et préoccupations tant dans leur vie quotidienne que lors d'une consultation au cabinet. Le but de notre étude est de comprendre les expériences et vécus des adolescents avec des MUS ainsi que de leurs parents afin d'aider le praticien dans la compréhension de son patient dans sa globalité et ainsi d'améliorer sa prise en charge. Dans le premier article présenté, nous nous sommes intéressés à la vie quotidienne de ces adolescents en étudiant leurs relations avec leur famille et leur entourage ainsi que les répercussions sur leurs parcours scolaire et leurs activités extrascolaires. Dans le second article nous nous sommes penchés sur les relations qu'entretiennent ces adolescents et leurs parents avec le système de santé. Nous avons collecté des données qualitatives en moyennant des groupes focus incluant 16 adolescents atteints de troubles fonctionnels et leurs parents. L'analyse a permis de faire émerger les difficultés que ces jeunes et leurs familles vivent au quotidien et comment ils sont confrontés à la solitude dû principalement à l'incompréhension sociale. Les résultats mettent aussi en évidence l'insatisfaction de ces jeunes et de leurs parents par rapport à la prise en charge médical, notamment en raison d'un manque de communication. -- Medically unexplained symptoms (MUS) are common among adolescents and are frequently encountered in primary care. Our aim was to explore how these adolescents and their parents experience the condition and its impact on their daily lives and to provide recommendations for health professionals. Using a qualitative approach, six focus groups and two individual interviews were conducted. These involved a total of ten adolescents with different types of MUS and sixteen parents. The respondents were recruited in a university hospital in Switzerland. A thematic analysis was conducted according to the Grounded Theory. The analysis of the data highlighted four core themes: disbelief, being different, concealing symptoms, and priority to adolescent's health. Transcending these themes was a core issue regarding the discrepancy between the strategies that adolescents and their parents use to cope with the symptoms. Health professionals should be made aware of the emotional needs of these patients and their families.

Fischer-Tropsch Slurry Bubble Column Reactor Modeling

The literature part of the work reviews overall Fischer-Tropsch process, Fischer-Tropsch reactors and catalysts. Fundamentals of Fischer-Tropsch modeling are also presented. The emphasis is on the reactor unit. Comparison of the reactors and the catalysts is carried out to choose the suitable reactor setup for the modeling work. The effects of the operation conditions are also investigated. Slurry bubble column reactor model operating with cobalt catalyst is developed by taking into account the mass transfer of the reacting components (CO and H2) and the consumption of the reactants in the liquid phase. The effect of hydrostatic pressure and the change in total mole flow rate in gas phase are taken into account in calculation of the solubilities. The hydrodynamics, reaction kinetics and product composition are determined according to literature. The cooling system and furthermore the required heat transfer area and number of cooling tubes are also determined. The model is implemented in Matlab software. Commercial scale reactor setup is modeled and the behavior of the model is investigated. The possible inaccuraries are evaluated and the suggestions for the future work are presented. The model is also integrated to Aspen Plus process simulation software, which enables the usage of the model in more extensive Fischer-Tropsch process simulations. Commercial scale reactor of diameter of 7 m and height of 30 m was modeled. The capacity of the reactor was calculated to be about 9 800 barrels/day with CO conversion of 75 %. The behavior of the model was realistic and results were in the right range. The highest uncertainty to model was estimated to be caused by the determination of the kinetic rate.

Investigação de Er3+ nos dois sítios cristalográficos de Gd2SiO5 através da fotoluminescência resolvida no tempo

Gadolinium oxyortho-silicate, Gd2SiO5, presents a monoclinic structure with two crystallographic sites in which Gd3+ ions are equally distributed with coordination numbers CN, 7 and 9, respectively. By doping this host with Er3+ it is possible to distinguish and attribute the two sites by means of lifetime determination of the 4S3/2 state, (in this case, Er3+ substitutes Gd3+ ions). Samples doped with 0.1 and 5.0% molar Er3+ were prepared by solid state reaction and characterized by X-ray Diffractometry, Vibrational and Electronic Absorption Spectroscopies, and Time Resolved Photoluminescence. Based on the experimental results, it is possible to verify that, for the 5,0% doped sample, the lifetime value of the 4S3/2 state of the erbium ion inserted in site 1, (CN = 9), is 2.7 ± 0.1 mus, and for the one inserted in site 2, (CN = 7), it is 1.5 ± 0.1 mus.