Salivary gland cancer in Finland: Incidence, histological distribution, outcome and prognostic factors

Salivary gland cancer (SGC) is a rare cancer. The histological classification of SGC is complex and its biological behavior highly variable: it may vary from a low-grade tumor to a high-grade and often fatal malignancy. These circumstances make this cancer a diagnostic and therapeutic challenge. Older age and exposure to ionizing radiation are known risk factors. The mainstay of treatment is surgery combined with adjuvant radiation therapy, when appropriate. In addition to the histological type, the only well known prognostic factor is the TNM classification, which describes the tumor size and the amount of metastases. This study was performed using a full population-based nationwide cohort of SGC patients and tumors diagnosed in Finland in 1991-1996. The annual incidence of SGC in the entire population was, on average, 47.7 per year. By histological re-evaluation of 237 specimens the most frequent histological types were the adenoid cystic carcinoma (n=65; 27%), the mucoepidermoid carcinoma (n=45; 19%) and the acinic cell carcinoma (n=41; 17%). The highest 10-year disease-specific survival rate occurred among patients with acinic cell carcinoma (90%), followed by mucoepidermoid carcinoma (81%) and adenoid cystic carcinoma (60%). A high volume-corrected index (VCI) of Ki-67 correlated with worse survival of patients with SGC. Computer-assisted morphometric analyses of CD34-positive vessels indicated an unfavorable prognosis for patients with mucoepidermoid carcinoma and an association with poor survival among patients with acinic cell carcinoma. A high level of expression of matrix metalloproteinase-9 (MMP-9) showed a trend for a poorer prognosis in salivary duct carcinoma, and a high level of MMP-13 and a low level of MMP-1 had a trend for a poorer prognosis of patients with SGC. A low level of MMP-7 was associated with a poor prognosis of patients with acinic cell and mucoepidermoid carcinoma.

Predicting Market Crashes: An Examination of the Performance of Macroeconomic Indicators and Technical Analysis

The purpose of this study is to examine macroeconomic indicators‟ and technical analysis‟ ability to signal market crashes. Indicators examined were Yield Spread, The Purchasing Managers Index and the Consumer Confidence Index. Technical Analysis indicators were moving average, Moving Average Convergence-Divergence and Relative Strength Index. We studied if commonly used macroeconomic indicators can be used as a warning system for a stock market crashes as well. The hypothesis is that the signals of recession can be used as signals of stock market crash and that way a basis for a hedging strategy. The data is collected from the U.S. markets from the years 1983-2010. Empirical studies show that macroeconomic indicators have been able to explain the future GDP development in the U.S. in research period and they were statistically significant. A hedging strategy that combined the signals of yield spread and Consumer Confidence Index gave most useful results as a basis of a hedging strategy in selected time period. It was able to outperform buy-and-hold strategy as well as all of the technical indicator based hedging strategies.

Added Value of Combining Value and Momentum Indicators in the Swiss Stock Market

The purpose of the thesis is to examine the added value of combining value and momentum indicators in the Swiss stock exchange. Value indicators employed are P/E, EV/EBITDA, P/CF, P/B ja P/S. Momentum indicators examined are 52-week high, acceleration rate, 12-month past return and 6-month past return. The thesis examines whether the composite value measures based on the above mentioned ratios can add value and whether the inclusion of momentum can further improve the risk return profile of the value portfolios. The data is gathered from the Swiss equity market during the sample period from May 2001 to May 2011. Previous studies have shown that composite value measures can somewhat add value to the value portfolio strategy. Similarly, recent academic literature have found evidence that momentum works well as a timing indicator for time to entry to value stocks. This study indicates that the added value of composite value measures exists. It also shows that momentum combined to acceleration rate can significantly improve the risk adjusted performance of value-only portfolios.

Material embodiment and energy flows as efficiency indicators of soybean (Glycine max) production in Brazil

As the requirement for agriculture to be environmentally suitable there is a necessity to adopt indicators and methodologies approaching sustainability. In Brazil, biodiesel addition into diesel is mandatory and soybean oil is its main source. The material embodiment determines the convergence of inputs into the crop. Moreover, the material flows are necessary for any environmental analysis. This study evaluated distinct production scenarios, and also conventional versus GMO crops, through the material embodiment and energy analysis. GMO crops demanded less indirectly applied inputs. The energy balance showed linearity with yield, whereas for EROI, the increases in input and yield were not affected.

Setting efficiency indicators for center pivots

In this study, it was discussed the efficiency criteria in each of the elements that compose a central pivot, and this analysis was applied to two sets of systems located in regions of Cruz Alta and Santo Augusto, state of Rio Grande do Sul, Brazil. The methodology used combines water and energy assessment through an indicator called Normalized Specific Consumption in Irrigation (C ENI), allowing thus a comparison between equipment and projects. The C ENI in Cruz Alta region showed 72% of the equipment above the standard (8.68 kWh mm-1 ha-1 100m-1), and in Santo Augusto region 64.28% with consumption above the standard. The mean irrigation efficiency for Cruz Alta region was 29.85%, with standard deviation of 5.41%, and for Santo Augusto region, it was 29.02%, with standard deviation of 5.15%.

Technical and economic indicators of the yellow passion fruit tree irrigated with underground water supply

The research aimed to quantify technical and economic indicators of yellow passion fruit tree irrigated with fractions of irrigation with underground source of water, to generate information that helps farmers in decision making on the implementation of investment in irrigated fruit growing (yellow passion fruit). For this purpose, we used the passion fruit crop irrigated with Microjet type irrigation system, with conducting system in simple espaliers. The treatments consisted of five hours of application of the depth of water required by the crop with irrigation frequency of two days. The results showed that the highest yield (16660kg ha-1) was obtained with the fractionation of irrigation twice a day (50% to 7h and 50% to 21h30), which provided an increase in productivity of 54%, demonstrating the financial viability and being highly profitable to the interest rate of 2% per year, with low sensitivity of financial risk to real interest rates above the prevailing market.

Water quality indicators for environmental and resistance profile of Escherichia coli strains isolated in Rio Cascavel, Paraná, Brazil

In this article it was evaluated the quality of water in the Cascavel river, in the city of Cascavel - Paraná using microbiological indicators, physical and chemical pollution and susceptibility / resistance in strains of Escherichia coli isolated antimicrobial trade. The water sampling was conducted between 2010-July and 2011-June at three points: a) near the source, b) urban area, c) rural area. The samples were analyzed for physical, chemical and microbiological variables: temperature, pH, color, turbidity, electrical conductivity, total nitrogen and total phosphorus, total coliforms (CT), fecal coliform (CTe) and Escherichia coli. Tests were also performed to nine antimicrobial commercial resistances. The variables studied indicated that the Cascavel river water was presented at disagreement with the resolution 357/2005 CONAMA (class I), ranking in the index as regular water quality. The physical, chemical and rainfall did not affect the growth of CT and CTe, with higher counts of E. coli in the urban area. The greatest resistance profiles of the strains of E. coli isolated from Cascavel river water was found in section 2, the urban area as a probable consequence of human influence on water quality.

Cloroplast pigments as indicators of lead stress

Plants respond to environmental adversities, becoming an indicator for assessing the environment quality. In this aspect, chlorophyll contents as well, carotenoids are used as a reliable indicator to associate environmental quality and pollution, mainly regarding the toxicity of heavy metals in higher plants. So, we aimed to evaluate the content of chlorophyll a, b, and total chlorophylls and carotenoids in plants vetiver [Vetiveria zizanioides (L.) Nash], maize (Zea mays L.) cv. AG 1051, sunflower (Helianthus annuus L.) cv. BRS 122/V-2000, and castor beans (Ricinus communis L. ) cv . Northeastern BRS grown in contaminated soil with lead, with and without correction of soil pH, so they were used as indicators of metal stress by the soil. From the biochemical point of view, the correction of soil pH values caused chlorophyll a, b and total statistically higher for vetiver species and castor beans in the analyzed periods, except for the analysis performed 60 days after transplanting where only the species vetiver benefited from the correction of soil pH on the content of chlorophyll b and total. On the other hand plants without correction of soil pH showed a decrease of all chlorophyll levels. In addition, the largest increase in the synthesis of carotenoids, indicated that under stress the plants have developed alternative routes of dissipation of energy in order to avoid problems of photo-inhibition and photo-oxidation.

Immunohistochemical evaluation for P53 and VEGF (Vascular Endothelial Growth Factor) is not prognostic for long term survival in end stage esophageal adenocarcinoma

OBJECTIVES: To correlate the expression of p53 protein and VEGF with the prognosis of patients submitted to curative resection to treat esophageal adenocarcinoma. METHODS: Forty-six patients with esophageal adenocarcinoma, submitted to curative resection, were studied. The expressions of p53 protein and VEGF were assessed by immunohistochemistry in 52.2% and 47.8% of tumors, respectively. RESULTS: P53 protein and VEGF expressions coincided in 26% of the cases, and no correlation between these expressions was observed. None of the clinicopathological factors showed a significant correlation with p53 protein or VEGF expressions. There was no significant association between p53 protein and VEGF expressions and long-term survival. CONCLUSION: The expression of p53 protein and VEGF did not correlate with prognosis in esophageal adenocarcinoma patients submitted to curative resection.

Testate amoebae (thecamoebians) as indicators of aquatic mine impact

The environmental impacts of a single mine often remain local, but acidic and metal-rich acid mine drainage (AMD) from the waste materials may pose a serious threat to adjacent surface waters and their ecosystems. Testate amoebae (thecamoebian) analysis was used together with lake sediment geochemistry to study and evaluate the ecological effects of sulphidic metal mines on aquatic environments. Three different mines were included in the study: Luikonlahti Cu-mine in Kaavi, eastern Finland, Haveri Cu-Au mine in Ylöjärvi, southern Finland and Pyhäsalmi Zn-Cu-S mine in Pyhäjärvi, central Finland. Luikonlahti and Haveri are closed mines, but Pyhäsalmi is still operating. The sampling strategy was case specific, and planned to provide a representative sediment sample series to define natural background conditions, to detect spatial and temporal variations in mine impacts, to evaluate the possible recovery after the peak contamination, and to distinguish the effects of other environmental factors from the mining impacts. In the Haveri case, diatom analyses were performed alongside thecamoebian analysis to evaluate the similarities and differences between the two proxies. The results of the analyses were investigated with multivariate methods (direct and indirect ordinations, diversity and distance measure indices). Finally, the results of each case study were harmonized, pooled, and jointly analyzed to summarize the results for this dissertation. Geochemical results showed broadly similar temporal patterns in each case. Concentrations of ions in the pre-disturbance samples defined the natural baseline against which other results were compared. The beginning of the mining activities had only minor impacts on sediment geochemistry, mainly appearing as an increased clastic input into the lakes at Haveri and Pyhäsalmi. The active mining phase was followed by the metallic contamination and, subsequently, by the most recent change towards decreased but still elevated metal concentrations in the sediments. Because of the delay in the oxidation of waste material and formation of AMD, the most intense, but transient metal contamination phase occurred in the post-mining period at Luikonlahti and Haveri. At Pyhäsalmi, the highest metal contamination preceded effluent mitigation actions. Spatial gradients were observed besides the temporal evolution in both the pre-disturbance and mine-impacted samples from Luikonlahti and Pyhäsalmi. The geochemical gradients varied with distance from the main source of contaminants (dispersion and dilution) and with water depth (redox and pH). The spatial extent of the highest metal contamination associated with these mines remained rather limited. At Haveri, the metallic impact was widespread, with the upstream site in another lake basin found to be contaminated. Changes in thecamoebian assemblages corresponded well with the geochemical results. Despite some differences, the general features and ecological responses of the faunal assemblages were rather similar in each lake. Constantly abundant strains of Difflugia oblonga, Difflugia protaeiformis and centropyxids formed the core of these assemblages. Increasing proportions of Cucurbitella tricuspis towards the surface samples were found in all of the cases. The results affirmed the indicator value of some already known indicator forms, but such as C. tricuspis and higher nutrient levels, but also elicited possible new ones such as D. oblonga ‘spinosa’ and clayey substrate, high conductivity and/or alkalinity, D. protaeiformis ‘multicornis’ and pH, water hardness and the amount of clastic material and Centropyxis constricta ‘aerophila’ and high metal and S concentrations. In each case, eutrophication appeared to be the most important environmental factor, masking the effects of other variables. Faunal responses to high metal inputs in sediments remained minor, but were nevertheless detectable. Besides the trophic state of the lake, numerical methods suggested overall geochemical conditions (pH, redox) to be the most important factor at Luikonlahti, whereas the Haveri results showed the clearest connection between metals and amoebae. At Pyhäsalmi, the strongest relationships were found between Ca- and S-rich present loading, redox conditions and substrate composition. Sediment geochemistry and testate amoeba analysis proved to be a suitable combination of methods to detect and describe the aquatic mine impacts in each specific case, to evaluate recovery and to differentiate between the effects of different anthropogenic and natural environmental factors. It was also suggested that aquatic mine impacts can be significantly mitigated by careful design and after-care of the waste facilities, especially by reducing and preventing AMD. The case-specific approach is nevertheless necessary because of the unique characteristics of each mine and variations in the environmental background conditions.

Evaluation of prognostic factors of decompressive craniectomy in the treatment of severe traumatic brain injury

OBJECTIVE: to determine predictive factors for prognosis of decompressive craniectomy in patients with severe traumatic brain injury (TBI), describing epidemiological findings and the major complications of this procedure.METHODS: we conducted a retrospective study based on analysis of clinical and neurological outcome, using the extended Glasgow outcome in 56 consecutive patients diagnosed with severe TBI scale treated in the emergency department from February 2004 to July 2012. The variables assessed were age, mechanism of injury, presence of pupillary changes, Glasgow coma scale (GCS) score on admission, CT scan findings (volume, type and association of intracranial lesions, deviation from the midline structures and classification in the scale of Marshall and Rotterdam).RESULTS: we observed that 96.4% of patients underwent unilateral decompressive craniectomy (DC) with expansion duraplasty, and the remainder to bilateral DC, 53.6% of cases being on the right 42.9% on the left, and 3.6% bilaterally, with predominance of the fourth decade of life and males (83.9%). Complications were described as transcalvarial herniation (17.9%), increased volume of brain contusions (16.1%) higroma (16.1%), hydrocephalus (10.7%), swelling of the contralateral lesions (5.3%) and CSF leak (3.6%).CONCLUSION: among the factors studied, only the presence of mydriasis with absence of pupillary reflex, scoring 4 and 5 in the Glasgow Coma Scale, association of intracranial lesions and diversion of midline structures (DML) exceeding 15mm correlated statistically as predictors of poor prognosis.

Resection of liver metastasis from neuroendocrine tumors: evaluation of results and prognostic factors

OBJECTIVES: to determine the prognostic factors that may impact on morbidity and mortality and survival of patients undergoing surgical treatment of liver metastases from neuroendocrine tumors. METHODS: We studied 22 patients undergoing liver resection for metastases from neuroendocrine tumors between 1997 and 2007. Epidemiological and clinical data were correlated with morbidity and mortality and overall and disease-free survivals. RESULTS: twelve patients were male and ten female, with a mean age of 48.5 years. Bilobar disease was present in 17 patients (77.3%). In ten patients (45.5%) the primary tumor originated in the pancreas, terminal ileum in eight, duodenum in two, rectum in one and jejunum in one. Complete surgical resection (R0) was achieved in 59.1% of patients. Eight patients (36.3%) developed complications in the immediate postoperative period, one of them dying from septicemia. All patients undergoing re-hepatectomy and/or two-stage hepatectomy had complications in the postoperative period. The overall survival at one and five years was 77.3% and 44.2%. The disease-free survival at five years was 13.6%. The primary pancreatic neuroendocrine tumor (p = 0.006) was associated with reduced overall survival. Patients with number of metastatic nodules < 10 (p = 0.03) and asymptomatic at diagnosis (p = 0.015) had higher disease-free survival. CONCLUSION: liver metastases originating from pancreatic neuroendocrine tumors proved to be a negative prognostic factor. Symptomatic patients with multiple metastatic nodules showed a significant reduction in disease-free survival.

Key performance indicators for successful metadata governance

Metadata in increasing levels of sophistication has been the most powerful concept used in management of unstructured information ever since the first librarian used the Dewey decimal system for library classifications. It remains to be seen, however, what the best approach is to implementing metadata to manage huge volumes of unstructured information in a large organization. Also, once implemented, how is it possible to track whether it is adding value to the company, and whether the implementation has been successful? Existing literature on metadata seems to either focus too much on technical and quality aspects or describe issues with respect to adoption for general information management initiatives. This research therefore, strives to contribute to these gaps: to give a consolidated framework for striving to understand the value added by implementing metadata. The basic methodology used is that of case study, which incorporates aspects of design science, surveys, and interviews in order to provide a holistic approach to quantitative and qualitative analysis of the case. The research identifies the various approaches to implementing metadata, particularly studying the one followed by the unit of analysis of case study, a large company in the Oil and Gas Sector. Of the three approaches identified, the selected company already follows an approach that appears to be superior. The researcher further explores its shortcomings, and proposes a slightly modified approach that can handle them. The research categorically and thoroughly (in context) identifies the top effectiveness criteria, and corresponding key performance indicators(KPIs) that can be measured to understand the level of advancement of the metadata management initiative in the company. In an effort to contrast and have a basis of comparison for the findings, the research also includes views from information managers dealing with core structured data stored in ERPs and other databases. In addition, the results include the basic criteria that can be used to evaluate metrics, in order to classify a metric as a KPI.

An Overview of the Cleantech Sector - Evaluating Environmental Indicators

The purpose of the thesis is to give an overview of the cleantech sector and to give an answer how cleantech companies can evaluate the environmental sustainability of their business by utilizing various indicators and measures. The thesis is a literature study and it is based on a secondary data. Thesis presents the definitions to cleantech as well as its history and the main industries. Cleantech market overview in Finland and worldwide is also introduced. Furthermore, various indicators are presented in order to evaluate the environmental sustainability of companies' business. In the end, indicators used in cleantech sector are evaluated. As a result, the thesis presents the following methodologies that can be used in evaluating the environmental sustainability in the cleantech sector: Sustainability assessment framework, Environmental value analysis, COMPLIMENT - Environmental performance index for industries and Environmental assessment for cleaner production. More tools are still needed to evaluate environmental sustainability in the cleantech sector.

Internal quality control indicators of cervical cytopathology exams performed in laboratories monitored by the External Quality Control Laboratory

PURPOSE: To evaluate the impact of continued education provided by an external quality control laboratory on the indicators of internal quality control of cytopathology exams.METHODS: The internal quality assurance indicators for cytopathology exams from 12 laboratories monitored by the External Quality Control Laboratory were evaluated. Overall, 185,194 exams were included, 98,133 of which referred to the period preceding implementation of a continued education program, while 87,061 referred to the period following this intervention. Data were obtained from the Cervical Cancer Database of the Brazilian National Health Service.RESULTS: Following implementation of the continued education program, the positivity index (PI) remained within recommended limits in four laboratories. In another four laboratories, the PI progressed from below the limits to within the recommended standards. In one laboratory, the PI remained low, in two laboratories, it remained very low, and in one, it increased from very low to low. The percentage of exams compatible with a high-grade squamous intraepithelial lesion (HSIL) remained within the recommended limits in five laboratories, while in three laboratories it progressed from below the recommended levels to >0.4% of the total number of satisfactory exams, and in four laboratories it remained below the standard limit. Both the percentage of atypical squamous cells of undetermined significance (ASC-US) in relation to abnormal exams, and the ratio between ASC-US and intraepithelial lesions remained within recommended levels in all the laboratories investigated.CONCLUSION: An improvement was found in the indicators represented by the positivity index and the percentage of exams compatible with a high-grade squamous intraepithelial lesion, showing that the role played by the external quality control laboratory in providing continued education contributed towards improving laboratory staff skills in detecting cervical cancer precursor lesions.