A European survey on current practices in epilepsy monitoring units and implications for patients' safety.

OBJECTIVE: This study aimed to survey current practices in European epilepsy monitoring units (EMUs) with emphasis on safety issues. METHODS: A 37-item questionnaire investigating characteristics and organization of EMUs, including measures for prevention and management of seizure-related serious adverse events (SAEs), was distributed to all identified European EMUs plus one located in Israel (N=150). RESULTS: Forty-eight (32%) EMUs, located in 18 countries, completed the questionnaire. Epilepsy monitoring unit beds are 1-2 in 43%, 3-4 in 34%, and 5-6 in 19% of EMUs; staff physicians are 1-2 in 32%, 3-4 in 34%, and 5-6 in 19% of EMUs. Personnel operating in EMUs include epileptologists (in 69% of EMUs), clinical neurophysiologists trained in epilepsy (in 46% of EMUs), child neurologists (in 35% of EMUs), neurology and clinical neurophysiology residents (in 46% and in 8% of EMUs, respectively), and neurologists not trained in epilepsy (in 27% of EMUs). In 20% of EMUs, patients' observation is only intermittent or during the daytime and primarily carried out by neurophysiology technicians and/or nurses (in 71% of EMUs) or by patients' relatives (in 40% of EMUs). Automatic detection systems for seizures are used in 15%, for body movements in 8%, for oxygen desaturation in 33%, and for ECG abnormalities in 17% of EMUs. Protocols for management of acute seizures are lacking in 27%, of status epilepticus in 21%, and of postictal psychoses in 87% of EMUs. Injury prevention consists of bed protections in 96% of EMUs, whereas antisuffocation pillows are employed in 21%, and environmental protections in monitoring rooms and in bathrooms are implemented in 38% and in 25% of EMUs, respectively. The most common SAEs were status epilepticus reported by 79%, injuries by 73%, and postictal psychoses by 67% of EMUs. CONCLUSIONS: All EMUs have faced different types of SAEs. Wide variation in practice patterns and lack of protocols and of precautions to ensure patients' safety might promote the occurrence and severity of SAEs. Our findings highlight the need for standardized and shared protocols for an effective and safe management of patients in EMUs.

Discriminating crop, weeds and soil surface with a terrestrial LIDAR sensor

In this study, the evaluation of the accuracy and performance of a light detection and ranging (LIDAR) sensor for vegetation using distance and reflection measurements aiming to detect and discriminate maize plants and weeds from soil surface was done. The study continues a previous work carried out in a maize field in Spain with a LIDAR sensor using exclusively one index, the height profile. The current system uses a combination of the two mentioned indexes. The experiment was carried out in a maize field at growth stage 12–14, at 16 different locations selected to represent the widest possible density of three weeds: Echinochloa crus-galli (L.) P.Beauv., Lamium purpureum L., Galium aparine L.and Veronica persica Poir.. A terrestrial LIDAR sensor was mounted on a tripod pointing to the inter-row area, with its horizontal axis and the field of view pointing vertically downwards to the ground, scanning a vertical plane with the potential presence of vegetation. Immediately after the LIDAR data acquisition (distances and reflection measurements), actual heights of plants were estimated using an appropriate methodology. For that purpose, digital images were taken of each sampled area. Data showed a high correlation between LIDAR measured height and actual plant heights (R2 = 0.75). Binary logistic regression between weed presence/absence and the sensor readings (LIDAR height and reflection values) was used to validate the accuracy of the sensor. This permitted the discrimination of vegetation from the ground with an accuracy of up to 95%. In addition, a Canonical Discrimination Analysis (CDA) was able to discriminate mostly between soil and vegetation and, to a far lesser extent, between crop and weeds. The studied methodology arises as a good system for weed detection, which in combination with other principles, such as vision-based technologies, could improve the efficiency and accuracy of herbicide spraying.

Nuevos datos sobre los yacimientos wurmienses del litoral catalán

We present a new bed of cold Malacological fauna of the Wrm in the Catalan littoral, one af its species is dated for the first time iii the hlediterranean (Sipho curtus). We point out the predorninance of Gasteropoda as regards Bivalves in comparison with the other cold beds known.

Cancer incidence in Vaud (2003-2007)

CANCER CARE FACILITIES: In 2005, the registration area had about 3200 hospital beds available for cancer diagnosis and treatment (about 5 per 1000 residents). There were about 3600 hospital medical residents and private practitioners (1 per 180 residents). The canton has a major, multidisciplinary, public university oncology and radiotherapy centre and two private radiotherapy units (available to all residents), as well as several peripheral (mostly hospital-based) medical and surgical oncology facilities and specialists. REGISTRY STRUCTURE AND METHODS: The registry is part of the Cancer Epidemiology Unit of the Institute of Social and Preventive Medicine within the Faculty of Biology and Medicine of the University of Lausanne. Notiĺcation is voluntary. The registry's main sources of information are the University Institute of Pathology at the University of Lausanne and three major private pathology laboratories. Passive and active follow-up are conducted. Data on all deaths in the canton (including cancer deaths) are available. Other features of the registry are good registration of non-melanoma skin cancers, linkage of reports of selected preneoplastic conditions to the registry database (to study subsequent cancer risk), analysis.

Stratigraphy and petrology of the Miocene Montjuic delta: (Barcelona, Spain).

The Neogene rift in the Catalan Coastal Ranges, which is located in the NE part of the Eastern Iberian Margin, corresponds to a system of grabens formed at the nort h - we s t e rn edge of the Valencia Trough. In the central part of the Catalan Coastal Ranges are the Valls - Peneds half-graben in the onshore and the Barcelona half-graben in the offshore, which are separated by the Garraf and the Collserola-Montnegre horsts. Montjuc hill is a tilted block, which is located to the S of the Barcelona city, between the Collserola-Montn egre horst and the Barcelona half-graben . The Middle Miocene section of Montjuc is constituted by an alternation of conglomerate, sandstone, mudstone and marlstone beds. The Montjuc section was divided into four lithostratigraphic units from base to top: (1) The Morrot conglomerate and sandstone Unit, interpreted as delta plain deposits; (2) the Castell conglomerate, sandstone and mudstone Unit considered as proximal delta front deposits; (3) the Miramar marlstone Unit attributed

Tobacco control policies in hospitals before and after the implementation of a national smoking ban in Catalonia, Spain

Background: Diverse projects and guidelines to assist hospitals towards the attainment of comprehensive smoke-free policies have been developed. In 2006, Spain government passed a new smoking ban that reinforce tobacco control policies and banned completely smoking in hospitals. This study assesses the progression of tobacco control policies in the Catalan Network of Smokefree Hospitals before and after a comprehensive national smoking ban. Methods: We used the Self-Audit Questionnaire of the European Network for Smoke-free Hospitals to score the compliance of 9 policy standards (global score = 102). We used two crosssectional surveys to evaluate tobacco control policies before (2005) and after the implementation of a national smoking ban (2007) in 32 hospitals of Catalonia, Spain. We compared the means of the overall score in 2005 and 2007 according to the type of hospital, the number of beds, the prevalence of tobacco consumption, and the number of years as a smoke-free hospital. Results: The mean of the implementation score of tobacco control policies was 52.4 (95% CI:45.4-59.5) in 2005 and 71.6 (95% CI: 67.0-76.2) in 2007 with an increase of 36.7% (p < 0.01). The hospitals with greater improvement were general hospitals (48% increase; p < 0.01), hospitals with > 300 beds (41.1% increase; p < 0.01), hospitals with employees' tobacco consumption prevalence 35-39% (72.2% increase; p < 0.05) and hospitals that had recently implemented smoke-free policies (74.2% increase; p < 0.01). Conclusion: The national smoking ban appears to increase tobacco control activities in hospitals combined with other non-bylaw initiatives such as the Smoke-free Hospital Network.

Tobacco control policies in hospitals before and after the implementation of a national smoking ban in Catalonia, Spain

Background: Diverse projects and guidelines to assist hospitals towards the attainment of comprehensive smoke-free policies have been developed. In 2006, Spain government passed a new smoking ban that reinforce tobacco control policies and banned completely smoking in hospitals. This study assesses the progression of tobacco control policies in the Catalan Network of Smokefree Hospitals before and after a comprehensive national smoking ban. Methods: We used the Self-Audit Questionnaire of the European Network for Smoke-free Hospitals to score the compliance of 9 policy standards (global score = 102). We used two crosssectional surveys to evaluate tobacco control policies before (2005) and after the implementation of a national smoking ban (2007) in 32 hospitals of Catalonia, Spain. We compared the means of the overall score in 2005 and 2007 according to the type of hospital, the number of beds, the prevalence of tobacco consumption, and the number of years as a smoke-free hospital. Results: The mean of the implementation score of tobacco control policies was 52.4 (95% CI:45.4-59.5) in 2005 and 71.6 (95% CI: 67.0-76.2) in 2007 with an increase of 36.7% (p < 0.01). The hospitals with greater improvement were general hospitals (48% increase; p < 0.01), hospitals with > 300 beds (41.1% increase; p < 0.01), hospitals with employees' tobacco consumption prevalence 35-39% (72.2% increase; p < 0.05) and hospitals that had recently implemented smoke-free policies (74.2% increase; p < 0.01). Conclusion: The national smoking ban appears to increase tobacco control activities in hospitals combined with other non-bylaw initiatives such as the Smoke-free Hospital Network.

Reproductive morphology in Mediterranean Seirospora giraudyi (Ceramiales, Rhodophyta)

This paper presents a detailed description of the reproductive characters of Mediterranean Seirospora giraudyi based on fresh material collected in the northwestern coast of Spain. Vegetative cells are uninucleate. The plant is monoecious. Spermantangial parent’s cells are clustered on modified dwarf determinate filaments, usually situated on adaxial surfaces of branches. One to four spermatia are formed by elongation and proximal divisions of the spermatangial parent cells. Spermatium with a nucleus situated ina mec. The thallus is procarpic. The four-celled carpogonial branch is initially L-shaped, and it is situated on a periaxial supporting fertile axial cell. The mature carpogonial branch is U-shaped and the supporting cell and second periaxial cell enlarge and divide transversely to reproduce a pair uninicleate auxiliary cell. The nucleus in the ferlilized carpogonium divides twice and the carpogonium cleaves vertically into two cells that, turn, cut off a pair of uninucleate connecting cells that fuse with the auxiliary cells on opposite sides; the diploid nuclei in the connecting cells divide at the site of fusion and one of the nuclei enters the auxiliary cell white the other is extruded. Each auxiliary cell gives to a terminal primary gonimolobe initials. Gonimolobes form lax chains of carposporangia. As the gonimoblasts mature, both lobes of the foot cell which is situated on the supporting cell elongate the upper one secondary connecting with the supporting cell, and the lower one with the fertile axial cell. The gonimoblasts are subtended at maturity by one to several clusters of involucral flaments. Seirospora is currently placed in the tribe Euptiloteae; however the reproductive character of S.giraudyi is dentical to those described for the Cañllithamnieae. Molecular studies are needed to confirm the taxonomic position of S.giraudyi as well as that of the other species placed Seirospora

Lämmöntalteenottokattilan kehittäminen kaasumoottoreille ja teollisuuskaasuturbiineille

Tässä diplomityössä on kehitetty kustannustehokas lämmöntalteenottokattila savukaasun virtaukselle alle 150 kg/s. Kehitettävä kattila on luonnonkiertoinen ja pystyrakenteinen. Valitun kattilatyypin etuja muihin kattilatyyppeihin nähden on tarkasteltu. Erityistä huomiota kattilassa on kiinnitetty vedenkäsittelyn yksinkertaistamiseen. Tämä on saavutettu tulistinratkaisulla, jonka säätötarve on vähäinen. Tuorehöyryn lämpötilan säätöön käytettyjä säätömenetelmiä on tarkasteltu ja eri tulistinratkaisuja käyttämällä saavutettavia tuorehöyrymääriä ja säätötarvetta on tutkittu simulointiohjelmaa hyväksi käyttäen. Tulistinratkaisun lisäksi työssä on tarkasteltu syöttöveden käyttöä ulkoiseen lämmitykseen sekä lämmönsiirrinpakettien tuentaa. Lisäpolton toteutusta sekä syöttövesiventtiilin sijoittamista ja syöttövesipumpun valintaa on myös tarkasteltu. Osana työtä on lisäksi tehty kehitettyä kattilaa varten mitoitusohjelma ja mitoitettu sitä käyttäen esimerkkilaitos.

Sairaalan tarkkailuosaston hyödyt ja kustannukset

Työn tavoitteena oli tutkia Etelä-Karjalan keskussairaalaan mahdollisesti perustettavan yhdistelmätarkkailuosaston kannattavuutta määrittämällä osaston kustannukset ja hyödyt. Määritettyjen kustannusten avulla vertailtiin päivystys-potilaiden eri hoitoketjuvaihtoehtoja. Lähdeaineistona työssä käytettiin sairaalan omia materiaaleja ja tilastoja, henkilöstön haastatteluja sekä muita kirjallisuuslähteitä. Kirjallisuuden mukaan sairaalan ylikuormitus johtuu sen huonosta potilasvirtojen kulusta, jota voidaan parantaa joko toimintaa tehostamalla tai investoimalla uusiin resursseihin. Eräs vaihtoehto ylikuormituksen purkuun on tarkkailuosaston perustaminen, joka ei ole vain lisätila vaan potilasvirtojen ohjauskeino. Tehtyjen laskemien mukaan Etelä-Karjalan keskussairaalan tarkkailuosasto vaikuttaisi kannattavalta. Tarkkailuosaston kustannukset vuodessa olisivat 1 099 745 €, tuotot 1 170 108 € ja voitto 70 363 €. Osaston perustamiskustannukset olisivat 950 324 €. Hoitoketjujen potilaskohtaisen kannattavuuden mukaan päivystyspotilaiden tarkkailu ja lyhytaikainen hoito kannattaisi tehdä joko vuodeosastoilla tai tarkkailuosastolla, mutta ei tappiota tuottavalla ensiapupoliklinikalla. Tarkkailuosastosta olisi taloudellisten tekijöiden lisäksi myös muita hyötyjä ja haittoja sairaalan sidosryhmille. Sairaalan valitsemasta ylikuormituksen vähentämiskeinosta riippumatta, on sen tärkeätä aloittaa jo lähivuosina valmistautuminen väestön ikääntymisen aiheuttamaan lisääntyvään kuormitukseen.

Genome sequence of the Drosophila melanogaster male-killing Spiroplasma strain MSRO endosymbiont.

Spiroplasmas are helical and motile members of a cell wall-less eubacterial group called Mollicutes. Although all spiroplasmas are associated with arthropods, they exhibit great diversity with respect to both their modes of transmission and their effects on their hosts; ranging from horizontally transmitted pathogens and commensals to endosymbionts that are transmitted transovarially (i.e., from mother to offspring). Here we provide the first genome sequence, along with proteomic validation, of an endosymbiotic inherited Spiroplasma bacterium, the Spiroplasma poulsonii MSRO strain harbored by Drosophila melanogaster. Comparison of the genome content of S. poulsonii with that of horizontally transmitted spiroplasmas indicates that S. poulsonii has lost many metabolic pathways and transporters, demonstrating a high level of interdependence with its insect host. Consistent with genome analysis, experimental studies showed that S. poulsonii metabolizes glucose but not trehalose. Notably, trehalose is more abundant than glucose in Drosophila hemolymph, and the inability to metabolize trehalose may prevent S. poulsonii from overproliferating. Our study identifies putative virulence genes, notably, those for a chitinase, the H2O2-producing glycerol-3-phosphate oxidase, and enzymes involved in the synthesis of the eukaryote-toxic lipid cardiolipin. S. poulsonii also expresses on the cell membrane one functional adhesion-related protein and two divergent spiralin proteins that have been implicated in insect cell invasion in other spiroplasmas. These lipoproteins may be involved in the colonization of the Drosophila germ line, ensuring S. poulsonii vertical transmission. The S. poulsonii genome is a valuable resource to explore the mechanisms of male killing and symbiont-mediated protection, two cardinal features of many facultative endosymbionts. IMPORTANCE: Most insect species, including important disease vectors and crop pests, harbor vertically transmitted endosymbiotic bacteria. These endosymbionts play key roles in their hosts' fitness, including protecting them against natural enemies and manipulating their reproduction in ways that increase the frequency of symbiont infection. Little is known about the molecular mechanisms that underlie these processes. Here, we provide the first genome draft of a vertically transmitted male-killing Spiroplasma bacterium, the S. poulsonii MSRO strain harbored by D. melanogaster. Analysis of the S. poulsonii genome was complemented by proteomics and ex vivo metabolic experiments. Our results indicate that S. poulsonii has reduced metabolic capabilities and expresses divergent membrane lipoproteins and potential virulence factors that likely participate in Spiroplasma-host interactions. This work fills a gap in our knowledge of insect endosymbionts and provides tools with which to decipher the interaction between Spiroplasma bacteria and their well-characterized host D. melanogaster, which is emerging as a model of endosymbiosis.

CFD study of penetration and mixing of fuel in a circulating fluidized bed furnace

The aim of this thesis is to study the mixing of fuel and, also to some extent, the mixing of air in a circulating fluidized bed boiler. In the literature survey part of this thesis, a review is made of the previous experimental studies related to the fuel and air mixing in the circulating fluidized beds. In the simulation part of it the commercial computational fluid dynamics software (FLUENT) is used with the Eulerian multiphase model for studying the fuel mixing in the two and three-dimensional furnace geometries. The results of the three-dimensional simulations are promising and, therefore suggestions are made for the future simulations. The two-dimensional studies give new information of the effects of the fluidization velocity, fuel particle size and fuel density on the fuel mixing. However, the present results show that three-dimensional models produce more realistic representation of the circulating fluidized bed behavior.

Maalämpöpumpun mitoitusjärjestelmän kehittäminen

Työn tavoitteena oli kehittää maalämpöpumppujärjestelmään kuuluvien komponenttien mitoitusta. Työ tehtiin Alufer Oy nimiselle yritykselle, joka on työskennellyt jo kolme vuotta maalämpöpumppujärjestelmän tuotekehityksen parissa. Maalämpöpumppujärjestelmä tullaan suunnittelemaan mahdollisimman suorituskykyiseksi ja joustavaksi. Suunnittelun lähtökohtana on, että lämmitysjärjestelmä on ns. matalalämpö-järjestelmä, joka käytännössä usein toteutetaan lattialämmityksenä. Ensimmäiseksi työssä on selvitetty mitä maalämpö on ja mitkä ovat yleisimmät maalämpöpumppujärjestelmän lämmönkeruuputkistojen asennustavat. Tällä hetkellä käytössä on joko vaakaan (maa, vesi) tai pystyyn asennettava lämmönkeruuputkisto (porakaivo). Seuraavaksi työssä on lähdetty selvittämään maalämpöpumppumarkkinoita Suomessa sekä selvitetty kolmen suurimman valmistajan Geopro Systemsin, Suomen Lämpöpumpputekniikan ja Ekowellin tuotteita sekä tekniikkaa. Työssä selvitetään myös muutamien Eurooppalaisten maiden markkinat. Mitoitusjärjestelmässä tarkastelu on aloitettu uudisrakennuksen lämmitystehon tarpeesta ja käyttöveden lämmityksen tarvitsemasta tehosta. Tarvittavan lämmitysenergian perusteella määriteltiin lämpöpumppujärjestelmään kuuluvat komponentit. Maalämpöpumppujärjestelmä koostuu seuraavista pääkomponenteista: höyrystin, kompressori, lauhdutin ja paisuntaventtiili. Höyrystimen tehon mitoituksessa on huomioitu lämmönkeruuputkistossa kulkevan nesteen aineominaisuudet, massavirta ja lämpötilaero höyrystimen nesteen ulostulon sekä sisään menon välillä. Kompressorin teho on määritetty valitun kylmäaineen (R407C) lg p-h piirroksesta tai määritetty teoreettisesti kompressorivalmistajien omista valintaohjelmista. Lauhduttimen teho on määritelty höyrystimen sekä kompressorin tehon summasta. Samalla määräytyy myös uudisrakennuksen lämmitystehontarve. Lopuksi työssä on käsitelty maalämpöpumppujärjestelmän kehitysmahdollisuuksia. Vaihtoehtoina on huomioitu tulistin, alijäähdytin ja varaaja, joilla voidaan huomattavasti parantaa maalämpöpumpun lämpökerrointa.

Handling of TDM Connections with Cello Media Gateway

UMTS is a 3rd generation telecommunication system, which introduces new network architecture. The change in the network architecture introduces new logical network nodes and changes the role of existing nodes in the network. This architecture changes the current vertically specialized network into a horizontally layered structure. In practice, the layering means that different levels in network hierarchy are separated, and they communicate over well-specified interfaces. The Connectivity Layer, at the bottom of the UMTS network architecture, contains Media Gateways (MGW). The GSM radio access network and UMTS access network are connected to the connectivity network via a MGW. External networks, e.g. ISDN networks, are accessed via other MGWs. The user plane is transported across the connectivity network between/via MGWs. ATM network is used as the backbone in Ericsson’s UMTS core network release 2.0. The main goal of this thesis is to study how the MGW is used to bridge ATM and TDM networks. The Circuit Emulation Service (CES) for ATM is studied, as the conversion from TDM to ATM is made according it. The transportation is made using AAL2 and the issues that it has with voice traffic are studied. The implementation and usage of TDM switching service in MGW are described in detail.

En face optical coherence tomography of foveal microstructure in full-thickness macular hole: a model to study perifoveal müller cells.

PURPOSE: To characterize perifoveal intraretinal cavities observed around full-thickness macular holes (MH) using en face optical coherence tomography and to establish correlations with histology of human and primate maculae. DESIGN: Retrospective nonconsecutive observational case series. METHODS: Macular en face scans of 8 patients with MH were analyzed to quantify the areas of hyporeflective spaces, and were compared with macular flat mounts and sections from 1 normal human donor eye and 2 normal primate eyes (Macaca fascicularis). Immunohistochemistry was used to study the distribution of glutamine synthetase, expressed by Müller cells, and zonula occludens-1, a tight-junction protein. RESULTS: The mean area of hyporeflective spaces was lower in the inner nuclear layer (INL) than in the complex formed by the outer plexiform (OPL) and the Henle fiber layers (HFL): 5.0 × 10(-3) mm(2) vs 15.9 × 10(-3) mm(2), respectively (P < .0001, Kruskal-Wallis test). In the OPL and HFL, cavities were elongated with a stellate pattern, whereas in the INL they were rounded and formed vertical cylinders. Immunohistochemistry confirmed that Müller cells followed a radial distribution around the fovea in the frontal plane and a "Z-shaped" course in the axial plane, running obliquely in the OPL and HFL and vertically in the inner layers. In addition, zonula occludens-1 co-localized with Müller cells within the complex of OPL and HFL, indicating junctions in between Müller cells and cone axons. CONCLUSION: The dual profile of cavities around MHs correlates with Müller cell morphology and is consistent with the hypothesis of intra- or extracellular fluid accumulation along these cells.