Hule- ja suotovesien hallintajärjestelmän kehittäminen Ämmässuon nykyisellä kaatopaikalla

Työssä käsitellään hule- ja suotovesien hallintajärjestelmän kehittämistä Ämmässuon nykyisellä kaatopaikalla. Hallintajärjestelmää kehitettäessä on huomioitu ympäristölliset tekijät kuten topografia, sadanta, pinta- ja pohjavesiolosuhteet, maa- ja kallioperä sekä kaatopaikkaa ympäröivä alue. Vallitseva lainsäädäntö ja kaatopaikkaa koskevat luvat on selvitetty ennen hallintajärjestelmän kehittämisen suunnittelua. Kaatopaikkojen hule- ja suotovesien hallintajärjestelmän tärkeimpinä osina ovat olleet hule- ja suotovesien määrät ja niiden muutokset esim. kaatopaikan täyttösuunnitelman tai viimeistelysuunnitelman muutoksen vaikutuksesta. Määräarvioiden jälkeen on selvitetty vesien keräily, tasaus ja johtamistavat. Näitä osa-alueita suunniteltaessa on määritetty olemassa olevat rakenteet ja tarvittava lisärakennustarve. Myös mahdolliset poikkeustilanteet, kuten heikentynyt huleveden laatu, on huomioitu johtamisjärjestelyitä suunniteltaessa. Tämän lisäksi hallintajärjestelmään on liitetty suotoveden erillis- ja esikäsittelytarpeet sekä mahdollinen kierrättäminen takaisin jätetäyttöön paremman biohajoavuuden aikaan saamiseksi. Vesien keräilyn, virtauksen tasaamisen ja johtamisen lisäksi hallintajärjestelmään kuuluvat mittaavat ja ohjaavat automaatiojärjestelmät sekä tiedonkeräily- ja käsittelyjärjestelmät. Varsinainen mittaus- ja automaatiosuunnittelu on jätetty tämän työn ulkopuolelle. Työhön on lisäksi liitetty aikataulu- ja kustannustarkastelu. Näin on mahdollista varautua järjestelmän rakenteellisten osien toteuttamiseen sekä niistä aiheutuviin kustannuksiin

Surgery for unruptured arteriovenous malformations of the brain is better than conservative management for selected cases : a prospective cohort study

Object. The aim of this study was to identify patients who are likely to benefit from surgery for unruptured brain arterriovenous malformations (ubAVMs). Methods. The authors' database was interrogated for the risk and outcome of hemorrhage after referral and the out- come from surgery. Furthermore, the outcome from surgery incorporated those cases excluded from surgery because of perceived greater risk (sensitivity analysis). Finally, a comparison was made for the authors' patients between the natural history and surgery. Data were collected for 427 consecutively enrolled patients with ubAVMs in a database that in- cluded patients who were conservatively managed. Kaplan-Meier analysis was performed on patients observed for more than 1 day to determine the risk of hemorrhage. Variables that may influence the risk of first hemorrhage were assessed using Cox proportional hazard regression models and Kaplan-Meier life table analyses from referral until the first occur- rence of the following: hemorrhage, treatment, or last review. The outcome from surgery (leading to a new permanent neurological deficit with last review modified Rankin Scale [mRS] score > 1) was determined. Further sensitivity analy- sis was made to predict risk from surgery for the total ubAVM cohort by incorporating outcomes of surgical cases as well as cases excluded from surgery because of perceived risk, and assuming an adverse outcome for these excluded cases. Results. A total of 377 patients with a ubAVM were included in the analysis of the risk of hemorrhage. The 5-year risk of hemorrhage for ubAVM was 11.5%. Hemorrhage resulted in an mRS score > 1 in 14 cases (88% [95% CI 63%-98%]). Patients with Spetzler-Ponce Class A ubAVMs treated by surgery (n = 190) had a risk from surgery of 1.6% (95% CI 0.3%-4.8%) for a permanent neurological deficit leading to an mRS score > 1 and 0.5% (95% CI< 0.1%-3.2%) for a permanent neurological deficit leading to an mRS score > 2. Patients with Spetzler-Ponce Class B ubAVMs treated by surgery (n = 107) had a risk from surgery of 14.0% (95% CI 8.6%-22.0%) for a permanent neurological deficit leading to an mRS score > 1. Sensitivity analysis of Spetzler-Ponce Class B ubAVMs, including those in patients excluded from surgery, showed that the true risk for surgically eligible patients may have been as high as 15.6% (95% CI 9.9%-23.7%) for mRS score > 1, had all patients who were perceived to have a greater risk experienced an adverse outcome. Patients with Spetzler-Ponce Class C ubAVMs treated by surgery (n = 44) had a risk from surgery of 38.6% (95% CI 25.7%-53.4%) for a permanent neurological deficit leading to an mRS score >1. Sensitivity analysis of Class C ubAVMs, including those harbored by patients excluded from surgery, showed that the true risk for surgically eligible patients may have been as high as 60.9% (95% CI 49.2%-71.5%) for mRS score > 1, had all patients who were perceived to have a greater risk experienced an adverse outcome. Conclusion. Surgical outcomes for Spetzler-Ponce Class ubAVMs are better than those for conservative management.

Serum anticholinergic activity and postoperative cognitive dysfunction in elderly parients

BACKGROUND: Cerebral cholinergic transmission plays a key role in cognitive function, and anticholinergic drugs administered during the perioperative phase are a hypothetical cause of postoperative cognitive dysfunction (POCD). We hypothesized that a perioperative increase in serum anticholinergic activity (SAA) is associated with POCD in elderly patients. METHODS: Seventy-nine patients aged >65 years undergoing elective major surgery under stan- dardized general anesthesia (thiopental, sevoflurane, fentanyl, and atracurium) were investi- gated. Cognitive functions were assessed preoperatively and 7 days postoperatively using the extended version of the CERAD-Neuropsychological Assessment Battery. POCD was defined as a postoperative decline >1 z-score in at least 2 test variables. SAA was measured preop- eratively and 7 days postoperatively at the time of cognitive testing. Hodges-Lehmann median differences and their 95% confidence intervals were calculated for between-group comparisons. RESULTS: Of the patients who completed the study, 46% developed POCD. Patients with POCD were slightly older and less educated than patients without POCD. There were no relevant differences between patients with and without POCD regarding gender, demographically cor- rected baseline cognitive functions, and duration of anesthesia. There were no large differences between patients with and without POCD regarding SAA preoperatively (pmol/mL, median [inter- quartile range]/median difference [95% CI], P; 1.14 [0.72, 2.37] vs 1.13 [0.68, 1.68]/0.12 [−0.31, 0.57], P = 0.56), SAA 7 days postoperatively (1.32 [0.68, 2.59] vs 0.97 [0.65, 1.83]/0.25 [−0.26, 0.81], P = 0.37), or changes in SAA (0.08 [−0.50, 0.70] vs −0.02 [−0.53, 0.41]/0.1 [−0.31, 0.52], P = 0.62). There was no significant relationship between changes in SAA and changes in cognitive function (Spearman rank correlation coefficient preoperatively of 0.03 [95% CI, −0.21, 0.26] and postoperatively of −0.002 [95% CI, −0.24, 0.23]). CONCLUSIONS: In this panel of patients with low baseline SAA and clinically insignificant periopera- tive anticholinergic burden, although a relationship cannot be excluded in some patients, our analysis suggests that POCD is probably not a substantial consequence of anticholinergic medications admin- istered perioperatively but rather due to other mechanisms.

Plant diversity across five vegetation belts in the Pyrenees (Catalonia, Spain)

In this paper we analyze the size and habitat partitioning of the vascular floras of five areas of the NE Iberian Peninsula, representing five distinct vegetation belts and three floristic regions: Mediterranean (basal belt), medio-European (submontane and montane belts) and Boreo-Alpine (subalpine and alpine belts). Each area covered over 1000 ha, and was fairly uniform in terms of potential vegetation, bedrock and bioclimate. They excluded large villages and field areas, the landscape being mainly natural or moderately anthropized.

Relationship between oral cancer and implants: clinical cases and systematic literature review

The use of implants for oral rehabilitation of edentulous spaces has recently been on the increase, which has also led to an increase in complications such as peri-implant inflammation or peri-implantitis. Chronic inflammation is a risk factor for developing oral squamous cell carcinoma (OSCC). Objectives: To review the literature of cases that associate implant placement with the development of oral cancer. Study design: We present two clinical cases and a systematic review of literature published on the relationship between oral cancer and implants. Results: We found 13 articles published between the years 1996 and 2009, referencing 18 cases in which the osseointegrated implants are associated with oral squamous cell carcinoma. Of those, 6 articles were excluded because they did not meet the inclusion criteria. Of the 18 cases reported, only 7 cases did not present a previous history of oral cancer or cancer in other parts of the body. Conclusions: Based on the review of these cases, a clear cause-effect relationship cannot be established, although it can be deduced that there is a possibility that implant treatment may constitute an irritant and/or inflammatory cofactor which contributes to the formation and/or development of OSCC.

Biojätteen erilliskeräyksen ja sekajätteenkeräyksen kustannusvertailu

Tutkimuksessa selvitetään biojätteen erilliskeräyksen ja sekajätteenkeräyksen kustannusero. Tutkimuksen tarkastelualueena käytetään Etelä-Karjalan Jätehuolto Oy:n toiminta-aluetta. Selvityksessä käytettään alueelle tyypillisiä keräystapoja ja lähtötietoja. Selvityksessä tarkastellaan ainoastaan kotitalouksissa syntyvän jätteen keräyskustannuksia. Ulkopuolelle on jätetty liikekiinteistöt ja liiketiloja sisältävät asuintaloudet sekä aluekeräyspisteet, mutta muuten kustannustekijät on pyritty huomioimaan mahdollisimman laajalti. Tutkimuksen mukaan biojätteen erilliskeräyksen kustannukset ovat selvästi suuremmat kuin sekajätteen keräyksen. Omakotitaloalueilla keräyskustannukset ovat kaksi kertaa suuremmat kuin kerros- ja rivitaloalueella. Sekajätteenkeräyksen kokonaiskustannukset ovat noin 1960 mk/t ja biojätteen erilliskeräyksen noin 2900 mk/t. Muita tutkimuksia suurempi kustannusero selittyy osin sillä, että kustannustekijöitä on huomioitu laajemmin kuin muissa tämäntyyppisissä tutkimuksissa. Jätteenkeräyksen kustannuksia pystytään pienentämään esimerkiksi lisäämällä omatoimista kompostointia, keräysvälineiden teknillisellä kehittämisellä ja pientaloaluilla kiinteistöryhmäkohtaisten keräyspisteiden muodostamisella.

Estudi de la producció i de la qualitat farratgera de les pastures de la finca dels Cingles de l'Avenc (Tavertet). 2011

A Catalunya, la protecció i gestió de zones d’especial interès natural ha estat majoritàriament realitzada pel conjunt de les administracions públiques. Tot i així, en els últims anys han sorgit un conjunt d’iniciatives privades que a través d’acords de custòdia han passat a tenir un paper actiu en la protecció i gestió d’algunes finques amb un alt valor natural. És el cas de la finca els Cingles de l’Avenc, on s’ha dut a terme aquest treball, en la qual es pretén desenvolupar una activitat ramadera compatible amb la conservació dels valors naturals de la finca. L’objectiu principal d’aquest treball és conèixer la producció i qualitat farratgera dels diferents tipus de pastures que hi ha a la finca, i establir la càrrega ramadera que poden admetre. Aquest estudi ha tingut una durada de 3 anys i en aquest treball es presenten els resultats del 2011 i es fa l’anàlisi dels resultats dels 3 anys (2009, 2010, i 2011). L’estudi s’ha portat a terme en els 4 tipus principals de pastures que hi ha a la finca: joncedes, pastures mesòfiles, prats de dall i pastures sembrades. S’han utilitzat 11 parcel·les permanents excloses de la pastura, establertes l’any 2009, que inclouen la diversitat de tipus i zones de pastura. S’ha realitzat un mostreig de la biomassa mensual, d’abril a novembre, que ha consistit en dallar 4 quadrats de 50 x 50 cm, i s’ha calculat la producció anual. S’ha determinat la qualitat farratgera de l’herba de 4 moments de l’any: maig, juny, juliol i octubre. Després dels tres anys d’estudi hem obtingut que les pastures sembrades i els prats de dall són els més productius (1.067 g/m2.any i 1.005 g/m2.any, respectivament). La producció de les pastures mesòfiles i de les joncedes són més baixes (554 g/m2.any i 291 g/m2.any, respectivament). La qualitat farratgera de les pastures és bona a totes les comunitats, amb valors mitjans de proteïna digerible de 6,63%, de fibra bruta de 29,13%, de lignina de 7,29% i de 0,69 (ENL/1,700) unitats farratgeres. La producció anual global obtinguda a la finca durant aquests tres anys permet suportar una càrrega ramadera admissible d’unes 208 UBG (Unitats de Bestiar Gros. 1 U.B.G equival a 1 vaca a partir de 2 anys).

The dynamics of coexistence: habitat sharing versus segregation patterns among three sympatric montane vipers

Contact zones of closely related and ecologically similar species constitute rare opportunities to study the evolutionary consequences of past speciation processes. They represent natural laboratories in which strong competition could lead to the exclusion of one species, or the various species may switch into distinct ecological niches. Alternatively, if reproductive isolation has not yet been achieved, they may hybridize. We elucidate the degree of taxon integrity by comparing genetics and habitat use of three similar-sized congeneric viper species, Vipera ammodytes, Viperaaspis, and Viperaberus, of Nadiza Valley in western Slovenia. No hybridization was detected for either mitochondrial or nuclear genomes. Similarly, external intermediacy by a single prestudy viper (probably V.ammodytesxV. aspis) indicates that hybridization occasionally occurs, but should be very rare. Populations of the three related viperids are partially allopatric in Nadiza Valley, but they also coexist in a narrow contact zone in the montane grassland along the south-exposed slope of Mount Stol (1673m a.s.l.). Here, the three species that occupy areas in or near patches of rocky microhabitats (e.g. stone piles, slides, and walls) live in syntopy. However, fine-scale measurements of structural components show partial habitat segregation, in which V.berus becomes more dominant at elevations above 1400m and occupies mostly the mountain ridge and north-exposed slopes of Mount Stol, V.aspis occurs below 1300m and is the only species to inhabit stoneless patches of grass and bushes around 1000m and lower, and V.ammodytes occurs at all elevations up to 1500m, but is restricted to a rocky microhabitat. We suggest that a high degree of microstructure divergence, slightly different environmental niches, and a generally favourable habitat for all three viper species, keep the pressure for mis-mating and hybridization low, although mechanisms such as reduced hybrid inferiority and temporal mating segregation cannot yet be excluded.

A microquasar model applied to unidentified gamma-ray sources

Among unidentified gamma-ray sources in the galactic plane, there are some that present significant variability and have been proposed to be high-mass microquasars. To deepen the study of the possible association between variable low galactic latitude gamma-ray sources and microquasars, we have applied a leptonic jet model based on the microquasar scenario that reproduces the gamma-ray spectrum of three unidentified gamma-ray sources, 3EG J1735-1500, 3EG J1828+0142 and GRO J1411-64, and is consistent with the observational constraints at lower energies. We conclude that if these sources were generated by microquasars, the particle acceleration processes could not be as efficient as in other objects of this type that present harder gamma-ray spectra. Moreover, the dominant mechanism of high-energy emission should be synchrotron self-Compton (SSC) scattering, and the radio jets may only be observed at low frequencies. For each particular case, further predictions of jet physical conditions and variability generation mechanisms have been made in the context of the model. Although there might be other candidates able to explain the emission coming from these sources, microquasars cannot be excluded as counterparts. Observations performed by the next generation of gamma-ray instruments, like GLAST, are required to test the proposed model.

Incidence and Risk Factors of Abdominal Complications After Lung Transplantation.

BACKGROUND: Due to the underlying diseases and the need for immunosuppression, patients after lung transplantation are particularly at risk for gastrointestinal (GI) complications that may negatively influence long-term outcome. The present study assessed the incidences and impact of GI complications after lung transplantation and aimed to identify risk factors. METHODS: Retrospective analysis of all 227 consecutively performed single- and double-lung transplantations at the University hospitals of Lausanne and Geneva was performed between January 1993 and December 2010. Logistic regressions were used to test the effect of potentially influencing variables on the binary outcomes overall, severe, and surgery-requiring complications, followed by a multiple logistic regression model. RESULTS: Final analysis included 205 patients for the purpose of the present study, and 22 patients were excluded due to re-transplantation, multiorgan transplantation, or incomplete datasets. GI complications were observed in 127 patients (62 %). Gastro-esophageal reflux disease was the most commonly observed complication (22.9 %), followed by inflammatory or infectious colitis (20.5 %) and gastroparesis (10.7 %). Major GI complications (Dindo/Clavien III-V) were observed in 83 (40.5 %) patients and were fatal in 4 patients (2.0 %). Multivariate analysis identified double-lung transplantation (p = 0.012) and early (1993-1998) transplantation period (p = 0.008) as independent risk factors for developing major GI complications. Forty-three (21 %) patients required surgery such as colectomy, cholecystectomy, and fundoplication in 6.8, 6.3, and 3.9 % of the patients, respectively. Multivariate analysis identified Charlson comorbidity index of ≥3 as an independent risk factor for developing GI complications requiring surgery (p = 0.015). CONCLUSION: GI complications after lung transplantation are common. Outcome was rather encouraging in the setting of our transplant center.

Acute Lyme Neuroborreliosis With Transient Hemiparesis and Aphasia.

Nervous system involvement in Lyme disease often mimics other conditions and thus represents a diagnostic challenge, especially in an emergency department setting. We report a case of a female teenager presenting with sudden-onset aphasia and transient right-sided faciobrachial hemiplegia, along with headache and agitation. Ischemia, vasculitis, or another structural lesion was excluded by brain imaging. Toxicologic evaluation results were negative. Cerebral perfusion computed tomography and electroencephalography showed left parietotemporal brain dysfunction. Lumbar puncture result, although atypical, suggested bacterial infection and intravenous ceftriaxone was initiated. Finally, microbiological cerebrospinal fluid analysis revealed Lyme neuroborreliosis, showing specific intrathecal antibody production and high level of C-X-C motif chemokine 13. The patient rapidly recovered. To our knowledge, this report for the first time illustrates that acute-onset language and motor symptoms may be directly related to Lyme neuroborreliosis. Neuroborreliosis may mimic other acute neurologic events such as stroke and should be taken into diagnostic consideration even in the absence of classic symptoms and evolution.

The Combined Pedicled Anterolateral Thigh and Vastus Lateralis Flap as Filler for Complex Perineal Defects.

Extensive defects of the pelvis and genitoperineal region are a reconstructive challenge. We discuss a consecutive series of 25 reconstructions with the pedicled anterolateral thigh (ALT) flap including muscle part of the vastus lateralis (VL) in 23 patients from October 1999 to September 2012.Only surface defects larger than 100 cm and reconstructions by composite ALT + VL were included in this retrospective analysis. Of the 23 patients, 19 underwent oncologic resection, whereas 4 cases presented Fournier gangrene. Three patients did not reach 6 months of follow-up and were excluded from further data analysis. Among the remaining 20 patients (22 reconstructions), average follow-up period was 14 months (range, 10-18 months). Patient's average age was 60 years. Average size of the defect was 182 cm.Postoperative complications included 1 (4.5%) flap necrosis out of 22 raised flaps, 1 partial flap necrosis after venous congestion, and 2 cases where a complementary reconstructive procedure was performed due to remaining defect or partial flap failure. In 6 cases, peripheral wound dehiscence (27%) was treated by debridement followed by split-thickness skin graft or advancement local flaps. Defect size was significantly related to postoperative complications and increased hospital stay, especially in those patients who underwent preoperative radiotherapy. At the end of the follow-up period, a long-term and satisfactory coverage was obtained in all patients without functional deficits.This consecutive series of composite ALT + VL flap shows that, in case of extended defects, the flap provides an excellent and adjustable muscle mass, is reliable with minimal donor-site morbidity, and can even be designed as a sensate flap.

CTP in Transient Global Amnesia: A Single-Center Experience of 30 Patients.

BACKGROUND AND PURPOSE: Medial temporal lobe abnormalities on DWI and functional imaging are occasionally observed in patients with transient global amnesia. We used CTP to study these patients during or briefly after resolution of their amnesic syndrome. MATERIALS AND METHODS: From 2002 onward, patients satisfying clinical criteria for transient global amnesia who underwent CTP were included. Patients with additional clinical features suggesting transient ischemic attack or stroke and those with an ischemic lesion on subsequent DWI were excluded. If deemed necessary by the clinician, DWI was performed within 10 days. RESULTS: Thirty patients with transient global amnesia underwent CTP at a median latency of 5.9 hours (interquartile range, 4.3-9.7 hours) after symptom onset. All findings, except for those in 1 patient, were normal, including those in the 14 patients with well-imaged hippocampi. In the patient with abnormal findings, CTP and PWI showed hypoperfusion in both lentiform nuclei extending into the insulae, with normalization on the repeat CTP 6 days later. In 10 patients, DWI was performed at a median latency of 2 days (interquartile range, 0-9 days). Of these, 2 showed punctate hippocampal lesions, often seen in transient global amnesia. In 2 patients excluded because of mildly atypical transient global amnesia and ischemic lesions on subsequent DWI, acute CTP findings were also normal. CONCLUSIONS: Patients with transient global amnesia had normal CTP findings in the acute phase with the exception of 1 patient with transient hypoperfusion in both basal ganglia. If imaging is performed for typical and atypical transient global amnesia, DWI should be the preferred method.

The initial oxidation of transition metal surfaces

Due to their numerous novel technological applications ranging from the example of exhaust catalysts in the automotive industry to the catalytic production of hydro- gen, surface reactions on transition metal substrates have become to be one of the most essential subjects within the surface science community. Although numerous applications exist, there are many details in the different processes that, after many decades of research, remain unknown. There are perhaps as many applications for the corrosion resistant materials such as stainless steels. A thorough knowledge of the details of the simplest reactions occuring on the surfaces, such as oxidation, play a key role in the design of better catalysts, or corrosion resistant materials in the future. This thesis examines the oxidation of metal surfaces from a computational point of view mostly concentrating on copper as a model material. Oxidation is studied from the initial oxidation to the oxygen precovered surface. Important parameters for the initial sticking and dissociation are obtained. The saturation layer is thoroughly studied and the calculated results arecompared with available experimental results. On the saturated surface, some open questions still remain. The present calculations demonstrate, that the saturated part of the surface is excluded from being chemically reactive towards the oxygen molecules. The results suggest, that the reason for the chemical activity of the saturated surface is due to a strain effect occuring between the saturated areas of the surface.

E-hankinta ja sen käyttö ja hyödyntäminen teollisuusyrityksessä

Tässä tutkimuksessa olen selvittänyt sähköisten työkalujen hyödyntämisen mandollisuuksista teollisuusyrityksessä epäsuorissa hankinnoissa. Tutkimuksessa olen paneuduttu e-hankinnan terminologiaan ja menetelmiin, joita markkinoilla on käytössä. E-hankinta on keskeisin tutkimusalue. Toimittajien etsintään ja niiden hallinnointiin keskittyvät työkalut olen rajannut pois tutkimuksestani. Tutkimuksessa olen selvittänyt e-hankinnan keskeisiä haasteita ja onnistumisen elementtejä, jotta e-hankinnan käyttöönotto olisi mandollisimman helposti tehtävissä. Lukuisten esimerkkien avulla pyrin kartoittamaan e-hankinnan levinneisyyttä ja lisäksi tuon esille niitä potentiaalisia säästökohteita ja kustannusten leikkauksia, joita on mandollista toteuttaa ottamalla käyttöön sähköisen hankintamallin. Tutkimuksen loppuosassa keskityn tutkimaan Perloksen hankintavolyymeja ja löytämään sieltä ne hankintakategoriat, joille tämä sähköinen hankintamalli olisi mandollista ottaa käyttöön. Tässä tutkimuksessa tulen esittämään sähköisen hankintamallin käyttöönottoa ja samalla merkittävän kehityshankkeen toteuttamista lähitulevaisuudessa. Lopullisen päätöksen sähköisen hankintamallin käyttöönotosta ja projektin toteuttamisesta tekee yrityksen johto. Yrityksen johdolle sitten lopulta jää punnittavaksi, kuinka strategisena ja ajankohtaan nähden sopivana tämän tyyppisen kehitysprojektin toteuttaminen nähdään.