Measurement with an automated oscillometric wrist device with position sensor leads to lower values than measurements obtained with an automated oscillometric arm device from the same manufacturer in elderly persons.

OBJECTIVE: Home blood pressure (BP) monitoring is recommended by several clinical guidelines and has been shown to be feasible in elderly persons. Wrist manometers have recently been proposed for such home BP measurement, but their accuracy has not been previously assessed in elderly patients. METHODS: Forty-eight participants (33 women and 15 men, mean age 81.3±8.0 years) had their BP measured with a wrist device with position sensor and an arm device in random order in a sitting position. RESULTS: Average BP measurements were consistently lower with the wrist than arm device for systolic BP (120.1±2.2 vs. 130.5±2.2 mmHg, P<0.001, means±SD) and diastolic BP (66.0±1.3 vs. 69.7±1.3 mmHg, P<0.001). Moreover, a 10 mmHg or greater difference between the arm and wrist device was observed in 54.2 and 18.8% of systolic and diastolic measures, respectively. CONCLUSION: Compared with the arm device, the wrist device with position sensor systematically underestimated systolic as well as diastolic BP. The magnitude of the difference is clinically significant and questions the use of the wrist device to monitor BP in elderly persons. This study points to the need to validate BP measuring devices in all age groups, including in elderly persons.

Optimisation of data analysis method for a fluidized bed combustion test rig

Nowadays the used fuel variety in power boilers is widening and new boiler constructions and running models have to be developed. This research and development is done in small pilot plants where more faster analyse about the boiler mass and heat balance is needed to be able to find and do the right decisions already during the test run. The barrier on determining boiler balance during test runs is the long process of chemical analyses of collected input and outputmatter samples. The present work is concentrating on finding a way to determinethe boiler balance without chemical analyses and optimise the test rig to get the best possible accuracy for heat and mass balance of the boiler. The purpose of this work was to create an automatic boiler balance calculation method for 4 MW CFB/BFB pilot boiler of Kvaerner Pulping Oy located in Messukylä in Tampere. The calculation was created in the data management computer of pilot plants automation system. The calculation is made in Microsoft Excel environment, which gives a good base and functions for handling large databases and calculations without any delicate programming. The automation system in pilot plant was reconstructed und updated by Metso Automation Oy during year 2001 and the new system MetsoDNA has good data management properties, which is necessary for big calculations as boiler balance calculation. Two possible methods for calculating boiler balance during test run were found. Either the fuel flow is determined, which is usedto calculate the boiler's mass balance, or the unburned carbon loss is estimated and the mass balance of the boiler is calculated on the basis of boiler's heat balance. Both of the methods have their own weaknesses, so they were constructed parallel in the calculation and the decision of the used method was left to user. User also needs to define the used fuels and some solid mass flowsthat aren't measured automatically by the automation system. With sensitivity analysis was found that the most essential values for accurate boiler balance determination are flue gas oxygen content, the boiler's measured heat output and lower heating value of the fuel. The theoretical part of this work concentrates in the error management of these measurements and analyses and on measurement accuracy and boiler balance calculation in theory. The empirical part of this work concentrates on the creation of the balance calculation for the boiler in issue and on describing the work environment.

Extension of Murray's law using a non-Newtonian model of blood flow.

BACKGROUND: So far, none of the existing methods on Murray's law deal with the non-Newtonian behavior of blood flow although the non-Newtonian approach for blood flow modelling looks more accurate. MODELING: In the present paper, Murray's law which is applicable to an arterial bifurcation, is generalized to a non-Newtonian blood flow model (power-law model). When the vessel size reaches the capillary limitation, blood can be modeled using a non-Newtonian constitutive equation. It is assumed two different constraints in addition to the pumping power: the volume constraint or the surface constraint (related to the internal surface of the vessel). For a seek of generality, the relationships are given for an arbitrary number of daughter vessels. It is shown that for a cost function including the volume constraint, classical Murray's law remains valid (i.e. SigmaR(c) = cste with c = 3 is verified and is independent of n, the dimensionless index in the viscosity equation; R being the radius of the vessel). On the contrary, for a cost function including the surface constraint, different values of c may be calculated depending on the value of n. RESULTS: We find that c varies for blood from 2.42 to 3 depending on the constraint and the fluid properties. For the Newtonian model, the surface constraint leads to c = 2.5. The cost function (based on the surface constraint) can be related to entropy generation, by dividing it by the temperature. CONCLUSION: It is demonstrated that the entropy generated in all the daughter vessels is greater than the entropy generated in the parent vessel. Furthermore, it is shown that the difference of entropy generation between the parent and daughter vessels is smaller for a non-Newtonian fluid than for a Newtonian fluid.

Asiakaslähtöinentilaus-toimitus-prosessin kehittäminen räätälöivässä yrityksessä

Tapa, jolla yritys vastaa sen räätälöityvien tuotteiden kysyntään, määrittää yrityksen menestymisen. Sen on ymmärrettävä mikä arvo asiakkaalle syntyy, kun sen yksilökohtaiset tarpeet otetaan huomioon tuotetta räätälöitäessä. Toisaalta, yrityksen on ymmärrettävä kustannus, joka näiden tarpeiden huomioon ottamimisesta syntyy. Yhdistämällä nämä tiedot oikein tilaus-toimitus-prosessin suunnittelussa ja valinnassa voidaan kutakin valittua asiakasta tai asiakasryhmää palvella kannattavasti. Tämän diplomityöntavoite on kehittää tutkimuksen toimeksiantajan Vahterus Oy:n tilaus-toimitus-prosessia. Perusteena ovat kolmen tärkeimmän asiakasryhmän tarpeet sekä tieto nykyisestä prosessista. Tutkimuksen teoreettinen perusta luodaan tutustumalla kirjallisuuteen räätälöinnistä, asiakaslähtöisyydestä sekä toimitus-prosessien eriyttämisestä. Order-winner ja order-qualifier kriteerien selvittäminen ja niiden käyttö oikean prosessin valinnassa muodostaa tutkimuksen teoreettisen ytimen. Empiriaosassa analysoitiin case-yrityksen nykyisen tilaus-toimitus-prosessin toiminta. Prosessin kehittämistyön pohjaksi selvitetettiin case-yrityksen kolmen tärkeimmän asiakasryhmän erityispiirteet ja tarpeet haastattelututkimuksella. tilaus-toimitus-prosessin analyysissä havaittiin huomattavaa asiakasryhmäkohtaista vaihtelua läpimenoajoissa. Tämä johtui tilatun tuotteen tyypistä sekä asiakkaiden erityisvaatimuksista. Haastattelututkimuksessa vahvistuinäkemys asiakasryhmien tilaus-toimitus-prosessille asettamien vaatimuksien selkeistä eroista. Johtopäätöksenä esitetään erilaisia toimitusstrategioita eri asiakasryhmille. Kustannus-tehokkuutta ja nopeutta vaativalle asiakasryhmälle prosessia tehostetaan suunnitteluprosessin automatisoinnilla. Joustavuutta vaativaa, korkeampia kustannuksia sallivaa asiakasryhmää palvellaan paremmin kehittämällä projektihallinnan ja myynnin työkaluja sekä henkilökunnan osaamista. Tutkimuksen tärkein kontribuutio yritykselle oli asiakasryhmien erojen tiedostaminen ja niiden huomioon ottaminen toimitustrategioiden ja organisaation jatkuvassa kehittämisessä.

Arvonmääritysmallin kehittäminen sijoittajan näkökulmasta: Case F-secure

Työn tavoitteena on kehittää Microsoft Excel -taulukkolaskentaohjelmaan pohjautuva arvonmääritysmalli. Mallin avulla osaketutkimusta tekevät analyytikot ja sijoittajat voivat määrittää osakkeen fundamenttiarvon. Malli kehitetään erityisesti piensijoittajien työkaluksi. Työn toisena tavoitteena on soveltaa kehitettyä arvonmääritysmallia case-yrityksenä toimivan F-Securen arvonmäärityksessä ja selvittää mallin avulla onko F-Securen osake pörssissä fundamentteihin nähden oikein hinnoiteltu. Työn teoriaosassa esitellään arvonmäärityksen käyttökohteet ja historia, arvonmääritysprosessin vaiheet (strateginen analyysi, tilinpäätösanalyysi, tulevaisuuden ennakointi, yrityksen arvon laskeminen), pääoman kustannuksen määrittäminen ja sijoittajan eri arvonmääritysmenetelmät, joita ovat diskontattuun kassavirtaan perustuvassa arvonmäärityksessä käytettävät mallit sekä suhteellisen arvonmäärityksentunnusluvut. Empiirinen osa käsittää arvonmääritysmallin kehittämisen ja rakenteen kuvauksen sekä F-Securen arvonmääritysprosessin. Vaikka F-Securen tulevaisuus näyttää varsin valoisalta, osake on hinnoiteltu markkinoilla tällä hetkellä(23.02.2006) korkeammalle kuin näihin odotuksiin nähden olisi järkevää. Eri menetelmät antavat osakkeelle arvoja 2,25 euron ja 2,97 euron väliltä. Kehitetty Excel -malli määrittää F-Securen osakkeen tavoitehinnaksi eri menetelmien mediaanina 2,29 euroa. Tutkimuksen tuloksena F-Securen osaketta voidaan pitää yliarvostettuna, sillä sen hinta pörssissä on 3,05 euroa.

Assessment of glenoid inclination on routine clinical radiographs and computed tomography examinations of the shoulder.

BACKGROUND: Accurate assessment of glenoid inclination is of interest for a variety of conditions and procedures. The purpose of this study was to develop an accurate and reproducible measurement for glenoid inclination on standardized anterior-posterior (AP) radiographs and on computed tomography (CT) images. MATERIALS AND METHODS: Three consistently identifiable angles were defined: Angle α by line AB connecting the superior and inferior glenoid tubercle (glenoid fossa) and the line identifying the scapular spine; angle β by line AB and the floor of the supraspinatus fossa; angle γ by line AB and the lateral margin of the scapula. Experimental study: these 3 angles were measured in function of the scapular position to test their resistance to rotation. Conventional AP radiographs and CT scans were acquired in extension/flexion and internal/external rotation in a range up to ±40°. Clinical study: the inter-rater reliability of all angles was assessed on AP radiographs and CT scans of 60 patients (30 with proximal humeral fractures, 30 with osteoarthritis) by 2 independent observers. RESULTS: The experimental study showed that angle α and β have a resistance to rotation of up to ±20°. The deviation from neutral position was not more than ±10°. The results for the inter-rater reliability analyzed by Bland-Altman plots for the angle β fracture group were (mean ± standard deviation) -0.1 ± 4.2 for radiographs and -0.3 ± 3.3 for CT scans; and for the osteoarthritis group were -1.2 ± 3.8 for radiographs and -3.0 ± 3.6 for CT scans. CONCLUSION: Angle β is the most reproducible measurement for glenoid inclination on conventional AP radiographs, providing a resistance to positional variability of the scapula and a good inter-rater reliability.

Verkostovaikutteisen tuotteen lanseerauksen erityispiirteet business to business-markkinoilla

Tutkielman empiriaosuus kerättiin teemahaastatteluin. Case yrityksenä oli Osuma Finland Oy, jonka kehittämä kanta-asiakasjärjestelmä omasi verkostovaikutuksia. Yrityksen tekemää lanseerausstrategiaa peilataan teoriaan ja näin sekä teorian että empirian kautta löydetään vastaus siihen, kuinka verkostovaikutteisen tuotteen erityispiirteet vaikuttavat tuotteen lanseeraukseen. Johtopäätöksistä tärkeimmät ovat verkostovaikutteisen tuotteen ja tavallisen tuotteen erityispiirteiden erottamisen tärkeys ja niiden huomioon ottaminen lanseerausstrategiaa suunniteltaessa. Verkostovaikutteisen tuotteen lanseerauksessa tärkein tavoite on kasvattaa mahdollisimman nopeasti mahdollisimman suuri käyttäjämäärä. Lanseerausstrategiaa suunniteltaessa on tärkeää ottaa huomioon sekä tuotteen endogeeniset että eksogeeniset arvot. Tutkielman satona löytyneet eksogeeniset arvot, joita voidaan kuvata lanseerausstrategian kulmakiviksi, voidaan kiteyttää neljään tärkeään elementtiin, jotka ovat: hinnoittelu, sitominen eli kytkykauppa, segmentointi ja ennakkomarkkinointi. Verkostovaikutteisen tuotteen omaksuminen markkinoilla ei välttämättä perustu tuotteen tekniseen paremmuuteen, vaan oleellisinta on ymmärtää, ettätällaisen tuotteen arvo kasvaa, mitä suuremmaksi sen käyttäjien muodostama verkosto kasvaa. Lanseerausstrategiaa suunniteltaessa on tärkeää tunnistaa ja huomioida nämä erityispiirteet.

Does the working environment influence health care professionals' values, meaning in life and religiousness? Palliative care units compared with maternity wards.

CONTEXT: Increased altruism, self-transcendence, and quests for meaning in life (MiL) have been found in palliative care (PC) patients and their families who experience the finiteness of life. Similar changes were observed in healthy subjects who were experimentally confronted with their mortality. OBJECTIVES: The study investigated how daily experiences of the transitoriness of life influence PC health care professionals' (HCPs) values, MiL, and religiousness. METHODS: In a cross-sectional study, the Schwartz Value Survey, the Schedule for Meaning in Life Evaluation, and the Idler Index of Religiosity were used to investigate personal values, MiL, and private religiousness. HCPs working in PC (confronted with death) were compared with a control group of HCPs working at maternity wards (MWs) using multivariate models. Differences were considered to be statistically significant at P < 0.05. RESULTS: Seventy PC- and 70 MW-HCPs took part in the study (response rate 74.0%). No differences between the groups were found in overall MiL satisfaction scores. PC-HCPs were significantly more religious than MW-HCPs; they listed spirituality and nature experience more often as areas in which they experience MiL. Furthermore, hedonism was more important for PC-HCPs, and they had higher scores in openness-to-change values (stimulation and self-direction). MW-HCPs were more likely to list family as a MiL area. They assigned more importance to health and scored higher in conservation values (conformity and security). Duration of professional experience did not influence these results. CONCLUSION: Basic differences in values, MiL, and religiousness between PC-HCPs and MW-HCPs might have influenced the choice of working environment because no effect of job duration was observed. Longitudinal research is needed to confirm this hypothesis.

Clinical chemistry variables in normal elderly and healthy ambulatory populations: comparison with reference values.

Laboratory values of the most commonly assayed clinical chemistry variables were determined in selected elderly and healthy ambulatory populations. The upper and lower limits (2.5 and 97.5 fractiles) were compared with the adult reference values in use in university hospitals of Switzerland. The results suggest that conventional adult reference values can be used for most variables in the elderly and that these values are also useful in an ambulatory population.

A game theoretical approach to the algebraic counterpart of the Wagner hierarchy

La hiérarchie de Wagner constitue à ce jour la plus fine classification des langages ω-réguliers. Par ailleurs, l'approche algébrique de la théorie de langages formels montre que ces ensembles ω-réguliers correspondent précisément aux langages reconnaissables par des ω-semigroupes finis pointés. Ce travail s'inscrit dans ce contexte en fournissant une description complète de la contrepartie algébrique de la hiérarchie de Wagner, et ce par le biais de la théorie descriptive des jeux de Wadge. Plus précisément, nous montrons d'abord que le degré de Wagner d'un langage ω-régulier est effectivement un invariant syntaxique. Nous définissons ensuite une relation de réduction entre ω-semigroupes pointés par le biais d'un jeu infini de type Wadge. La collection de ces structures algébriques ordonnée par cette relation apparaît alors comme étant isomorphe à la hiérarchie de Wagner, soit un quasi bon ordre décidable de largeur 2 et de hauteur ω. Nous exposons par la suite une procédure de décidabilité de cette hiérarchie algébrique : on décrit une représentation graphique des ω-semigroupes finis pointés, puis un algorithme sur ces structures graphiques qui calcule le degré de Wagner de n'importe quel élément. Ainsi le degré de Wagner de tout langage ω-régulier peut être calculé de manière effective directement sur son image syntaxique. Nous montrons ensuite comment construire directement et inductivement une structure de n''importe quel degré. Nous terminons par une description détaillée des invariants algébriques qui caractérisent tous les degrés de cette hiérarchie. Abstract The Wagner hierarchy is known so far to be the most refined topological classification of ω-rational languages. Also, the algebraic study of formal languages shows that these ω-rational sets correspond precisely to the languages recognizable by finite pointed ω-semigroups. Within this framework, we provide a construction of the algebraic counterpart of the Wagner hierarchy. We adopt a hierarchical game approach, by translating the Wadge theory from the ω-rational language to the ω-semigroup context. More precisely, we first show that the Wagner degree is indeed a syntactic invariant. We then define a reduction relation on finite pointed ω-semigroups by means of a Wadge-like infinite two-player game. The collection of these algebraic structures ordered by this reduction is then proven to be isomorphic to the Wagner hierarchy, namely a well-founded and decidable partial ordering of width 2 and height $\omega^\omega$. We also describe a decidability procedure of this hierarchy: we introduce a graph representation of finite pointed ω-semigroups allowing to compute their precise Wagner degrees. The Wagner degree of every ω-rational language can therefore be computed directly on its syntactic image. We then show how to build a finite pointed ω-semigroup of any given Wagner degree. We finally describe the algebraic invariants characterizing every Wagner degree of this hierarchy.

The effects of productivity on profitability: a case study at firm level using an activity-based costing approach

Productivity and profitability are important concepts and measures describing the performance and success of a firm. We know that increase in productivity decreases the costs per unit produced and leads to better profitability. This common knowledge is not, however, enough in the modern business environment. Productivity improvement is one means among others for increasing the profitability of actions. There are many means to increase productivity. The use of these means presupposes operative decisions and these decisions presuppose informationabout the effects of these means. Productivity improvement actions are in general made at floor level with machines, cells, activities and human beings. Profitability is most meaningful at the level of the whole firm. It has been very difficult or even impossible to analyze closely enough the economical aspects of thechanges at floor level with the traditional costing systems. New ideas in accounting have only recently brought in elements which make it possible to considerthese phenomena where they actually happen. The aim of this study is to supportthe selection of objects to productivity improvement, and to develop a method to analyze the effects of the productivity change in an activity on the profitability of a firm. A framework for systemizing the economical management of productivity improvement is developed in this study. This framework is a systematical way with two stages to analyze the effects of productivity improvement actions inan activity on the profitability of a firm. At the first stage of the framework, a simple selection method which is based on the worth, possibility and the necessity of the improvement actions in each activity is presented. This method is called Urgency Analysis. In the second stage it is analyzed how much a certain change of productivity in an activity affects the profitability of a firm. A theoretical calculation model with which it is possible to analyze the effects of a productivity improvement in monetary values is presented. On the basis of this theoretical model a tool is made for the analysis at the firm level. The usefulness of this framework was empirically tested with the data of the profit center of one medium size Finnish firm which operates in metal industry. It is expressedthat the framework provides valuable information about the economical effects of productivity improvement for supporting the management in their decision making.

Theoretical Analysis and Simulations of Vertically Vibrated Granular Materials

The dynamical properties ofshaken granular materials are important in many industrial applications where the shaking is used to mix, segregate and transport them. In this work asystematic, large scale simulation study has been performed to investigate the rheology of dense granular media, in the presence of gas, in a three dimensional vertical cylinder filled with glass balls. The base wall of the cylinder is subjected to sinusoidal oscillation in the vertical direction. The viscoelastic behavior of glass balls during a collision, have been studied experimentally using a modified Newton's Cradle device. By analyzing the results of the measurements, using numerical model based on finite element method, the viscous damping coefficient was determinedfor the glass balls. To obtain detailed information about the interparticle interactions in a shaker, a simplified model for collision between particles of a granular material was proposed. In order to simulate the flow of surrounding gas, a formulation of the equations for fluid flow in a porous medium including particle forces was proposed. These equations are solved with Large Eddy Simulation (LES) technique using a subgrid-model originally proposed for compressible turbulent flows. For a pentagonal prism-shaped container under vertical vibrations, the results show that oscillon type structures were formed. Oscillons are highly localized particle-like excitations of the granular layer. This self-sustaining state was named by analogy with its closest large-scale analogy, the soliton, which was first documented by J.S. Russell in 1834. The results which has been reportedbyBordbar and Zamankhan(2005b)also show that slightly revised fluctuation-dissipation theorem might apply to shaken sand, which appears to be asystem far from equilibrium and could exhibit strong spatial and temporal variations in quantities such as density and local particle velocity. In this light, hydrodynamic type continuum equations were presented for describing the deformation and flow of dense gas-particle mixtures. The constitutive equation used for the stress tensor provides an effective viscosity with a liquid-like character at low shear rates and a gaseous-like behavior at high shear rates. The numerical solutions were obtained for the aforementioned hydrodynamic equations for predicting the flow dynamics ofdense mixture of gas and particles in vertical cylindrical containers. For a heptagonal prism shaped container under vertical vibrations, the model results were found to predict bubbling behavior analogous to those observed experimentally. This bubbling behavior may be explained by the unusual gas pressure distribution found in the bed. In addition, oscillon type structures were found to be formed using a vertically vibrated, pentagonal prism shaped container in agreement with computer simulation results. These observations suggest that the pressure distribution plays a key rolein deformation and flow of dense mixtures of gas and particles under vertical vibrations. The present models provide greater insight toward the explanation of poorly understood hydrodynamic phenomena in the field of granular flows and dense gas-particle mixtures. The models can be generalized to investigate the granular material-container wall interactions which would be an issue of high interests in the industrial applications. By following this approach ideal processing conditions and powder transport can be created in industrial systems.