Myocardial perfusion scintigraphy in the detection of silent ischemia in asymptomatic diabetic patients

OBJECTIVE: This study was aimed to evaluate myocardial perfusion in asymptomatic patients with type 1 (DM1) and type 2 diabetes mellitus (DM2) without previous diagnoses of coronary artery disease (CAD) or cerebral infarction. MATERIALS AND METHODS: Fifty-nine consecutive asymptomatic patients (16 DM1, 43 DM2) underwent myocardial perfusion scintigraphy with 99mTc-sestamibi (MPS). They were evaluated for body mass index, metabolic control of DM, type of therapy, systemic arterial hypertension, dyslipidemia, nephropathy, retinopathy, peripheral neuropathy, smoking, and familial history of CAD. RESULTS: MPS was abnormal in 15 patients (25.4%): 12 (20.3%) with perfusion abnormalities, and 3 with isolated left ventricular dysfunction. The strongest predictors for abnormal myocardial perfusion were: age 60 years and above (p = 0.017; odds ratio [OR] = 6.0), peripheral neuropathy (p = 0.028; OR = 6.1), nephropathy (p = 0.031; OR = 5.6), and stress ECG positive for ischemia (p = 0.049; OR = 4.08). CONCLUSION: Silent myocardial ischemia occurs in more than one in five asymptomatic diabetic patients. The strongest predictors of ischemia in this study were: patient age, peripheral neuropathy, nephropathy, retinopathy and a stress ECG positive for ischemia.

Extrafascial injection for interscalene brachial plexus block reduces respiratory complications compared with a conventional intrafascial injection: a randomized, controlled, double-blind trial?.

BACKGROUND: Hemidiaphragmatic paresis after ultrasound-guided interscalene brachial plexus block is reported to occur in up to 100% of patients. We tested the hypothesis that an injection lateral to the brachial plexus sheath reduces the incidence of hemidiaphragmatic paresis compared with a conventional intrafascial injection, while providing similar analgesia. METHODS: Forty ASA I-III patients undergoing elective shoulder and clavicle surgery under general anaesthesia were randomized to receive an ultrasound-guided interscalene brachial plexus block for analgesia, using 20 ml bupivacaine 0.5% with epinephrine 1:200 000 injected either between C5 and C6 within the interscalene groove (conventional intrafascial injection), or 4 mm lateral to the brachial plexus sheath (extrafascial injection). The primary outcome was incidence of hemidiaphragmatic paresis (diaphragmatic excursion reduction >75%), measured by M-mode ultrasonography, before and 30 min after the procedure. Secondary outcomes were forced vital capacity, forced expiratory volume in 1 s, and peak expiratory flow. Additional outcomes included time to first opioid request and pain scores at 24 h postoperatively (numeric rating scale, 0-10). RESULTS: The incidences of hemidiaphragmatic paresis were 90% (95% CI: 68-99%) and 21% (95% CI: 6-46%) in the conventional and extrafascial injection groups, respectively (P<0.0001). Other respiratory outcomes were significantly better preserved in the extrafascial injection group. The mean time to first opioid request was similar between groups (conventional: 802 min [95% CI: 620-984 min]; extrafascial: 973 min [95% CI: 791-1155 min]; P=0.19) as were pain scores at 24 h postoperatively (conventional: 1.6 [95% CI: 0.9-2.2]; extrafascial: 1.6 [95% CI: 0.8-2.4]; P=0.97). CONCLUSIONS: Ultrasound-guided interscalene brachial plexus block with an extrafascial injection reduces the incidence of hemidiaphragmatic paresis and impact on respiratory function while providing similar analgesia, when compared with a conventional injection. CLINICAL TRIAL REGISTRATION: NCT02074397.

Kumpulan tiedekirjaston maantieteen monografiat

Maantieteen lainattavien monografioiden kokoelma sisältää 7288 (7.8.2007) nidettä. Kokoelma on luokiteltu UDK-luokituksen mukaisesti. Asiasanoituksessa on käytetty YSA:n asiasanoja sekä tarpeen vaatiessa vapaita asiasanoja. Kopioinnissa tulleita asiasanoja ei ole poistettu, vaan ne ovat käytössä (esim. Kongressin asiasanat). Monografiat ovat pääosin englannin-, suomen, saksan- ja ruotsinkielisiä. Kirjat ovat vapaasti käytettävissä ja lainattavissa. Laina-aika on 28 vuorokautta. Kokoelman kehittäjien tavoitteena on aina ollut korkeatasoinen maantieteen tieteellinen kokoelma, joka vastaa ainelaitoksen tutkijoiden, opettajien ja opiskelijoiden tarpeita. Laitoksen johto on pitänyt tärkeänä riittävää budjetointia hankinnan tarpeisiin. Hankintapäätökset on tehnyt tieteenalan asiantuntija, yleensä laitoksen johtaja yhteistyössä kirjaston kanssa. Käyttäjät ovat pääsääntöisesti olleet omalta ainelaitokselta, mutta tieteenalan luonteen vuoksi kokoelman käyttäjiä ovat myös lukuisten lähitieteiden tutkijat ja muut yksityishenkilöt. Maantieteen kokoelma sisältää myös laajan aluesuunnittelun kokoelman.

Externalities of Shipping in the Gulf of Finland until 2015

During the last few years, the discussion on the marginal social costs of transportation has been active. Applying the externalities as a tool to control transport would fulfil the polluter pays principle and simultaneously create a fair control method between the transport modes. This report presents the results of two calculation algorithms developed to estimate the marginal social costs based on the externalities of air pollution. The first algorithm calculates the future scenarios of sea transport traffic externalities until 2015 in the Gulf of Finland. The second algorithm calculates the externalities of Russian passenger car transit traffic via Finland by taking into account both sea and road transport. The algorithm estimates the ship-originated emissions of carbon dioxide (CO₂), nitrogen oxides (NO_x), sulphur oxides (SO_x), particulates (PM) and the externalities for each year from 2007 to 2015. The total NOx emissions in the Gulf of Finland from the six ship types were almost 75.7 kilotons (Table 5.2) in 2007. The ship types are: passenger (including cruisers and ROPAX vessels), tanker, general cargo, Ro-Ro, container and bulk vessels. Due to the increase of traffic, the estimation for NO_x emissions for 2015 is 112 kilotons. The NO_x emission estimation for the whole Baltic Sea shipping is 370 kilotons in 2006 (Stipa & al, 2007). The total marginal social costs due to ship-originated CO₂, NO_x, SO_x and PM emissions in the GOF were calculated to almost 175 million Euros in 2007. The costs will increase to nearly 214 million Euros in 2015 due to the traffic growth. The major part of the externalities is due to CO₂ emissions. If we neglect the CO2 emissions by extracting the CO₂ externalities from the results, we get the total externalities of 57 million Euros in 2007. After eight years (2015), the externalities would be 28 % lower, 41 million Euros (Table 8.1). This is the result of the sulphur emissions reducing regulation of marine fuels. The majority of the new car transit goes through Finland to Russia due to the lack of port capacity in Russia. The amount of cars was 339 620 vehicles (Statistics of Finnish Customs 2008) in 2005. The externalities are calculated for the transportation of passenger vehicles as follows: by ship to a Finnish port and, after that, by trucks to the Russian border checkpoint. The externalities are between 2 – 3 million Euros (year 2000 cost level) for each route. The ports included in the calculations are Hamina, Hanko, Kotka and Turku. With the Euro-3 standard trucks, the port of Hanko would be the best choice to transport the vehicles. This is because of lower emissions by new trucks and the saved transport distance of a ship. If the trucks are more polluting Euro 1 level trucks, the port of Kotka would be the best choice. This indicates that the truck emissions have a considerable effect on the externalities and that the transportation of light cargo, such as passenger cars by ship, produces considerably high emission externalities. The emission externalities approach offers a new insight for valuing the multiple traffic modes. However, the calculation of the marginal social costs based on the air emission externalities should not be regarded as a ready-made calculation system. The system is clearly in the need of some improvement but it can already be considered as a potential tool for political decision making.

Sport

Samlingen med signum HB XII finns vid huvudbiblioteket och innehåller litteratur till och med år 1999 om gymnastik, sport, lekar och spel som exempel litteratur om scouting och schack. Litteraturen i samlingen söks i Alma med sökfunktionen Signum och söktermen HB XII. En del litteratur tryckt före 1980 skall sökas manuellt i huvudbibliotekets systematiska kortkatalog, men retroaktiv inmatning i Alma av litteratur tryckt mellan 1830 och 1979 pågår. Från och med år 2000 ingår litteratur vid huvudbiblioteket i en numerus currens-samling. År 1978 erhöll biblioteket en donation av Thorsten Gauffin om 620 volymer schacklitteratur och denna litteratur infogades inte i klass HB XII. Specialsamlingen har signum HB Saml. Gauffin.

New Distance Transforms for Gray Level Image Compression

This thesis deals with distance transforms which are a fundamental issue in image processing and computer vision. In this thesis, two new distance transforms for gray level images are presented. As a new application for distance transforms, they are applied to gray level image compression. The new distance transforms are both new extensions of the well known distance transform algorithm developed by Rosenfeld, Pfaltz and Lay. With some modification their algorithm which calculates a distance transform on binary images with a chosen kernel has been made to calculate a chessboard like distance transform with integer numbers (DTOCS) and a real value distance transform (EDTOCS) on gray level images. Both distance transforms, the DTOCS and EDTOCS, require only two passes over the graylevel image and are extremely simple to implement. Only two image buffers are needed: The original gray level image and the binary image which defines the region(s) of calculation. No other image buffers are needed even if more than one iteration round is performed. For large neighborhoods and complicated images the two pass distance algorithm has to be applied to the image more than once, typically 3 10 times. Different types of kernels can be adopted. It is important to notice that no other existing transform calculates the same kind of distance map as the DTOCS. All the other gray weighted distance function, GRAYMAT etc. algorithms find the minimum path joining two points by the smallest sum of gray levels or weighting the distance values directly by the gray levels in some manner. The DTOCS does not weight them that way. The DTOCS gives a weighted version of the chessboard distance map. The weights are not constant, but gray value differences of the original image. The difference between the DTOCS map and other distance transforms for gray level images is shown. The difference between the DTOCS and EDTOCS is that the EDTOCS calculates these gray level differences in a different way. It propagates local Euclidean distances inside a kernel. Analytical derivations of some results concerning the DTOCS and the EDTOCS are presented. Commonly distance transforms are used for feature extraction in pattern recognition and learning. Their use in image compression is very rare. This thesis introduces a new application area for distance transforms. Three new image compression algorithms based on the DTOCS and one based on the EDTOCS are presented. Control points, i.e. points that are considered fundamental for the reconstruction of the image, are selected from the gray level image using the DTOCS and the EDTOCS. The first group of methods select the maximas of the distance image to new control points and the second group of methods compare the DTOCS distance to binary image chessboard distance. The effect of applying threshold masks of different sizes along the threshold boundaries is studied. The time complexity of the compression algorithms is analyzed both analytically and experimentally. It is shown that the time complexity of the algorithms is independent of the number of control points, i.e. the compression ratio. Also a new morphological image decompression scheme is presented, the 8 kernels' method. Several decompressed images are presented. The best results are obtained using the Delaunay triangulation. The obtained image quality equals that of the DCT images with a 4 x 4

Empirics of the international inequality in CO2 emissions intensity: explanatory factors according to complementary decomposition methodologies

This paper analyses the international inequalities in CO2 emissions intensity for the period 1971- 2009 and assesses explanatory factors. Multiplicative, group and additive methodologies of inequality decomposition are employed. The first allows us to clarify the separated role of the carbonisation index and the energy intensity in the pattern observed for inequalities in CO2 intensities; the second allows us to understand the role of regional groups; and the third allows us to investigate the role of different fossil energy sources (coal, oil and gas). The results show that, first, the reduction in global emissions intensity has coincided with a significant reduction in international inequality. Second, the bulk of this inequality and its reduction are attributed to differences between the groups of countries considered. Third, coal is the main energy source explaining these inequalities, although the growth in the relative contribution of gas is also remarkable. Fourth, the bulk of inequalities between countries and its decline are explained by differences in energy intensities, although there are significant differences in the patterns demonstrated by different groups of countries.

The materiality of the immaterial. Services sectors and CO2 emissions in Uruguay

This paper analyzes the carbon dioxide emissions of the services sectors subsystem of Uruguay in 2004. Services, with the exception of transport, are often considered intangible because of their low level of direct emissions. However, the provision of services requires inputs produced by other sectors, including several highly materialintensive sectors. Through input–output analysis we investigate the relationship between the services subsystem and the rest of the economy as regards carbon dioxide emissions. This approach allows us to study the importance of the set of services branches as a unit in the economic structure as well as to analyze in detail the relationship between the branches. The results depict that services’ direct emissions are the main component, as a consequence of transport-related sectors. However, the pollution that the services subsystem makes the rest of the economy produce is very significant, and it is almost all explained by non-transport-related sectors. This analysis is useful for determining the sectors in which mitigation policies are more effective, and whether they would be better tackled through technical improvements and better practices or through demand policies.

Energy intensity in road freight transport of heavy goods vehicles in Spain

This paper examines the factors that have influenced the energy intensity of the Spanish road freight transport of heavy goods vehicles over the period 1996–2012. This article aims to contribute to a better understanding of the factors behind the energy intensity change of road freight and also to inform the design of measures to improve energy efficiency in road freight transport. The paper uses both annual single-period and chained multi-period multiplicative LMDI-II decomposition analysis. The results suggest that the decrease in the energy intensity of Spanish road freight in the period is explained by the change in the real energy intensity index (lower energy consumption per tonne-kilometre transported), which is partially offset by the behaviour of the structural index (greater share in freight transport of those commodities the transportation of which is more energy intensive). The change in energy intensity is analysed in more depth by quantifying the contribution of each commodity through the attribution of changes in Divisia indices.

The causal factors of international inequality in CO2 emissions per capita: a regression-based inequality decomposition analysis

This paper uses the possibilities provided by the regression-based inequality decomposition (Fields, 2003) to explore the contribution of different explanatory factors to international inequality in CO2 emissions per capita. In contrast to previous emissions inequality decompositions, which were based on identity relationships (Duro and Padilla, 2006), this methodology does not impose any a priori specific relationship. Thus, it allows an assessment of the contribution to inequality of different relevant variables. In short, the paper appraises the relative contributions of affluence, sectoral composition, demographic factors and climate. The analysis is applied to selected years of the period 1993–2007. The results show the important (though decreasing) share of the contribution of demographic factors, as well as a significant contribution of affluence and sectoral composition.

De lingvis igneis, qvam Christi redemtoris auxilio nixus

Invocatio: [Alpha et Omega].