Free Flap Monitoring. Using Tissue Oxygen Measurement and Positron Emission Tomography

Aims:This study was carried out to evaluate the feasibility of two different methods to determine free flap perfusion in cancer patients undergoing major reconstructive surgery. The hypotheses was that low perfusion in the flap is associated with flap complications. Patients and methods: Between August 2002 and June 2008 at the Department of Otorhinolaryngology – Head and Neck Surgery, Department of Surgery, and at the PET Centre, Turku, 30 consecutive patients with 32 free flaps were included in this study. The perfusion of the free microvascular flaps was assessed with positron emission tomography (PET) and radioactive water ([¹⁵O] H₂O) in 40 radiowater injections in 33 PET studies. Furthermore, 24 free flaps were monitored with a continuous tissue oxygen measurement using flexible polarographic catheters for an average of three postoperative days. Results: Of the 17 patients operated on for head and neck (HN) cancer and reconstructed with 18 free flaps, three re-operations were carried out due to poor tissue oxygenation as indicated by p_tiO₂ monitoring results and three other patients were reoperated on for postoperative hematomas in the operated area. Blood perfusion assessed with PET (BF_PET) was above 2.0 mL / min / 100 g in all flaps and a low flap-to-muscle BFPET ratio appeared to correlate with poor survival of the flap. Survival in this group of HN cancer patients was 9.0 months (median, range 2.4-34.2) after a median follow-up of 11.9 months (range 1.0-61.0 months). Seven HN patients of this group are alive without any sign of recurrence and one patient has died of other causes. All of the 13 breast reconstruction patients included in the study are alive and free of disease at a median follow-up time of 27.4 months (range 13.9-35.7 months). Re-explorations were carried out in three patients due data provided by p_tiO₂ monitoring and one re-exploration was avoided on the basis of adequate blood perfusion assessed with PET. Two patients had donorsite morbidity and 3 patients had partial flap necrosis or fat necrosis. There were no total flap losses. Conclusions: P_tiO₂ monitoring is a feasible method of free flap monitoring when flap temperature is monitored and maintained close to the core temperature. When other monitoring methods give controversial results or are unavailable, [₁₅O] H₂O PET technique is feasible in the evaluation of the perfusion of the newly reconstructed free flaps.

Measurement and Improvement of Wet Paper Web Strength

Various strength properties of paper are measured to tell how well it resists breaks in a paper machine or in printing presses. The most often measured properties are dry tensile strength and dry tear strength. However, in many situations where paper breaks, it is not dry. For example, in web breaks after the wet pressing the dry matter content can be around 45%. Thus, wet-web strength is often a more critical paper property than dry strength. Both wet and dry strength properties of the samples were measured with a L&W tensile tester. Originally this device was not designed for the measurement of the wet web tensile strength, thus a new procedure to handle the wet samples was developed. The method was tested with Pine Kraft (never dried). The effect of different strength additives on the wet-web and dry paper tensile strength was studied. The polymers used in this experiment were aqueous solution of a cationic polyamidoamine-epichlorohydrin resin (PAE), cationic hydrophilised polyisocyanate and cationic polyvinylamine (PVAm). From all three used chemicals only Cationic PAE considerably increased the wet web strength. However it was noticed that at constant solids content all chemicals decreased the wet web tensile strength. So, since all chemicals enhanced solid content it can be concluded that they work as drainage aids, not as wet web strength additives. From all chemicals only PVAm increased the dry strength and two other chemicals even decreased the strength. As chemicals were used in strong diluted forms and were injected into the pulp slurry, not on the surface of the papersheets, changes in samples densities did not happen. Also it has to be noted that all these chemicals are mainly used to improve the wet strength after the drying of the web.

Performance Measurement of the Logistics Process

The objective of the thesis was to create a performance measurement system for the logistics process of a company. In addition, one goal was to make suggestions for improvements based on description and analysis of the process and current measures. The logistics process was described in detail, and the objectives for it were derived from the company strategy and goals. Suggestions for performance measurement system and process improvement were made based on current state analysis. As a result of the thesis, three new performance measures were decided to take into use. In addition, several improvements were suggested to the ERP system to make process smoother. Some of the improvements have already been added to the system and the rest will be added in the near future.

Harmonized performance measurement system for basic industry's service centers

The objective of this study is to create measurement system that is capable to measure performance in basic industry’s service centers. First it is examined what is performance and how it can be measured. The study also introduces commonly known measurement frameworks. After theory the study investigates how companies in the field of basic industry measure their operations in practise. The investigation is done examining three case examples and by analyzing survey results from basic industry companies. On the survey results focus is on what meters and measurement systems companies use. It is also viewed what measurement problems companies have faced. In the applied part of the study harmonized performance measurement system is created. The framework of the measurement system is introduced and measurement system for the target company is created. The target company felt that the harmonized performance measurement system has good potential and continues to develop it further.

Phase voltage control and filtering in a converter-fed single-phase customer-end system of the LVDC distribution network

In recent years, the network vulnerability to natural hazards has been noticed. Moreover, operating on the limits of the network transmission capabilities have resulted in major outages during the past decade. One of the reasons for operating on these limits is that the network has become outdated. Therefore, new technical solutions are studied that could provide more reliable and more energy efficient power distributionand also a better profitability for the network owner. It is the development and price of power electronics that have made the DC distribution an attractive alternative again. In this doctoral thesis, one type of a low-voltage DC distribution system is investigated. Morespecifically, it is studied which current technological solutions, used at the customer-end, could provide better power quality for the customer when compared with the current system. To study the effect of a DC network on the customer-end power quality, a bipolar DC network model is derived. The model can also be used to identify the supply parameters when the V/kW ratio is approximately known. Although the model provides knowledge of the average behavior, it is shown that the instantaneous DC voltage ripple should be limited. The guidelines to choose an appropriate capacitance value for the capacitor located at the input DC terminals of the customer-end are given. Also the structure of the customer-end is considered. A comparison between the most common solutions is made based on their cost, energy efficiency, and reliability. In the comparison, special attention is paid to the passive filtering solutions since the filter is considered a crucial element when the lifetime expenses are determined. It is found out that the filter topology most commonly used today, namely the LC filter, does not provide economical advantage over the hybrid filter structure. Finally, some of the typical control system solutions are introduced and their shortcomings are presented. As a solution to the customer-end voltage regulation problem, an observer-based control scheme is proposed. It is shown how different control system structures affect the performance. The performance meeting the requirements is achieved by using only one output measurement, when operating in a rigid network. Similar performance can be achieved in a weak grid by DC voltage measurement. An additional improvement can be achieved when an adaptive gain scheduling-based control is introduced. As a conclusion, the final power quality is determined by a sum of various factors, and the thesis provides the guidelines for designing the system that improves the power quality experienced by the customer.

Creating a Performance Measurement System for Accounting Services of Large Paper Company

The main objective of this research is creating a performance measurement system for accounting services of a large paper industry company. In this thesis there are compared different performance measurement system and then selected two systems, which are presented and compared more detailed. Performance Prism system is the used framework in this research. Performance Prism using success maps to determining objectives. Model‟s target areas are divided into five groups: stakeholder satisfaction, stakeholder contribution, strategy, processes and capabilities. The measurement system creation began by identifying stakeholders and defining their objectives. Based on the objectives are created success map. Measures are created based on the objectives and success map. Then is defined needed data for measures. In the final measurement system, there are total just over 40 measures. Each measure is defined specific target level and ownership. Number of measures is fairly large, but this is the first version of the measurement system, so the amount is acceptable.

Automated, adaptive methods for forest inventory

Forest inventories are used to estimate forest characteristics and the condition of forest for many different applications: operational tree logging for forest industry, forest health state estimation, carbon balance estimation, land-cover and land use analysis in order to avoid forest degradation etc. Recent inventory methods are strongly based on remote sensing data combined with field sample measurements, which are used to define estimates covering the whole area of interest. Remote sensing data from satellites, aerial photographs or aerial laser scannings are used, depending on the scale of inventory. To be applicable in operational use, forest inventory methods need to be easily adjusted to local conditions of the study area at hand. All the data handling and parameter tuning should be objective and automated as much as possible. The methods also need to be robust when applied to different forest types. Since there generally are no extensive direct physical models connecting the remote sensing data from different sources to the forest parameters that are estimated, mathematical estimation models are of "black-box" type, connecting the independent auxiliary data to dependent response data with linear or nonlinear arbitrary models. To avoid redundant complexity and over-fitting of the model, which is based on up to hundreds of possibly collinear variables extracted from the auxiliary data, variable selection is needed. To connect the auxiliary data to the inventory parameters that are estimated, field work must be performed. In larger study areas with dense forests, field work is expensive, and should therefore be minimized. To get cost-efficient inventories, field work could partly be replaced with information from formerly measured sites, databases. The work in this thesis is devoted to the development of automated, adaptive computation methods for aerial forest inventory. The mathematical model parameter definition steps are automated, and the cost-efficiency is improved by setting up a procedure that utilizes databases in the estimation of new area characteristics.

Sales performance measurement and steering in a multinational company

The objective of the study is to find out how sales performance should be measured and how should sales be steered in a multinational company. The beginning of the study concentrates on the literature regarding sales, performance measurement, sales performance measurement, and sales steering. The empirical part of the study is a case study, in which the information was acquired from interviews with the key personnel of the company. The results of the interviews and the revealed problems were analyzed, and comparison for possible solutions was performed. When measuring sales performance, it is important to discover the specific needs and objectives for such a system. Specific needs should be highlighted in the design of the system. The system should be versatile and the structure of the system should be in line with the organizational structure. The role of the sales performance measurement system was seen to be important in helping sales steering. However, the importance of personal management and especially conversations were seen as really critical issue in the steering. Sales performance measurement could be based on the following perspectives: financial, market, customer, people, and future. That way the sales department could react to the environmental changes more rapidly.

Measurement and simulation of solar radiation availability in relation to the growth of coffee plants in an agroforestry system with rubber trees

Solar radiation is an important factor for plant growth, being its availability to understory crops strongly modified by trees in an Agroforestry System (AFS). Coffee trees (Coffea arabica - cv. Obatã IAC 1669-20) were planted at a 3.4 x 0.9 m spacing inside and aside rows of monocrops of 12 year-old rubber trees (Hevea spp.), in Piracicaba-SP, Brazil (22º42'30" S, 47º38'00" W - altitude: 546m). One-year-old coffee plants exposed to 25; 30; 35; 40; 45; 80; 90; 95 and 100% of the total solar radiation were evaluated according to its biophysical parameters of solar radiation interception and capture. The Goudriaan (1977) adapted by Bernardes et al. (1998) model for radiation attenuation fit well to the measured data. Coffee plants tolerate a decrease in solar radiation availability to 50% without undergoing a reduction on growth and LAI, which was approximately 2m².m-2 under this condition. Further reductions on the availability of solar radiation caused a reduction in LAI (1.5m².m-2), thus poor land cover and solar radiation interception, resulting in growth reduction.

Exploring Adaptive Implementation of On-Chip Networks

As technology geometries have shrunk to the deep submicron regime, the communication delay and power consumption of global interconnections in high performance Multi- Processor Systems-on-Chip (MPSoCs) are becoming a major bottleneck. The Network-on- Chip (NoC) architecture paradigm, based on a modular packet-switched mechanism, can address many of the on-chip communication issues such as performance limitations of long interconnects and integration of large number of Processing Elements (PEs) on a chip. The choice of routing protocol and NoC structure can have a significant impact on performance and power consumption in on-chip networks. In addition, building a high performance, area and energy efficient on-chip network for multicore architectures requires a novel on-chip router allowing a larger network to be integrated on a single die with reduced power consumption. On top of that, network interfaces are employed to decouple computation resources from communication resources, to provide the synchronization between them, and to achieve backward compatibility with existing IP cores. Three adaptive routing algorithms are presented as a part of this thesis. The first presented routing protocol is a congestion-aware adaptive routing algorithm for 2D mesh NoCs which does not support multicast (one-to-many) traffic while the other two protocols are adaptive routing models supporting both unicast (one-to-one) and multicast traffic. A streamlined on-chip router architecture is also presented for avoiding congested areas in 2D mesh NoCs via employing efficient input and output selection. The output selection utilizes an adaptive routing algorithm based on the congestion condition of neighboring routers while the input selection allows packets to be serviced from each input port according to its congestion level. Moreover, in order to increase memory parallelism and bring compatibility with existing IP cores in network-based multiprocessor architectures, adaptive network interface architectures are presented to use multiple SDRAMs which can be accessed simultaneously. In addition, a smart memory controller is integrated in the adaptive network interface to improve the memory utilization and reduce both memory and network latencies. Three Dimensional Integrated Circuits (3D ICs) have been emerging as a viable candidate to achieve better performance and package density as compared to traditional 2D ICs. In addition, combining the benefits of 3D IC and NoC schemes provides a significant performance gain for 3D architectures. In recent years, inter-layer communication across multiple stacked layers (vertical channel) has attracted a lot of interest. In this thesis, a novel adaptive pipeline bus structure is proposed for inter-layer communication to improve the performance by reducing the delay and complexity of traditional bus arbitration. In addition, two mesh-based topologies for 3D architectures are also introduced to mitigate the inter-layer footprint and power dissipation on each layer with a small performance penalty.