Determinants of antithrombotic choice for patent foramen ovale in cryptogenic stroke.

OBJECTIVE: We examined the influence of clinical, radiologic, and echocardiographic characteristics on antithrombotic choice in patients with cryptogenic stroke (CS) and patent foramen ovale (PFO), hypothesizing that features suggestive of paradoxical embolism might lead to greater use of anticoagulation. METHODS: The Risk of Paradoxical Embolism Study combined 12 databases to create the largest dataset of patients with CS and known PFO status. We used generalized linear mixed models with a random effect of component study to explore whether anticoagulation was preferentially selected based on the following: (1) younger age and absence of vascular risk factors, (2) "high-risk" echocardiographic features, and (3) neuroradiologic findings. RESULTS: A total of 1,132 patients with CS and PFO treated with anticoagulation or antiplatelets were included. Overall, 438 participants (39%) were treated with anticoagulation with a range (by database) of 22% to 54%. Treatment choice was not influenced by age or vascular risk factors. However, neuroradiologic findings (superficial or multiple infarcts) and high-risk echocardiographic features (large shunts, shunt at rest, and septal hypermobility) were predictors of anticoagulation use. CONCLUSION: Both antithrombotic regimens are widely used for secondary stroke prevention in patients with CS and PFO. Radiologic and echocardiographic features were strongly associated with treatment choice, whereas conventional vascular risk factors were not. Prior observational studies are likely to be biased by confounding by indication.

Prediction in transformed images

The study is related to lossless compression of greyscale images. The goal of the study was to combine two techniques of lossless image compression, i.e. Integer Wavelet Transform and Differential Pulse Code Modulation to attain better compression ratio. This is an experimental study, where we implemented Integer Wavelet Transform, Differential Pulse Code Modulation and an optimized predictor model using Genetic Algorithm. This study gives encouraging results for greyscale images. We achieved a better compression ration in term of entropy for experiments involving quadrant of transformed image and using optimized predictor coefficients from Genetic Algorithm. In an other set of experiments involving whole image, results are encouraging and opens up many areas for further research work like implementing Integer Wavelet Transform on multiple levels and finding optimized predictor at local levels.

The Increasing Spectrum of Indications of Whole-Body MRI Beyond Oncology: Imaging Answers to Clinical Needs.

Whole-body coverage using MRI was developed almost 2 decades ago. The first applications focused on the investigation of the skeleton to detect neoplastic disease, mainly metastases from solid cancers, and involvement by multiple myeloma and lymphoma. But the extensive coverage of the whole musculoskeletal system, combined with the exquisite sensitivity of MRI to tissue alteration in relation to different pathologic conditions, mainly inflammation, has led to the identification of a growing number of indications outside oncology. Seronegative rheumatisms, systemic sclerosis, inflammatory diseases involving muscles or fascias, and multifocal osseous, vascular, or neurologic diseases represent currently validated or emerging indications of whole-body MRI (WB-MRI). We first illustrate the most valuable indications of WB-MRI in seronegative rheumatisms that include providing significant diagnostic information in patients with negative or ambiguous MRI of the sacroiliac joints and the lumbar spine, assessing disease activity in advanced (ankylosed) central disease, and evaluating the peripherally dominant forms of spondyloarthropathy. Then we review the increasing indications of WB-MRI in other rheumatologic and nonneoplastic disorders, underline the clinical needs, and illustrate the role of WB-MRI in the positive diagnosis and evaluation of disease burden, therapeutic decisions, and treatment monitoring.

To analyse a trace or not? Evaluating the decision-making process in the criminal investigation

In order to broaden our knowledge and understanding of the decision steps in the criminal investigation process, we started by evaluating the decision to analyse a trace and the factors involved in this decision step. This decision step is embedded in the complete criminal investigation process, involving multiple decision and triaging steps. Considering robbery cases occurring in a geographic region during a 2-year-period, we have studied the factors influencing the decision to submit biological traces, directly sampled on the scene of the robbery or on collected objects, for analysis. The factors were categorised into five knowledge dimensions: strategic, immediate, physical, criminal and utility and decision tree analysis was carried out. Factors in each category played a role in the decision to analyse a biological trace. Interestingly, factors involving information available prior to the analysis are of importance, such as the fact that a positive result (a profile suitable for comparison) is already available in the case, or that a suspect has been identified through traditional police work before analysis. One factor that was taken into account, but was not significant, is the matrix of the trace. Hence, the decision to analyse a trace is not influenced by this variable. The decision to analyse a trace first is very complex and many of the tested variables were taken into account. The decisions are often made on a case-by-case basis.

Recuperação de sílica-gel utilizando processos oxidativos avançados: uma alternativa simples e de baixo custo

Silica gel is widely used as adsorbent for isolating and purifying natural compounds. Intensive use and high cost make this process expensive and generate solid residues contaminated with many different organic compounds. In the present work a simple method for recycling silica was investigated, by using Advanced Oxidative Processes. Silica gel was treated with H2O2/solar light and compared with a sample treated by conventional methods (high temperature and oxidation with KMnO4). High temperature treatment changes the structure of the silica and, consequently, the separation efficiency. Oxidation by using KMnO4 requires multiple steps and produces residues, including manganese and oxalic acid. The method using H2O2/solar light to recuperate silica gel does not modify its separation efficiency and is less expensive than the traditional methods. Additionally, HPLC and GC-MS analysis indicate that H2O2/solar light eliminates all residues of the silica gel.

Towards open access networks – prototyping with the Lappeenranta model

The provision of Internet access to large numbers has traditionally been under the control of operators, who have built closed access networks for connecting customers. As the access network (i.e. the last mile to the customer) is generally the most expensive part of the network because of the vast amount of cable required, many operators have been reluctant to build access networks in rural areas. There are problems also in urban areas, as incumbent operators may use various tactics to make it difficult for competitors to enter the market. Open access networking, where the goal is to connect multiple operators and other types of service providers to a shared network, changes the way in which networks are used. This change in network structure dismantles vertical integration in service provision and enables true competition as no service provider can prevent others fromcompeting in the open access network. This thesis describes the development from traditional closed access networks towards open access networking and analyses different types of open access solution. The thesis introduces a new open access network approach (The Lappeenranta Model) in greater detail. The Lappeenranta Model is compared to other types of open access networks. The thesis shows that end users and service providers see local open access and services as beneficial. In addition, the thesis discusses open access networking in a multidisciplinary fashion, focusing on the real-world challenges of open access networks.

A Quantitative method for the characterization of lytic metastases of the bone from radiographic images

The aim of our study was to assess the diagnostic usefulness of the gray level parameters to distinguish osteolytic lesions using radiological images. Materials and Methods: A retrospective study was carried out. A total of 76 skeletal radiographs of osteolytic metastases and 67 radiographs of multiple myeloma were used. The cases were classified into nonflat (MM1 and OL1) and flat bones (MM2 and OL2). These radiological images were analyzed by using a computerized method. The parameters calculated were mean, standard deviation, and coefficient of variation (MGL, SDGL, and CVGL) based on gray level histogram analysis of a region-of-interest.Diagnostic utility was quantified bymeasurement of parameters on osteolyticmetastases andmultiplemyeloma, yielding quantification of area under the receiver operating characteristic (ROC) curve (AUC). Results: Flat bone groups (MM2 and OL2) showed significant differences in mean values of MGL ( = 0.048) and SDGL ( = 0.003). Their corresponding values of AUC were 0.758 for MGL and 0.883 for SDGL in flat bones. In nonflat bones these gray level parameters do not show diagnostic ability. Conclusion: The gray level parametersMGL and SDGL show a good discriminatory diagnostic ability to distinguish between multiple myeloma and lytic metastases in flat bones.

Performance evaluation of MPEG-4 Video encoder on Adres

Actualment un típic embedded system (ex. telèfon mòbil) requereix alta qualitat per portar a terme tasques com codificar/descodificar a temps real; han de consumir poc energia per funcionar hores o dies utilitzant bateries lleugeres; han de ser el suficientment flexibles per integrar múltiples aplicacions i estàndards en un sol aparell; han de ser dissenyats i verificats en un període de temps curt tot i l’augment de la complexitat. Els dissenyadors lluiten contra aquestes adversitats, que demanen noves innovacions en arquitectures i metodologies de disseny. Coarse-grained reconfigurable architectures (CGRAs) estan emergent com a candidats potencials per superar totes aquestes dificultats. Diferents tipus d’arquitectures han estat presentades en els últims anys. L’alta granularitat redueix molt el retard, l’àrea, el consum i el temps de configuració comparant amb les FPGAs. D’altra banda, en comparació amb els tradicionals processadors coarse-grained programables, els alts recursos computacionals els permet d’assolir un alt nivell de paral•lelisme i eficiència. No obstant, els CGRAs existents no estant sent aplicats principalment per les grans dificultats en la programació per arquitectures complexes. ADRES és una nova CGRA dissenyada per I’Interuniversity Micro-Electronics Center (IMEC). Combina un processador very-long instruction word (VLIW) i un coarse-grained array per tenir dues opcions diferents en un mateix dispositiu físic. Entre els seus avantatges destaquen l’alta qualitat, poca redundància en les comunicacions i la facilitat de programació. Finalment ADRES és un patró enlloc d’una arquitectura concreta. Amb l’ajuda del compilador DRESC (Dynamically Reconfigurable Embedded System Compile), és possible trobar millors arquitectures o arquitectures específiques segons l’aplicació. Aquest treball presenta la implementació d’un codificador MPEG-4 per l’ADRES. Mostra l’evolució del codi per obtenir una bona implementació per una arquitectura donada. També es presenten les característiques principals d’ADRES i el seu compilador (DRESC). Els objectius són de reduir al màxim el nombre de cicles (temps) per implementar el codificador de MPEG-4 i veure les diferents dificultats de treballar en l’entorn ADRES. Els resultats mostren que els cícles es redueixen en un 67% comparant el codi inicial i final en el mode VLIW i un 84% comparant el codi inicial en VLIW i el final en mode CGA.

Production Cycle Optimization: Defining the Market Potential for a New Planning Tool

An optimization tool has been developed to help companies to optimize their production cycles and thus improve their overall supply chain management processes. The application combines the functionality that traditional APS (Advanced Planning System) and ARP (Automatic Replenishment Program) systems provide into one optimization run. A qualitative study was organized to investigate opportunities to expand the product’s market base. Twelve personal interviews were conducted and the results were collected in industry specific production planning analyses. Five process industries were analyzed to identify the product’s suitability to each industry sector and the most important product development areas. Based on the research the paper and the plastic film industries remain the most potential industry sectors at this point. To be successful in other industry sectors some product enhancements would be required, including capabilities to optimize multiple sequential and parallel production cycles, handle sequencing of complex finishing operations and to include master planning capabilities to support overall supply chain optimization. In product sales and marketing processes the key to success is to find and reach the people who are involved directly with the problems that the optimization tool can help to solve.

Customized agile development process for embedded software development

Agile software development has grown in popularity starting from the agile manifesto declared in 2001. However there is a strong belief that the agile methods are not suitable for embedded, critical or real-time software development, even though multiple studies and cases show differently. This thesis will present a custom agile process that can be used in embedded software development. The reasons for presumed unfitness of agile methods in embedded software development have mainly based on the feeling of these methods providing no real control, no strict discipline and less rigor engineering practices. One starting point is to provide a light process with disciplined approach to the embedded software development. Agile software development has gained popularity due to the fact that there are still big issues in software development as a whole. Projects fail due to schedule slips, budget surpassing or failing to meet the business needs. This does not change when talking about embedded software development. These issues are still valid, with multiple new ones rising from the quite complex and hard domain the embedded software developers work in. These issues are another starting point for this thesis. The thesis is based heavily on Feature Driven Development, a software development methodology that can be seen as a runner up to the most popular agile methodologies. The FDD as such is quite process oriented and is lacking few practices considered commonly as extremely important in agile development methodologies. In order for FDD to gain acceptance in the software development community it needs to be modified and enhanced. This thesis presents an improved custom agile process that can be used in embedded software development projects with size varying from 10 to 500 persons. This process is based on Feature Driven Development and by suitable parts to Extreme Programming, Scrum and Agile Modeling. Finally this thesis will present how the new process responds to the common issues in the embedded software development. The process of creating the new process is evaluated at the retrospective and guidelines for such process creation work are introduced. These emphasize the agility also in the process development through early and frequent deliveries and the team work needed to create suitable process.

Generalized Differential Evolution for Global Multi-Objective Optimization with Constraints

The objective of this thesis work is to develop and study the Differential Evolution Algorithm for multi-objective optimization with constraints. Differential Evolution is an evolutionary algorithm that has gained in popularity because of its simplicity and good observed performance. Multi-objective evolutionary algorithms have become popular since they are able to produce a set of compromise solutions during the search process to approximate the Pareto-optimal front. The starting point for this thesis was an idea how Differential Evolution, with simple changes, could be extended for optimization with multiple constraints and objectives. This approach is implemented, experimentally studied, and further developed in the work. Development and study concentrates on the multi-objective optimization aspect. The main outcomes of the work are versions of a method called Generalized Differential Evolution. The versions aim to improve the performance of the method in multi-objective optimization. A diversity preservation technique that is effective and efficient compared to previous diversity preservation techniques is developed. The thesis also studies the influence of control parameters of Differential Evolution in multi-objective optimization. Proposals for initial control parameter value selection are given. Overall, the work contributes to the diversity preservation of solutions in multi-objective optimization.

Colecistectomia laparoscópica em um paciente com ducto cístico duplo

Our objective is to report a case of laparoscopic cholecystectomy in a patient with duplicated cystic duct. A 34 year old male presented with episodic pain in the upper rigth quadrant of the abdomen. Murphy' s sign was not present. Ultrassonography showed gallbladder with multiple calculi and a thickened wall. At laparoscopic cholecystectomy, a duplicated cystic duct was found. Careful dissection and intraoperative cholangiography were performed to rule out common bile duct injury.

AMB system for high-speed motors using automatic commissioning

The general trend towards increasing e ciency and energy density drives the industry to high-speed technologies. Active Magnetic Bearings (AMBs) are one of the technologies that allow contactless support of a rotating body. Theoretically, there are no limitations on the rotational speed. The absence of friction, low maintenance cost, micrometer precision, and programmable sti ness have made AMBs a viable choice for highdemanding applications. Along with the advances in power electronics, such as signi cantly improved reliability and cost, AMB systems have gained a wide adoption in the industry. The AMB system is a complex, open-loop unstable system with multiple inputs and outputs. For normal operation, such a system requires a feedback control. To meet the high demands for performance and robustness, model-based control techniques should be applied. These techniques require an accurate plant model description and uncertainty estimations. The advanced control methods require more e ort at the commissioning stage. In this work, a methodology is developed for an automatic commissioning of a subcritical, rigid gas blower machine. The commissioning process includes open-loop tuning of separate parts such as sensors and actuators. The next step is to apply a system identi cation procedure to obtain a model for the controller synthesis. Finally, a robust model-based controller is synthesized and experimentally evaluated in the full operating range of the system. The commissioning procedure is developed by applying only the system components available and a priori knowledge without any additional hardware. Thus, the work provides an intelligent system with a self-diagnostics feature and an automatic commissioning.

Nuorten kokemien elämysten yksilölliset ja yhteisölliset merkitykset

Tutkimuksessa tarkastellaan nuorten antamia merkityksiä elämykseksi nimetylle kokemukselle ja tunteelle. Tavoitteena on ollut selvittää elämysten kokemista nuorten näkökulmasta ja suhteuttaa nuorten kokemuksilleen antamia merkityksiä laajemmin nuoruutta ja elämyksien kokemista käsittelevään yhteiskunnalliseen keskusteluun. Elämysten merkityksellistämistä analysoidaan suhteessa identiteetin muodostukseen. Yksilöllisesti koetut elämykset saavat merkityksensä diskursiivisesti rakentuneen todellisuuden ympäröimänä. Tutkimus paikantuu sosiologisen nuorisotutkimuksen ja tunteiden tutkimuksen alaan sekä metodologisesti fenomenologis-konstruktivistisen tutkimuksen alaan. Tutkimuksen taustalla on elämyshakuisuutta käsittelevä teoria. Elämyshakuisuuden tulkinta fenomenologisesta viitekehyksestä tuo käsitteen ymmärtämiseen uuden ulottuvuuden. Elämyshakuisuus kuvaa asennoitumistapaa eli sitä, miten yksilö orientoituu ympäröivään maailmaan. Tällöin ei edellytetä intentionaalisten tekojen tietoista luonnetta. Toiminnalliset prosessit muovautuvat vuorovaikutuksen myötä samaan tapaan kuin ihminen ruumiillisena subjektina muovautuu. Tutkimuksen aineisto koostuu lukion ensimmäisen luokan oppilaiden kirjoituksista (519 kpl), lastensuojeluinstituutioissa ja kuntoutuskeskuksissa asuvien nuorten yksilöteemahaastatteluista (16 nuorta) sekä seikkailualan asiantuntijoiden teemahaastatteluista (20 aikuista). Nuorten kirjoitukset on kerätty vuosina 1996–1997 ja 2002–2003. Aineiston analyysi on aineistolähtöinen. Erilaiset osa-aineistot työssäni avaavat erilaisia näkökulmia elämysten kokemiseen. Aineistojen analyysi ja tutkimukset teoreettiset lähtökohdat ovat rakentuneet analyysin edetessä ja vuorovaikutussuhteessa toisiinsa. Nuorten elämyksiä käsittelevä kerronta on moninaista ja elämyksiä koetaan erilaisissa tilanteissa. Elämykselle ei ole yhtä määritelmää, kokemisen paikkaan tai kokemisen syytä vaan kokemuksen merkitys rakentuu tilanteisesti. Elämys kuitenkin erottuu muista kokemuksista sen muistettavuuden, ainutlaatuisuuden, uutuuden ja intensiivisyyden perusteella. Nuorten elämyksellisissä hetkissä korostuvat harrastusten yhteydessä koetut uudet, erilaiset, yhteisöllisesti jaetut, mutta myös maailmaa nuorille avaavat itsenäisyyden tunnetta ja hallintaa tuottavat kokemukset. Yksi merkittävä uusia elämyksiä ja tietoa tuottava asia nuorten elämässä on seurustelu. Myös matkailu, erilaiset retket ja leirit olivat nuorille elämyksiä tuottavia tilanteita. Kaikilla nuorilla ei kuitenkaan ole sellaisia harrastuksia, joihin he olisivat sitoutuneita tai joissa he pääsisivät ilmaisemaan itseään ja kokemaan onnistumista. Nuorten elämyksiä käsittelevissä hetkissä nuorten vapaa-ajan toiminta, ympäristö ja sosiaaliset suhteet ovat keskeisessä asemassa. Nuoret eivät ensisijaisesti ajatelleet itse etsivänsä tai toisten nuorten etsivän elämyksiä viihdeteollisuuden tuottamista asioista. Elämyksissä arvostettiin aitoutta ja koettu tunne määritti sitä, oliko jokin koettu elämyksenä vai ei. Toisaalta erilaisten päihteiden todettiin mahdollisesti tuottavan elämyksiä, mutta niidenkin yhteydessä korostettiin usein muita asioita kokemusta rakentavina. Nuorten elämyskokemuksissa toisten nuorten merkitys, luottamus, läheisyyteen ja hyväksyntään liittyvät kokemukset korostuvat. Myös aikuisten asiantuntijoiden omaa nuoruutta käsittelevät elämykset olivat emotionaaliselta merkitykseltään hyvin samanlaisia kuin tämän päivän nuorten esittämät. Elämyksiksi miellettyjä kokemuksia pidettiin arvokkaina. Niiden uskottiin suuntaavan yksilön toimintaa.

Laajeneva ohjelmointiesimerkkikokoelma Ohjelmoinnin perusteet -kurssille

Lappeenrannan teknillisen yliopiston Ohjelmoinnin perusteet -kurssin osallistujilla on ollut vaikeuksia aloittelevan ohjelmoijan kannalta laajojen ohjelmien tuottamisessa ja tällaisten ohjelmien jäsentelemisessä aliohjelmiksi. Kurssin harjoitustyö on kuitenkin vaatinut tällaisen laajan ja jäsennellyn ohjelman tuottamista ja osallistujien ongelmat edellä mainittujen asioiden suhteen ovat ilmenneet palautetuista harjoitustöistä. Tässä työssä pyritään tuottamaan ratkaisu edellä kuvattuun ongelmaan konstruktiivisen tutkimuksen keinoin. Työssä tuotettava konstruktio on ohjelmointiesimerkkikokoelma ja sen avulla kurssin osallistujille voidaan esitellä kuinka laajoja ohjelmia voidaan tuottaa vaiheittain ja kuinka tällaisia ohjelmia voidaan jäsennellä aliohjelmiksi.