Differentiating origins of outflow tract ventricular arrhythmias: a comparison of three different electrocardiographic algorithms

Our objective is to evaluate the accuracy of three algorithms in differentiating the origins of outflow tract ventricular arrhythmias (OTVAs). This study involved 110 consecutive patients with OTVAs for whom a standard 12-lead surface electrocardiogram (ECG) showed typical left bundle branch block morphology with an inferior axis. All the ECG tracings were retrospectively analyzed using the following three recently published ECG algorithms: 1) the transitional zone (TZ) index, 2) the V2 transition ratio, and 3) V2 R wave duration and R/S wave amplitude indices. Considering all patients, the V2 transition ratio had the highest sensitivity (92.3%), while the R wave duration and R/S wave amplitude indices in V2 had the highest specificity (93.9%). The latter finding had a maximal area under the ROC curve of 0.925. In patients with left ventricular (LV) rotation, the V2 transition ratio had the highest sensitivity (94.1%), while the R wave duration and R/S wave amplitude indices in V2 had the highest specificity (87.5%). The former finding had a maximal area under the ROC curve of 0.892. All three published ECG algorithms are effective in differentiating the origin of OTVAs, while the V2 transition ratio, and the V2 R wave duration and R/S wave amplitude indices are the most sensitive and specific algorithms, respectively. Amongst all of the patients, the V2 R wave duration and R/S wave amplitude algorithm had the maximal area under the ROC curve, but in patients with LV rotation the V2 transition ratio algorithm had the maximum area under the ROC curve.

Software business expansion through distribution channel : Case M-Files - Denmark

The purpose of this study was to find out how a software company can successfully expand business to the Danish software market through distribution channel. The study was commissioned by a Finnish software company and it was conducted using a qualitative research method by analyzing external and internal business environment, and interviewing Danish ICT organizations and M-Files personnel. Interviews were semi-structured interviews, which were designed to collect comprehensive information on the existing ICT and software market in Denmark. The research used three external and internal analyzing frameworks; PEST analysis (market level), Porter´s Five Force analysis (industry level competition) and SWOT analysis (company level). Distribution channels theory was a base to understand why and what kind of distribution channels the case company uses, and what kind of channels target markets companies’ uses. Channel strategy and design were integrated to the industry level analysis. The empirical findings revealed that Denmark has very business friendly ICT environment. Several organizations have ranked Denmark´s information and communication technology as the best in the world. Denmark’s ICT and software market are relatively small, compared to many other countries in Europe. Danish software market is centralized. Largest software clusters are in the largest cities; Copenhagen, Aarhus, Odense and Aalborg. From these clusters, software companies can most likely find suitable resellers. The following growing trends are clearly seen in the software market: mobile and wireless applications, outsourcing, security solutions, cloud computing, social business solutions and e-business solutions. When expanding software business to the Danish market, it is important to take into account these trends. In Denmark distribution channels varies depending on the product or service. For many, a natural distribution channel is a local partner or internet. In the public sector solutions are purchased through a public procurement process. In the private sector the buying process is more straight forwarded. Danish companies are buying software from reliable suppliers. This means that they usually buy software direct from big software vendors or local partners. Some customers prefer to use professional consulting companies. These consulting companies can strongly influence on the selection of the supplier and products, and in this light, consulting companies can be important partners for software companies. Even though the competition is fierce in ECM and DMS solutions, Danish market offers opportunities for foreign companies. Penetration to the Danish market through reseller channel requires advanced solutions and objective selection criteria for channel partners. Based on the findings, Danish companies are interested in advanced and efficient software solutions. Interest towards M-Files solutions was clearly seen and the company has excellent opportunity to expand business to the Danish market through reseller channel. Since the research explored the Danish ICT and software market, the results of the study may offer valuable information also to the other software companies which are expanding their business to the Danish market.

Purple urine bag syndrome in end-stage chronic kidney disease

Introduction: When faced with violet, purple or purplish-blue urine, clinicians should consider urinary tract infection in their differential diagnosis. Case report: A 60-year-old woman with end-stage kidney disease and non-adherence to renal replacement therapy was admitted to our hospital for placement of hemodialysis catheter. During her hospitalization she had purple urine, and purple urine bag syndrome (PUBS) was diagnosed. She was effectively treated with antibiotics and her urine returned to a dark yellow color. Discussion: Although this condition is often easily treated, diagnosing PUBS in chronic renal patients probably means an increased serum concentration of indoxyl sulfate, metabolite that is involved in the progression of both CKD and cardiovascular disease. Conclusion: Hence, in the context of our renal patients, perhaps PUBS is not as benign as supposed.

Verkostoskenaarioiden arviointi sähkön jakeluverkkotoiminnan valvontamenetelmien kannalta

Tämän työn tavoitteena oli selvittää sähkön jakeluverkkotoiminnan valvontamenetelmien muutoksien vaikutuksia Loiste Sähköverkko Oy:n talouteen neljännellä ja viidennellä valvontajaksolla. Tarkastelua varten tehtiin talousmalli, joka mallintaa verkkoyhtiön taloutta vuoteen 2040 asti. Talousmallissa mallinnettiin kaikkien kannustimien vaikutus paitsi innovaatio- ja toimitusvarmuuskannustimien vaikutus. Talousmallinnuksen perusperiaate oli, että mitä ei pystytä kattamaan siirtotuloilla, rahoitetaan vieraalla pääomalla, kun kassavirran minimitaso ja investointitaso ovat valittu. Talousmallilla tarkasteltiin neljää erilaista verkostoskenaariota. Tarkasteltavat verkostoskenaariot olivat kehittämissuunnitelman mukainen skenaario, nopeutettu kehittämissuunnitelman mukainen skenaario, kaapelointipainotteinen skenaario ja kunnossapitopainotteinen skenaario. Verkon arvon kehittyminen verkostoskenaarioissa mallinnettiin Loiste Sähköverkko Oy:n investointimallilla ja kuvattiin talousmallinnusta varten jälleenhankinta-arvon, nykykäyttöarvon, investointien ja tasapoistojen kehittymisellä vuoteen 2029 asti. Työn tulosten perusteella kehittämissuunnitelman mukaisessa skenaariossa vieraan pääoman määrä pysyy kohtuullisena ja mahdollistaa kohtuullisen kassavirran tarkastelujakson lopussa. Nopeutetussa kehittämissuunnitelman mukaisessa skenaariossa ja kaapelointipainotteisissa skenaariossa vieraan pääoman määrä kasvaa merkittävästi, mikä voi lisätä liiketaloudellisia riskejä, mutta toisaalta mahdollistavat korkeamman kassavirran tarkastelujakson lopussa. Kunnossapitopainotteisessa skenaariossa vieraan pääoman määrä on matala, mutta kassavirta myös pysyy matalana tarkastelujakson loppuun asti.

Pertussis: infection, vaccination and gene polymorphisms

Pertussis or whooping cough is a human respiratory tract infection and a vaccine-preventable disease that is caused by Bordetella pertussis bacteria. Pertussis vaccination has been part of the Finnish national vaccine program since 1952. Despite extensive vaccinations, the incidence of pertussis has increased in many countries during the last decades. Large epidemics have been observed also in countries with high vaccine coverage. Inter-individual variation in immune responses is always encountered after vaccination. Low vaccine responses may cause vulnerability to pertussis even straight after vaccination. Reasons for low responses are not fully understood. The innate immune system is responsible for the initial recognition of pathogens and vaccine antigens. The role of innate immunity on pertussis immunity has not been thoroughly investigated. Mannose-binding lectin (MBL) and toll-like receptor 4 (TLR4) are important molecules of the innate immune system and in the recognition of pathogens. Cytokines form a signaling network that have a notable role in immune responses after infections as well as after vaccinations. Single nucleotide polymorphism (SNP) is common in genes encoding these molecules and the polymorphisms have been reported to affect vaccine response after viral and bacterial vaccines. This study investigated the gene polymorphisms of MBL2, TLR4 and interleukin (IL)-10 promoter and their association with vaccine responses after acellular pertussis (aP) vaccination in Finnish adolescents and infants. Cell-mediated immune responses were investigated ten years after the previous pertussis vaccinations in young adults. In addition, the role of MBL deficiency in pertussis infection susceptibility was evaluated. The results of this study show that subjects with TLR4 polymorphism had lower antibody production and persistence after aP vaccination compared with normal allele. A specific SNP in the TLR4 gene was associated with decreased antibody responses and persistence in adolescents after aP booster vaccination. Cell-mediated immune responses were partly detected ten years after the previous vaccination; booster vaccine clearly enhanced the responses. In addition, subjects with IL-10 polymorphism had altered cell-mediated immune responses. MBL deficiency was found to be more frequent in pertussis patients than healthy controls but the polymorphism of MBL2 was not associated with antibody responses after acellular pertussis vaccination. The novel finding of this study was that genetic variation in the innate immune system seems to play a role in altered pertussis vaccine responses as well as in pertussis infection. These new findings enlighten the mechanisms behind the low responses after pertussis vaccination and help to predict risk factors related to this phenomenon.

Liquidity levels of Finnish SME’s from 2007 to 2013 and a closer analysis of the IC sector

TAVOITTEET: Tämän tutkielman tarkoitus on tarkastella eri toimialojen likviditeettitasoja vuosien 2007 ja 2013 välillä. Se tarkastelee myös kassanhallinnan ja likviditeetin kirjallisuutta, erilaisia likviditeettiä kuvaavia tunnuslukuja sekä asioita, joilla on vaikutusta likviditeettiin. Tämän lisäksi se tutkii informaatio ja kommunikaatio sektoria tarkemmin. DATA: Data on kerätty Orbis tietokannasta. Toimialakohtaiset keskiarvot on laskettu joko kappaleen 2 esittämillä kaavoilla tai noudettu suoraan tietokannasta. Hajonta kuvaajat on tehty Excelillä ja korrelaatio matriisi ja regressioanalyysit SAS EG:llä. TULOKSET: Tämä tutkimus esittää toimialakohtaiset keskiarvot liquidity ratiosta, solvency ratiosta sekä gearingista, kuten monista muista likviditeettiä kuvaavista tai siihen vaikuttavista tunnusluvuista. Tutkimus osoittaa, että keskimäärin likviditeetti ja maksuvalmius ovat säilyneet melko samana, mutta toimialakohtaiset muutokset ovat voimakkaita. IC sektorilla likviditeettiin vaikuttaa katetuotto, työntekijöiden määrä, liikevaihto, taseen määrä sekä maksuaika.

Vedenalainen hitsaus

Tässä kandidaatintyössä esitellään ensin vedenalainen hitsaus yleisesti. Työssä käydään läpi vedenalaisen hitsauksen eri pääalueet ja niissä käytetyt hitsaustekniikat, sekä tarkastellaan veden vaikutusta hitsiin. Työ sisältää myös materiaali esimerkkejä, joita vedenalaisessa hitsauksessa käytetään. Vedenalainen hitsaus toimii asennus- ja korjaushitsauksena. Hitsausprosessit, joita työssä käsitellään, ovat puikko-, täytelanka- ja kitkahitsaus. Näitä hitsaustekniikoita käytetään märkähitsauksessa, mikä poikkeaa selvästi kuivassa ympäristössä tapahtuvaan hitsaamiseen, jossa hitsi ei pääse välittömästi kosketukseen veden kanssa. Työn tarkoituksena on antaa informaatiota vedenalaisesta hitsauksesta ja sen hyödyntämisestä hitsaustekniikassa.

Ulkoistuksesta luopumisen kannattavuusarviointi panimoalan yrityksessä

Ulkoistaminen on ollut pitkään yhtenä strategisen päätöksenteon osa-alueena, mutta ulkoistuksesta luopuminen on ollut vähemmän esillä. Tämä työ käsittelee lahtelaisen Teerenpeli Panimo & Tislaamo Oy:n yhden logistiikan osa-alueen ulkoistamisen ja ulkoistuksesta luopumisen välistä kannattavuutta. Tällä hetkellä ulkopuolinen yritys vastaa ravintola-astioiden pesu- ja varastointijärjestelyistä. Nyt laajentuneen toiminnan ja kasvaneen kysynnän ansiosta selvitetään ulkoistuksesta luopumisen mahdollisuutta yhtenä tulevaisuuden vaihtoehtona. Vaihtoehtoisia toimintamalleja on kaksi. Ensimmäisessä yritys investoisi omaan pesu- ja täyttöjärjestelmään ja vastaisi myös ravintola-astioiden logistiikasta kokonaisuudessaan. Näin ollen ulkopuolisen toimijan hyödyntäminen ravintolaastioiden logistiikassa jäisi pois. Toinen vaihtoehtoinen malli liittyy äskettäin markkinoilla suosiota saaneisiin niin sanottujen yksisuuntaisten ravintola-astioiden käyttöönottoon. Näitä astioita ei uudelleen pestä lainkaan, vaan käytön jälkeen hävitetään edelleen kierrätettäväksi. Diplomityön lopussa arvioidaan eri mallien välistä kannattavuutta taloudellisin perustein. Tämän lisäksi mallien välistä kannattavuutta arvioidaan taloudellisten mittareiden ulkopuolisilla tekijöillä, esimerkiksi ulkoistuksesta luopumisen vaikutuksia muuhun jäljelle jäävään yhteistyön. Lopussa annetaan myös toimintaohjeet tulevaa varten.

Liiketoimintayksikön materiaalihallinnan nykytila ja sen tehostaminen materiaalien suoratoimituksilla

Tutkimuksen tarkoituksena on tutkia kansainvälisesti toimivan konserniyrityksen yhden liiketoimintayksikön materiaalinhallinnan ja siihen liittyvien toimintojen nykytilaa. Lisäksi tutkimuksessa selvitetään, miten materiaalinhallintaa varastoinnin osalta voidaan kehittää suoratoimitusmallin periaatetta hyödyntäen ja mitä säästöpotentiaaleja tämän kaltaiseen malliin liittyy kohdeorganisaation toimintaympäristö huomioiden. Tutkimuksen teoriaosion lähdeaineisto koostuu materiaalinhallinnan perusteosten lisäksi tieteellisistä artikkelijulkaisuista. Käytännönosuuden aineisto pohjautuu kohdeorganisaatiossa käytyihin keskusteluihin, tuotannonohjausjärjestelmästä saatuun tietoon ja omiin havaintoihin. Nykytilanteen analyysissä selvisi, että kohdeorganisaation varastointiin liittyy tehostamispotentiaalia erityisesti tila-, käsittely, ja työkustannusten osalta. Kohdeorganisaation varastoinnin tehostamista tutkittiin suoratoimitusmallin avulla. Suoratoimitusmallissa materiaalit eivät kierrä kohdeorganisaation pitämän välivaraston kautta, vaan ne toimitetaan toimittajan tiloista suoraan tuotannon välittömään tarpeeseen. Mallin avulla voidaan jakaa toimittajien kanssa sellaisia resursseja, joita molempien toiminta vaatii ja täten vapauttaa nykyistä varastointitilaa ja keventää sisäisen logistiikan kuormaa. Suoratoimitusmallin liittyvien hyötyjen kannalta on oleellista, että malliin valitaan sellaiset materiaalit, jotka sisältävät eniten potentiaalia niin säästö- kuin soveltuvuusnäkökulmasta. Valittujen kriteerien avulla kohdeorganisaation hankkimista materiaaleista löydettiin joukko materiaaleja, joiden avulla pystyttiin osoittamaan, että suoratoimitusmallin avulla on mahdollista saavuttaa kustannussäätöjä varastoinnin osalta.

John W. Fisher Fonds, 1937-1961, 1964-1989, 1993, n.d.

Norah and Fred Fisher welcomed John Fisher into the world on November 29, 1912, not knowing what an influential role he would play in shaping Canada's history. John Fisher grew up as the middle child of five brothers and sisters in Frosty Hollow, New Brunswick, close to today’s town of Sackville. Sackville’s main industry was the Enterprise Foundry which the Fisher family owned and operated; however, Fisher had no plans of going into the family business. He was more inspired by his maternal grandfather, Dr. Cecil Wiggins, who lived with the family after retiring from the Anglican ministry. Wiggins encouraged all his grandchildren to be well read and to take part in discussions on current events. There were often visitors in the Fisher household taking part in discussions about politics, religion, and daily life. Fisher forced himself to take part in these conversations to help overcome his shyness in social settings. These conversations did help with his shyness and also in forming many opinions and observations about Canada. It put Fisher on the road to becoming Mr. Canada and delivering the many eloquent speeches for which he was known. Fisher did not venture far from home to complete his first degree. In 1934 he graduated from Mount Allison University in Sackville, NB with an Arts degree. The same year Fisher enrolled in Dalhousie’s law school. During his time at Dalhousie, Fisher discovered radio through Hugh Mills. Mills or “Uncle Mel” was on CHNS, Halifax’s only radio station at the time. Fisher began by making appearences on the radio drama show. By 1941 he had begun writing and broadcasting his own works and joined the staff as an announcer and continuity writer. In 1936 the Canadian Broadcasting Corporation was formed, the first National radio station. Fisher joined the CBC shortly after it’s beginning and remained with them, as well as the Halifax Herald newspaper, even after his law school graduation in 1937. By 1943 Fisher’s talks became a part of the CBC’s programming for a group of maritime radio stations. Fisher once described his talks as follows “my talks weren’t meant to be objective. . . they were meant to be favourable. They were ‘pride builders’” He began his famed John Fisher Reports at CBC Toronto when he transfered there shortly after the war. This program brought emmence pride to the fellow Canadians he spoke about leading to approximately 3500 requests per year to speak at banquets and meeting throughout Canada and the United States. Fisher was a well travelled indivdual who would draw on personal experiences to connect with his audience. His stories were told in simple, straight forward language for anyone to enjoy. He became a smooth, dynamic and passionate speaker who sold Canada to Canadians. He became a renowned journalist, folk historian, writer and broadcaster. Fisher was able to reach a vast array of people through his radio work and build Canadian pride, but he did not stop there. Other ways Fisher has contributed to Canada and the Canadian people include: Honoured by five Canadian Universities. 1956, became the Director of the Canadian Tourist Association. 1961, was appointed Special Assistant to the Prime Minister of Canada. 1963, Commissioner of the Centennial Commission (the Federal Agency Responsible for Canada’s 100th birthday) 1968, received the Service Medal , a coveted Order of Canada. President of John Fisher Enterprises Ltd., private consultant work, specializing in Centennial planning, broadcasts, lectures and promotion. John Fisher continued recording radio broadcasts even after his diagnosis with cancer. He would record 3 or 4 at a time so he was free to travel across Canada, the U.S., Europe and Mexico in search of treatments. Fisher passed away from the disease on February 15, 1981 and he is buried at Mount Pleasant Cemetery in Toronto.

Effects of Instruction on Walking and Turning Performance in Individuals with Parkinson's Disease

Parkinson’s disease (PD) is characterized by postural instability and gait impairment. Verbal instructions can reduce postural sway and improve gait performance in PD. For gait, this evidence is limited to unobstructed straight-path walking. As falls in PD often occur when turning, the purpose of this thesis was to determine if instructions can benefit turning performance in this population. Twelve individuals with PD performed two walking tasks (normal walking, walking with a 180 degree turn) under four instruction conditions (no instruction, take big steps, make larger trunk movements, focus on end and/or turn point). Task duration and trunk yaw and roll sway were calculated. In general, the results demonstrated that the instruction to take big steps improved performance for both tasks compared to providing no instruction or externally based instruction. These results suggest that instructions related to step amplitude may facilitate walking and turning performance in PD.

Canadian Niagara Power Glass Slide - Engineer Drawing of Sections of Discharge Tunnel

Consulting Engineer drawing of Sections of the Discharge Tunnel. Included in the drawing is the "cross section of tunnel with timbering" and "longitudinal section showing Timber in straight tunnel". Dated October 1902.

Maid of the Mist, Niagara, U.S.A.

The description of the image is "(6) Majestically Grand - the Falls from the 'Maid of the Mist,' Niagara, U.S.A.". The reverse of the image reads "You are on the deck of the small but sturdy little steamer that runs along near the foot of the falls. At this moment you are pretty nearly mid-stream, looking south. The American shore are up over your left shoulder. That tall, dark cliff at the extreme left of what you see is Goat Island. The people up there outlined against the sky look like dolls and no wonder; they are more than 160 feet above your head. Some of them are looking off over the unspeakable grandeurs of the Horseshoe Fall there at the right; some are without doubt looking down at the very boat and remarking that the passengers look like dolls. It is an awesome experience to go so near that never-ceasing downpour of waters from the sky. The air is full of the roar and iridescent spray, and it seems as if the boat must be drawn in under the overwhelming floods never to rise again. Yet, curiously enough, the river right around the boat is not so madly excited as you might expect. It seems more like some great creature, dazed, bewildered, stunned by some incredible experience and not yet quite aware of what has happened. (When it gets down into the Whirlpool Rapids, two miles below here, it is dramatically alive to its situation!) The gigantic curve of the cliffs, reaching in up-stream straight ahead, makes a contour line of over 3000 feet before it comes up against the Canadian banks on the west (right). Geologists say that the Falls ages ago must have been at least seven miles farther down the river (behind you) and have gradually won their way back. Even now the curve of the Horseshoe is worn away from two to four feet in a year. No wonder; 12, 000, 000 cubic feet of water (about 375, 000 tons) sweep over the rocks in one minute, and the same the next minute and the next and the next. See Niagara through the Stereoscope, with special maps locating all the landmarks about the Falls.

Serpentine Cattle Chute Gives Handling Advantages

The article discusses the efficiency of a curved chute as opposed to a straight chute when leading cattle into a conveyor restrainer. The article was published in The National Provisioner in 1984.

Wrestling Card - Earl McCready

The wrestler's name is Earl McCready and the number stamped on the reverse is 928. McCready was born in Lansdowne, Ontario and won three straight NCAA wrestling championships in the 1920s. He was dubbed the greatest amateur wrestler Canada ever produced. He went on to be a flag bearer at the 1928 Summer Olympics in Amsterdam and his honours included: Canadian Wrestling Hall of Fame, Canadian Sports Hall of Fame, US Wrestling Hall of Fame.