Critical leg ischaemia with tissue loss : a challenge for the vascular surgeon

There is a widespread reporting habit of combining the outcomes for patients with rest pain (Fontaine III) and tissue loss (Fontaine IV) under the single category of critical leg ischaemia (CLI). This study focused on patients with ischaemic tissue loss treated with infrainguinal bypass surgery (IBS). All patients included in the study were treated at Helsinki University Central Hospital in 2000-2007. First, ulcer healing time after IBS and factors influencing healing time were prospectively assessed in 2 studies including 148 and 110 patients, respectively. Second,the results of redo IBS were retrospectively evaluated in 593 patients undergoing primary IBS for CLI with tissue loss . Third,long-term outcome were retrospectively analysed in 636 patients who underwent IBS for CLI with tissue loss . Fourth, the outcome of IBS was retrospectively compared with endovascular treatment (PTA) of the infrapopliteal arteries in 1023 CLI patients. Fifth, the influence multidrug resistant Pseudomans aeruginosa (MDR Pa) bacteria contamination in CLI patients treated with IBS was retropectively assessed. Sixty-four patients with positive MDR Pa -culture were matched with 64 MDR Pa - negative controls. Complete ulcer healing rate, including the ischemic ulcers and incisional wounds, was 40% at 6 months after IBS and 75% at one year. Diabetes was a risk factor for prolonged complete ulcer healing time. Ischaemic tissue lesions located in mid-and hindfoot healed poorly. At one year after IBS 50% of the patients were alive with salvaged leg and completely healed ulcers. The absence of gap between tertiary graft patency and leg salvage rates indicates the importance of a patent infrainguinal graft to save a leg with ischaemic tissue loss. Long-term survival for patients with ischaemic tissue loss was poor, 38% at 5 years. Only 30% of the patients were alive without amputation at 5 years. Several of the patient comorbidities increased independently the mortality risk; coronary artery disease, renal insufficiency, chronic obstructive lung disease and high age. When both PTA and bypass is feasible, infrapopliteal PTA as a first-line strategy is expected to achieve similar long-term results to bypass surgery in CLI when redo surgery is actively utilized. MDR Pa in a patient with CLI should be considered as a serious event with increased risk of early major amputation or death. Conclusion: Despite a successful infrainguinal bypass healing of the ischaemic ulcers and incisional wounds ulcer healing is a slow process especially in diabetics. Bypass surgery and PTA improve the outcome of the ischaemic leg but the mortality rate of the patients is high due to their severe comorbidities.

Suomi toisena kielenä vai lukivaikeus? : Luokanopettajien käsityksiä oppilaiden kielellisistä vaikeuksista

Goals. Immigrant pupils are over-represented in special education. Linguistic difficulties are the most pivotal reasons for social exclusion of immigrant pupils during their school career. Addedly reading, writing, and language development disorders are the most common reasons for both part-time and extensive special education. I studied class teachers' perceptions of the typical linguistic difficulties of pupils who speak Finnish as their second language and of those who have dyslexia, because I suspect that telling the difference between linguistic competency in progress and the symptoms of dyslexia isn't easy. I look for overlappings in the perceptions of linguistic difficulties, their causes and their support measures, which would reveal the challenges in recognizing linguistic difficulties, which in turn might partly explain why immigrant pupils are over-represented in special education. Methods. This study was carried out as structured individual interviews with nine class teachers from the Helsinki Metropolitan Area. To increase reliability, complementary information was gathered about the same phenomenon with a questionnaire that each interviewee filled out at the end of the interview. It was required that the interviewees have experience of teaching both dyslexic pupils and pupils who speak Finnish as a second language. The material analysis was mainly deductive, but the material that wasn't in line with the theoretical frame of reference was analyzed inductively. Results and conclusions. There were overlappings in the class teachers' perceptions of the linguistic difficulties, support measures fitting them and, based on the questionnaire results, also of the causes of these difficulties. Additionally all the interviewees said it to be difficult to recognize dyslexia in a pupil who speaks Finnish as a second language. I came to the conclusion that distinguishing different linguistic difficulties from one another is a challenge to which class teachers don't always feel competent to rise, which is why they consider the assistance of special teachers and other professionals beneficial.

Second harmonic generation in some donor-acceptor ethylenes—I

We report the absorption spectra, oscillator strengths, ground state and excited state dipole moments, and molecular second order polarizability coefficients (βCT) due to donor—acceptor charge transfer in four trisubstituted ethylenes, namely 1,1-bisdimethylamino-2-nitroethylene, 1,1-bispyrolidino-2-nitroethylene, 1,1-bispiperidino-2-nitroethylene and 1,1-bismorpholino-2-nitroethylene. The results are compared with that of trans-N,N-dimethylamino-nitroethylene, which has a large βCT. The powder second harmonic generation (SHG) intensity of all these molecules is also measured and only 1,1-bispiperidino-2-nitroethylene is found to possess an efficiency of 20% of that of urea under the same conditions. The SHG efficiency of this compound and deficiency in the other molecules in the powdered state is discussed in terms of their arrangements in the unit cell. The crystal structure of the active molecule is also presented and the structure—property relationship is critically examined in all these molecules.

New results on systems with second-class constraints

We show how, for large classes of systems with purely second-class constraints, further information can be obtained about the constraint algebra. In particular, a subset consisting of half the full set of constraints is shown to have vanishing mutual brackets. Some other constraint brackets are also shown to be zero. The class of systems for which our results hold includes examples from non-relativistic particle mechanics as well as relativistic field theory. The results are derived at the classical level for Poisson brackets, but in the absence of commutator anomalies the same results will hold for the commutators of the constraint operators in the corresponding quantised theories.

Gauge-invariant reformulation of theories with second-class constraints

Given a classical dynamical theory with second-class constraints, it is sometimes possible to construct another theory with first-class constraints, i.e., a gauge-invariant one, which is physically equivalent to the first theory. We identify some conditions under which this may be done, explaining the general principles and working out several examples. Field theoretic applications include the chiral Schwinger model and the non-linear sigma model. An interesting connection with the work of Faddeev and Shatashvili is pointed out.

Crumpling and second sound in lyotropic lamellar phases

We study relative concentration fluctuations in two component lamellar smectic liquid crystals consisting of surfactant layers of width w separated by a background fluid and show that these fluctuations are dominated by crumpling fluctuations of the surfactant layers when (w/l)2

Three Dimensional Line-Clipping by Systematic Enumeration

Three dimensional clipping is a critical component of the 3D graphics pipeline. A new 3D clipping algorithm is presented in this paper. An efficient 2D clipping routine reported earlier has been used as a submodule. This algorithm uses a new classification scheme for lines of all possible orientations with respect to a rectangular parallelopiped view volume. The performance of this algorithm has been evaluated using exact arithmetic operation counts. It is shown that our algorithm requires less arithmetic operations than the Cyrus-Beck 3D clipping algorithm in all cases. It is also shown that for lines that intersect the clipping volume, our algorithm performs better than the Liang-Barsky 3D clipping algorithm.

Effect of tolerance on the propagation characteristic of a superconducting thin film microstrip delay line

The propagation constant of a superconducting microstrip transmission delay line is evaluated using the spectral domain immitance approach, modelling the superconductor as a surface current having an equivalent surface impedance found through the complex resistive boundary condition. The sensitivity approach is used to study the beta variations with substrate parameters and film characteristics. Results show that the surface impedance does not have much influence on beta sensitivities with respect to epsilon r, W and h. However, it can be observed that the surface impedance plays a crucial role in determining the optimum design.

High Pressure NMR Study of Ammonium Thiocyanate

Wide-line proton NMR spectra of ammonium thiocyanate have been recorded at 77 K as a function of external hydrostatic pressure. Contrary to expectations the line-width and the second moment decrease with the increase of pressure. This, however, is in accordance with the anomalous behaviour observed in other magnetic resonance studies of this compound and can be understood in terms of the change of electron density around the nitrogen atom of the SCN- group.

Suomussalmen varhaisproterotsooisten diabaasien mineralogia tektonisessa tulkinnassa

The object of this research is to study the mineralogy of the diabase dykes in Suomussalmi and the relevance of the mineralogy to tectonic events, specifically large block movements in the Archaean crust. Sharp tectonic lines separate two anomalies in the dyke swarms, shown on a geomagnetic map as positive anomalies. In one of these areas, the Toravaara anomaly, the diabases seem to contain pyroxenes as a main component. Outside the Toravaara anomaly hornblende is the main ferromagnesian mineral in diabases. The aim of this paper is to research the differences in the diabases inside and outside the anomalies and interpret the processes that formed the anomalies. The data for this sudy consist of field observations, 120 thin sections, 334 electron microprobe analyses, 19 whole-rock chemical analyses, a U-Pb age analysis and geomagnetic low-altitude aerial survey maps. The methods are interpretation of field observations, chemical analyses, microprobe analyses of single minerals and radiometric age determination, microscopic studies of the thin sections, geothermometers and geobarometers. On the basis of field observations and petrographic studies the diabases in the area are divided into pyroxene diabases, hornblende diabases and the Lohisärkkä porphyritic dyke swarm. Hornblende diabases are found in the entire study area, while the pyroxene diabases concentrate on the area of the Toravaara geomagnetic anomaly. The Lohisärkkä swarm transects the whole area as a thin line from east to west. The diabases are fairly homogenous both chemically and by mineral composition. The few exceptions are part of rarer older swarms or are significantly altered. The Lohisärkkä dyke swarm was dated as 2,21 Ga old, significantly older than the most common 1,98 Ga swarm in the area. The geothermometers applied showed that the diabases on the Toravaara anomaly were stabilized at a much higher temperature than the dykes outside the anomaly. The geobarometers showed the pyroxenes to have crystallized at varying depths. The research showed the Toravaara anomaly to have formed by a vertical block movement, and the fault on its west side to have a total lateral transfer of only a few kilometers. The formation of the second anomaly was also interpreted to be tectonic in nature. In addition, the results of the geothermobarometry uncovered necessary conditions for the study of diabase emplacement depth: the minerals for the study must be chosen by minimum crystallization depth, and a geobarometer capable of determining the magmatic temperature must be used. In addition, it would be more suitable to conduct this kind of study in an area where the dykes are more exposed.

X-ray diffraction line profile analysis of deformation microstructure in boron modified Ti-6Al-4V alloy

X-ray diffraction line profile analysis (XRDLPA) techniques have been applied to investigate the deformed microstructure of a recently developed boron modified two-phase titanium alloy Ti-6Al-4V. The alloy was hot compressed at 750 degrees C up to 50% height reduction at two different strain rates (10(-3) S-1 and 1 S-1). Microstructural parameters like average domain size, average microstrain within the domain and dislocation density of the two phases were determined using X-ray diffraction line profile analysis. The results indicate an increase in the microstrain and dislocation density for the alpha-phase and decrease for the beta-phase in the case of boron modified alloys as compared to the normal material. Microstructural modifications viz, the grain refinement and the presence of hard, brittle TiB particles in the case of boron modified alloy are held responsible for the observed difference in the dislocation density. (C) 2010 Elsevier Inc. All rights reserved.

Second harmonic generation in poled molecularly doped polymer films : Push-pull butadienes in poly(methyl methacrylate) and polystyrene

We report second harmonic generation in a new class of organic materials, namely donor-acceptor substituted all-trans butadienes doped in poly(methyl methacrylate) or polystyrene and oriented by corona poling at elevated temperatures. Second harmonic measurements were made at room temperature. The observed d33 coefficients are greater than those of potassium dihydrogen phosphate or 4-dimethylamino-4'-nitrostilbene doped in similar polymer matrices. Rotational diffusion coefficients estimated from the decay characteristics of the second harmonic intensity in the polymer films indicate that the polymer matrix plays a major role in stabilizing the dopants in a nonlinear optics conducive environment.

1H NMR study of molecular dynamics and phase transition in (NH4)2ZnBr4

The proton second moment (M2) and spin-lattice relaxation time (T1) have been measured in (NH4)2ZnBr4 in the range 77-300 K. The room-temperature spectrum shows a structure which disappears around 243 K. The signal is strong and narrow even at 77 K. Proton T1 shows a maximum at 263 K, caused by spin rotation interaction and decreases with decreasing temperature till 235 K, where it shows a sudden increase. Below 235 K, again it decreases and shows a slope change around 216.5 K (reported Tc). From 216.5 K, T1 decreases continuously without exhibiting any minimum down to 77 K. The narrow line at 77 K, and absence of a T1 minimum down to 77 K indicate the possibility of quantum mechanical tunnelling in this system. Motional parameters such as activation energy and pre-exponential factor have been evaluated for the reorientational motion of the NH+4 ion.

Molecular Dynamics Simulations of Orientational Relaxation in Dipolar Lattice: Lack of Diffusive Decay for Second and Higher Rank Correlation Functions

Extensive molecular dynamics simulations have been carried out to calculate the orientational correlation functions Cl(t), G(t) = [4n/(21 + l)]Ci=-l (Y*lm(sZ(0)) Ylm(Q(t))) (where Y,,(Q) are the spherical harmonics) of point dipoles in a cubic lattice. The decay of Cl(t) is found to be strikingly different from higher l-correlation functions-the latter do not exhibit diffusive dynamics even in the long time. Both the cumulant expansion expression of Lynden-Bell and the conventional memory function equation provide very good description of the Cl(t) in the short time but fail to reproduce the observed slow, long time decay of c1 (t) .

Bayesian Learning for Joint Sparse OFDM Channel Estimation and Data Detection

The impulse response of a typical wireless multipath channel can be modeled as a tapped delay line filter whose non-zero components are sparse relative to the channel delay spread. In this paper, a novel method of estimating such sparse multipath fading channels for OFDM systems is explored. In particular, Sparse Bayesian Learning (SBL) techniques are applied to jointly estimate the sparse channel and its second order statistics, and a new Bayesian Cramer-Rao bound is derived for the SBL algorithm. Further, in the context of OFDM channel estimation, an enhancement to the SBL algorithm is proposed, which uses an Expectation Maximization (EM) framework to jointly estimate the sparse channel, unknown data symbols and the second order statistics of the channel. The EM-SBL algorithm is able to recover the support as well as the channel taps more efficiently, and/or using fewer pilot symbols, than the SBL algorithm. To further improve the performance of the EM-SBL, a threshold-based pruning of the estimated second order statistics that are input to the algorithm is proposed, and its mean square error and symbol error rate performance is illustrated through Monte-Carlo simulations. Thus, the algorithms proposed in this paper are capable of obtaining efficient sparse channel estimates even in the presence of a small number of pilots.