The role of gadoxetic acid as a paramagnetic contrast medium in the characterization and detection of focal liver lesions: a review

Recent studies have demonstrated that the use of paramagnetic hepatobiliary contrast agents in the acquisition of magnetic resonance images remarkably improves the detection and differentiation of focal liver lesions, as compared with extracellular contrast agents. Paramagnetic hepatobiliary contrast agents initially show the perfusion of the lesions, as do extracellular agents, but delayed contrast-enhanced images can demonstrate contrast uptake by functional hepatocytes, providing further information for a better characterization of the lesions. Additionally, this intrinsic characteristic increases the accuracy in the detection of hepatocellular carcinomas and metastases, particularly the small-sized ones. Recently, a hepatobiliary contrast agent called gadolinium ethoxybenzyl dimeglumine, that is simply known as gadoxetic acid, was approved by the National Health Surveillance Agency for use in humans. The authors present a literature review and a practical approach of magnetic resonance imaging utilizing gadoxetic acid as contrast agent, based on patients' images acquired during their initial experiment.

An ABC for decision making

The present study was aimed at proposing a systematic evaluation of cranial computed tomography, identifying the main aspects to be analyzed in order to facilitate the decision making process regarding diagnosis and management in emergency settings. The present descriptive study comprised a literature review at the following databases: Access Medicine and Access Emergency Medicine (McGraw- Hill Education); British Medical Journal Evidence Center; UptoDate; Bireme; PubMed; Lilacs; SciELO; ProQuest; Micromedex (Thomson Reuters); Embase. Once the literature review was completed, the authors identified the main diseases with tomographic repercussions and proposed the present system to evaluate cranial computed tomography images. An easy-to-memorize ABC system will facilitate the decision making in emergency settings, as it covers the main diseases encountered by intensivists and emergency physicians, and provides a sequential guidance about anatomical structures to be investigated as well as their respective alterations.

Abdominal tuberculosis: a radiological review with emphasis on computed tomography and magnetic resonance imaging findings

AbstractTuberculosis is a disease whose incidence has increased principally as a consequence of HIV infection and use of immunosuppressive drugs. The abdomen is the most common site of extrapulmonary tuberculosis. It may be confused with several different conditions such as inflammatory bowel disease, cancer and other infectious diseases. Delay in the diagnosis may result in significantly increased morbidity, and therefore an early recognition of the condition is essential for proper treatment. In the present essay, cases with confirmed diagnosis of abdominal tuberculosis were assessed by means of computed tomography and magnetic resonance imaging, demonstrating the involvement of different organs and systems, and presentations which frequently lead radiologists to a diagnostic dilemma. A brief literature review was focused on imaging findings and their respective prevalence.

Utilization of Incident Reporting in The Finnish Maritime Industry

Marine traffic is expected to increase rapidly in the future, both in the Baltic Sea and in the Gulf of Finland. As the number of vessels in the area increases, so does the risk of serious marine accidents. To help prevent such accidents in the future, the International Maritime Organization (IMO) has put forth the International Safety Management Code (the ISM Code), which aims to improve the safety of the vessels. The second work package of the Development of maritime safety culture (METKU) project investigates the effects of the ISM Code and potential areas of improvement in maritime safety. The first phase in the work package used a literature review to determine how maritime safety culture could be improved. Continuous improvement, management commitment and personnel empowerment and motivation were found to be essential. In the second phase, shipping companies and administrators were interviewed. It was discovered that especially incident reporting based on continuous improvement was felt to be lacking. This third phase aims to take a closer look at incident reporting and suggest improvements based on the findings. Both the IMO and national legislation encourage shipping companies in incident reporting, and on the national level a shared incident reporting system (ForeSea) is being pushed forward. The objective of this research project was to find out the IMO’s attitude towards incident reporting, to establish a theoretical framework of reference in incident reporting, and to observe how reporting is actually being employed on the seas. Existing incident reporting systems were also researched. The study was carried out using a literature review and the results previously gathered in interviews. The results of phase two were elaborated further for themes relating to incident reporting. According to the findings of this research, the theoretical background of incident reporting dates back to the early 20th century. Although some theories are widely accepted, some have also received criticism. The lack of a concise, shared terminology poses major difficulties in maritime incident reporting and in determining its efficiency. A central finding is the fact that existing incident reporting focuses mostly on information flow away from the ship, whereas the backward information flow is much less planned and monitored. In incident reporting, both nationally and internationally, stakeholders are plenty. The information produced by these parties is scattered, however, and thus not very usable. Based on this research, the centralizing of this information should be made a priority. Traditionally, the success of incident reporting has been determined statistically, from the number of reported incidents. Yet existing reporting systems have not been designed with such statistical analysis in mind, so different methodologies might yield a more comprehensive view. The previous findings of seafarers and management (including shipping companies and administration) having differing views on safety work and safety management were backed up by the results of this study. Seafarers find seamanship and storytelling important, while management wants a more systematic and broad approach on safety matters. The research project was carried out by the Centre for Maritime Studies of the University of Turku, in the Kotka unit (Maritime Logistics Research), with coordination by the Kotka Maritime Research Centre. The major financiers of the project were the European Union and the city of Kotka. The financing authority was the Regional Council of Päijät-Häme. Partners in the project were the shipping companies Finnlines Oyj, Kristina Cruises Oy, Meriaura Oy and VG-Shipping Oy, and the ports of Helsinki, Kotka and Hamina. The partners provided both funding for the project and information for the research.

Use of penetrometers in agriculture: a review

Soil physical quality can be easily and quickly evaluated by using simple equipment to identify levels of soil compaction. Hence, it is necessary to know the variables responsible for changes in the soil penetration resistance (SPR). The aim of this review is to identify the main factors related to the various equipment used for assessing SPR as a soil physical quality indicator in agriculture. This literature review describes the different types of equipment used and its relationship with SPR. A wide range of procedures, devices, and equipments are available. Much of variability in SPR results is related to the equipment model, cone angle and diameter, and penetration rate. Usually, restrictions to root growth are correlated with SPR values above 2-3 MPa. However, comparisons of SPR values obtained under different soil moisture regimes in the same soil type have provided conflicting results of difficult interpretation. In order to minimize these problems, there is a need for standardization of measurement procedures and interpretation, and/or correction of SPR values according to a soil water content of reference.

Strategic outsourcing of R&D: The location-specific advantages of India to the pharmaceutical industry

Companies are increasingly under pressure to be more efficient both in terms of costs and overall performance and thus, they seek new ways to develop their products and innovate. For pharmaceutical industry it can take several decades to launch a new drug to the markets. Since pharmaceutical industry is one of the most research-intensive industries, is outsourcing one way to enhance the R&D processes of such companies. It is said that outsourcing to offshore locations is vastly more challenging and complicated than any other exporting activity or inter-company relationship that has evoked a lot of discussion. By outsourcing strategically, companies must also thoroughly focus on transaction costs and core competences. Today, the suppliers are looked for beyond national boundaries and furthermore, the location of the outsourcing activity must also be thoroughly considered. Consequently, the purpose of this study is to analyze what is known of strategic outsourcing of pharmaceutical R&D to India. In order to meet the purpose of the study, this study tries to answer three sub-questions set to it: first, what is strategic outsourcing, second, why pharmaceutical companies utilize strategic outsourcing of R&D and last, why pharmaceutical companies select India as the location for outsourcing their R&D. The study is a qualitative study. The purpose of the study was approached by a literature review with systematic elements and sub-questions were analyzed through different relevant theories, such as theory of transaction costs, core competences and location advantages. Applicable academic journal articles were comprehensively included in the study. The data was collected from electronic journal article databases using key words and almost only peer-reviewed, as new as possible articles were included. Also both the reference list of the included articles and article recommendations from professionals generated more articles for inclusion. The data was analyzed through thematization that resulted in themes that illuminate the purpose of the study and sub-questions. As an outcome of the analysis, each of the theory chapters in the study represents one sub-question. The literature used in this study revealed that strategic outsourcing of R&D is increasingly used in pharmaceutical industry and the major motives to practice it has to do with lowering costs, accessing skilled labor, resources and knowledge and enhancing their quality while speeding up the introduction of new drugs. Mainly for the above-mentioned motives India is frequently chosen as the target location for pharma outsourcers. Still, the literature is somewhat incomplete in this complex phenomenon and more research is needed.

A Method for reducing throughput-time in industrial electronics

Lyhyet toimitusajat tuovat yrityksille kilpailuetua nopeasti muuttuvassa teollisuusympäristössä. Tämän diplomityön ensisijaisena tavoitteena on löytää kirjallisuuden avulla yrityksen käyttöön soveltuva menetelmä, joka soveltuu systemaattiseen läpimenoaikojen lyhentämiseen. Tärkeää on myös varmistaa valitun menetelmän soveltuvuus kohdeyrityksen ympäristöön. Työn toisena tavoitteena on ymmärtää, että minkälaisella panostuksella yhden päivän läpimenoaika voidaan saavuttaa. Kirjallisuustutkimuksen avulla on valittu tarkoitukseen sopiva toimintamalli. Menetelmä on testattu yhdellä tuotantolinjalla ja saadut tulokset sekä palaute osoittavat, että se näyttäisi soveltuvan kohdeyrityksen käyttöön. Tuotantolinjalle on tehty toimintasuunnitelma yhden päivän toimitusajan saavuttamiseksi vuoden 2013 aikana. Haasteen laajuutta koko kohdeyrityksessä on tutkittu erillisessä ideointisessiossa. Session tulosten perusteella on tehty prioriteettilista, joka antaa käsityksen toimitusajan merkittävän lyhentämisen vaatimuksista. Yleisesti ottaen kysynnän vaihtelun hallinta on suurin haaste, mutta useita ratkaisuvaihtoehtoja tämän hallitsemiseksi on tunnistettu.

DEVELOPING A CROWDSOURCED VIDEOGRAPHIC RESEARCH METHOD FOR CONSUMER CULTURE RESEARCH

The purpose of this study is to develop a crowdsourced videographic research method for consumer culture research. Videography provides opportunities for expressing contextual and culturally embedded relations. Thus, developing new ways to conduct videographic research is meaningful. This study develops the crowdsourced videographic method based on a literature review and evaluation of a focal study. The literature review follows a qualitative systematic review process. Through the literature review, based on different methodological, crowdsourcing and consumer research related literature, this study defines the method, its application process and evaluation criteria. Furthermore, the evaluation of the focal study, where the method was applied, completes the study. This study applies professional review with self-evaluation as a form of evaluation, drawing from secondary data including research task description, screenshots of the mobile application used in the focal study, videos collected from the participants, and self-evaluation by the author. The focal study is analyzed according to its suitability to consumer culture research, research process and quality. Definitions and descriptions of the research method, its process and quality criteria form the theoretical contribution of this study. Evaluating the focal study using these definitions underlines some best practices of this type of research, generating the practical contribution of this study. Finally, this study provides ideas for future research. First, defining the boundaries of the use of crowdsourcing in various parts of conducting research. Second, improving the method by applying it to new research contexts. Third, testing how changes in one dimension of the crowdsourcing models interact with other dimension. Fourth, comparing the quality criteria applied in this study to various other quality criteria to improve the method’s usefulness. Overall, this study represents a starting point for further development of the crowdsourced videographic research method.

Hissien tasonovien palotestauspalveluiden arviointi.

Elevator landing doors are fire tested to measure their fire resistance. The objective of this master’s thesis was to create a method to evaluate the fire tests and the organizations that provide these testing services. The main focus area was in creating accurate evaluation criteria and weighting the criteria. The thesis was formed by first presenting the reader with the literature review of the closest related theories. The theories which were chosen were systematic decision making, supplier selection, and make or buy and outsourcing theories. In the empirical section the created process of evaluating fire testing is presented, with analysis of the current situation of fire testing processes and evaluation methods. Evaluating fire testing services required two types of criteria to be formed, technical criteria to evaluate the technical requirements, and service criteria to evaluate the organization which was offering the testing service. These criteria formed the core for the evaluation process which consisted of five different phases that were developed based on the literature review. The process was tested to create best practices and to make improvement proposals accordingly. Systematical process for evaluating fire testing helps to recognize the most important technical and service related aspects. The created criteria can be also used in future to benchmark and monitor the situation of fire testing. The results of the process can be used when deciding whether to outsource the service or to keep it in-house.

Ensuring the efficient utilization of Business Intelligence

In recent years, chief information officers (CIOs) around the world have identified Business Intelligence (BI) as their top priority and as the best way to enhance their enterprises competitiveness. Yet, many enterprises are struggling to realize the business value that BI promises. This discrepancy causes important questions, for example: what are the critical success factors of Business Intelligence and, more importantly, how it can be ensured that a Business Intelligence program enhances enterprises competitiveness. The main objective of the study is to find out how it can be ensured that a BI program meets its goals in providing competitive advantage to an enterprise. The objective is approached with a literature review and a qualitative case study. For the literature review the main objective populates three research questions (RQs); RQ1: What is Business Intelligence and why is it important for modern enterprises? RQ2: What are the critical success factors of Business Intelligence programs? RQ3: How it can be ensured that CSFs are met? The qualitative case study covers the BI program of a Finnish global manufacturer company. The research questions for the case study are as follows; RQ4: What is the current state of the case company’s BI program and what are the key areas for improvement? RQ5: In what ways the case company’s Business Intelligence program could be improved? The case company’s BI program is researched using the following methods; action research, semi-structured interviews, maturity assessment and benchmarking. The literature review shows that Business Intelligence is a technology-based information process that contains a series of systematic activities, which are driven by the specific information needs of decision-makers. The objective of BI is to provide accurate, timely, fact-based information, which enables taking actions that lead to achieving competitive advantage. There are many reasons for the importance of Business Intelligence, two of the most important being; 1) It helps to bridge the gap between an enterprise’s current and its desired performance, and 2) It helps enterprises to be in alignment with key performance indicators meaning it helps an enterprise to align towards its key objectives. The literature review also shows that there are known critical success factors (CSFs) for Business Intelligence programs which have to be met if the above mentioned value is wanted to be achieved, for example; committed management support and sponsorship, business-driven development approach and sustainable data quality. The literature review shows that the most common challenges are related to these CSFs and, more importantly, that overcoming these challenges requires a more comprehensive form of BI, called Enterprise Performance Management (EPM). EPM links measurement to strategy by focusing on what is measured and why. The case study shows that many of the challenges faced in the case company’s BI program are related to the above-mentioned CSFs. The main challenges are; lack of support and sponsorship from business, lack of visibility to overall business performance, lack of rigid BI development process, lack of clear purpose for the BI program and poor data quality. To overcome these challenges the case company should define and design an enterprise metrics framework, make sure that BI development requirements are gathered and prioritized by business, focus on data quality and ownership, and finally define clear goals for the BI program and then support and sponsor these goals.

ICT-varautumisen analyysi ja kehittäminen julkisen sektorin virastossa

Lainsäädäntö velvoittaa valtionhallintoa huolehtimaan riittävästä ICT-varautumisesta, jotta yhteiskunnan kriittiset toiminnot ovat turvattu normaaliolojen lisäksi normaaliolojen häiriötilanteissa ja poikkeusoloissa. ICT-varautumisen vaatimukset on määrätty VAHTI ICT-varautumisen vaatimukset - ohjeessa. ICT-varautuminen on riskienhallintaan perustuvaa toimintaa, joka liittyy keskeisesti organisaation kokonaisturvallisuuteen, tietohallintoon ja yleiseen varautumiseen. Tutkielman teoriakatsauksessa perehdytään riskienhallintaan ja kokonaisturvallisuuteen painottaen ICT-varautumisen kannalta tärkeitä osa-alueita tietoturvallisuutta ja IT-riskienhallintaa. Kohdeorganisaation ICT-varautumisen toimintajärjestelmää varten kartoitetaan ICT-varautumisen viitekehys. Empiirisessä osiossa toteutetaan tapaustutkimuksena kohdeorganisaation ICT-varautumisen nykytilan suppea analyysi ja laaditaan kehittämisehdotelmana toimintamalli ICT-varautumisen organisoimiseksi ja käyttöönottamiseksi. Tutkielman tuotoksena kohdeorganisaatiolla on systemaattinen organisaation eri tasot huomioiva toimintamalli ICT-varautumisen toteuttamiseksi.

Building a Roadmap for a Market Intelligence function in a Global B2B company

Tämän diplomityötutkimuksen tarkoituksena on luoda markkinaälyyn (MI) erikoistunut funktio suurelle, globaalisti toimivalle B2B-yritykselle. Tämän päivän muut-tuvilla markkinoilla, teollisuusyrityksen on oltava markkinalähtöinen selviytyäkseen. Markkinatiedon tehokas hyödyntäminen ei pelkästään luo tietoa markkinoista, vaan tuottaa kilpailukykyistä tietoa ja toimii strategisen päätöksenteon tukena pitkällä aikavälillä. Tämä tutkimus on kvalitatiivinen toimintatutkimus, joka sisältää kirjallisuuskat-sauksen, yritystapaustutkimuksen sekä syväanalyysin yrityksen MI-ympäristöstä. Kirjallisuuskatsaus pitää sisällään teoriaa liittyen markkinaälyyn useassa eri kon-tekstissa, asiakassuhteeseen, sekä prosessinmallintamiseen. Empiiriseen osaa seuraa tutkimusmenetelmäkappale, joka sisältää kaksivaiheisen tutkimuksen mukaan lu-kien 20 päällikkötason haastattelua sekä yhden laaja-alaisen työryhmätapaamisen. Työn tuloksena syntyy kolmivaiheinen tiekartta, jonka tarkoitus on toimia pohjana uuden MI-funktion rakentamiselle Case-yrityksessä. Tuloksen mukaan MI-funktio tulisi sijoittaa yrityksen asiakasrajapintaan sekä tukea yksiköiden välistä integraa-tiota. Markkinaälyn jakaminen yrityksen sisällä vaatii käytäntöjen, tarpeiden ja ta-voitteiden systemaattista viestintää eri organisaatiotasoille, jotta yritys voi edelleen saada asiakkaalta tarpeeseen vastaavaa tietoa. Viestintä yrityksen ja asiakkaan välil-lä on oltava molemminpuolista, jotta tulokset voisivat parantaa asiakassuhdetta. Kun asiakassuhde paranee, yritys voi oppia asiakkaalta arvokasta tietoa, markkinaälyä.

HPV vaccines: a controversial issue?

Controversy still exists over whether the benefits of the available HPV vaccines outweigh the risks and this has suppressed uptake of the HPV vaccines in comparison to other vaccines. Concerns about HPV vaccine safety have led some physicians, healthcare officials and parents to withhold the recommended vaccination from the target population. The most common reason for not administering the prophylactic HPV vaccines are concerns over adverse effects. The aim of this review is the assessment of peer-reviewed scientific data related to measurable outcomes from the use of HPV vaccines throughout the world with focused attention on the potential adverse effects. We found that the majority of studies continue to suggest a positive risk-benefit from vaccination against HPV, with minimal documented adverse effects, which is consistent with other vaccines. However, much of the published scientific data regarding the safety of HPV vaccines appears to originate from within the financially competitive HPV vaccine market. We advocate a more independent monitoring system for vaccine immunogenicity and adverse effects to address potential conflicts of interest with regular systematic literature reviews by qualified individuals to vigilantly assess and communicate adverse effects associated with HPV vaccination. Finally, our evaluation suggests that an expanded use of HPV vaccine into more diverse populations, particularly those living in low-resource settings, would provide numerous health and social benefits.

Tilintarkastuksen odotuskuilu ja keinot odotuskuilun kaventamiseen kansainvälisten tieteellisten tutkimusten näkökulmasta

Tilintarkastuksen odotuskuilua on tutkittu pitkään ja yhtämittaisesti jo vuosikymmenten ajan ympäri maailmaa. Kansainvälisiä tutkimuksia tilintarkastuksen odotuskuilusta on valtava määrä, mutta tutkimustulokset odotuskuilun muodostumiseen vaikuttavista syistä ovat osittain epäselviä. Tämän pro gradu -tutkielman tavoitteena on koota yhteen kansainvälisten tutkimusten tuloksien pohjalta keskeisimmät syyt odotuskuilun muodostumiselle ja keinot odotuskuilun kaventamiseen käyttäen lähdemateriaalina 2000-luvulla ja sen jälkeen julkaistuja tutkimuksia. Tutkimus on toteutettu systemaattisena kirjallisuuskatsauksena. Lähdeaineisto haettiin systemaattisesti EBSCO-tietokannasta, jonka kautta lopulliseen aineistoon valikoitui yhteensä 31 tutkimusta. Tutkimustulokset osoittavat, että tilintarkastuksen odotuskuilu muodostuu ensisijaisesti johtuen yleisön kohtuuttomista odotuksista ja yleisön tietämättömyydestä tilintarkastajien velvollisuuksista. Todennäköisinä keinoina odotuskuilun kaventamisessa ovat tilintarkastusraportoinnin laajentaminen sekä yleisön kouluttaminen erityisesti tilintarkastajien roolista heitä koskevista velvollisuuksista. Tutkimustulokset eivät kuitenkaan osoittaneet yksimielistä keinoa siihen, kuinka yleisön kouluttaminen pitäisi toteuttaa.