Did Dumbo suffer a heart attack? independent association between earlobe crease and cardiovascular disease.

BACKGROUND: Earlobe crease (ELC) has been associated with cardiovascular diseases (CVD) or risk factors (CVRF) and could be a marker predisposing to CVD. However, most studies studied only a small number of CVRF and no complete assessment of the associations between ELC and CVRF has been performed in a single study. METHODS: Population-based study (n = 4635, 46.7 % men) conducted between 2009 and 2012 in Lausanne, Switzerland. RESULTS: Eight hundred six participants (17.4 %) had an ELC. Presence of ELC was associated with male gender and older age. After adjusting for age and gender (and medication whenever necessary), presence of ELC was significantly (p < 0.05) associated with higher levels of body mass index (BMI) [adjusted mean ± standard error: 27.0 ± 0.2 vs. 26.02 ± 0.07 kg/m(2)], triglycerides [1.40 ± 0.03 vs. 1.36 ± 0.01 mmol/L] and insulin [8.8 ± 0.2 vs. 8.3 ± 0.1 μIU/mL]; lower levels of HDL cholesterol [1.61 ± 0.02 vs. 1.64 ± 0.01 mmol/L]; higher frequency of abdominal obesity [odds ratio and (95 % confidence interval) 1.20 (1.02; 1.42)]; hypertension [1.41 (1.18; 1.67)]; diabetes [1.43 (1.15; 1.79)]; high HOMA-IR [1.19 (1.00; 1.42)]; metabolic syndrome [1.28 (1.08; 1.51)] and history of CVD [1.55 (1.21; 1.98)]. No associations were found between ELC and estimated cardiovascular risk, inflammatory or liver markers. After further adjustment on BMI, only the associations between ELC and hypertension [1.30 (1.08; 1.56)] and history of CVD [1.47 (1.14; 1.89)] remained significant. For history of CVD, further adjustment on diabetes, hypertension, total cholesterol and smoking led to similar results [1.36 (1.05; 1.77)]. CONCLUSION: In this community-based sample ELC was significantly and independently associated with hypertension and history of CVD.

Le sentiment de gratitude en soins palliatifs : un facteur contribuant au bien-être et à la qualité de vie ? [Gratitude in palliative care: is it a psychological factor contributing to well-being and quality of life?]

En s'appuyant sur la littérature scientifique et l'état de la recherche, cet article a pour objectif de montrer pourquoi la prise en compte du sentiment de gratitude peut s'avérer utile dans le contexte palliatif en mettant en évidence dans quelle mesure cette émotion ou disposition individuelle: 1) entre en résonance avec le concept de croissance posttraumatique et certains enjeux relationnels chez les patients en fin de vie; 2) représente un facteur favorisant le bien-être et la qualité de vie; 3) peut être considérée comme un facteur protecteur contre les troubles psychopathologiques. Based on the scientific literature and the state of research, this article aims to show why the feeling of gratitude may represent a point of interest for palliative care. We will highlight the following in this article: 1) why this feeling of gratitude resonates with the concept of post-traumatic growth and relational challenges in end-of-life patients; 2) in which measure this feeling represents a factor contributing to well-being and quality of life; 3) in which measure this feeling may be considered as a protective factor against psychopathological troubles.

Cost-effectiveness analysis of cardiac resynchronization therapy in patients with NYHA I and NYHA II heart failure in Spain

Objectives: The aim of the study was to combine clinical results from the European Cohort of the REVERSE study and costs associated with the addition of cardiac resynchronization therapy (CRT) to optimal medical therapy (OMT) in patients with mild symptomatic (NYHA I-II) or asymptomatic left ventricular dysfunction and markers of cardiac dyssynchrony in Spain. Methods: A Markov model was developed with CRT + OMT (CRT-ON) versus OMT only (CRT-OFF) based on a retrospective cost-effectiveness analysis. Raw data was derived from literature and expert opinion, reflecting clinical and economic consequences of patient"s management in Spain. Time horizon was 10 years. Both costs (euro 2010) and effects were discounted at 3 percent per annum. Results: CRT-ON showed higher total costs than CRT-OFF; however, CRT reduced the length of hospitalization in ICU by 94 percent (0.006 versus 0.091 days) and general ward in by 34 percent (0.705 versus 1.076 days). Surviving CRT-ON patients (88.2 percent versus 77.5 percent) remained in better functional class longer, and they achieved an improvement of 0.9 life years (LYGs) and 0.77 years quality-adjusted life years (QALYs). CRT-ON proved to be cost-effective after 6 years, except for the 7th year due to battery depletion. At 10 years, the results were 18,431 per LYG and 21,500 per QALY gained. Probabilistic sensitivity analysis showed CRT-ON was cost-effective in 75.4 percent of the cases at 10 years. Conclusions: The use of CRT added to OMT represents an efficient use of resources in patients suffering from heart failure in NYHA functional classes I and II.

Digital evidence, 'absence' of data and ambiguous patterns of reasoning

In this paper we discuss the use of digital data by the Swiss Federal Criminal Court in a recent case of attempted homicide. We use this case to examine drawbacks for the defense when the presentation of scientific evidence is partial, especially when the only perspective mentioned is that of the prosecution. We tackle this discussion at two distinct levels. First, we pursue an essentially non-technical presentation of the topic by drawing parallels between the court's summing up of the case and flawed patterns of reasoning commonly seen in other forensic disciplines, such as DNA and particle traces (e.g., gunshot residues). Then, we propose a formal analysis of the case, using elements of probability and graphical probability models, to justify our main claim that the partial presentation of digital evidence poses a risk to the administration of justice in that it keeps vital information from the defense. We will argue that such practice constitutes a violation of general principles of forensic interpretation as established by forensic science literature and current recommendations by forensic science interest groups (e.g., the European Network of Forensic Science Institutes). Finally, we posit that argument construction and analysis using formal methods can help replace digital evidence appropriately into context and thus support a sound evaluation of the evidence.

The uncertain relationship between transparency and accountability revisited through four Swiss cases

Accountability and transparency are of growing importance in contemporary governance. The academic literature have broadly studied the two concepts separately, defining and redefining them, and including them into various framework, sometimes mistakenly using them as synonyms. The relationship between the two concepts has, curiously, only been studied by a few scholars with preliminary approaches. This theoretical paper will focus on both concepts, trying first to describe them taking into account the various evolutions in the literature and the recent evolutions as well as the first attempts to link the two concepts. In order to show a new approach linking the concepts, four cases from the Swiss context will be portrayed and will demonstrate the necessity to reconsider the relationship between transparency and accountability. Consequently, a new framework, based on Fox's framework (2007) will be presented and theoretically delimited.

Sovereigns and banks in the euro area : a tale of two crises

This study attempts to identify and trace inter-linkages between sovereign and banking risk in the euro area. To this end, we use an indicator of banking risk in each country based on the Contingent Claim Analysis literature, and 10-year government yield spreads over Germany as a measure of sovereign risk. We apply a dynamic approach to testing for Granger causality between the two measures of risk in 10 euro area countries, allowing us to check for contagion in the form of a significant and abrupt increase in short-run causal linkages. The empirical results indicate that episodes of contagion vary considerably in both directions over time and within the different EMU countries. Significantly, we find that causal linkages tend to strengthen particularly at the time of major financial crises. The empirical evidence suggests the presence of contagion, mainly from banks to sovereigns.

Coolant Flow and Heat Transfer in Pebble-Bed Reactor Core

This thesis gathers knowledge about ongoing high-temperature reactor projects around the world. Methods for calculating coolant flow and heat transfer inside a pebble-bed reactor core are also developed. The thesis begins with the introduction of high-temperature reactors including the current state of the technology. Process heat applications that could use the heat from a high-temperature reactor are also introduced. A suitable reactor design with data available in literature is selected for the calculation part of the thesis. Commercial computational fluid dynamics software Fluent is used for the calculations. The pebble-bed is approximated as a packed-bed, which causes sink terms to the momentum equations of the gas flowing through it. A position dependent value is used for the packing fraction. Two different models are used to calculate heat transfer. First a local thermal equilibrium is assumed between the gas and solid phases and a single energy equation is used. In the second approach, separate energy equations are used for the phases. Information about steady state flow behavior, pressure loss, and temperature distribution in the core is obtained as results of the calculations. The effect of inlet mass flow rate to pressure loss is also investigated. Data found in literature and the results correspond each other quite well, considered the amount of simplifications in the calculations. The models developed in this thesis can be used to solve coolant flow and heat transfer in a pebble-bed reactor, although additional development and model validation is needed for better accuracy and reliability.

Fama y verdad en la épica quinientista española. El virgilianismo político y la tradición castellana del siglo xv

Fame and truth in Spanish XVth century epic. !e political vergilianism and the castilian tradition of the XVth century. The starting premise of this essay is that the Spanish Golden Age epic must be read from a historical perspective that takes into account the Hispanic literary tradition ofthe XVth century. In particular, it argues that epic should be approached from a theoretical perspective that explores its relationship with history in order to illuminate the diferences between Italian and Spanish epic theory and practice in the XVth century. The relationship between the discourses of epic and history can be explained through the imitation of the Vergilian model, specifically the Aeneid´s ideological representation of empire. However, it is also necessary to consider theoretical aspects in the light of the diferent uses of classical literature by Italian humanists and Castilian writers of the XV th century. Thus, its primary thesis is that although XVI th century Spanish epic shares the general principles of the Western Epic tradition, it should be approached from a specifically perspective Hispanic, in the light of the «political vergilianism» already enshrined in authors like Enrique de Villena and Juan de Mena, which is essential to appreciate how epic genre serves as memory for the present

Soveltuvuuden arviointiperusteet kansallisissa julkisissa hankinnoissa

Osallistuessaan julkisten hankintojen tarjouskilpailuun yritys pyrkii tekemään tarjouksen, jolla se voittaa kilpailun. Ennen tarjousten vertailua yrityksen soveltuvuus arvioidaan tarjoajien valinnassa. Tutkimuksen tavoite on selvittää miten yritys voi varmistaa tarjousvertailuun pääsyn. Tutkimusmenetelmänä on lainoppi. Empiirisessä osiossa aineistona ovat hankintailmoitukset ja -aineistot, joita analysoidaan kvalitatiivisen tutkimuksen keinoin. Lain, lainvalmisteluaineiston, oikeuskirjallisuuden ja oikeuskäytännön perusteella muodostetaan peilaavan vastauksen malli. Yritys varmistaa jatkoon pääsyn, kun se tarjouksessaan kuvaa resurssinsa peilaten hankintayksikön ilmoittamia vaatimuksia sekä toimittaa vaaditut liiteasiakirjat määräajassa. Aineiston perusteella mallin todetaan toimivan silloin, kun myös hankintayksikkö toimii mallin odotusten mukaan. Kun hankintayksikkö ei toimi mallin oletusten mukaisesti, yrityksen mallin mukaista toimintaa ei voi arvioida.

The maximum voltage drop in an on-chip power distribution network: analysis of square, triangular and hexagonal power pad arrangements

A mathematical model of the voltage drop which arises in on-chip power distribution networks is used to compare the maximum voltage drop in the case of different geometric arrangements of the pads supplying power to the chip. These include the square or Manhattan power pad arrangement, which currently predominates, as well as equilateral triangular and hexagonal arrangements. In agreement with the findings in the literature and with physical and SPICE models, the equilateral triangular power pad arrangement is found to minimize the maximum voltage drop. This headline finding is a consequence of relatively simple formulas for the voltage drop, with explicit error bounds, which are established using complex analysis techniques, and elliptic functions in particular.

Success factors of customer and supplier master data system

Especially in global enterprises, key data is fragmented in multiple Enterprise Resource Planning (ERP) systems. Thus the data is inconsistent, fragmented and redundant across the various systems. Master Data Management (MDM) is a concept, which creates cross-references between customers, suppliers and business units, and enables corporate hierarchies and structures. The overall goal for MDM is the ability to create an enterprise-wide consistent data model, which enables analyzing and reporting customer and supplier data. The goal of the study was defining the properties and success factors of a master data system. The theoretical background was based on literature and the case consisted of enterprise specific needs and demands. The theoretical part presents the concept, background, and principles of MDM and then the phases of system planning and implementation project. Case consists of background, definition of as is situation, definition of project, evaluation criterions and concludes the key results of the thesis. In the end chapter Conclusions combines common principles with the results of the case. The case part ended up dividing important factors of the system in success factors, technical requirements and business benefits. To clarify the project and find funding for the project, business benefits have to be defined and the realization has to be monitored. The thesis found out six success factors for the MDM system: Well defined business case, data management and monitoring, data models and structures defined and maintained, customer and supplier data governance, delivery and quality, commitment, and continuous communication with business. Technical requirements emerged several times during the thesis and therefore those can’t be ignored in the project. Conclusions chapter goes through these factors on a general level. The success factors and technical requirements are related to the essentials of MDM: Governance, Action and Quality. This chapter could be used as guidance in a master data management project.

Calculation of the carbon footprint of Finnish barley products - methodology and possible applications

The purpose of this thesis was to define how product carbon footprint analysis and its results can be used in company's internal development as well as in customer and interest group guidance, and how these factors are related to corporate social responsibility. From-cradle-to-gate carbon footprint was calculated for three products; Torino Whole grain barley, Torino Pearl barley, and Elovena Barley grit & oat bran, all of them made of Finnish barley. The carbon footprint of the Elovena product was used to determine carbon footprints for industrial kitchen cooked porridge portions. The basic calculation data was collected from several sources. Most of the data originated from Raisio Group's contractual farmers and Raisio Group's cultivation, processing and packaging specialists. Data from national and European literature and database sources was also used. The electricity consumption for porridge portions' carbon footprint calculations was determined with practical measurements. The carbon footprint calculations were conducted according to the ISO 14044 standard, and the PAS 2050 guide was also applied. A consequential functional unit was applied in porridge portions' carbon footprint calculations. Most of the emissions from barley products' life cycle originate from primary production. The nitrous oxide emissions from cultivated soil and the use and production of nitrogenous fertilisers contribute over 50% of products' carbon footprint. Torino Pearl barley has the highest carbon footprint due to the lowest processing output. The reductions in products' carbon footprint can be achieved with developments in cultivation and grain processing. The carbon footprint of porridge portion can be reduced by using domestically produced plant-based ingredients and by making the best possible use of the kettle. Carbon footprint calculation can be used to determine possible improvement points related to corporate environmental responsibility. Several improvement actions are related to economical and social responsibility through better raw material utilization and expense reductions.

Synthesis and characterization of solid 2-methoxycinnamylidenepyruvic acid

The 2-methoxycinnamylidenepyruvic acid (2-MeO-HCP) was synthesized and characterized for nuclear magnetic resonance (¹H and 13C NMR), mass spectrometry (MS), Infrared spectroscopy (FTIR) and differential scanning calorimetry (DSC). The application of DSC for purity determination is well documented in literature and is used in the analysis of pure organic compounds. The molecular geometry and vibrational frequencies of 2-MeO-HCP have been calculated.

Romanssien ja runouden aikakausi. Thomas Warton keskiaikaa määrittelemässä 1750–1790

Tutkimukseni käsittelee keskiajan nousua historian tärkeäksi periodiksi 1700-luvun Englannissa näkökulmanaan Thomas Wartonin (1726–1790) kirjoitukset. Warton oli Oxfordin yliopistossa toiminut oppinut antikvaari. Wartonin pääteos History of English Poetry (1774–1781) ei nimestään huolimatta ollut moderni kirjallisuushistoria vaan 1000–1500-luvun kirjoitettua kulttuuria laajasti käsitellyt vernakulaariin kirjallisuuteen pohjautunut esitys. Warton ja hänen lähipiiriinsä kuuluneet tutkijat tarjoavat erityisen mahdollisuuden tarkastella, miten käsitys keskiajasta omana aikakautenaanmuodostui 1700-luvun lopulla. Tutkin Wartonin ja hänen aikalaistensa toisen vuosituhannen alusta kirjoittamia arvioita Michel de Certeaun historiografisen operaation käsitteen avulla. Se koostuu kolmesta vaiheesta: Alue määrittelee sosiaaliset riippuvuussuhteet ja vaikuttimet, jotka ohjaavat tutkimusta. Käytäntö viittaa siihen, miten historioitsija valitsee materiaalinsa ja muokkaa siitä historiankirjoituksena hahmottuvan kokonaisuuden. Lopuksi kirjoitus konkreettisena ja fyysisenä ilmiönä luo illuusion lopullisuudesta ja huonosti sopivien osien yhteenkuuluvuudesta. de Certeaun teoria soveltuu paremmin vanhemman historiankirjoituksen ja oppineisuuden tarkasteluun kuin historiantutkimuksen narratiiveja analysoivat teokset, koska se kontekstualisoi laajemmin historiankirjoitukseen vaikuttavat ilmiöt. Thomas Warton ja muut 1700-luvun puolivälin oppineet määrittelivät keskiajan fiktiivisten tekstien avulla. Warton tutustui tarkasti romansseihin ja kronikoihin. Erityisen suuri merkitys keskiajan hahmottamisen kannalta oli Geoffrey Monmouthilaisen kronikalla Historia regum britanniae, joka esitteli Englannin myyttisen varhaisen historian yhdistämällä Rooman ja oman kansallisen perinteen. Geoffreyn kronikan avulla Warton huomasi keskiaikaisten tarinoiden laajan vaikutuksen; hän kirjoitti erityisesti kuningas Arthuriin liittyneiden kertomusten merkityksestä, joka jatkui aina 1500-luvulle asti. Näin Warton löysi antiikin perinteelle haastajan keskiaikaisesta kulttuurista. Wartonin tapa esitellä keskiaikaa perustui osittain valistusajan sulavasti kirjoitetuille universaalihistorioille, osittain oppineelle luettelomaiselle esitystavalle. Käytännössä Wartonin pitkät johdantotutkielmat kuitenkin johdattavat lukijaa keskeisiin teemoihin. Niitä ovat mielikuvituksen väheneminen uusimmassa kirjallisuudessa ja toisaalta hienostuneisuuden ja tiedon kasvu. Warton ei missään vaiheessa kerro, liittyvätkö nämä teemat yhteen, mutta tulkintani mukaan ne liittyivät. Warton ajatteli kirjallisuuden menettäneen olennaisen mielikuvituksen samaan aikaan, kun yhteiskunta oli kehittynyt. Tämä auttaa hahmottamaan koko kirjallisuuden historiaa: Warton etsi alkuperäistä mielikuvitusta niin antiikin Kreikasta, Orientista kuin muinaisesta Skandinaviasta. History of English Poetry ei pohtinut vain kirjallisuuden ja yhteiskunnan suhdetta, sillä Warton ajatteli voivansa tutkia keskiajan yhteiskuntaa kronikoiden ja romanssien avulla. Hänen käsityksensä feodalismista, hovien elämästä ja keskiaikaisista tavoista perustuivat niihin. Warton ei huomannut, että hänen käyttämänsä lähteet olivat tietoisia kirjallisia konstruktioita vaan hän piti niitä totuudenmukaisina kuvauksina. Toisaalta Wartonin tulkintaan heijastuivat myös 1700-luvun käsitykset yhteiskunnasta. Keskiajan lähteiden kuvaukset ja 1700-luvun ideaalit vaikuttivat lopulta siihen, millaiseksi populaari kuva keskiajasta kehittyi.

Potentiometric and conductimetric studies of chemical equilibria for pyridoxine hydrochloride in aqueous solutions: simple experimental determination of pKa values and analytical applications to pharmaceutical analysis

The combination of two low-cost classical procedures based on titrimetric techniques is presented for the determination of pyridoxine hydrochloride in pharmaceuticals samples. Initially some experiments were carried out aiming to determine both pKa1 and pKa2 values, being those compared to values of literature and theoretical procedures. Commercial samples containing pyridoxine hydrochloride were electrochemically analysed by exploiting their acid-base and precipitation reactions. Potentiometric titrations accomplished the reaction between the ionizable hydrogens present in pyridoxine hydrochloride, being NaOH used as titrant; while the conductimetric method was based on the chemical precipitation between the chloride of pyridoxine hydrochloride molecule and Ag+ ions from de silver nitrate, changing the conductivity of the solution. Both methods were applied to the same commercial samples leading to concordant results when compared by statistical tests (95 and 98% confidence levels). Recoveries ranging from 99.0 to 108.1% were observed, showing no significant interference on the results.