988 resultados para peaks over threshold


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In less than twenty years, what began as a concept for the treatment of exsanguinating truncal trauma patients has become the primary treatment model for numerous emergent, life threatening surgical conditions incapable of tolerating traditional methods. Its core concepts are relative straightforward and simple in nature: first, proper identification of the patient who is in need of following this paradigm; second, truncation of the initial surgical procedure to the minimal necessary operation; third, aggressive, focused resuscitation in the intensive care unit; fourth, definitive care only once the patient is optimized to tolerate the procedure. These simple underlying principles can be molded to a variety of emergencies, from its original application in combined major vascular and visceral trauma to the septic abdomen and orthopedics. A host of new resuscitation strategies and technologies have been developed over the past two decades, from permissive hypotension and damage control resuscitation to advanced ventilators and hemostatic agents, which have allowed for a more focused resuscitation, allowing some of the morbidity of this model to be reduced. The combination of the simple, malleable paradigm along with better understanding of resuscitation has proven to be a potent blend. As such, what was once an almost lethal injury (combined vascular and visceral injury) has become a survivable one.

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With information technology (IT) playing an increasing important role in driving the business, the value of IT investment is often challenged because not all of those investment decisions are made in a reasonable way or aligned with business strategies. IT investment portfolio management (PfM) is an effective way to prioritize and select the right IT projects to invest in, by taking all the project proposals into consideration as a whole, based on their business value, risks, costs, and interrelationships. There are different decision models to prioritise projects, and the Analytic Hierarchy Process (AHP) is one of the most commonly-used methods and is discussed in this master thesis. At the same time, there are IT projects on different levels for a multinational company, from global to local. For instance, many of them are probably proposed by joint ventures on local level. In the oil & gas industry, joint ventures are often formed especially in the area of the upstream (exploration & production). How to involve those projects into the IT investment PfM approach of the parent company is a challenge, because the parent company cannot make the decisions on its own. It needs to prioritize all projects in an adequate way, communicate with JVs and influence them. Also, different control levels on JVs need to be considered. This paper hence attempts to introduce a tailored approach of IT investment PfM for a multinational oil & gas company to address the issues around JVs.

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Kirjallisuudesta välittyy useitten vuosikymmenten ajalta tietämys sotilaslentämisen fyysisestä kuormittavuudesta. G-voimista aiheutuva kuormittuminen näyttää johtavan joko akuutisti tai pitkäaikaisesti lentäjän tuki- ja liikuntaelimistön toimintakykyä alentaviin ongelmiin. Erityisesti on selvitetty niskan alueen työperäisten ongelmien syntyä, jolloin on havaittu lentotoiminnan fyysisen kuormittavuuden johtavan ennenaikaiseen rakenteelliseen rappeumaan, haittaa aiheuttavan oireen lisäksi. Kansainvälisen kirjallisuuden mukaan ammatista johtuvista eli työperäisistä oireista kärsii vähintään 2/3 kaikista sotilaslentäjistä. Tietyin edellytyksin lentäjien kaularangan alueen rappeuma on Suomessa hyväksytty ammattitaudiksi vuodesta 1995 alkaen. On arveltu, että hyvästä fyysisestä suorituskyvystä olisi apua tuki- ja liikuntaelin (TULE)-oireilun ennaltaehkäisemisessä ja toimintakyvyn ylläpitämisessä. Tutkimusnäyttö tästä on lentäjien osalta ollut toistaiseksi erittäin niukkaa. Tämän tutkimuksen tavoitteena oli selvittää suomalaisten sotilaslentäjien työperäisen TULE-oireilun esiintyvyyttä, oireista koetun haitan tasoa, lentäjien fyysisen kunnon tasoja virkauran aikana ja näitten kaikkien välisiä yhteyksiä sekä työperäisen TULE-oireen merkitystä sotilaan toimintakykyyn. Tutkimus jakautui kahteen osaan. Poikkileikkauksena lentotoimintaperäisiä TULE-oireita kartoitettiin kyselytutkimuksella, johon vastasi vuositarkastuksen yhteydessä 267 lentäjää vuosina 2004-2005. Joukosta poimittiin ne 195 lentäjää, jotka olivat suorittaneet yleissotilaalliset kuntotestit puolen vuoden sisällä kyselyyn vastaamisesta, ja mitatut testitulokset yhdistettiin kyselytutkimusaineistoon. Tässä aineistossa toteutettiin fyysisesti erilailla kuormittuvien lentäjäryhmien välisiä vertailuja fyysisen kunnon, TULE-esiintyvyyden ja koetun haitan suhteen. Poikkileikkausosassa tutkittiin myös lentäjien virkauran aikaisia tasoeroja yleissotilaallisissa kuntotesteissä (n=195) verrattuna muihin suomalaisiin sotilaisiin. Lisäksi (N=289) selvitettiin ilmailulääketieteellisen tarkastuksen yhteydessä mitattuja, ns. ammatillisia fyysisiä erityisominaisuuksia eri ikäluokissa. Pitkittäisosassa seurattiin 67:n Hawk-suihkuharjoituskoneella aloittaneen Ilmavoimien sotilaslentäjien lentouran aikaista lentotoimintaperäisten TULE-oireitten esiintyvyyttä vuosien 1996 ja 2008 välillä. Lisäksi tutkittiin lentäjien kontakteja työterveyshuoltoon, oireen aiheuttamaa lentokelvottomuusaikaa, työn kuormituksen kumulatiivista kertymää lentotuntien lisääntyessä ja TULE-oireiden esiintyvyyden kannalta kriittisiä ajankohtia lentouran aikana. Tulokset osoittivat, että kaikki seurannassa olleet suomalaiset sotilaslentäjät kokivat jonkinasteisen lentotoimintaperäisen TULE-oireen uransa aikana. Niskan ammattitautiluokituksen tasoisen ongelman esiintyvyys oli 4 % koko lentäjäpopulaatiosta ja 10 % suihkuharjoituskonevaiheen jo läpäisseistä, mutta vastaavanlaisia TULE-ongelmia, ilman riittävää näyttöä ammattitaudista, esiintyi lähes joka kolmannella sotilaslentäjällä. Alaselän osalta lentäjät oireilivat lähes samassa määrin, mutta näitä oireita ei toistaiseksi ole mahdollista määrittää ammattitaudiksi. Lentäjät kävivät varsin vähän valittamassa oireistaan työterveyshuoltoon, jossa käytäneen vasta silloin, kun oire jo selvästi heikentää työtehtävissä vaadittavaa toimintakykyä. Merkittävin lentotoimintaperäisten oireitten esiintymisen kasvu ajoittui 200 Hawk-lentotunnin kohdalle, jolloin koneella saavutetaan eräänlainen optimaalinen G-indeksi eli taktisen liikehtelyn G-tasoylitysten vaihtelu. Tämän jälkeen lentäjät ovat erityisen alttiina akuuteille lennonaikaisille TULE-ongelmille. Oireitten esiintyminen kasvoi eksponentiaalisesti noin 600 lentotuntiin asti. Monimuuttujamallien mukaan työperäisen TULE-oireen esiintyvyysriskiä vähensivät alaraajojen hyvä motoriikka, korkeat valintapisteet ja korkea kaulan fleksion voimataso maksimaalisessa isometrisessä testissä. Yleissotilaallisilla kuntotasoilla ei ollut yhteyttä oireiluun, mutta lihaskunnoltaan voimakkaimmat lentäjät kärsivät tilastollisesti merkittävästi vähemmän haittaa lentotoimintaperäisistä TULE-oireistaan. Yleissotilaallisissa kuntotesteissä lentäjät olivat parempia kuin muut suomalaiset sotilaat. Aktiivisimman lentouran aikana, 30-40-vuotiaina, lentäjien fyysinen suorituskyky oli normaaliväestöön nähden vain keskimääräinen ja urheilijoihin nähden keskimääräistä heikompi. Käytännössä lentäjät eivät kyenneet ylläpitämään valintavaiheen fyysistä suorituskykyään edes kadettivaiheen loppuun asti. Huomattavaa oli lisäksi, että aktiivisen lentouran päätyttyä fyysinen kunto näytti jossain määrin palautuvan kohti lähtötasoa lentäjien ikääntymisestä huolimatta. Lentäjien valintavaiheen aikana mitatun fyysisen suorituskyvyn tason säilyminen aktiivisen lentopalveluksen loppuun asti vaatisi lentäjien fyysisen toimintakyvyn ylläpidon ja kehittämisen tehostamista koulutuksen ja työuran eri vaihessa. Tähän tavoitteeseen nähden Ilmavoimien fyysisen kasvatuksen järjestelyt vaikuttivat alimitoitetuilta. Operatiivisesti huolestuttavaa oli Ilmavoimien ohjaajien fyysisen suorituskyvyn heikentyminen silloin, kun heidän taitojensa puolesta olisi pitänyt olla suorituskykyisimpiä taistelutehtäviinsä. Myös lentäjän terveyttä ja toimintakykyä pitäisi pystyä reaaliaikaisemmin seuraamaan koko lentouran aikana. Ilmavoimille suositellaan moniammatillista lähestymistä sotilaslentäjien toimintakyvyn ylläpitämiseen ja terveysriskien hallintaan yhdessä liikunnan, työterveyshuollon, lentoturvallisuusalan ja operatiivisen suunnittelun asiantuntijoitten kanssa. Lisäksi suositellaan avoimempaa ja eettisesti kestävämpää suhtautumista ammattiin liittyvien terveysongelmien kuvaamiseen sekä fyysisen kunnon kysymyksiin jo lentäjien rekrytointivaiheessa.

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kuv., 13 x 17 cm

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PURPOSE: To assess if arylsulfatase A activity (ASA) and sulfatide (SL) concentration in the human endometrium can be predictive of the development of endometrial polyps over the years, since ASA activity reflects the endometrial sensitivity to hormones. METHODS: ASA activity and SL concentration were determined by biochemical procedures on endometrial samples collected between 1990 and 1994 in non-menopausal women. These women underwent a new endometrial sampling following the clinical indication some years after the first endometrial sampling. The histological assessment of the second endometrial specimens found four patients with normal endometrial pattern and 10 patients with one or more endometrial polyps. ASA activity/years elapsed and SL concentration/years elapsed were compared using two tailed Mann-Whitney test for unpaired data between patients with normal pattern and patients with endometrial polyps. RESULTS: Median ASA activities were 2.62 (normal pattern) versus 1.85 (endometrial polyps) nmol hydrolized substrate/min. Median activity/years elapsed is higher in patients with second endometrial sample presenting normal pattern (p=0.006) and median SL concentration/years elapsed does not differ significantly among groups, even if median SL concentration seems to be higher in patients who subsequently developed polyps (1031 µg/g of fresh tissue versus 341,5 µg/g of fresh tissue). CONCLUSIONS: ASA activity can predict the onset of endometrial polyps over the years.

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PURPOSE: To analyze the prevalence of and factors associated with fragility fractures in Brazilian women aged 50 years and older. METHODS: This cross-sectional population survey, conducted between May 10 and October 31, 2011, included 622 women aged >50 years living in a city in southeastern Brazil. A questionnaire was administered to each woman by a trained interviewer. The associations between the occurrence of a fragility fracture after age 50 years and sociodemographic data, health-related habits and problems, self-perception of health and evaluation of functional capacity were determined by the χ2 test and Poisson regression using the backward selection criteria. RESULTS: The mean age of the 622 women was 64.1 years. The prevalence of fragility fractures was 10.8%, with 1.8% reporting hip fracture. In the final statistical model, a longer time since menopause (PR 1.03; 95%CI 1.01-1.05; p<0.01) and osteoporosis (PR 1.97; 95%CI 1.27-3.08; p<0.01) were associated with a higher prevalence of fractures. CONCLUSIONS: These findings may provide a better understanding of the risk factors associated with fragility fractures in Brazilian women and emphasize the importance of performing bone densitometry.

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Purpose To compare the predictive capability of HPV and Pap smear tests for screening pre-cancerous lesions of the cervix over a three-year follow-up, in a population of users of the Brazilian National Health System (SUS). Methods This is a retrospective cohort study of 2,032 women with satisfactory results for Pap smear and HPV tests using second-generation hybrid capture,made in a previous study. We followed them for 36 months with data obtained from medical records, the Cervix Cancer Information System (SISCOLO), and the Mortality Information System (SIM). The outcome was a histological diagnosis of cervical intraepithelial neoplasia grade 2 or more advanced lesions (CIN2ş). We constructed progression curves of the baseline test results for the period, using the Kaplan-Meier method, and estimated sensitivity, specificity, positive and negative predictive value, and positive and negative likelihood ratios for each test. Results A total of 1,440 women had at least one test during follow-up. Progression curves of the baseline test results indicated differences in capability to detect CIN2ş (p < 0.001) with significantly greater capability when both tests were abnormal, followed by only a positive HPV test. The HPV test was more sensitive than the Pap smear (88.7% and 73.6%, respectively; p < 0.05) and had a better negative likelihood ratio (0.13 and 0.30, respectively). Specificity and positive likelihood ratio of the tests were similar. Conclusions These findings corroborate the importance of HPV test as a primary cervical cancer screening.

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Valmistustekniikoiden kehittyessä IC-piireille saadaan mahtumaan yhä enemmän transistoreja. Monimutkaisemmat piirit mahdollistavat suurempien laskutoimitusmäärien suorittamisen aikayksikössä. Piirien aktiivisuuden lisääntyessä myös niiden energiankulutus lisääntyy, ja tämä puolestaan lisää piirin lämmöntuotantoa. Liiallinen lämpö rajoittaa piirien toimintaa. Tämän takia tarvitaan tekniikoita, joilla piirien energiankulutusta saadaan pienennettyä. Uudeksi tutkimuskohteeksi ovat tulleet pienet laitteet, jotka seuraavat esimerkiksi ihmiskehon toimintaa, rakennuksia tai siltoja. Tällaisten laitteiden on oltava energiankulutukseltaan pieniä, jotta ne voivat toimia pitkiä aikoja ilman akkujen lataamista. Near-Threshold Computing on tekniikka, jolla pyritään pienentämään integroitujen piirien energiankulutusta. Periaatteena on käyttää piireillä pienempää käyttöjännitettä kuin piirivalmistaja on niille alunperin suunnitellut. Tämä hidastaa ja haittaa piirin toimintaa. Jos kuitenkin laitteen toiminnassa pystyään hyväksymään huonompi laskentateho ja pienentynyt toimintavarmuus, voidaan saavuttaa säästöä energiankulutuksessa. Tässä diplomityössä tarkastellaan Near-Threshold Computing -tekniikkaa eri näkökulmista: aluksi perustuen kirjallisuudesta löytyviin aikaisempiin tutkimuksiin, ja myöhemmin tutkimalla Near-Threshold Computing -tekniikan soveltamista kahden tapaustutkimuksen kautta. Tapaustutkimuksissa tarkastellaan FO4-invertteriä sekä 6T SRAM -solua piirisimulaatioiden avulla. Näiden komponenttien käyttäytymisen Near-Threshold Computing –jännitteillä voidaan tulkita antavan kattavan kuvan suuresta osasta tavanomaisen IC-piirin pinta-alaa ja energiankulusta. Tapaustutkimuksissa käytetään 130 nm teknologiaa, ja niissä mallinnetaan todellisia piirivalmistusprosessin tuotteita ajamalla useita Monte Carlo -simulaatioita. Tämä valmistuskustannuksiltaan huokea teknologia yhdistettynä Near-Threshold Computing -tekniikkaan mahdollistaa matalan energiankulutuksen piirien valmistaminen järkevään hintaan. Tämän diplomityön tulokset näyttävät, että Near-Threshold Computing pienentää piirien energiankulutusta merkittävästi. Toisaalta, piirien nopeus heikkenee, ja yleisesti käytetty 6T SRAM -muistisolu muuttuu epäluotettavaksi. Pidemmät polut logiikkapiireissä sekä transistorien kasvattaminen muistisoluissa osoitetaan tehokkaiksi vastatoimiksi Near- Threshold Computing -tekniikan huonoja puolia vastaan. Tulokset antavat perusteita matalan energiankulutuksen IC-piirien suunnittelussa sille, kannattaako käyttää normaalia käyttöjännitettä, vai laskea sitä, jolloin piirin hidastuminen ja epävarmempi käyttäytyminen pitää ottaa huomioon.

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Superconductor – normal metal point contacts were investigated, using different combinations of Cu, brass, Nb and NbTi. The resulting spectra contained side peaks. The currents at which these side peaks appeared, depended on the radii of the contacts. For contacts with Nb this dependence was quadratic, while for contacts with NbTi it was linear. Based on this, we argue that the side peaks in the case of the Nb contacts are due to the critical current density being exceeded. In contrast, side peaks of the NbTi contacts are caused by the self-magnetic field exceeding the lower critical field of NbTi. The NbTi contacts did not show the expected contribution from the vanishing Maxwell resistance of the superconductor, a question which remained open.

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A non isotropic turbulence model is extended and applied to three dimensional stably stratified flows and dispersion calculations. The model is derived from the algebraic stress model (including wall proximity effects), but it retains the simplicity of the "eddy viscosity" concept of first order models. The "modified k-epsilon" is implemented in a three dimensional numerical code. Once the flow is resolved, the predicted velocity and turbulence fields are interpolated into a second grid and used to solve the concentration equation. To evaluate the model, various steady state numerical solutions are compared with small scale dispersion experiments which were conducted at the wind tunnel of Mitsubishi Heavy Industries, in Japan. Stably stratified flows and plume dispersion over three distinct idealized complex topographies (flat and hilly terrain) are studied. Vertical profiles of velocity and pollutant concentration are shown and discussed. Also, comparisons are made against the results obtained with the standard k-epsilon model.

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The purpose of this study is to examine how a launch of a pharmaceutical over-the-counter sold (OTC) brand can be done by using creative solutions and thus affecting the product life cycle. The study is inspired by a phenomenon called Burana. The Burana brand has been a market leader of OTC painkillers in Finland for the past 27 years. The aim of this study is to “solve the mystery” behind Burana brand’s success by focusing on the launch phase of Burana as an OTC medicine. Farmos Group Ltd (the owner of the brand in 1980´s) had not originally invented the product in question – ibuprofen – and the product had already reached it´s maturity phase, if not even decline from the product life cycle aspect when this phenomenon takes place. This has made the marketing choices, the product launch phase as well as the product management even more interesting from the company point of view as well as from a learning point of view. The methodology in this study is qualitative with a descriptive research strategy, while the study is conducted as a longitudinal single-case study. The methods used in this study have been collecting, analyzing and interpreting the data, which is based on the interviewees’ comments and observed behavior. According to the study, the successful launch phase helped in setting the product one step ahead of the competitors and thus aided the brand leadership and prolonged the product life cycle. Another notable aspect that became clear from the interviews and the documentary of Burana´s launch phase was the innovative idea of involving the people of the distribution chain into the product launch through education. As this study has pointed out, it is not enough to for a company to build an innovative team of employees, but also to offer them an involved and encouraging management. According to the interviews, the support from the company management gave the marketing team the encouragement to be innovative. It can be thus stated that the management of a company has an essential role in fostering the creativity within the company.

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Presentation at the Nordic Perspectives on Open Access and Open Science seminar, Helsinki, October 15, 2013

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The unsteady, viscous, supersonic flow over a spike-nosed body of revolution is numerically investigated by solving the Navier-Stokes equations. The time-accurate computations are performed employing an implicit algorithm based on the second-order time-accurate LU-SGS scheme with the incorporation of a subiteration procedure to maintain time accuracy. The characteristics of the flow field for a Mach number of 3.0, Reynolds number of 7.87 x 10(6)/m, and angles of attack of 5 and 10 degrees are described. Self-sustained asymmetric shock wave oscillations were observed in the numerical computations for these angles of attack. The main characteristic of the flow field, as well as its influence on drag coefficient is discussed.

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Nowadays biomass transformation has a great potential for the synthesis of value-added compounds with a wide range of applications. Terpenoids, extracted from biomass, are inexpensive and renewable raw materials which often have a biological activity and are widely used as important organic platform molecules in the development of new medicines as well as in the synthesis of fine chemicals and intermediates. At the same time, special attention is devoted to the application of gold catalysts to fine chemical synthesis due to their outstanding activity and/or selectivity for transformations of complex organic compounds. Conversion of renewable terpenoids in the presence of gold nanoparticles is one of the new and promising directions in the transformation of biomass to valuable chemicals. In the doctoral thesis, different kinds of natural terpenoids, such as α-pinene, myrtenol and carvone were selected as starting materials. Gold catalysts were utilized for the promising routes of these compounds transformation. Investigation of selective α-pinene isomerization to camphene, which is an important step in an industrial process towards the synthesis of camphor as well as other valuable substrates for the pharmaceutical industry, was performed. A high activity of heterogeneous gold catalysts in the Wagner-Meerwein rearrangement was demonstrated for the first time. Gold on alumina carrier was found to reach the α-pinene isomerization conversion up to 99.9% and the selectivity of 60-80%, thus making this catalyst very promising from an industrial viewpoint. A detailed investigation of kinetic regularities including catalyst deactivation during the reaction was performed. The one-pot terpene alcohol amination, which is a promising approach to the synthesis of valuable complex amines having specific physiological properties, was investigated. The general regularities of the one-pot natural myrtenol amination in the presence of gold catalysts as well as a correlation between catalytic activity, catalyst redox treatment and the support nature were obtained. Catalytic activity and product distribution were shown to be strongly dependent on the support properties, namely acidity and basicity. The gold-zirconia (Au/ZrO2) catalyst pretreated under oxidizing atmosphere was observed to be rather active, resulting in the total conversion of myrtenol and the selectivity to the corresponding amine of about 53%. The reaction kinetics was modelled based on the mechanistic considerations with the catalyst deactivation step incorporated in the mechanism. Carvone hydrogenation over a gold catalyst was studied with the general idea of investigating both the activity of gold catalysts in competitive hydrogenation of different functional groups and developing an approach to the synthesis of valuable carvone derivatives. Gold was found to promote stereo- and chemoselective carvone hydrogenation to dihydrocarvone with a predominant formation of the trans-isomer, which generally is a novel synthetic method for an industrially valuable dihydrocarvone. The solvent effect on the catalytic activity as well as on the ratio between trans- and cis-dihydrocarvone was evaluated.

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Two field experiments were conducted to evaluate the effects of multispecies weed competition on wheat grain yield and to determine their economic threshold on the crop. The experiments were conducted in 2002, on two sites in Iran: at the Agricultural Research Station on Ferdowsi University of Mashhad (E1) and on the fields of Shirvan's Agricultural College (E2). A 15 x 50 m area of a 15 ha wheat field in E1 and a 15 x 50 m area of a 28 ha wheat field in E2 were selected as experimental sites. These areas were managed like other parts of the fields, except for the use of herbicides. At the beginning of the shooting stage, 30 points were randomly selected by dropping a 50 x 50 cm square marker on each site. The weeds present in E1 were: Avena ludoviciana, Chenopodium album, Solanum nigrum, Stellaria holostea, Convolvulus spp., Fumaria spp., Sonchus spp., and Polygonum aviculare. In E2 the weeds were A. ludoviciana, Erysimum sp., P. aviculare, Rapistrum rugosum, C. album, Salsola kali, and Sonchus sp. The data obtained within the sampled squares were submitted to regression equations and weeds densities were calculated in terms of TCL (Total Competitive Load). The regression analysis model indicated that only A. ludoviciana, Convolvulus spp. and C. album, in E1; and A. ludoviciana, S. kali, and R. rugosum, in E2 had a significant effect on the wheat yield reduction. Weed economic thresholds were 5.23 TCL in E1 and 6.16 TCL in E2; which were equivalent to 5 plants m-2 of A. ludoviciana or 12 plants m-2 of Convolvulus spp. or 19 plants m-2 of C. album in E1; and 6 plants m-2 A. ludoviciana, 13 plants m-2 S. kali and 27 plants m-2 R. rugosum in E2. Simulations of economic weed thresholds using several wheat grain prices and weed control costs allowed a better comparison of the experiments, suggesting that a more competitive crop at location E1 than at E2 was the cause of a lower weed competitive ability at the first location.