Predictive Capability of HPV and Pap Tests in Screening for Cervical Cancer over a Three-Year Follow-up

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.

Rasvankestävät paperit ja kartongit

Rasvankestävyydellä tarkoitetaan sitä, että materiaali hylkii tai kestää rasvaa tietyn ajan läpäisemättä sen pintaa. Rasvankestäviä papereita ja kartonkeja löytyy kaikkialta. Erilaiset ruuanvalmistuspaperit, kuten esimerkiksi leivinpaperi ja voipaperi, ovat rasvankestäviä. Myös pakkauksissa käytetään paljon rasvankestäviä papereita ja kartonkeja. Rasvankestäviltä tuotteilta vaaditaan erilaisia ominaisuuksia riippuen niiden käyttötarkoituksesta. Pakkausmateriaaleilta vaaditaan esimerkiksi lujuutta ja kestävyyttä fyysistä rasitusta, valoa, hajuja ja mikrobeja vastaan. Ruuanvalmistusmateriaaleilta vaaditaan puolestaan lujuutta ja kestävyyttä lämpöä, kosteutta ja fyysistä rasitusta vastaan. Rasvankestäviltä papereilta vaaditaan rasvankestävyyden lisäksi hyvää vetolujuutta, märkälujuutta ja hyviä optisia ominaisuuksia. Neliömassan tulee asettua 20─80 g/m2 välille ja metallipitoisuudet eivät saa olla liian korkeat. Myös tuotteiden kierrätettävyys on nostanut asemaansa viimeaikoina. Tuotteen tuotannon ja itse tuotteen ympäristöystävällisyys ovat todella arvostettuja kuluttajan, tuottajan, Suomen, EU:n ja koko maailman näkökulmista. Jotta tuotteesta saadaan rasvankestävää, vaaditaan siltä erilaisia barrier-ominaisuuksia. Rasvankestävällä paperilla vaaditaan hyviä barrier-ominaisuuksia esimerkiksi rasvan, ilman, veden, vesihöyryn sekä hapen läpäisevyyksissä. Rasvankestäviä papereita ja kartonkeja voidaan valmistaa kemiallisilla ja mekaanisilla tavoilla. Happokäsittely ja fluorokemikaalien lisääminen ovat kemiallisia tapoja, kun taas sellun jauhaminen pitkään matalassa lämpötilassa on mekaaninen tapa valmistaa rasvankestävää paperia. Näiden tapojen lisäksi rasvankestäviä papereita voidaan tehdä erilaisten pinnoitusten avulla. Erilaiset muovit ovat yleisemmin käytettyjä pinnoitemateriaaleja. Esimerkiksi PE- ja PET-päällysteet ovat käytettyjä rasvankestävissä tuotteissa. Viime aikoina on kehitetty paljon erilaisia biomateriaaleja, joista voidaan tehdä rasvankestävä pinnoite. Lipideistä, hydrokolloideista ja erilaisista komposiiteista voidaan luoda uusien tekniikoiden avulla rasvankestäviä pinnoitteita. Rasvankestävyydestä voidaan saada jonkinlainen käsitys WVTR-asteen, Cobb-arvon ja kontaktikulman mittausten avulla. Rasvankestävyyttä voidaan myös mitata erilaisten standarditestien avulla. TAPPI:lla, ISO:lla ja ASTM:llä on useita erilaisia standardeja. Lähes kaikissa rasvankestävyysstandardeissa tuloksen saaminen perustuu visuaaliseen havaintoon, mikä aiheuttaa välillä hankaluuksia tulosten luotettavuuteen, koska tuloksen määrittää ihmissilmä, ja kaikilla testin tekijöillä on erilainen silmä, joka aistii eri tavalla.

Lengsel - en kraft til helse

The aim of this study is to explore longing and its implication for health. The overall purpose is to develop a theory model of longing. The research question is: What is the substance of longing in a caring science perspective? The model is developed based on theoretical and empirical studies, which contains three different research materials; hermeneutic reading of texts by Augustine and Kierkegaard, and interpretation of research interviews with nine women in a cancer context. The design of the study is explorative and the ontological hermeneutics of Gadamer is chosen as a guidance for understanding. The main standpoint of the study is performed within the systematic caring science, which through basic research, generates knowledge about the human desire as crucial for the deeper health processes. Through the contextual study there is a link to the clinical caring science. In the ontology of the systematic caring science, the character of longing is in touch with two different aspects. Longing is rooted in the inner source of love of the ethos of the human where the inscrutable depth exists and contains the reality beyond the visible. Further, longing is essential for human being becoming in health and suffering, through holiness as a unit of body, soul and spirit. The results of the study are presented in a theory model. The model has by abduction provided new and deeper understanding of dimensions of longing related to health. On a general level the forces in longing unfolds in two perspectives; suffering and the basis of love. There appears to be a relationship between human and the source of love in all three materials. When human opens up his life in a larger perspective, resting in love, he can manage to stand in the thrill, and acknowledge loss and emptiness. In the transparency of an inner dialogue unfolding dispair, deeper longing can be opened up so that lives are released from the source of love. The holiness of the human desire has such appeal because the holiness of the source of love is always more than the suffering and the particular. The holiness in longing seems to satisfy the hearts deepest searching. The directon of longing is performed in relation to human and the source of love. The study reveals how longing is associated with the source of love, where the holiness of longing seems to drag the human and by that gives the answer to the seeking of the heart. Dynamics forces have direction from the human suffering in the foundation and a release of the power is given back to transform, deepen and reconcile life and suffering. The movements of the power released by longing are keys to understand the suffering of human in relation to the source of love, becoming in health. By this study, results contribute to deepen the ontological core of caring science. Firstly, human in his longing is connected to the inner ethos and by that the most sacred and absolute in itself so that parts of the potential of love can be released to health. Secondly, longing is the road of reconciliation and can further expand to authentic reconciliation, where human is becoming towards unity and holiness. Thirdly, the spirituality is unfolding through longing and the transcendental is received. In longing, human is in touch with the mystery, the longing exceeds the present and moving towards eternity and infinity, and is in what is yet to come. Such deep experience of longing moments leave an impression and show the longing fulfilled.

Evaluation of Bubble Formation and Break Up in Suppression Pools by Using Pattern Recognition Methods

During a possible loss of coolant accident in BWRs, a large amount of steam will be released from the reactor pressure vessel to the suppression pool. Steam will be condensed into the suppression pool causing dynamic and structural loads to the pool. The formation and break up of bubbles can be measured by visual observation using a suitable pattern recognition algorithm. The aim of this study was to improve the preliminary pattern recognition algorithm, developed by Vesa Tanskanen in his doctoral dissertation, by using MATLAB. Video material from the PPOOLEX test facility, recorded during thermal stratification and mixing experiments, was used as a reference in the development of the algorithm. The developed algorithm consists of two parts: the pattern recognition of the bubbles and the analysis of recognized bubble images. The bubble recognition works well, but some errors will appear due to the complex structure of the pool. The results of the image analysis were reasonable. The volume and the surface area of the bubbles were not evaluated. Chugging frequencies calculated by using FFT fitted well into the results of oscillation frequencies measured in the experiments. The pattern recognition algorithm works in the conditions it is designed for. If the measurement configuration will be changed, some modifications have to be done. Numerous improvements are proposed for the future 3D equipment.

Magnetic Resocance Imaging Methods in the Follow-up of Multiple Sclerosis and in Farby Disease

Multiple sclerosis (MS) is a chronic immune-mediated inflammatory disorder of the central nervous system. MS is the most common disabling central nervous system (CNS) disease of young adults in the Western world. In Finland, the prevalence of MS ranges between 1/1000 and 2/1000 in different areas. Fabry disease (FD) is a rare hereditary metabolic disease due to mutation in a single gene coding α-galactosidase A (alpha-gal A) enzyme. It leads to multi-organ pathology, including cerebrovascular disease. Currently there are 44 patients with diagnosed FD in Finland. Magnetic resonance imaging (MRI) is commonly used in the diagnostics and follow-up of these diseases. The disease activity can be demonstrated by occurrence of new or Gadolinium (Gd)-enhancing lesions in routine studies. Diffusion-weighted imaging (DWI) and diffusion tensor imaging (DTI) are advanced MR sequences which can reveal pathologies in brain regions which appear normal on conventional MR images in several CNS diseases. The main focus in this study was to reveal whether whole brain apparent diffusion coefficient (ADC) analysis can be used to demonstrate MS disease activity. MS patients were investigated before and after delivery and before and after initiation of diseasemodifying treatment (DMT). In FD, DTI was used to reveal possible microstructural alterations at early timepoints when excessive signs of cerebrovascular disease are not yet visible in conventional MR sequences. Our clinical and MRI findings at 1.5T indicated that post-partum activation of the disease is an early and common phenomenon amongst mothers with MS. MRI seems to be a more sensitive method for assessing MS disease activity than the recording of relapses. However, whole brain ADC histogram analysis is of limited value in the follow-up of inflammatory conditions in a pregnancy-related setting because the pregnancy-related physiological effects on ADC overwhelm the alterations in ADC associated with MS pathology in brain tissue areas which appear normal on conventional MRI sequences. DTI reveals signs of microstructural damage in brain white matter of FD patients before excessive white matter lesion load can be observed on conventional MR scans. DTI could offer a valuable tool for monitoring the possible effects of enzyme replacement therapy in FD.

E-business solutions as a part of a customer service portfolio

Tässä työssä tutkittiin sähköisen liiketoiminnan palveluiden tarvetta kartonkiteollisuudessa. Palveluiden tarvetta ja sisältöä tutkittiin suomalaisessa metsäteollisuusyrityksessä. Tutkimus suoritettiin teemahaastatteluin ja sitä täydennettiin tekemällä yritys case. Tutkimuksen pohjana toimi esiselvitys, jossa muutamia sähköisen liiketoiminnan palveluita oli tunnistettu. Sähköisen liiketoiminnan palveluiden on havaittu lisääntyneen merkittävästi yritystenvälisessä liiketoiminnassa. Kuluttajakaupassa sähköisen liiketoiminnan palvelut ovat olleet jo pitkään käytössä. Sähköisen kaupankäynnin lisääntyminen on ajanut yrityksiä perustamaan sähköisiä kauppapaikkoja, modernisoimaan toimitusmallejaan tai palvelukonseptejaan sekä huomioimaan sähköisen tiedonvaihdon vaikutuksia liiketoimissaan. Tutkimuksen tulokset johtivat kolmeen johtopäätökseen. Tutkimus osoitti, että sähköisen liiketoiminnan palvelut ovat osa nykyaikaista yritystenvälistä liiketoimintaa. Palveluita on olemassa ja niitä on tarjolla yrityksen kilpailijoiden toimesta maailmanlaajuisesti. Toiseksi tutkimus osoitti, että toimitusketjun tulevaisuus on palveluiden kehittämisessä ja niiden rakentamisessa. Kartonkituotteet lähenevät toisiaan laadullisesti kokoajan, sähköiset palvelut voivat tuoda kilpailuetua ja niiden avulla voidaan erottua markkinoilla. Kolmanneksi, sähköiseen liiketoimintaan on panostettava ja palveluita on rakennettava toimitusmalleja tukevaksi. Palveluiden sisällön on huomioitava asiakastarpeet.

Scaling up stepwise feature introduction to construction of large software systems

Developing software is a difficult and error-prone activity. Furthermore, the complexity of modern computer applications is significant. Hence,an organised approach to software construction is crucial. Stepwise Feature Introduction – created by R.-J. Back – is a development paradigm, in which software is constructed by adding functionality in small increments. The resulting code has an organised, layered structure and can be easily reused. Moreover, the interaction with the users of the software and the correctness concerns are essential elements of the development process, contributing to high quality and functionality of the final product. The paradigm of Stepwise Feature Introduction has been successfully applied in an academic environment, to a number of small-scale developments. The thesis examines the paradigm and its suitability to construction of large and complex software systems by focusing on the development of two software systems of significant complexity. Throughout the thesis we propose a number of improvements and modifications that should be applied to the paradigm when developing or reengineering large and complex software systems. The discussion in the thesis covers various aspects of software development that relate to Stepwise Feature Introduction. More specifically, we evaluate the paradigm based on the common practices of object-oriented programming and design and agile development methodologies. We also outline the strategy to testing systems built with the paradigm of Stepwise Feature Introduction.

Design of a Test Stand for a Centrifugal Compressor

The goal of the Master’s thesis is to design a test stand for a centrifugal compressor. Different theoretical aspects of flow parameters measurements and test rigs built for the similar purposes in other research units are described in the theoretical part of the work. The process of components selection and the description of chosen components are given in the second part of the thesis. Besides measuring and control stages, the designed test stand has a closed-loop piping, an aftercooler and a surge tank. Overview and layout of the test rig is presented in the last chapter of the work.

Preparation for ramp-up production process in metal manufacturin

Collaboration is essential for successful new product development. In the preparation for ramp-up production collaboration between R&D and supply chain functions is crucial. This thesis examines the meaning of collaboration and the effects of collaboration between R&D and supply chain. The aim of this thesis is to analyse and advice on how to improve the collaboration between the research and development department and supply chain within the preparation for rampup process. This thesis begins by introducing the reader to the product development methodologies and collaboration literature. The following part of the thesis describes the current situation and the results of the qualitative research. The last part of the thesis will explain the improvement suggestions. The main improvement suggestions are clarification of the processes and responsibilities and the introduction of a kick-off meeting.

Greenhouse gas emissions from peat and biomass-derived fuels, electricity and heat — Estimation of various production chains by using LCA methodology

More discussion is required on how and which types of biomass should be used to achieve a significant reduction in the carbon load released into the atmosphere in the short term. The energy sector is one of the largest greenhouse gas (GHG) emitters and thus its role in climate change mitigation is important. Replacing fossil fuels with biomass has been a simple way to reduce carbon emissions because the carbon bonded to biomass is considered as carbon neutral. With this in mind, this thesis has the following objectives: (1) to study the significance of the different GHG emission sources related to energy production from peat and biomass, (2) to explore opportunities to develop more climate friendly biomass energy options and (3) to discuss the importance of biogenic emissions of biomass systems. The discussion on biogenic carbon and other GHG emissions comprises four case studies of which two consider peat utilization, one forest biomass and one cultivated biomasses. Various different biomass types (peat, pine logs and forest residues, palm oil, rapeseed oil and jatropha oil) are used as examples to demonstrate the importance of biogenic carbon to life cycle GHG emissions. The biogenic carbon emissions of biomass are defined as the difference in the carbon stock between the utilization and the non-utilization scenarios of biomass. Forestry-drained peatlands were studied by using the high emission values of the peatland types in question to discuss the emission reduction potential of the peatlands. The results are presented in terms of global warming potential (GWP) values. Based on the results, the climate impact of the peat production can be reduced by selecting high-emission-level peatlands for peat production. The comparison of the two different types of forest biomass in integrated ethanol production in pulp mill shows that the type of forest biomass impacts the biogenic carbon emissions of biofuel production. The assessment of cultivated biomasses demonstrates that several selections made in the production chain significantly affect the GHG emissions of biofuels. The emissions caused by biofuel can exceed the emissions from fossil-based fuels in the short term if biomass is in part consumed in the process itself and does not end up in the final product. Including biogenic carbon and other land use carbon emissions into the carbon footprint calculations of biofuel reveals the importance of the time frame and of the efficiency of biomass carbon content utilization. As regards the climate impact of biomass energy use, the net impact on carbon stocks (in organic matter of soils and biomass), compared to the impact of the replaced energy source, is the key issue. Promoting renewable biomass regardless of biogenic GHG emissions can increase GHG emissions in the short term and also possibly in the long term.

Photosynthetic characteristics of hybrid and conventional rice plants as a function of plant competition

The objective of this work was to evaluate the characteristics related to the photosynthetic ability of hybrid and inbred rice varieties, as a way to assess which of the two presented higher potential to stand out under conditions of competition. The trial was set in a greenhouse in completely randomized block design and 2 x 6 factorial scheme with four replications. Factor A consisted of rice varieties (hybrid or inbred) and factor B by competition levels. Treatments consisted in maintaining one plant of either BRS Pelota (inbred) or Inov (hybrid) variety at the center of the plot, under competition with 0, 1, 2, 3, 4 or 5 plants of the variety BRS Pelota at the periphery of the experimental unit, according to the treatment. Fifty days after emergence (DAE), sub-stomatal CO2 concentration (Ci - mmol mol-1), photosynthetic rate (A - mmol m-2 s-1) and CO2 consumed (DC - mmol mol-1) were quantified, as well as shoot dry mass(SDM).Hybrid plants present higher photosynthesis capacity than inbred plants, when competing with up to 3 times its own density. When under the same competitive intensity, hybrid plants surpass the inbred. However, it should be emphasized that, when in farm condition, the lower competitive capacity with weeds often attributed to the hybrid varieties, probably is due to their lower planting density, but if weed competition is kept at low levels, hybrid rice plants may perform in the same way or usually better than inbred plants.

Mobiilialan Start-up -yrityksen jakelukanavan valinta

Diplomityössä tutkitaan mobiilisovellusten keskitettyjä jakelukanavia Start-up – yritysten näkökulmasta. Työssä selvitetään, mitkä tekijät vaikuttavat Start-up – yrityksen jakelukanavan valintaan ja millä perusteilla valinta tehdään. Työn tuloksena saatiin 318 sovelluskehittäjän arvio kymmeneen valintakriteeriin. Merkittävin yksittäinen tekijä Start-up –yrityksille on laitekannan koko. Lisäksi Start-up –yritykset arvostavat muita enemmän sovellusten löydettävyyttä, odotettuja tulovirtoja ja omaa asiantuntemustansa. Mielipiteet Start-up –yritysten kesken jakaa kuitenkin valittu jakelukanava. Suurin yksittäinen päätöskriteeri on markkinatutkimus, yksin tai yhdessä media- ja lehdistötietojen kanssa.