Accuracy of sonography and hysteroscopy in the diagnosis of premalignant and malignant polyps in postmenopausal women

PURPOSE: To evaluate the accuracy of sonographic endometrial thickness and hysteroscopic characteristics in predicting malignancy in postmenopausal women undergoing surgical resection of endometrial polyps. METHODS: Five hundred twenty-one (521) postmenopausal women undergoing hysteroscopic resection of endometrial polyps between January 1998 and December 2008 were studied. For each value of sonographic endometrial thickness and polyp size on hysteroscopy, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated in relation to the histologic diagnosis of malignancy. The best values of sensitivity and specificity for the diagnosis of malignancy were determined by the Receiver Operating Characteristic (ROC) curve. RESULTS: Histologic diagnosis identified the presence of premalignancy or malignancy in 4.1% of cases. Sonographic measurement revealed a greater endometrial thickness in cases of malignant polyps when compared to benign and premalignant polyps. On surgical hysteroscopy, malignant endometrial polyps were also larger. An endometrial thickness of 13 mm showed a sensitivity of 69.6%, specificity of 68.5%, PPV of 9.3%, and NPV of 98% in predicting malignancy in endometrial polyps. Polyp measurement by hysteroscopy showed that for polyps 30 mm in size, the sensitivity was 47.8%, specificity was 66.1%, PPV was 6.1%, and NPV was 96.5% for predicting cancer. CONCLUSIONS: Sonographic endometrial thickness showed a higher level of accuracy than hysteroscopic measurement in predicting malignancy in endometrial polyps. Despite this, both techniques showed low accuracy for predicting malignancy in endometrial polyps in postmenopausal women. In suspected cases, histologic evaluation is necessary to exclude malignancy.

Vesihöyrypiirin kiertolaskenta kuplapetikattilassa

Työssä selvitetään kiertolaskennan periaatteita kuplapetikattilassa, esitetään lyhyesti kattilan toimintaperiaate ja paneudutaan alan laskentaohjelmistoihin. Luonnonkierto kattilan vesihöyrypiirissä on seurausta hydrostaattisesta paineesta, joka aiheutuu tiheyserosta nousu- ja laskuputkien välillä. Kiertolaskennassa on huomioitava kaksifaasivirtauksen ominaispiirteet. Höyry ja neste virtaavat putkistossa eri nopeuksilla, jolloin esimerkiksi painehäviön määrityksessä käytetään erilaisia korrelaatioita ja käyrästöjä. Kaksifaasivirtauksen laskennassa tarvitaan kolmea eri taseyhtälöä: energiatasetta, massatasetta ja liikemäärätasetta. Luonnonkiertokattiloissa höyrykierron suunnittelussa on kaksi pääasiallista ehtoa. Ensimmäiseksi tulee varmistaa riittävä kiertoveden massavirta, jotta vältetään höyrystinputkien puhki palaminen. Toiseksi tulee välttää höyrystinputken pinnan lämpötilavaihteluita ja värähtelyitä. Alustavassa luonnonkierron mitoituksessa turvaudutaan kokemusperäiseen tietoon. Myöhemmässä tarkemmassa mitoituksessa käytettäviä ohjelmistoja ovat NOWA sekä kaupalliset PPSD ja Apros. Laskenta lähtee liikkeelle siitä, että lasketaan ensin vesihöyrykierron massavirrat erilaisilla lämpökuormilla ja höyryntuotanto määritellään painehäviöiden perusteella. NOWA- ja PPSD- ohjelmistoilla tehtyjen esimerkkilaskelmien perusteella voidaan sanoa, että tulokset riippuvat käytetystä laskentamallista.

Sosiaali- ja terveydenhuollon asiantuntijoiden palveluprosessien mallintaminen osana vastaanottotoiminnan kehittämistä

Diplomityön tavoitteena on soveltaa perinteisesti teollisesta tuotannosta lähtöisin olevia prosessijohtamisen menetelmiä sosiaali- ja terveydenhuollon vastaanottotoiminnan kehittämiseen. Tarkoituksena on asiantuntijapalveluprosessien mallintamisen avulla kartoittaa prosessien nykytilaa tunnistamalla ongelma- ja kehittämiskohteita, joiden ratkaisemiseksi annettavien kehittämistoimenpide-ehdotusten muodostamisessa sovelletaan prosessijohtamisen menetelmien periaatteita. Tutkimuksen teoreettisen viitekehyksen mukaisesti tarkastellaan mm. prosessien mallintamista, eli kuvaamista ja analysointia, sekä sosiaali- ja terveydenhuoltoa palvelutuotantona. Tutkimuksessa hyödynnetään sekä kvalitatiivisia että kvantitatiivisia menetelmiä, ja tutkimusaineistoa kerätään haastattelujen, havainnoinnin ja tilastojen avulla. Asiantuntijoiden palveluprosesseista laaditaan aineiston perusteella kuvaukset, ja tunnistetaan prosesseihin tai laajemminkin sosiaali- ja terveydenhuolto-organisaatioon liittyviä ongelma- ja kehittämiskohteita. Kehittämistoimenpiteissä korostuvat asiakaslähtöisyys ja tuottavuus, ja niissä huomioidaan niin asiakkaan, henkilöstön, prosessien kuin asiakasohjauksen näkökulma. Työn keskeisimmät tulokset ovat prosessikuvaukset, tunnistetut ongelma- ja kehittämiskohteet sekä prosessien uudelleenmäärittämiseksi muodostetut kehittämistoimenpide-ehdotukset, joiden hyötyjä ja vaikutuksia mm. suorituskykyyn arvioidaan. Tulosten perusteella voidaan päätellä, että prosessijohtamisen menetelmät soveltuvat sosiaali- ja terveydenhuollon toiminnan kehittämiseen, kunhan huomioidaan toimintaympäristön erityispiirteet ja haasteet.

Anatomical and histological characteristics of teeth in agouti (Dasyprocta prymnolopha Wagler, 1831)

The agouti species Dasyprocta prymnolopha (D. prymnolopha) is a medium-sized rodent, diurnal, and characteristic of northeastern Brazil, south of the Amazon. Several studies have been made on these rodents. However, there is a lack of analysis of masticatory system, in particular morphology of the teeth. Thus, this research seeks to describe anatomical and histological aspects of the agouti teeth. For this purpose, we used adult agouti, in which measurements and descriptions of teeth and dental tissues were made. It was observed that the dental arch of D. prymnolopha comprises of twenty teeth, evenly distributed in the upper and lower arch, being inferior teeth larger than their corresponding higher. The incisors are larger, and between the posterior premolars and molars, there is a gradual increase in length in the anterior-posterior arch. In microscopic examination, a prismatic appearance was observed consisting of enamel prisms arranged in different directions, behind the enamel and dentin with standard tubular dentinal tubules with variable diameter and far between, also showing a sinuous path from the inner portion to the junction with more superficial enamel. Morphological analysis of dental tissues showed that an enamel with structural organization adapted to the act of chewing and high impact dentin compatible with standard tubular function resilience and mechanical damping of masticatory forces, as found in larger animals, confirming the understanding of eating habits that define much of its ecological functions within the ecosystem they inhabit.

Auscultatory and electrocardiographic characteristics of Crioulo horses

In order to determine auscultatory and electrocardiographic characteristics of Crioulo horses, one hundred animals ranging between one and twenty-six years of age (21 stallions, nine geldings, 27 pregnant mares e 43 not pregnant mares) were evaluated. The cardiac auscultation was performed during the clinical examination of the cardiovascular system, evaluating frequency, rate, normal and abnormal heart sounds (heart murmurs). The electrocardiographic examination followed the bipolar base-apex derivative system with animals at rest, by using an ECG-PC TEB equipment. The cardiac frequency, heart rate, morphology, duration, wave and complex amplitudes and interval durations were determined. The results were submitted to ANOVA and Tukey tests with an error probability of 5%. The cardiac auscultation revealed presence of functional systolic and diastolic murmur (10.00%) and systolic murmur compatible with tricuspid regurgitation besides normal heart sounds S1 (100.0%), S2 (100.0%), S3 (19.0%) and S4 (34.0%). The cardiac frequency obtained the average of 43.64 bpm, observing significative differences in relation to sexual and age factors and training level. The sinus rhythm was the most frequent (57.00%), followed by sinus tachycardia (38.00%) and sinus arrhythmia (5.00%), being observed rhythm disturbances in 16% of tracings. The P and T waves were observed more frequently in their forms P bifida positive (95.00%) and biphasic T (91.00%), being variable at tracing. There were also observed Q waves in 12.00% of the tracings. Thus, it was concluded that the auscultatory characteristics of Crioulo horses are according to the described in the literature for the species and the sexual factor, category, age factor and training level can influence some electrocardiographic parameters.

Keskeneräisen tuotannon hallinta sähkönjakeluverkon urakointiprojekteissa

The main objective of the study was to find new approaches to the management of work in process in a rapidly changing power distribution network contracting environment in order to improve the efficiency of the management of capital and workload. The study describes the operating environment of a power distribution network contractor based in Eastern Finland and combines various activity indicators to create a general view. The literature review discusses scientific articles on project production, work in process and working capital management, analytical tools for projects as well as Lean criteria. The analysis of two case studies dealing with the characteristics of the power distribution network restructuring, focuses on how production management and management of work in process can potentially be improved in power distribution network contracting environments. The main results are the summary of the key figures of production, the data concerning the significance of different project types for work in process as well as the ways of improving the efficiency of production and business development in the present context.

Fracture modes and acoustic emission characteristics of hydrogen-assisted cracking in high-strength low-alloy steel weldment

The aim of the present paper is to study the relationship between the fracture modes in hydrogen-assisted cracking (HAC) in microalloied steel and the emission of acoustic signals during the fracturing process. For this reason, a flux-cored arc weld (FCAW) was used in a high-strength low-alloy steel. The consumable used were the commercially available AWS E120T5-K4 and had a diameter of 1.6 mm. Two different shielding gases were used (CO2 and CO2+5% H2) to obtain complete phenomenon characterization. The implant test was applied with three levels of restriction stresses. An acoustic emission measurement system (AEMS) was coupled to the implant test apparatus. The output signal from the acoustic emission sensor was passed through an electronic amplifier and processed by a root mean square (RMS) voltage converter. Fracture surfaces were examined by scanning electron microscopy (SEM) and image analysis. Fracture modes were related with the intensity, the energy and the number of the peaks of the acoustic emission signal. The shielding gas CO2+5% H2 proved to be very useful in the experiments. Basically, three different fracture modes were identified in terms of fracture appearance: microvoid coalescence (MVC), intergranular (IG) and quasi-cleavage (QC). The results show that each mode of fracture presents a characteristic acoustic signal.

Hydrodynamics Characteristics and Gas-Liquid Mass Transfer in a Three Phase Fluidized Bed Reactor

This paper presents the experimental characterization of hydrodynamics and gas-liquid mass transfer in a three-phase fluidized bed containing polystyrene and nylon particles. The influence of gas and liquid velocities on phase holdups and volumetric gas-liquid mass transfer coefficient was investigated for flow conditions similar to those applied in biotechnological process. The phase holdups were obtained by the pressure profile technique. The volumetric gas-liquid mass transfer coefficient was obtained adjusting the experimental concentration profiles of dissolved oxygen in the liquid phase with the predictions of the axial dispersion model. According to experimental results the liquid holdup increases with the gas velocity, whereas the solid holdup decreases. The gas holdup increases significantly with the increase in gas velocity, and it shows for the three-phase fluidized bed comparable values or larger than those of bubble column. The volumetric gas-liquid mass transfer coefficient increases significantly with an increase in the air velocity for both bubble column and fluidized beds. In addition, in the operational condition of high liquid velocity, the presence of low-density particles in the bed increased the gas-liquid mass transfer, and thus the volumetric mass transfer coefficient values obtained in the fluidized bed were comparable or larger than those of bubble column.

Experimental Vibration Characteristics of a Beam with Nonlinear Support Using Receptance Coupling Analysis

This paper applies the Multi-Harmonic Nonlinear Receptance Coupling Approach (MUHANORCA) (Ferreira 1998) to evaluate the frequency response characteristics of a beam which is clamped at one end and supported at the other end by a nonlinear cubic stiffness joint. In order to apply the substructure coupling technique, the problem was characterised by coupling a clamped linear beam with a nonlinear cubic stiffness joint. The experimental results were obtained by a sinusoidal excitation with a special force control algorithm where the level of the fundamental force is kept constant and the level of the harmonics is kept zero for all the frequencies measured.

Deregulation’s Impact on the Railway Freight Transport Sector’s Future in the Baltic Sea Region

The European transport market has confronted several changes during the last decade. Due to European Union legislative mandates, the railway freight market was deregulated in 2007. The market followed the trend started by other transport modes as well as other previously regulated industries such as banking, telecommunications and energy. Globally, the first country to deregulate the railway freight market was the United States, with the introduction of the Staggers Rail Act in 1980. Some European countries decided to follow suit already before regulation was mandated; among the forerunners were the United Kingdom, Sweden and Germany. The previous research has concentrated only on these countries, which has provided an interesting research gap for this thesis. The Baltic Sea Region consists of countries with different kinds of liberalization paths, including Sweden and Germany, which have been on the frontline, whereas Lithuania and Finland have only one active railway undertaking, the incumbent. The transport market of the European Union is facing further challenges in the near future, due to the Sulphur Directive, oil dependency and the changing structure of European rail networks. In order to improve the accessibility of this peripheral area, further action is required. This research focuses on topics such as the progression of deregulation, barriers to entry, country-specific features, cooperation and internationalization. Based on the research results, it can be stated that the Baltic Sea Region’s railway freight market is expected to change in the future. Further private railway undertakings are anticipated, and these would change the market structure. The realization of European Union’s plans to increase the improved rail network to cover the Baltic States is strongly hoped for, and railway freight market counterparts inside and among countries are starting to enhance their level of cooperation. The Baltic Sea Region countries have several special national characteristics which influence the market and should be taken into account when companies evaluate possible market entry actions. According to thesis interviews, the Swedish market has a strong level of cooperation in the form of an old-boy network, and is supported by a positive attitude of the incumbent towards the private railway undertakings. This has facilitated the entry process of newcomers, and currently the market has numerous operating railway undertakings. A contrary example was found from Poland, where the incumbent sent old rolling stock to the scrap yard rather than sell it to private railway undertakings. The importance of personal relations is highlighted in Russia, followed by the railway market’s strong political bond with politics. Nonetheless, some barriers to entry are shared by the Baltic Sea Region, the main ones being acquisition of rolling stock, bureaucracy and needed investments. The railway freight market is internationalizing, which is perceived via several alliances as well as the increased number of mergers and acquisitions. After deregulation, markets seem to increase the number of railway undertakings at a rather fast pace, but with the passage of time, the larger operators tend to acquire smaller ones. Therefore, it is expected that in a decade’s time, the number of railway undertakings will start to decrease in the deregulation pioneer countries, while the ones coming from behind might still experience an increase. The Russian market is expected to be totally liberalized, and further alliances between the Russian Railways and European railway undertakings are expected to occur. The Baltic Sea Region’s railway freight market is anticipated to improve, and, based on the interviewees’ comments, attract more cargoes from road to rail.

Russia, China, India Foresight for Small and Medium size Enterprises in Uusimaa : Changes forecast in the Russian, Chinese and Indian operating environments from the viewpoint of small and middle-sized enterprises in Uusimaa

The report describes those factors of the future that are related to the growth and needs of Russia, China, and India and that may provide significant internationalisation potential for Uusimaa companies. The report examines the emerging trends and market-entry challenges for each country separately. Additionally, it evaluates the training needs of Uusimaa companies in terms of the current offerings available for education on topics related to Russia, China, and India. The report was created via the Delphi method: experts were interviewed, and both Trendwiki material and the latest literature were used to create a summary of experts’ views, statements, and reasons behind recent developments. This summary of views was sent back to the experts with the objective of reaching consensus synthesising the differing views or, at least, of providing argumentation for the various alternative lines of development. In addition to a number of outside experts and business leaders, all heads of Finpro’s Finland Trade Centers participated in the initial interviews. The summary was commented upon by all Finpro consultants and analysts for Russia, China, and India, with each focusing on his or her own area of expertise. The literature used consisted of reports, listed for each country, and an extensive selection of the most recent newspaper articles. The report was created in January-April 2010. On 22 April 2010 its results were reviewed at the final report presentation in cooperation with the Uusimaa ELY Centre.

Cultural distance and negotiation behavior : Perception of entrepreneurs operating in Turku

This thesis investigates the influence of cultural distance on entrepreneurs’ negotiation behaviour. For this purpose, Turku was chosen as the unit of analysis due to the exponential demographic change experienced during the last two decades that has derived in a more diversified local environment. The research aim set for this study was to identify to what extent entrepreneurs face cultural distance, how cultural distance influences the entrepreneur’s negotiation behaviour and how can it be addressed in order to turn dissimilarities into opportunities. This study presented the relation and apparent dichotomy of cultural distance and global culture, including the component of diversity. The impact of cultural distance in the entrepreneurial mindset and its consequent effect in negotiation behaviour was presented too. Addressing questions about the way individuals perceive, behave and interact allowed the use of interviews for this qualitative research study. In the empirical part of this study it was found that negotiation behaviour differed in terms of how congenial entrepreneurs felt when managing cultural distance, encompassing their performance. It was also acknowledged that after time and effort, some of the personal traits were enhanced while others reduced, allowing for more flexibility and adaptation. Furthermore, depending on the level of trust and shared interests, entrepreneurs determined their attitudinal approach, being adaptive or reactive subject to situational aspects. Additionally, it was found that the acquisition of cultural savvy not necessarily conveyed to more creativity. This experiential learning capability led to the proposition of new ways of behaviour. Likewise, it was proposed that growing cultural intelligence bridge distances, reducing mistrusts and misunderstandings. The capability of building more collaborative relationships allows entrepreneurs to see cultural distance as a cultural perspective instead of as a threat. Therefore it was recommended to focus on proximity rather than distance to better identify and exploit untapped opportunities and better perform when negotiating in whichever cultural conditions.

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.

Pressure filtration characteristics of enzymatically hydrolyzed biomass suspensions

Enzymatic hydrolysis of lignocellulosic polymers is likely to become one of the key technologies enabling industrial production of liquid biofuels and chemicals from lignocellulosic biomass. Certain types of enzymes are able to hydrolyze cellulose and hemicellulose polymers to shorter units and finally to sugar monomers. These monomeric sugars are environmentally acceptable carbon sources for the production of liquid biofuels, such as bioethanol, and other chemicals, such as organic acids. Liquid biofuels in particular have been shown to contribute to the reduction of net emissions of greenhouse gases. The solid residue of enzymatic hydrolysis is composed mainly of lignin and partially degraded fibers, while the liquid phase contains the produced sugars. It is usually necessary to separate these two phases at some point after the hydrolysis stage. Pressure filtration is an efficient technique for this separation. Solid-liquid separation of biomass suspensions is difficult, because biomass solids are able to retain high amounts of water, which cannot be readily liberated by mechanical separation techniques. Most importantly, the filter cakes formed from biomaterials are compressible, which ultimately means that the separation may not be much improved by increasing the filtration pressure. The use of filter aids can therefore facilitate the filtration significantly. On the other hand, the upstream process conditions have a major influence on the filtration process. This thesis investigates how enzymatic hydrolysis and related process conditions affect the filtration properties of a cardboard suspension. The experimental work consists of pressure filtration and characterization of hydrolysates. The study provides novel information about both issues, as the relationship between enzymatic hydrolysis conditions and subsequent filtration properties has so far not been considered in academic studies. The results of the work reveal that the final degree of hydrolysis is an important factor in the filtration stage. High hydrolysis yield generally increases the average specific cake resistance. Mixing during the hydrolysis stage resulted in undefined changes in the physical properties of the solid residue, causing a high filtration resistance when the mixing intensity was high. Theoretical processing of the mixing data led to an interesting observation: the average specific cake resistance was observed to be linearly proportional to the mixer shear stress. Another finding worth attention is that the size distributions of the solids did not change very dramatically during enzymatic hydrolysis. There was an observable size reduction during the first couple of hours, but after that the size reduction was minimal. Similarly, the size distribution of the suspended solids remained almost constant when the hydrolyzed suspension was subjected to intensive mixing. It was also found that the average specific cake resistance was successfully reduced by the use of filter aids. This reduction depended on the method of how the filter aids were applied. In order to obtain high filtration capacity, it is recommended to use the body feed mode, i.e. to mix the filter aid with the slurry prior to filtration. Regarding the quality of the filtrate, precoat filtration was observed to produce a clear filtrate with negligible suspended solids content, while the body feed filtrates were turbid, irrespective of which type of filter aid was used.