Special commentary : a call for intensive metabolic support.

PURPOSE OF REVIEW: This special commentary addresses recent clinical reviews regarding appropriate nutrition and metabolic support in the critical care setting. RECENT FINDINGS: There are divergent approaches between North America and Europe for the use of early nutrition support and combined enteral nutrition and parenteral nutrition support possibly due to the commercial availability of specific parenteral nutrients. The advent of intensive insulin therapy has changed the landscape of metabolic support in the intensive care unit, and previous notions about infective risk of parenteral nutrition will need to be re-addressed. Patients with brain failure may benefit from an intensive insulin therapy with a blood glucose target that is higher than that used in patients without brain failure. Patients with heart failure may benefit from the addition of nutritional pharmacology that targets proximate oxidative pathophysiological pathways. Intradialytic parenteral nutrition may be viewed as another form of supplemental parenteral nutrition when enteral nutrition is insufficient in patients on hemodialysis in the intensive care unit. SUMMARY: It is proposed that intensive metabolic support be routinely implemented in the intensive care unit based on the following steps: intensive insulin therapy with an appropriate blood glucose target, nutrition risk assessment, early and if needed combined enteral nutrition and parenteral nutrition to target 20-25 kcal/kg/day and 1.2-1.5 g protein/kg/day, and nutritional and metabolic monitoring.

Image-Based Coral Reef Classification and Thematic Mapping

This paper presents a novel image classification scheme for benthic coral reef images that can be applied to both single image and composite mosaic datasets. The proposed method can be configured to the characteristics (e.g., the size of the dataset, number of classes, resolution of the samples, color information availability, class types, etc.) of individual datasets. The proposed method uses completed local binary pattern (CLBP), grey level co-occurrence matrix (GLCM), Gabor filter response, and opponent angle and hue channel color histograms as feature descriptors. For classification, either k-nearest neighbor (KNN), neural network (NN), support vector machine (SVM) or probability density weighted mean distance (PDWMD) is used. The combination of features and classifiers that attains the best results is presented together with the guidelines for selection. The accuracy and efficiency of our proposed method are compared with other state-of-the-art techniques using three benthic and three texture datasets. The proposed method achieves the highest overall classification accuracy of any of the tested methods and has moderate execution time. Finally, the proposed classification scheme is applied to a large-scale image mosaic of the Red Sea to create a completely classified thematic map of the reef benthos

Task Support in Scenario Process: Case LUT 2016

This thesis attempts to find whether scenario planning supports the organizational strategy as a method for addressing uncertainty. The main issues are why, what and how scenario planning fits in organizational strategy and how the process could be supported to make it more effective. The study follows the constructive approach. It starts with examination of competitive advantage and the way that an organization develops strategy and how it addresses the uncertainty in its operational environment. Based on the conducted literature review, scenario methods would seem to provide versatile platform for addressing future uncertainties. The construction is formed by examining the scenario methods and presenting suitable support methods, which results in forming of the theoretical proposition for supporter scenario process. The theoretical framework is tested in laboratory conditions, and the results from the test sessions are used a basis for scenario stories. The process of forming the scenarios and the results are illustrated and presented for scrutiny

Genome-wide prediction of matrix attachment regions that increase gene expression in mammalian cells.

Gene transfer in eukaryotic cells and organisms suffers from epigenetic effects that result in low or unstable transgene expression and high clonal variability. Use of epigenetic regulators such as matrix attachment regions (MARs) is a promising approach to alleviate such unwanted effects. Dissection of a known MAR allowed the identification of sequence motifs that mediate elevated transgene expression. Bioinformatics analysis implied that these motifs adopt a curved DNA structure that positions nucleosomes and binds specific transcription factors. From these observations, we computed putative MARs from the human genome. Cloning of several predicted MARs indicated that they are much more potent than the previously known element, boosting the expression of recombinant proteins from cultured cells as well as mediating high and sustained expression in mice. Thus we computationally identified potent epigenetic regulators, opening new strategies toward high and stable transgene expression for research, therapeutic production or gene-based therapies.

Self-Organising Maps and Correlation Analysis as a Tool to Explore Patterns in Excitation-Emission Matrix Data Sets and to Discriminate Dissolved Organic Matter Fluorescence Components

Dissolved organic matter (DOM) is a complex mixture of organic compounds, ubiquitous in marine and freshwater systems. Fluorescence spectroscopy, by means of Excitation-Emission Matrices (EEM), has become an indispensable tool to study DOM sources, transport and fate in aquatic ecosystems. However the statistical treatment of large and heterogeneous EEM data sets still represents an important challenge for biogeochemists. Recently, Self-Organising Maps (SOM) has been proposed as a tool to explore patterns in large EEM data sets. SOM is a pattern recognition method which clusterizes and reduces the dimensionality of input EEMs without relying on any assumption about the data structure. In this paper, we show how SOM, coupled with a correlation analysis of the component planes, can be used both to explore patterns among samples, as well as to identify individual fluorescence components. We analysed a large and heterogeneous EEM data set, including samples from a river catchment collected under a range of hydrological conditions, along a 60-km downstream gradient, and under the influence of different degrees of anthropogenic impact. According to our results, chemical industry effluents appeared to have unique and distinctive spectral characteristics. On the other hand, river samples collected under flash flood conditions showed homogeneous EEM shapes. The correlation analysis of the component planes suggested the presence of four fluorescence components, consistent with DOM components previously described in the literature. A remarkable strength of this methodology was that outlier samples appeared naturally integrated in the analysis. We conclude that SOM coupled with a correlation analysis procedure is a promising tool for studying large and heterogeneous EEM data sets.

Troubleshooting in extracorporeal life support.

Since the first clinical use of extracorporeal circulation in the last century [1] by John Gibbon and the first successful mechanical support of the left ventricular function by Forest Dodrill [2], the progress of techniques and technologies has helped to develop minimised systems for extracorporeal circulatory and respiratory support. However, the fact is that, despite the advanced technologies used for extracorporeal support, successful application in order to be benefit a critically ill population requires highly trained and skilled teams. Application of these highly sophisticated techniques in life-saving situations inside and/or outside the operating room is a procedure with certain pitfalls and dangers. The aim of this review is to provide a short overview of the technical aspects of extracorporeal circulation, with a look at the recent literature and clinical experiences focusing on technical as well surgical considerations regarding the urgent and/or emergent usage of a central as well as peripheral extracorporeal system.

Covariance Matrix Estimation and Mean-Variance Optimization in application to International Diversification

Tutkimus keskittyy kansainväliseen hajauttamiseen suomalaisen sijoittajan näkökulmasta. Tutkimuksen toinen tavoite on selvittää tehostavatko uudet kovarianssimatriisiestimaattorit minimivarianssiportfolion optimointiprosessia. Tavallisen otoskovarianssimatriisin lisäksi optimoinnissa käytetään kahta kutistusestimaattoria ja joustavaa monimuuttuja-GARCH(1,1)-mallia. Tutkimusaineisto koostuu Dow Jonesin toimialaindekseistä ja OMX-H:n portfolioindeksistä. Kansainvälinen hajautusstrategia on toteutettu käyttäen toimialalähestymistapaa ja portfoliota optimoidaan käyttäen kahtatoista komponenttia. Tutkimusaieisto kattaa vuodet 1996-2005 eli 120 kuukausittaista havaintoa. Muodostettujen portfolioiden suorituskykyä mitataan Sharpen indeksillä. Tutkimustulosten mukaan kansainvälisesti hajautettujen investointien ja kotimaisen portfolion riskikorjattujen tuottojen välillä ei ole tilastollisesti merkitsevää eroa. Myöskään uusien kovarianssimatriisiestimaattoreiden käytöstä ei synnytilastollisesti merkitsevää lisäarvoa verrattuna otoskovarianssimatrisiin perustuvaan portfolion optimointiin.

The power of support: an exploration of the mentoring relationship

Tutkimuksen pääasiallisena tavoitteena on selvittää ne moninaiset näkökulmat, joita mentori sekä mentoroitava läpikäyvät osallistuessaan mentorointiohjelmaan. Tutkimuksen avulla pyritään myös selvittämään vastaavanlaisen tuen saannin tehokkuutta sekä mentoroinnin sisältäminen elementtien hyödyllisyyttä. Pyrkimyksenä on myös selvittää sekä ymmärtää ne dynaamiset mentorointiprosessin ominaisuudet molempien prosessiin osallistuvien tahojen näkökulmasta. Tutkimuksen teoriaosuudessa käsitellään mentorointia, mentorointiin liittyviä vuorovaikutussuhteita sekä näihin liittyviä eri näkökulmia. Teoria koostuu monipuolisesta, kansainvälisestä sekä kotimaisesta kirjallisuudesta. Tutkimuksen aineiston keruu suoritetaan puolistrukturoiduilla avoimilla haastatteluilla, jotka suoritetaan järjestämällä kahdenkeskisiä teemahaastatteluita. Mentorointisuhteella on todettu olevan voimakas vaikutus siihen osallistuvien henkilöiden elämään. Mentorointisuhteen tarkoituksellisuus on tullut todettua myös kun itse vuorovaikutussuhde on osoittautunut hyödylliseksi osallistujille. Mentoroitavilla on odotuksia, että mentorit täyttävät seuraavanlaisia rooleja: neuvonantaja, roolimalli sekä mahdollisesti tukea antava ystävä. Kaikissa läpikäydyissä tapauksissa mentori pystyi tarjoamaan jonkun näistärooleista mentoroitavalle. Mentoroitava, puolestaan, otti tämän tuen vastaan jahyötyi siitä.

Different concentrations of Mg++ ions affect nuclear matrix protein distribution during thermal stabilization of isolated nuclei.

The nuclear matrix, a proteinaceous network believed to be a scaffolding structure determining higher-order organization of chromatin, is usually prepared from intact nuclei by a series of extraction steps. In most cell types investigated the nuclear matrix does not spontaneously resist these treatments but must be stabilized before the application of extracting agents. Incubation of isolated nuclei at 37C or 42C in buffers containing Mg++ has been widely employed as stabilizing agent. We have previously demonstrated that heat treatment induces changes in the distribution of three nuclear scaffold proteins in nuclei prepared in the absence of Mg++ ions. We studied whether different concentrations of Mg++ (2.0-5 mM) affect the spatial distribution of nuclear matrix proteins in nuclei isolated from K562 erythroleukemia cells and stabilized by heat at either 37C or 42C. Five proteins were studied, two of which were RNA metabolism-related proteins (a 105-kD component of splicing complexes and an RNP component), one a 126-kD constituent of a class of nuclear bodies, and two were components of the inner matrix network. The localization of proteins was determined by immunofluorescent staining and confocal scanning laser microscope. Mg++ induced significant changes of antigen distribution even at the lowest concentration employed, and these modifications were enhanced in parallel with increase in the concentration of the divalent cation. The different sensitivity to heat stabilization and Mg++ of these nuclear proteins might reflect a different degree of association with the nuclear scaffold and can be closely related to their functional or structural role.

Improving globally distributed software development and support processes - A workflow view

We propose a new approach and related indicators for globally distributed software support and development based on a 3-year process improvement project in a globally distributed engineering company. The company develops, delivers and supports a complex software system with tailored hardware components and unique end-customer installations. By applying the domain knowledge from operations management on lead time reduction and its multiple benefits to process performance, the workflows of globally distributed software development and multitier support processes were measured and monitored throughout the company. The results show that the global end-to-end process visibility and centrally managed reporting at all levels of the organization catalyzed a change process toward significantly better performance. Due to the new performance indicators based on lead times and their variation with fixed control procedures, the case company was able to report faster bug-fixing cycle times, improved response times and generally better customer satisfaction in its global operations. In all, lead times to implement new features and to respond to customer issues and requests were reduced by 50%.

Value added logistical support service. Part 1 : Trends and new concept model

The aim of `Valssi' study was to find out the service requirements in `business-to-business' (B2B) markets and to present a new logistics service concept, where the traditional logistics service is expanded with significant manufacturing and value addedfacilities. The traditional third-party logistics service providers are not necessarily able to offer services, which cover widely the needs of potential customers. The study has been outlined to spare part markets in metal industry. In the second phase of the Valssi-project the aim is to examine the economical conditions and potentiality of the new logistics business concept. This research report (Part 1) concentrates on examining current trends in global and domestic logistics markets. Based on detailed survey among the participating companies, the study presents basis for a new logistics business concept model. The developed concept consists of 12 different service modules, which are split into deeper details of processes. The integration of worldwide supplier and service provider network together with customer companies systems is a challenge. The report focuses on evaluating the requirements for the new business concept from the customer-companies point of view. The study paints an overall picture of distribution and service provider network including an abstract about the software and system integration possibilities. As a result of the survey, it can be concluded that thereis need for the new business concept among the participating companies, and a modular service concept meets the requirements of them, because the new sophisticated concept considers the specialities involved in spare part logistics in metal industry.

Developing Support for Scenario Process: A Scenario Study on Lappeenranta University of Technology from 2006 to 2016

Epävarmuus ei ole outoa enää julkishallinon alueellakaan. Globalisaation,tietotalous ja muut yksityissektoria ravistelleet ilmiöt ovat lisänneet mielenkiintoa erilaisiin tekniikoihin joilla voidaan lievittää epävarmuudesta aiheutuvia ongelmia. Tämä raportti kuvailee skenaariosuunnittelun käyttöä eräänä mahdollisuutena epävarmuuden hallintaan julkishallinnossa ja yksityissektorilla. Raportti sijoittuu samaan skenaariotutkimuksen jatkumoon edellisten LTY:ssä toteutettujen skenaariotutkimusten kanssa. tutkimus valottaa tutkimuksen ja käytännön työn nykytilaa helposti hyödynnettävässä muodossa. Rapostin kontribuutio on kuvata tutkimukseen perustuva tuettu skenaarioprosessi ja syntyneet skenaariot, keskittyen prosessin tukemiseen eri menetelmin.

Value added logistical support service: logistiikan palveluiden tarjoajat Suomessa. osa 4

Tämä osatutkimus on VALSSI- tutkimusprojektin (Value Added Logistical Support Service) neljäs osavaihe. VALSSI- tutkimuksen tarkoituksena on ollut selvittää logistiikkapalveluiden vaatimuksia business-to-business (B2B) ympäristössä ja määrittää logistiikkapalveluiden palvelukonsepti, jossa perinteiset logistiikkapalvelut on laajennettu tuotannollisilla ja lisäarvoa tuottavilla palveluilla. Tutkimuksen tarkoituksena on ollut tuottaa ulkoistamista helpottavaa materiaalia erityisesti varastoinnin ja kuljetusten osalta. Edellisistä osavaiheista on saatavilla tutkimusraportit yliopiston Internet-sivuilta(www.lut.fi/tutkimus/valore). Tämän tutkimuksen tarkoituksena oli kartoittaa Suomessa toimivien logistiikkapalveluyritysten palvelutarjonta. Tutkimus on keskittynyt palveluntarjoajiin, jotka tarjoavat erikoistunutta logistiikkaa (mm. tuotannollisia palveluita, hankintoja ja pakkauspalveluita) asiakkailleen. Tutkimukseen osallistuneet yritykset olivat suomalaisia ja kansainvälisiä sekä kuljetuspalveluita tarjoavia että logistiikkapalveluyrityksiä sekä alihankkijoina/tukkureina toimivia palveluntarjoajia. Huomionarvoista onkin, että moni yrityksistä käytti markkinoilta saatavia kuljetuspalveluita eikä toiminut itse kuljetusoperaattorina. Logistiikkapalveluyrityksissä huomattiin eroavaisuuksia asiakaspalvelun laajuudessa, ICT strategioissa, hankintojen ja kotiinkutsujen organisoinnissa, tuotannollisissa palveluissa sekä paluulogistiikassa. Varsinaiset varastointipalvelut ovat homogeenisia ja varastointiin liittyvät pakkaamispalvelut ovat pääasiassasamankaltaisia. Markkinoilla toimivien tukkukauppiaiden logistiikkaprosessit eroavat perinteisistä palveluntarjoajista. Tukkurit hoitavat laajasti mm. asiakaspalvelua, teknistä tukea sekä erikoistuneita tuotannollisia palveluita. Nykypäivänä asiakkaat asettavat enemmän vaatimuksia logistiikkapalveluyrityksen prosesseille ja prosessien johtamiselle. Tulevaisuudessa Suomessa ja maailmalla toimivat logistiikkapalveluyritykset tulevat toimimaan yhteistyöverkoissa Itä- Euroopan maat ovat entistä suuremmassa roolissa uusia jakelukanavia ja palveluita mietittäessä. Jo nyt on huomattavissa, että asiakkaat vaativat logistiikan palvelutarjoajia tarjoamaan entistä monipuolisempia ja tuotteistetumpia palveluita.

Value added logistical support service: logistics cost structure and performance in the new concept. Part 3

The aim of this study is to present an Activity-Based Costing spreadsheet tool for analyzing the logistics costs. The tool can be used both by customer-companies and logistics service providers. The study discusses the influence of different activity models on costs. Additionally this paper discusses about the logistical performance across the total supply chain This study is carried out using ananalytical research approach and literature material has been used for supplementing the concerned research approach. Cost structure analysis was based on the theory of activity-based management. This study was outlined to spare part logistics in machine-shop industry. The outlines of logistics services and logisticalperformance discussed in this report are based on the new logistics business concept (LMS-concept), which has been presented earlier in the Valssi-project. Oneof the aims of this study is to increase awareness of different activity modelson logistics costs. The report paints an overall picture about the business environment and requirements for the new logistics concept.