Community-acquired pneumonia in adult patients with special reference to rapid methods for etiological diagnosis

Aikuispotilaan kotisyntyisen keuhkokuumeen etiologinen diagnostiikka mikrobiologisilla pikamenetelmillä Tausta. Keuhkokuume on vakava sairaus, johon sairastuu Suomessa vuosittain n. 60 000 aikuista. Huolimatta siitä, että taudin hoito on kehittynyt, siihen liittyy yhä merkittävä, 6-15%:n kuolleisuus. Alahengitystieinfektion aiheuttajamikrobien tunnistaminen on myös edelleen haasteellista. Tavoitteet. Tämän työn tavoitteena oli tutkia Turun yliopistollisessa keskussairaalassa hoidettujen aikuispotilaiden keuhkokuumeen etiologiaa sekä selvittää uusien mikrobiologisten pikamenetelmi¬en hyödyllisyyttä taudinaiheuttajan toteamisessa. Aineisto. Osatöiden I ja III aineisto koostui 384 Turun yliopistollisen keskussairaalaan infektio-osastolla hoidetusta keuhkokuumepotilaasta. Osatyössä I tutkittiin keuhkokuumeen aiheuttaja¬mikrobeja käyttämällä perinteisten menetelmien lisäksi antigeeniosoitukseen ja PCR-tekniikkaan perustuvia pikamenetelmiä. Osatyö II käsitti 231 potilaasta koostuvan alaryhmän, jossa tutkittiin potilaiden nielun limanäytteestä rinovirusten ja enterovirusten esiintyvyyttä. Osatyössä III potilailta tutkittiin plasman C-reaktiivisen proteiinin (CRP) pitoisuus ensimmäisten viiden sairaalahoitopäi¬vän aikana. Laajoja tilastotieteellisiä analyysejä käyttämällä selvitettiin CRP:n käyttökelpoisuutta sairauden vaikeusasteen arvioinnissa ja komplikaatioiden kehittymisen ennustamisessa. Osatyössä IV 68 keuhkokuumepotilaan sairaalaan tulovaiheessa otetuista näytteistä määritettiin neutrofiilien pintareseptorien ekspressio. Osatyössä V analysoitiin sisätautien vuodeosastoilla vuosina 1996-2000 keuhkokuumepotilaille tehtyjen keuhkohuuhtelunäytteiden laboratoriotutkimustulokset. Tulokset. Keuhkokuumeen aiheuttaja löytyi 209 potilaalta, aiheuttajamikrobeja löydettiin kaikkiaan 230. Näistä aiheuttajista 135 (58.7%) löydettiin antigeenin osoituksella tai PCR-menetelmillä. Suu¬rin osa, 95 (70.4%), todettiin pelkästään kyseisillä pikamenetelmillä. Respiratorinen virus todettiin antigeeniosoituksella 11.1% keuhkokuumepotilaalla. Eniten respiratorisia viruksia löytyi vakavaa keuhkokuumetta sairastavilta potilailta (20.3%). 231 keuhkokuumepotilaan alaryhmässä todettiin PCR-menetelmällä picornavirus 19 (8.2%) potilaalla. Respiratorinen virus löytyi tässä potilasryh¬mässä kaiken kaikkiaan 47 (20%) potilaalta. Näistä 17:llä (36%) löytyi samanaikaisesti bakteerin aiheuttama infektio. CRP-tasot olivat sairaalaan tulovaiheessa merkitsevästi korkeammat vakavaa keuhkokuumetta (PSI-luokat III-V) sairastavilla potilailla kuin lievää keuhkokuumetta (PSI-luokat I-II) sairastavilla potilailla (p <0.001). Yli 100 mg/l oleva CRP-taso neljän päivän kuluttua sairaa¬laan tulosta ennusti keuhkokuumeen komplikaatiota tai huonoa hoitovastetta. Neutrofiilien komple¬menttireseptorin ekspressio oli pneumokokin aiheuttamaa keuhkokuumetta sairastavilla merkitse¬västi korkeampi kuin influenssan aiheuttamaa keuhkokuumetta sairastavilla. BAL-näytteistä vain yhdessä 71:stä (1.3%) todettiin diagnostinen bakteerikasvu kvantitatiivisessa viljelyssä. Uusilla menetelmilläkin keuhkokuumeen aiheuttaja löytyi vain 9.8% BAL-näytteistä. Päätelmät. Uusilla antigeeniosoitus- ja PCR-menetelmillä keuhkokuumeen etiologia voidaan saada selvitettyä nopeasti. Lisäksi näitä menetelmiä käyttämällä taudin aiheuttajamikrobi löytyi huomattavasti suuremmalta osalta potilaista kuin pelkästään tavanomaisia menetelmiä käyttämällä. Pikamenetelmien hyödyllisyys vaihteli taudin vaikeusasteen mukaan. Respiratorinen virus löytyi huomattavan usein keuhkokuumetta sairastavilta potilailta, ja näiden potilaiden taudinkuva oli usein vaikea. Tulovaiheen korkeaa CRP-tasoa voidaan käyttää lisäkeinona arvioitaessa keuhkokuumeen vaikeutta. CRP on erityisen hyödyllinen arvioitaessa hoitovastetta ja riskiä komplikaatioiden ke¬hittymiseen. Neutrofiilien komplementtireseptorin ekspression tutkiminen näyttää lupaavalta pi¬kamenetelmältä erottamaan bakteerien ja virusten aiheuttamat taudit toisistaan. Antimikrobihoitoa saavilla potilailla BAL-tutkimuksen löydökset olivat vähäiset ja vaikuttivat hoitoon vain harvoin.

Effects of the sewage pollution in the structure and dynamics of the community of Cystoseira mediterranea (Fucales, Phaeophyceae)

We performed a study on the specific composition, structure, and dynamics of two Cystoseira mediterranea communities from the north-western Mediterranean submitted to different degrees of pollution. The structural complexity (species richness, specific distribution, and species and pattern diversity) and biomass production were lower in the polluted site. In this station, opportunistic algae (mainly Ulva rigida) loomed, and Mesophyllum lichenoides and some encrusting brown algae increased their cover. Other species (Jania rubens, and some Ceramiales) decreased their abundance when compared with the polluted site

Active du/dt Filtering for Variable-Speed AC Drives

An oscillating overvoltage has become a common phenomenon at the motor terminal in inverter-fed variable-speed drives. The problem has emerged since modern insulated gate bipolar transistors have become the standard choice as the power switch component in lowvoltage frequency converter drives. Theovervoltage phenomenon is a consequence of the pulse shape of inverter output voltage and impedance mismatches between the inverter, motor cable, and motor. The overvoltages are harmful to the electric motor, and may cause, for instance, insulation failure in the motor. Several methods have been developed to mitigate the problem. However, most of them are based on filtering with lossy passive components, the drawbacks of which are typically their cost and size. In this doctoral dissertation, application of a new active du/dt filtering method based on a low-loss LC circuit and active control to eliminate the motor overvoltages is discussed. The main benefits of the method are the controllability of the output voltage du/dt within certain limits, considerably smaller inductances in the filter circuit resulting in a smaller physical component size, and excellent filtering performance when compared with typical traditional du/dt filtering solutions. Moreover, no additional components are required, since the active control of the filter circuit takes place in the process of the upper-level PWM modulation using the same power switches as the inverter output stage. Further, the active du/dt method will benefit from the development of semiconductor power switch modules, as new technologies and materials emerge, because the method requires additional switching in the output stage of the inverter and generation of narrow voltage pulses. Since additional switching is required in the output stage, additional losses are generated in the inverter as a result of the application of the method. Considerations on the application of the active du/dt filtering method in electric drives are presented together with experimental data in order to verify the potential of the method.

Knowledge Sharing in a Virtual Learning Community

The focus of this Master’s Thesis is on knowledge sharing in a virtual Learning community. The theoretical part of this study aims at presenting the theory of knowledge sharing, competence development and learning in virtual teams. The features of successful learning organizations as well as enablers of effective knowledge sharing in virtual communities are also introduced to the reader in the theoretical framework. The empirical research for this study was realized in a global ICT company, specifically in its Human Resources business unit. The research consisted of two rounds of online questionnaires, which were conducted among all the members of the virtual Learning community. The research aim was to find shared opinions concerning the features of a successful virtual Learning community. The analysis of the data in this study was conducted using a qualitative research methodology. The empirical research showed that the main important features of a successful virtual Learning community are members’ passion towards the community way of working as well as the relevance of the content in the virtual community. In general, it was found that knowledge sharing and competence development are important matters in dynamic organizations as well as virtual communities as method and tool for sharing knowledge and hence increasing both individual and organizational knowledge. This is proved by theoretical and by empirical research in this study.

Nematode community, trophic structure and population fluctuation in soybean fields

Temporal (monthly in three fields for 12 months) and spatial (once in 23 fields during March-April) samplings were conducted in the major soybean (Glycine max)-growing region of the Brazilian Federal District. Fifty-three nematode genera were found in both samplings, but 13 were detected only by the temporal sampling, and one only by the spatial sampling. Fifty-three percent were plant-parasites, 35% were bacterivores, and about 12% were fungivores, predators and omnivores constituted the community that was dominated by the genera Helicotylenchus (40% of total abundance), Acrobeles (15%), Cephalobus (7.6%), Meloidogyne(5.6%) and Pratylenchus (4.9%). Heterodera glycines was not found in this study. There were no differences in ten ecological measurements [Ds, H', Es, T, FF/BF, (FF+BF)/PP, MI, PPI, mMI, and Dorylaimida (%)] between the two sampling types, but differences in indexes d and J'. Plant parasite populations dropped at the end of the crop cycle, remained at low levels during the dry season and the seedling period, then increased again in the crop-growing season. Fungivores maintained their low populations throughout the year, increasing only in June and July, the post-harvest period, when soil fungi decomposed root tissue. The population of bacterivores slightly declined during the dry season and the initial rainy season, but peaked in the middle of the rainy season, apparently associated with soil humidity. In the five most abundant nematodes, those of Acrobeles and Pratylenchus were more populous in wet soils, Cephalobus and Meloidogyne adapted well in dry soils, but Helicotylenchus survived abundantly in a wide range of soil moisture.

Multilevel converter modulation: implementation and analysis

Multilevel converters provide an attractive solution to bring the benefits of speed-controlled rotational movement to high-power applications. Therefore, multilevel inverters have attracted wide interest in both the academic community and in the industry for the past two decades. In this doctoral thesis, modulation methods suitable especially for series connected H-bridge multilevel inverters are discussed. A concept of duty cycle modulation is presented and its modification is proposed. These methods are compared with other well-known modulation schemes, such as space-vector pulse width modulation and carrier-based modulation schemes. The advantage of the modified duty-cycle modulation is its algorithmic simplicity. A similar mathematical formulation for the original duty cycle modulation is proposed. The modified duty cycle modulation is shown to produce well-formed phase-to-neutral voltages that have lower total harmonic distortion than the space-vector pulse width modulation and the duty cycle modulation. The space-vector-based solution and the duty cycle modulation, on the other hand, result in a better-quality line-to-line voltage and current waveform. The voltage of the DC links in the modules of the series-connected H-bridge inverter are shown to fluctuate while they are under load. The fluctuation causes inaccuracies in the voltage production, which may result in a failure of the flux estimator in the controller. An extension for upper-level modulation schemes, which changes the switching instants of the inverter so that the output voltage meets the reference voltage accurately regardless of the DC link voltages, is proposed. The method is shown to reduce the error to a very low level when a sufficient switching frequency is used. An appropriate way to organize the switching instants of the multilevel inverter is to make only one-level steps at a time. This causes restrictions on the dynamical features of the modulation schemes. The produced voltage vector cannot be rotated several tens of degrees in a single switching period without violating the above-mentioned one-level-step rule. The dynamical capabilities of multilevel inverters are analyzed in this doctoral thesis, and it is shown that the multilevel inverters are capable of operating even in dynamically demanding metal industry applications. In addition to the discussion on modulation schemes, an overvoltage in multilevel converter drives caused by cable reflection is addressed. The voltage reflection phenomenon in drives with long feeder cables causes premature insulation deterioration and also affects the commonmode voltage, which is one of the main reasons for bearing currents. Bearing currents, on the other hand, cause fluting in the bearings, which results in premature bearing failure. The reflection phenomenon is traditionally prevented by filtering, but in this thesis, a modulationbased filterless method to mitigate the overvoltage in multilevel drives is proposed. Moreover, the mitigation method can be implemented as an extension for upper-level modulation schemes. The method exploits the oscillations caused by two consecutive voltage edges so that the sum of the oscillations results in a mitigated peak of the overvoltage. The applicability of the method is verified by simulations together with experiments with a full-scale prototype.

Phase voltage control and filtering in a converter-fed single-phase customer-end system of the LVDC distribution network

In recent years, the network vulnerability to natural hazards has been noticed. Moreover, operating on the limits of the network transmission capabilities have resulted in major outages during the past decade. One of the reasons for operating on these limits is that the network has become outdated. Therefore, new technical solutions are studied that could provide more reliable and more energy efficient power distributionand also a better profitability for the network owner. It is the development and price of power electronics that have made the DC distribution an attractive alternative again. In this doctoral thesis, one type of a low-voltage DC distribution system is investigated. Morespecifically, it is studied which current technological solutions, used at the customer-end, could provide better power quality for the customer when compared with the current system. To study the effect of a DC network on the customer-end power quality, a bipolar DC network model is derived. The model can also be used to identify the supply parameters when the V/kW ratio is approximately known. Although the model provides knowledge of the average behavior, it is shown that the instantaneous DC voltage ripple should be limited. The guidelines to choose an appropriate capacitance value for the capacitor located at the input DC terminals of the customer-end are given. Also the structure of the customer-end is considered. A comparison between the most common solutions is made based on their cost, energy efficiency, and reliability. In the comparison, special attention is paid to the passive filtering solutions since the filter is considered a crucial element when the lifetime expenses are determined. It is found out that the filter topology most commonly used today, namely the LC filter, does not provide economical advantage over the hybrid filter structure. Finally, some of the typical control system solutions are introduced and their shortcomings are presented. As a solution to the customer-end voltage regulation problem, an observer-based control scheme is proposed. It is shown how different control system structures affect the performance. The performance meeting the requirements is achieved by using only one output measurement, when operating in a rigid network. Similar performance can be achieved in a weak grid by DC voltage measurement. An additional improvement can be achieved when an adaptive gain scheduling-based control is introduced. As a conclusion, the final power quality is determined by a sum of various factors, and the thesis provides the guidelines for designing the system that improves the power quality experienced by the customer.

Does the edge effect influence plant community structure in a tropical dry forest?

Edge effects are considered a key factor in regulating the structure of plant communities in different ecosystems. However, regardless to few studies, edge influence does not seem to be decisive in semiarid regions such as the Brazilian tropical dry forest known as Caatinga but this issue remains inconclusive. The present study tests the null hypothesis that the plant community of shrubs and trees does not change in its structure due to edge effects. Twenty-four plots (20 x 20 m) were set up in a fragment of Caatinga, in which 12 plots were in the forest edges and 12 plots were inside the fragment. Tree richness, abundance and species composition did not differ between edge and interior plots. The results of this study are in agreement with the pattern previously found for semiarid environments and contrasts with previous results obtained in different environments such as Rainforests, Savanna and Forest of Araucaria, which indicate abrupt differences between the border and interior of the plant communities in these ecosystems, and suggest that the community of woody plants of the Caatinga is not ecologically affected by the presence of edges.