Modified method for bronchial suture by Ramirez Gama compared to separate stitches suture: experimental study

OBJECTIVE: To experimentally compare two classic techniques described for manual suture of the bronchial stump.METHODS: We used organs of pigs, with isolated trachea and lungs, preserved by refrigeration. We dissected 30 bronchi, which were divided into three groups of ten bronchi each, of 3mm, 5mm, and 7mm, respectively. In each, we performed the suture with simple, separated, extramucosal stitches in five other bronchi, and the technique proposed by Ramirez and modified by Santos et al in the other five. Once the sutures were finished, the anastomoses were tested using compressed air ventilation, applying an endotracheal pressure of 20mmHg.RESULTS: the Ramirez Gama suture was more effective in the bronchi of 3, 5 and 7 mm, and there was no air leak even after subjecting them to a tracheal pressure of 20mmHg. The simple interrupted sutures were less effective, with extravasation in six of the 15 tested bronchi, especially in the angles of the sutures. These figures were not significant (p = 0.08).CONCLUSION: manual sutures of the bronchial stumps were more effective when the modified Ramirez Gama suture was used in the caliber bronchi arms when tested with increased endotracheal pressure.

Transoperative refusion: a simple and safe method in emergency surgery

The objective is to reinforce the importance of blood reinfusion as a cheap, safe and simple method, which can be used in small hospitals, especially those in which there is no blood bank. Moreover, even with the use of devices that perform the collection and filtration of blood, more recent studies show that the cost-benefit ratio is much better when autologous transfusion is compared with blood transfusions, even when there is injury to hollow viscera and blood contamination. It is known that the allogeneic blood transfusion carries a number of risks to patients, among them are the coagulation disorders mediated by excess enzymes in the conserved blood, and deficiency in clotting factors, mainly the Factor V, the proacelerin. Another factor would be the risk of contamination with still unknown pathogens or that are not investigated during screening for selection of donors, such as the West Nile Fever and Creutzfeldt-Jacob, better known as "Mad Cow" disease. Comparing both methods, we conclude that blood autotransfusion has numerous advantages over heterologous transfusion, even in large hospitals. We are not against blood transfusions, just do not agree that the patient's own blood is discarded without making sure there will be enough blood in stock to get him out of the hemorrhagic shock.

Practical Framework for Monitoring the Performance of Agile IT Projects in an Output-Based Outsourcing Context

Over the past decade, organizations worldwide have begun to widely adopt agile software development practices, which offer greater flexibility to frequently changing business requirements, better cost effectiveness due to minimization of waste, faster time-to-market, and closer collaboration between business and IT. At the same time, IT services are continuing to be increasingly outsourced to third parties providing the organizations with the ability to focus on their core capabilities as well as to take advantage of better demand scalability, access to specialized skills, and cost benefits. An output-based pricing model, where the customers pay directly for the functionality that was delivered rather than the effort spent, is quickly becoming a new trend in IT outsourcing allowing to transfer the risk away from the customer while at the same time offering much better incentives for the supplier to optimize processes and improve efficiency, and consequently producing a true win-win outcome. Despite the widespread adoption of both agile practices and output-based outsourcing, there is little formal research available on how the two can be effectively combined in practice. Moreover, little practical guidance exists on how companies can measure the performance of their agile projects, which are being delivered in an output-based outsourced environment. This research attempted to shed light on this issue by developing a practical project monitoring framework which may be readily applied by organizations to monitor the performance of agile projects in an output-based outsourcing context, thus taking advantage of the combined benefits of such an arrangement Modified from action research approach, this research was divided into two cycles, each consisting of the Identification, Analysis, Verification, and Conclusion phases. During Cycle 1, a list of six Key Performance Indicators (KPIs) was proposed and accepted by the professionals in the studied multinational organization, which formed the core of the proposed framework and answered the first research sub-question of what needs to be measured. In Cycle 2, a more in-depth analysis was provided for each of the suggested Key Performance Indicators including the techniques for capturing, calculating, and evaluating the information provided by each KPI. In the course of Cycle 2, the second research sub-question was answered, clarifying how the data for each KPI needed to be measured, interpreted, and acted upon. Consequently, after two incremental research cycles, the primary research question was answered describing the practical framework that may be used for monitoring the performance of agile IT projects delivered in an output-based outsourcing context. This framework was evaluated by the professionals within the context of the studied organization and received positive feedback across all four evaluation criteria set forth in this research, including the low overhead of data collection, high value of provided information, ease of understandability of the metric dashboard, and high generalizability of the proposed framework.

Application of the scrum framework in non-software project management

Scrum is an agile project management approach that has been widely practiced in the software development projects. It has proven to increase quality, productivity, customer satisfaction, transparency and team morale among other benefits from its implementation. The concept of scrum is based on the concepts of incremental innovation strategies, lean manufacturing, kaizen, iterative development and so on and is usually contrasted with the linear development models such as the waterfall method in the software industry. The traditional approaches to project management such as the waterfall method imply intensive upfront planning and approval of the entire project. These sort of approaches work well in the well-defined stable environments where all the specifications of the project are known in the beginning. However, in the uncertain environments when a project requires continuous development and incorporation of new requirements, they do not tend to work well. The scrum framework was inspiraed by Nonaka’s article about new product developement and was later adopted by software development practitioners. This research explores conditions for and benefits of the application of scrum framework beyond software development projects. There are currently a few case studies on the scrum implementation in non-software projects, but there is a noticeable trend of it in the scrum practitioners’ community. The research is based on the real-life context multiple case study analysis of three different non-software projects. The results of the research showed that in order to succeed within scrum projects need to satisfy certain conditions – necessary and sufficient. Among them the key factors are uncertainty of the project environment, not well defined outcomes, commitment of the scrum teams and management support. The top advantages of scrum implementation identified in the present research include improved transparency, accountability, team morale, communications, cooperation and collaboration. Further researches are advised to be carried out in order to validate these findings on a larger sample and to focus on more specific areas of scrum project management implementation.

Ulkomaalaisen yrityksen verkostosuhteet Venäjällä

Tutkimuksen tavoitteena on konkreettisen yritysverkoston avulla selvittää, minkälaisia ovat ulkomaalaisen yrityksen potentiaaliset kumppanit ja yritysten väliset suhteet Venäjällä. Toisena tavoitteena on kuvata käytännön työelämään sopivalla menetelmällä riittävän kokonaisvaltaisesti yritysverkoston kumppanit sekä kumppaneiden ja kärkiyrityksen väliset suhteet. Samalla tarkastellaan yritysten välisten suhteiden riskejä. Selvitysmenetelmällä pyritään nopeuteen ja ketteryyteen ja sen tavoitteena on lisätä ulkomaisen johdon käsitystä yritysverkostosta johdon päätöksentekoa varten. Tutkimus jakaantuu teoria tarkasteluun ja yhden Venäjällä toimivan ulkomaisen yrityksen osto-osaston verkostoa selvittävään empiiriseen osaan. Teoriatarkastelussa selvitetään erilaisia lähestymistapoja ja laajempia viitekehyksiä yritysverkostojen tutkimukseen. Teoriatarkastelun perusteella valittiin viitekehykset yrityskumppaneiden ja yritysten välisen suhteen sekä riskien arviointiin. Empiirisen osan tutkimus toteutettiin haastattelukyselytutkimuksena perustuen näihin viitekehyksiin. Yrityskumppaneita ja yritysten välisiä suhteita tarkastellaan tilastollisin menetelmin ja riskejä arvioidaan laadullisella tutkimusotteella. Tutkimustulokset vastaavat monelta osin liiketoimintakulttuurista ja –ympäristöstä saatua kokemukseen ja tutkimustietoon perustuvaa käsitystä. Verkostoitumisen kulmakivet ovat hyvin toimivat ja määritellyt vaihdannan liiketoiminta- ja tukiprosessit, hyvin tunnetut kumppanit ja tälle perustalle rakennetut sosiaaliset suhteet sekä liiketoimintaympäristöön ja –kulttuuriin soveltuvat yhteistyökompetenssit. Tutkitun yritysverkoston yhteistyösuhteet voidaan jakaa hierarkkiseen organisaatiokumppanuuteen, toimittajakumppanuuteen, luottamukseen perustuvaan markkinaehtoiseen suhteeseen ja opportunistiseen markkinasuhteeseen. Hyviä yhteistyökumppaneita ja –suhteita löytyy taustaltaan erilaisista toimittajista. Tutkimuksessa käytetyt viitekehykset toimivat hyvin erityisesti yrityskumppanin arvioinnissa. Yritysten välisen suhteen arviointiin käytetyn viitekehyksen ongelmat liittyivät lähinnä erilaiseen liiketoimintakulttuuriin ja käsitykseen yritysten välisestä strategisesta suhteesta. Riskit liittyivät toimitussuhteeseen useammin kuin omaan organisaatioon tai toimittajaan.

Development of an environmentally friendly method of starch oxidation by hydrogen peroxide and a complex water-soluble Iron catalyst

Oxidized starch is a key component in the paper industry, where it is used as both surfacing sizer and filler. Large quantities are annually used for this purpose; however, the methods for the oxidation are not environmentally friendly. In our research, we have studied the possibility to replace the harmful oxidation agents, such as hypochlorite or iodates and transition metal catalysts, with a more environmentally friendly oxidant, hydrogen peroxide (H2O2), and a special metal complex catalyst (FePcS), of which only a small amount is needed. The work comprised batch and semi-batch studies by H2O2, ultrasound studies of starch particles, determination of low-molecular by-products and determination of the decomposition kinetics of H2O2 in the presence of starch and the catalyst. This resulted in a waste-free oxidation method, which only produces water and oxygen as side products. The starch oxidation was studied in both semi-batch and batch modes in respective to the oxidant (H2O2) addition. The semi-batch mode proved to yield a sufficient degree of substitution (COOH groups) for industrial purposes. Treatment of starch granules by ultrasound was found to improve the reactivity of starch. The kinetic results were found out to have a rather complex pattern – several oxidation phases were observed, apparently due to the fact that the oxidation reaction in the beginning only took place on the surface, whereas after a prolonged reaction time, partial degradation of the solid starch granules allowed further reaction in the interior parts. Batch-mode experiments enabled a more detailed study of the mechanisms of starch in the presence of H2O2 and the catalyst, but yielded less oxidized starch due to rapid decomposition of H2O2 due to its high concentrations. The effect of the solid-liquid (S/L) ratio in the reaction system was studied in batch experiments. These studies revealed that the presence of the catalyst and the starch enhance the H2O2 decomposition.

A Method for reducing throughput-time in industrial electronics

Lyhyet toimitusajat tuovat yrityksille kilpailuetua nopeasti muuttuvassa teollisuusympäristössä. Tämän diplomityön ensisijaisena tavoitteena on löytää kirjallisuuden avulla yrityksen käyttöön soveltuva menetelmä, joka soveltuu systemaattiseen läpimenoaikojen lyhentämiseen. Tärkeää on myös varmistaa valitun menetelmän soveltuvuus kohdeyrityksen ympäristöön. Työn toisena tavoitteena on ymmärtää, että minkälaisella panostuksella yhden päivän läpimenoaika voidaan saavuttaa. Kirjallisuustutkimuksen avulla on valittu tarkoitukseen sopiva toimintamalli. Menetelmä on testattu yhdellä tuotantolinjalla ja saadut tulokset sekä palaute osoittavat, että se näyttäisi soveltuvan kohdeyrityksen käyttöön. Tuotantolinjalle on tehty toimintasuunnitelma yhden päivän toimitusajan saavuttamiseksi vuoden 2013 aikana. Haasteen laajuutta koko kohdeyrityksessä on tutkittu erillisessä ideointisessiossa. Session tulosten perusteella on tehty prioriteettilista, joka antaa käsityksen toimitusajan merkittävän lyhentämisen vaatimuksista. Yleisesti ottaen kysynnän vaihtelun hallinta on suurin haaste, mutta useita ratkaisuvaihtoehtoja tämän hallitsemiseksi on tunnistettu.