Sequentially aerated membrane biofilm reactors for autotrophic nitrogen removal: microbial community composition and dynamics

Membrane-aerated biofilm reactors performing autotrophic nitrogen removal can be successfully applied to treat concentrated nitrogen streams. However, their process performance is seriously hampered by the growth of nitrite oxidizing bacteria (NOB). In this work we document how sequential aeration can bring the rapid and long-term suppression of NOB and the onset of the activity of anaerobic ammonium oxidizing bacteria (AnAOB). Real-time quantitative polymerase chain reaction analyses confirmed that such shift in performance was mirrored by a change in population densities, with a very drastic reduction of the NOB Nitrospira and Nitrobacter and a 10-fold increase in AnAOB numbers. The study of biofilm sections with relevant 16S rRNA fluorescent probes revealed strongly stratified biofilm structures fostering aerobic ammonium oxidizing bacteria (AOB) in biofilm areas close to the membrane surface (rich in oxygen) and AnAOB in regions neighbouring the liquid phase. Both communities were separated by a transition region potentially populated by denitrifying heterotrophic bacteria. AOB and AnAOB bacterial groups were more abundant and diverse than NOB, and dominated by the r-strategists Nitrosomonas europaea and Ca. Brocadia anammoxidans, respectively. Taken together, the present work presents tools to better engineer, monitor and control the microbial communities that support robust, sustainable and efficient nitrogen removal

Neurophysiologic diagnosis, clinical symptoms and neuropathologic findings in polyneuropathies

Tausta: Polyneuropatia (PNP) on ääreishermoston sairaus, joka aiheuttaa laaja-alaisia, yleensä symmetrisiä vaurioita ääreishermostossa. PNP:aan johtavia syitä on satoja. Tavoitteet: Löytää parhaat neurofysiologiset menetelmät uremian, myelooman hoidossa käytettävän talidomidin sekä Fabryn taudin aiheuttaman PNP:n diagnosoimiseksi. Fabryn taudissa tutkin lisäksi ohutsäieneuropatian aiheuttamia neuropatologisia löydöksiä iholta otetusta koepalasta. Tutkimuksissa kartoitettiin lisäksi PNP:n aiheuttamien subjektiivisten oireiden korrelaatio neurofysiologisten ja neuropatologisten löydösten kanssa. Munuaisten vajaatoimintaa sairastavilla potilailla tavoitteena oli tutkia dialyysihoidon tehon vaikutusta autonomisen hermoston toimintaan sekä yhden dialyysikerran vaikutusta neurofysiologisiin löydöksiin. Aineisto ja menetelmät: I: Tutkittiin 21 uremiapotilaan sensoristen ja motoristen hermojen vasteet, värinä- sekä lämpötuntokynnykset ennen ja jälkeen hemodialyysin. Subjektiiviset PNP oireet kartoitettiin PNP oireita kysyvillä kaavakkeella. II:12 talidomidi hoitoa saavaa myeloomapotilasta, tutkimuksen menetelmät olivat samat kuin tutkimuksessa I. III: 12 Fabryn tautia sairastavaa potilasta, edellä mainittujen neurofysiologisten tutkimusten lisäksi potilailta otettiin ihobiopsia säären alueelta. Ihobiopsiasta laskettiin ohuiden hermosyiden määrä koepalan värjäyksen jälkeen. Subjektiiviset PNP oireet kartoitettiin kyselykaavakkeella. Sydämen sykevaihtelu tutkittiin levossa taajuustason analyysillä. IV: 32 uremiapotilaan autonomisen hermoston toimintaa tutkittiin sydämen sykevaihtelun aikatason analysillä, paksujen myelinoituneiden säikeiden toimintaa tutkittiin perifeeristen sensoristen hermojen mittauksilla toistetusti noin 2.9 vuoden aikana. Tulokset: Ureemisen PNP:n diagnostiikassa herkimmät tutkimukset ovat F-aaltojen parametrit alaraajojen motorisista hermoista, värinätuntokynnys alaraajoista sekä suralishermon amplitudi. Positiiviset PNP oireet uremiassa korreloivat värinätunto-kynnyksen sekä sensoristen hermojen neurografialöydösten kanssa. Neurofysiologisten tutkimusten ajankohdalla dialyysiajankohtaan nähden ei ole merkitystä. Talidomidi-PNP on pääasiassa sensorinen, mutta motoriset syyt ovat lievästi vaurioituneet. Talidomidi PNP:ssa subjektiiviset oireet korreloivat huonosti neurofysiologisten löydösten kanssa. Fabryn taudissa naisilla on oletettua enemmän ohutsäieneuropatian aiheuttamia oireita ja löydöksiä. Paksujen säikeiden löydöksiä ei tullut esiin. Ohutsäieneuropatian diagnostiikassa ihobiopsia ja kvantitatiiviset tuntokynnysmittaustestit täydentävät toisiaan. Tehokas dialyysi parantaa autonomisen hermoston toimintaa uremiapotilailla. Päätelmät: Erityyppisten polyneuropatioiden diagnostiikassa pitää etukäteen valita PNP tyypille oikeat tutkimusmenetelmät raskaiden tutkimuspatterien vähentämiseksi sekä diagnostiikan parantamiseksi. PNP:n aiheuttamat oireet ja kliiniset löydökset pitää aina tutkia, mutta yksin ne eivät ole herkkiä PNP:n diagnostiikassa.

The destinal question of language

How can we think the destinal place of language in the essentially historical condition of our existence if such historicity cannot be understood on the basis of the labor of negativity alone? The attempt is made here to think language in a more originary manner, as non-negative finitude, that affirms what is outside dialectical-speculative closure, what is to come. The notion of 'destinal' itself is thus transformed. No longer being merely a categorical grasp of "entities presently given", language is an originary exposure to the event of arrival in its lightning flash. Destiny appears as that of the messianic arrival of the 'not yet' which is not a telos that the immanent movement of historical reason reaches by an irresistible force of the negative. This essay reads Schelling, Heidegger and Kierkegaard to think language as a "place" of exposure to the non-teleological destiny that may erupt even today, here and now, without any given conditionality.

The fear of openness : an essay on friendship and the roots of morality

Det förefaller självklart att begrepp som lojalitet, respekt, rättigheter eller altruism beskriver något entydigt gott. Men tänk om det i själva verket är så att de aktualiseras bara där vi avvisat godheten? Tänk om vår moral och hela vårt liv genomsyras av en djup förvirring, av en ovilja att se vad som egentligen pågår mellan oss? I min avhandling ställer jag de här obekväma frågorna. Utgångspunkten är en diskussion om vänskap, som jag beskriver som en förbehållslös, helhjärtad öppenhet mellan människor. Denna öppenhet – som lika väl kan kallas godhet eller kärlek – är det svåraste som finns. Samtidigt finns öppenheten alltid där mellan oss, om så bara som en anad möjlighet som skrämmer oss, som vi sluter oss för och inte vill veta av. Vi lever i en ständig spänning mellan öppenhet och avvisande, och denna spänning yttrar sig i allt vi gör, känner och tänker. Det är vad jag vill visa. Bland de filosofer jag diskuterar kan nämnas Aristoteles, Kant, Kierkegaard, Nietzsche och Emmanuel Levinas.

Kampen for livet i vemodets slør : å leve i spenningsfeltet mellom livets mulighet og dødens nødvendighet

The overallpurpose of this research is to develop knowledge about health and suffering in connection with serious cancer disease through the development of a contextual model describing how patients live their lives between the possibility of life and the necessity of death. The research takes its point of departure from a caring science perspective, and Gadamer's hermeneutical philosophy is chosen as the overall methodology. In addition to the caring science perspective, the existential philosophy of Kierkegaard constructs a framework of interpretation. The research consists of three empirical studies. In two of the studies 21 patients participated, whilst 8 nurses took part in the remaining study. The patients were seriously ill and the nurses had long experience of caring for seriously ill patients. Scientific conversations were used for data collection. The findings from the patient studies show that the relationship with one-self, others, God or the supernatural and nature, constitute the unit of meaning, in which the struggle between health and suffering takes place. This struggle takes the form of a dialectic movement between being delivered and being accommodated and confirmed. The patients strive, in their delivery, for health and integration, for being a self by being reconciled with one self. The patients are lonely in this struggle, as conversations related to existence and death seldom occurs with either the natural or the professional caregivers. Themes related to patients' death remain mainly unarticulated. The patients' life struggle appears on the existential level as a threefold struggle against time and annihilation, towards being accommodatedand confirmed and for restoration and reconciliation. Through the hermeneutic process the struggle at the ontological level appears as a struggle of the will between anxiety and love. The patients in this research experience their life's tragedy. A holistic interpretation of living under the pressure created between the possibility of life and the necessity of death appears to be a struggle for life in the veil of pensiveness. The nurses want to be involved in the patients' struggle, and they show a deep desire to support the dignity of the patients. The depth in the nurses' view of their responsibility for the patient as an entityof body, soul and spirit seems to be related to the nurses' understanding of life.

Ansvar som klangbotten i vårdandets meningssammanhang

Avhandlingen Ansvar som klangbotten i vårdandets meningssammanhang är en vårdvetenskaplig studie om ansvar som inre etik. Riktningen för teoribildningen i studien ges av följande satser: Ansvar är etik och ansvar är en vårdetisk grundkategori inom den caritativa vårdetiken, samt att ansvar har sin utgångspunkt i vårdandets ethos. Ansvar som inre etik handlar här om det meningsbärande innehållet i begreppen frihet, skuld och kärlek. Den hermeneutiska metodologin är en genomgående röd tråd i studien. Frihet, skuld och kärlek granskas med utgångspunkt i ordböcker, i religionsfilosofiska texter av Lèvinas, Buber och Kierkegaard samt i vårdetiska artiklar. Förståelse och tolkning vävs samman och denna rörelse leder oavbrutet fram till nya helheter om ansvarets inre betydelseinnehåll. Den inre ansvarsetiken tar form kring hälsa och lidande som görande, varande och vardande samt kring Kierkegaards estetiska, etiska och religiösa stadier på livets väg. Konturerna av en teorimodell för vårdandets etik som ansvarsetik börjar framträda. Skulden, som central kraft för ansvaret, är den källa som på ett verkligt sätt formar det inre ansvaret till olika mognadsstadier. En personlig inre etik handlar här om en oavbruten skapelseakt, där skulden får sin positiva laddning och kraft av friheten och kärleken. Skulden ses som verksam och meningsbärande substans för ansvarets gärningar, ett svar på att kärlek existerar. De mönster som skapats i studien ger förståelse för frihetens, skuldens och kärlekens samverkan och starka beroende av varandra. Den nya förståelse av ansvarets inre verklighet som synliggjorts i avhandlingen gestaltar på ett nytt sätt ansvar i vårdandets meningssammanhang och fångar på ett överskådligt sätt ansvarets betydelserikedom och komplexitet. Ansvar kan belysas och tolkas på många olika sätt, beroende bl.a. på disciplin, perspektiv och forskningsfrågor. I denna studie är teorigenereringen om det inre ansvaret sanningslik för ansvar i vårdandets meningssammanhang. Ansvar har avtäckts som den kärna som finns bortom det direkt synliga, den kärna som enligt Eriksson (2009) "blir bärare av de ursprungliga vårdande substanserna och avspeglar en djup mänsklig tillvaro".

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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.