SIOG (International Society of Geriatric Oncology) recommendations for anthracycline use in the elderly

A taskforce of the International Society of Geriatric Oncology (SIOG) has recently submitted recommendations on the use of anthracyclines in elderly patients. Despite the aging of the population and the high proportion of elderly individuals in the population of patients with non-Hodgkin's lymphoma, the development of specialist expertise in the treatment of elderly patients with cancer is relatively recent. Treatment of the elderly is complex because they are a highly heterogeneous population, with large variations in health status, comorbidities and life expectancy. In addition, these patients are generally more susceptible than young patients to the cardiotoxic effects of anthracyclines. Strategies for assessing elderly patients with cancer, reducing the risk of congestive heart failure, and assessing the cardiotoxic effects of treatments are discussed. In addition, a summary of the SIOG recommendations is presented

Epoetin Biosimilars in the Treatment of Chemotherapy-Induced Anemia: 10 Years' Experience Gained.

High-quality, safe, and effective biosimilars have the potential to increase access to biological therapies worldwide and to reduce cancer care costs. The European Medicines Agency (EMA) was the first regulatory authority to establish legislative procedures for the approval of biosimilars when they published their guidelines on similar biological medicinal products in 2005. Biosimilar epoetins were first approved in 2007, and a wealth of data has been collected over the last decade. Two biosimilar epoetins (under five commercial names) have been approved by the EMA so far. The availability of epoetin biosimilars generated discussion among the oncology community regarding prescribing these products, their efficacy, and their safety. These agents are approved only if they are shown in extensive analytical and clinical testing to have comparable quality, safety, and efficacy to the reference medicine, and real-world studies provide further data that biosimilar epoetins are an effective and well-tolerated option for the treatment of chemotherapy-induced anemia in patients with cancer. Other countries have adopted similar regulatory pathways to those in Europe and have approved epoetin biosimilars. The now extensive European experience with biosimilar epoetins should reassure regulators from other territories

Frail old patients as a target population for cancer trials

The recent distinction between co-morbidity and multi-morbidity well stresses the difficulty of managing old patients with cancer whose complexity is not captured by a list of diagnoses or biological burden alone. The most adequate answer found by oncologists and geriatricians was to work together for better evaluating the physiological age and body reserve of the patient. The gold standard tool to assess old patient with cancer is named Comprehensive Geriatric Assessment. Its systematic application needs geriatric competences and time. In this context, a great number of cancer patients are considered as "frail” because they have reduced available physiological reserves. They might not withstand stress when challenged. Oncologists and geriatricians have imagined an innovative process to change the screening procedure of these patients, determine the prognosis, adapt the treatment strategy, to increase the patient's survival and his/her quality of life. The internet website "www.clinicaltrials.com” only lists 8 studies focused on frail elders with cancer. Six of them are focused on specific cancers or specific treatments, one was applied to all kind of cancers and the last was an opinion overview from oncologists and geriatricians. The selection criteria of frail patients are very diverse and probably include cancer patients who are not comparable. It is now time to try to identify new practical, reliable and accurate tools to facilitate the inclusion of the same kind of patients suffering from the same kind of cancer to be able to give more appropriate care and at the same time to constitute a valuable data base. Existing tools are reviewed and analyze

Kilpailutusprosessin kehittäminen sähköiseksi : case Kaarinan kaupunki

Kaarinan kaupungin ja muiden hankintayksiköiden on kehitettävä julkisia hankintoja, jotta arjen haasteisiin ja uudistuvan hankintalain velvoitteisiin vastattaisiin mahdollisimman toimivalla tavalla. Opinnäytetyön ensisijaisena tavoitteena oli löytää Kaarinan kaupungille sopivin kilpailutusjärjestelmäratkaisu. Tarkoituksena oli myös tarkastella uudistuvan hankintalain keskeisintä sisältöä ja hankintaprosessin kehittymistä sähköisiin hankintaratkaisuihin. Työ keskittyy tarkastelemaan kilpailutuksen sähköistämistä, sähköisiä hankintamenetelmiä ja kilpailutusjärjestelmiä. Kirjoittamisprosessin aikana hyödynnettiin etenkin julkisiin hankintoihin liittyvää kirjallisuutta ja sähköisiä julkaisuja. Yhteistyö kilpailutusjärjestelmien tarjoajien kanssa oli merkittävässä asemassa, jotta pystyttiin takaamaan tietojen virheettömyys ja luotettavuus. Työ alkaa julkisten hankintojen ja kilpailutusprosessin yleisluontoisella kuvaamisella. Sähköisen hankinnan tarkastelun jälkeen Kaarinan kaupungille löydettiin sopivin kilpailutusjärjestelmäratkaisu. Työssä kuvattiin perinteisen ja sähköisen kilpailutusprosessin sekä dynaamisen hankintajärjestelmän ja sähköisen huutokaupan vaiheita. Oleellisin tulos oli sopivan kilpailutusjärjestelmän löytyminen Kaarinan kaupungin tarpeisiin. Työn avulla alalla opiskelevat ja työskentelevät saavat puolueettoman käsityksen sähköisen hankinnan eduista sekä kilpailutusjärjestelmän keskeisimmistä toiminnoista.During the next few years the new procurement law will put under an obligation that public procurement must be tendered electronically. The main objective of this thesis was to find an electronic tendering system which can bring many benefits to the city of Kaarina. The objective of this thesis was also to explore why and how the public tendering is developing to electronic, as well as to describe how tendering process will change. This thesis focuses on a competitive tendering electrification, as well as electronic procurement methods and tendering systems. During the writing process, public procurement literature was used, as well as electronic publications. Co-operation with system providers was in an important role, so that information which concern electronic tendering solutions is accurate. This thesis begins by examining the public procurement and ends with a demonstration of electronic tendering. Ultimately, the suitable tendering system solution for the city of Kaarina is introduced. The thesis succeeded to describe clearly the stages of traditional and electronic tendering processes. Also dynamic purchasing system and electronic auction stages is described clearly. The most important result was the finding of suitable tendering system for the city of Kaarina. This thesis provides an objective view of the benefits of electronic procurement and tendering systems’ main activities

Factors in Active Damping Design to Mitigate Grid Interactions in Three-Phase Grid-Connected Photovoltaic Inverters

An LCL filter provides excellent mitigation capability of the switching frequency harmonics, and is, therefore, widely used in grid-connected inverter applications. The resonant behavior induced by the filter must be attenuated with passive or active damping methods in order to preserve the stability of the grid-connected converter. Active damping can be implemented with different control algorithms, and it is frequently used due to its relatively simple and low-cost implementation. However, active damping may easily impose stability problems if it is poorly designed.This thesis presents a comprehensive small-signal model of a three-phase grid-connected photovoltaic inverter with LCL filter. The analysis is focused on a capacitor-currentfeedback (i.e., a multi-current feedback) active damping and its effects on the system dynamics. Furthermore, a single-current-feedback active damping technique, which is based on reduced number of measurements, is also studied. The main objective of this thesis is to present an accurate multi-variable small-signal model for assessing the control performance as well as the grid interaction sensitivity of grid-connected converters in the frequency domain.The state-of-the-art literature studies regarding the active damping are mainly concentrated on stability evaluation of the output-current loop, and the effect on external characteristics such as susceptibility to background harmonics and impedance-based instability has been overlooked. As the active damping affects significantly the sensitivity to grid interactions, accurate predictions of the system transfer functions, e.g. the output impedance, must be utilized in order to assess the active-damping-induced properties. Moreover, the single-current-feedback active damping method lacks the aforementioned analysis in the literature and, therefore, the need for accurate full-order small-signal models is evident.This thesis presents design criteria for the active damping in a wide range of operating conditions. Accordingly, peculiarities regarding the active damping are discussed for both multi and single-current-feedback active damping schemes. In addition, the parametric influence of the active damping on the output-impedance characteristics is explicitly analyzed. It is shown that the active damping design has a significant effect on the output impedance and, therefore, the impedance characteristics should be considered in the converter design for improved robustness against background harmonics and impedancebased interactions

Leibnizin jalanjälkiä eli vektorilaskentaa reaalikertoimisessa avaruudessa

Rakennetaan erityisesti euklidisen avaruuden matematiikkaa matriiseja välttäen ja tähdäten Rogersin—Milnorin analyyttiseen todistukseen Brouwerin kiintopistelauseelle. Kehitetään analyysin ja multilineaarisen algebran perusteita, joista mainittakoon tulon derivaatta sekä determinantti, joista Leibniz tunnetaan—tästä otsikko. Tieteellisistä kontribuutioista maininnan ansaitsevat tensorien määritelmä indeksoituina perheinä sekä ulkotulon yleistys tällaisille tensoreille. Luvuissa 1 ja 3 kehitetään analyysiä käyttäen tangenssirelaation käsitettä. Luvussa 2 määritellään tensorit indeksoituina perheinä, mikä tekee niistä kantariippumattomia. Ulkotulon määritelmä nojaa originaaleihin kombinatorisiin tuloksiin. Luvussa 4 määritellään determinantti ulkotulon avulla käyttäen transvektioita ja dilataatioita, jotka korvaavat matriisien rivi- ja sarakeoperaatiot. Luontevia jatkokehityksen ja harjoitustehtävien aiheita voisivat olla heterogeeniset tensorit, ulkoderivaatta sekä differentiaaligeometrian ja -topologian alkeet

Modeling dynamics of photovoltaic inverter with LCL-type grid filter

Photovoltaic generator is a unique power source with both constant-current and constant-voltage-like characteristics depending on the operating point. The operating point affects system’s dynamic response, because the generator has a varying dynamic resistance, which causes design constraints, e.g., to the control system design. Therefore, it is necessary to include the source-effect to the full-order dynamic model to predict inverter behavior accurately in its application area. A full-order small-signal model of the three-phase VSI-based photovoltaic inverter with an LCL-type output filter was derived in this thesis, which does not neglect cross-coupling effects or parasitic elements such as ohmic losses in inductors, capacitors and switches. Therefore, the model is also suitable for analysis in cases where strong cross-coupling between the d and q-channels is expected, e.g., when output filter components have large values at high power levels. The model was derived in the synchronous reference frame (i.e., in dq-domain), where the steady-state operating point required for linearization can be solved. Additionally, the effect of non-ideal source and load impedances were included in the model as they have a significant effect on inverter dynamics. The model is shown to give accurate predictions on the control-related transfer functions, which are essential in deterministic control design. Moreover, the closed-loop model allows the full-order output and input impedances to be accurately predicted which is important when analyzing the impedance-based stability of grid-connected PV inverter. The small-signal model has been verified by extracting frequency responses from a scaled-down prototype. The model uses a cascaded control scheme to regulate DC-link voltage and output currents as well as phase-locked-loop as the grid synchronization method. Furthermore, more sophisticated control systems, e.g., feed-forward, space-vector modulation with DC-link voltage sensing etc. can be included in the model. The measured transfer functions were found out to correlate very closely with the predictions