Essays on social value creation in the not-for-profit sector

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Scale dependent diversity of bryozoan assemblages in the reefs of the Late Ordovician Vasalemma Formation, Estonia

The fieldwork for BK and AP was partly funded by the Academy of Finland project ‘Ecological Engineering as a Biodiversity Driver in Deep Time’ (Decision No. 309422). Deutsche Forschungsgemeinschaft (DFG) is appreciated for financial support of AE (project ER 278/10.1). The work is a contribution to the IGCP program 735 ‘Rocks and the Rise of Ordovician Life’.The reefs of the Vasalemma Formation, late Sandbian, Late Ordovician, of northern Estonia contain an exceptional rich and abundant bryozoan fauna. They are an example of contemporaneous bryozoan-rich reefs known from around the world, representing the peak diversification interval of this group during the Ordovician. The global Ordovician bryozoan diversification was associated with a decrease in provinciality, a pattern known from other skeletal marine metazoans of this period. The diversification is associated with climatic cooling and increasing atmospheric and sea water oxygenation. However, the mechanisms that led to the bryozoan diversification are poorly known. Here we estimate the bryozoan richness (α and γ diversity) and turnover (β diversity) at the level of samples, reefs, and formations in the Vasalemma Formation and in contemporaneous reef limestone occurrences of the Baltoscandian region. The resulting richness and turnover values differ among the three observational levels and hence are scale dependent. A consistent pattern with lowest between-reef turnover and relatively high between-sample turnover could be detected, reflecting high small-scale (within reef) heterogeneities in lithology and original bryozoan habitat. This is consistent with published work, in which evidence has been presented for small-scale substrate heterogeneity as the most important diversification driver of the Ordovician brachiopod diversification in the Baltoscandian region. The fact that reefs and their local substrate are strongly organism moderated environments sheds light on the potentially important ecosystem engineering role of organisms, such as bryozoans, for the Ordovician diversification.Publisher PDFPeer reviewe

Diagnosis of Gastric Cancer in the Excluded Stomach After RYGB by Jejunogastrostomy Using a LAMS

For patients after bariatric surgery, diagnosis of gastric cancer is a challenge. We present a patient after Roux-en-Y gastric bypass with upper abdominal pain and abnormal computed tomography scan with diffuse wall thickening of the gastric antrum. Various biopsy techniques have been described, with surgical (laparoscopic) exploration being the most common. We were able to successfully diagnose gastric cancer in the excluded stomach by biopsy using a jejunogastrostomy, which proved to be safe and effective

Hyperferritinemia without iron overload in patients with bilateral cataracts: a case series

Hepatologists and internists often encounter patients with unexplained high serum ferritin concentration. After exclusion of hereditary hemochromatosis and hemosiderosis, rare disorders like hereditary hyperferritinemia cataract syndrome should be considered in the differential diagnosis. This autosomal dominant syndrome, that typically presents with juvenile bilateral cataracts, was first described in 1995 and has an increasing number of recognized molecular defects within a regulatory region of the L-ferritin gene (FTL). CASE PRESENTATION: Two patients (32 and 49-year-old Caucasian men) from our ambulatory clinic were suspected as having this syndrome and a genetic analysis was performed. In both patients, sequencing of the FTL 5' region showed previously described mutations within the iron responsive element (FTL c.33 C > A and FTL c.32G > C). CONCLUSION: Hereditary hyperferritinemia cataract syndrome should be considered in all patients with unexplained hyperferritinemia without signs of iron overload, particularly those with juvenile bilateral cataracts. Liver biopsy and phlebotomy should be avoided in this disorder

Fludarabine-treosulfan compared to thiotepa-busulfan-fludarabine or FLAMSA as conditioning regimen for patients with primary refractory or relapsed acute myeloid leukemia: a study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT)

Background: Limited data is available to guide the choice of the conditioning regimen for patients with acute myeloid leukemia (AML) undergoing transplant with persistent disease. Methods: We retrospectively compared outcome of fludarabine-treosulfan (FT), thiotepa-busulfan-fludarabine (TBF), and sequential fludarabine, intermediate dose Ara-C, amsacrine, total body irradiation/busulfan, cyclophosphamide (FLAMSA) conditioning in patients with refractory or relapsed AML. Results: Complete remission rates at day 100 were 92%, 80%, and 88% for FT, TBF, and FLAMSA, respectively (p = 0.13). Non-relapse mortality, incidence of relapse, acute (a) and chronic (c) graft-versus-host disease (GVHD) rates did not differ between the three groups. Overall survival at 2 years was 37% for FT, 24% for TBF, and 34% for FLAMSA (p = 0.10). Independent prognostic factors for survival were Karnofsky performance score and patient CMV serology (p = 0.01; p = 0.02), while survival was not affected by age at transplant. The use of anti-thymocyte globulin (ATG) was associated with reduced risk of grade III–IV aGVHD (p = 0.02) and cGVHD (p = 0.006), with no influence on relapse. Conclusions: In conclusion, FT, TBF, and FLAMSA regimens provided similar outcome in patients undergoing transplant with active AML. Survival was determined by patient characteristics as Karnofsky performance score and CMV serology, however was not affected by age at transplant. ATG appears able to reduce the incidence of acute and chronic GVHD without influencing relapse risk

Quick defence acommodation measures against wave impacts

Human development has hardened the coastline, dynamic by definition, and so restricted its self-defense capacity. Each major eastern storm, which affects the Catalan coast the most, cause erosion, beach retreat, flooding and infrastructure damages. The location of the most affected areas by storms along the Catalan coast and the development of a landscape of risks is the first task carried out in this minor thesis. Hard solutions to these problems cannot be the final answer to this problem due to its high costs and its environmental impact. Alternative proactive solutions have to be found in order to work with nature. Nowadays, trustworthy 48 hours forecasted storm data is available, and consequently a time window exists that could be used to build up a defense measure against a specific hazard such as flooding or beach erosion. This high adaptive response concept is studied in this minor thesis by analyzing the response of a Catalan beach with an implemented sand dune, built up in the abovementioned time window, to a series of synthetic storms. Several simulations with XBEACH code show notable results in terms of gained beach width when a sand dune is implemented and low energy storms impact the beach.El desenvolupament humà ha endurit la línia de la costa, dinàmica per definició, restringint la seva capacitat d’autodefensa. En cada temporal de llevant en la costa catalana, es produeixen fenòmens d’erosió, disminució de platges i danys a infraestructura. La localització de les zones que més pateixen aquestes conseqüències, i la identificació dels riscos associats és la primera tasca realitzada en aquesta tesina. La implantació d’infraestructura dura a aquests problemes no pot ser la resposta definitiva degut a l’elevat cost i l’impacte ambiental associat. És necessari implementar solucions proactives i alternatives per tal de treballar amb la natura. Avui en dia es disposa d’una previsió de temporal fiable amb 48 hores d’antelació. Per tant es té d’un període de temps que pot ser emprat en la construcció d’una mesura de defensa contra un risc específic com la inundació o l’erosió. Aquest concepte de ràpida resposta és estudiat en aquesta tesina analitzant la resposta d’una platja catalana en la qual s’hi ha construït una duna de sorra, en el període de temps esmenat, enfront d’una sèrie de temporals sintètics. Diverses simulacions amb el codi XBEACH mostren resultats acceptables, en termes de pèrdua de platja, quan un temporal de baixa intensitat es propaga a una platja amb una duna de sorra

Quick defence acommodation measures against wave impacts

Human development has hardened the coastline, dynamic by definition, and so restricted its self-defense capacity. Each major eastern storm, which affects the Catalan coast the most, cause erosion, beach retreat, flooding and infrastructure damages. The location of the most affected areas by storms along the Catalan coast and the development of a landscape of risks is the first task carried out in this minor thesis. Hard solutions to these problems cannot be the final answer to this problem due to its high costs and its environmental impact. Alternative proactive solutions have to be found in order to work with nature. Nowadays, trustworthy 48 hours forecasted storm data is available, and consequently a time window exists that could be used to build up a defense measure against a specific hazard such as flooding or beach erosion. This high adaptive response concept is studied in this minor thesis by analyzing the response of a Catalan beach with an implemented sand dune, built up in the abovementioned time window, to a series of synthetic storms. Several simulations with XBEACH code show notable results in terms of gained beach width when a sand dune is implemented and low energy storms impact the beach.El desenvolupament humà ha endurit la línia de la costa, dinàmica per definició, restringint la seva capacitat d’autodefensa. En cada temporal de llevant en la costa catalana, es produeixen fenòmens d’erosió, disminució de platges i danys a infraestructura. La localització de les zones que més pateixen aquestes conseqüències, i la identificació dels riscos associats és la primera tasca realitzada en aquesta tesina. La implantació d’infraestructura dura a aquests problemes no pot ser la resposta definitiva degut a l’elevat cost i l’impacte ambiental associat. És necessari implementar solucions proactives i alternatives per tal de treballar amb la natura. Avui en dia es disposa d’una previsió de temporal fiable amb 48 hores d’antelació. Per tant es té d’un període de temps que pot ser emprat en la construcció d’una mesura de defensa contra un risc específic com la inundació o l’erosió. Aquest concepte de ràpida resposta és estudiat en aquesta tesina analitzant la resposta d’una platja catalana en la qual s’hi ha construït una duna de sorra, en el període de temps esmenat, enfront d’una sèrie de temporals sintètics. Diverses simulacions amb el codi XBEACH mostren resultats acceptables, en termes de pèrdua de platja, quan un temporal de baixa intensitat es propaga a una platja amb una duna de sorra