Rekisteritutkimus Oulun yliopistollisen sairaalan lasten elinsiirtopotilaiden verenpaineen hoidosta ja seurannasta

Tiivistelmä. Yhä useammalla lapsella esiintyy kohonnutta verenpainetta. Lapsen kohonnut verenpaine voi johtaa aikuisiällä verenpainetautiin, kardiovaskulaarisairauksiin ja pahimmillaan jopa kuolemaan. Elinsiirtopotilaiden verenpaineet ovat kohtalaisesti koholla lähes kaikissa ikäryhmissä. Etenkin yönaikainen hypertensio on yleistä tässä potilasryhmässä, sillä usein elinsiirtopotilailla ei havaita normaalia yönaikaista verenpaineen laskua. Nykyään elinsiirtopotilaille suositellaan verenpaineen vuorokausirekisteröintiä, jotta voidaan havaita yönaikainen hypertensio tai piilevä hypertensio, jota ei poliklinikkamittauksilla saada diagnosoitua. Tämän tutkimuksen tarkoituksena oli selvittää, kuinka monelle OYS:n lasten elinsiirtopotilaalle on tehty verenpaineen vuorokausiseuranta, vastaako vuorokausiseurannan lukemat sekä poliklinikkamittaukset kansainvälisiä suosituksia, sekä kuinka monella elinsiirtopotilaalla on verenpainelääkitys ja mitkä lääkeryhmät ovat edustettuina. Aineisto kerättiin potilastietojärjestelmä Eskosta ja taulukoitiin Exceliin. Aineistoon kerättiin OYS:n seurannassa olleet lasten elinsiirtopotilaat aikaväliltä syyskuu 2018 — syyskuu 2020. Aineistoa verrattiin American Academy of Pediatricsin 2017 julkaisemiin lasten verenpainesuosituksiin. Tutkimuksessa selvisi, että vain 60%:lla OYS:n lasten elinsiirtopotilaista oli verenpaineet kansainvälisten hoitosuositusten mukaisella tasolla, kun analysoitiin verenpaineen vuorokausiseurannan päiväarvoja ja muiden potilaiden poliklinikkamittauksia. Toisaalta tutkimuksessa luettiin verenpainelukemia yhden mmHg:n tarkkuudella, joten mikäli verenpaine ylitti suositusten rajat edes yhdellä yksiköllä, katsottiin potilas hypertensiiviseksi, eikä näin ollen otettu huomioon mittaukseen vaikuttavia ulkoisia tekijöitä. 50%:lla potilaista oli verenpainelääkitys käytössä seurantajakson lopussa. Eniten edustettu lääkeryhmä verenpainetta alentavana lääkityksenä tässä potilasryhmässä oli kalsiumkanavan salpaajat, joita pidetään myös ensilinjan lääkkeenä verenpaineen hoidossa joidenkin tutkimusten mukaan potilailla, joilla ei ole proteinuriaa

x509-free access to WLCG resources

Access to WLCG resources is authenticated using an x509 and PKI infrastructure. Even though HEP users have always been exposed to certificates directly, the development of modern Web Applications by the LHC experiments calls for simplified authentication processes keeping the underlying software unmodified. In this work we will show a solution with the goal of providing access to WLCG resources using the user's home organisations credentials, without the need for user-acquired x509 certificates. In particular, we focus on identity providers within eduGAIN, which interconnects research and education organisations worldwide, and enables the trustworthy exchange of identity-related information. eduGAIN has been integrated at CERN in the SSO infrastructure so that users can authenticate without the need of a CERN account. This solution achieves x509-free access to Grid resources with the help of two services: STS and an online CA. The STS (Security Token Service) allows credential translation from the SAML2 format used by Identity Federations to the VOMS-enabled x509 used by most of the Grid. The IOTA CA (Identifier-Only Trust Assurance Certification Authority) is responsible for the automatic issuing of short-lived x509 certificates. The IOTA CA deployed at CERN has been accepted by EUGridPMA as the CERN LCG IOTA CA, included in the IGTF trust anchor distribution and installed by the sites in WLCG. We will also describe the first pilot projects which are integrating the solution.Peer reviewe

Posttraumatic epilepsy in intensive care unit-treated pediatric traumatic brain injury patients

publishedVersionPeer reviewe

Relationship between galactomannan structure and physicochemical properties of films produced thereof

In this work five sources of galactomannans, Adenanthera pavonina, Cyamopsis tetragonolobus, Caesalpinia pulcherrima, Ceratonia siliqua and Sophora japonica, presenting mannose/galactose ratios of 1.3, 1.7, 2.9, 3.4 and 5.6, respectively, were used to produce galactomannan-based films. These films were characterized in terms of: water vapour, oxygen and carbon dioxide permeabilities (WVP, O 2 P and CO 2 P); moisture content, water solubility, contact angle, elongation-at-break (EB), tensile strength (TS) and glass transition temperature (T g ). Results showed that films properties vary according to the galactomannan source (different galactose distribution) and their mannose/galactose ratio. Water affinity of mannan and galactose chains and the intermolecular interactions of mannose backbone should also be considered being factors that affect films properties. This work has shown that knowing mannose/galactose ratio of galactomannans is possible to foresee galactomannan-based edible films properties.The authors thank the fellowship (SFRH/BPD/ 72753/2010) from the Fundação para a Ciência e Tecnologia (FCT, Portugal). The authors also thank the FCT Strategic Project of UID/BIO/ 04469/2013 unit, the project RECI/BBB-EBI/0179/2012 (FCOMP-010124-FEDER-027462) and the project BBioInd - Biotechnology and Bioengineering for improved Industrial and Agro-Food processes, REF. NORTE-07-0124-FEDER-000028 Co-funded by the Programa OperacionalRegionaldoNorte(ON.2–ONovoNorte),QREN,FEDER. Fundação Cearense de Apoio ao Desenvolvimento Científico e Tecnológico – FUNCAP, CE Brazil (CI1-0080-00055.01.00/13)

On opportunistic software reuse

The availability of open source assets for almost all imaginable domains has led the software industry toopportunistic design-an approach in which people develop new software systems in an ad hoc fashion by reusing and combining components that were not designed to be used together. In this paper we investigate this emerging approach. We demonstrate the approach with an industrial example in whichNode.jsmodules and various subsystems are used in an opportunistic way. Furthermore, to study opportunistic reuse as a phenomenon, we present the results of three contextual interviews and a survey with reuse practitioners to understand to what extent opportunistic reuse offers improvements over traditional systematic reuse approaches.Peer reviewe

Phase state of ambient aerosol linked with water uptake and chemical aging in the southeastern US

Abstract. During the summer 2013 Southern Aerosol and Oxidant Study (SOAS) field campaign in a rural site in the southeastern United States, the effect of hygroscopicity and composition on the phase state of atmospheric aerosol particles dominated by the organic fraction was studied. The analysis is based on hygroscopicity measurements by a Hygroscopic Tandem Differential Mobility Analyzer (HTDMA), physical phase state investigations by an Aerosol Bounce Instrument (ABI) and composition measurements using a high-resolution time-of-flight aerosol mass spectrometer (HR-ToF-AMS). To study the effect of atmospheric aging on these properties, an OH-radical oxidation flow reactor (OFR) was used to simulate longer atmospheric aging times of up to 3 weeks. Hygroscopicity and bounce behavior of the particles had a clear relationship showing higher bounce at elevated relative humidity (RH) values for less hygroscopic particles, which agrees well with earlier laboratory studies. Additional OH oxidation of the aerosol particles in the OFR increased the O : C and the hygroscopicity resulting in liquefying of the particles at lower RH values. At the highest OH exposures, the inorganic fraction starts to dominate the bounce process due to production of inorganics and concurrent loss of organics in the OFR. Our results indicate that at typical ambient RH and temperature, organic-dominated particles stay mostly liquid in the atmospheric conditions in the southeastern US, but they often turn semisolid when dried below ∼ 50 % RH in the sampling inlets. While the liquid phase state suggests solution behavior and equilibrium partitioning for the SOA particles in ambient air, the possible phase change in the drying process highlights the importance of thoroughly considered sampling techniques of SOA particles. </jats:p

Air temperature changes in Toruń (central Poland) from 1871 to 2010

The article presents a detailed analysis of changes in air temperature in Toruń in the period 1871–2010 on the basis of homogenised monthly, seasonal and annual air temperature series which have been newly constructed (i.e. extended by the 50 years of 1871–1920). Over the 140-year study period, a sizeable and statistically significant increase of 0.1 °C per decade was found in the air temperature in Toruń. The greatest increases occurred for spring and winter, at 0.12 and 0.11 °C, respectively. A lesser warming, meanwhile, was recorded for autumn (0.10 °C/10 years), and particularly for summer (0.07 °C/10 years). The air temperature trends are statistically significant for all seasons. Air temperature differences between the monthly averages of three analysed subperiods (1871–1900, 1901–1950 and 1951–2010) and averages for the entire period under review rarely exceeded ± 0.5 °C. In all of these periods, the highest average air temperatures occurred in July and the lowest in January. The period of 1981–2010 had the highest frequency of occurrence of very and extremely warm seasons and years. Meanwhile, the highest frequency of very and extremely cool seasons and years was recorded in the 1940s and in the nineteenth century. In the period of 1871–2010, winters shortened markedly (by 7%) and summers lengthened by 3.8%. All of the presented aspects of air temperature in Toruń, which is representative of the climate of central Poland, are in close agreement with the findings of analogous studies of the same for other areas of Poland and Central Europe

Social- and Health Care Educators’ Cultural Competence

Introduction and aim: Cultural differences have significant impacts on classroom behaviours and communication in teaching. The aim of this study is to explore social and healthcare educators’ cultural competence in transcultural education. Methodology: Data was collected from semi-structured focus group interviews at universities of applied sciences and vocational colleges. Inductive content analysis was used in the analysis process. Results: Educators’ cultural competence in transcultural education emerges as generic categories: transcultural education, educatorship and ethical attitudes, and underpins by the sub-categories: language and linguistics, different learning styles, integrating multicultural students, cultural knowledge and sensitivity, collaborating and cooperating, self-awareness and openness, and respecting and caring. Conclusion: Cultural competence represents a core competence for social-and health care educators. Educators need to know students’ background, master different learning styles, be flexible in their pedagogical approaches and have an open and ethical attitude.  </p

Utilization of galactomannan from Gleditsia triacanthos in polysaccharide-based films : effects of interactions between film constituents on film properties

The objective of this work was to evaluate the effect of the concentrations of Gleditsia triacanthos galactomannan and glycerol and the presence of corn oil in the physical properties of edible films. The influence of interactions between those constituents on films' permeability to gases (water vapour, CO2 and O2), solubility in water, mechanical properties and colour was evaluated. The effects of those variables were analysed according to a 23 factorial design; regression coefficients were used to understand the influence of each variable (factor) on the studied properties, and a multifactor model was developed. Results show that galactomannan concentration is the most significant factor affecting the studied properties; moreover, the increase of plasticizer concentration and the presence of oil showed to be the most influent in the particular cases of solubility and transport properties (water vapour permeability and O2 permeability), respectively. These results show that galactomannan films' properties can be tailored to allow their use as alternative to non-biodegradable, non-edible packaging materials.The author M. A. Cerqueira is recipient of a fellowship from Fundacao para a Ciencia e Tecnologia (FCT, SFRH/BPD/72753/2010) and B. W. S. Souza is a recipient of a fellowship from the Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior, Brazil (Capes, Brazil)