Ferric carboxymaltose with or without erythropoietin for the prevention of red-cell transfusions in the perioperative period of osteoporotic hip fractures: a randomized contolled trial. The PAHFRAC-01 project

Background: Around one third to one half of patients with hip fractures require red-cell pack transfusion. The increasing incidence of hip fracture has also raised the need for this scarce resource. Additionally, red-cell pack transfusions are not without complications which may involve excessive morbidity and mortality. This makes it necessary to develop blood-saving strategies. Our objective was to assess safety, efficacy, and cost-effictveness of combined treatment of i.v. ferric carboxymaltose and erythropoietin (EPOFE arm) versus i.v. ferric carboxymaltose (FE arm) versus a placebo (PLACEBO arm) in reducing the percentage of patients who receive blood transfusions, as well as mortality in the perioperative period of hip fracture intervention. Methods/Design: Multicentric, phase III, randomized, controlled, double blinded, parallel groups clinical trial. Patients > 65 years admitted to hospital with a hip fracture will be eligible to participate. Patients will be treated with either a single dosage of i.v. ferric carboxymaltose of 1 g and subcutaneous erythropoietin (40.000 IU), or i.v. ferric carboxymaltose and subcutaneous placebo, or i.v. placebo and subcutaneous placebo. Follow-up will be performed until 60 days after discharge, assessing transfusion needs, morbidity, mortality, safety, costs, and health-related quality of life. Intention to treat, as well as per protocol, and incremental cost-effectiveness analysis will be performed. The number of recruited patients per arm is set at 102, a total of 306 patients. Discussion: We think that this trial will contribute to the knowledge about the safety and efficacy of ferric carboxymaltose with/without erythropoietin in preventing red-cell pack transfusions in patients with hip fracture. ClinicalTrials.gov identifier: NCT01154491

What Stops Designers from Designing Sustainable Packaging?—A Review of Eco-design Tools with Regard to Packaging Design

Packaging has caused much waste and its sustainability has received much attention in the past decades. Designers have made efforts to mitigate environmental impacts of packaging. However, many packaging designs are still far from achieving their sustainability goals. The purpose of this study is to perform a literature review of the principal design methods and tools for sustainable packaging published over the last twenty years. The objective is to understand the main obstacles that limit their effective implementation in the packaging design process. This study develops a sustainable packaging design and development model and proposes criteria for accessing packaging tools and methods. This study has found that to achieve sustainable design, many tools have limitations in demonstrating usage and balancing trade-off situations. Most of the tools focus on defining problems rather than suggesting possible solutions

Metabolic adaptation of two in silico mutants of Mycobacterium tuberculosis during infection

ABSTRACT: Background: Up to date, Mycobacterium tuberculosis (Mtb) remains as the worst intracellular killer pathogen. To establish infection, inside the granuloma, Mtb reprograms its metabolism to support both growth and survival, keeping a balance between catabolism, anabolism and energy supply. Mtb knockouts with the faculty of being essential on a wide range of nutritional conditions are deemed as target candidates for tuberculosis (TB) treatment. Constraint-based genome-scale modeling is considered as a promising tool for evaluating genetic and nutritional perturbations on Mtb metabolic reprogramming. Nonetheless, few in silico assessments of the effect of nutritional conditions on Mtb’s vulnerability and metabolic adaptation have been carried out. Results: A genome-scale model (GEM) of Mtb, modified from the H37Rv iOSDD890, was used to explore the metabolic reprogramming of two Mtb knockout mutants (pfkA- and icl-mutants), lacking key enzymes of central carbon metabolism, while exposed to changing nutritional conditions (oxygen, and carbon and nitrogen sources). A combination of shadow pricing, sensitivity analysis, and flux distributions patterns allowed us to identify metabolic behaviors that are in agreement with phenotypes reported in the literature. During hypoxia, at high glucose consumption, the Mtb pfkA-mutant showed a detrimental growth effect derived from the accumulation of toxic sugar phosphate intermediates (glucose-6-phosphate and fructose-6-phosphate) along with an increment of carbon fluxes towards the reductive direction of the tricarboxylic acid cycle (TCA). Furthermore, metabolic reprogramming of the icl-mutant (icl1&icl2) showed the importance of the methylmalonyl pathway for the detoxification of propionyl-CoA, during growth at high fatty acid consumption rates and aerobic conditions. At elevated levels of fatty acid uptake and hypoxia, we found a drop in TCA cycle intermediate accumulation that might create redox imbalance. Finally, findings regarding Mtb-mutant metabolic adaptation associated with asparagine consumption and acetate, succinate and alanine production, were in agreement with literature reports. Conclusions: This study demonstrates the potential application of genome-scale modeling, flux balance analysis (FBA), phenotypic phase plane (PhPP) analysis and shadow pricing to generate valuable insights about Mtb metabolic reprogramming in the context of human granulomas

Kaffillari - kahvilapyörän suunnittelu

Opinnäytetyön tavoitteena oli suunnitella polkupyörän päällä toimiva liikkuva kahvila eli kahvilapyörä turkulaissyntyisen yrityksen Kaffillarin käyttöön. Kahvilapyörän piti ulkoasullaan ilmentää Kaffillarin kahvintäyteistä maailmankuvaa sekä kyetä tarjoamaan edellytykset kahvin valmistamiseen itsenäisesti paikasta rippumatta. Suunnittelun tueksi vertailtiin tehtyjä tavarapyörärakennelmia sekä määriteltiin moodboardin avulla tunnelmaa, johon pyrittiin. Suunnittelun pohjaksi kartoitettiin ja määriteltiin mahdollisuuksia ja rajoituksia. Liikkuvaan kahvilatoimintaan tutustuttiin prototyyppien ja havainnoinnin kautta kahvilapyörän oikeassa ympäristössä. 3D-mallintaminen toimi suunnittelun päätyökaluna yhdessä hahmomallien kanssa, joilla näyttöruudun toisinaan harhaanjohtavia mittasuhteita tuotiin fyysiseen maailmaan. Rakenteiden tukevuutta testattiin ja tuotannollisuutta kehitettiin yhdessä valmistajan kanssa. Tuloksena saatiin toimiva prototyyppi, jota käytettiin Kaffillarin toiminnassa ensimmäisellä kesäkaudella sekä valmiit suunnitelmat Kaffillarin ensimmäiseen varsinaiseen tuotannolliseen versioon, jota jo rakennettiin opinnäytetyön loppuvaiheessa.The aim of the thesis was to design a fully functional café bicycle for a company in Turku called Kaffillari. The appearance of the café bicycle should represent the coffee filled worldview of Kaffillari and enable the best ground for making outstanding coffee self-reliantly anywhere. Benchmarking was conducted with already existing cargo bicycle creations and moodboard was used for defining the desired atmosphere. Functional possibilities and limitations were defined for the basis of the design. Prototypes were used to explore and observe the mobile café working in the real future environment of the café bicycle. 3D-modeling was the key tool for the entire project. It was used hand in hand with mock-ups to ensure the real life scale which sometimes may become blurry when only seen in the computer screen. The stability of the structure and producibility was developed with the manufacturer. The end results of the project were a working prototype which was used by Kaffillari for its first high season summer and ready plans for the actual first production model which is already under construction