An asymptomatic schwannoma of the nasal septum: report of a unique case.

Schwannomas of the nasal septum are extremely rare, and therefore their diagnosis and treatment can pose certain challenges. We describe the case of an incidentally discovered schwannoma of the nasal septum that was unique in that the lesion was completely asymptomatic. In view of our finding, we believe that routine examinations of both nasal fossae should be considered during routine diagnostic laryngeal flexible endoscopy

Quantification of urinary total luteinizing hormone immunoreactivity may improve the prediction of ovulation time

ObjectivesMost of the currently available ovulation prediction kits provide a relatively rough estimation of ovulation time with a short fertility window. This is due to their focus on the maximum probability of conception occurring one day before ovulation, with no follow-up after LH surge until ovulation nor during the subsequent days thereafter. Earlier studies have shown that urine of reproductive age women contains at least 3 different molecular forms of luteinizing hormone (LH); 1) intact LH, 2) LH beta-subunit (LH beta) and a 3) small molecular weight fragment of LH beta, LH beta core fragment (LH beta cf). The proportion of these LH forms in urine varies remarkably during the menstrual cycle, particularly in relation to the mid-cycle LH surge. In this exploratory study, we studied the potential implications of determining the periovulatory course of total LH immunoreactivity in urine (U-LH-ir) and intact LH immunoreactivity in serum (S-LH-ir) in the evaluation of the fertility window from a broader aspect with emphasis on the post-surge segment. MethodsWe determined total U-LH-ir in addition to intact S-LH-ir, follicle-stimulating hormone (FSH), progesterone, and estradiol in 32 consecutive samples collected daily from 10 women at reproductive age. Inference to the non-intact U-LH-ir levels was made by calculating the proportion of total U-LH-ir to intact S-LH-ir. ResultsTotal U-LH-ir increased along with LH surge and remained at statistically significantly higher levels than those in serum for 5 consecutive days after the surge in S-LH-ir. S-LH-ir returned to follicular phase levels immediately on the following day after the LH surge, whereas the same took 7 days for total U-LH-ir. ConclusionsThe current exploratory study provides preliminary evidence of the fact that U-LH-ir derived from degradation products of LH remains detectable at peak levels from the LH surge until ovulation and further during the early postovulatory period of fecundability. Thus, non-intact (or total) U-LH-ir appears to be a promising marker in the evaluation of the post-surge segment of the fertility window. Future studies are needed to unravel if this method can improve the prediction of ovulation time and higher rates of fecundability in both natural and assisted conception.Peer reviewe

A customer's possibilities to increase the performance of a service provider by adding value and deepening the partnership in facility management service

Reliable and good suppliers are an important competitive advantage for a customer and that is why the development of suppliers, improvement of performance and enhancement of customership are also in the interest of the customer. The purpose of this study is to clarify a customer’s possibilities to increase the performance of a service provider and to develop the service process in FM services and thus help to improve partnership development. This research is a qualitative research. The research complements the existing generic model of supplier development towards partnership development by customer and clarifies the special features that facility management services bring to this model. The data has been gathered from interviews of customers and service providers in the facility management service sector. The result is a model of customers’ possibilities to develop the performance of service providers from the viewpoint of value addition and relationship development and in that way ensure added value to the customer and the development of a long-term relationship. The results can be beneficial to customers when they develop the cooperation between the customer and the service provider toward being more strategic and more partnership focused.fi=vertaisarvioitu|en=peerReviewed

Modern empirical and modelling study approaches in fluvial geomorphology to elucidate sub-bend-scale meander dynamics

Major developments in theory and modelling techniques have taken place within the past couple of decades in the field of the fluvial geomorphology. In this review, we examine the state-of-the-art empirical and modelling approaches and discuss their potential benefits and shortcomings in deepening understanding of the sub-bend-scale fluvial geomorphology of meander bends. Meandering rivers represent very complex 3D flow and sedimentary processes. We focus on high-resolution techniques which have improved the spatial and temporal resolution of the data and thereby enabled investigation of processes, which have been thus far beyond the capacity of the measurement techniques. This review covers the measurement techniques applied in the field and in laboratory circumstances as well as the close-range remote sensing techniques and computational approaches. We discuss the key research questions in fluvial geomorphology of meander bends and demonstrate how the contemporary approaches have been and could be applied to solve these questions.</jats:p

Effect of hospital size and on-call arrangements on intrapartum and early neonatal mortality among low-risk newborns in Finland

Objective: To evaluate the influence of delivery unit size and on-call staffing in the performance of low-risk deliveries in Finland. Study design: A population-based study of hospital size and level based on Medical Birth Register data. Population was all hospital births in Finland in 2005-2009. Inclusion criteria were singleton births (birth weight 2500 g or more) without major congenital anomalies or birth defects. Additionally, only intrapartum stillbirths were included. Birthweights and maternal background characteristics were adjusted for by logistic regression. Main outcome measures were intrapartum or early neonatal mortality, neonatal asphyxia and newborns' need for intensive care or transfer to other hospital and longer duration of care. On-call arrangements were asked from each of the hospitals. Results: Intrapartum mortality was higher in units where physicians were at home when on-call (OR 1.25; 95% CI 1.02-1.52). A tendency to a higher mortality was also recorded in non-university hospitals (OR 1.18; 95% CI 0.99-1.40). Early neonatal mortality was twofold in units with less than 1000 births annually (OR 2.11; 95% CI 0.97-4.56) and in units where physicians were at home when on-call (OR 1.85; 95% CI 0.91-3.76). These results did not reach statistical significance. No differences between the units were found regarding Apgar scores or umbilical cord pH. Conclusion: The differences in mortality rates between different level hospitals suggest that adverse outcomes during delivery should be studied in detail in relation to hospital characteristics, such as size or level, and more international studies determining obstetric patient safety indicators are required. (C) 2016 Elsevier Ireland Ltd. All rights reserved.Peer reviewe

Measurements of light transfer through drift ice and landfast ice in the northern Baltic Sea

The aim of this study was to investigate the light transfer through sea ice with a focus on bio-optical substances both in fast ice and in the drift ice zones in the northern Baltic Sea. The measurements included snow and ice structure, spectral irradiance and photo-synthetically active radiation below the sea ice. We also measured the concentrations of the three main bio-optical substances which are chlorophyll-a, suspended particulate matter, and coloured dissolved organic matter (CDOM). These bio-optical substances were determined for melted ice samples and for the underlying sea water. The present study provides the first spectral light transfer data set for drift ice in the Baltic Sea. We found high CDOM absorption values typical to the Baltic Sea waters also within sea ice. Our results showed that the transmittance through bare ice was lower for the coastal fast ice than for the drift ice sites. Bio-optical substances, in particular CDOM, modified the spectral distribution of light penetrating through the ice cover. Differences in crystal structure and the amount of gas inclusions in the ice caused variation in the light transfer. Snow cover on ice was found to be the dominant factor influencing the light field under ice, confirming previous studies. In conclusion, snow cover dominated the amount of light under the ice, but did not modify its spectral composition. CDOM in the ice absorbs strongly in the short wavelengths. As pure water absorbs most in the long wavelengths, the light transfer through ice was highest in the green (549-585 nm). (C) 2020 Institute of Oceanology of Polish Academy of Sciences. Published by Elsevier B.V.Peer reviewe

The impact of increased number of low-risk deliveries on maternal and neonatal outcomes: A retrospective cohort study in Finland in 2011-2015

Objectives: Our aim was to demonstrate the influence of increased number of low-risk deliveries on obstetric and neonatal outcome. Study design: The study hospital was Katiloopisto Maternity Hospital in Helsinki. Simultaneously, we studied all three delivery units in the Helsinki region in the population-based analysis. The study population was singleton hospital deliveries occurring between 2011 and 2012, and 2014-2015. The study hospital included 11 237 and 15 637 births and the population-based group included 28 950 and 27 979 births. We compared outcome measures in different periods by calculating adjusted odds ratios (AOR). Main outcome measures were induced delivery, mode of delivery, third or fourth degree perinea, tear, Apgar score at five minutes 7 days, and perinatal death. Results: In the study hospital, induction rate increased from 22.4% to 24.8% (AOR 1.06, 95% CI; 1.00-1.12) while in the population-based analysis the rate decreased from 22.2% to 21.5% (AOR 0.96, 95% CI; 0.92-1.00). Percentage of neonatal transfers, low Apgar scores, and severe perineal tears increased both in study hospital and in population-based group. Changes in operative delivery rate and other adverse perinatal outcomes were statistically insignificant. Conclusions: Increasing the volume of a delivery unit does not compromise maternal or neonatal outcome. Specific characteristics of a delivery unit affect the volume outcome association. (C) 2018 Elsevier B.V. All rights reserved.Peer reviewe