Spatial data is playing a bigger role within many fields outside of Geographic Information Systems (GIS) and spatial analysis. With more and more users with varying levels of previous spatial analysis experience using this kind of data, there is a growing demand on how this information is best presented to the user. This user-centered design is an increasingly common theme in other adjacent fields, but is still in its infancy in the field of GIS. Currently there is no obvious generalized solution that provides the answer to how to present data, no matter if it is spatial or not. How to present data in a smart and comprehensive way is still an everyday challenge across many fields. The objective of this thesis is to create a prototype of a web based Network Information System (NIS) where the layman user is in the center of the entire design process. This includes both the actual visualizations, but also the choice of tools and the interface design. The prototype is designed around the role of the customer service representative in a utility company using a NIS. This type of layman user is the kind of user that today works in a system that is designed with neither their role nor their GIT experience or training in mind. From this prototype, the efficacy of different visualization techniques on layman users is evaluated, producing more general guidelines for user-centered development directed at layman users. The first step of this user-centered design process is to understand the user. By interviewing users of the system, their current work flows and opinions of their current system are better understood. From this, information about which tools they need, which current features work well and which need revising is gathered. Based on this, a mock-up is created which is then transformed into a prototype. Finally, the prototype is evaluated by the target audience with comments on a presentation as well as a larger survey. The results show that in general the prototype is well-received with regards to existing functionality and how it is presented through the interface design. The implemented visualizations are well understood by most of the expert users, but are less successful with the layman users in the survey. Especially with regards to the icon choices and other point representations, there is a discrepancy between the intended visualization and the perception of the survey takers, which may partly be due to the lack of context presented. An appreciated fact is that the functionality implemented in the prototype is tailored to the requirements put forth by the users. User-centric design processes depend heavily on the developer's understanding of the user and their needs. This is as true for functionality as for visualizations, where familiarity and associations can be both beneficial and detrimental, depending on how well understood they are. Using icons to represent objects is very efficient, as long as the context and the meaning of the icons themselves are well defined and conveyed. Finally, it is imperative to not throw too much information at the user. Whether in the shape of too many tools and options, or by displaying too much on the map, the same clutter-problem occurs. When presenting a situation or a scenario, the core message cannot be obfuscated by unnecessary features, functions or choices.

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Background: It has been reported that transjugular intrahepatic portosystemic shunting (TIPS) might be utilized as a salvage option for hepatorenal syndrome (HRS), while randomized controlled trials are pending and real-world contemporary data on inpatient mortality is lacking. Methods: We conducted an observational retrospective cohort study from the National Inpatient Sample from 2005 to 2014. We included all adult patients admitted with HRS and cirrhosis, using ICD 9-CM codes. We excluded cases with variceal bleeding, Budd–Chiari, end-stage renal disease, liver transplant and transfers to acute-care facilities. TIPS’ association with inpatient mortality was assessed using multivariable mixed-effects logistic regression, as well as exact-matching, thus mitigating for TIPS selection bias. The exact-matched analysis was repeated among TIPS-only versus dialysis-only patients. Results: A total of 79,354 patients were included. Nine hundred eighteen (1.2%) underwent TIPS. Between TIPS and non-TIPS groups, mean age (58 years) and gender (65% males) were similar. Overall mortality was 18% in TIPS and 48% in dialysis-only cases (n = 10,379; 13.1%). Ninety six (10.5%) TIPS patients underwent dialysis. In-hospital mortality in TIPS patients was twice less likely than in non-TIPS patients (adjusted odds ratio [aOR] = 0.43, 95% CI 0.30–0.62; p < 0.001), with similar results in matched analysis [exact-matched (em) OR = 0.39, 95% CI 0.17–0.89; p < 0.024; groups = 96; unweighted n = 463]. Head-to-head comparison showed that TIPS-only patients were 3.3 times less likely to succumb inpatient versus dialysis-only patients (contrast aOR = 0.31, 95% CI 0.20–0.46; p < 0.001), with similar findings post-matching (emOR = 0.22, 95% CI 0.15–0.33; p < 0.001; groups = 54, unweighted n = 1457). Conclusions: Contemporary, real-world data reveal that TIPS on its own, and when compared to dialysis, is associated with decreased inpatient mortality when utilized in non-bleeders-HRS patients. Further randomized studies are needed to establish the long-term benefit of TIPS in these patients.

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The thesis entitled ‘Studies of NIS Mediated Cyclopropane Ring Opening Reactions in Carbohydrate Chemistry’ is divided into four chapters. Chapter 1: Section 1: Efficient Synthesis of Fused Perhydrofuro[2,3-b]pyrans (and furans) by Ring Opening of 1,2-Cyclopropanated Sugar Derivatives. In this section a general and efficient methodology for the synthesis of carbohydrate derived perhydrofuro[2,3-b]pyrans (and furans) from the corresponding 1,2-cyclopropane carboxylates has been discussed. A wide range of linear-fused perhydrofuro[2,3-b]pyran or furan ring systems are encountered in a number of biologically active natural products. A few approaches are available for the construction of this kind of fused motifs which involve harsh reaction conditions and lengthy reaction sequence. The methodology utilizes the potential ability of cyclopropanated sugars to undergo N-iodosuccinimide (NIS) mediated electrophilic ring opening assisted by the pyran ring oxygen followed by intramolecular trapping of oxonium intermediate to generate the furan ring system. Cyclopropantion of tribenzyl glucal using methyl diazoacetate and catalytic amount of dirhodiumtetracetate furnished corresponding exo-1,2-cyclopropane carboxylate exclusively. To generate a nucleophile, cyclopropane carboxylate ester was reduced to the corresponding alcohol which upon treatment with NIS in CH3CN underwent ring opening followed by intramolecular ring closure to give the corresponding perhydro[2,3-b]furopyran along with an oxidized product. After various modifications we found that using CH2Cl2 as a solvent gave the expected perhydrofuropyran as the sole product in good yield (Scheme I). The stereochemistry of the product was established on the basis of 1H-1H NOESY experiment. There are many natural products that contain the perhydrofuro[2,3-b]furyl glycal core such as clerodin, jodrelline B and caryoptin, which show insect anti-feedant properties. With this in mind, the methodology has been successfully extended to the cyclopropanated tetrahydrofuran derivatives resulting in the synthesis of furofuryl glycal moiety (Scheme II). Scheme II Chapter 1: Section 2: Synthesis of Carbohydrate Derived Fused Perhydrofuro/pyrano[2,3-b]-γ-butyrolactones. In this section a general and efficient methodology for the synthesis of carbohydrate derived perhydrofuro/pyrano[2,3-b]-γ-butyrolactones has been discussed. The fusion of the γ-butyrolactone onto a substituted tetrahydrofuran/pyran ring makes a distinctive class natural diterpenoids. Representative members of this family include the marine diterpenoids norrisilide and miniolutelide A. In this chapter we describe a neutral and general method for the construction of perhydrofuro/pyrano[2,3-b]-γ-butyrolactones by NIS mediated ring opening of carbohydrate derived 1,2-cyclopropane carboxylic acids (Scheme III). Scheme III The present strategy is complementary to the existing methods and it is useful since it incorporates an additional chiral center in the molecule under milder conditions, which can be used for further transformations. Chapter 2: Ring Opening of Activated Cyclopropanes with NIS/NaN3: One-pot Synthesis of C-1 Linked Pseudo Disaccharides. Ring opening reactions of activated cyclopropanes have been widely used in organic synthesis. But they are restricted to only selected nucleophiles such as alcohol/ water, as most of the ring opening reactions need acidic activation. This chapter deals with studies of reactivity of various activated cyclopropanes with NIS as a neutral activator and sodium azide as a source of nitrogen nucleophile (Scheme IV). Scheme IV We have clearly demonstrated not only the importance of the donor-acceptor feature in the cyclopropanes in the electrophilic ring opening reaction, but also the selectivity in its functionality. Scheme V This methodology has been successfully utilized in a one-pot synthesis of C-1 linked pseudo-disaccharides from carbohydrate derived 1,2-cyclopropane carboxylates (Scheme V). Chapter 3: Synthesis of Unnatural C-2 Amino Acid Nucleosides Using NIS Mediated Ring Opening of 1,2-Cyclopropane Carboxylated Sugar Derivatives. In this chapter, we have efficiently demonstrated the utility of NIS mediated regioselective ring opening of carbohydrate derived donor-acceptor cyclopropanes for the synthesis of C-2 amino acid nucleosides. This leads to a new class of analogs of peptidyl nucleosides (Scheme VI). Scheme VI One of the advantageous factors is the attachment of nucleobase as well as generation of amino acid precursor in the same reaction which avoids lengthy reaction sequence. We have also shown the synthetic utility of our methodology to pyrimidine based furanosyl C-2 amino acid nucleosides which are of interest, since polyoxins having similar structural core exhibit antifungal activity (Scheme VII). Chapter 4: Attempts Towards the Synthesis of Carbohydrate Derived Spiro-perhydrofuropyrans Using NIS Mediated Cyclopropane Ring Opening Reaction. In this chapter we present various attempts to synthesize spiro-perhydrofuropyran/furans by ring opening of spiro-cylopropane derivatives and attempts towards stereoselective synthesis of spiro-cyclopropane carboxylates. Spiroacetal can be synthesized from the corresponding exo-cyclopropyl methanol, which can be obtained from the corresponding exo- cyclopropane carboxylate. The cyclopropyl carboxylate can be obtained from an exo- vinyl ether. Cyclopropanation of carbohydrate derived exo-glycal failed to give any selectivity under a variety of reaction conditions (Scheme VIII). Carbohydrate derived C1-unsaturated ester on cyclopropanation reaction using standard conditions (Pd(OAc)2/CH2N2) was found to be inert. The reaction under Simmons-Smith cyclopropanation conditions also gave similar results. Reduction of the ester part of the molecule to the corresponding alcohol was found to be helpful in the Simmon-Smith cyclopropanation reaction (CH2I2, Et2Zn) to obtain the corresponding exo-cyclopropane, but disappointingly without any selectivity (Scheme IX). In order to get exo-cyclopropane carboxylate with high stereoselectivity, we decided to use one of the hydroxyl group present in the molecule, as a chiral auxiliary. All the established methods for the diazoester formation failed to attach diazo ester at C-4 position (Scheme X). Scheme X (For structural formula pl see the pdf file)

Abstract The aim of this dissertation is to analyse the process of change in management accounting in public-sector health care. The change is examined through the implementation of a nationally homogeneous Diagnosis Related Grouping (DRG) system. The DRG system is used to classify health-care diagnoses into groups for service productisation and pricing. The system has been proposed as a solution for cost accounting and budgeting. The practical motivation of the dissertation is to analyse the embedding of change in organisations´ practises. The theoretical motivation of the dissertation is to extend the investigation of change by analysing the process of implementation of a nationally homogeneous system. The research data comprise 39 interviews conducted between 2006 and 2011 with hospital district representatives, the representatives of the company managing the DRG system, the DRG system supplier, and the representatives of the National Institute for Health and Welfare and the Association of Finnish Local and Regional Authorities. In addition to interviews, the data consists of participative observations, telephone inquiries, and newspaper articles. This dissertation consists of four essays that analyse the data through the lens of two theories: the Actor Network (ANT) and Institutional theory (NIS). The results indicate how the use of multiple theories (ANT ja NIS) as a methodology enriches and extends the insight into the change process in management accounting. For instance, the analysis of the homogeneous use of the DRG system, without investigating the practices of actors by making use of the ANT, the results could have been different in this respect. Especially, this dissertation indicates how important it is that actors’ actions are also examined in the processes of change in the implementation of public-sector management accounting systems. The idea for the DRG system was introduced to Finland almost twenty years ago. However, the results indicate that it has spread very slowly. According to earlier research, an institutional environment is considered to exercise pressure on organisations in order to make them adopt new practices that are homogeneous with other institutional practices. There is indirect pressure in decentralised health care in Finland, though its power for change is weak. This dissertation shows how the decentralisation of responsibilities in large-scale institutions, such as the health-care system in Finland, also slows down and decentralises reforms. As institutional power becomes weaker, the power of organisations to promote things seems to grow stronger, however. / Tiivistelmä Tämän väitöskirjatyön tarkoituksena on analysoida johdon laskentatoimen muutosprosessia julkisen sektorin terveydenhoidossa. Muutosta tarkastellaan kansallisesti yhtenäisen diagnoosiperustaisen ryhmittelyjärjestelmän (Diagnosis Related Grouping, DRG) käyttöönottoprosessin kautta. DRG on järjestelmä, jossa luokitellaan terveydenhoidon diagnoosit ryhmiin palvelujen tuotteistusta ja hinnoittelua varten. Järjestelmää on esitetty ratkaisuna kustannuslaskentaan ja budjetointiin. Väitöskirjatyön käytännön motivaationa on analysoida muutoksen asettumista organisaatioiden käytäntöihin. Väitöskirjatyön teoreettisena motivaationa on laajentaa muutostutkimusta tarkastelemalla kansallisesti yhtenäisen järjestelmän käyttöönottoa. Tutkimuksen aineisto koostuu 39 haastattelusta, joita on kerätty vuosien 2006 ja 2011 välillä. Tutkimuksessa on haastateltu sairaanhoitopiirien henkilökuntaa, DRG-järjestelmän hallinnoiman yhtiön edustajia, järjestelmän toimittajaa, Terveyden ja hyvinvoinnin laitoksen sekä Kuntaliiton edustajia. Aineisto sisältää haastattelujen lisäksi osallistuvaa havainnointia, puhelinkyselyjä sekä lehtiartikkeleita. Tämä väitöskirjatyö koostuu neljästä esseestä, joissa analysoidaan aineistoa kahden eri teorian, toimijaverkostoteorian (ANT) ja institutionaalisen teorian (NIS), avulla. Tulokset tuovat esille, kuinka kahden teorian (ANT ja NIS) metodologinen käyttö rikastuttaa ja laajentaa näkemystä johdon laskentatoimen muutosprosessista. Esimerkiksi analysoitaessa DRG-järjestelmän yhtenäistä käyttöä tutkimatta toimijoiden toimintaa toimijaverkostoteoriaa hyödyntäen, tulokset voisivat tältä osin olla erilaiset. Erityisesti tämä väitöskirjatyö osoittaa, kuinka tärkeää julkisen sektorin johdon laskentajärjestelmien käyttöönoton muutosprosessia tutkittaessa on tutkia myös toimijoiden toimintaa. Idea DRG-järjestelmästä esitettiin Suomessa melkein kaksikymmentä vuotta sitten. Tulokset osoittavat kuitenkin, että sen leviäminen on ollut hyvin hidasta. Aikaisempien tutkimusten mukaan institutionaalisen ympäristön katsotaan painostavan organisaatioita, jotta ne ottaisivat käyttöön uusia menetelmiä, jotka ovat yhdenmukaiset muiden institutionaalisten käytänteiden kanssa. Suomen hajautetussa terveydenhoidossa esitetään epäsuoraa painetta, mutta sen voima muutokseen ei ole vahva. Väitöskirjatyö tuo esille miten suurien instituutioiden, kuten Suomen terveydenhoidon, vastuun hajautuessa myös reformit hidastuvat ja hajautuvat. Institutionaalisten voimien heikentyessä organisaatioiden voima ajaa asioita näyttää kuitenkin vahvistuvan.

Past studies often find that, upon arrival U.S. immigrants generally have favorable health profiles than native-born persons, but their health deteriorates with prolonged stay. The classical explanations of this phenomenon are healthy immigrant selection and negative acculturation. With the number of foreign-born people living in the United States reaching an all-time high, the health and financial costs of this “negative acculturation” is substantial. Meanwhile, the negative duration effect on health is contradictory to expectations from classic assimilation theory and what has been observed by labor economists. This study aims to empirically study the effect of duration on immigrant health, with particular attention given to how socioeconomic status differentiates the duration-health relationship. Results based on two national datasets confirmed that immigrants, especially recent arrivals, have a considerably lower risk of worse health relative to native-born adults. I also found that socioeconomic status plays an essential role in the varying level of initial health selectivity among immigrants. The analysis of the interaction effect between duration and SES reveals that duration effects on health vary significantly by socioeconomic status. High SES immigrants tend to experience a non-negative duration effect regardless of their length of U.S. residence, while immigrants with lower socioeconomic standing are more likely to experience a negative duration effect on health with longer duration. Moreover, this study also shows that the initial foreign-born advantages in health are typically larger for persons with low SES than for persons with high SES. However, little evidence suggests there is a health convergence between long-term immigrants and their native-born counterparts with similar socioeconomic status. Potential explanations and implications of these findings are also discussed. / text

Title: Deconvolution fluorescence microscopy of yeast cells Author: Tomáš Štec Department: Institute of Physics of Charles University Supervisor: prof. RNDr. Jarmoír Plášek, CSc., Institute of Physics of Charles Uni- versity Abstract: Fluorescence microscopy presents an fast and cheap alternative to more advanced imaging methods like confocal and electron microscopy, even though it is subject to heavy image distortion. It is possible to recover most of the original distortion-free image using deconvolution in computer image processing. This al- lows reconstruction of 3D structure of studied objects. Deconvolution procedure of NIS Elements AR program undergoes an thorough inspection in this diploma the- sis. It is then applied on restoration of 3D structure of calcofluor stained cell wall of budding yeast Saccharomyces cerevisiae. Changes of the structure of the cell wall during cell ageing are being examined. Cell wall of aged cells shows increased surface roughness and even ruptures at the end of cell life. Keywords: fluorescence, microscopy, deconvolution, NIS Elements AR, calcofluor, yeast, cell wall, ageing