Class of 2011 Abstract / OBJECTIVES: To assess the role of patient, payer, clinical and disease-related factors in charges and mortality among adult inpatient cases of polycythemia vera in the United States from 2004 to 2008. METHODS: This retrospective cohort study utilized hospital discharge records from the Agency for Healthcare Research and Quality (AHRQ) Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) five consecutive years from 2004 to 2008. RESULTS: There were a total of 156,490 episodes of care involving polycythemia vera between 2004 and 2008. Average age upon admission was 65.94 years (±16.03), with 56% of cases being male (n=87,662). The mean length of stay was 5.14 days (±5.31) and inpatient mortality occurred in 3.1% of cases (n=4,927). The mean number of procedures performed was 1.43 (±2.08) and the mean number of diagnoses on record was 9.56 (±3.86). Charges for each episode of care averaged $32,620 (±42,801), summing to a national bill of $5.02 billion (2010 dollars) over the five-year time horizon. Higher charges were associated with longer length of stay, larger hospital bed size, urban hospital location, teaching status, increased number of diagnoses and procedures, private payer, Western U.S. region, and higher income bracket. Increased mortality was associated with increased age, increased number of diagnoses and procedures, self pay, payer other than Medicare, Medicaid, private or self, and the comorbidities of congestive heart failure, coagulopathy, and fluid/electrolyte disorders. CONCLUSION: Polycythemia vera is associated with considerable burden of illness.

This thesis describes the hospital information system (HIS) CLINICOM, focusing on the department of radiology. It analyses the problems linked with Internet transport of patient image documentation and it provides instructions how to create remote access interface on the department of radiology. It gives also a detailed guide describing installation and components configuration of HIS CLINICOM.

Tato práce se v první části zabývá představením technologií a nástrojů pro centrální správu a přihlašování uživatelů v GNU/Linux. Ukazuje využití adresářových služeb v síťové infrastruktuře, konkrétně služby NIS a její porovnání s dnes pravděpodobně nejrozšířenější adresářovou službou LDAP. Dále práce popisuje proces autentizace na klientských stanicích, konkrétně použití PAM a NSS a možné rozšíření celého systému zavedením cache díky démonu SSSD. Druhá část popisuje návrh a implementaci NIS provideru pro SSSD.

Syfte: År 2016 blev det lagstadgat i Sverige att större företag måste inkludera uppgifter om hållbarhet i sin årsredovisning. Eftersom större organisationer från trävaruindustrin i Sverige generellt sett publicerar omfattande och presentabla hållbarhetsrapporter, hade det varit intressant att undersöka incitamenten till detta med utgångspunkt i NIS. Syftet med studien är att undersöka vilka isomorfa faktorer som påverkar hur ett större företag inom den svenska trävaruindustrin utformar sin hållbarhetsrapport.  Metod: Studien genomfördes som en kvalitativ fallstudie med ett induktivt angreppssätt. Semistrukturerade intervjuer genomfördes med 10 personer i ett företag inom den svenska trävaruindustrin. Det insamlade materialet har kodats tematiskt för att sedan kunna analysera den tillsammans med analysmodellen från teoretiska referensramen.  Resultat & slutsats: Studiens resultat visar att det undersökta företaget blir påverkade av två isomorfa faktorer. Tvingande isomorfism påverkar företaget i högre grad medan den normativa isomorfismen påverkar företaget till viss del. Den härmande isomorfismen påverkar inte företaget i lika hög utsträckning. Examensarbetets bidrag: Studiens teoretiska bidrag är att öka förståelsen för vilka isomorfa faktorer som påverkar hur ett företag inom trävarubranschen upprättar sin hållbarhetsrapport. Det praktiska bidraget är att företag måste ta hänsyn till vad omgivningen efterfrågar ur hållbarhetsrapporten för att undvika att förlora sin legitimitet. Förslag till fortsatt forskning: Utföra studier på fler företag inom samma bransch och jämföra resultatet. Även inkludera fler kontextuella teorier för att undersöka andra faktorer som påverkar rapportens utseende. Det hade även varit intressant att studera hållbarhetsrapporter över tid för att undersöka om det finns en förändring. Till sist hade det varit till stor hjälp att ta fram ett jämförelseinstrument för hållbarhetsrapporter. / Aim: In 2016, it became statutory in Sweden that larger companies must include information on sustainability in their annual report. Since larger organizations from the lumber industry in Sweden generally publish comprehensive and presentable reports, it would have been interesting to examine the incentives for this based on NIS. The purpose of the study is to investigate which isomorphic factors affect how a major company in the Swedish lumber industry designs its sustainability report.  Method: The study was conducted as a qualitative case study using an inductive approach. Semi-structured interviews were conducted with 10 employees in a company in the Swedish lumber industry. The empirical material has been coded thematically in order to then be able to analyze it together with the analysis model from the theoretical framework. Result & Conclusions: The results of the study show that the examined company is affected by two isomorphic factors. Coercive isomorphism affects the company to a greater extent, while normative isomorphism affects the company to some extent. The mimetic isomorphism does not affect the company to the same extent. Contribution of the thesis: The theoretical contribution of the study is to increase the understanding of which isomorphic factors affect how a company in the lumber industry establish their sustainability report. The practical contribution is that companies must consider what the environment demands from the sustainability report in order to avoid losing their legitimacy. Suggestions for future research: Perform studies on several companies in the same industry and compare the results. Also include more contextual theories to investigate other factors that affect the appearance of the report. It would also have been interesting to study sustainability reports over time to investigate whether there is a change or not. Finally, it would be helpful to develop a comparison instrument for sustainability reports.

I detta examensarbete är syftet att undersöka svenska verksamheters utmaningar i att uppnå en ISO 27001-certifiering med sitt arbete inom informationssäkerhet. Digitala medier och verktyg är numera en stor del av samhällsviktiga verksamheters tjänster samt operationer och det har bidragit till stora möjligheter såväl som stora sårbarheter. ISO 27001-certifieringar är den standard som ligger till grund för säkerhetsskyddslagen såväl som NIS-direktivet vilket gör att det är en standard som svenska verksamheter kan applicera. Genom bakgrunden ges en inblick i vad informationssäkerhet är och hur det står i relation med cybersäkerhet. Bakgrunden innehåller även en introduktion till den svenska lagstiftningen inom informationssäkerhet såväl som ISO 27001-standarden för att belysa vad svenska verksamheter har att förhålla sig till när det kommer till sitt arbete med informationssäkerhet. I problemformuleringen lyfts de aktuella hoten och myndigheters uttalanden inom informationssäkerhet i Sverige och hur svenska verksamheter brister i dessa. Detta i kombination med den tidigare forskningen om hur utmaningar inom ISO 27001-certifieringar har tagit sitt uttryck för andra verksamheter. Metoden redovisar hur kvalitativa intervjuer använts som verktyg för datainsamling till fallstudien men även hur det tagit sitt uttryck och beskriver processen – från förberedelse till läsbar produkt, vilket är detta examensarbete. I analysen ställs den insamlade datan i relation till tidigare forskning samt aktuella händelser för att se vilka utmaningar svenska verksamheter har för att uppnå en ISO 27001-certifiering. Resultatet baseras på den insamlade datan då det är svenska verksamheters utmaningar som är aktuellt för fallstudien. Det resulterade i fyra utmaningar: motivation, tid och ekonomi, bransch samt komplexitet. Dessa utmaningar och dess bidragande faktorer redovisas i text såväl som figurer. Somliga av dessa utmaningar är utmaningar som lyfts i tidigare forskning, vilket gör att de även kan appliceras som utmaningar för svenska verksamheter. Uppsatsen avslutas med en diskussion där fallstudiens resultat diskuteras i olika perspektiv – samhälleliga, etiska samt vetenskapliga. Diskussion om val av metod, studiens resultat samt förslag på framtida forskning lyfts, där det diskuteras om hur lagar samt standarder inom informationssäkerhet är svåra att implementera samt förstå och om det ens är möjligt att göra det lättare.

Condensed matter physics provides us with an opportunity to explore a large variety of systems with diverse properties. Central to the understanding of these systems is a characterization of the nature of their ground states and low energy excitation. Often, such systems show various forms of emergent properties that are absent in the microscopic level. Identification of such emergent phases of condensed matter form an important avenue of research in the field. In this thesis example of such phases and their associated phase transitions have been studied. The work presented here may be broadly divided into two themes: construction of the theoretical framework for understanding materials already studied experimentally, and, trying to provide new theoretical avenues which may be relevant for understanding future experiments. In these studies we shall explore some unconventional phases and phase transitions that may occur in condensed matter systems. A comprehensive understanding of the properties of such unconventional phases and phase transitions is important in the context of the large array of experimentally studied materials that regularly defy conventional wisdom in more than one way. The thesis consists of two distinct parts. In the first part we study three problems in frustrated magnets. The second part consists of studies of the tunnelling spectroscopy of metal-insulator-superconductor junctions in graphene. Studies in frustrated magnets have opened up the possibility of existence of a whole range of phases beyond the already known magnetically ordered ones. Some of these new phases, like the spin nematic or the valence bond solid, display some other conventional order themselves. Others, like the much sort after spin liquid phases displays a whole new kind of order that cannot be captured through the celebrated Landau’s classification of phases on the basis of symmetry breaking and associated order parameters. The phase transitions in these systems are also equally interesting and lead to intriguing possibilities that demand new modes of analysis. In this part of the thesis we shall study the different properties of three magnets with spin-1/2, 1 and 3/2 respectively. We start by providing an introduction to frustrated spin systems in Chapter [1]. The origin of antiferromagnetic interactions in Mott insulators is discussed and the concept of frustration of magnetic interaction is explained. We also point out the causes that may destroy magnetic order in spin systems, particularly the role of quantum fluctuations in presence or absence of magnetic frustration. This is followed with a brief outline of various magnetically ordered and disordered ground states with particular emphasis on the description of the later. We also give a brief outline of various properties of such phases and associated quantum phase transitions particularly noting the influences of quantum interferences encoded in the Berry phase terms. A brief description of the finite temperature properties is also provided. We end an outline of various experimentally relevant compounds that requires comprehensive understanding, some of which have been addressed in this thesis. In Chapter [2] we study the properties of a spin-nematic state in context of the recently discovered spin-1 Mott insulator Nickel Gallium Sulphide (NiGa2S4). This isotropic triangular lattice compound shows no spin ordering till low temperatures. We propose that it may have a particular type of spin-nematic ground state and explain the experimentally observed properties of the compound on the basis of our proposal. Starting from a two band Hubbard model description, relevant for the compound, we derive the Bilinear Biquadratic spin Hamiltonian. We then show, within mean field theory, that this Hamiltonian describes a transition from the spiral state to a ferro-nematic state as a function of the ratio of bilinear and biquadratic couplings. We also study the possible effects of small pinning disorder andmagnetic field and suggest experiments that can possibly distinguish the proposed nematic state from others. In Chapter [3] we explore the effects of the magneto-elastic coupling in the spin-3/2 B-site chromite spinel Cadmium Chromite (CdCr2O4). In this compound the spins form a pyrochlore lattice. Nearest neighbour spins interact antiferromagnetically. Due to frustration the system does not order at low temperatures and instead goes into a classical spin liquid state. Such a cooperative paramagnet is very susceptible to external perturbations which may relieve their frustration. In CdCr2O4, at lower temperatures the magnetic frustration is relieved by distorting the lattice through a first order magnetoelastic transition. Thus the compound presents a case where the relevant perturbation to the frustrated spin interactions is provided by spin-phonon coupling. An effect of such perturbations on a cooperative paramagnet is of general interest and all aspects of this are not understood presently. We take the initial step of characterizing the spin-phonon interaction in detail. Based on recent sound velocity experiments, we construct a microscopic theory for the sound velocity renormalization due to the spin-phonon coupling and explain the recent experimental data obtained by S. Zherlitsyn et al. using our theory we can explain the dependence of the sound velocity on temperature as well as magnetic field. We also construct a Landau theory to explain (qualitatively) the behaviour of sound velocity across the magneto-structural transition. Further, we discuss the effects due to the small Dzyaloshinskii-Moriya interaction that may be present in these compounds. In Chapter [4] we study the possibility of a direct second order quantum phase transition from spiral to dimer phase in two dimensional antiferromagnets. Such transitions between phases with incompatible symmetries are forbidden within conventional Landau Ginzburg-Wilson paradigm of critical phenomena. Early works showed that when the spiral is destroyed by long wavelength fluctuations a fractionalized Z2 spin liquid is obtained. In this work we show an alternative way–the quantum destruction of the spiral magnet. We argue that, when the defects of the spiral phase proliferate and condense, their associated Berry phase automatically leads to dimerization. We apply our theory to study concrete lattice models where such transitions may be observed. This transition is an example of a Landau forbidden deconfined quantum phase transition. The proposed critical theory is naturally written in terms of fractional degrees of freedom which emerge right at the critical point. These fractional particles interact with each other through emergent gauge fields and are deconfined right at the critical point (but are confined in either of the two adjoining phases). We argue, based on existing results, that the monopoles of the gauge field are dangerously irrelevant right at the critical point rendering the later noncompact. The critical point is characterized by an emergent global U (1) conservation law that is absent in the microscopic model, a typical feature of a deconfined quantum critical point. The resultant field theory belongs to the class of anisotropic NCCP3 class which may be studied numerically in future to understand its critical properties. In modern condensed matter physics the emergence of new and novel phases of matter have often been associated with the presence of strong correlations. Indeed, strongly correlated systems seem to harbour in them the potential to realize some of the most unconventional and exotic emergent phases of matter. However in graphene, which is a single layer of graphite, the emergence of novel properties, as present experiments suggest, is due to its unique band structure and not a fallout of intricate correlation effects. Band structure studies of graphene suggest that the material is a zero gap semiconductor with the low energy excitations resembling massless Dirac quasi-particles. The consequence of this is immediate and interesting. It has lead to the possibility of exploring the physics of relativistic fermions in two spatial dimensions and much of this has been studied with great vigour in the last five years. In our studies, presented in Chapter [5], we explore one of the many consequence of this emergent Dirac structure of the low energy quasi-particles, namely the properties of metal-insulator-superconductor junctions of graphene. The twin effect of Klein tunneling of Dirac fermions (and associated transmission resonances) and Andreev reflection (both specular and retro) sets them aside from their conventional counterparts. The graphene normal metal-insulator-superconductor (NIS) junctions show strikingly different properties like oscillations in the sub-gap tunneling conductance as a function of both barrier strength and width. We make a detailed study of this for arbitrary barrier strengths and widths with and without Fermi-surface mismatch between the normal and the superconducting sides. The amplitude of these oscillations are maximum for aligned Fermi surface and vanishes for large Fermi surface mismatch. We provide an understanding for this unconventional behaviour of graphene NIS junctions. We also suggest experimental tests for our theory. Such experimental verification will reveal one more remarkable emergent property in a condensed matter system.

Cyber attacks can target any nodes of the space infrastructure, and while these attacks are called non-violent, there is a credible capability to use cyber attacks to cause direct or indirect physical damage, injury or death. However, the vulnerability of satellites and other space assets to cyber attack is often overlooked, which is a significant failing given society's substantial and ever increasing reliance on satellite technologies. Through a policy analysis, this dissertation assess the set of political provisions provided by the European Union to address the cyber security issue of the space infrastructure. Such study aims at exploring the geopolitical consequences linked to space cyber security risks, and at assessing the political preparedness of the European Union to address these challenges. The perspective of transatlantic cooperation to further support both American and European effort to tackle this security risk is also addressed. The overarching value of the study is to contribute to future European cyber security for space and transatlantic debates by providing useful perspectives and key takeaways on these two domains. Ultimately, he existing set of policies are not sufficient to address the cyber security issue in Outer Space, a unified approach by the European Union and the United...

Critical infrastructures are vital services, and attacks on such systems affect people's social and economic well-being. Therefore, operators of such services must have appropriate measures in place to handle IT-related incidents. However, reports show that organisations classified as Operators of Essential Services (OES) do not have appropriate measures to handle IT-related incidents. A case study approach is used in this study to test the usability and the applicability of Wahlgren's Escalation Maturity Model level within various public sector organisations in Sweden regarding their escalation and communication of IT-related incidents. A follow-up semi-structured interview is also conducted with employees at the technical level to determine if the current organisation's maturity level shortcomings are known across different organisational levels. The tool's maturity level scaling attributes are difficult to understand because all organisations in this study achieve the same level of maturity, even though there is a wide range of performance regarding the number of questions answered in the affirmative. The data output generated from the testing of the model can assist organisations in improving their incident escalation activities. However, the lack of precision of the model makes it challenging to apply in the public sector. The results reveal that all the five organisations obtained an escalation maturity level of zero (0), non-existent, regarding escalation of IT-related incidents. As a result, with the current model, the participating organisations will have a difficult task complying with the NIS Directive's security and notification requirements.

No description available.

Endokrin aktive Substanzen (EACs) sind exogene Substanzen natürlichen oder synthetischen Ursprungs, die mit der Feedbackregulation hormoneller Netzwerke interferieren können und somit deren Homöostase beeinflussen. Störungen der Hypothalamus-Hypophysen-Schilddrüsenachse (HPT-Achse) haben weitreichende Konsequenzen, da Schilddrüsenhormone essentiell für die Regulation von Entwicklung, Wachstum und Stoffwechsel sind. In der vorliegenden Arbeit wurde das Wirkprofil potenter Inhibitoren der thyreotropen Achse am Beispiel von 4-Methylbenzyliden-campher (4-MBC) und Genistein (GEN) untersucht. Der UV-Filter 4-MBC wurde in der ovariektomierten Ratte als goitrogene Substanz identifiziert. 4-MBC interferiert auf Ebene von Hypothalamus und Hypophyse mit der Expression Feedback-assoziierter Gene und beeinflusst daher die Feedbackregulation der thyreotropen Achse. Darüber hinaus wird die Biosynthese von Schilddrüsenhormonen durch Inhibition des Iodidtransports bei gleichzeitig erhöhter messenger RNA (mRNA)-Konzentration des Natrium-Iodid-Symporters (NIS) durch 4-MBC beeinträchtigt. Parallel dazu lässt die verstärkte Expression des Angiogenesemarkers vascular endothelial growth factor (VEGF) nach subakuter Exposition auf die Entstehung einer Hypothyreose schließen. Die damit einhergehenden Veränderungen sind auch in peripheren Organen durch die Analyse 3,3‘,5-Triiod-L-thyronin (T3)-regulierter Zielgene dokumentiert. Zudem wurden diese Effekte maßgeblich durch die Expositionszeit beeinflusst, da nach chronischer Exposition vermutlich auch kompensatorische Prozesse eine wichtige Rolle spielen. Die gezeigten speziesspezifischen Effekte lassen sich möglicherweise auf Unterschiede in der Pharmakokinetik zurückführen, z.B. in Folge differentieller Expression von Cytochrom P450-Genen. / Endocrine active compounds (EACs) can be of natural or synthetic origin and show hormone-like effects that interfere with feedback regulation of hormonal networks. Interferences with the hypothalamic-pituitary-thyroid axis (HPT-axis) result in extensive consequences as thyroid hormones are essential for regulation of development, growth, and metabolism. In the work presented here, the active profile of potent inhibitors of the HPT-axis namely 4-methylbenzylidene-camphor (4-MBC) and genistein (GEN) was investigated. 4-MBC, a UV filter used in sunscreens and various cosmetics, was identified as a goiter causing agent using ovariectomized rats. 4-MBC acts at the level of hypothalamus and pituitary gland by modulating the expression of thyrotropin-releasing hormone (TRH) as well as thyroid-stimulating hormone (TSH) that regulate feedback on the HPT-axis. Furthermore, biosynthesis of thyroid hormones was impaired by 4-MBC secondary to the inhibition of iodide transport with concomitantly increased messenger RNA (mRNA)-levels of the sodium-iodide symporter (NIS). In parallel expression of the angiogenesis marker vascular endothelial growth factor (VEGF) was increased, indicating hypothyroidism. After the application of 4-MBC the expression of L-3,3’,5-triiodothyronine (T3)-regulated target genes was reduced in the periphery both on the mRNA and protein level. The documented species-specific effects indicate a difference in pharmacokinetics, possibly secondary to differential expression of cytochrome P450 genes. GEN is contained in soy and red clover and its mechanistic analysis was carried out in thyroid hormone receptor (TR) deficient mice (TRα0/0). The gender-dependent effects of GEN on tissue specificity did not follow an obvious pattern and warrant continuative analysis. The work presented here supports the assumption that EACs can interfere with function and regulation of the HPT-axis at levels that were previously considered safe.