Live kidney donors are healthy volunteers who are exposed to major surgical procedure and physical harms with no direct therapeutic benefits. Efforts to minimize their risks and morbidity are therefore of utmost importance. The current thesis describes studies on donor evaluation, surgical procedure and postoperative management of live kidney donors. The overall purpose is to evaluate and possibly improve routines and treatments in order to reduce risks and the overall morbidity of live kidney donors. In Study I, we evaluated the assessment of kidney function during donor evaluation and found that the accuracy of iohexol glomerular filtration rate (GFR) is compromised by large variations in repeated measurements in presumably healthy donors. We proposed that there is a need for improvement of GFR measurements and that the assessment of predonation kidney function should be more comprehensive, involving GFR, laboratory investigations, functional and morphological examinations and sound clinical judgment. In Study II, we addressed the risk of perioperative venous thromboembolism (VTE) and concluded that expanding the standard screening protocol for VTE to include perioperative venous duplex can potentially decrease the VTE-related morbidity. In studies III and IV, we investigated the impact of hand-assisted retroperitoneoscopic (HARS) nephrectomy on donor safety and perioperative morbidity. The HARS nephrectomy uses the hand-assisted approach, which enables immediate manual compression for hemostasis in case of sudden and severe bleeding. Additionally, the pure retroperitoneal access further increases the safety margin of laparoscopic donor nephrectomy by 1) minimizing the risk of intestinal injury, and 2) exposure of the retroperitoneal nerves, making HARS suitable for continuous infusion of local anesthetics (CILA). CILA effectively reduces the need for opioid consumption and has the potential to totally obviate opiate analgesics postoperatively. Consequently, CILA in combination with HARS reduces morphine-related morbidity and promotes postoperative recovery. In accordance with these data, we recommend improvement and modification of the donor evaluation process as well as a broad introduction of HARS nephrectomy in combination with CILA to increase the safety margin for live kidney donors.

Dental caries and periodontal disease are the major causes for tooth loss. While dental caries commonly involve the posterior teeth in both jaws, the teeth most commonly lost due to periodontal problems are the first and second molars in the maxilla. As a consequence, the upper posterior jaw is frequently edentulous. Implant therapy today is a predictable treatment modality for prosthetic reconstruction of edentulous patient. Insufficient amounts of bone, due to atrophy following loss of teeth or due to the presence of the maxillary sinus, can make it impossible to insert implants in the posterior maxilla. During the 1970s and 1980s, Tatum, Boyne and James and Wood and Moore first described maxillary sinus floor augmentation whereby, after the creation of a lateral access point, autologous bone grafts are inserted to increase crestal bone height and to create the necessary conditions for the insertion of implants. This surgical procedure requires a two-stage approach and a double surgical site: first, bone is harvested from a donor site and transplanted to the recipient site; then, after a proper healing period of between 4 to 6 months, the implants are inserted. This kind of bone reconstruction, even if well documented, has its limitations, not least in the creation of two different surgical sites and the consequent increased risk of morbidity. In 2004, Lundgren et al. described a new, simplified technique for the elevation of the sinus floor. The authors showed that by lifting the sinus membrane an empty space was created in which blood clot formations resulted in the establishment of new bone. The implants were placed simultaneously to function as “tent poles”, thus maintaining the sinus membrane in a raised position during the subsequent healing period. An essential prerequisite of this technique is to obtain optimal primary implant stability from the residual bone in the sinus floor. An extremely resorbed maxillary sinus floor, with, for example, less than 2-3 mm of poor quality residual bone, could impair implant insertion. The aims of the present research project were (i) to evaluate the donor site morbidity and the acceptance level of patients when a bone graft is harvested from the anterior iliac crest, (ii) to evaluate implant stability, new bone formation inside the maxillary sinus and marginal bone resorption around the implants in long term follow up when maxillary sinus floor augmentation is performed through sinus membrane elevation and without the addition of any grafting material, (iii) to investigate new bone formation inside the maxillary sinus, in experimental design, using a resorbable space-maker device in order to maintain elevation of the sinus membrane where there is too little bone to insert implants with good primary stability. In Paper I, 70 consecutively treated patients were retrospectively evaluated in terms of postoperative donor site morbidity and donor site complications. With regard to donor site morbidity, 74% of patients were free of pain within 3 weeks, whereas 26% had a prolonged period of pain lasting from a few weeks to several months. For 11% of patients there was still some pain or discomfort 2 years after the grafting surgery. Nevertheless, patients acceptance was high and treatment significantly improved oral function, facial appearance, and recreation/social activities and resulted in an overall improvement in the quality of life of formerly edentulous patients. In Paper I and III, some differently shaped space-making devices were tested on primates (tufted capuchin - Cebus apella) in two experimental models aimed at evaluating whether a two-stage procedure for sinus floor augmentation could benefit from the use of a space-making device to increase the bone volume and enable later implant installation with good primary stability, without the use of any grafting material. An histological examination of the specimens showed that it is possible to obtain bone formation in contact with both the Schneiderian membrane and the device. In most cases the device was displaced. The process of bone formation indicated that this technique is potentially useful for two-stage sinus floor augmentation. The lack of device stability within the sinus requires further improvement in space-makers if predictable bone augmentation is to be achieved. In Paper IV, a total of 84 patients were subjected to 96 membrane elevation procedures and the simultaneous placement of 239 implants. Changes of intra-sinus and marginal bone height in relation to the implants were measured in intraoral radiographs carried out during insertion after 6 months of healing, after 6 months of loading and then annually. Computerised tomography was performed pre-surgically and 6 months post-surgically. Resonance frequency analysis measurements were performed at the time of implant placement, at abutment connection and after 6 months of loading. The implant follow-up period ranged from a minimum of one to a maximum of 6 years after implant loading. All implants were stable after 6 months of healing. A total of three implants were lost during the follow-up period giving a survival rate of 98.7%. Radiography demonstrated an average of 5.3 ± 2.1 mm of intra-sinus new bone formation after 6 months of healing. RFA measurements showed adequate primary stability (implant stability quotient 67.4 ± 6.1) and small changes over time. In conclusion, harvesting bone from the iliac crest could result in temporary donor site morbidity, but in 11% of patients pain or discomfort was still present up to 2 years after surgery. However, patient satisfaction was good despite this slow or incomplete recovery, as showed by the quality of life questionnaire. Maxillary sinus membrane elevation without the use of bone grafts or bone substitutes results in predictable bone formation both in animal design, where the sinus membrane is supported by a resorbable device, and in clinical conditions, where the membrane is kept in the upper position by dental implants. This new bone formation is accompanied by a high implant survival rate of 98.7% over a follow-up period of up to 6 years. Intra-sinus bone formation remained stable in the long-term follow-up. It is suggested that the secluded compartment allowed bone formation in accordance with the principle of guided tissue regeneration. This technique reduces the risks of morbidity related to bone graft harvesting and eliminates the costs of grafting materials.

This thesis advances a feminist critique of Canadian legal responses to disputes over frozen in vitro embryos and embryo donor anonymity. It argues that current laws that provide spouses or partners with joint control over the use and disposition of embryos created from their genetic materials, that mandate the creation of agreements setting out these parties intentions in the event of a disagreement or divorce and that protect donor anonymity without providing mechanisms to allow donors, recipients and donor offspring to voluntarily exchange information do not adequately account for the lived experiences of women who undergo in vitro fertilization treatment or who serve as embryo donors. This thesis provides recommendations for how Canadian laws and policies might better support the express objectives and intentions of Canadian federal and provincial statutes to protect the rights, interests and health of women who seek to build their families through assisted reproductive technologies.

No description available.

In Sweden, lowest acceptable haemoglobin levels in blood donators are 125g/L for women and 135g/L for men for a test sample taken in the beginning of the blood donation. Levels, which are 10g/L lower, are accepted if the sample is taken after the blood donation. Earlier studies show that the haemoglobin level decreases for a person that is lying down. The two aims of this study were to examine how much the haemoglobin levels change during blood donation and to examine if the photometrical instrument Pronto-7TM shows equivalent results to that of the established method Cell-Dyn Sapphire. In the study, 120 blood donors participated. Blood samples were taken in the beginning and in the end of the donation. Analyses by Pronto-7TM were done before and after the donation. The haemoglobin level decreased significantly during the blood donation. The difference was in mean value 5,9g/L according to Cell-Dyn Sapphire. The decrease was significantly less than 10g/L. The Pronto-7TM gave levels that were 1,6g/L higher than Cell-Dyn Sapphire in mean and the standard deviation was higher for Pronto-7TM than for Cell-Dyn Sapphire. In conclusion, the decrease of the haemoglobin levels was significantly less than the expected difference 10g/L. Pronto-7TM gives results that differs a little from the results of the established method.

The aims of the thesis were synthesis and studies of the properties of new solution processable electron-transporting and ambipolar donor-acceptor hybrids as well as the synthesis and investigation of the properties of dendritic charge-transporting materials possessing luminescence and redox characteristics. It is found that the newly synthesized solution processable bay carbazol-2-yl or -3-yl substituted perylene bisimides are applicable as ambipolar organic semiconductors with complementary charge-transporting properties. Bay triphenylamino substituted perylene bisimide is found to relevant for the fabrication of solution processable ambipolar organic field-effect transistor. Furthermore, electron-donor functionalized pyrene, triazine and triphenylamine core-centred organic materials exhibiting good luminescence, charge-transport and redox characteristics are appropriate for application in optoelectronic devices. / Disertacijos tikslas - naujų elektronus pernešančių ir bipolinių junginių skirtų organiniams lauko tranzistoriams sintezė ir savybių tyrimas. Taip pat dendritinių liuminescuojančių junginių, skirtų organiniams šviesos diodams, sintezė ir savybių tyrimas. Nustatyta, kad susintetinti nauji perilenbisimido dariniai su karbazol-2-il- ir karbazol-3-il pakaitais pasižymi ir teigiamų ir neigiamų krūvininkų pernašos savybėmis; pernašos efektyvumas priklauso nuo chromoforų sujungimo topologijos. Perilenbisimido darinys su trifenilamino pakaitais yra tinkamas naudoti bipoliniuse organiniuose lauko tranzistoriuose, kurių sluoksniai gaunami, liejant tirpalus. Taip pat elektronų donorinėmis grupėmis funkcionalizuoti, pireno, triazino ir trifenilamino šerdis turintys junginiai, pasižymintys liuminescensija, krūvininkų pernaša ir gali būti panaudoti organiniuose šviesos dioduose.

Improvement in information sharing and communication about the foreign aid resources between the donors and the aid-recipient countries have always been considered very important. In recent years, the integration of advanced technology in the area of aid coordination has received a tremendous amount of attention. The following thesis studies the influence of technology in the area aid coordination within the context of Afghanistan. Guided by the Actor-Network Theory, the thesis examines how the social and technological aspects of the Development Assistance Database (DAD), as an advanced aid information management technology, influences aid coordination and information sharing between the donors and the government of Afghanistan. Using a case study methodology, the research also investigates whether or not the DAD adheres to the principles of aid effectiveness. The findings reveal that although technology had a profound impact in the area of aid management in Afghanistan, there are several areas that still face challenges. The present study highlights these challenges and recommends the appropriate solutions.

Darbo tikslas - įvertinti Kauno donorystės centro donorų nemokamos donorystės galimą pokytį bei motyvaciją duoti kraujo ir su ja susijusius veiksnius. Metodika. Buvo vykdomas dviejų metų palyginamasis tyrimas, tyrime buvo apklausiami 2009 metų ir 2011 metų kraujo donorai, kurie atėjo duoti kraujo į Kauno kraujo donorystės centrą. Respondentams buvo pateikta anoniminė anketa, kurią sudarė 20 klausimų, apimantys bendrąją informaciją, informaciją apie žinias bei nuomonę. 2009 metais buvo išdalinta 330 anketų, o pavyko apklausti 330 donorų. 2011 metais buvo išdalinta 250 anketų, respondentai atsakė į 212 anketas. Respondentų amžius svyravo nuo 18 iki 58 m. Hipotezėms, kad požymiai tarpusavyje susiję, tikrinti skaičiuotas chi kvadrato (χ2) kriterijus. Rezultatai. Nagrinėjant 2009 metų Kauno kraujo donorystės centro donorų motyvus ir su ja susijusius veiksnius buvo nustatyta, kad Kauno kraujo centre besilankantys donorai dažniausiai gauna piniginę kompensaciją. Taip pat nustatėme, kad efektyviausias informavimo būdas, kurį įvardino respondentai buvo reklama per radiją ir televiziją. Kraujo donorus vyrus labiau motyvuoja gaunama nauda už kraujo davimą, tuo tarpu moterys labiau duoda kraujo pastūmėtos altruizmo. Tyrimas parodė, kad vyrai dažniau tampa pastoviais kraujo donorais nei moterys. Nagrinėdami respondentų atsakymus 2011 metais, nustatėme: dažniausiai kraujo donorai donorystės centre gauna piniginę kompensaciją už kraujo davimą; dažniau kraujo duoda vyrai; populiariausiu... [toliau žr. visą tekstą] / Purpose of a Work: to evaluate a possible change of Kaunas blood donation center donors in non-paid blood donation, motivation to give blood and factors related with it. Methodology. A comparative two year reseach was managed in 2009th and 2011th. Blood donors that came to Kaunas blood donation center were questioned. In 2009th 330 questionnaires from 330 blood donors were collected. In 2011th 250 questionnaires were shared and 212 collected. Age of respondents varies from 18 to 58 y.o. Statistical analysis was made by using SPSS 20.0 version. To prove hypotheses about a connection between factors Chi Square (χ2) was used. Results. When analysing motives of Kaunas blood donation center donors and factors that impact them in 2009, it was stated that usually blood donors get money for donations. The most effective way to inform donors was advertising through radio and television. Male blood donors were more often motivated by the gain that they got for donating blood while women were more motivated by altruism. The research has shown that men became regular blood donors more often compared to women. When analysing data of 2011th, results shown that blood donors in blood donation center usually got money for donating blood. Men gave blood more often. Television is the most popular source of information. Just like in 2009, women were motivated by altruism while men were looking for additional gain. Conclusions. Blood donation system in Lithuania is not working effectively... [to full text]

A systematic study of propylene polymerization using a 4th generation Ziegler-Natta catalyst is presented in this thesis. The apparent kinetic rate constants for propylene polymerization were estimated in the presence and absence of hydrogen and/or donor. The estimated activation energies for activation, propagation, and deactivation were found to be close to values previously reported in the literature for similar catalysts. The polypropylene samples were characterized using high-temperature gel permeation chromatography (GPC), carbon-13 nuclear magnetic resonance (13C NMR), and crystallization elution fractionation (CEF). The effect of hydrogen and external electron donor on polypropylene microstructure was investigated at two polymerization temperatures. In addition to the expected electron donor positive effect on tacticity, hydrogen was also found to increase polypropylene tacticity. The effect of changing these polymerization conditions on molecular weight and polydispersity was also investigated. Finally, CEF profiles show how the distribution of polypropylene crystallizability changes by adding hydrogen and electron donor to the reactor. The concentrations of hydrogen and external donor were also varied to study their effect of polymerization kinetics and polymer microstructure. The estimated activation energies were close to those found in the first part of this investigation in the presence and/or absence of donor and hydrogen. A polypropylene microstructural study showed a positive effect of hydrogen concentration on mmmm pentad at low donor concentration, likely due to an increase in stereoselectivity of the aspecific sites by hydrogen. However, increasing donor concentration over a given threshold seems to transform the aspecific sitess into stereospecific sites that are no longer significantly affected by hydrogen. These experimental results were compared to a previously developed Monte Carlo model and found to agree with the trends predicted by simulation. Finally, the effect of diisopropyldimethoxysilane (P), n-propyltrimethoxysilane (N), paraethoxyethylbenzoate (PEEB), and dicyclopentyldimethoxysilane (D) external donors on catalyst activity and stereoselectivity was investigated. P and D donors were more stereoselective than N and PEEB donors; however, D donor had the best activity among all donors investigated. Therefore, D donor was mixed with PEEB to combine its high activity with the self-extinguishing properties of PEEB. The D/PEEB 90/10 (mol/mol) mixture generated a catalyst with good stereoselectivity but poor activity. When the ratio was increased to 95/5 and 98/2, the resulting catalyst had high activity and good stereoselectivity. Interestingly, the D/PEEB combination with just a small fraction of PEEB has a positive effect on the catalysts activation term which may decrease polymerization costs with this system.

No description available.