Nontraumatic subarachnoid hemorrhage management: evaluation with reduced iodine volume at CT angiography.

PURPOSE: To evaluate the technical quality and the diagnostic performance of a protocol with use of low volumes of contrast medium (25 mL) at 64-detector spiral computed tomography (CT) in the diagnosis and management of adult, nontraumatic subarachnoid hemorrhage (SAH). MATERIALS AND METHODS: This study was performed outside the United States and was approved by the institutional review board. Intracranial CT angiography was performed in 73 consecutive patients with nontraumatic SAH diagnosed at nonenhanced CT. Image quality was evaluated by two observers using two criteria: degree of arterial enhancement and venous contamination. The two independent readers evaluated diagnostic performance (lesion detection and correct therapeutic decision-making process) by using rotational angiographic findings as the standard of reference. Sensitivity, specificity, and positive and negative predictive values were calculated for patients who underwent CT angiography and three-dimensional rotational angiography. The intraclass correlation coefficient was calculated to assess interobserver concordance concerning aneurysm measurements and therapeutic management. RESULTS: All aneurysms were detected, either ruptured or unruptured. Arterial opacification was excellent in 62 cases (85%), and venous contamination was absent or minor in 61 cases (84%). In 95% of cases, CT angiographic findings allowed optimal therapeutic management. The intraclass correlation coefficient ranged between 0.93 and 0.95, indicating excellent interobserver agreement. CONCLUSION: With only 25 mL of iodinated contrast medium focused on the arterial phase, 64-detector CT angiography allowed satisfactory diagnostic and therapeutic management of nontraumatic SAH.

Multidimensional Adaptations for Open Learning Management Systems

Our work is focused on alleviating the workload for designers of adaptive courses on the complexity task of authoring adaptive learning designs adjusted to specific user characteristics and the user context. We propose an adaptation platform that consists in a set of intelligent agents where each agent carries out an independent adaptation task. The agents apply machine learning techniques to support the user modelling for the adaptation process

The clinical use of quantitative ultrasound (QUS) in the detection and management of osteoporosis

For the detection and management of osteoporosis and osteoporosis-related fractures, quantitative ultrasound (QUS) is emerging as a relatively low-cost and readily accessible alternative to dual-energy X-ray absorptiometry (DXA) measurement of bone mineral density (BMD) in certain circumstances. The following is a brief, but thorough review of the existing literature with respect to the use of QUS in 6 settings: 1) assessing fragility fracture risk; 2) diagnosing osteoporosis; 3) initiating osteoporosis treatment; 4) monitoring osteoporosis treatment; 5) osteoporosis case finding; and 6) quality assurance and control. Many QUS devices exist that are quite different with respect to the parameters they measure and the strength of empirical evidence supporting their use. In general, heel QUS appears to be most tested and most effective. Overall, some, but not all, heel QUS devices are effective assessing fracture risk in some, but not all, populations, the evidence being strongest for Caucasian females over 55 years old. Otherwise, the evidence is fair with respect to certain devices allowing for the accurate diagnosis of likelihood of osteoporosis, and generally fair to poor in terms of QUS use when initiating or monitoring osteoporosis treatment. A reasonable protocol is proposed herein for case-finding purposes, which relies on a combined assessment of clinical risk factors (CR.F) and heel QUS. Finally, several recommendations are made for quality assurance and control.

XML-based information management environment for PE technologies

Printed electronics is an emerging concept in electronics manufacturing and it is in very early development stage. The technology is not stable, design kits are not developed, and flows and Computer Aided Design (CAD) tools are not fixed yet. The European project TDK4PE addresses all this issues and this PFC has been realized on this context. The goal is to develop an XML-based information system for the collection and management of information from the technology and cell libraries developed in TDK4PE. This system will ease the treatment of that information for a later generation of specific Design Kits (DK) and the corresponding documentation. This work proposes a web application to generate technology files and design kits in a formatted way; it also proposes a structure for them and a database implementation for storing the needed information. The application will allow its users to redefine the structure of those files, as well as export and import XML files, between other formats.

Linking landscape- and population ecology for large population management modelling: the case of Ibex (capra ibex) in Switzerland

La biologie de la conservation est communément associée à la protection de petites populations menacées d?extinction. Pourtant, il peut également être nécessaire de soumettre à gestion des populations surabondantes ou susceptibles d?une trop grande expansion, dans le but de prévenir les effets néfastes de la surpopulation. Du fait des différences tant quantitatives que qualitatives entre protection des petites populations et contrôle des grandes, il est nécessaire de disposer de modèles et de méthodes distinctes. L?objectif de ce travail a été de développer des modèles prédictifs de la dynamique des grandes populations, ainsi que des logiciels permettant de calculer les paramètres de ces modèles et de tester des scénarios de gestion. Le cas du Bouquetin des Alpes (Capra ibex ibex) - en forte expansion en Suisse depuis sa réintroduction au début du XXème siècle - servit d?exemple. Cette tâche fut accomplie en trois étapes : En premier lieu, un modèle de dynamique locale, spécifique au Bouquetin, fut développé : le modèle sous-jacent - structuré en classes d?âge et de sexe - est basé sur une matrice de Leslie à laquelle ont été ajoutées la densité-dépendance, la stochasticité environnementale et la chasse de régulation. Ce modèle fut implémenté dans un logiciel d?aide à la gestion - nommé SIM-Ibex - permettant la maintenance de données de recensements, l?estimation automatisée des paramètres, ainsi que l?ajustement et la simulation de stratégies de régulation. Mais la dynamique d?une population est influencée non seulement par des facteurs démographiques, mais aussi par la dispersion et la colonisation de nouveaux espaces. Il est donc nécessaire de pouvoir modéliser tant la qualité de l?habitat que les obstacles à la dispersion. Une collection de logiciels - nommée Biomapper - fut donc développée. Son module central est basé sur l?Analyse Factorielle de la Niche Ecologique (ENFA) dont le principe est de calculer des facteurs de marginalité et de spécialisation de la niche écologique à partir de prédicteurs environnementaux et de données d?observation de l?espèce. Tous les modules de Biomapper sont liés aux Systèmes d?Information Géographiques (SIG) ; ils couvrent toutes les opérations d?importation des données, préparation des prédicteurs, ENFA et calcul de la carte de qualité d?habitat, validation et traitement des résultats ; un module permet également de cartographier les barrières et les corridors de dispersion. Le domaine d?application de l?ENFA fut exploré par le biais d?une distribution d?espèce virtuelle. La comparaison à une méthode couramment utilisée pour construire des cartes de qualité d?habitat, le Modèle Linéaire Généralisé (GLM), montra qu?elle était particulièrement adaptée pour les espèces cryptiques ou en cours d?expansion. Les informations sur la démographie et le paysage furent finalement fusionnées en un modèle global. Une approche basée sur un automate cellulaire fut choisie, tant pour satisfaire aux contraintes du réalisme de la modélisation du paysage qu?à celles imposées par les grandes populations : la zone d?étude est modélisée par un pavage de cellules hexagonales, chacune caractérisée par des propriétés - une capacité de soutien et six taux d?imperméabilité quantifiant les échanges entre cellules adjacentes - et une variable, la densité de la population. Cette dernière varie en fonction de la reproduction et de la survie locale, ainsi que de la dispersion, sous l?influence de la densité-dépendance et de la stochasticité. Un logiciel - nommé HexaSpace - fut développé pour accomplir deux fonctions : 1° Calibrer l?automate sur la base de modèles de dynamique (par ex. calculés par SIM-Ibex) et d?une carte de qualité d?habitat (par ex. calculée par Biomapper). 2° Faire tourner des simulations. Il permet d?étudier l?expansion d?une espèce envahisseuse dans un paysage complexe composé de zones de qualité diverses et comportant des obstacles à la dispersion. Ce modèle fut appliqué à l?histoire de la réintroduction du Bouquetin dans les Alpes bernoises (Suisse). SIM-Ibex est actuellement utilisé par les gestionnaires de la faune et par les inspecteurs du gouvernement pour préparer et contrôler les plans de tir. Biomapper a été appliqué à plusieurs espèces (tant végétales qu?animales) à travers le Monde. De même, même si HexaSpace fut initialement conçu pour des espèces animales terrestres, il pourrait aisément être étndu à la propagation de plantes ou à la dispersion d?animaux volants. Ces logiciels étant conçus pour, à partir de données brutes, construire un modèle réaliste complexe, et du fait qu?ils sont dotés d?une interface d?utilisation intuitive, ils sont susceptibles de nombreuses applications en biologie de la conservation. En outre, ces approches peuvent également s?appliquer à des questions théoriques dans les domaines de l?écologie des populations et du paysage.<br/><br/>Conservation biology is commonly associated to small and endangered population protection. Nevertheless, large or potentially large populations may also need human management to prevent negative effects of overpopulation. As there are both qualitative and quantitative differences between small population protection and large population controlling, distinct methods and models are needed. The aim of this work was to develop theoretical models to predict large population dynamics, as well as computer tools to assess the parameters of these models and to test management scenarios. The alpine Ibex (Capra ibex ibex) - which experienced a spectacular increase since its reintroduction in Switzerland at the beginning of the 20th century - was used as paradigm species. This task was achieved in three steps: A local population dynamics model was first developed specifically for Ibex: the underlying age- and sex-structured model is based on a Leslie matrix approach with addition of density-dependence, environmental stochasticity and culling. This model was implemented into a management-support software - named SIM-Ibex - allowing census data maintenance, parameter automated assessment and culling strategies tuning and simulating. However population dynamics is driven not only by demographic factors, but also by dispersal and colonisation of new areas. Habitat suitability and obstacles modelling had therefore to be addressed. Thus, a software package - named Biomapper - was developed. Its central module is based on the Ecological Niche Factor Analysis (ENFA) whose principle is to compute niche marginality and specialisation factors from a set of environmental predictors and species presence data. All Biomapper modules are linked to Geographic Information Systems (GIS); they cover all operations of data importation, predictor preparation, ENFA and habitat suitability map computation, results validation and further processing; a module also allows mapping of dispersal barriers and corridors. ENFA application domain was then explored by means of a simulated species distribution. It was compared to a common habitat suitability assessing method, the Generalised Linear Model (GLM), and was proven better suited for spreading or cryptic species. Demography and landscape informations were finally merged into a global model. To cope with landscape realism and technical constraints of large population modelling, a cellular automaton approach was chosen: the study area is modelled by a lattice of hexagonal cells, each one characterised by a few fixed properties - a carrying capacity and six impermeability rates quantifying exchanges between adjacent cells - and one variable, population density. The later varies according to local reproduction/survival and dispersal dynamics, modified by density-dependence and stochasticity. A software - named HexaSpace - was developed, which achieves two functions: 1° Calibrating the automaton on the base of local population dynamics models (e.g., computed by SIM-Ibex) and a habitat suitability map (e.g. computed by Biomapper). 2° Running simulations. It allows studying the spreading of an invading species across a complex landscape made of variously suitable areas and dispersal barriers. This model was applied to the history of Ibex reintroduction in Bernese Alps (Switzerland). SIM-Ibex is now used by governmental wildlife managers to prepare and verify culling plans. Biomapper has been applied to several species (both plants and animals) all around the World. In the same way, whilst HexaSpace was originally designed for terrestrial animal species, it could be easily extended to model plant propagation or flying animals dispersal. As these softwares were designed to proceed from low-level data to build a complex realistic model and as they benefit from an intuitive user-interface, they may have many conservation applications. Moreover, theoretical questions in the fields of population and landscape ecology might also be addressed by these approaches.

Semantic data integration in a newspaper content management system

A newspaper content management system has to deal with a very heterogeneous information space as the experience in the Diari Segre newspaper has shown us. The greatest problem is to harmonise the different ways the involved users (journalist, archivists...) structure the newspaper information space, i.e. news, topics, headlines, etc. Our approach is based on ontology and differentiated universes of discourse (UoD). Users interact with the system and, from this interaction, integration rules are derived. These rules are based on Description Logic ontological relations for subsumption and equivalence. They relate the different UoD and produce a shared conceptualisation of the newspaper information domain.

Learning through Computer Model Improvisations

It has been convincingly argued that computer simulation modeling differs from traditional science. If we understand simulation modeling as a new way of doing science, the manner in which scientists learn about the world through models must also be considered differently. This article examines how researchers learn about environmental processes through computer simulation modeling. Suggesting a conceptual framework anchored in a performative philosophical approach, we examine two modeling projects undertaken by research teams in England, both aiming to inform flood risk management. One of the modeling teams operated in the research wing of a consultancy firm, the other were university scientists taking part in an interdisciplinary project experimenting with public engagement. We found that in the first context the use of standardized software was critical to the process of improvisation, the obstacles emerging in the process concerned data and were resolved through exploiting affordances for generating, organizing, and combining scientific information in new ways. In the second context, an environmental competency group, obstacles were related to the computer program and affordances emerged in the combination of experience-based knowledge with the scientists' skill enabling a reconfiguration of the mathematical structure of the model, allowing the group to learn about local flooding.

Centralized password management in a global enterprise

Käyttäjien tunnistaminen tietojärjestelmissä on ollut yksi tietoturvan kulmakivistä vuosikymmenten ajan. Ajatus käyttäjätunnuksesta ja salasanasta on kaikkein kustannustehokkain ja käytetyin tapa säilyttää luottamus tietojärjestelmän ja käyttäjien välillä. Tietojärjestelmien käyttöönoton alkuaikoina, jolloin yrityksissä oli vain muutamia tietojärjestelmiä ja niitä käyttivät vain pieni ryhmä käyttäjiä, tämä toimintamalli osoittautui toimivaksi. Vuosien mittaan järjestelmien määrä kasvoi ja sen mukana kasvoi salasanojen määrä ja monimuotoisuus. Kukaan ei osannut ennustaa, kuinka paljon salasanoihin liittyviä ongelmia käyttäjät kohtaisivat ja kuinka paljon ne tulisivat ruuhkauttamaan yritysten käyttäjätukea ja minkälaisia tietoturvariskejä salasanat tulisivat aiheuttamaan suurissa yrityksissä. Tässä diplomityössä tarkastelemme salasanojen aiheuttamia ongelmia suuressa, globaalissa yrityksessä. Ongelmia tarkastellaan neljästä eri näkökulmasta; ihmiset, teknologia, tietoturva ja liiketoiminta. Ongelmat osoitetaan esittelemällä tulokset yrityksen työntekijöille tehdystä kyselystä, joka toteutettiin osana tätä diplomityötä. Ratkaisu näihin ongelmiin esitellään keskitetyn salasanojenhallintajärjestelmän muodossa. Järjestelmän eri ominaisuuksia arvioidaan ja kokeilu -tyyppinen toteutus rakennetaan osoittamaan tällaisen järjestelmän toiminnallisuus.

Case management for emergency department frequent users : a randomized controlled trial

Background: Emergency department frequent users (EDFUs) account for a disproportionally high number of emergency department (ED) visits, contributing to overcrowding and high health-care costs. At the Lausanne University Hospital, EDFUs account for only 4.4% of ED patients, but 12.1% of all ED visits. Our study tested the hypothesis that an interdisciplinary case management intervention red. Methods: In this randomized controlled trial, we allocated adult EDFUs (5 or more visits in the previous 12 months) who visited the ED of the University Hospital of Lausanne, Switzerland between May 2012 and July 2013 either to an intervention (N=125) or a standard emergency care (N=125) group and monitored them for 12 months. Randomization was computer generated and concealed, and patients and research staff were blinded to the allocation. Participants in the intervention group, in addition to standard emergency care, received case management from an interdisciplinary team at baseline, and at 1, 3, and 5 months, in the hospital, in the ambulatory care setting, or at their homes. A generalized, linear, mixed-effects model for count data (Poisson distribution) was applied to compare participants' numbers of visits to the ED during the 12 months (Period 1, P1) preceding recruitment to the numbers of visits during the 12 months monitored (Period 2, P2).

Technical Aspects of Internet-Shopping, Comparative study in Finland/Russia

Isot ja keskikokoiset yritykset harkitsevat sähköistä kaupankäyntiä Internetissä, Internet - kauppojen muodossa. Organisaatiot pyrkivät kilpailukykyiseen ja moderniin tyyliin kaupankäynnissä sekä yrityksen eri prosessien automatisointiin. Yrityksen on onnistuttava uusimpien tekniikoiden ja työkalujen omaksumisessa kilpailukykynsä parantamiseksi. Sähköinen kaupankäynti on suhteellisen uusi tekniikka, joka mahdollistaa kaupankäynnin esittämisen uudessa, sähköisessä muodossa. Tämä työ sisältää katsauksen yrityksen mahdollisiin sähköisen kaupankäynnin eri muotoihin. Työ sisältää mahdollisia ratkaisuja Internet-kaupan rakentamiseen, sähköisen kaupankäynnin hallintaan sekä erityyppisten Internet- kauppojen kuvauksia. Sähköisen kaupankäynnin ongelmat ovat myös tarkastelussa. Välttämättömät asiat sähköisen kaupankäynnin perustamiseksi on lueteltu. Työn kokeellinen osuus sisältää vertailututkimusta sähköisen kaupankäynnin muodoista Suomessa ja Venäjällä. Sähköisen kaupankäynnin ongelmat, niiden mahdolliset ratkaisut, eroavaisuudet sekä samankaltaisuudet molempien maiden välillä on esitetty tässä työssä. Työssä on arvioitu Internet-kaupan kehittämistä sekä edistämistä esimerkein. Tutkimuksen tulokset on esitetty.

Segmentation model for small and medium size business sector: Case Oy Compaq Computer Ab

Markkinasegmentointi nousi esiin ensi kerran jo 50-luvulla ja se on ollut siitä lähtien yksi markkinoinnin peruskäsitteistä. Suuri osa segmentointia käsittelevästä tutkimuksesta on kuitenkin keskittynyt kuluttajamarkkinoiden segmentointiin yritys- ja teollisuusmarkkinoiden segmentoinnin jäädessä vähemmälle huomiolle. Tämän tutkimuksen tavoitteena on luoda segmentointimalli teollismarkkinoille tietotekniikan tuotteiden ja palveluiden tarjoajan näkökulmasta. Tarkoituksena on selvittää mahdollistavatko case-yrityksen nykyiset asiakastietokannat tehokkaan segmentoinnin, selvittää sopivat segmentointikriteerit sekä arvioida tulisiko tietokantoja kehittää ja kuinka niitä tulisi kehittää tehokkaamman segmentoinnin mahdollistamiseksi. Tarkoitus on luoda yksi malli eri liiketoimintayksiköille yhteisesti. Näin ollen eri yksiköiden tavoitteet tulee ottaa huomioon eturistiriitojen välttämiseksi. Tutkimusmetodologia on tapaustutkimus. Lähteinä tutkimuksessa käytettiin sekundäärisiä lähteitä sekä primäärejä lähteitä kuten case-yrityksen omia tietokantoja sekä haastatteluita. Tutkimuksen lähtökohtana oli tutkimusongelma: Voiko tietokantoihin perustuvaa segmentointia käyttää kannattavaan asiakassuhdejohtamiseen PK-yritys sektorilla? Tavoitteena on luoda segmentointimalli, joka hyödyntää tietokannoissa olevia tietoja tinkimättä kuitenkaan tehokkaan ja kannattavan segmentoinnin ehdoista. Teoriaosa tutkii segmentointia yleensä painottuen kuitenkin teolliseen markkinasegmentointiin. Tarkoituksena on luoda selkeä kuva erilaisista lähestymistavoista aiheeseen ja syventää näkemystä tärkeimpien teorioiden osalta. Tietokantojen analysointi osoitti selviä puutteita asiakastiedoissa. Peruskontaktitiedot löytyvät mutta segmentointia varten tietoa on erittäin rajoitetusti. Tietojen saantia jälleenmyyjiltä ja tukkureilta tulisi parantaa loppuasiakastietojen saannin takia. Segmentointi nykyisten tietojen varassa perustuu lähinnä sekundäärisiin tietoihin kuten toimialaan ja yrityskokoon. Näitäkään tietoja ei ole saatavilla kaikkien tietokannassa olevien yritysten kohdalta.

Expanding the Customer Relationship Management scope to the non-profit organizations : an analysis focused on the e-university domain

Peer-reviewed

Management of Exceptions on Access Control Policies

Peer-reviewed

Design and evaluation of learning algorithms for dynamic resource management in virtual networks

Network virtualisation is considerably gaining attentionas a solution to ossification of the Internet. However, thesuccess of network virtualisation will depend in part on how efficientlythe virtual networks utilise substrate network resources.In this paper, we propose a machine learning-based approachto virtual network resource management. We propose to modelthe substrate network as a decentralised system and introducea learning algorithm in each substrate node and substrate link,providing self-organization capabilities. We propose a multiagentlearning algorithm that carries out the substrate network resourcemanagement in a coordinated and decentralised way. The taskof these agents is to use evaluative feedback to learn an optimalpolicy so as to dynamically allocate network resources to virtualnodes and links. The agents ensure that while the virtual networkshave the resources they need at any given time, only the requiredresources are reserved for this purpose. Simulations show thatour dynamic approach significantly improves the virtual networkacceptance ratio and the maximum number of accepted virtualnetwork requests at any time while ensuring that virtual networkquality of service requirements such as packet drop rate andvirtual link delay are not affected.