Possible benefit of consolidation therapy with high-dose cytarabine on overall survival of adults with non-promyelocytic acute myeloid leukemia

In adults with non-promyelocytic acute myeloid leukemia (AML), high-dose cytarabine consolidation therapy has been shown to influence survival in selected patients, although the appropriate doses and schemes have not been defined. We evaluated survival after calculating the actual dose of cytarabine that patients received for consolidation therapy and divided them into 3 groups according to dose. We conducted a single-center, retrospective study involving 311 non-promyelocytic AML patients with a median age of 36 years (16-79 years) who received curative treatment between 1978 and 2007. The 131 patients who received cytarabine consolidation were assigned to study groups by their cytarabine dose protocol. Group 1 (n=69) received <1.5 g/m2 every 12 h on 3 alternate days for up to 4 cycles. The remaining patients received high-dose cytarabine (≥1.5 g/m2 every 12 h on 3 alternate days for up to 4 cycles). The actual dose received during the entire consolidation period in these patients was calculated, allowing us to divide these patients into 2 additional groups. Group 2 (n=27) received an intermediate-high-dose (<27 g/m2), and group 3 (n=35) received a very-high-dose (≥27 g/m2). Among the 311 patients receiving curative treatment, the 5-year survival rate was 20.2% (63 patients). The cytarabine consolidation dose was an independent determinant of survival in multivariate analysis; age, karyotype, induction protocol, French-American-British classification, and de novo leukemia were not. Comparisons showed that the risk of death was higher in the intermediate-high-dose group 2 (hazard ratio [HR]=4.51; 95% confidence interval [CI]: 1.81-11.21) and the low-dose group 1 (HR=4.43; 95% CI: 1.97-9.96) than in the very-high-dose group 3, with no significant difference between those two groups. Our findings indicated that very-high-dose cytarabine during consolidation in adults with non-promyelocytic AML may improve survival.

Nichesourcing The Uralic Languages For The Benefit Of Linguistic Research And Lingual Societies

The emerging technologies have recently challenged the libraries to reconsider their role as a mere mediator between the collections, researchers, and wider audiences (Sula, 2013), and libraries, especially the nationwide institutions like national libraries, haven’t always managed to face the challenge (Nygren et al., 2014). In the Digitization Project of Kindred Languages, the National Library of Finland has become a node that connects the partners to interplay and work for shared goals and objectives. In this paper, I will be drawing a picture of the crowdsourcing methods that have been established during the project to support both linguistic research and lingual diversity. The National Library of Finland has been executing the Digitization Project of Kindred Languages since 2012. The project seeks to digitize and publish approximately 1,200 monograph titles and more than 100 newspapers titles in various, and in some cases endangered Uralic languages. Once the digitization has been completed in 2015, the Fenno-Ugrica online collection will consist of 110,000 monograph pages and around 90,000 newspaper pages to which all users will have open access regardless of their place of residence. The majority of the digitized literature was originally published in the 1920s and 1930s in the Soviet Union, and it was the genesis and consolidation period of literary languages. This was the era when many Uralic languages were converted into media of popular education, enlightenment, and dissemination of information pertinent to the developing political agenda of the Soviet state. The ‘deluge’ of popular literature in the 1920s to 1930s suddenly challenged the lexical orthographic norms of the limited ecclesiastical publications from the 1880s onward. Newspapers were now written in orthographies and in word forms that the locals would understand. Textbooks were written to address the separate needs of both adults and children. New concepts were introduced in the language. This was the beginning of a renaissance and period of enlightenment (Rueter, 2013). The linguistically oriented population can also find writings to their delight, especially lexical items specific to a given publication, and orthographically documented specifics of phonetics. The project is financially supported by the Kone Foundation in Helsinki and is part of the Foundation’s Language Programme. One of the key objectives of the Kone Foundation Language Programme is to support a culture of openness and interaction in linguistic research, but also to promote citizen science as a tool for the participation of the language community in research. In addition to sharing this aspiration, our objective within the Language Programme is to make sure that old and new corpora in Uralic languages are made available for the open and interactive use of the academic community as well as the language societies. Wordlists are available in 17 languages, but without tokenization, lemmatization, and so on. This approach was verified with the scholars, and we consider the wordlists as raw data for linguists. Our data is used for creating the morphological analyzers and online dictionaries at the Helsinki and Tromsø Universities, for instance. In order to reach the targets, we will produce not only the digitized materials but also their development tools for supporting linguistic research and citizen science. The Digitization Project of Kindred Languages is thus linked with the research of language technology. The mission is to improve the usage and usability of digitized content. During the project, we have advanced methods that will refine the raw data for further use, especially in the linguistic research. How does the library meet the objectives, which appears to be beyond its traditional playground? The written materials from this period are a gold mine, so how could we retrieve these hidden treasures of languages out of the stack that contains more than 200,000 pages of literature in various Uralic languages? The problem is that the machined-encoded text (OCR) contains often too many mistakes to be used as such in research. The mistakes in OCRed texts must be corrected. For enhancing the OCRed texts, the National Library of Finland developed an open-source code OCR editor that enabled the editing of machine-encoded text for the benefit of linguistic research. This tool was necessary to implement, since these rare and peripheral prints did often include already perished characters, which are sadly neglected by the modern OCR software developers, but belong to the historical context of kindred languages and thus are an essential part of the linguistic heritage (van Hemel, 2014). Our crowdsourcing tool application is essentially an editor of Alto XML format. It consists of a back-end for managing users, permissions, and files, communicating through a REST API with a front-end interface—that is, the actual editor for correcting the OCRed text. The enhanced XML files can be retrieved from the Fenno-Ugrica collection for further purposes. Could the crowd do this work to support the academic research? The challenge in crowdsourcing lies in its nature. The targets in the traditional crowdsourcing have often been split into several microtasks that do not require any special skills from the anonymous people, a faceless crowd. This way of crowdsourcing may produce quantitative results, but from the research’s point of view, there is a danger that the needs of linguists are not necessarily met. Also, the remarkable downside is the lack of shared goal or the social affinity. There is no reward in the traditional methods of crowdsourcing (de Boer et al., 2012). Also, there has been criticism that digital humanities makes the humanities too data-driven and oriented towards quantitative methods, losing the values of critical qualitative methods (Fish, 2012). And on top of that, the downsides of the traditional crowdsourcing become more imminent when you leave the Anglophone world. Our potential crowd is geographically scattered in Russia. This crowd is linguistically heterogeneous, speaking 17 different languages. In many cases languages are close to extinction or longing for language revitalization, and the native speakers do not always have Internet access, so an open call for crowdsourcing would not have produced appeasing results for linguists. Thus, one has to identify carefully the potential niches to complete the needed tasks. When using the help of a crowd in a project that is aiming to support both linguistic research and survival of endangered languages, the approach has to be a different one. In nichesourcing, the tasks are distributed amongst a small crowd of citizen scientists (communities). Although communities provide smaller pools to draw resources, their specific richness in skill is suited for complex tasks with high-quality product expectations found in nichesourcing. Communities have a purpose and identity, and their regular interaction engenders social trust and reputation. These communities can correspond to research more precisely (de Boer et al., 2012). Instead of repetitive and rather trivial tasks, we are trying to utilize the knowledge and skills of citizen scientists to provide qualitative results. In nichesourcing, we hand in such assignments that would precisely fill the gaps in linguistic research. A typical task would be editing and collecting the words in such fields of vocabularies where the researchers do require more information. For instance, there is lack of Hill Mari words and terminology in anatomy. We have digitized the books in medicine, and we could try to track the words related to human organs by assigning the citizen scientists to edit and collect words with the OCR editor. From the nichesourcing’s perspective, it is essential that altruism play a central role when the language communities are involved. In nichesourcing, our goal is to reach a certain level of interplay, where the language communities would benefit from the results. For instance, the corrected words in Ingrian will be added to an online dictionary, which is made freely available for the public, so the society can benefit, too. This objective of interplay can be understood as an aspiration to support the endangered languages and the maintenance of lingual diversity, but also as a servant of ‘two masters’: research and society.

Nichesourcing for the benefit of linguistic research and native speakers

The National Library of Finland is implementing the Digitization Project of Kindred Languages in 2012–16. Within the project we will digitize materials in the Uralic languages as well as develop tools to support linguistic research and citizen science. Through this project, researchers will gain access to new corpora 329 and to which all users will have open access regardless of their place of residence. Our objective is to make sure that the new corpora are made available for the open and interactive use of both the academic community and the language societies as a whole. The project seeks to digitize and publish approximately 1200 monograph titles and more than 100 newspapers titles in various Uralic languages. The digitization will be completed by the early of 2015, when the Fenno-Ugrica collection would contain around 200 000 pages of editable text. The researchers cannot spend so much time with the material that they could retrieve a satisfactory amount of edited words, so the participation of a crowd in editing work is needed. Often the targets in crowdsourcing have been split into several microtasks that do not require any special skills from the anonymous people, a faceless crowd. This way of crowdsourcing may produce quantitative results, but from the research’s point of view, there is a danger that the needs of linguistic research are not necessarily met. Also, the number of pages is too high to deal with. The remarkable downside is the lack of shared goal or social affinity. There is no reward in traditional methods of crowdsourcing. Nichesourcing is a specific type of crowdsourcing where tasks are distributed amongst a small crowd of citizen scientists (communities). Although communities provide smaller pools to draw resources, their specific richness in skill is suited for the complex tasks with high-quality product expectations found in nichesourcing. Communities have purpose, identity and their regular interactions engenders social trust and reputation. These communities can correspond to research more precisely. Instead of repetitive and rather trivial tasks, we are trying to utilize the knowledge and skills of citizen scientists to provide qualitative results. Some selection must be made, since we are not aiming to correct all 200,000 pages which we have digitized, but give such assignments to citizen scientists that would precisely fill the gaps in linguistic research. A typical task would editing and collecting the words in such fields of vocabularies, where the researchers do require more information. For instance, there’s a lack of Hill Mari words in anatomy. We have digitized the books in medicine and we could try to track the words related to human organs by assigning the citizen scientists to edit and collect words with OCR editor. From the nichesourcing’s perspective, it is essential that the altruism plays a central role, when the language communities involve. Upon the nichesourcing, our goal is to reach a certain level of interplay, where the language communities would benefit on the results. For instance, the corrected words in Ingrian will be added onto the online dictionary, which is made freely available for the public and the society can benefit too. This objective of interplay can be understood as an aspiration to support the endangered languages and the maintenance of lingual diversity, but also as a servant of “two masters”, the research and the society.

On a practical realization of Kolb's experiential learning cycle

This study aims to extend prior knowledge on the learning and developmental outcomes of the experiential learning cycle of David Kolb by the analysis of its practical realization at Team Academy. The study is based on the constructivist approach to learning and considers, among others, the concepts of autonomy support, Nonaka and Takeuchi's knowledge creation model, Luft and Ingham's Johari Window and Deci and Ryan's Self-determination theory. For the investigation deep interviews were carried out with the participants of Team Academy, both learners and coaches. Taking the interview results and the above described theories into consideration this study concludes that experiential learning results not only in effective learning, but also in a remarkable soft skill acquisition, self-development and increase in motivation with an internal locus of causality. Real-life projects permit the learners to experience real challenges. By the practical activities and teamwork they also get the possibility to find out their personal strengths, weaknesses and unique capacities.

A substantive theory of the realization of stroke patients’ dignity in hospital care

Dignity is seen important in health care context but considered as a controversial and complex concept. In health care context, it is described as being influenced by for example autonomy, respect, communication, privacy and hospital environment. Patient dignity is related to satisfaction with care, reduced stress, better confidence in health services, enhanced patient outcomes and shorter stay in a hospital. Stroke patients may struggle for dignity as being dependent on other people has impact on the patients’ self-image. In all, stroke patients are very specific patient group and considered vulnerable from emotional aspect. Therefore study findings from other patient groups in the area of ethical problems cannot be transferred to the stroke patients. This master’s thesis consists of two parts. The first part is the literature review of patients’ dignity in hospital care. The literature defined dignity and described factors promoting and reducing it. The results were ambiguous and thus a clear understanding was not able to create. That was the basis for the second part of the master’s thesis, the empirical study. This part aimed to develop theoretical construction to explore the realization of stroke patients’ dignity in hospital care. The data of the second part was collected by interviewing 16 stroke patients and analyzed using the constant comparison of Grounded Theory. The result was ‘The Theory of Realization of Stroke Patients’ Dignity in Hospital Care’ which is described not only in this master’s thesis but also as a scientific article. The theory consists of the core category, four generic elements and five specific types on realization. The core category emerged as ‘dignity in a new situation’. After a stroke, dignity is defined in a new way which is influenced by the generic elements: life history, health history, individuality and a stroke. Stroke patient’s dignity is realized through five specific types on realization: person related dignity type, control related dignity type, independence related dignity type, social related dignity type and care related dignity type. The theory points out possible special characteristics of stroke patients’ dignity in control related dignity type and independence related dignity type. Before implementing the theory, the relation between the core category, generic elements and specific types on realization needs to be studied further.

Understanding how a spiritual retreat enhances the search for meaning and fulfillment in a large corporate workplace /

This study explored the concept of a spiritual retreat for frontline employees of a large corporate call centre. During a 1 day retreat, 4 call centre employees were introduced to various meditation and retreat activities. Follovsdng the retreat the participants were asked to incorporate the various meditations and activities into their workplace. The participants kept journals throughout the study in an effort to determine what occurred when these practices were transferred from the retreat setting to the workplace. This study examined how a working spirituality enhances one's sense of fulfillment, defined by certain critical elements: relationship, awareness, ritual, internal commitment, and choice. Although the retreat was a successful means of exploring these elements, the degree to which each employee could benefit from them was determined by the extent of their internal commitment not only to themselves, but also to their jobs.

Principles and proceedings of the inhabitants of the District of Niagara for addressing His Royal Highness the Prince Regent, respecting claims of sufferers in war, lands to militiamen and the general benefit of Upper Canada. --

Cover title.

Principles and proceedings of the inhabitants of the District of Niagara for addressing His Royal Highness the Prince Regent, respecting claims of sufferers in war, lands to militiamen and the general benefit of Upper Canada

Printed at the Niagara Spectator Office

Examining Bullying Intervention Motivations Through a Cost/Benefit Analysis

The purpose of the present study was to examine the role of the bystander in bullying situations. A cost/benefit model was explored in researching factors adolescents consider in deciding whether to intervene when witnessing bullying. Adolescents in the present study (N = 101 (50.5% female), between the ages of 12 to 18, M = 15.37 years; SD = 1.71 years) completed self-report questionnaires, and also responded to bullying scenarios, stating how the bystander would react, while explaining potential personal costs and benefits. Adolescents were able to articulate various personal costs and benefits when making the decision to intervene. Conclusions of the present study include: 1) the evolutionary approach is quite informative in illuminating the decision process of the bystander, 2) adolescents’ beliefs about bullying and the role of bystanders are different from their teachers’, and 3) the rather explicit cost/benefit model could be used to develop more targeted anti-bullying programs.

Patents, the Healthcare System and Benefit-Sharing

Lorraine Sheremeta, Research Associate, Health Law Institute, University of Alberta

The euro impact of the banking system of Greece : cost-benefit analysis.

Rapport de recherche

Technologies de prescription informatisée et transformation du rôle des pharmaciens communautaires

L’amélioration de la qualité de l’utilisation des médicaments dans les soins primaires est devenue un enjeu crucial. Les pharmaciens communautaires se présentent comme des acteurs centraux dans l’atteinte de cet objectif, en réclamant une extension de leur rôle. L’objectif principal de cette thèse est de mieux comprendre comment les technologies de prescription informatisée (eRx) influencent la transformation du rôle des pharmaciens communautaires. Le premier article présente les résultats d’une étude de cas qui aborde la transformation du rôle des pharmaciens communautaires à partir du concept de professionnalisation. Elle propose un modèle logique des influences d’une technologie de eRx sur cette professionnalisation, élaboré à partir de la typologie de Davenport. Ce modèle logique a été validé en interviewant douze pharmaciens communautaires participant à un projet pilote typique de technologie de eRx. A partir des perceptions des pharmaciens communautaires, nous avons établi que la technologie était susceptible de soutenir la professionnalisation des pharmaciens en passant par cinq mécanismes : la capacité analytique, l’élimination des intermédiaires, l’intégration, l’automatisation et la diffusion des connaissances. Le deuxième article analyse les perturbations induites par les différentes fonctions des technologies de eRx sur la stabilité de la juridiction des pharmaciens communautaires, en se basant sur un cadre de référence adapté d’Abbott. À partir de trente-trois entrevues, avec des praticiens (médecins et pharmaciens) et des élites, cette étude de cas a permis de décrire en détail les influences des différentes fonctions sur les modalités d’action des professionnels, ainsi que les enjeux soulevés par ces possibilités. La perturbation principale est liée aux changements dans la distribution des informations, ce qui influence les activités de diagnostic et d’inférence des professionnels. La technologie peut redistribuer les informations relatives à la gestion des médicaments autant au bénéfice des médecins qu’au bénéfice des pharmaciens, ce qui suscite des tensions entre les médecins et les pharmaciens, mais aussi parmi les pharmaciens. Le troisième article présente une revue systématique visant à faire une synthèse des études ayant évalué les effets des technologies de eRx de deuxième génération sur la gestion des médicaments dans les soins primaires. Cette revue regroupe dix-neuf études menées avec des méthodes observationnelles. Les résultats rapportés révèlent que les technologies sont très hétérogènes, le plus souvent immatures, et que les effets ont été peu étudiés au-delà des perceptions des utilisateurs, qui sont mitigées. Le seul effet positif démontré est une amélioration de la qualité du profil pharmacologique accessible aux professionnels, alors que des effets négatifs ont été démontrés au niveau de l’exécution des prescriptions, tels que l’augmentation du nombre d’appels de clarification du pharmacien au prescripteur. Il semble donc que l’on en connaisse peu sur les effets des technologies de eRx de deuxième génération. Ces trois études permettent de constater que les nouvelles technologies de eRx peuvent effectivement influencer la transformation du rôle du pharmacien communautaire en perturbant les caractéristiques des prescriptions, et surtout, l’information et sa distribution. Ces perturbations génèrent des possibilités pour une extension du rôle des pharmaciens communautaires, tout en soulignant les défis intra et interprofessionnels associés à l’actualisation de ces possibilités. Dans l’ensemble, nos résultats soulignent que les perturbations associées aux technologies de eRx dépassent les éléments techniques du travail des utilisateurs, pour englober de multiples perturbations quant à la nature même du travail et du rôle des professionnels. Les décideurs et acteurs impliqués dans le déploiement des technologies de eRx auraient avantage à prendre en compte l’ensemble de ces considérations pour rapprocher les effets observés des bénéfices promis de ces technologies.

Realization of Optical Logic Gates Using the Thermal Lens Effect

A sensitive method based on the principle of photothermal phenomena to realize optical logic gates is presented. A dual beam thermal lens method using low power cw lasers in a dye-doped polymer can be very effectively used as an alternate technique to perform the logical function such as NAND, AND and OR.

Realization of a Scanning Photoacoustic Technique: Thermal properties of Bulk and Film Samples

Among the large number of photothcrmal techniques available, photoacoustics assumes a very significant place because of its essential simplicity and the variety of applications it finds in science and technology. The photoacoustic (PA) effect is the generation of an acoustic signal when a sample, kept inside an enclosed volume, is irradiated by an intensity modulated beam of radiation. The radiation absorbed by the sample is converted into thermal waves by nonradiative de-excitation processes. The propagating thermal waves cause a corresponding expansion and contraction of the gas medium surrounding the sample, which in tum can be detected as sound waves by a sensitive microphone. These sound waves have the same frequency as the initial modulation frequency of light. Lock-in detection method enables one to have a sufficiently high signal to noise ratio for the detected signal. The PA signal amplitude depends on the optical absorption coefficient of the sample and its thermal properties. The PA signal phase is a function of the thermal diffusivity of the sample.Measurement of the PA amplitude and phase enables one to get valuable information about the thermal and optical properties of the sample. Since the PA signal depends on the optical and thennal properties of the sample, their variation will get reflected in the PA signal. Therefore, if the PA signal is collected from various points on a sample surface it will give a profile of the variations in the optical/thennal properties across the sample surface. Since the optical and thermal properties are affected by the presence of defects, interfaces, change of material etc. these will get reflected in the PA signal. By varying the modulation frequency, we can get information about the subsurface features also. This is the basic principle of PA imaging or PA depth profiling. It is a quickly expanding field with potential applications in thin film technology, chemical engineering, biology, medical diagnosis etc. Since it is a non-destructive method, PA imaging has added advantages over some of the other imaging techniques. A major part of the work presented in this thesis is concemed with the development of a PA imaging setup that can be used to detect the presence of surface and subsmface defects in solid samples.Determination of thermal transport properties such as thermal diffusivity, effusivity, conductivity and heat capacity of materials is another application of photothennal effect. There are various methods, depending on the nature of the sample, to determine these properties. However, there are only a few methods developed to determine all these properties simultaneously. Even though a few techniques to determine the above thermal properties individually for a coating can be found in literature, no technique is available for the simultaneous measurement of these parameters for a coating. We have developed a scanning photoacoustic technique that can be used to determine all the above thermal transport properties simultaneously in the case of opaque coatings such as paints. Another work that we have presented in this thesis is the determination of thermal effusivity of many bulk solids by a scanning photoacoustic technique. This is one of the very few methods developed to determine thermal effiisivity directly.