ASTRAL-R score predicts non-recanalisation after intravenous thrombolysis in acute ischaemic stroke.

Intravenous thrombolysis (IVT) as treatment in acute ischaemic strokes may be insufficient to achieve recanalisation in certain patients. Predicting probability of non-recanalisation after IVT may have the potential to influence patient selection to more aggressive management strategies. We aimed at deriving and internally validating a predictive score for post-thrombolytic non-recanalisation, using clinical and radiological variables. In thrombolysis registries from four Swiss academic stroke centres (Lausanne, Bern, Basel and Geneva), patients were selected with large arterial occlusion on acute imaging and with repeated arterial assessment at 24 hours. Based on a logistic regression analysis, an integer-based score for each covariate of the fitted multivariate model was generated. Performance of integer-based predictive model was assessed by bootstrapping available data and cross validation (delete-d method). In 599 thrombolysed strokes, five variables were identified as independent predictors of absence of recanalisation: Acute glucose > 7 mmol/l (A), significant extracranial vessel STenosis (ST), decreased Range of visual fields (R), large Arterial occlusion (A) and decreased Level of consciousness (L). All variables were weighted 1, except for (L) which obtained 2 points based on β-coefficients on the logistic scale. ASTRAL-R scores 0, 3 and 6 corresponded to non-recanalisation probabilities of 18, 44 and 74 % respectively. Predictive ability showed AUC of 0.66 (95 %CI, 0.61-0.70) when using bootstrap and 0.66 (0.63-0.68) when using delete-d cross validation. In conclusion, the 5-item ASTRAL-R score moderately predicts non-recanalisation at 24 hours in thrombolysed ischaemic strokes. If its performance can be confirmed by external validation and its clinical usefulness can be proven, the score may influence patient selection for more aggressive revascularisation strategies in routine clinical practice.

Tehdasalueiden liikenneturvallisuutta kehittävä malli

Työn tavoitteena oli antaa tietoa tehdasalueiden turvallisuuteen vaikuttavista tekijöistä ja luoda malli tehdasalueen liikenteen turvallisuuden parantamiseen päätöksenteon tukivälineitä apuna käyttäen. Työ sai alkunsa todellisen turvallisuutta parantavan investoinnin analysointi-tarpeesta. Aluksi työssä perehdytään yleisesti tehdasalueiden turvallisuuteen tarkastelemalla työturvallisuuden, riskienhallinnan ja turvallisuusjohtamisen asemaa, mittaamista ja taloudellisia vaikutuksia yrityksen toiminnalle. Yleiskatsaus tehdasalueiden turvallisuuteen antaa kuvan, millaiseen toimintaympäristöön turvallisuutta parantavaa mallia ollaan kehittämässä. Malli koostuu viidestä vaiheesta, joita voidaan käyttää kokonaisuutena tai toisistaan erillään. Ensin selvitään tutkittavan alueen kulkuväylät ja liikenne sekä mallinnetaan se. Tämän jälkeen kartoitetaan ongelmakohdat ja etsitään sopivia vaihtoehtoja niiden turvallisuuden parantamiseksi. Vaihtoehtoja analysoidaan SWOT-menetelmän avulla. Turvallisuutta parantavien investointien arvioimiseen esitetään muutamia mittareita, joita voidaan käyttää hankintojen arvioimiseen. Viimeisessä vaiheessa tutustutaan päätöksenteon tukisysteemeihin ja esitetään tietokoneavusteinen päätöksentekomenetelmä AHP. Käytännön soveltaminen on esitetty esimerkein mallin eri vaiheiden yhteydessä.Malli on tarkoitettu suunnittelijoiden, johdon ja työsuojelun työkaluksi, jonka avulla voidaan parantaa tehdasympäristön liikenteen tehokkuutta ja turvallisuutta sekä tutustuttaa käyttäjä päätöksentekomenetelmiin.

Reducing Cardiovascular Mortality Through Prevention and Management of Raised Blood Pressure: A World Heart Federation Roadmap.

Prospective epidemiological data have shown that blood pressure has a graded, continuous adverse effect on the risk of various forms of CVD (including stroke, myocardial infarction, heart failure, peripheral arterial disease and end-stage renal disease). 'Raised blood pressure' is frequently considered to be any systolic blood pressure greater than 115 mmHg. It accounts for 45% of all heart disease deaths and 51% of all stroke-related deaths [1], which together are the biggest causes of morbidity and mortality worldwide [2,3,4]. Annually, there are >17 million deaths due to CVD worldwide, of which 9.4 million are attributable to complications of raised blood pressure. This highlights the importance of both high-risk and population-based strategies in blood pressure management and control.

Venäläisvetoinen yrittäjyys Suomessa

Venäjän maantieteellinen läheisyys ja kasvavat markkinat ovat yhä edelleen tärkeimpiä syitä suomalaisyritysten Venäjä-toiminnoille. Vuorovaikutus rajan yli ei kuitenkaan ole yksipuolista, vaan maantieteellisen läheisyyden vuoksi myös venäläisyritysten voisi olettaa pitävän Suomea luonnollisena vaihtoehtona kansainvälistymiselleen. Suomessa toimivissa venäläisyrityksissä on havaittavissa ominaispiirteitä, jotka erottavat ne kotimaisesta yritystoiminnasta. Samalla kuitenkin venäläisyritysten piirteet eivät ole yhteneviä muualla maailmassa havaittujen etnisten yritysten ominaisuuksien kanssa. Toisin kuin etniset yritykset yleensä, venäläiset yritykset eivät ole syntyneet julkisen tuen avustuksella, eivätkä ne toimi matalan kannattavuuden aloilla. Venäläisen yritystoiminnan rooli on merkittävä Suomen ja Venäjän välisessä kaupassa, ja samalla se tuo lisämausteensa suomalaiseen pienyrityskenttään.

Assessment of facilitators' design thinking

Meeting design is one of the most critical prerequisites of the success of facilitated meetings but how to achieve the success is not yet fully understood. This study presents a descriptive model of the design of technology supported meetings based on literature findings about the key factors contributing to the success of collaborative meetings, and linking these factors to the meeting design steps by exploring how facilitators consider the factors in practice in their design process. The empirical part includes a multiple-case study conducted among 12 facilitators. The case concentrates on the GSS laboratory at LUT, which has been working on facilitation and GSS for the last fifteen years. The study also includes ‘control’ cases from two comparable institutions. The results of this study highlight both the variances and commonalities among facilitators in how they design collaboration processes. The design thinking of facilitators of all levels of experience is found to be largely consistent wherefore the key design factors as well as their role across the design process can be outlined. Session goals, group composition, supporting technology, motivational aspects, physical constraints, and correct design practices were found to outline the key factors in design thinking. These factors are further categorized into three factor types of controllable, constraining, and guiding design factors, because the study findings indicate the factor type to have an effect on the factor’s importance in design. Furthermore, the order of considering these factors in the design process is outlined.

SQualTrack: A Tool for Robust Fault Detection

One of the techniques used to detect faults in dynamic systems is analytical redundancy. An important difficulty in applying this technique to real systems is dealing with the uncertainties associated with the system itself and with the measurements. In this paper, this uncertainty is taken into account by the use of intervals for the parameters of the model and for the measurements. The method that is proposed in this paper checks the consistency between the system's behavior, obtained from the measurements, and the model's behavior; if they are inconsistent, then there is a fault. The problem of detecting faults is stated as a quantified real constraint satisfaction problem, which can be solved using the modal interval analysis (MIA). MIA is used because it provides powerful tools to extend the calculations over real functions to intervals. To improve the results of the detection of the faults, the simultaneous use of several sliding time windows is proposed. The result of implementing this method is semiqualitative tracking (SQualTrack), a fault-detection tool that is robust in the sense that it does not generate false alarms, i.e., if there are false alarms, they indicate either that the interval model does not represent the system adequately or that the interval measurements do not represent the true values of the variables adequately. SQualTrack is currently being used to detect faults in real processes. Some of these applications using real data have been developed within the European project advanced decision support system for chemical/petrochemical manufacturing processes and are also described in this paper

An analytic approach to distribution logistics strategic management

Logistics management is increasingly being recognised by many companies to be of critical concern. The logistics function includes directly or indirectly many of the new areas for achieving or maintaining competitive advantage that companies have been forced to develop due to increasing competitive pressures. The key to achieving a competitive advantage is to manage the logistics function strategically which involves determining the most cost effective method of providing the necessary customer service levels from the many combinations of operating procedures in the areas of transportation, warehousing, order processing and information systems, production, and inventory management. In this thesis, a comprehensive distribution logistics strategic management process is formed by integrating the periodic strategic planning process with a continuous strategic issues management process. Strategic planning is used for defining the basic objectives for a company and assuring co operation and synergy between the different functions of a company while strategic issues management is used on a continuous basis in order to deal with environmental and internal turbulence. The strategic planning subprocess consists of the following main phases: (1) situational analyses, (2) defining the vision and strategic goals for the logistics function, (3) determining objectives and strategies, (4) drawing up tactical action plans, and (5) evaluating the implementation of the plans and making the needed adjustments. The aim of the strategic issues management subprocess is to continuously scan the environment and the organisation for early identification of the issues having a significant impact on the logistics function using the following steps: (1) the identification of trends, (2) assessing the impact and urgency of the identified trends, (3) assigning priorities to the issues, and (4) planning responses to the, issues. The Analytic Hierarchy Process (AHP) is a systematic procedure for structuring any problem. AHP is based on the following three principles: decomposition, comparative judgements, and synthesis of priorities. AHP starts by decomposing a complex, multicriteria problem into a hierarchy where each level consists of a few manageable elements which are then decomposed into another set of elements. The second step is to use a measurement methodology to establish priorities among the elements within each level of the hierarchy. The third step in using AHP is to synthesise the priorities of the elements to establish the overall priorities for the decision alternatives. In this thesis, decision support systems are developed for different areas of distribution logistics strategic management by applying the Analytic Hierarchy Process. The areas covered are: (1) logistics strategic issues management, (2) planning of logistic structure, (3) warehouse site selection, (4) inventory forecasting, (5) defining logistic action and development plans, (6) choosing a distribution logistics strategy, (7) analysing and selecting transport service providers, (8) defining the logistic vision and strategic goals, (9) benchmarking logistic performance, and (10) logistic service management. The thesis demonstrates the potential of AHP as a systematic and analytic approach to distribution logistics strategic management.

Integrating distributed generation and Smart Grids into single-family house

This study examines Smart Grids and distributed generation, which is connected to a single-family house. The distributed generation comprises small wind power plant and solar panels. The study is done from the consumer point of view and it is divided into two parts. The first part presents the theoretical part and the second part presents the research part. The theoretical part consists of the definition of distributed generation, wind power, solar energy and Smart Grids. The study examines what the Smart Grids will enable. New technology concerning Smart Grids is also examined. The research part introduces wind and sun conditions from two countries. The countries are Finland and Germany. According to the wind and sun conditions of these two countries, the annual electricity production from wind power plant and solar panels will be calculated. The costs of generating electricity from wind and solar energy are calculated from the results of annual electricity productions. The study will also deal with feed-in tariffs, which are supporting systems for renewable energy resources. It is examined in the study, if it is cost-effective for the consumers to use the produced electricity by themselves or sell it to the grid. Finally, figures for both countries are formed. The figures include the calculated cost of generating electricity from wind power plant and solar panels, retail and wholesale prices and feed-in tariffs. In Finland, it is not cost-effective to sell the produced electricity to the grid, before there are support systems. In Germany, it is cost-effective to sell the produced electricity from solar panels to the grid because of feed-in tariffs. On the other hand, in Germany it is cost-effective to produce electricity from wind to own use because the retail price is higher than the produced electricity from wind.

Environmental policy instruments concerning industrial end-use energy efficiency

Energy efficiency and saving energy are the main question marks when thinking of reducing carbon dioxide emissions or cutting costs. The objective of thesis is to evaluate policy instruments concerning end-use energy efficiency of heavy industry in European Union. These policy instruments may be divided in various ways, but in this thesis the division is to administrative, financial, informative and voluntary instruments. Administrative instruments introduced in this thesis are Directive on Integrated Pollution Prevention and Control, Directive on Energy End-use Efficiency and Energy Services, and Climate and Energy Package. Financial means include energy and emission taxation, EU Emission Trading Scheme and diverse support systems. Informative instruments consist of horizontal BAT Reference Document for Energy Efficiency, as well as substantial EU documents including Green Paper on Energy Efficiency, Action Plan for Energy Efficiency and An Energy Policy for Europe. And finally, voluntary instruments include environmental managements systems like ISO 14001 and EMAS, energy auditing and benchmarking. The efficiency of different policy instruments vary quite a lot. Informative instruments lack the commitment from industry and are thus almost ineffective, contrary to EU Emission Trading Scheme, which is said to be the solution to climate problems. The efficiency of administrative means can be placed between those mentioned and voluntary instruments are still quite fresh to be examined fruitfully. However, each instrument has their potential and challenges. Cases from corporate world strengthen the results from theoretical part. Cases were written mainly on the basis of interviews. The interviewees praised the energy efficiency contract of Finnish industry, but the EU ETS takes the leading role of policy instruments. However, for industry the reductions do not come easily.

Complexity Optimization in Product Development with Modularization

A company’s competence to manage its product portfolio complexity is becoming critically important in the rapidly changing business environment. The continuous evolvement of customer needs, the competitive market environment and internal product development lead to increasing complexity in product portfolios. The companies that manage the complexity in product development are more profitable in the long run. The complexity derives from product development and management processes where the new product variant development is not managed efficiently. Complexity is managed with modularization which is a method that divides the product structure into modules. In modularization, it is essential to take into account the trade-off between the perceived customer value and the module or component commonality across the products. Another goal is to enable the product configuration to be more flexible. The benefits are achieved through optimizing complexity in module offering and deriving the new product variants more flexibly and accurately. The developed modularization process includes the process steps for preparation, mapping the current situation, the creation of a modular strategy and implementing the strategy. Also the organization and support systems have to be adapted to follow-up targets and to execute modularization in practice.

Päätöksentekomenetelmien hyödyntäminen pientalon lämmitysjärjestelmän valinnassa

Tämän diplomityön tavoitteena on valita sopiva lämmitysjärjestelmä case taloon käyttäen apuna päätöksentekoprosessia ja eri vaiheissa sovellettavia menetelmiä. Työn avulla pyritään selvittämään kuinka hyvin päätöksentekomenetelmät sopivat lämmitysjärjestelmän valintaan ja mitä hyötyjä se tuo tullessaan. Prosessissa selvitetään lämmitysjärjestelmiin liittyviä asiakastarpeita, arvioidaan lämmitysjärjestelmien ominaisuuksia ja tehdään valinta näiden tietojen pohjalta. Kymmenhenkinen kuluttajaryhmä teki lopullisen päätöksen valittavasta lämmitysjärjestelmästä. Menetelmien avulla saatiin luotua kattava kuva erilaisista asiakastarpeista, jotka otettiin huomioon valinnassa. Ryhmä valitsi case taloon seitsemästä yleisestä lämmitysjärjestelmästä maalämmön. Työssä käytetyt menetelmät toimivat hyvin yhteistyössä toistensa kanssa. Menetelmien käyttö mahdollisti kaikkien kriteereiden huomioimisen ja tuloksien lähemmän tarkastelun. Työssä saatuja tuloksia voidaan hyödyntää lämmitysjärjestelmän valinnassa ottaen huomioon erilaiset lähtötilanteet. Herkkyysanalyyseissa maalämpö kesti monien kriteerien painotuksien muuttamista ja osoittautui tällä tavoin sopivimmaksi järjestelmäksi.

New and Emerging Challenges of the ICT-Mediated Health and Well-Being Services

This monograph dissertation looks into the field of ICT-mediated health and well-being services. Through six chapters that extend the work done in the reviewed and published articles, the dissertation focuses on new and emerging technologies, and to impact of their use on the beneficiary; the individual who eventually derives advantage from the services. As the field is currently going through major changes particularly in the OECD countries, the focus is on shortterm developments in the field and the analysis on the long term developments is cursory by nature. The dissertation includes theoretical and empirical elements. Most of the empirical elements are linked to product development and conceptualization performed in the national MyWellbeing project that ended in 2010. In the project, the emphasis was on conceptualization of a personal aid for the beneficiary that could be used for managing information and services in the field of health and well-being services. This work continued the theme of developing individual-centric solutions for the field; a work that started in the InnoElli Senior program in 2006. The nature of this thesis is foremost a conceptual elaboration based on a literature review, illustrated in empirical work performed in different projects. As a theoretical contribution, this dissertation elaborates the role of a mediator, i.e. an intermediary, and it is used as an overarching theme. The role acts as a ‘lens’ through which a number of technology-related phenomena are looked at, pinned down and addressed to a degree. This includes introduction of solutions, ranging from anthropomorphic artefacts to decision support systems that may change the way individuals experience clinical encounters in the near-future. Due to the complex and multiform nature of the field, it is impractical and effectively impossible to cover all aspects that are related to mediation in a single work. Issues such as legislation, financing and privacy are all of equal importance. Consideration of all these issues is beyond the scope of this dissertation and their investigation is left to other work. It follows from this that the investigation on the role is not intended as inclusive one. The role of the mediator is also used to highlight some of the ethical issues related to personal health information management, and to mediating health and well-being related issues on behalf of another individual, such as an elderly relative or a fellow member of a small unit in the armed forces. The dissertation concludes in a summary about the use and functions of the mediator, describing some potential avenues for implementing such support mechanisms to the changing field of ICT-mediated health and well-being services. The conclusions also describe some of the limitations of this dissertation, including remarks on methodology and content.

Liiketoiminta-analytiikka osana yritysten päätöksentekoa

Liiketoiminta-analytiikka on yksi yritysten suorituskyvyn johtamisen osa-alue, joka on viime aikoina noussut vahvasti esille yritysten kilpailuedun mahdollistavana avaintekijänä. Tämän tutkimuksen tavoitteena oli kartoittaa yritysten liiketoiminta-analytiikan nykytila ja tarpeet Suomessa. Tutkimus on luonteeltaan kvalitatiivinen vertaileva tutkimus. Tutkimuksen empiirinen aineisto kerättiin kahden menetelmän yhdistelmänä. Liiketoiminta-analytiikan hyödyntämisessä edistyneempien yrityksien asiantuntijoille toteutettiin haastattelut. Lisäksi toteutettiin sähköpostitse lomakemuotoinen kyselytutkimus, jotta saavutettaisiin kattavampi näkemys analytiikan markkinoista. Tutkimuksessa on kartoitettu, miten Suomessa ymmärretään liiketoiminta- analytiikan käsite eri yrityksien analytiikan asiantuntijoiden toimesta, sekä minkälaisissa päätöksentekotilanteissa liiketoiminta-analytiikkaa hyödynnetään ja minkälaisilla tavoilla. Lisäksi on selvitetty, miten liiketoiminta-analytiikan kehittämistä ja analytiikan kyvykkyyksiä hallitaan yrityksissä. Liiketoiminta-analytiikka on Suomessa tietyillä toimialoilla erittäin kehittynyttä, mutta yleisesti ollaan jäljessä alan edelläkävijöitä ja esimerkiksi Ruotsia. Liiketoiminta-analytiikan hyödyntäminen ja tarpeet ovat pitkälti kohdistuneet päätöksentekotilanteisiin, joissa yritys kohtaa asiakkaansa. Suurin yksittäinen este liiketoiminta-analytiikan hyödyntämiselle on resurssi- ja osaamisvaje.

Management of Soft Information in Sales and Operations Planning

With a Sales and Operations Planning (S&OP) process, a company aims to manage the demand and supply by planning and forecasting. The studied company uses an integrated S&OP process to improve the company's operations. The aim of this thesis is to develop this business process by finding the best possible way to manage the soft information in S&OP, whilst also understanding the importance and types (assumptions, risks and opportunities) of soft information in S&OP. The soft information in S&OP helps to refine future S&OP planning, taking into account the uncertainties that affect the balance of the long-term demand and supply (typically 12-18 months). The literature review was used to create a framework for soft information management process in S&OP. There were not found a concrete way how to manage soft information in the existing literature. In consequence of the poor literature available the Knowledge Management literature was used as the base for the framework creation, which was seen in the very same type of information management like the soft information management is. The framework created a four-stage process to manage soft information in S&OP that included also the required support systems. First phase is collecting and acquiring soft information in S&OP, which include also categorization. The categorization was the cornerstone to identify different requirements that needs to be taken into consideration when managing soft information in S&OP process. The next phase focus on storing data, which purpose is to ensure the soft information is managed in a common system (support system) in a way that the following phase makes it available to users in S&OP who need by help of sharing and applications process. The last phase target is to use the soft information to understand assumptions and thoughts of users behind the numbers in S&OP plans. With this soft management process the support system will have a key role. The support system, like S&OP tool, ensures that soft information is stored in the right places, kept up-to-date and relevancy. The soft information management process in S&OP strives to improve the relevant soft information documenting behind the S&OP plans into the S&OP support system. The process offers an opportunity to individuals to review, comment and evaluate soft information in S&OP made by their own or others. In the case company it was noticed that without a properly documented and distributed soft information in S&OP it was seen to cause mistrust towards the planning.

Ohjelmistoyrityksen tuoteliiketoiminnan ohjaaminen elinkaarimallin avulla

Nopeasti muuttuvissa kilpailutilanteissa varsinkin pienet ja keskisuuret ohjelmistoyritykset joutuvat kilpailuetuja saavuttaakseen tekemään strategisia päätöksiä, joiden vaikutukset voidaan todeta vasta pitkän ajan kuluttua. Sen vuoksi yritysjohto tarvitsee päätöksentekoa varten tukijärjestelmiä, jotka sekä tuottavat informaatiota päätöksenteon tueksi että auttavat vähentämään päätöksistä aiheutuneita riskejä. Tämän työn tavoitteena oli kehittää ohjelmistoyritysten ohjelmistotuoteliiketoimintaa varten elinkaarikustannusmalli, jonka avulla yritysjohto voi arvioida ohjelmistotuotteiden koko-naiskustannuksia koko elinkaaren ajalta. Elinkaarikustannusmallia tutkittiin sekä elinkaarikustannusten että ohjelmistotuotantoprosessien teoreettisissa viitekehyksissä. Empiirinen tieto kerättiin tutkimukseen osallistuneen ohjelmistoyrityksen avulla. Tutkimuksessa kehitetty elinkaarikustannusmalli eroaa monista muista tutkituista kustannusmalleista siinä, että se lähestyy elinkaarikustannusten problematiikkaa strategisesta näkökulmasta, kun taas monet muut mallit toteuttavat tietoteknistä lähestymistapaa. Siten ohjelmistoyrityksen johto voi ohjata tuoteliiketoimintaa osana strategista päätöksentekoa sekä tuotteen elinkaaren kokonaiskustannusten avulla että elinkaarikustannusmallin epäsuorien vaikutusten kautta