Prognostic value of serial blood S100B determinations in stage IIB-III melanoma patients: a corollary study to EORTC trial 18952.

S100B is a prognostic factor for melanoma as elevated levels correlate with disease progression and poor outcome. We determined its prognostic value based on updated information using serial determinations in stage IIb/III melanoma patients. 211 Patients who participated in the EORTC 18952 trial, evaluating efficacy of adjuvant intermediate doses of interferon α2b (IFN) versus observation, entered a corollary study. Over a period of 36 months, 918 serum samples were collected. The Cox time-dependent model was used to assess prognostic value of the latest (most recent) S100B determination. At first measurement, 178 patients had S100B values <0.2 μg/l and 33 ≥ 0.2 μg/l. Within the first group, 61 patients had, later on, an increased value of S100B (≥ 0.2 μg/l). An initial increased value of S100B, or during follow-up, was associated with worse distant metastasis-free survival (DMFS); hazard ratio (HR) of S100B ≥ 0.2 versus S100B < 0.2 was 5.57 (95% confidence interval (CI) 3.81-8.16), P < 0.0001, after adjustment for stage, number of lymph nodes and sex. In stage IIb patients, the HR adjusted for sex was 2.14 (95% CI 0.71, 6.42), whereas in stage III, the HR adjusted for stage, number of lymph nodes and sex was 6.76 (95% CI 4.50-10.16). Similar results were observed regarding overall survival (OS). Serial determination of S100B in stage IIb-III melanoma is a strong independent prognostic marker, even stronger compared to stage and number of positive lymph nodes. The prognostic impact of S100B ≥ 0.2 μg/l is more pronounced in stage III disease compared with stage IIb.

Health-related quality of life in survivors of childhood cancer: the role of chronic health problems.

INTRODUCTION: The influence of specific health problems on health-related quality of life (HRQoL) in childhood cancer survivors is unknown. We compared HRQoL between survivors of childhood cancer and their siblings, determined factors associated with HRQoL, and investigated the influence of chronic health problems on HRQoL. METHODS: Within the Swiss Childhood Cancer Survivor Study, we sent a questionnaire to all survivors (≥16 years) registered in the Swiss Childhood Cancer Registry, who survived >5 years and were diagnosed 1976-2005 aged <16 years. Siblings received similar questionnaires. We assessed HRQoL using Short Form-36 (SF-36). Health problems from a standard questionnaire were classified into overweight, vision impairment, hearing, memory, digestive, musculoskeletal or neurological, and thyroid problems. RESULTS: The sample included 1,593 survivors and 695 siblings. Survivors scored significantly lower than siblings in physical function, role limitation, general health, and the Physical Component Summary (PCS). Lower score in PCS was associated with a diagnosis of central nervous system tumor, retinoblastoma or bone tumor, having had surgery, cranio-spinal irradiation, or bone marrow transplantation. Lower score in Mental Component Summary was associated with older age. All health problems decreased HRQoL in all scales. Most affected were survivors reporting memory problems and musculoskeletal or neurological problems. Health problems had the biggest impact on physical functioning, general health, and energy and vitality. CONCLUSIONS: In this study, we showed the negative impact of specific chronic health problems on survivors' HRQoL. IMPLICATIONS FOR CANCER SURVIVORS: Therapeutic preventive measures, risk-targeted follow-up, and interventions might help decrease health problems and, consequently, improve survivors' quality of life.

Analysis of linear networks with inconsistent initial conditions

This paper presents a new method to analyze timeinvariant linear networks allowing the existence of inconsistent initial conditions. This method is based on the use of distributions and state equations. Any time-invariant linear network can be analyzed. The network can involve any kind of pure or controlled sources. Also, the transferences of energy that occur at t=O are determined, and the concept of connection energy is introduced. The algorithms are easily implemented in a computer program.

Using spatially distributed parameters and multi-response objective functions to solve parameterization of complex applications of semi-distributed hydrological models

Application of semi-distributed hydrological models to large, heterogeneous watersheds deals with several problems. On one hand, the spatial and temporal variability in catchment features should be adequately represented in the model parameterization, while maintaining the model complexity in an acceptable level to take advantage of state-of-the-art calibration techniques. On the other hand, model complexity enhances uncertainty in adjusted model parameter values, therefore increasing uncertainty in the water routing across the watershed. This is critical for water quality applications, where not only streamflow, but also a reliable estimation of the surface versus subsurface contributions to the runoff is needed. In this study, we show how a regularized inversion procedure combined with a multiobjective function calibration strategy successfully solves the parameterization of a complex application of a water quality-oriented hydrological model. The final value of several optimized parameters showed significant and consistentdifferences across geological and landscape features. Although the number of optimized parameters was significantly increased by the spatial and temporal discretization of adjustable parameters, the uncertainty in water routing results remained at reasonable values. In addition, a stepwise numerical analysis showed that the effects on calibration performance due to inclusion of different data types in the objective function could be inextricably linked. Thus caution should be taken when adding or removing data from an aggregated objective function.

Segmental Durations of Speech

This dissertation considers the segmental durations of speech from the viewpoint of speech technology, especially speech synthesis. The idea is that better models of segmental durations lead to higher naturalness and better intelligibility. These features are the key factors for better usability and generality of synthesized speech technology. Even though the studies are based on a Finnish corpus the approaches apply to all other languages as well. This is possibly due to the fact that most of the studies included in this dissertation are about universal effects taking place on utterance boundaries. Also the methods invented and used here are suitable for any other study of another language. This study is based on two corpora of news reading speech and sentences read aloud. The other corpus is read aloud by a 39-year-old male, whilst the other consists of several speakers in various situations. The use of two corpora is twofold: it involves a comparison of the corpora and a broader view on the matters of interest. The dissertation begins with an overview to the phonemes and the quantity system in the Finnish language. Especially, we are covering the intrinsic durations of phonemes and phoneme categories, as well as the difference of duration between short and long phonemes. The phoneme categories are presented to facilitate the problem of variability of speech segments. In this dissertation we cover the boundary-adjacent effects on segmental durations. In initial positions of utterances we find that there seems to be initial shortening in Finnish, but the result depends on the level of detail and on the individual phoneme. On the phoneme level we find that the shortening or lengthening only affects the very first ones at the beginning of an utterance. However, on average, the effect seems to shorten the whole first word on the word level. We establish the effect of final lengthening in Finnish. The effect in Finnish has been an open question for a long time, whilst Finnish has been the last missing piece for it to be a universal phenomenon. Final lengthening is studied from various angles and it is also shown that it is not a mere effect of prominence or an effect of speech corpus with high inter- and intra-speaker variation. The effect of final lengthening seems to extend from the final to the penultimate word. On a phoneme level it reaches a much wider area than the initial effect. We also present a normalization method suitable for corpus studies on segmental durations. The method uses an utterance-level normalization approach to capture the pattern of segmental durations within each utterance. This prevents the impact of various problematic variations within the corpora. The normalization is used in a study on final lengthening to show that the results on the effect are not caused by variation in the material. The dissertation shows an implementation and prowess of speech synthesis on a mobile platform. We find that the rule-based method of speech synthesis is a real-time software solution, but the signal generation process slows down the system beyond real time. Future aspects of speech synthesis on limited platforms are discussed. The dissertation considers ethical issues on the development of speech technology. The main focus is on the development of speech synthesis with high naturalness, but the problems and solutions are applicable to any other speech technology approaches.

Customer satisfaction data utilization: identifying value drivers and information use practices

The objective of this master’s thesis was twofold: first to examine the concept of customer value and its drivers and second to identify information use practices. The first part of the study represents explorative research that was carried out by examining a case company’s customer satisfaction data that was used to identify sales and technical customer service related value drivers on a detailed attribute level. This was followed by an examination of whether these attributes had been commented on in a positive or a negative light and what were the reasons why the case company had received higher or lower ratings than its competitor. As a result a classification of different sales and technical customer service related attributes was created. The results indicated that the case company has performed well, but that the results varied on the company’s business segment level. The case company’s staff, service and the benefits from a long-lasting relationship came up in a positive light whereas attitude, flexibility and reaction time came up in a negative light. The reasons for a higher or lower score in comparison to competitor varied. The results indicated that a customer’s satisfaction with the company’s performance did not always mean that the company was outperforming the competition. The second part of the study focused on customer satisfaction information use from the viewpoints of information access, dissemination and reaction. The study was conducted by running an internal survey among the case company’s staff. The results showed that information use practices varied across the company and some units or teams had taken a more proactive approach to the information use than others.

Internationalization of small and medium-sized enterprises and impact of institutions on international entrepreneurship in emerging economies: the case of Russia

The doctoral study presents a comprehensive analysis of the impact of the institutional environment on the internationalization-based growth strategic choices of small and mediumsized enterprises (SMEs) in emerging economies. In responding to the calls for more research on institutions and international entrepreneurship, this dissertation extends the linkages between the two to the context of emerging economies. The study presents a comprehensive analysis of institutional challenges and their impact on the internationalization of SMEs in emerging economies, particularly in Russia. The research contributes to the adoption of the institution-based view in international entrepreneurship. The dissertation is presented through five research papers. Based on primary and secondary data, the study categorizes the possible sources of institutional influences on internationalization and empirically tests their impact by applying a method triangulation research design. The result of the conducted research is a proposed theoretical model of the institutional impact on the internationalization of SMEs in emerging economies. The model is specifically focused on the growth stage of the entrepreneurial process and considers only its internationalization facet. The research identifies and provides empirical support for the existence of a positive influence of a transparent and supportive regulatory environment, an institutionalized pool of general business knowledge, and collectivistic value orientation on the proclivity of SMEs to internationalize. A level of appreciation of entrepreneurial initiatives in home country and a greater positive institutional gap provide a positive impact on the international performance of SMEs. The research provides contextualized knowledge of the institutional impact on the internationalization of SMEs in Russia. The obtained results present theoretical value in terms of showing how the environmental conditions effect the entrepreneurial internationalization-based growth in emerging economies, providing the methodological insights into the measurement of the institutional effects, and empirically contextualizing the linkage between institutions and internationalization in the Russian business environment. The research also provides value for the business and policy making stakeholders by identifying ways of utilizing the conditions in the external institutional environment.

Effects of filtration methods on the neutralization yield of crude marine fish oil

The evaluation of filtration methods on the yield and oleochemicals characteristics on the crude fish oil from the soapstock of marine fish for purposes of nutrition has been conducted in this work. The analytical properties of the crude and the neutralized oil with three excesses of sodium hydroxide (NaOH, 20%, 40% and 60%) were carried out on two different ways with organza and the “glass wool”. The neutralization of the oil brought about a notable improvement in the analytical properties of the oil. Thus, it leads to a high quality fish oil in terms of taste, colour, odours, shelf life and market value. Based on the improved characteristics of the oil, it could be suitable for applications in pharmaceutical and food industries.

Understanding value congruence : a sport organization case study

With the recent growth in cultural complexity, many organizations are faced with increasingly diverse employee pools. Gaining a greater understanding of the values that employees possess is the first step in effectively satisfying their needs and achieving a more productive workforce (lung & Avolio, 2000). Values playa significant role in influencing individual behaviours. It is therefore necessary to assess the qualities of employee value systems and directly link them to the values of the organization. The importance of values and value congruence has been emphasized by many organizational behaviour researchers (cf. Adkins & Caldwell, 2004; Erdogan, Kraimer, & Liden, 2004; Jung & Avolio, 2000; Rokeach, 1973); however the emphasis on value studies remains fairly stagnant within the sport industry (Amis, Slack, & Hinings, 2002). In order to examine the realities that were constructed by the participants in this study a holistic view of the impact of values within a specific sport organization were provided. The purpose of this case study was to examine organizational and employee values to understand the effects of values and value congruence on employee behaviours within the context of a large Canadian sport organization. A mUltiple methods case study approach was adopted in order to fully serve the purpose and provide a comprehensive view of the organization being examined. Document analysis, observations, surveys, as well as semi-structured interviews were conducted. The process allowed for triangulation and confirmability of the findings. Each method functioned to create an overarching understanding of the values and value congruence within this organization. The analysis of the findings was divided into qualitative and quantitative sections. The qualitative documents were analyzed twice, once manually by the researcher and once via AtIas.ti Version 4 (1998). The a priori and emergent coding that took place was based on triangulating the findings and uncovering common themes throughout the data. The Rokeach Value Survey (1973) that was incorporated into the survey design of the study was analyzed using descriptive statistics, as well as Mann-Whitney U, and Kruskal Wallis formulas. These were deemed appropriate for analysis given the non-parametric nature of the survey instrument (Kinnear & Gray, 2004). The quantitative survey served to help define the values and value congruence that was then holistically examined through the qualitative interviews, document analyses, and observations. The results of the study indicated incongruent value levels between employees and those stated or perceived as the organization's values. Each finding demonstrated that varying levels of congruence may have diverse affects on individual behaviours. These behaviours range from production levels to interactions with fellow employees to turnover. In addition to the findings pertaining to the research questions, a number of other key issues were uncovered regarding departmentalization, communication, and board relations. Each has contributed to a greater understanding of the organization and has created direction for further research within this area of study.

Condition physique, performance motrice, comportements et fonctions cognitives chez les enfants ayant un trouble du déficit de l’attention avec hyperactivité

Cette thèse poursuit un double objectif. D’une part, mesurer et situer le niveau de la condition physique, de la performance motrice et de la participation aux activités physiques chez des enfants ayant un TDAH. D’autre part, apprécier l’impact d’un programme structuré en activité physique sur la condition physique, la performance motrice, certains comportements cibles ainsi que sur les fonctions cognitives propres à ces enfants. Pour vérifier l’atteinte de ces objectifs, trois études expérimentales ont été complétées et ont fait l’objet d’articles soumis pour publications. Dans le premier article, on évalue la condition physique et la performance motrice chez des enfants ayant un TDAH prenant ou non de la médication. Les résultats obtenus démontrent que la condition physique, comprenant ici des variables reliées à la composition corporelle, l’endurance musculaire et la flexibilité de ces enfants, ne diffèrent pas de celle des membres d’un groupe témoin. Seul l’indice de masse corporelle est significativement moins élevé chez les enfants ayant un TDAH prenant de la médication. Aucune différence n’est observée entre les groupes en ce qui a trait à la capacité aérobie telle que mesurée lors d’une épreuve de tapis roulant. Par contre, lorsqu’évaluée à partir d’un test navette, la performance aérobie de tous les participants est significativement moins élevée, d’où l’importance du choix de l’instrument de mesure. Finalement, les enfants ayant un TDAH ont significativement plus de problèmes de motricité globale que les enfants du groupe témoin. Ces difficultés sont particulièrement importantes pour la locomotion. Dans le cadre d’un programme d’activités physiques structurées et supervisées, le deuxième article porte, d’une part, sur l’évaluation de l’intensité de la participation aux exercices proposés chez des enfants ayant un TDAH. D’autre part, l’impact potentiel de facteurs comme les problèmes de poids et la présence de difficultés motrices sont également pris en considération. Les résultats obtenus suggèrent que ces enfants atteignent une intensité et une durée d’exercice qui ne diffèrent pas de celles des enfants du groupe témoin. Quant aux enfants qui ont un problème de poids ou des difficultés motrices, l’intensité et la durée de leur participation ne diffèrent pas de celles des participants témoins. Sur la base des données obtenues, les enfants ayant un TDAH peuvent parvenir à un degré de participation aux exercices qui permet de bénéficier des bienfaits de la pratique d’activités physiques. Le troisième article traite de l’impact potentiel d’un programme d’activités physiques sur la condition physique, la performance motrice, certains comportements ainsi que sur les fonctions cognitives des enfants ayant un TDAH. Sur la base des résultats obtenus, il est possible de faire valoir que la participation à un tel programme permet d’améliorer les capacités musculaires, les habiletés motrices, certains comportements observés par les parents et les enseignants ainsi que la capacité d’attention. Cela pourrait produire un impact significatif dans l’adaptation fonctionnelle de ces jeunes. Ces résultats soulignent le besoin de continuer la recherche dans les domaines de l’activité physique et du TDAH. La discussion générale présente les liens existants entre les manuscrits en fonction du modèle de l’engagement dans les activités physiques. Le déficit de la motricité globale ainsi que l’impact clinique potentiel de l’activité physique dans le traitement du TDAH sont les deux axes de recherche qui semblent le plus propices à des travaux futurs.

Zur Konvergenz der Randpunktmethode

Das von Maz'ya eingeführte Approximationsverfahren, die Methode der näherungsweisen Näherungen (Approximate Approximations), kann auch zur numerischen Lösung von Randintegralgleichungen verwendet werden (Randpunktmethode). In diesem Fall hängen die Komponenten der Matrix des resultierenden Gleichungssystems zur Berechnung der Näherung für die Dichte nur von der Position der Randpunkte und der Richtung der äußeren Einheitsnormalen in diesen Punkten ab. Dieses numerisches Verfahren wird am Beispiel des Dirichlet Problems für die Laplace Gleichung und die Stokes Gleichungen in einem beschränkten zweidimensionalem Gebiet untersucht. Die Randpunktmethode umfasst drei Schritte: Im ersten Schritt wird die unbekannte Dichte durch eine Linearkombination von radialen, exponentiell abklingenden Basisfunktionen approximiert. Im zweiten Schritt wird die Integration über den Rand durch die Integration über die Tangenten in Randpunkten ersetzt. Für die auftretende Näherungspotentiale können sogar analytische Ausdrücke gewonnen werden. Im dritten Schritt wird das lineare Gleichungssystem gelöst, und eine Näherung für die unbekannte Dichte und damit auch für die Lösung der Randwertaufgabe konstruiert. Die Konvergenz dieses Verfahrens wird für glatte konvexe Gebiete nachgewiesen.

Software Development: Testing

This presentation discusses the role and purpose of testing in the systems/Software Development Life Cycle. We examine the consequences of the 'cost curve' on defect removal and how agile methods can reduce its effects. We concentrate on Black Box Testing and use Equivalence Partitioning and Boundary Value Analysis to construct the smallest number of test cases, test scenarios necessary for a test plan.

Análisis ecocardiográfico de la función sistólica del ventrículo izquierdo por médicos no cardiólogos con un dispositivo de bolsillo

Se realizó un estudio transversal, se incluyeron 3 residentes no cardiólogos y se les dio formación básica en ecocardiografía (horas teóricas 22, horas prácticas 65), con recomendaciones de la Sociedad Americana de Ecocardiografia y aportes del aprendizaje basado en problemas, con el desarrollo de competencia técnicas y diagnósticas necesarias, se realizó el análisis de concordancia entre residentes y ecocardiografistas expertos, se recolectaron 122 pacientes hospitalizados que cumplieran con los criterios de inclusión y exclusión, se les realizo un ecocardiograma convencional por el experto y una valoración ecocardiográfica por el residente, se evaluó la ventana acústica, contractilidad, función del ventrículo izquierdo y derrame pericárdico. La hipótesis planteada fue obtener una concordancia moderada. Resultados: Se analizó la concordancia entre observadores para la contractilidad miocárdica (Kappa: 0,57 p=0,000), función sistólica del ventrículo izquierdo (Kappa 0,54 p=0.000) siendo esta moderada por estar entre 0,40 – 0,60 y con una alta significancia estadística, para la calidad de la ventana acústica (Kappa: 0,22 p= 0.000) y presencia de derrame pericárdico (Kappa: 0,26 p= 0.000) se encontró una escasa concordancia ubicándose entre 0,20 – 0,40. Se estableció una sensibilidad de 90%, especificidad de 67%, un valor predictivo positivo de 80% y un valor predictivo negativo de 85% para el diagnóstico de disfunción sistólica del ventrículo izquierdo realizado por los residentes.

Visibility and proximity on triangulated surfaces

En aquesta tesi es solucionen problemes de visibilitat i proximitat sobre superfícies triangulades considerant elements generalitzats. Com a elements generalitzats considerem: punts, segments, poligonals i polígons. Les estrategies que proposem utilitzen algoritmes de geometria computacional i hardware gràfic. Comencem tractant els problemes de visibilitat sobre models de terrenys triangulats considerant un conjunt d'elements de visió generalitzats. Es presenten dos mètodes per obtenir, de forma aproximada, mapes de multi-visibilitat. Un mapa de multi-visibilitat és la subdivisió del domini del terreny que codifica la visibilitat d'acord amb diferents criteris. El primer mètode, de difícil implementació, utilitza informació de visibilitat exacte per reconstruir de forma aproximada el mapa de multi-visibilitat. El segon, que va acompanyat de resultats d'implementació, obté informació de visibilitat aproximada per calcular i visualitzar mapes de multi-visibilitat discrets mitjançant hardware gràfic. Com a aplicacions es resolen problemes de multi-visibilitat entre regions i es responen preguntes sobre la multi-visibilitat d'un punt o d'una regió. A continuació tractem els problemes de proximitat sobre superfícies polièdriques triangulades considerant seus generalitzades. Es presenten dos mètodes, amb resultats d'implementació, per calcular distàncies des de seus generalitzades sobre superfícies polièdriques on hi poden haver obstacles generalitzats. El primer mètode calcula, de forma exacte, les distàncies definides pels camins més curts des de les seus als punts del poliedre. El segon mètode calcula, de forma aproximada, distàncies considerant els camins més curts sobre superfícies polièdriques amb pesos. Com a aplicacions, es calculen diagrames de Voronoi d'ordre k, i es resolen, de forma aproximada, alguns problemes de localització de serveis. També es proporciona un estudi teòric sobre la complexitat dels diagrames de Voronoi d'ordre k d'un conjunt de seus generalitzades en un poliedre sense pesos.

Grey-box radial basis function modelling: the art of incorporating prior knowledge

A basic principle in data modelling is to incorporate available a priori information regarding the underlying data generating mechanism into the modelling process. We adopt this principle and consider grey-box radial basis function (RBF) modelling capable of incorporating prior knowledge. Specifically, we show how to explicitly incorporate the two types of prior knowledge: the underlying data generating mechanism exhibits known symmetric property and the underlying process obeys a set of given boundary value constraints. The class of orthogonal least squares regression algorithms can readily be applied to construct parsimonious grey-box RBF models with enhanced generalisation capability.