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.

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

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.

Model of Big Data Failure: Review of Information System Failure

In the new age of information technology, big data has grown to be the prominent phenomena. As information technology evolves, organizations have begun to adopt big data and apply it as a tool throughout their decision-making processes. Research on big data has grown in the past years however mainly from a technical stance and there is a void in business related cases. This thesis fills the gap in the research by addressing big data challenges and failure cases. The Technology-Organization-Environment framework was applied to carry out a literature review on trends in Business Intelligence and Knowledge management information system failures. A review of extant literature was carried out using a collection of leading information system journals. Academic papers and articles on big data, Business Intelligence, Decision Support Systems, and Knowledge Management systems were studied from both failure and success aspects in order to build a model for big data failure. I continue and delineate the contribution of the Information System failure literature as it is the principal dynamics behind technology-organization-environment framework. The gathered literature was then categorised and a failure model was developed from the identified critical failure points. The failure constructs were further categorized, defined, and tabulated into a contextual diagram. The developed model and table were designed to act as comprehensive starting point and as general guidance for academics, CIOs or other system stakeholders to facilitate decision-making in big data adoption process by measuring the effect of technological, organizational, and environmental variables with perceived benefits, dissatisfaction and discontinued use.

Model of Big Data Failure: Review of Information System Failure

In the new age of information technology, big data has grown to be the prominent phenomena. As information technology evolves, organizations have begun to adopt big data and apply it as a tool throughout their decision-making processes. Research on big data has grown in the past years however mainly from a technical stance and there is a void in business related cases. This thesis fills the gap in the research by addressing big data challenges and failure cases. The Technology-Organization-Environment framework was applied to carry out a literature review on trends in Business Intelligence and Knowledge management information system failures. A review of extant literature was carried out using a collection of leading information system journals. Academic papers and articles on big data, Business Intelligence, Decision Support Systems, and Knowledge Management systems were studied from both failure and success aspects in order to build a model for big data failure. I continue and delineate the contribution of the Information System failure literature as it is the principal dynamics behind technology-organization-environment framework. The gathered literature was then categorised and a failure model was developed from the identified critical failure points. The failure constructs were further categorized, defined, and tabulated into a contextual diagram. The developed model and table were designed to act as comprehensive starting point and as general guidance for academics, CIOs or other system stakeholders to facilitate decision-making in big data adoption process by measuring the effect of technological, organizational, and environmental variables with perceived benefits, dissatisfaction and discontinued use.

A portal for the Canadian Virtual Health Library / Bibliothèque virtuelle canadienne de la santé (CVHL/BVCS): Accomplishments and possibilities, scope and structure - a review of best practices

Introduction: Coordination through CVHL/BVCS gives Canadian health libraries access to information technology they could not offer individually, thereby enhancing the library services offered to Canadian health professionals. An example is the portal being developed. Portal best practices are of increasing interest (usability.gov; Wikipedia portals; JISC subject portal project; Stanford clinical portals) but conclusive research is not yet available. This paper will identify best practices for a portal bringing together knowledge for Canadian health professionals supported through a network of libraries. Description: The portal for Canadian health professionals will include capabilities such as: • Authentication • Question referral • Specialist “branch libraries” • Integration of commercial resources, web resources and health systems data • Cross-resource search engine • Infrastructure to enable links from EHR and decision support systems • Knowledge translation tools, such as highlighting of best evidence Best practices will be determined by studying the capabilities of existing portals, including consortia/networks and individual institutions, and through a literature review. Outcomes: Best practices in portals will be reviewed. The collaboratively developed Virtual Library, currently the heart of cvhl.ca, is a unique database collecting high quality, free web documents and sites relevant to Canadian health care. The evident strengths of the Virtual Library will be discussed in light of best practices. Discussion: Identification of best practices will support cost-benefit analysis of options and provide direction for CVHL/BVCS. Open discussion with stakeholders (libraries and professionals) informed by this review will lead to adoption of the best technical solutions supporting Canadian health libraries and their users.

A model of Distributed Ayurvedic Diagnosis and Therapy System for Hridroga Using Agents

Diagnosis of Hridroga (cardiac disorders) in Ayurveda requires the combination of many different types of data, including personal details, patient symptoms, patient histories, general examination results, Ashtavidha pareeksha results etc. Computer-assisted decision support systems must be able to combine these data types into a seamless system. Intelligent agents, an approach that has been used chiefly in business applications, is used in medical diagnosis in this case. This paper is about a multi-agent system named “Distributed Ayurvedic Diagnosis and Therapy System for Hridroga using Agents” (DADTSHUA). It describes the architecture of the DADTSHUA model .This system is using mobile agents and ontology for passing data through the network. Due to this, transport delay can be minimized. It is a system which will be very helpful for the beginning physicians to eliminate his ambiguity in diagnosis and therapy. The system is implemented using Java Agent DEvelopment framework (JADE), which is a java-complaint mobile agent platform from TILab.

Soil organic carbon management for sustainable land use in Sudano-Sahelian West Africa

Judged by their negative nutrient balances, low soil cover and low productivity, the predominant agro-pastoral farming systems in the Sudano-Sahelian zone of West Africa are highly unsustainable for crop production intensification. With kaolinite as the main clay type, the cation exchange capacity of the soils in this region, often less than 1 cmol_c kg^-1 soil, depends heavily on the organic carbon (Corg) content. However, due to low carbon sequestration and to the microbe, termite and temperature-induced rapid turnover rates of organic material in the present land-use systems, Corg contents of the topsoil are very low, ranging between 1 and 8 g kg^-1 in most soils. For sustainable food production, the availability of phosphorus (P) and nitrogen (N) has to be increased considerably in combination with an improvement in soil physical properties. Therefore, the adoption of innovative management options that help to stop or even reverse the decline in Corg typically observed after cultivating bush or rangeland is of utmost importance. To maintain food production for a rapidly growing population, targeted applications of mineral fertilisers and the effective recycling of organic amendments as crop residues and manure are essential. Any increase in soil cover has large effects in reducing topsoil erosion by wind and water and favours the accumulation of wind-blown dust high in bases which in turn improves P availability. In the future decision support systems, based on GIS, modelling and simulation should be used to combine (i) available fertiliser response data from on-station and on-farm research, (ii) results on soil productivity restoration with the application of mineral and organic amendments and (iii) our present understanding of the cause-effect relationships governing the prevailing soil degradation processes. This will help to predict the effectiveness of regionally differentiated soil fertility management approaches to maintain or even increase soil Corg levels.

Adaptive business intelligence for an open negotiation environment

Engineering of negotiation model allows to develop effective heuristic for business intelligence. Digital ecosystems demand open negotiation models. To define in advance effective heuristics is not compliant with the requirement of openness. The new challenge is to develop business intelligence in advance exploiting an adaptive approach. The idea is to learn business strategy once new negotiation model rise in the e-market arena. In this paper we present how recommendation technology may be deployed in an open negotiation environment where the interaction protocol models are not known in advance. The solution we propose is delivered as part of the ONE Platform, open source software that implements a fully distributed open environment for business negotiation

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

A Negotiation Style Recommender Based on Computational Ecology in Open Negotiation Environments

The system described herein represents the first example of a recommender system in digital ecosystems where agents negotiate services on behalf of small companies. The small companies compete not only with price or quality, but with a wider service-by-service composition by subcontracting with other companies. The final result of these offerings depends on negotiations at the scale of millions of small companies. This scale requires new platforms for supporting digital business ecosystems, as well as related services like open-id, trust management, monitors and recommenders. This is done in the Open Negotiation Environment (ONE), which is an open-source platform that allows agents, on behalf of small companies, to negotiate and use the ecosystem services, and enables the development of new agent technologies. The methods and tools of cyber engineering are necessary to build up Open Negotiation Environments that are stable, a basic condition for predictable business and reliable business environments. Aiming to build stable digital business ecosystems by means of improved collective intelligence, we introduce a model of negotiation style dynamics from the point of view of computational ecology. This model inspires an ecosystem monitor as well as a novel negotiation style recommender. The ecosystem monitor provides hints to the negotiation style recommender to achieve greater stability of an open negotiation environment in a digital business ecosystem. The greater stability provides the small companies with higher predictability, and therefore better business results. The negotiation style recommender is implemented with a simulated annealing algorithm at a constant temperature, and its impact is shown by applying it to a real case of an open negotiation environment populated by Italian companies