How Reliable Is Ki-67 Immunohistochemistry in Grade 2 Breast Carcinomas? A QA Study of the Swiss Working Group of Breast- and Gynecopathologists.

Adjuvant chemotherapy decisions in breast cancer are increasingly based on the pathologist's assessment of tumor proliferation. The Swiss Working Group of Gyneco- and Breast Pathologists has surveyed inter- and intraobserver consistency of Ki-67-based proliferative fraction in breast carcinomas. METHODS: Five pathologists evaluated MIB-1-labeling index (LI) in ten breast carcinomas (G1, G2, G3) by counting and eyeballing. In the same way, 15 pathologists all over Switzerland then assessed MIB-1-LI on three G2 carcinomas, in self-selected or pre-defined areas of the tumors, comparing centrally immunostained slides with slides immunostained in the different laboratoires. To study intra-observer variability, the same tumors were re-examined 4 months later. RESULTS: The Kappa values for the first series of ten carcinomas of various degrees of differentiation showed good to very good agreement for MIB-1-LI (Kappa 0.56-0.72). However, we found very high inter-observer variabilities (Kappa 0.04-0.14) in the read-outs of the G2 carcinomas. It was not possible to explain the inconsistencies exclusively by any of the following factors: (i) pathologists' divergent definitions of what counts as a positive nucleus (ii) the mode of assessment (counting vs. eyeballing), (iii) immunostaining technique, and (iv) the selection of the tumor area in which to count. Despite intensive confrontation of all participating pathologists with the problem, inter-observer agreement did not improve when the same slides were re-examined 4 months later (Kappa 0.01-0.04) and intra-observer agreement was likewise poor (Kappa 0.00-0.35). CONCLUSION: Assessment of mid-range Ki-67-LI suffers from high inter- and intra-observer variability. Oncologists should be aware of this caveat when using Ki-67-LI as a basis for treatment decisions in moderately differentiated breast carcinomas.

Sensitivity analysis, dominant factors, and robustness of the ECETOC TRA v3, Stoffenmanager 4.5, and ART 1.5 occupational exposure models

Occupational exposure modeling is widely used in the context of the E.U. regulation on the registration, evaluation, authorization, and restriction of chemicals (REACH). First tier tools, such as European Centre for Ecotoxicology and TOxicology of Chemicals (ECETOC) targeted risk assessment (TRA) or Stoffenmanager, are used to screen a wide range of substances. Those of concern are investigated further using second tier tools, e.g., Advanced REACH Tool (ART). Local sensitivity analysis (SA) methods are used here to determine dominant factors for three models commonly used within the REACH framework: ECETOC TRA v3, Stoffenmanager 4.5, and ART 1.5. Based on the results of the SA, the robustness of the models is assessed. For ECETOC, the process category (PROC) is the most important factor. A failure to identify the correct PROC has severe consequences for the exposure estimate. Stoffenmanager is the most balanced model and decision making uncertainties in one modifying factor are less severe in Stoffenmanager. ART requires a careful evaluation of the decisions in the source compartment since it constitutes ∼75% of the total exposure range, which corresponds to an exposure estimate of 20-22 orders of magnitude. Our results indicate that there is a trade off between accuracy and precision of the models. Previous studies suggested that ART may lead to more accurate results in well-documented exposure situations. However, the choice of the adequate model should ultimately be determined by the quality of the available exposure data: if the practitioner is uncertain concerning two or more decisions in the entry parameters, Stoffenmanager may be more robust than ART.

Voting advice applications : impact on voting decisions in the 2011 Swiss national elections

In most democracies voting Advice Applications (VAAs) advising citizens which candidate or party they should vote for become more and more popular. It is therefore crucial to know more about the functioning and the effects of such tools. After some general remarks about the spread of these tools and their possible effects gathered so far in various studies, this paper presents the latest results from a research conducted in the course of the 2011 Swiss national elections. They confirm that VAAs can lead to better informed voters and are likely to have a positive impact on electoral turnout. Additionally it can be shown that the Swiss VAA smartvote made voters change their voting intention and that they voted for a different party. This was particularly advantageous for the Green Liberal Party. At the moment, only a minority of voters rely on the voting recommendation by smartvote. This might change dramatically with the introduction of e-voting. Once people can vote electronically, there are hardly any possibilities to prevent voters from transferring their selection of candidates based on the recommendation given by a VAA into the official electronic ballot paper. If this is possible, e-voting will become more popular than postal voting.

Imaging of the adrenal gland lesions

With the steep increase in the use of cross-sectional imaging in recent years, the incidentally detected adrenal lesion, or "incidentaloma", has become an increasingly common diagnostic problem for the radiologist, and a need for an approach to classifying these lesions as benign, malignant or indeterminate with imaging has spurred an explosion of research. While most incidentalomas represent benign disease, typically an adenoma, the possibility of malignant involvement of the adrenal gland necessitates a reliance on imaging to inform management decisions. In this article, we review the literature on adrenal gland imaging, with particular emphasis on computed tomography, magnetic resonance imaging, and photon-emission tomography, and discuss how these findings relate to clinical practice. Emerging technologies, such as contrast-enhanced ultrasonography, dual-energy computed tomography, and magnetic resonance spectroscopic imaging will also be briefly addressed.

The role of the tourism sector in economic development. Lessons from the Spanish experience

Tourism is one of the most important sectors in the global economy and is considered an efficient tool with which to promote economic growth. The case of Spain¿s economy is well known in this respect; in fact, widespread consensus exists on the part played by tourism in enhancing the industrialisation process in Spain and the part played by foreign currency receipts from tourism in financing the imports of capital goods, which made the expansion of manufacturing possible. This paper aims to assess the real role of foreign currency receipts from tourism in Spain¿s economy from 1960 to the present. The results of Spain¿s experience may well help to guide policy decisions in developing countries in similar circumstances.

The role of the tourism sector in economic development. Lessons from the Spanish experience

Tourism is one of the most important sectors in the global economy and is considered an efficient tool with which to promote economic growth. The case of Spain¿s economy is well known in this respect; in fact, widespread consensus exists on the part played by tourism in enhancing the industrialisation process in Spain and the part played by foreign currency receipts from tourism in financing the imports of capital goods, which made the expansion of manufacturing possible. This paper aims to assess the real role of foreign currency receipts from tourism in Spain¿s economy from 1960 to the present. The results of Spain¿s experience may well help to guide policy decisions in developing countries in similar circumstances.

When decisions of others matter to me: an electrophysiological analysis.

Background: Actions of others may have immediate consequences for oneself. We probed the neural responses associated with the observation of another person"s action using event-related potentials in a modified gambling task. In this task a"performer" bet either a higher or lower number and could win or lose this amount. Three different groups of"observers" were also studied. The first (neutral) group simply observed the performer"s action, which had no consequences for the observers. In the second (parallel) group, wins/losses of the performer were paralleled by similar wins and losses by the observer. In the third (reverse) group, wins of the performer led to a loss of the observer and vice versa. Results: ERPs of the performers showed a mediofrontal feedback related negativity (FRN) to losses. The neutral and parallel observer groups did similarly show an FRN response to the performer"s losses with a topography indistinguishable from that seen in the performers. In the reverse group, however, the FRN occurred for wins of the performer which translated to losses for the observer. Conclusions: Taking into account previous experiments, we suggest that the FRN response in observers is driven by two evaluative processes (a) related to the benefit/loss for oneself and (b) related to the benefit/loss of another person

Assessing functional relations in single-case designs: Quantitative proposals in the context of the evidence-based movement

In the context of the evidence-based practices movement, the emphasis on computing effect sizes and combining them via meta-analysis does not preclude the demonstration of functional relations. For the latter aim, we propose to augment the visual analysis to add consistency to the decisions made on the existence of a functional relation without losing sight of the need for a methodological evaluation of what stimuli and reinforcement or punishment are used to control the behavior. Four options for quantification are reviewed, illustrated, and tested with simulated data. These quantifications include comparing the projected baseline with the actual treatment measurements, on the basis of either parametric or nonparametric statistics. The simulated data used to test the quantifications include nine data patterns in terms of the presence and type of effect and comprising ABAB and multiple baseline designs. Although none of the techniques is completely flawless in terms of detecting a functional relation only when it is present but not when it is absent, an option based on projecting split-middle trend and considering data variability as in exploratory data analysis proves to be the best performer for most data patterns. We suggest that the information on whether a functional relation has been demonstrated should be included in meta-analyses. It is also possible to use as a weight the inverse of the data variability measure used in the quantification for assessing the functional relation. We offer an easy to use code for open-source software for implementing some of the quantifications.

A simulation model of the optimal maintenance strategy: conceptual agent-based approach

In this Master’s thesis agent-based modeling has been used to analyze maintenance strategy related phenomena. The main research question that has been answered was: what does the agent-based model made for this study tell us about how different maintenance strategy decisions affect profitability of equipment owners and maintenance service providers? Thus, the main outcome of this study is an analysis of how profitability can be increased in industrial maintenance context. To answer that question, first, a literature review of maintenance strategy, agent-based modeling and maintenance modeling and optimization was conducted. This review provided the basis for making the agent-based model. Making the model followed a standard simulation modeling procedure. With the simulation results from the agent-based model the research question was answered. Specifically, the results of the modeling and this study are: (1) optimizing the point in which a machine is maintained increases profitability for the owner of the machine and also the maintainer with certain conditions; (2) time-based pricing of maintenance services leads to a zero-sum game between the parties; (3) value-based pricing of maintenance services leads to a win-win game between the parties, if the owners of the machines share a substantial amount of their value to the maintainers; and (4) error in machine condition measurement is a critical parameter to optimizing maintenance strategy, and there is real systemic value in having more accurate machine condition measurement systems.

Competitive advantage through proprietary erp implementation: analysis of the project Väinämö

In the market where companies similar in size and resources are competing, it is challenging to have any advantage over others. In order to stay afloat company needs to have capability to perform with fewer resources and yet provide better service. Hence development of efficient processes which can cut costs and improve performance is crucial. As business expands, processes become complicated and large amount of data needs to be managed and available on request. Different tools are used in companies to store and manage data, which facilitates better production and transactions. In the modern business world the most utilized tool for that purpose is ERP - Enterprise Resource Planning system. The focus of this research is to study how competitive advantage can be achieved by implementing proprietary ERP system in the company; ERP system that is in-house created, tailor made to match and align business needs and processes. Market is full of ERP software, but choosing the right one is a big challenge. Identifying the key features that need improvement in processes and data management, choosing the right ERP, implementing it and the follow-up is a long and expensive journey companies undergo. Some companies prefer to invest in a ready-made package bought from vendor and adjust it according to own business needs, while others focus on creating own system with in-house IT capabilities. In this research a case company is used and author tries to identify and analyze why organization in question decided to pursue the development of proprietary ERP system, how it has been implemented and whether it has been successful. Main conclusion and recommendation of this research is for companies to know core capabilities and constraints before choosing and implementing ERP system. Knowledge of factors that affect system change outcome is important, to make the right decisions on strategic level and implement on operational level. Duration of the project in the case company has lasted longer than anticipated. It has been reported that in cases of buying ready product from vendor, projects are delayed and completed over budget as well. In general, in case company implementation of proprietary ERP has been successful both from business performance figures and usability of system by employees. In terms of future research, conducting a study to calculate statistically ROI of both approaches; of buying ready product and creating own ERP will be beneficial.

Organization of the marketing communication activities after fusion - the integration and the decision making processes

This master’s thesis was made in order to gain answers to the question of how the integration of the marketing communications and the decision making related to it in a geographically dispersed service organization could be improved in a situation where an organization has gone through a merger. The effects of the organizational design dimensions towards the integration of the marketing communications and the decision making related to it was the main focus. A case study as a research strategy offered a perfect frames for an exploratory study and the data collection was conducted by semi-structured interviews and observing. The main finding proved that from the chosen design dimensions, decentralization, coordination and power, could be found specific factors that in a geographically dispersed organization are affecting the integration of the marketing communications negatively. The effects can be seen mostly in the decision making processes, roles and in the division of responsibility, which are affecting the other dimensions and by this, the integration. In a post-merger situation, the coordination dimension and especially the information asymmetry and the information flow seem to have a largest affect towards the integration of the marketing communications. An asymmetric information distribution with the lack of business and marketing education resulted in low self-assurance and at the end in fragmented management and to the inability to set targets and make independent decisions. As conclusions it can be stated, that with the organizational design dimensions can the effects of a merger towards the integration process of the marketing communications to be evaluated.

Effects of internationalization on packaging decisions of manufacturing companies

The world has witnessed a great deal of globalization and a rise in international activities in recent years compared to decades ago. This has contributed to an upsurge in competition among manufacturing firms resulting in the use of different marketing strategies to survive. Packaging is one of the tools that has been used by marketers to make products different and appealing to both local and international customers. The purpose of this research work was to investigate more on packaging as a marketing tool and how internationalization affects the decisions management makes in relation to it. To this effect, a qualitative research was conducted using five manufacturing companies as case studies and data collected through semi-structured interviews and also personal observation. Secondary sources were also used in order to get deeper insight into the case companies under study. The study revealed that there are many advantages that internationalization provides firms. The general revelations made by the firms that were researched did not point to a negative impact of internationalization on their packaging decisions. Internationalization has provided positive improvements on their packaging and made them more competitive. This proves that for packaging decisions to improve better, one key enabler will be exposure to the international environment since it provides a wider array of options for package improvements for firms.

TAKING ADVANTAGE OF THE LOCAL ADVANTAGE? - Investment value of the analyst local advantage in the Finnish stock market in 2006–2014

An investor can either conduct independent analysis or rely on the analyses of others. Stock analysts provide markets with expectations regarding particular securities. However, analysts have different capabilities and resources, of which investors are seldom cognizant. The local advantage refers to the advantage stemming from cultural or geographical proximity to securities analyzed. The research has confirmed that local agents are generally more accurate or produce excess returns. This thesis tests the investment value of the local advantage regarding Finnish stocks via target price data. The empirical section investigates the local advantage from several aspects. It is discovered that local analysts were more focused on certain sectors generally located close to consumer markets. Market reactions to target price revisions were generally insignificant with the exception to local positive target prices. Both local and foreign target prices were overly optimistic and exhibited signs of herding. Neither group could be identified as a leader or follower of new information. Additionally, foreign price change expectations were more in line with the quantitative models and ideas such as beta or return mean reversion. The locals were more accurate than foreign analysts in 5 out of 9 sectors and vice versa in one. These sectors were somewhat in line with coverage decisions and buttressed the idea of local advantage stemming from proximity to markets, not to headquarters. The accuracy advantage was dependent on sample years and on the measure used. Local analysts ranked magnitudes of price changes more accurately in optimistic and foreign analysts in pessimistic target prices. Directional accuracy of both groups was under 50% and target prices held no linear predictive power. Investment value of target prices were tested by forming mean-variance efficient portfolios. Parallel to differing accuracies in the levels of expectations foreign portfolio performed better when short sales were allowed and local better when disallowed. Both local and non-local portfolios performed worse than a passive index fund, albeit not statistically significantly. This was in line with previously reported low overall accuracy and different accuracy profiles. Refraining from estimating individual stock returns altogether produced statistically significantly higher Sharpe ratios compared to local or foreign portfolios. The proposed method of testing the investment value of target prices of different groups suffered from some inconsistencies. Nevertheless, these results are of interest to investors seeking the advice of security analysts.

Omnibus accounts to Finnish investors? – An analysis of the costs and benefits that omnibus account structure brings to Finnish account operators and investors

The Finnish Securities Markets are being harmonized to enable better, more reliable and timely settlement of securities. Omnibus accounts are a common practice in the European securities markets. Finland forbids the use of omnibus accounts from its domestic investors. There is a possibility that the omnibus account usage is allowed for Finnish investors in the future. This study aims to build a comprehensive image to Finnish investors and account operators in determining the costs and benefits that the omnibus account structure would have for them. This study uses qualitative research methods. A literature review provides the framework for this study. Different kinds of research articles, regulatory documents, studies performed by European organisations, and Finnish news reportages are used to analyse the costs and benefits of omnibus accounts. The viewpoint is strictly of account operators and investors, and different effects on them are contemplated. The results of the analysis show that there are a number of costs and benefits that investors and account operators must take into consideration regarding omnibus accounts. The costs are related to development of IT-systems so that participants are able to adapt to the new structure and operate according to its needs. Decrease in the holdings’ transparency is a disadvantage of the structure and needs to be assessed precisely to avoid some problems it might bring. Benefits are mostly related to the increased competition in the securities markets as well as to the possible cost reductions of securities settlement. The costs and benefits were analysed according to the study plan of this thesis and as a result, the significance and impact of omnibus accounts to Finnish investors and account operators depends on the competition level and the decisions that all market participants make when determining if the account structure is beneficial for their operations.

Macroeconomic trouble and policy challenges in the wake of the financial bust

Contrasting with the 1929 great crisis, authorities intervened forcefully in 2008 to stop the disintegration of the financial system. Governments and central banks then sought to revise the prudential regulation in depth. It would be optimistic, however, to believe that prudential measures, alone, could deliver full economic recovery, at least in the countries that had been involved in the financial turmoil. Indeed, the collapse of the "state of confidence" and the negative effects of private debts on consumption and investment decisions have fed depressive forces and policy challenges which could hold for a while, even once the financial sector is made safe. On the one hand, the economic slowdown and the direct and indirect assistance provided by the governments to the private sectors are having a heavy impact on public finances, meanwhile, on the other hand, the massive amounts of money which artificially inflated the prices of housing and financial products could produce inflationary pressures in the post-crisis period, unless a new assets bubble is allowed for. Authorities could therefore be facing high unemployment in a damaged context of public deficits and inflationary pressures. The paper aims at discussing these new challenges. The inadequacy of inflation targets and fiscal orthodoxy in a depressed economy is emphasized, and the outlines of a Post Keynesian alternative policy are examined.