Functional outcome and health-related quality of life after traumatic brain injury in the framework of the International Classification of Functioning, Disability and Health (ICF)

Traumatic brain injury (TBI) affects people of all ages and is a cause of long-term disability. In recent years, the epidemiological patterns of TBI have been changing. TBI is a heterogeneous disorder with different forms of presentation and highly individual outcome regarding functioning and health-related quality of life (HRQoL). The meaning of disability differs from person to person based on the individual s personality, value system, past experience, and the purpose he or she sees in life. Understanding of all these viewpoints is needed in comprehensive rehabilitation. This study examines the epidemiology of TBI in Finland as well as functioning and HRQoL after TBI, and compares the subjective and objective assessments of outcome. The frame of reference is the International Classification of Functioning, Disability and Health (ICF). The subjects of Study I represent the population of Finnish TBI patients who experienced their first TBI between 1991 and 2005. The 55 Finnish subjects of Studies II and IV participated in the first wave of the international Quality of life after brain injury (QOLIBRI) validation study. The 795 subjects from six language areas of Study III formed the second wave of the QOLIBRI validation study. The average annual incidence of Finnish hospitalised TBI patients during the years 1991-2005 was 101:100 000 in patients who had TBI as the primary diagnosis and did not have a previous TBI in their medical history. Males (59.2%) were at considerably higher risk of getting a TBI than females. The most common external cause of the injury was falls in all age groups. The number of TBI patients ≥ 70 years of age increased by 59.4% while the number of inhabitants older than 70 years increased by 30.3% in the population of Finland during the same time period. The functioning of a sample of 55 persons with TBI was assessed by extracting information from the patients medical documents using the ICF checklist. The most common problems were found in the ICF components of Body Functions (b) and Activities and Participation (d). HRQoL was assessed with the QOLIBRI which showed the highest level of satisfaction on the Emotions, Physical Problems and Daily Life and Autonomy scales. The highest scores were obtained by the youngest participants and participants living independently without the help of other people, and by people who were working. The relationship between the functional outcome and HRQoL was not straightforward. The procedure of linking the QOLIBRI and the GOSE to the ICF showed that these two outcome measures cover the relevant domains of TBI patients functioning. The QOLIBRI provides the patients subjective view, while the GOSE summarises the objective elements of functioning. Our study indicates that there are certain domains of functioning that are not traditionally sufficiently documented but are important for the HRQoL of persons with TBI. This was the finding especially in the domains of interpersonal relationships, social and leisure activities, self, and the environment. Rehabilitation aims to optimize functioning and to minimize the experience of disability among people with health conditions, and it needs to be based on a comprehensive understanding of human functioning. As an integrative model, the ICF may serve as a frame of reference in achieving such an understanding.

On duality in linear fractional programming

In this paper, a dual of a given linear fractional program is defined and the weak, direct and converse duality theorems are proved. Both the primal and the dual are linear fractional programs. This duality theory leads to necessary and sufficient conditions for the optimality of a given feasible solution. A unmerical example is presented to illustrate the theory in this connection. The equivalence of Charnes and Cooper dual and Dinkelbach’s parametric dual of a linear fractional program is also established.

Nonnegative integral solution of linear equations

A method to obtain a nonnegative integral solution of a system of linear equations, if such a solution exists is given. The method writes linear equations as an integer programming problem and then solves the problem using a combination of artificial basis technique and a method of integer forms.

A functional style of programming with CSP-like communication mechanisms

This paper introduces CSP-like communication mechanisms into Backus’ Functional Programming (FP) systems extended by nondeterministic constructs. Several new functionals are used to describe nondeterminism and communication in programs. The functionals union and restriction are introduced into FP systems to develop a simple algebra of programs with nondeterminism. The behaviour of other functionals proposed in this paper are characterized by the properties of union and restriction. The axiomatic semantics of communication constructs are presented. Examples show that it is possible to reason about a communicating program by first transforming it into a non-communicating program by using the axioms of communication, and then reasoning about the resulting non-communicating version of the program. It is also shown that communicating programs can be developed from non-communicating programs given as specifications by using a transformational approach.

An efficient algorithm for linear programming

A simple but efficient algorithm is presented for linear programming. The algorithm computes the projection matrix exactly once throughout the computation unlike that of Karmarkar’s algorithm where in the projection matrix is computed at each and every iteration. The algorithm is best suitable to be implemented on a parallel architecture. Complexity of the algorithm is being studied.

Purification and functional characteristics of an endocellulase from Chaetomium thermophile var. coprophile

An endocellulase (1→4)-β-d-glucan 4-glucanohydrolase was isolated from the culture filtrates of Chaetomium thermophile. The enzyme was homogeneous by PAGE and SDS-PAGE. The molecular weight was 36 000 by SDS-PAGE and 38 000 by gel filtration. It was a glycoprotein. From the amino acid composition, it was found to be rich in glycine, threonine, and aspartic and glutamic acids, but contained only low proportions of histidine and sulfur-containing amino acids. It was optimally active at pH 6 and at 60°. The enzyme did not hydrolyze cellobiose and cellotriose, but hydrolyzed cello-tetraose, -pentaose, and -hexaose at comparable rates. It was specific for molecules containing β-(1→4) linkages. It showed high activity towards amorphous cellulose, and the reaction products contained cellobiose to cellopentaose, showing that it effects random cleavage of cellulose.

Functional regulation of the Neurofibromatosis 2 tumor suppressor merlin

Neurofibromatosis 2 (NF2) is an autosomal dominant disorder manifested by the formation of multiple benign tumors of the nervous system. Affected individuals typically develop bilateral vestibular schwannomas which lead to deafness and balance disorders. The syndrome is caused by inactivation of the NF2 tumor suppressor gene, and mutation or loss of the NF2 product, merlin, is sufficient for tumorigenesis in both hereditary and sporadic NF2-associated tumors. Merlin belongs to the band 4.1 superfamily of cytoskeletal proteins, which also contain the related ezrin, radixin, and moesin (ERM) proteins. The ERM members provide a link between the cell cytoskeleton and membrane by connecting membrane-associated proteins to actin filaments. By stabilizing complexes in the cell cortex, the ERMs modulate morphology, growth, and migration of cells. Despite their structural homology, overlapping subcellular distribution, direct molecular association, and partial overlap of molecular interactions, merlin and ezrin exert opposite effects on cell proliferation. Merlin suppresses cell proliferation, whereas ezrin expression is linked to oncogenic activity. We hypothesized that the regions which differ between the proteins might explain merlin s specificity as a tumor suppressor. We therefore analyzed the regions, which are most diverse between merlin and ezrin; the N-terminal tail and the C-terminus. To determine the properties of the C-terminal region, we studied the two most predominant merlin isoforms together with truncation variants similar to those found in patients. We also focused on the evolutionally conserved C-terminal residues, E545-E547, that harbor disease causing mutations in its corresponding DNA sequence. In addition to inhibiting cell proliferation, merlin regulates cytoskeletal organization. The morphogenic properties of merlin may play a role in tumor suppression, since patient-derived tumor cells demonstrate cytoskeletal abnormalities. We analyzed the mechanisms of merlin-induced extension formation and determined that the C-terminal region of amino acids 538-568 is particularly important for the morphogenic activity. We also characterized the role of C-terminal merlin residues in the regulation of proliferation, phosphorylation, and intramolecular associations. In contrast to previous reports, we demonstrated that both merlin isoforms are able to suppress cell proliferation, whereas C-terminally mutated merlin constructs showed reduced growth inhibition. Phosphorylation serves as a mechanism to regulate the tumor suppressive activity of merlin. The C-terminal serine 518 is phosphorylated in response to both p21-activated kinase (PAK) and protein kinase A (PKA), which inactivates the growth inhibitory function of merlin. However, at least three differentially phosphorylated forms of the protein exist. In this study we demonstrated that also the N-terminus of merlin is phosphorylated by AGC kinases, and that both PKA and Akt phosphorylate merlin at serine 10 (S10). We evaluated the impact of this N-terminal tail phosphorylation, and showed that the phosphorylation state of S10 is an important regulator of merlin s ability to modulate cytoskeletal organization but also regulates the stability of the protein. In summary, this study describes the functional effect of merlin specific regions. We demonstrate that both S10 in the N-terminal tail and residues E545-E547 in the C-terminus are essential for merlin activity and function.

An optimal parallel algorithm for sparse matrix bandwidth reduction on a linear array

A simple and efficient algorithm for the bandwidth reduction of sparse symmetric matrices is proposed. It involves column-row permutations and is well-suited to map onto the linear array topology of the SIMD architectures. The efficiency of the algorithm is compared with the other existing algorithms. The interconnectivity and the memory requirement of the linear array are discussed and the complexity of its layout area is derived. The parallel version of the algorithm mapped onto the linear array is then introduced and is explained with the help of an example. The optimality of the parallel algorithm is proved by deriving the time complexities of the algorithm on a single processor and the linear array.

Visuaalisen työmuistin vapaasti jaettavat resurssit : muistiedustusten lukumäärä ja tarkkuus ääriviivakuvioilla

According to the most prevalent view, there are 3-4 fixed "slots" in visual working memory for temporary storage. Recently this view has been challenged with a theory of dynamic resources which are restricted in their totality but can be freely allocated. The aim of this study is to clarify which one of the theories better describes the performance in visual working memory tasks with contour shapes. Thus in this study, the interest is in both the number of recalled stimuli and the precision of the memory representations. Stimuli in the experiments were radial frequency patterns, which were constructed by sinusoidally modulating the radius of a circle. Five observers participated in the experiment and it consisted of two different tasks. In the delayed discrimination task the number of recalled stimuli was measured with 2-interval forced choice task. Observer was shown serially two displays with 1, 5 s ISI (inter stimulus interval). Displays contained 1-6 patterns and they differed from each other with changed amplitude in one pattern. The participant s task was to report whether the changed pattern had higher amplitude in the first or in the second interval. The amount of amplitude change was defined with QUEST-procedure and the 75 % discrimination threshold was measured in the task. In the recall task the precision of the memory representations was measured with subjective adjustment method. First, observer was shown 1-6 patterns and after 1, 5 s ISI one location of the previously shown pattern was cued. Observer s task was to adjust amplitude of a probe pattern to match the amplitude of the pattern in working memory. In the delayed discrimination task the performance of all observes declined smoothly when the number of presented patterns was increased. The result supports the resource theory of working memory as there was no sudden fall in the performance. The amplitude threshold for one item was 0.01 0.05 and as the number of items increased from 1 to 6 there was a 4 15 -fold linear increase in the amplitude threshold (0.14 0.29). In the recall adjustment task the precision of four observers performance declined smoothly as the number of presented patterns was increased. The result also supports the resource theory. The standard deviation for one item was 0.03 0.05 and as the number of items increased from 1 to 6 there was a 2 3 -fold linear increase in the amplitude threshold (0.06 0.11). These findings show that the performance in a visual working memory task is described better according to the theory of freely allocated resources and not to the traditional slot-model. In addition, the allocation of the resources depends on the properties of the individual observer and the visual working memory task.

2-Dimensional Linear-Stability of Premixed Laminar Flames Under Zero-Gravity

This paper reports on the numerical study of the linear stability of laminar premixed flames under zero gravity. The study specifically addresses the dependence of stability on finite rate chemistry with low activation energy and variable thermodynamic and transport properties. The calculations show that activation energy and details of chemistry play a minor role in altering the linear neutral stability results from asymptotic analysis. Variable specific heat makes a marginal change to the stability. Variable transport properties on the other hand tend to substantially enhance the stability from critical wave number of about 0.5 to 0.20. Also, it appears that the effects of variable properties tend to nullify the effects of non-unity Lewis number. When the Lewis number of a single species is different from unity, as will happen in a hydrogen-air premixed flame, the stability results remain close to that of unity Lewis number.

A note on resolving infeasibility in linear programs by constraint relaxation

We study the problem of finding a set of constraints of minimum cardinality which when relaxed in an infeasible linear program, make it feasible. We show the problem is NP-hard even when the constraint matrix is totally unimodular and prove polynomial-time solvability when the constraint matrix and the right-hand-side together form a totally unimodular matrix.

Interruption and Uncooperativeness in Academic ELF Group Work : An Application of Linear Unit Grammar

This study addresses the challenge of analyzing interruption in spoken interaction. It begins with my observation of eight hours of academic group work among speakers of English as a lingua franca (ELF) in a university course. Unlike the common findings of ELF research which underscore the cooperative orientation of ELF users, this particular group gave strong impressions of interruption and uncooperativeness as they prepared a scientific group presentation. In the effort to investigate these impressions, I found that no satisfactory method exists for systematically identifying and analyzing interruptions. A useful tool was found in Linear Unit Grammar or LUG (Sinclair & Mauranen 2006), which analyzes spoken interaction prospectively as linear text. In the course of transcribing one of the early group work meetings, I developed a model of LUG-based criteria for identifying individual instances of interruption. With this system in place, I was then able to evaluate the aggregate occurrences of interruption in the group work and identify co-occurring interactive features which further influenced the perception of uncooperativeness. Finally, these aggregate statistics directed a return to the data and a contextually sensitive, qualitative analysis. This research cycle illuminates the interactive features which contributed to my own impressions of uncooperativeness, as well as the group members orientations to their own interruptive practice.