Treatment deviating from guidelines does not influence status epilepticus prognosis.

Status epilepticus (SE) prognosis is related to nonmodifiable factors (age, etiology), but the exact role of drug treatment is unclear. This study was undertaken to address the prognostic role of treatment adherence to guidelines (TAG). We prospectively studied over 26 months a cohort of adults with incident SE (excluding postanoxic). TAG was assessed in terms of drug doses (± 30 % of recommendations) and medication sequence; its prognostic impact on mortality and return to baseline conditions was adjusted for etiology, SE severity [Status Epilepticus Severity Score (STESS)], and comorbidities. Of 225 patients, 26 (12 %) died and 82 (36 %) were discharged with a new handicap; TAG was observed in 142 (63 %). On univariate analysis, age, etiology, SE severity, and comorbidities were significantly related to outcome, while TAG was associated with neither outcome nor likelihood of SE control. Logistic regression for mortality identified etiology [odds ratio (OR) 18.8, 95 % confidence interval (CI) 4.3-82.8] and SE severity (STESS ≥ 3; OR 1.7, 95 % CI 1.2-2.4) as independent predictors, and for lack of return to baseline, again etiology (OR 7.4, 95 % CI 3.9-14.0) and STESS ≥ 3 (OR 1.7, 95 % CI 1.4-2.2). Similar results were found for the subgroup of 116 patients with generalized-convulsive SE. Receiver operator characteristic (ROC) analyses confirmed that TAG did not improve outcome prediction. This study of a large SE cohort suggests that treatment adherence to recommendations using current medications seems to play a negligible prognostic role (class III), confirming the importance of the biological background. Awaiting further treatment trials, it appears mandatory to apply resources towards identification of new therapeutic approaches.

Factors affecting the adoption of electronic invoicing

Tämän diplomityön tarkoituksena oli selvittää tekijät, jotka vaikuttavat verkkolaskutuksen leviämiseen yrityksissä sekä selvittää verkkolaskutuksen levinneisyys Etelä-Karjalassa. Erityisesti haluttiin selvittää tekijät, jotka hidastavat diffuusiota. Työn teoreettinen osuus esittelee lyhyesti diffuusionkäsitettä; pääpaino on kirjallisuudesta löytyvillä innovaatioiden omaksumiseen vaikuttavilla tekijöillä. Teorian pohjalta muodostettiin 16 hypoteesia, jotka testattiin empiirisessä osassa. Empiirinen aineisto kerättiin eteläkarjalaisilta pk-yrityksiltä postikyselyn avulla. Vastanneet yritykset jaettiin verkkolaskutuksen omaksuneisiin ja ei-omaksuneisiin yrityksiin. Vastanneista yrityksistä 7.5 % käytti verkkolaskutusta. 17.8 % vasta testasi verkkolaskujen lähetystä ja/tai vastaanottamista. Näin ollen 25.3 % yrityksistä oli verkkolaskuominaisuudet tietojärjestelmissään. Suurin osa vastaajista ei ollut tehnyt päätöstä verkkolaskutukseen siirtymisen suhteen. Seitsemän hypoteesia jäi voimaan ja yhdeksän hylättiin.Hypoteesien ulkopuolelta löydettiin lisäksi kaksi tärkeää tekijää, joilla on mahdollisesti vaikutusta verkkolaskutuksen omaksumiseen yrityksissä. Yritykset kokivat, että suurempi painostus yrityksen ulkopuolelta nopeuttaisi penetraatiota, ja toisaalta verkkolaskutusta koskevan informaation määrä on koettu liian alhaiseksi. Työn lopussa esitellään toimenpide-ehdotuksia verkkolaskutuksen leviämisennopeuttamiseksi.

Monitoring System Resources During Automated Testing in Symbian Operating System

Tässä diplomityössä esitellään ohjelmistotestauksen ja verifioinnin yleisiä periaatteita sekä käsitellään tarkemmin älypuhelinohjelmistojen verifiointia. Työssä esitellään myös älypuhelimissa käytettävä Symbian-käyttöjärjestelmä. Työn käytännön osuudessa suunniteltiin ja toteutettiin Symbian-käyttöjärjestelmässä toimiva palvelin, joka tarkkailee ja tallentaa järjestelmäresurssien käyttöä. Verifiointi on tärkeä ja kuluja aiheuttava tehtävä älypuhelinohjelmistojen kehityssyklissä. Kuluja voidaan vähentää automatisoimalla osa verifiointiprosessista. Toteutettu palvelin automatisoijärjestelmäresurssien tarkkailun tallentamalla tietoja niistä tiedostoon testien ajon aikana. Kun testit ajetaan uudestaan, uusia tuloksia vertaillaan lähdetallenteeseen. Jos tulokset eivät ole käyttäjän asettamien virherajojen sisällä, siitä ilmoitetaan käyttäjälle. Virherajojen ja lähdetallenteen määrittäminen saattaa osoittautua vaikeaksi. Kuitenkin, jos ne määritetään sopivasti, palvelin tuottaa hyödyllistä tietoa poikkeamista järjestelmäresurssien kulutuksessa testaajille.

La imagen turística de Barcelona en la comunidad de flickr

Las redes sociales están teniendo un papel trascendental no sólo como fuente para informar y promocionar destinos o planificar viajes, sino también como instrumento para obtener información de los visitantes. El artículo que se presenta a continuación es un estudio sobre los cambios que ha introducido la era digital en la práctica fotográfica, a partir de analizar las fotografías digitales publicadas por los turistas de un destino (concretamente Barcelona) en la red social flickr. Los resultados permiten ver como la irrupción de la fotografía digital ha transformado la imagen del destino

Recursos electrònics amb accés des de dispositius mòbils a les Biblioteques UPC

Infografia que recull recursos d'informació d'interès per a la recerca accessibles des de dispositius mòbils

A methodology to estimate the potential to move inpatient to one day surgery.

BACKGROUND: The proportion of surgery performed as a day case varies greatly between countries. Low rates suggest a large growth potential in many countries. Measuring the potential development of one day surgery should be grounded on a comprehensive list of eligible procedures, based on a priori criteria, independent of local practices. We propose an algorithmic method, using only routinely available hospital data to identify surgical hospitalizations that could have been performed as one day treatment. METHODS: Moving inpatient surgery to one day surgery was considered feasible if at least one surgical intervention was eligible for one day surgery and if none of the following criteria were present: intervention or affection requiring an inpatient stay, patient transferred or died, and length of stay greater than four days. The eligibility of a procedure to be treated as a day case was mainly established on three a priori criteria: surgical access (endoscopic or not), the invasiveness of the procedure and the size of the operated organ. Few overrides of these criteria occurred when procedures were associated with risk of immediate complications, slow physiological recovery or pain treatment requiring hospital infrastructure. The algorithm was applied to a random sample of one million inpatient US stays and more than 600 thousand Swiss inpatient stays, in the year 2002. RESULTS: The validity of our method was demonstrated by the few discrepancies between the a priori criteria based list of eligible procedures, and a state list used for reimbursement purposes, the low proportion of hospitalizations eligible for one day care found in the US sample (4.9 versus 19.4% in the Swiss sample), and the distribution of the elective procedures found eligible in Swiss hospitals, well supported by the literature. There were large variations of the proportion of candidates for one day surgery among elective surgical hospitalizations between Swiss hospitals (3 to 45.3%). CONCLUSION: The proposed approach allows the monitoring of the proportion of inpatient stay candidates for one day surgery. It could be used for infrastructure planning, resources negotiation and the surveillance of appropriate resource utilization.

Electronic Business Model for International Software Market

Tämän diplomityön tavoitteena on muodostaa sähköinen liiketoimintamalli kansainvälisen ohjelmistoyrityksen tarpeisiin. Ohjelmiston uusi ominaisuus antaa kolmansille osapuolille mahdollisuuden määritellä itse rakennusmallintamisessa tarvittavia komponentteja, mikä luo mahdollisuuden uuteen liiketoimintaan. Liiketoimintamallien teoria ja asiantuntijoiden haastattelut tulevat osoittamaan, että paras ratkaisu tässä tapauksessa on portaali, joka rakentuu komponenttimarkkinoista, e-kaupasta ja virtuaaliyhteisöstä. Komponenttimarkkinat on jaettu vapaaseen vaihdantaan ja sertifioitujen kehittäjien kaupankäyntiin. Tämä tarjoaa mahdollisuuksia kehittäjille valita sitoutuneisuutensa taso, samoin kuin motivoi heitä osallistumaan. E-kauppa on suunniteltu sovelluksille ja monimutkaisemmille komponenteille. Virtuaaliyhteisön kautta käyttäjät voivat keskustella mielipiteistään ja saada tukea ohjelmiston käyttämiseen sekä komponenttien kehittämiseen.

Potential Accessibility of Web-based mathematical information resources

This paper presents a research concerning the conversion of non-accessible web pages containing mathematical formulae into accessible versions through an OCR (Optical Character Recognition) tool. The objective of this research is twofold. First, to establish criteria for evaluating the potential accessibility of mathematical web sites, i.e. the feasibility of converting non-accessible (non-MathML) math sites into accessible ones (Math-ML). Second, to propose a data model and a mechanism to publish evaluation results, making them available to the educational community who may use them as a quality measurement for selecting learning material.Results show that the conversion using OCR tools is not viable for math web pages mainly due to two reasons: many of these pages are designed to be interactive, making difficult, if not almost impossible, a correct conversion; formula (either images or text) have been written without taking into account standards of math writing, as a consequence OCR tools do not properly recognize math symbols and expressions. In spite of these results, we think the proposed methodology to create and publish evaluation reports may be rather useful in other accessibility assessment scenarios.

Forecasting coal resources and reserves in heterogeneous coal zones using 3D facies models (As Pontes Basin, NW Spain)

Forecasting coal resources and reserves is critical for coal mine development. Thickness maps are commonly used for assessing coal resources and reserves; however they are limited for capturing coal splitting effects in thick and heterogeneous coal zones. As an alternative, three-dimensional geostatistical methods are used to populate facies distributionwithin a densely drilled heterogeneous coal zone in the As Pontes Basin (NWSpain). Coal distribution in this zone is mainly characterized by coal-dominated areas in the central parts of the basin interfingering with terrigenous-dominated alluvial fan zones at the margins. The three-dimensional models obtained are applied to forecast coal resources and reserves. Predictions using subsets of the entire dataset are also generated to understand the performance of methods under limited data constraints. Three-dimensional facies interpolation methods tend to overestimate coal resources and reserves due to interpolation smoothing. Facies simulation methods yield similar resource predictions than conventional thickness map approximations. Reserves predicted by facies simulation methods are mainly influenced by: a) the specific coal proportion threshold used to determine if a block can be recovered or not, and b) the capability of the modelling strategy to reproduce areal trends in coal proportions and splitting between coal-dominated and terrigenousdominated areas of the basin. Reserves predictions differ between the simulation methods, even with dense conditioning datasets. Simulation methods can be ranked according to the correlation of their outputs with predictions from the directly interpolated coal proportion maps: a) with low-density datasets sequential indicator simulation with trends yields the best correlation, b) with high-density datasets sequential indicator simulation with post-processing yields the best correlation, because the areal trends are provided implicitly by the dense conditioning data.

Guideline adaptation: an approach to enhance efficiency in guideline development and improve utilisation.

BACKGROUND: Developing and updating high-quality guidelines requires substantial time and resources. To reduce duplication of effort and enhance efficiency, we developed a process for guideline adaptation and assessed initial perceptions of its feasibility and usefulness. METHODS: Based on preliminary developments and empirical studies, a series of meetings with guideline experts were organised to define a process for guideline adaptation (ADAPTE) and to develop a manual and a toolkit made available on a website (http://www.adapte.org). Potential users, guideline developers and implementers, were invited to register and to complete a questionnaire evaluating their perception about the proposed process. RESULTS: The ADAPTE process consists of three phases (set-up, adaptation, finalisation), 9 modules and 24 steps. The adaptation phase involves identifying specific clinical questions, searching for, retrieving and assessing available guidelines, and preparing the draft adapted guideline. Among 330 registered individuals (46 countries), 144 completed the questionnaire. A majority found the ADAPTE process clear (78%), comprehensive (69%) and feasible (60%), and the manual useful (79%). However, 21% found the ADAPTE process complex. 44% feared that they will not find appropriate and high-quality source guidelines. DISCUSSION: A comprehensive framework for guideline adaptation has been developed to meet the challenges of timely guideline development and implementation. The ADAPTE process generated important interest among guideline developers and implementers. The majority perceived the ADAPTE process to be feasible, useful and leading to improved methodological rigour and guideline quality. However, some de novo development might be needed if no high quality guideline exists for a given topic.

UniPathway: a resource for the exploration and annotation of metabolic pathways.

UniPathway (http://www.unipathway.org) is a fully manually curated resource for the representation and annotation of metabolic pathways. UniPathway provides explicit representations of enzyme-catalyzed and spontaneous chemical reactions, as well as a hierarchical representation of metabolic pathways. This hierarchy uses linear subpathways as the basic building block for the assembly of larger and more complex pathways, including species-specific pathway variants. All of the pathway data in UniPathway has been extensively cross-linked to existing pathway resources such as KEGG and MetaCyc, as well as sequence resources such as the UniProt KnowledgeBase (UniProtKB), for which UniPathway provides a controlled vocabulary for pathway annotation. We introduce here the basic concepts underlying the UniPathway resource, with the aim of allowing users to fully exploit the information provided by UniPathway.

Working memory load improves early stages of independent visual processing.

Increasing evidence suggests that working memory and perceptual processes are dynamically interrelated due to modulating activity in overlapping brain networks. However, the direct influence of working memory on the spatio-temporal brain dynamics of behaviorally relevant intervening information remains unclear. To investigate this issue, subjects performed a visual proximity grid perception task under three different visual-spatial working memory (VSWM) load conditions. VSWM load was manipulated by asking subjects to memorize the spatial locations of 6 or 3 disks. The grid was always presented between the encoding and recognition of the disk pattern. As a baseline condition, grid stimuli were presented without a VSWM context. VSWM load altered both perceptual performance and neural networks active during intervening grid encoding. Participants performed faster and more accurately on a challenging perceptual task under high VSWM load as compared to the low load and the baseline condition. Visual evoked potential (VEP) analyses identified changes in the configuration of the underlying sources in one particular period occurring 160-190 ms post-stimulus onset. Source analyses further showed an occipito-parietal down-regulation concurrent to the increased involvement of temporal and frontal resources in the high VSWM context. Together, these data suggest that cognitive control mechanisms supporting working memory may selectively enhance concurrent visual processing related to an independent goal. More broadly, our findings are in line with theoretical models implicating the engagement of frontal regions in synchronizing and optimizing mnemonic and perceptual resources towards multiple goals.

FPGA-Based Control Design for Power Electronic Applications

Tehoelektoniikkalaitteella tarkoitetaan ohjaus- ja säätöjärjestelmää, jolla sähköä muokataan saatavilla olevasta muodosta haluttuun uuteen muotoon ja samalla hallitaan sähköisen tehon virtausta lähteestä käyttökohteeseen. Tämä siis eroaa signaalielektroniikasta, jossa sähköllä tyypillisesti siirretään tietoa hyödyntäen eri tiloja. Tehoelektroniikkalaitteita vertailtaessa katsotaan yleensä niiden luotettavuutta, kokoa, tehokkuutta, säätötarkkuutta ja tietysti hintaa. Tyypillisiä tehoelektroniikkalaitteita ovat taajuudenmuuttajat, UPS (Uninterruptible Power Supply) -laitteet, hitsauskoneet, induktiokuumentimet sekä erilaiset teholähteet. Perinteisesti näiden laitteiden ohjaus toteutetaan käyttäen mikroprosessoreja, ASIC- (Application Specific Integrated Circuit) tai IC (Intergrated Circuit) -piirejä sekä analogisia säätimiä. Tässä tutkimuksessa on analysoitu FPGA (Field Programmable Gate Array) -piirien soveltuvuutta tehoelektroniikan ohjaukseen. FPGA-piirien rakenne muodostuu erilaisista loogisista elementeistä ja niiden välisistä yhdysjohdoista.Loogiset elementit ovat porttipiirejä ja kiikkuja. Yhdysjohdot ja loogiset elementit ovat piirissä kiinteitä eikä koostumusta tai lukumäärää voi jälkikäteen muuttaa. Ohjelmoitavuus syntyy elementtien välisistä liitännöistä. Piirissä on lukuisia, jopa miljoonia kytkimiä, joiden asento voidaan asettaa. Siten piirin peruselementeistä voidaan muodostaa lukematon määrä erilaisia toiminnallisia kokonaisuuksia. FPGA-piirejä on pitkään käytetty kommunikointialan tuotteissa ja siksi niiden kehitys on viime vuosina ollut nopeaa. Samalla hinnat ovat pudonneet. Tästä johtuen FPGA-piiristä on tullut kiinnostava vaihtoehto myös tehoelektroniikkalaitteiden ohjaukseen. Väitöstyössä FPGA-piirien käytön soveltuvuutta on tutkittu käyttäen kahta vaativaa ja erilaista käytännön tehoelektroniikkalaitetta: taajuudenmuuttajaa ja hitsauskonetta. Molempiin testikohteisiin rakennettiin alan suomalaisten teollisuusyritysten kanssa soveltuvat prototyypit,joiden ohjauselektroniikka muutettiin FPGA-pohjaiseksi. Lisäksi kehitettiin tätä uutta tekniikkaa hyödyntävät uudentyyppiset ohjausmenetelmät. Prototyyppien toimivuutta verrattiin vastaaviin perinteisillä menetelmillä ohjattuihin kaupallisiin tuotteisiin ja havaittiin FPGA-piirien mahdollistaman rinnakkaisen laskennantuomat edut molempien tehoelektroniikkalaitteiden toimivuudessa. Työssä on myösesitetty uusia menetelmiä ja työkaluja FPGA-pohjaisen säätöjärjestelmän kehitykseen ja testaukseen. Esitetyillä menetelmillä tuotteiden kehitys saadaan mahdollisimman nopeaksi ja tehokkaaksi. Lisäksi työssä on kehitetty FPGA:n sisäinen ohjaus- ja kommunikointiväylärakenne, joka palvelee tehoelektroniikkalaitteiden ohjaussovelluksia. Uusi kommunikointirakenne edistää lisäksi jo tehtyjen osajärjestelmien uudelleen käytettävyyttä tulevissa sovelluksissa ja tuotesukupolvissa.

R&D Performance Analysis: Case Studies on the Challenges and Promotion of the Evaluation and Measurement of R&D

Due to the intense international competition, demanding, and sophisticated customers, and diverse transforming technological change, organizations need to renew their products and services by allocating resources on research and development (R&D). Managing R&D is complex, but vital for many organizations to survive in the dynamic, turbulent environment. Thus, the increased interest among decision-makers towards finding the right performance measures for R&D is understandable. The measures or evaluation methods of R&D performance can be utilized for multiple purposes; for strategic control, for justifying the existence of R&D, for providing information and improving activities, as well as for the purposes of motivating and benchmarking. The earlier research in the field of R&D performance analysis has generally focused on either the activities and considerable factors and dimensions - e.g. strategic perspectives, purposes of measurement, levels of analysis, types of R&D or phases of R&D process - prior to the selection of R&Dperformance measures, or on proposed principles or actual implementation of theselection or design processes of R&D performance measures or measurement systems. This study aims at integrating the consideration of essential factors anddimensions of R&D performance analysis to developed selection processes of R&D measures, which have been applied in real-world organizations. The earlier models for corporate performance measurement that can be found in the literature, are to some extent adaptable also to the development of measurement systemsand selecting the measures in R&D activities. However, it is necessary to emphasize the special aspects related to the measurement of R&D performance in a way that make the development of new approaches for especially R&D performance measure selection necessary: First, the special characteristics of R&D - such as the long time lag between the inputs and outcomes, as well as the overall complexity and difficult coordination of activities - influence the R&D performance analysis problems, such as the need for more systematic, objective, balanced and multi-dimensional approaches for R&D measure selection, as well as the incompatibility of R&D measurement systems to other corporate measurement systems and vice versa. Secondly, the above-mentioned characteristics and challenges bring forth the significance of the influencing factors and dimensions that need to be recognized in order to derive the selection criteria for measures and choose the right R&D metrics, which is the most crucial step in the measurement system development process. The main purpose of this study is to support the management and control of the research and development activities of organizations by increasing the understanding of R&D performance analysis, clarifying the main factors related to the selection of R&D measures and by providing novel types of approaches and methods for systematizing the whole strategy- and business-based selection and development process of R&D indicators.The final aim of the research is to support the management in their decision making of R&D with suitable, systematically chosen measures or evaluation methods of R&D performance. Thus, the emphasis in most sub-areas of the present research has been on the promotion of the selection and development process of R&D indicators with the help of the different tools and decision support systems, i.e. the research has normative features through providing guidelines by novel types of approaches. The gathering of data and conducting case studies in metal and electronic industry companies, in the information and communications technology (ICT) sector, and in non-profit organizations helped us to formulate a comprehensive picture of the main challenges of R&D performance analysis in different organizations, which is essential, as recognition of the most importantproblem areas is a very crucial element in the constructive research approach utilized in this study. Multiple practical benefits regarding the defined problemareas could be found in the various constructed approaches presented in this dissertation: 1) the selection of R&D measures became more systematic when compared to the empirical analysis, as it was common that there were no systematic approaches utilized in the studied organizations earlier; 2) the evaluation methods or measures of R&D chosen with the help of the developed approaches can be more directly utilized in the decision-making, because of the thorough consideration of the purpose of measurement, as well as other dimensions of measurement; 3) more balance to the set of R&D measures was desired and gained throughthe holistic approaches to the selection processes; and 4) more objectivity wasgained through organizing the selection processes, as the earlier systems were considered subjective in many organizations. Scientifically, this dissertation aims to make a contribution to the present body of knowledge of R&D performance analysis by facilitating dealing with the versatility and challenges of R&D performance analysis, as well as the factors and dimensions influencing the selection of R&D performance measures, and by integrating these aspects to the developed novel types of approaches, methods and tools in the selection processes of R&D measures, applied in real-world organizations. In the whole research, facilitation of dealing with the versatility and challenges in R&D performance analysis, as well as the factors and dimensions influencing the R&D performance measure selection are strongly integrated with the constructed approaches. Thus, the research meets the above-mentioned purposes and objectives of the dissertation from the scientific as well as from the practical point of view.

ME - Mobile Electronic Personality

Digital services require personal information for a variety of reasons. Due to advances in communication technology, new types of services are evolving alongwith traditional Internet services. Due to the diversity of services, the traditional approaches to personal information handling designed for Internet services are inadequate. Therefore, new approaches are necessary. In this thesis, a solution where personal information is stored in and accessed from the user's mobile device is presented. This approach is called Mobile Electronic Personality (ME). The ME approach is compared to the existing approaches which rely on a database either at a service, a trusted third party or a client program. Various personal information properties are taken into account in the comparison of storage locations. The thesis presents both the internal and the communication architecture of the ME. The internal architecture defines how the information is stored in the mobile device. The communication architecture defines how the information can be accessed by different types of services from the ME. The use of the architecture is described for services in different environments. A simple ME based solution for the authentication of a user is defined. The authentication of service, which is required to protect the privacy of the users is also presented.