Enhancing the Availability of Electronic Health Records for Secondary Purposes – A Case Study

Due to the sensitive nature of patient data, the secondary use of electronic health records (EHR) is restricted in scientific research and product development. Such restrictions pursue to preserve the privacy of respective patients by limiting the availability and variety of sensitive patient data. Current limitations do not correspond with the actual needs requested by the potential secondary users. In this thesis, the secondary use of Finnish and Swedish EHR data is explored for the purpose of enhancing the availability of such data for clinical research and product development. Involved EHR-related procedures and technologies are analysed to identify the issues limiting the secondary use of patient data. Successful secondary use of patient data increases the data value. To explore the identified circumstances, a case study of potential secondary users and use intentions regarding EHR data was carried out in Finland and Sweden. The data collection for the conducted case study was performed using semi-structured interviews. In total, 14 Finnish and Swedish experts representing scientific research, health management, and business were interviewed. The motivation for the corresponding interviews was to evaluate the protection of EHR data used for secondary purposes. The efficiency of implemented procedures and technologies was analysed in terms of data availability and privacy preserving. The results of the conducted case study show that the factors affecting EHR availability are divided to three categories: management of patient data, preservation of patients' privacy, and potential secondary users. Identified issues regarding data management included laborious and inconsistent data request procedures and the role and effect of external service providers. Based on the study findings, two secondary use approaches enabling the secondary use of EHR data are identified: data alteration and protected processing environment. Data alteration increases the availability of relevant EHR data, further decreasing the value of such data. Protected processing approach restricts the amount of potential users and use intentions while providing more valuable data content.

Evaluation of the antioxidant activity and antitumor activity of marine invertebrates extracts

Dissertação de Mestrado, Biologia Marinha, Faculdade de Ciências e Tecnologias, Universidade do Algarve, 2014

Is there a need for “healthy” chocolate? Systematic literature review

Antecedentes: El chocolate tiene propiedades especiales que ayudan a proteger el cuerpo humano de enfermedades cardiovasculares, incrementa el colesterol HDL y reduce la presión sanguínea. El consumo de chocolate también ayuda a reducir el estrés, eleva el ´animo y reduce el cansancio. El propósito de esta revisión es identificar, seleccionar, organizar y resumir estudios que investiguen el chocolate en relación con la salud, las características sensoriales y las actitudes de las personas. Este artículo es parte de la tesis de maestría: Is there a need for “healthy” chocolate? Systematic literature review and consumer research in Belgium and in Denmark (Es necesario el chocolate “saludable”? Revisión sistemática de la literatura y estudio al consumidor en Bélgica y Dinamarca), presentada por la autora en Junio del 2015 a la Universidad de Aalborg en Copenhague. Métodos: Este estudio presenta tres áreas relacionadas con el chocolate: Chocolate y su relación con la salud; características sensoriales y aceptación del chocolate; y actitudes hacia el chocolate. Una revisión sistemática de la literatura fue realizada para identificar, seleccionar, organizar y resumir estudios que investiguen al chocolate en relación con estas tres áreas. Cuatro bases de datos fueron escogidas: PubMed, Science Direct, Scopus y Web of Science por sus extensiones y porque superponen investigaciones interdisciplinarias.Resultados: Se obtuvieron un total de 2062 hits en las cuatro bases de datos. Un total de sesenta artículos cumplieron los criterios y fueron identificados como relevantes. Los artículos fueron clasificados de acuerdo a las tres áreas incluidas en el estudio. En relación a la salud, se ha indicado en muchos estudios que los polifenoles en el chocolate pueden mejorar la salud, especialmente en enfermedades cardiovasculares. De acuerdo a las características sensoriales y aceptación del chocolate, se ha dicho que la forma del chocolate tiene una influencia en la percepción del mismo. Los polifenoles causan astringencia y amargor al chocolate, haciéndolo no muy apetecido para los consumidores; sin embargo, por razones de salud, los polifenoles deben ser conservados. Acerca de las actitudes hacia el chocolate, hay muchos factores que llevan al deseo incontrolable de consumir chocolate. El chocolate es el alimento más apetecido en Norte América, éste influencia el estado anímico y crea una sensación de saciedad. Conclusión: Con base en esta revisión se puede concluir que un chocolate “saludable” puede ser parte de una dieta saludable, a la gente le gusta disfrutar del chocolate, mujeres más que hombres. La literatura respalda las propiedades saludables que tiene el consumo del chocolate, por esto es necesario trabajar en el desarrollo de productos de chocolate.

Essays on competition in the pharmaceutical industry

Chapter 1: Patents and Entry Competition in the Pharmaceutical Industry: The Role of Marketing Exclusivity. Effective patent length for innovation drugs is severely curtailed because of extensive efficacy and safety tests required for FDA approval, raising concern over adequacy of incentives for new drug development. The Hatch-Waxman Act extends patent length for new drugs by five years, but also promotes generic entry by simplifying approval procedures and granting 180-day marketing exclusivity to a first generic entrant before the patent expires. In this paper we present a dynamic model to examine the effect of marketing exclusivity. We find that marketing exclusivity may be redundant and its removal may increase generic firms' profits and social welfare. ^ Chapter 2: Why Authorized Generics?: Theoretical and Empirical Investigations Facing generic competition, the brand-name companies some-times launch generic versions themselves called authorized generics. This practice is puzzling. If it is cannibalization, it cannot be profitable. If it is divisionalization, it should be practiced always instead of sometimes. I explain this phenomenon in terms of switching costs in a model in which the incumbent first develops a customer base to ready itself against generic competition later. I show that only sufficiently low switching costs or large market size justifies launch of AGs. I then use prescription drug data to test those results and find support. ^ Chapter 3: The Merger Paradox and R&D Oligopoly theory says that merger is unprofitable, unless a majority of firms in industry merge. Here, we introduce R&D opportunities to resolve this so-called merger paradox. We have three results. First, when there is one R&D firm, that firm can profitably merge with any number of non-R&D firms. Second, with multiple R&D firms and multiple non-R&D firms, all R&D firms can profitably merge. Third, with two R&D firms and two non-R&D firms, each R&D firms prefer to merge with a non-R&D firm. With three or more than non-R&D firms, however, the R&D firms prefer to merge with each other.^

Management of industrialization projects

Short time-to-market is a key success factor in the todays’ dynamic business environment and many companies are trying to improve their product development processes. A challenge is to develop products according to the time plan and at the same time keeping the cost low and the quality high. This study focuses on the project management within the product development process in an automotive industry. The background of this study started as a request from the research and development department at the automotive company, which led to the following questions; 1) what are the most crucial factors for project success? 2) How can these factors contribute to a more successful outcome? 3) How can project management decrease product development lead time by sharing knowledge? The research approach is a case study and the data collection consist of interviews and questioners at two companies connected to project management in product development projects. Spider charts are created from the collected data containing eleven dimensions to show similarities and differences between the project managers working within the research and development department as well as between the two companies. The main conclusions are that there is a need to allow a certain level of flexibility when managing projects, in order to more easily handle late changes. Being involved in a project from the concept phase could facilitate the product development activities later on, due to a deeper understanding regarding previous decisions. Further, knowledge sharing methods, such as databases, has to be designed to be suitable for a specific organization and user friendly which enables the users to more easily search for specific types of knowledge. Lastly, a low level on the detailed focus is shown to be another success factor, however, in some cases there is still a need of this detailed focus to solve specific problems but the details may never become a higher focus than the holistic view.

Plan de medios y posicionamiento digital

El principal objetivo de este trabajo de grado ha sido diseñar un plan estratégico de medios digitales para el lanzamiento de un nuevo producto para una compañía. En este trabajo, se han establecido parámetros como presupuesto, qué tipos de medios digitales serán usados y el porqué de ellos, se estableció las actividades por cada red social a usar y se muestra la relación costo – beneficio de realizar pauta publicitaria en redes sociales.

Prognostic significance of pulmonary multifocal neuroendocrine proliferation with typical carcinoid

Background. Clinical significance of multifocal pulmonary neuroendocrine proliferations (MNEP), including tumorlets and pulmonary neuroendocrine cell hyperplasia, in association with Typical Carcinoid (TC), is still debated. Methods. A large retrospective series of TC with long-term follow-up data prospectively collected from two institutions was evaluated. Recurrence or new TC development was followed-up. Patients with TC alone and MNEP+TC were compared. Results. 234 TC patients undergone surgery were included: 41 MNEP+TC (17.5%) and 193 TC alone (82.5%). In the MNEP+TC group older age (p<0.001), peripheral tumors (p=0.0032), smaller tumor size (p=0.011) and lymph-nodal spread (p=0.02) were observed in comparison with TC group. Relapses occurred in 8 patients (19.5%) in the MNEP+TC group and in 7 (3.6%) of the TC group. The 10-years progression-free survival were 96.1% in TC and 83.8% in MNEP+TC (p<0.001). After matching, in 36 pairs of patients a significantly higher 5-years progression-free survival was calculated for TC group (p<0.01). Furthermore the odds of belonging to MNEP+TC group was higher with work-related exposure to inhalant agents (p=0.008), asthma/bronchitis (p=0.002), emphysema, fibrosis and inflammatory status (p=0.032), micronodules on the chest CT scan and respiratory insufficiency (p=0.036). Conclusions. The identification of MNEP requires careful pathological examination and postoperative follow-up. MNEP seems to be an adverse prognostic factor in patients with synchronous TC. Therefore, suspicion of MNEP during the pre-operative assessment should not be underestimated, enabling changes in the surgical strategy.

In-car sound linear simulation

In recent years, vehicle acoustics have gained significant importance in new car development: increasingly advanced infotainment systems for spatial audio and sound enhancement algorithms have become the norm in modern vehicles. In the past, car manufacturers had to build numerous prototypes to study the sound behaviour inside the car cabin or the effect of new algorithms under development. Nowadays, advanced simulation techniques can reduce development costs and time. In this work, after selecting the reference test vehicle, a modern luxury sedan equipped with a high-end sound system, two independent tools were developed: a simulation tool created in the Comsol Multiphysics environment and an auralization tool developed in the Cycling ‘74 MAX environment. The simulation tool can calculate the impulse response and acoustic spectrum at a specific position inside the cockpit. Its input data are the vehicle’s geometry, acoustic absorption parameters of materials, the acoustic characteristics and position of loudspeakers, and the type and position of virtual microphones (or microphone arrays). The simulation tool can also provide binaural impulse responses thanks to Head Related Transfer Functions (HRTFs) and an innovative algorithm able to compute the HRTF at any distance and angle from the head. Impulse responses from simulations or acoustic measurements inside the car cabin are processed and fed into the auralization tool, enabling real-time interaction by applying filters, changing the channels gain or displaying the acoustic spectrum. Since the acoustic simulation of a vehicle involves multiple topics, the focus of this work has not only been the development of two tools but also the study and application of new techniques for acoustic characterization of the materials that compose the cockpit and the loudspeaker simulation. Specifically, three different methods have been applied for material characterization through the use of a pressure-velocity probe, a Laser Doppler Vibrometer (LDV), and a microphone array.

Towards the circularity of outdoor lighting systems

In recent years, there has been increasing attention to lighting energy efficiency, due to economics - lower energy costs - and environmental reasons - maninduced climate change. Driven by strict energy-efficiency requirements, the lighting industry started to replace the traditional lamps with LED lighting solutions, ignoring the limits of their maintenance and recycling. Faced with an increasing global population, rising resource consumption and associated negative environmental impacts, shifting from a traditional economic linear model to a more sustainable paradigm of growth is now becoming increasingly urgent. Whereas the topic of circular economy has been widely investigated in literature in the past, little attention has been reserved for the different evaluation tools to assess and improve product circularity and how companies can become more resource-efficient. Hence, the present thesis investigates the implementation of a circular economy in the lighting industry through the use of circularity indicators and ecodesign strategies. Concerning the real luminaire products, the role of the luminaire in the circular economy and recycling industry is explored, highlighting the limits of their End-of-life process. The main conclusions of the thesis reveal the significance of initial product development, reuse, remanufacturing and repair strategies in a transition towards a circular economy.

Development of a New Welding Product Quality Control and Management System Model for China

The Chinese welding industry is growing every year due to rapid development of the Chinese economy. Increasingly, companies around the world are looking to use Chinese enterprises as their cooperation partners. However, the Chinese welding industry also has its weaknesses, such as relatively low quality and weak management. A modern, advanced welding management system appropriate for local socio-economic conditions is required to enable Chinese enterprises to enhance further their business development. The thesis researches the design and implementation of a new welding quality management system for China. This new system is called ‗welding production quality control management model in China‘ (WQMC). Constructed on the basis of analysis of a survey and in-company interviews, the welding management system comprises the following different elements and perspectives: a ‗Localized congenital existing problem resolution strategies‘ (LCEPRS) database, a ‗human factor designed training system‘ (HFDT) training strategy, the theory of modular design, ISO 3834 requirements, total welding management (TWM), and lean manufacturing (LEAN) theory. The methods used in the research are literature review, questionnaires, interviews, and the author‘s model design experiences and observations, i.e. the approach is primarily qualitative and phenomenological. The thesis describes the design and implementation of a HFDT strategy in Chinese welding companies. Such training is an effective way to increase employees‘ awareness of quality and issues associated with quality assurance. The study identified widely existing problems in the Chinese welding industry and constructed a LCEPRS database that can be used in efforts to mitigate and avoid common problems. The work uses the theory of modular design, TWM and LEAN as tools for the implementation of the WQMC system.

Development of new methodologies in sample treatment for proteomics workflow based on enzymatic probe sonication technology and mass spectrometry

Thesis submitted to the Universidade Nova de Lisboa, Faculdade de Ciências e Tecnologia, for the degree of Doctor of Philosophy in Biochemistry

Propolis: A complex natural product with a plethora of biological activities that can be explored for drug development

The health industry has always used natural products as a rich, promising, and alternative source of drugs that are used in the health system. Propolis, a natural resinous product known for centuries, is a complex product obtained by honey bees from substances collected from parts of different plants, buds, and exudates in different geographic areas. Propolis has been attracting scientific attention since it has many biological and pharmacological properties, which are related to its chemical composition. Several in vitro and in vivo studies have been performed to characterize and understand the diverse bioactivities of propolis and its isolated compounds, as well as to evaluate and validate its potential. Yet, there is a lack of information concerning clinical effectiveness. The goal of this review is to discuss the potential of propolis for the development of new drugs by presenting published data concerning the chemical composition and the biological properties of this natural compound from different geographic origins.

Introducing biomimetic approaches to materials development and product design for engineering students

In this paper, we present a new course entitled “Biomimicry: from life to nanotechnological innovations” at the Mines Nancy Engineering School, Nancy, France, and explain how we developed a specific curriculum covering biomimicry. We discuss strategies that can be followed by teachers to explain selected contents in the multi-disciplinary field of biomimicry and/or bioinspiration to undergraduate students and how practical classroom activities can be conducted as individual or team work. We hope that sharing our experience will help teachers and senior researchers disseminate useful concepts and real examples of biomimetic principles and tools for the development of new materials, new/improved design and fabrication strategies, and innovation methodologies.

The new final Clinical Skills examination in human medicine in Switzerland: Essential steps of exam development, implementation and evaluation, and central insights from the perspective of the national Working Group.

OBJECTIVE: Since 2011, the new national final examination in human medicine has been implemented in Switzerland, with a structured clinical-practical part in the OSCE format. From the perspective of the national Working Group, the current article describes the essential steps in the development, implementation and evaluation of the Federal Licensing Examination Clinical Skills (FLE CS) as well as the applied quality assurance measures. Finally, central insights gained from the last years are presented. METHODS: Based on the principles of action research, the FLE CS is in a constant state of further development. On the foundation of systematically documented experiences from previous years, in the Working Group, unresolved questions are discussed and resulting solution approaches are substantiated (planning), implemented in the examination (implementation) and subsequently evaluated (reflection). The presented results are the product of this iterative procedure. RESULTS: The FLE CS is created by experts from all faculties and subject areas in a multistage process. The examination is administered in German and French on a decentralised basis and consists of twelve interdisciplinary stations per candidate. As important quality assurance measures, the national Review Board (content validation) and the meetings of the standardised patient trainers (standardisation) have proven worthwhile. The statistical analyses show good measurement reliability and support the construct validity of the examination. Among the central insights of the past years, it has been established that the consistent implementation of the principles of action research contributes to the successful further development of the examination. CONCLUSION: The centrally coordinated, collaborative-iterative process, incorporating experts from all faculties, makes a fundamental contribution to the quality of the FLE CS. The processes and insights presented here can be useful for others planning a similar undertaking.