Addition of MR imaging features and genetic biomarkers strengthens glioblastoma survival prediction in TCGA patients.

PURPOSE: The purpose of our study was to assess whether a model combining clinical factors, MR imaging features, and genomics would better predict overall survival of patients with glioblastoma (GBM) than either individual data type. METHODS: The study was conducted leveraging The Cancer Genome Atlas (TCGA) effort supported by the National Institutes of Health. Six neuroradiologists reviewed MRI images from The Cancer Imaging Archive (http://cancerimagingarchive.net) of 102 GBM patients using the VASARI scoring system. The patients' clinical and genetic data were obtained from the TCGA website (http://www.cancergenome.nih.gov/). Patient outcome was measured in terms of overall survival time. The association between different categories of biomarkers and survival was evaluated using Cox analysis. RESULTS: The features that were significantly associated with survival were: (1) clinical factors: chemotherapy; (2) imaging: proportion of tumor contrast enhancement on MRI; and (3) genomics: HRAS copy number variation. The combination of these three biomarkers resulted in an incremental increase in the strength of prediction of survival, with the model that included clinical, imaging, and genetic variables having the highest predictive accuracy (area under the curve 0.679±0.068, Akaike's information criterion 566.7, P<0.001). CONCLUSION: A combination of clinical factors, imaging features, and HRAS copy number variation best predicts survival of patients with GBM.

EsPal: One-stop shopping for Spanish word properties

This article introduces EsPal: a Web-accessible repository containing a comprehensive set of properties of Spanish words. EsPal is based on an extensible set of data sources, beginning with a 300 million token written database and a 460 million token subtitle database. Properties available include word frequency, orthographic structure and neighborhoods, phonological structure and neighborhoods, and subjective ratings such as imageability. Subword structure properties are also available in terms of bigrams and trigrams, bi-phones, and bi-syllables. Lemma and part-of-speech information and their corresponding frequencies are also indexed. The website enables users to either upload a set of words to receive their properties, or to receive a set of words matching constraints on the properties. The properties themselves are easily extensible and will be added over time as they become available. It is freely available from the following website: http://www.bcbl.eu/databases/espal

Publication trends of shared decision making in 15 high impact medical journals: a full-text review with bibliometric analysis.

BACKGROUND: Shared Decision Making (SDM) is increasingly advocated as a model for medical decision making. However, there is still low use of SDM in clinical practice. High impact factor journals might represent an efficient way for its dissemination. We aimed to identify and characterize publication trends of SDM in 15 high impact medical journals. METHODS: We selected the 15 general and internal medicine journals with the highest impact factor publishing original articles, letters and editorials. We retrieved publications from 1996 to 2011 through the full-text search function on each journal website and abstracted bibliometric data. We included publications of any type containing the phrase "shared decision making" or five other variants in their abstract or full text. These were referred to as SDM publications. A polynomial Poisson regression model with logarithmic link function was used to assess the evolution across the period of the number of SDM publications according to publication characteristics. RESULTS: We identified 1285 SDM publications out of 229,179 publications in 15 journals from 1996 to 2011. The absolute number of SDM publications by journal ranged from 2 to 273 over 16 years. SDM publications increased both in absolute and relative numbers per year, from 46 (0.32% relative to all publications from the 15 journals) in 1996 to 165 (1.17%) in 2011. This growth was exponential (P < 0.01). We found fewer research publications (465, 36.2% of all SDM publications) than non-research publications, which included non-systematic reviews, letters, and editorials. The increase of research publications across time was linear. Full-text search retrieved ten times more SDM publications than a similar PubMed search (1285 vs. 119 respectively). CONCLUSION: This review in full-text showed that SDM publications increased exponentially in major medical journals from 1996 to 2011. This growth might reflect an increased dissemination of the SDM concept to the medical community.

PGW-linjan käyttövarmuuden ja kunnossapidon tehokuuden parantaminen kiinteällä kunnonvalvonnalla

Tämän diplomityön lähtökohtana on tutkia kiinteän kunnonvalvonnan ja ehkäisevän kunnossapidon edellytyksiä ja mahdollisuuksia Anjalan Paperitehtaan painehiomossa. Työn tavoitteena on kunnossapidon kustannustehokkuuden parantaminen ja häiriöaikojen vähentäminen ja sitä kautta koko tuotantoprosessin tuottavuuden nostaminen. Työn alussa tarkastellaan tämänhetkisiä prosessilaitteiston häiriötekijöitä ja kunnossapidon vaikutusmahdollisuuksia häiriöiden korjaukseen ja kustannuksiin. Tarkastelun perusteella päädyttiin painehiomossa ehkäisevän kunnossapidon määrän nostamiseen ja kiinteän kunnonvalvontajärjestelmän käyttöönottoon H4-linjalla. Jatkuvatoimisen kunnonvalvonnan edut tutkimuksen ja teorian perusteella ovat laitteiden käyttövarmuuden olennainen paraneminen ja kunnossapitokustannusten aleneminen. Työn kokeellisen osan perusteella kunnossapitokustannukset alenivat noin 24 % ja käytettävyyden tehostumisen johdosta laitehäiriöt alenivat 50 %:lla. Tulokset saatiin aikaan toteuttamalla suunnitellut ehkäisevät huollot kriittisille laitteille. Kiinteä kunnonvalvonta antoi kunnossapidolle tiedon laitteiden oikea-aikaisesta huoltovälistä. Investoinnin hyödyt saatiin täysmääräisesti käyttöön jo laitteiston ensimmäisen käyttövuoden aikana. Henkilöstön osaamiskapasiteetin nosto tulee vielä lisäämään edellä mainittuja hyötyjä.

Choosing a platform for a billing system

Enterprises have a need in use of billing. Before actual choose of a billing system an appropriate platform has to be deployed. This work presents a study of a platform choosing for a billing system and shows the role of optimally chosen platform. In evaluation of a platform several criteria were considered: cost, scalability, reliability, safety, usability, portability and efficiency. In the thesis three different platforms MAC OS, Linux and MS Windows were studied. The results of the evaluation of each platform are shown and according to this results the most suitable platform for a billing system was chosen.

The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) statement.

Routinely collected health data, obtained for administrative and clinical purposes without specific a priori research goals, are increasingly used for research. The rapid evolution and availability of these data have revealed issues not addressed by existing reporting guidelines, such as Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). The REporting of studies Conducted using Observational Routinely collected health Data (RECORD) statement was created to fill these gaps. RECORD was created as an extension to the STROBE statement to address reporting items specific to observational studies using routinely collected health data. RECORD consists of a checklist of 13 items related to the title, abstract, introduction, methods, results, and discussion section of articles, and other information required for inclusion in such research reports. This document contains the checklist and explanatory and elaboration information to enhance the use of the checklist. Examples of good reporting for each RECORD checklist item are also included herein. This document, as well as the accompanying website and message board (http://www.record-statement.org), will enhance the implementation and understanding of RECORD. Through implementation of RECORD, authors, journals editors, and peer reviewers can encourage transparency of research reporting.

Guideline adaptation: a methodology to enhance efficiency in guideline development and improve utilization.

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.

Performance Management of a Next Generation Network

Today's communication networks consist of numerous interdependent network components. To manage these networks and to ensure their reliable and efficient operation to meet the increasing customer usability demands, extensive network management tools are required from the service provider. The goal of this study was to adapt the Next Generation Network (NGN) providing VoIP services within a performance oriented network management system. This study focuses only on NGN network and the project was implemented as an assignment of the Network Operations Center of Elisa Corporation. The theoretical part of this study introduces the network environment of the Elisa NGN platform: its components and used signalling protocols as well as other exploitable communication protocols. In addition, the Simple Network Management Protocol (SNMP) is closely examined since it is commonly used as the basis of IP (Internet Protocol) network management. Also some primary applications enabled by the NGN technology are introduced. The empirical part of this study contains a short overview of the implemented network performance management system and its properties. The most crucial monitored MIB modules, SNMP parameters and implemented performance measurements are described. The trap topology and the role of the traps for management of the NGN platform are considered and finally, the conclusion based on the several disquisitions is made supported with suggestions for future improvements.

Ikäihminen tietokoneen käyttäjänä : Nettirohkeus-kurssien sisällön ja opetusmenetelmien kehittäminen

Opinnäytetyöni koostuu Kontupisteen Nettirohkeus-kurssien uudistetusta kurssirungosta sekä kirjallisesta osasta, johon kuuluu alkuperäisten Nettirohkeus-kurssien kenttähavainnointituloksien sekä uudistetun kurssirungon käytettävyystestauksen tulosten raportointi. Opinnäytetyön teososa, Nettirohkeus-kurssien uudistettu kurssirunko sisältää tutkimuksen avulla aikaansaadun johdonmukaisemman rakenteen sekä uusia yksityiskohtia opetuksessa, joita ei alkuperäisellä kurssilla ollut otettu huomioon. Uudistettu kurssirunko on kehitetty havainnoimalla alkuperäisen kurssin opetusta ja myöhemmin korjaamalla käytettävyystestauksessa havaitut puutteet ja epäkohdat. Nettirohkeus-kursseja on järjestetty Kontulassa sijaitsevan Kontupisteen tiloissa. Kontupiste on Lasipalatsin Mediakeskus Oy:n hanke, jonka tavoitteisiin kuuluu uusien helposti lähestyttävien palvelukonseptien kehittäminen tietoyhteiskunnan arkisiin tarpeisiin. Kurssit on tarkoitettu kaikille tietokoneenkäytön aloittelijoille, mutta koska tutkimuksen kohteena olleen vuoden 2007 syksyn kurssien kaikki oppilaat olivat iäkkäämpiä ihmisiä, tutkimuksessa käsitellään ikäihmisiä tietokoneen ja Internetin käytön oppijoina. Internetin ja tietokoneen käyttö ovat tärkeitä taitoja kansalaisille alati kehittyvässä tietoyhteiskunnassa. Tämän päivän ikäihmiset ovat tottuneet käyttämään henkilökohtaisia asiakaspalveluita arjessaan, eivätkä ole saaneet koulutusta tietotekniikan käyttöön saatika kasvaneet lapsesta tietotekniikan kehityksen mukana. Teososan uudistettu kurssirunko vastaa tutkimuksen avulla löytyneiden erityisvaatimuksien mukaista rakennetta.

Suomen esihistoria Museoviraston ja maakuntamuseoiden WWW-sivuilla : informaatiosta elämyksiin

Tässä opinnäytetyössä tutkitaan, millaisia keinoja Suomen esihistoriaa käsittelevillä virallisilla Internet-sivuilla on käytetty aiheen houkuttelevaksi ja kiehtovaksi tekemiseen sekä ehdotetaan keinoja, joilla houkuttelevuutta ja kiehtovuutta voisi edesauttaa. Tutkimuksen innoittajana on näkemys, jonka mukaan suomalaisten keskimäärin pitäisi tuntea esihistoriansa ja muinaisjäännöksiä suojelevat säädökset nykyistä paremmin. Internet olisi luonteva väylä yleisen tietämyksen lisäämiseen näistä aiheista. Tutkimuksessa käytetyt kriteerit pohjautuvat käytettävyyttä ja esteettömyyttä, edutaimentia sekä elämyksellisyyttä koskevaan teoriatietoon samoin kuin pienimuotoisen, vastaajien Internet-sivuja koskevia mieltymyksiä kartoittaneen kyselyn tuloksiin. Työn alussa määritellään siinä esiintyvät termit ja käytetyt tutkimuskriteerit. Sen jälkeen tutkitaan näiden kriteerien mukaan Museoviraston ja maakuntamuseoiden esihistoria-aiheiset www-sivut. Lopuksi esitetään yhteenveto tutkimuksen tuloksista sekä ideoita siitä, miten esihistoriasta kertovista verkkototeutuksista saataisiin houkuttelevampia, kiehtovampia ja elämyksellisempiä. Tutkimus osoitti, että Museoviraston ja maakuntamuseoiden WWW-sivuilla on paljon kehittämisen varaa, vaikka ne peruskäytettävyydeltään ovat pääosin mainioita. Havainnollistusta, orientointia ja muita kiehtovuutta lisääviä keinoja käyttäen niistä olisi kuitenkin mahdollista saada huomattavasti nykyistä houkuttelevampia, viihdyttävämpiä ja elämyksellisempiä.

Kuluttajien suhtautuminen aikakauslehden brändiin ja brändin persoonallisuuteen

Pro gradun tarkoituksena oli tutkia kuluttajien suhtautumista kolmen kuluttajille suunnatun aikakauslehden brändiin ja brändin persoonallisuuteen. Tutkimuksen kohteena olevat aikakauslehdet olivat naisille suunnattu, nuorille suunnattu sekä tekniikkaan keskittynyt aikakauslehti. Tässä tutkimuksessa käytettiin kvalitatiivista tutkimusmenetelmää. Sisällön erittelyn avulla tutkittiin eroja kuluttajien suhtautumisessa eri aikakauslehtibrändien ollessa kyseessä. Kuluttajien mielipiteitä aikakauslehtibrändin persoonallisuudesta selvitettiin aikakauslehtien verkkosivuilla olleen kyselytutkimuksen avulla, jonka tuloksia analysoitiin korrespondenssianalyysissä. Korrespondenssianalyysissä kvantifioitiin kvalitatiivista aineistoa. Aikakauslehtikustantajien mielipiteitä aikakauslehden brändistä tutkittiin aikakauslehtien verkkosivujen sisällön kautta. Kuluttajat näkivät aikakausilehtien brändeissä eri persoonallisuuksien piirteitä. Syyt kuluttajien suhtautumisessa eri aikakauslehtibrändeihin johtuvat pikemminkin eri kohderyhmistä kuin kustantajan rakentamista eroista. Kustantajien ja kuluttajien mielipiteet brändin persoonallisuudesta olivat naisille suunnatussa lehdessä hyvin yhtenevät, kun taas tekniikkaan suuntautunut lehti kärsi epäselvästä brändistä.

Die Konstruktion einer medizinischen Disziplin und ihre Herausforderungen: die Orthopädie in der Schweiz im 19. und 20. Jahrhundert [The construction of a medical discipline and its challenges: Orthopedics in Switzerland during the 19th and 20th centuries].

(ENGLISH VERSION BELOW) Dieser Beitrag fügt sich in eine post-doktorale Forschung über die Geschichte der Orthopädie ein, die unter dem Mandat des Centre Hospitalier Universitaire Vaudois (CHUV) geleitet wird und teilerweise auf die Archiv der Schweizerischen Gesellschaft für Orthopädie (aktuelle Swiss Orthopaedics) beruht. Die Autorin untersucht die Herausforderungen, welche die Geschichte der Orthopädie in der Schweiz prägten und berücksichtigt dabei die Anpassungsstrategien einer medizinischen und technischen Disziplin in einer sich wandelnden Gesellschaft. Zusammenfassung der Beitrag und Informationen auf der Website der Zeitschrift: http://econtent.hogrefe.com/toc/tum/72/7 This article is inspired by a post-doctorale research about the history of orthopedics, mandated by the Centre Hospitalier Universitaire Vaudois (CHUV), and partly supported by the Archiv of the Swiss Society of Orthopedics (nowadays Swiss Orthopaedics). By examining the implications that have shaped the history of orthopedics in Switzerland, the author seeks to shed light on the strategies that were implemented in adopting a medical and technical discipline within a transforming society. Summary of the article and information on the journal's website: http://econtent.hogrefe.com/toc/tum/72/7

Educational resources offered by the European Board of Physical and Rehabilitation Medicine (EBPRM)

Background .- Physical and Rehabilitation Medicine (PRM) is a very demanding medical speciality. To ensure high standard of research and care in PRM all across Europe, it is crucial to attract gifted trainees and offer them high quality education. At undergraduate level, many medical schools in Europe omit to offer teaching on disabled persons and on basic PRM knowledge. Thus PRM is hardly known to medical students. For postgraduate trainees access to evidence-based knowledge as well as teaching of research methodology specific to PRM, rehabilitation methodology, disability management and team building also need to be strengthened to increase the visibility of PRM. Action .- To address these issues the EBPRM proposes presently a specific undergraduate curriculum in PRM including the issues of disability, participation and handicap as a basis for general medical practice and postgraduate rehabilitation training. For PRM trainees many educational documents are now available on the EBPRM website. A growing number of educational sessions for PRM trainees take place during international and national PRM Congresses which can be accessed at low cost. Educational papers published regularly in European rehabilitation journals and European PRM Schools are offered free or at very low cost to trainees.

Identification of imaging selection patterns in acute ischemic stroke patients and the influence on treatment and clinical trial enrollment decision making.

BACKGROUND AND PURPOSE: For the STroke Imaging Research (STIR) and VISTA-Imaging Investigators The purpose of this study was to collect precise information on the typical imaging decisions given specific clinical acute stroke scenarios. Stroke centers worldwide were surveyed regarding typical imaging used to work up representative acute stroke patients, make treatment decisions, and willingness to enroll in clinical trials. METHODS: STroke Imaging Research and Virtual International Stroke Trials Archive-Imaging circulated an online survey of clinical case vignettes through its website, the websites of national professional societies from multiple countries as well as through email distribution lists from STroke Imaging Research and participating societies. Survey responders were asked to select the typical imaging work-up for each clinical vignette presented. Actual images were not presented to the survey responders. Instead, the survey then displayed several types of imaging findings offered by the imaging strategy, and the responders selected the appropriate therapy and whether to enroll into a clinical trial considering time from onset, clinical presentation, and imaging findings. A follow-up survey focusing on 6 h from onset was conducted after the release of the positive endovascular trials. RESULTS: We received 548 responses from 35 countries including 282 individual centers; 78% of the centers originating from Australia, Brazil, France, Germany, Spain, United Kingdom, and United States. The specific onset windows presented influenced the type of imaging work-up selected more than the clinical scenario. Magnetic Resonance Imaging usage (27-28%) was substantial, in particular for wake-up stroke. Following the release of the positive trials, selection of perfusion imaging significantly increased for imaging strategy. CONCLUSIONS: Usage of vascular or perfusion imaging by Computed Tomography or Magnetic Resonance Imaging beyond just parenchymal imaging was the primary work-up (62-87%) across all clinical vignettes and time windows. Perfusion imaging with Computed Tomography or Magnetic Resonance Imaging was associated with increased probability of enrollment into clinical trials for 0-3 h. Following the release of the positive endovascular trials, selection of endovascular only treatment for 6 h increased across all clinical vignettes.

New technologies and nursing: use and perception of primary healthcare nurses about electronic health record in Catalonia, Spain

This study was aimed to analyze and assess the use and perception of electronic health records (EHRs) by nurses. The study sample included 113 nurses from different shifts of primary health facilities in Catalonia, Spain, devoted to adult as well as pediatric outpatients using EHRs throughout the year 2010. A majority of the sample (87.5%) were women and 12.5% were men. The average age was 44.27 years and the average time working in primary healthcare was 47.15 months. A majority (80.4%) received specific training on the use of the EHR and 19.6% did not. The use of the application required side technical support (mean: 3.42) and it is considered necessary to learn more about the performance of the application (mean: 3.50). The relationship between the average ratings that nurses have about the EHR and age shows that there is no statistically significant linear relationship (r = - 0.002, p-value = 0.984). As to how long they have used the EHRs, there are significant differences (r= -0.304, p-value = 0.00), so the more time the nurse takes using the EHR, the greater degree of satisfaction is shown. In addition, there are significant differences between nurses" perceptions regarding the EHR and gender (t = - 0.421, p-value = 0.675). Nurses assessed as positive the contribution of the EHRs in their nursing care day work (average score: 2.55/5). Considering that the usability of the EHR device is assessed as satisfactory, the results of the perception of nurses show that we must also take into account the training and emphasize the need for a side technical support in the implementation process of the EHR. Doing so, the positive perception that nurses have in regard to information and communication technology in general and with respect to the EHR in particular may be increased.