New concepts in the pathophysiology of infective endocarditis.

Endocarditis pathogens colonize valves with pre-existing sterile vegetations or valves with minimal endothelial lesions. Inflamed endothelia produce cytokines, integrins, and tissue factor, which in turn attract fibronectin, monocytes, and platelets. Bacteria attaching to such structures further activate the cascade, becoming embedded and protected from host defenses. Staphylococcus aureus also actively invade the endothelium, causing apoptosis and endothelial damage. Knowledge of this interplay identifies host factors as potential therapeutic targets. Blocking infection by modulating host factors might be opportune because host factors are conserved. In contrast, interfering with bacterial virulence factors might be more complicated because they vary among different bacteria.

Oculopalatal tremor: current concepts and new observations.

PURPOSE OF REVIEW: Oculopalatal tremor (OPT) is an acquired disorder resulting from the interruption of a specific brainstem circuitry, the dentato-rubro-olivary pathway or Guillain-Mollaret triangle. The recent literature on OPT and olivary hypertrophy was reviewed with specific interest regarding causes, diagnostic procedures, physiopathology and therapies. RECENT FINDINGS: OPT is associated with inferior olivary hypertrophy, and recent findings have provided a better understanding of its intimate mechanisms. A dual-mechanism model, combining an oscillator (inferior olive) and a modulator/amplifier (cerebellum), best explains the development of OPT. Electrotonic coupling and specific Ca channels contribute to oscillations of inferior olivary nucleus neurons in OPT. Improvement of visual symptoms can be achieved with oral gabapentin or memantine. SUMMARY: Both the neuronal circuitry and the physiopathology of OPT are now better understood. This opens up an era of specific therapy for this rare cause of disabling oscillopsia.

Development of Concepts for Pavement Management, MLR-79-04, 1979

Sufficient evidence was not discovered in this brief search to alter the general opinion that the Serviceability (Present Serviceability Index-PSI) - Performance Concepts developed by the AASHO Road Test provides the optimum engineering basis for pavement management. Use of these concepts in Iowa has the additional advantage in that we have a reasonable quantity of historical data over a period of time on the change in pavement condition as measured by PSI's. Some additional benefits would be the ability to better assess our needs with respect to those being recommended to Congress by AASHTO Committees. These concepts have been the basis used for developing policies on dimensions and weight of vehicles and highway needs which the AASHTO Transport Committees have recommended to the United States House Committee on Ways and Means. The first recommendation based on these concepts was made in the mid 1960's. Iowa's participation in the evaluation for this recommendation was under the direction of our present Director of Transportation, Mr. Raymond Kassel. PSI Indexes had to be derived from subjective surface ratings at that time. The most recent recommendation to Congress was made in November of 1977. Based on the rationale expressed above, a pilot study of the major part of the rural interstate system was conducted. The Objective of the study was to measure pavement performance through the use of the Present Serviceability Index (PSI) - Pavement Performance concepts as developed by the AASHO Road Test and to explore the usefulness of this type of data as a pavement management tool. Projects in the vicinity of the major urban centers were not included in this study due to the extra time that would be required to isolate accurate traffic data in these areas. Projects consisting of asphalt surface courses on crushed stone base sections were not included.

Development of Evaluation, Rehabilitation, and Strengthening Concepts for Low Volume Bridges, Phase I Progress Report, HR-323, 1990

The primary objective of this project is to develop a design manual that would aid the county or municipal engineer in making structurally sound bridge strengthening or replacement decisions. The contents of this progress report are related only to Phase I of the study and deal primarily with defining the extent of the bridge problem in Iowa. In addition, the types of bridges to which the manual should be directed have been defined.

Repurposing Social Tagging Data for Extraction of Domain-level Concepts

The World Wide Web, the world¿s largest resource for information, has evolved from organizing information using controlled, top-down taxonomies to a bottom up approach that emphasizes assigning meaning to data via mechanisms such as the Social Web (Web 2.0). Tagging adds meta-data, (weak semantics) to the content available on the web. This research investigates the potential for repurposing this layer of meta-data. We propose a multi-phase approach that exploits user-defined tags to identify and extract domain-level concepts. We operationalize this approach and assess its feasibility by application to a publicly available tag repository. The paper describes insights gained from implementing and applying the heuristics contained in the approach, as well as challenges and implications of repurposing tags for extraction of domain-level concepts.

Therapeutic concepts in adult and paediatric eosinophilic oesophagitis.

Eosinophilic oesophagitis (EoE) was first described in the early 1990s. Although initially reported to be a rare entity, EoE has rapidly become a regularly diagnosed disease with a prevalence of approximately 1 in 2,000 individuals in the USA and Europe. The disease is characterized by a combination of oesophageal dysfunction and predominant eosinophilic infiltration of the oesophageal tissue. At diagnosis, other diseases that can be associated with oesophageal eosinophilic infiltration must be ruled out. Children with EoE present with a wide variety of symptoms, whereas adults mostly present with dysphagia for solid food and chest pain. Histologic features of EoE resemble those of T-helper type 2 inflammation. Endoscopy should be carried out to establish the diagnosis, but endoscopic abnormalities are not pathognomonic for EoE and the examination might not show histologic abnormality. Treatment modalities for EoE include drugs (corticosteroids, PPIs, antiallergic and biologic agents), hypoallergenic diets and oesophageal dilatation for strictures that are unresponsive to medical therapy. Unresolved eosinophilic inflammation leads to the formation of oesophageal strictures, which probably increase the risk of food bolus impactions. To date, long-term strategies for the therapeutic management of this chronic inflammatory disease remain poorly defined.

Assessing chronic disease management in European health systems : concepts and approaches

This book comprises two volumes and builds on the findings of the DISMEVAL project (Developing and validating DISease Management EVALuation methods for European health care systems), funded under the European Union's (EU) Seventh Framework Programme (FP7) (Agreement no. 223277). DISMEVAL was a three-year European collaborative project conducted between 2009 and 2011. It contributed to developing new research methods and generating the evidence base to inform decision-making in the field of chronic disease management evaluation (www.dismeval.eu). In this book, we report on the findings of the project's first phase, capturing the diverse range of contexts in which new approaches to chronic care are being implemented and evaluating the outcomes of these initiatives using an explicit comparative approach and a unified assessment framework. In this first volume, we describe the range of approaches to chronic care adopted in 12 European countries. By reflecting on the facilitators and barriers to implementation, we aim to provide policy-makers and practitioners with a portfolio of options to advance chronic care approaches in a given policy context.

BUSINESS CONCEPTS OF MOBILE VALUE-ADDED SERVICES FROM OPERATOR’S POINT OF VIEW

Tämä diplomityö on tehty Lappeenrannassa Telecom Business Research Centerin 5T-projektiin liittyen. Työssä tutkitaan matkaviestinnän lisäarvopalveluiden liiketoimintakonsepteja operaattoreiden näkökulmasta. Lisäarvopalvelut laajentavat operaattoreiden palveluvalikoimaa. Niiden osuuden telekommunikaatioalan yritysten ja erityisesti operaattoreiden tuotoista on ennustettu kasvavan huomattavasti. Työn tärkeimpänä tavoitteena on tuoda uusia näkökulmia ja lisätä ymmärrystä lisäarvopalveluiden liiketoimintakonseptin rakentamisprosessista. Tätä tietämystä käytetään edesauttamaan työn empiirisessä osuudessa tutkitun Content Gateway -tuotteen liiketoimintaa. Tarjoamalla nopean liitynnän ja laskutuskanavan ulkopuolisten palveluntarjoajien ja operaattorin välille tämä tuote mahdollistaa operaattorille ja palveluntarjoajille lisäarvopalveluiden liiketoiminnan käynnistämisen. Lisäarvopalveluiden arvonluontiprosessi vaatii lukuisia yhteistyötä tekeviä osapuolia, joiden yhteistoiminta on dynaamista ja tiedonvälitys avointa, interaktiivista ja nopeaa. Arvonluontiin liittyy myös monia konvergoituvia kehityssuuntia. Perinteinen arvoketjuajattelu on riittämätön uuteen, verkottuneeseen toimintaympäristöön ja sen tilalle on tullut modernimpi arvoverkostomalli. Arvoverkosto luo kilpailuetunsa muita verkostoja vastaan jakamalla resurssit ja kompetenssit optimaalisesti ja liittämällä strategisen ja operationaalisen johtamisen kulttuurit toisiinsa. Tässä työssä verrataan arvoverkoston teoreettisia tavoitteita kahteen lisäarvopalveluiden liiketoimintakonseptiin. Näistä ensimmäinen, i-mode –niminen konsepti on valittu vertailuun edistyksellisyytensä ja tulevaa kehitystä ennakoivien ominaispiirteidensä vuoksi. Toinen esimerkkikonsepti on rakennettu edellä mainitun Content Gateway -tuotteen ympärille. Tutkimus sisältää mm. liikekumppaneiden hankinnan, ansaintalogiikoiden ja verkostojen johtamisen analysoinnin. Työn tuloksena on saatu ohjeita siihen, miten operaattori voi rakentaa tällaista konseptia ja mitä seikkoja tulee ottaa huomioon erityisesti sanomapalveluihin liittyvässä liiketoiminnassa.

Diffusion-weighted MR imaging in musculoskeletal diseases: Current concepts.

MR imaging is currently regarded as a pivotal technique for the assessment of a variety of musculoskeletal conditions. Diffusion-weighted MR imaging (DWI) is a relatively recent sequence that provides information on the degree of cellularity of lesions. Apparent diffusion coefficient (ADC) value provides information on the movement of water molecules outside the cells. The literature contains many studies that have evaluated the role of DWI in musculoskeletal diseases. However, to date they yielded conflicting results on the use and the diagnostic capabilities of DWI in the area of musculoskeletal diseases. However, many of them have showed that DWI is a useful technique for the evaluation of the extent of the disease in a subset of musculoskeletal cancers. In terms of tissue characterization, DWI may be an adjunct to the more conventional MR imaging techniques but should be interpreted along with the signal of the lesion as observed on conventional sequences, especially in musculoskeletal cancers. Regarding the monitoring of response to therapy in cancer or inflammatory disease, the use of ADC value may represent a more reliable additional tool but must be compared to the initial ADC value of the lesions along with the knowledge of the actual therapy.