AN ATTEMPT TO DEFINE CONTEXT AWARENESS IN MOBILE E-HEALTH ENVIRONMENTS

Nurses, doctors, physiotherapists, psychologists and other professionals or specialists come together to provide care to home residing patients, making continuous assessment, diagnosis and treatment possible beyond the walls of hospitals. Such teams of professionals are focused on each individual patient, and are virtual, i.e. they make decisions without being together physically, dynamically, i.e. professionals come and go as needed, and collaborate, as they combine their knowledge to provide effective care. Our system, coined DITIS, is a web based system that enables the effective management and collaboration of virtual healthcare teams and accessing medical information in a secure manner from a variety of mobile devices from anytime and anyplace, adapting the information according to various parameters like, user role, access right, device capabilities and wireless medium. This paper introduces the DITIS system, and identifies the needs and challenges of co-ordinated teams of multidisciplinary healthcare professionals (HCPs) functioning in a context awareness environment under the wireless environment. Pilo

Towards a Back-End Framework for Supporting Affective Avatar-Based Interaction Systems

Avatar-based systems provide an intuitive way of interacting with users in the context of Ambient Assisted Living (AAL). These systems are typically supported by a diverse set of services for, e.g, social daily activities, leisure, education and safety. This paper studies the importance of specific services for two organizations, namely MRPS in Geneva, Switzerland and ORBIS in Sittard, Netherlands. Based on this study, we present the design of a backend framework that supports Avatar interaction by means of a comprehensive set of services for safe and independent living

Gemcitabine and Docetaxel for Epithelioid Sarcoma: Results from a Retrospective, Multi-Institutional Analysis

Objective: Epithelioid sarcoma (ES) presents unique clinical features in comparison to other sarcoma subtypes. Data regarding the benefits of chemotherapy are very limited. Combination regimens using gemcitabine and docetaxel (Gem/Doce) have proven to be effective, especially in uterine and nonuterine leiomyosarcoma. Yet, there is no available data on the efficacy of Gem/Doce in ES. Methods: A retrospective analysis of the three participating institutions was performed. Twenty-eight patients with an ES diagnosis presented at one of the participating institutions between 1989 and 2012. Of this group, 17 patients received chemotherapy. Results: Patients' median overall survival (OS) after the beginning of palliative chemotherapy was 21 months, and the 1-year OS was 87%. Twelve patients received Gem/Doce with a clinical benefit rate of 83%. The median progression-free survival (PFS) was 8 months for all patients receiving Gem/Doce. The best response was complete remission in 1 patient and partial remission in 6 patients. All 6 patients receiving Gem/Doce as a first-line treatment showed measurable responses with a median PFS of 9 months. Conclusions: In this retrospective study, Gem/Doce was an effective chemotherapeutic regimen for ES. Prospective studies are needed to better assess the effects of this combination drug therapy

Effect of radiotherapy on local recurrence, distant metastasis and overall survival in 1200 extremity soft tissue sarcoma patients.:Retrospective analysis using IPTW-adjusted models

Background and purpose: Neoadjuvant (NRTX) and adjuvant radiotherapy (ARTX) reduce local recurrence (LR) risk in extremity soft tissue sarcoma (eSTS), yet their impact on distant metastasis (DM) and overall survival (OS) is less well defined. This study aimed at analysing the influence of NRTX/ARTX on all three endpoints using a retrospective, multicentre eSTS cohort. Materials and methods: 1200 patients (mean age: 60.7 ± 16.8 years; 44.4 % females) were retrospectively included, treated with limb sparing surgery and curative intent for localised, high grade (G2/3) eSTS. 194 (16.2 %), 790 (65.8 %), and 216 (18.0 %) patients had received NRTX, ARTX and no RTX, respectively. For the resulting three groups (no RTX vs. NRTX, no RTX vs. ARTX, NRTX vs. ARTX) Fine&amp;Gray models for LR and DM, and Cox-regression models for OS were calculated, with IPTW-modelling adjusting for imbalances between groups. Results: In the IPTW-adjusted analysis, NRTX was associated with lower LR-risk in comparison to no RTX (SHR [subhazard ratio]: 0.236; p = 0.003), whilst no impact on DM-risk (p = 0.576) or OS (p = 1.000) was found. IPTW-weighted analysis for no RTX vs. ARTX revealed a significant positive association between ARTX and lower LR-risk (SHR: 0.479, p = 0.003), but again no impact on DM-risk (p = 0.363) or OS (p = 0.534). IPTW-weighted model for NRTX vs. ARTX showed significantly lower LR-risk for NRTX (SHR for ARTX: 3.433; p = 0.003) but no difference regarding DM-risk (p = 1.000) or OS (p = 0.639). Conclusion: NRTX and ARTX are associated with lower LR-risk, but do not seem to affect DM-risk or OS. NRTX may be favoured over ARTX as our results indicate better local control rates.</p