The prognostic value of global haemostatic tests in the intensive care unit setting.

BACKGROUND: Global haemostatic tests are often abnormal in critically ill patients, secondary to activation or consumption of coagulation factors or inhibitors. Methods for analysing plasma levels of these factors are, however, not widely available, and the predictive value of global tests is not known. We examined the clinical applicability to predict the outcome of the global haemostatic tests used at most hospitals. METHODS: Blood was collected from patients within 6 h of admission to an intensive care unit (ICU) and tested regarding platelet count, International Normalized Ratio (INR), and activated partial thromboplastin time (APTT). Ninety-two patients with platelet counts 1.36 and/or APTT >45 s were included in a study group, and an additional 92 patients with a comparable age and sex distribution, but not fulfilling these laboratory criteria, constituted a control group. The following data were recorded for each patient: number of days in the ICU and hospital; alive or deceased when released from the ICU and hospital; survival at 30 days and 180 days. RESULTS: Survival upon discharge from the ICU and hospital was significantly reduced in the study group. This was especially pronounced in patients with medical disorders, whereas the survival rate was slightly higher in surgery patients. Expressing the survival predicting ability of the screening tests as odds ratios for all patients (study and control groups together) indicated that prolonged APTT in particular foretold a lower survival rate at studied time-points after admission to the ICU. CONCLUSIONS: The global haemostatic tests INR and APTT can predict survival in critically ill patients, and prolonged APTT in particular seems to be associated with a negative prognosis

Design and validation of Segment - freely available software for cardiovascular image analysis

<p>Abstract</p> <p>Background</p> <p>Commercially available software for cardiovascular image analysis often has limited functionality and frequently lacks the careful validation that is required for clinical studies. We have already implemented a cardiovascular image analysis software package and released it as freeware for the research community. However, it was distributed as a stand-alone application and other researchers could not extend it by writing their own custom image analysis algorithms. We believe that the work required to make a clinically applicable prototype can be reduced by making the software extensible, so that researchers can develop their own modules or improvements. Such an initiative might then serve as a bridge between image analysis research and cardiovascular research. The aim of this article is therefore to present the design and validation of a cardiovascular image analysis software package (Segment) and to announce its release in a source code format.</p> <p>Results</p> <p>Segment can be used for image analysis in magnetic resonance imaging (MRI), computed tomography (CT), single photon emission computed tomography (SPECT) and positron emission tomography (PET). Some of its main features include loading of DICOM images from all major scanner vendors, simultaneous display of multiple image stacks and plane intersections, automated segmentation of the left ventricle, quantification of MRI flow, tools for manual and general object segmentation, quantitative regional wall motion analysis, myocardial viability analysis and image fusion tools. Here we present an overview of the validation results and validation procedures for the functionality of the software. We describe a technique to ensure continued accuracy and validity of the software by implementing and using a test script that tests the functionality of the software and validates the output. The software has been made freely available for research purposes in a source code format on the project home page <url>http://segment.heiberg.se</url>.</p> <p>Conclusions</p> <p>Segment is a well-validated comprehensive software package for cardiovascular image analysis. It is freely available for research purposes provided that relevant original research publications related to the software are cited.</p

Fourteen sequence variants that associate with multiple sclerosis discovered by meta-analysis informed by genetic correlations

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked FilesA meta-analysis of publicly available summary statistics on multiple sclerosis combined with three Nordic multiple sclerosis cohorts (21,079 cases, 371,198 controls) revealed seven sequence variants associating with multiple sclerosis, not reported previously. Using polygenic risk scores based on public summary statistics of variants outside the major histocompatibility complex region we quantified genetic overlap between common autoimmune diseases in Icelanders and identified disease clusters characterized by autoantibody presence/absence. As multiple sclerosis-polygenic risk scores captures the risk of primary biliary cirrhosis and vice versa (P = 1.6 x 10(-7), 4.3 x 10(-9)) we used primary biliary cirrhosis as a proxy-phenotype for multiple sclerosis, the idea being that variants conferring risk of primary biliary cirrhosis have a prior probability of conferring risk of multiple sclerosis. We tested 255 variants forming the primary biliary cirrhosis-polygenic risk score and found seven multiple sclerosis-associating variants not correlated with any previously established multiple sclerosis variants. Most of the variants discovered are close to or within immune-related genes. One is a low-frequency missense variant in TYK2, another is a missense variant in MTHFR that reduces the function of the encoded enzyme affecting methionine metabolism, reported to be dysregulated in multiple sclerosis brain.Swedish Research Council Knut and Alice Wallenberg Foundation AFA Foundation Swedish Brain Foundatio

Fourteen sequence variants that associate with multiple sclerosis discovered by meta-analysis informed by genetic correlations

A meta-analysis of publicly available summary statistics on multiple sclerosis combined with three Nordic multiple sclerosis cohorts (21,079 cases, 371,198 controls) revealed seven sequence variants associating with multiple sclerosis, not reported previously. Using polygenic risk scores based on public summary statistics of variants outside the major histocompatibility complex region we quantified genetic overlap between common autoimmune diseases in Icelanders and identified disease clusters characterized by autoantibody presence/absence. As multiple sclerosis-polygenic risk scores captures the risk of primary biliary cirrhosis and vice versa (P = 1.6 x 10(-7), 4.3 x 10(-9)) we used primary biliary cirrhosis as a proxy-phenotype for multiple sclerosis, the idea being that variants conferring risk of primary biliary cirrhosis have a prior probability of conferring risk of multiple sclerosis. We tested 255 variants forming the primary biliary cirrhosis-polygenic risk score and found seven multiple sclerosis-associating variants not correlated with any previously established multiple sclerosis variants. Most of the variants discovered are close to or within immune-related genes. One is a low-frequency missense variant in TYK2, another is a missense variant in MTHFR that reduces the function of the encoded enzyme affecting methionine metabolism, reported to be dysregulated in multiple sclerosis brain.publishedVersio

Connecting the data landscape of long-term ecological studies: The SPI-Birds data hub

The integration and synthesis of the data in different areas of science is drastically slowed and hindered by a lack of standards and networking programmes. Long-term studies of individually marked animals are not an exception. These studies are especially important as instrumental for understanding evolutionary and ecological processes in the wild. Furthermore, their number and global distribution provides a unique opportunity to assess the generality of patterns and to address broad-scale global issues (e.g. climate change). To solve data integration issues and enable a new scale of ecological and evolutionary research based on long-term studies of birds, we have created the SPI-Birds Network and Database (www.spibirds.org)\u2014a large-scale initiative that connects data from, and researchers working on, studies of wild populations of individually recognizable (usually ringed) birds. Within year and a half since the establishment, SPI-Birds has recruited over 120 members, and currently hosts data on almost 1.5 million individual birds collected in 80 populations over 2,000 cumulative years, and counting. SPI-Birds acts as a data hub and a catalogue of studied populations. It prevents data loss, secures easy data finding, use and integration and thus facilitates collaboration and synthesis. We provide community-derived data and meta-data standards and improve data integrity guided by the principles of Findable, Accessible, Interoperable and Reusable (FAIR), and aligned with the existing metadata languages (e.g. ecological meta-data language). The encouraging community involvement stems from SPI-Bird's decentralized approach: research groups retain full control over data use and their way of data management, while SPI-Birds creates tailored pipelines to convert each unique data format into a standard format. We outline the lessons learned, so that other communities (e.g. those working on other taxa) can adapt our successful model. Creating community-specific hubs (such as ours, COMADRE for animal demography, etc.) will aid much-needed large-scale ecological data integration

Fraud, corruption and the paradox of control

This paper utilizes a distinction between vertical and horizontal control to challenge the idea that a tight control system improves an organization's ability to counteract fraud and corruption. We draw on the management control, accounting and accountability literatures to characterize key dimensions of vertical control, with a vertical information flow in a formal organization structure, and horizontal control, based on lateral information exchange and empowerment. Using a case study of a U.S. high school undergoing change, we show how strong vertical control fosters fraud and corruption, rather than preventing and revealing such tendencies. We conclude with propositions concerning key mechanisms involved.Godkänd; 2008; 20090831 (anders_n

Accounting information systems in SMEs

The research questions concern the possible link between Accounting Information Systems (AIS) and profitability in small and medium-sized firms (SMEs). "Instrumental" functions of AIS are compared with profitability for 24SMEs in the Swedish prefab housing industry. Data were collected by extensive, structured interviews with firm CEOs and CFOs. Results are interpreted in the context of the "sense-making process". AIS parts include: budgets, cash management, calculations, accounting and reports. The instrumental functions are evaluated in terms of completeness, complexity, logic, consistency and timeliness. The findings indicate that instrumental features of calculations and reporting do matter and are related to profitability in the business. Well designed features of these parts of an AIS seemed to be necessary but not sufficient prerequisites for profitability. It is suggested that the relationships can be better understood in the light of sense-making aspects. On the basis of the findings a framework of decision models is proposed. The framework is based on two dimensions of a problematic situation: degree of structure and complexity.Godkänd; 1999; 20070219 (evan

Affärsidé och lönsamhet i medelstora företag

This paper is focused on the relationship between business concepts and profitability in mid-sized firms. A first research question addresses whether it is possible to identify a key characteristic of business concepts which stands out as important for profitability. A second question regards if co-variation can be demonstrated between such a key business concept characteristic and profitability among mid-sized firms in one industry. The paper is based on a literature review and results from an empirical study of all firms in the prefab-housing industry in the south of Sweden with more than 20 employees. The literature review indicates that the configuration of the business concept should be important for profitability although this relationship has not been tested empirically. The empirical results of our study show that the ratio between the number of local connections between themes in the business concepts and the total number of business concept themes co-varies with firm profitability. The study therefore supports the assumptions in the literature which suggest that a business concept should be configured in an operational way, highlighting cause/effect-relationships, and that this characteristic appears to be related to firm profitability.Artikeln behandlar förhållandet mellan affärsidé och lönsamhet i medelstora företag. Forskningsfrågorna avser möjligheterna att med hjälp av litteraturen identifiera en nyckelegenskap hos affärsidéer som framstår som väsentlig för ett företags möjligheter att uppnå lönsamhet, och vilken samvariation som går att påvisa mellan denna nyckelegenskap hos affärsidéer och graden av lönsamhet hos medelstora företag i en bransch. Artikeln baseras på en litteraturstudie och resultat från en empirisk undersökning av samtliga trähusföretag i södra Sverige med minst 20 anställda. Litteraturstudien indikerar att en affärsidés konfiguration bör vara väsentlig för ett företags möjligheter att uppnå lönsamhet men att detta inte prövats empiriskt. De empiriska resultaten av vår studie visar att kvoten mellan antalet logiska kopplingar mellan olika teman i företagens affärsidéer och totala antalet teman samvarierar med företagens lönsamhet. Studien stödjer därför antaganden i litteraturen om att en affärsidé bör konfigureras så att den är konkret och belyser orsak- och verkanssamband mellan teman, samt att denna egenskap förefaller kunna kopplas till företagets lönsamhet.Validerad; 2007; 20070803 (anders_n