Modeller for ankomstprocesser

Serviceydelser er en ydelser mange virksomheder, store som små, tilbyder deres kunder. Efterspørgslen efter en serviceydelse vil opstå mere eller mindre tilfældigt i løbet af en arbejdsdag, og set fra virksomhedens side vil den kunne kategoriseres efter kundernes ankomstmønster, ventetiden i køen, serviceopgaven og endelig hvornår man forlader køen. Den simple struktur i et køsystem kan betragtes som en proces hvor kunder udefra ankommer til en ydelse de efterspørger. Hvis ydelsen er optaget, må kunden vente indtil de kan blive serviceret. I det følgende vil vi se på strukturen: Ankomstproces -> køstruktur -> serviceproce

CRM i danske virksomheder

Kundeorientering er blevet et nyt og nødvendigt mantra hos mange virksomheder i jagten på vækst. Natur-ligvis profitabel vækst, det kan dog være en udfordring for mange at sikre dette viser erfaringerne. Her er CRM konceptet et centralt og afgørende element. Mange virksomheder oplever ikke alene knaphed på finan-sielle ressourcer, men også knaphed på kunder. Knapheden på kunder opleves som en udfordring, når profi-table kunder skal tiltrækkes, og eksisterende profitable kunder skal fastholdes. Derfor arbejder flere og flere virksomheder med CRM konceptet og loyalitetsteorien. Denne observation bekræftes i en analyse fra PwC1. Her siger hele 77 pct. af toplederne, at de forventer at investere i tiltag omkring fastholdelse af og mersalg til eksisterende kunder. Ligeledes fremhæver 67 pct. af toplederne, at højeste prioritet for investeringerne i de kommende 12 måneder er at forøge kundebasen. Det synes også i den grad som en nødvendig prioritering. En undersøgelse2 viser, at de europæiske forbruge-re kan undvære 92 pct. af de Brands som findes på markedet i dag. Derfor bør arbejdet med kundedata og kunderelationer være en essentiel prioritering, der er nødvendig for at skabe vækst på såvel top- som bund-linje. Aktiviteter vedrørende kunder kræver indsigt i, dels hvad der er kundens værdioplevelse, dels hvad kundens potentiale er i forhold til virksomheden (livstidsværdi), samt hvordan du som virksomhed bedst kommunike-rer med forskellige kundesegmenter (målrettet og relevant) på den mest effektfulde og effektive måde. Udfordringerne kan være mange, men netop en oplevelse af knaphed på kunder enten via lave fastholdelses-rater, lav tilgang af nye kunder eller en kombination, sætter behovet for viden i perspektiv. Det er ikke kun et spørgsmål om tilfredshed og villigheden til at ville anbefale og genkøbe et produkt/serviceydelse. Det er der-imod en systematisk indsamling, bearbejdning, deling og anvendelse af viden proaktivt og konstruktivt i rela-tion til kunder og markedet, der er et afgørende konkurrenceparameter. Ligesom evnen til at anvende og kommunikere denne viden så den af modtageren opleves målrettet og relevant, er afgørende for succesen. Ønsket om kundefastholdelse er et element, men ambitionen om vækst også gennem nye kunder stiller kon-stant nye krav til de måder, virksomheder tilbyder deres services og produkter. En anden udfordring synes at være, at forbrugernes adfærd og holdninger forandres. Den klassiske lineære tilgang til kunder og markedet (AIDA modellen) synes afløst af en cirkulær og mere ustruktureret adfærd som kan betegnes kundens ECO system3. Denne adfærd stiller store krav til opsamlin-gen af viden, bearbejdning heraf, delingen og anvendelsen af de touch points kunden samt virksomheden har. Den karakteristiske kampagnebaserede tilgang til markedet synes at have en mindre og mindre virk-ningsgrad. Kampagner vil blive afløst af en procesbaseret tilgang, der tager sit udgangspunkt i kundens ad-færd og holdninger i forhold til en gensidig værdiskabelse

Adjuvant radiation therapy in metastatic lymph nodes from melanoma

<p>Abstract</p> <p>Purpose</p> <p>To analyze the outcome after adjuvant radiation therapy with standard fractionation regimen in metastatic lymph nodes (LN) from cutaneous melanoma.</p> <p>Patients and methods</p> <p>86 successive patients (57 men) were treated for locally advanced melanoma in our institution. 60 patients (69%) underwent LN dissection followed by radiation therapy (RT), while 26 patients (31%) had no radiotherapy.</p> <p>Results</p> <p>The median number of resected LN was 12 (1 to 36) with 2 metastases (1 to 28). Median survival after the first relapse was 31.8 months. Extracapsular extension was a significant prognostic factor for regional control (p = 0.019). Median total dose was 50 Gy (30 to 70 Gy). A standard fractionation regimen was used (2 Gy/fraction). Median number of fractions was 25 (10 to 44 fractions). Patients were treated with five fractions/week. Patients with extracapsular extension treated with surgery followed by RT (total dose ≥50 Gy) had a better regional control than patients treated by surgery followed by RT with a total dose <50 Gy (80% vs. 35% at 5-year follow-up; p = 0.004).</p> <p>Conclusion</p> <p>Adjuvant radiotherapy was able to increase regional control in targeted sub-population (LN with extracapsular extension).</p

The TGF-β/Smad Repressor TG-Interacting Factor 1 (TGIF1) Plays a Role in Radiation-Induced Intestinal Injury Independently of a Smad Signaling Pathway

Despite advances in radiation delivery protocols, exposure of normal tissues during the course of radiation therapy remains a limiting factor of cancer treatment. If the canonical TGF-β/Smad pathway has been extensively studied and implicated in the development of radiation damage in various organs, the precise modalities of its activation following radiation exposure remain elusive. In the present study, we hypothesized that TGF-β1 signaling and target genes expression may depend on radiation-induced modifications in Smad transcriptional co-repressors/inhibitors expressions (TGIF1, SnoN, Ski and Smad7). In endothelial cells (HUVECs) and in a model of experimental radiation enteropathy in mice, radiation exposure increases expression of TGF-β/Smad pathway and of its target gene PAI-1, together with the overexpression of Smad co-repressor TGIF1. In mice, TGIF1 deficiency is not associated with changes in the expression of radiation-induced TGF-β pathway-related transcripts following localized small intestinal irradiation. In HUVECs, TGIF1 overexpression or silencing has no influence either on the radiation-induced Smad activation or the Smad3-dependent PAI-1 overexpression. However, TGIF1 genetic deficiency sensitizes mice to radiation-induced intestinal damage after total body or localized small intestinal radiation exposure, demonstrating that TGIF1 plays a role in radiation-induced intestinal injury. In conclusion, the TGF-β/Smad co-repressor TGIF1 plays a role in radiation-induced normal tissue damage by a Smad-independent mechanism

Identifying Canadian Freshwater Fishes through DNA Barcodes

BACKGROUND: DNA barcoding aims to provide an efficient method for species-level identifications using an array of species specific molecular tags derived from the 5' region of the mitochondrial cytochrome c oxidase I (COI) gene. The efficiency of the method hinges on the degree of sequence divergence among species and species-level identifications are relatively straightforward when the average genetic distance among individuals within a species does not exceed the average genetic distance between sister species. Fishes constitute a highly diverse group of vertebrates that exhibit deep phenotypic changes during development. In this context, the identification of fish species is challenging and DNA barcoding provide new perspectives in ecology and systematics of fishes. Here we examined the degree to which DNA barcoding discriminate freshwater fish species from the well-known Canadian fauna, which currently encompasses nearly 200 species, some which are of high economic value like salmons and sturgeons. METHODOLOGY/PRINCIPAL FINDINGS: We bi-directionally sequenced the standard 652 bp "barcode" region of COI for 1360 individuals belonging to 190 of the 203 Canadian freshwater fish species (95%). Most species were represented by multiple individuals (7.6 on average), the majority of which were retained as voucher specimens. The average genetic distance was 27 fold higher between species than within species, as K2P distance estimates averaged 8.3% among congeners and only 0.3% among concpecifics. However, shared polymorphism between sister-species was detected in 15 species (8% of the cases). The distribution of K2P distance between individuals and species overlapped and identifications were only possible to species group using DNA barcodes in these cases. Conversely, deep hidden genetic divergence was revealed within two species, suggesting the presence of cryptic species. CONCLUSIONS/SIGNIFICANCE: The present study evidenced that freshwater fish species can be efficiently identified through the use of DNA barcoding, especially the species complex of small-sized species, and that the present COI library can be used for subsequent applications in ecology and systematics

PEDIA: prioritization of exome data by image analysis.

PURPOSE: Phenotype information is crucial for the interpretation of genomic variants. So far it has only been accessible for bioinformatics workflows after encoding into clinical terms by expert dysmorphologists. METHODS: Here, we introduce an approach driven by artificial intelligence that uses portrait photographs for the interpretation of clinical exome data. We measured the value added by computer-assisted image analysis to the diagnostic yield on a cohort consisting of 679 individuals with 105 different monogenic disorders. For each case in the cohort we compiled frontal photos, clinical features, and the disease-causing variants, and simulated multiple exomes of different ethnic backgrounds. RESULTS: The additional use of similarity scores from computer-assisted analysis of frontal photos improved the top 1 accuracy rate by more than 20-89% and the top 10 accuracy rate by more than 5-99% for the disease-causing gene. CONCLUSION: Image analysis by deep-learning algorithms can be used to quantify the phenotypic similarity (PP4 criterion of the American College of Medical Genetics and Genomics guidelines) and to advance the performance of bioinformatics pipelines for exome analysis

GestaltMatcher Database - A global reference for facial phenotypic variability in rare human diseases

The most important factor that complicates the work of dysmorphologists is the significant phenotypic variability of the human face. Next-Generation Phenotyping (NGP) tools that assist clinicians with recognizing characteristic syndromic patterns are particularly challenged when confronted with patients from populations different from their training data. To that end, we systematically analyzed the impact of genetic ancestry on facial dysmorphism. For that purpose, we established the GestaltMatcher Database (GMDB) as a reference dataset for medical images of patients with rare genetic disorders from around the world. We collected 10,980 frontal facial images - more than a quarter previously unpublished - from 8,346 patients, representing 581 rare disorders. Although the predominant ancestry is still European (67%), data from underrepresented populations have been increased considerably via global collaborations (19% Asian and 7% African). This includes previously unpublished reports for more than 40% of the African patients. The NGP analysis on this diverse dataset revealed characteristic performance differences depending on the composition of training and test sets corresponding to genetic relatedness. For clinical use of NGP, incorporating non-European patients resulted in a profound enhancement of GestaltMatcher performance. The top-5 accuracy rate increased by +11.29%. Importantly, this improvement in delineating the correct disorder from a facial portrait was achieved without decreasing the performance on European patients. By design, GMDB complies with the FAIR principles by rendering the curated medical data findable, accessible, interoperable, and reusable. This means GMDB can also serve as data for training and benchmarking. In summary, our study on facial dysmorphism on a global sample revealed a considerable cross ancestral phenotypic variability confounding NGP that should be counteracted by international efforts for increasing data diversity. GMDB will serve as a vital reference database for clinicians and a transparent training set for advancing NGP technology.</p