Identification of potential organ donors after aneurysmal subarachnoid hemorrhage in a population-based neurointensive care in Eastern Finland

To analyze the organ donation action in population-based neurointensive care of acute aneurysmal subarachnoid hemorrhage (aSAH) and to seek factors that would improve the identification of potential organ donors (PODs) and increase the donor conversion rate (DCR) after aSAH. The Kuopio Intracranial Aneurysm Database, prospective since 1995, includes all aSAH patients admitted to the Kuopio University Hospital (KUH) from its defined Eastern Finnish catchment population. We analyzed 769 consecutive acute aSAH patients from 2005 to 2015, including their data from the Finnish Transplantation Unit and the national clinical registries. We analyzed PODs vs. actual donors among the 145 (19%) aSAH patients who died within 14 days of admission. Finland had implemented the national presumed consent (opt-out) within the study period in the end of 2010. We retrospectively identified 83 (57%) PODs while only 49 (34%) had become actual donors (total DCR 59%); the causes for non-donorship were 15/34 (44%) refusals of consent, 18/34 (53%) medical contraindications for donation, and 1/34 (3%) failure of recognition. In 2005-2010, there were 11 refusals by near relatives with DCR 52% (29/56) and only three in 2011-2015 with DCR 74% (20/27). Severe condition on admission (Hunt and Hess grade IV or V) independently associated with the eventual POD status. Nearly 20% of all aSAH patients acutely admitted to neurointensive care from a defined catchment population died within 14 days, almost half from cardiopulmonary causes at a median age of 69 years. Of all aSAH patients, 11% were considered as potential organ donors (PODs). Donor conversion rate (DCR) was increased from 52 to 74% after the national presumed consent (opt-out). Implicitly, DCR among aSAH patients could be increased by admitting them to the intensive care regardless of dismal prognosis for the survival, along a dedicated organ donation program for the catchment population.Peer reviewe

PENERAPAN DATA MINING UNTUK ANALISIS DATA BENCANA MILIK BNPB MENGGUNAKAN ALGORITMA K-MEANS DAN LINEAR REGRESSION

Indonesia memiliki sejarah kejadian bencana alam yang cukup banyak, diantaranya adalah tsunami, gempa bumi, tanah longsor, kekeringan, banjir, letusan gunung berapi, dan sebagainya. Salah satu penyebab banyaknya potensi kejadian bencana alam di Indonesia adalah letak Indonesia yang berada di pertemuan lempeng – lempeng Eurasia, Indo-Australia dan Pasifik. Pertemuan lempeng dalam jangka panjang akan menghimpun energi yang suatu waktu akan lepas dan dapat menghasilkan bencana. Pengetahuan teknologi dan informasi pada saat ini sedang mengalami perkembangan yang pesat.Informasi tentang jumlah kejadian bencana alam dibutuhkan untuk penanggulangan bencana.Pengolahan data bencana alam yang umum dilakukan yaitu menggunakan teknik data mining, karena metode ini dianggap mampu menjadi solusi atas permasalahan penanggulangan bencana alam. Oleh karena itu, dalam penelitian ini membahas tentang pengelompokkan jumlah data bencana dan prediksi data bencana yang akan terjadi 5 tahun kedepan menggunakan teknik data mining. Algoritmadata mining yang digunakan adalah K-Means untuk clustering dan Linear Regression untuk prediksi data bencana.Kata kunci: Clustering, Data Bencana Alam, Data Mining, Linear Regression, WEK

Association of Intracranial Aneurysms With Aortic Aneurysms in 125 Patients With Fusiform and 4253 Patients With Saccular Intracranial Aneurysms and Their Family Members and Population Controls

Background-Varying degrees of co-occurrence of intracranial aneurysms (IA) and aortic aneurysms (AA) have been reported. We sought to compare the risk for AA in fusiform intracranial aneurysms (fIA) and saccular intracranial aneurysms (sIA) disease and evaluate possible genetic connection between the fIA disease and AAs. Additionally, the characteristics and aneurysms of the fIA and sIA patients were compared. Methods and Results-The Kuopio Intracranial Aneurysm Database includes all 4253 sIA and 125 fIA patients from its Eastern Finnish catchment population, and 13 009 matched population controls and 18 455 first-degree relatives to the IA patients were identified, and the Finnish national registers were used to identify the individuals with AA. A total of 33 fIA patients were studied using an exomic gene panel of 37 genes associated with AAs. Seventeen (14.4%) fIA patients and 48 (1.2%) sIA patients had a diagnosis of AA. Both fIA and sIA patients had AAs significantly more often than their controls (1.2% and 0.5%) or relatives (0.9% and 0.3%). In a competing risks Cox regression model, the presence of fIA was the strongest risk factor for AA (subdistribution hazard ratio 7.6, 95% CI 3.9-14.9, P Conclusions-The prevalence of AAs is increased slightly in sIA patients and significantly in fIA patients. fIA patients are older and have more comorbid diseases than sIA patients but this alone does not explain their clinically significant AA risk.Peer reviewe

Altered cardiorespiratory response to exercise in overweight and obese women with polycystic ovary syndrome

In polycystic ovary syndrome (PCOS), cardiovascular risk is increased. Peak O2 uptake (V˙O2peak) predicts the cardiovascular risk. We were the first to examine the contribution of systemic O2 delivery and arteriovenous O2 difference to V˙O2peak in overweight and obese women with PCOS. Fifteen overweight or obese PCOS women and 15 age-, anthropometry-, and physical activity-matched control women performed a maximal incremental cycling exercise test. Alveolar gas exchange (volume turbine and mass spectrometry), arterial O2 saturation (pulse oximetry), and cardiac output (CO) (impedance cardiography) were monitored. Hb concentration was determined. Arterial O2 content and arteriovenous O2 difference (C(a-v)O2) (Fick equation) were calculated. Insulin resistance was evaluated by homeostasis model assessment (HOMA-IR). PCOS women had lower V˙O2peak than controls (40 ± 6 vs. 46 ± 5 mL/min/kg fat-free mass [FFM], P = 0.011). Arterial O2 content was similarly maintained in the groups throughout the exercise test (P > 0.05). Linear regression analysis revealed a pronounced response of CO to increasing V˙O2 in PCOS women during the exercise test: A ∆CO/∆V˙O2 slope was steeper in PCOS women than in controls (β = 5.84 vs. β = 5.21, P = 0.004). Eventually, the groups attained similar peak CO and peak CO scaled to FFM (P > 0.05). Instead, C(a-v)O2 at peak exercise was lower in PCOS women than in controls (13.2 ± 1.6 vs. 14.8 ± 2.4 mL O2/100 mL blood, P = 0.044). HOMA-IR was similar in the groups (P > 0.05). The altered cardiorespiratory responses to exercise in overweight and obese PCOS women indicate that PCOS per se is associated with alterations in peripheral adjustments to exercise rather than with limitations of systemic O2 delivery.Peer reviewe

Multimedia Home Platform palveluiden suorituskyky - tapaustutkimus

Suomessa digitaalisen television lisäarvopalvelut toteutetaan Multimedia Home Platform (MHP) alustaa hyväksi käyttäen. Parhaillaan menossa on lisäarvopalveluiden pilotointivaihe, jossa kerätään kokemusta lisäarvopalveluiden toteutuksesta ja käyttämisestä. Eräs esiin noussut ongelma on lisäarvopalveluiden hitaus: sovelluksien käynnistyminen kestää pitkään, käynnistymisajoissa esiintyy hajontaa ja käytön aikaisessa suorituskyvyssäkin olisi parannettavaa. Tässä työssä toteutettiin staattisesta sisällöstä koostuva informaatiopalvelu digitaaliseen televisioon. Työssä tutkittiin tehokkuusnäkökulmasta eri vaihtoehtoja palvelun toteuttamiseen. Palvelu toteutettiin ensiksi käyttämällä kaupallista XHTML-selainta ja seuraavaksi omana DVB-J sovelluksena, jossa hyödynnettiin Javan, MHP:n ja objektikarusellin optimointimenetelmiä. Käynnistysaikaa voi pienentää lataamalla sovelluksia etukäteen set-top boksin muistiin ennen kuin ne käynnistetään. Työssä toteutettiin vielä tällainen sovellus, joka käynnistyy automaattisesti kanavalle tultaessa ja aloittaa sitten etukäteen latauksen. Testien perusteella tärkeimpiä suorituskykyyn vaikuttavia tekijöitä ovat objektikarusellin pakkaaminen ja sisällön ja sovelluksen erottaminen toisistaan objektikarusellissa. Itse sovelluksen toteutuksessa on tärkeää suosia asynkronisia metodikutsuja, jotta sovelluksen käyttöliittymästä saadaan nopeasti reagoiva. Sovelluksen pieni koko on tärkeä edellytys sovelluksen nopealla käynnistymisellä. Tällä hetkellä hyvänä nyrkkisääntönä sovelluksen kooksi voi pitää alle 100 kilotavua. Työssä käytettiin tavukoodioptimoijaa sovelluksen koon pienentämiseen, minkä tuloksena sovelluksien koko pieneni 25-40%. Myös sovelluksien etukäteen lataamisella voidaan pienentää käynnistymiseen kuluvaa aikaa, eikä käynnistymisajoissa esiinny enää tällöin niin suurta hajontaa. Edellytyksenä kuitenkin on, että sovellus on ehtinyt suorittaa etukäteen latauksen ennen kuin sovellus käynnistetään