19 research outputs found
Adaptation Mechanism based on Service-Context Distance for Ubiquitous Computing
International audienceService adaptation is one of the main research subjects in Ubiquitous Computing. Dynamic service adaptation, at runtime, is necessary for services that cannot be stopped (banking, airport, etc.). The classical approaches for dynamic adaptation require predicting all service and context states in order to specify service and context-specific adaptation policies. This prediction may lead to a combinatorial explosion. The aim of this research is to create a service and context-independent adaptation mechanism. Our proposal is based on a service-context model that is causally connected with the service and context, in [email protected]. A closed-loop control principle is used for the adaptation mechanism. We introduce an equivalent for the error that is expressed by the notion of service-context distance. This distance represents a measure of how adequate is a service to its context. This distance is computed by some generic, reusable components. The adaptation algorithm that minimizes this distance is also service and context-independent
The diagnostic challenge of coexistent sarcoidosis and thyroid cancer - a retrospective study.
BACKGROUND: Sarcoid lesions may mimic metastatic disease or recurrence in thyroid cancer (TC) patients as both diseases may affect the lungs and lymph nodes. We present the first study to systematically evaluate the clinical course of patients with (TC) after adjuvant radioactive iodine therapy (RIT) and concomitant sarcoidosis of the lung or the lymph nodes. METHODS: We screened 3285 patients and retrospectively identified 16 patients with TC (11 papillary thyroid cancer (PTC), 3 follicular thyroid cancer (FTC), 1 oncocytic PTC, 1 oncocytic FTC) and coexisting sarcoidosis of the lung and/or the lymph nodes treated at our institute. All patients had undergone thyroidectomy and initial adjuvant RIT. Challenges in diagnosing and the management of these patients were evaluated during long term follow-up (median 4.9 years (0.8-15.0 years)). RESULTS: Median age at first diagnosis of TC was 50.1 years (33.0-71.5 years) and of sarcoidosis 39.4 years (18.0-63.9 years). During follow-up, physicians were able to differentiate between SA and persistent or recurrent TC in 10 of 16 patients (63%). Diagnosis was complicated by initial negative thyroglobulin (Tg), positive Tg antibodies and non-specific imaging findings. Histopathology can reliably distinguish between SA and TC in patients with one suspicious lesion. CONCLUSION: Physicians should be aware of the rare coexistence of sarcoidosis and TC. Lymphadenopathy and pulmonary lesions could be metastases, sarcoidosis or even a mix of both. Therefore, this rare patient group should receive a thorough work up including histopathological clarification and, if necessary, separately for each lesion