Testing Two Tools for Multimodal Navigation

The latest smartphones with GPS, electronic compasses, directional audio, touch screens, and so forth, hold a potential for location-based services that are easier to use and that let users focus on their activities and the environment around them. Rather than interpreting maps, users can search for information by pointing in a direction and database queries can be created from GPS location and compass data. Users can also get guidance to locations through point and sweep gestures, spatial sound, and simple graphics. This paper describes two studies testing two applications with multimodal user interfaces for navigation and information retrieval. The applications allow users to search for information and get navigation support using combinations of point and sweep gestures, nonspeech audio, graphics, and text. Tests show that users appreciated both applications for their ease of use and for allowing users to interact directly with the surrounding environment

Testing Two Tools for Multimodal Navigation

The latest smartphones with GPS, electronic compasses, directional audio, touch screens, and so forth, hold a potential for location-based services that are easier to use and that let users focus on their activities and the environment around them. Rather than interpreting maps, users can search for information by pointing in a direction and database queries can be created from GPS location and compass data. Users can also get guidance to locations through point and sweep gestures, spatial sound, and simple graphics. This paper describes two studies testing two applications with multimodal user interfaces for navigation and information retrieval. The applications allow users to search for information and get navigation support using combinations of point and sweep gestures, nonspeech audio, graphics, and text. Tests show that users appreciated both applications for their ease of use and for allowing users to interact directly with the surrounding environment

Asiakkaan valinnanvapaus ja asiakasarvon toteutuminen sote-palveluissa palvelusetelilainsäädännön kautta (VArvo)

Valinnanvapautta on viime vuosina pidetty merkittävänä tekijänä terveydenhuollon palveluiden asiakaslähtöisyyden ja vaikuttavuuden kehittämisessä. Valinnanvapauden keskeinen edellytys on, että asiakkaalla ylipäätään on tuottajia, joiden välillä valita. Tutkimuksessa tarkastellaan asiakkaan valinnanvapauden ja asiakasarvon toteutumista erityisesti terveydenhuollon markkinoiden luomisen ja ohjaamisen näkökulmasta, palvelujärjestelmän ja palveluiden järjestämisen tasoilla. Markkinoiden ohjaaminen ja sopivien kannustimien rakentaminen palveluiden kautta tavoiteltavien lopputulosten saavuttamiseksi voidaan toteuttaa monella eri tavalla. Kyse on myös tavoitteen asetannasta eli siitä, tavoitellaanko valinnanvapaudessa olemassa olevan resurssin tehokkaampaa käyttöä, palvelujen kehittämistä asiakaslähtöisempään suuntaan, vai molempia. Tutkimuksessa tarkastellaan asiakasarvoa tuottavan palvelumarkkinan synnyttämistä ja ohjaamista monipuolisesti niin teorian kuin empiriankin kautta. Kokeiluhankkeeseen osallistui monia tuottajia Ylä-Savossa, Jyväskylässä, Tampereella, Hämeenlinnassa ja Keski-Uudellamaalla. Kullakin alueella oli omia erityisiä kehittämisen teemojaan. Valinnanvapauskokeilu antoi tietoa palveluiden ja palvelujärjestelmän kehittämiseksi asiakaslähtöisempään ja enemmän asiakasarvoa tuottavaan suuntaan

Clinical characteristics and therapeutic responses in patients with Germ-line AIP mutations and pituitary adenomas : An international collaborative study

Context: AIP mutations (AIPmut) give rise to a pituitary adenoma predisposition that occurs in familial isolated pituitary adenomas and less often in sporadic cases. The clinical and therapeutic features of AIPmut-associated pituitary adenomas have not been studied comprehensively. Objective: The objective of the study was to assess clinical/therapeutic characteristics of AIPmut pituitary adenomas. Design: This study was an international, multicenter, retrospective case collection/database analysis. Setting: The study was conducted at 36 tertiary referral endocrine and clinical genetics departments. Patients: Patients included 96 patients with germline AIPmut and pituitary adenomas and 232 matched AIPmut-negative acromegaly controls. Results: The AIPmut population was predominantly young and male (63.5%); first symptoms occurred as children/adolescents in 50%. At diagnosis, most tumors were macroadenomas (93.3%); extension and invasion was common. Somatotropinomas comprised 78.1% of the cohort; there were also prolactinomas (n = 13), nonsecreting adenomas (n = 7), and a TSH-secreting adenoma. AIPmut somatotropinomas were larger (P = 0.00026), with higher GH levels (P = 0.00068), more frequent extension (P = 0.018) and prolactin cosecretion (P = 0.00023), and occurred 2 decades before controls (P < 0.000001). Gigantism was more common in the AIPmut group (P < 0.000001). AIPmut somatotropinoma patients underwent more surgical interventions (P = 0.00069) and had lower decreases in GH (P = 0.00037) and IGF-I (P = 0.028) and less tumor shrinkage with somatostatin analogs (P < 0.00001) vs. controls. AIPmut prolactinomas occurred generally in young males and frequently required surgery or radiotherapy. Conclusions: AIPmut pituitary adenomas have clinical features that may negatively impact treatment efficacy. Predisposition for aggressive disease in young patients, often in a familial setting, suggests that earlier diagnosis of AIPmut pituitary adenomas may have clinical utility

Climate change alters the egg development dynamics in cold-water adapted coregonids

201

Evolution of snow and ice temperature, thickness and energy balance in Lake Orajärvi, northern Finland

The seasonal evolution of snow and ice on Lake Orajärvi, northern Finland, was investigated for three consecutive winter seasons. Material consisting of numerical weather prediction model (HIRLAM) output, weather station observations, manual snow and ice observations, high spatial resolution snow and ice temperatures from ice mass balance buoys (SIMB), and Moderate Resolution Imaging Spectroradiometer (MODIS) lake ice surface temperature observations was gathered. A snow/ice model (HIGHTSI) was applied to simulate the evolution of the snow and ice surface energy balance, temperature profiles and thickness. The weather conditions in early winter were found critical in determining the seasonal evolution of the thickness of lake ice and snow. During the winter season (Nov.–Apr.), precipitation, longwave radiative flux and air temperature showed large inter-annual variations. The uncertainty in snow/ice model simulations originating from precipitation was investigated. The contribution of snow to ice transformation was vital for the total lake ice thickness. At the seasonal time scale, the ice bottom growth was 50–70% of the total ice growth. The SIMB is suitable for monitoring snow and ice temperatures and thicknesses. The Mean Bias Error (MBE) between the SIMB and borehole measurements was −0.7 cm for snow thicknesses and 1.7 cm for ice thickness. The temporal evolution of MODIS surface temperature (three seasons) agrees well with SIMB and HIGHTSI results (correlation coefficient, R=0.81). The HIGHTSI surface temperatures were, however, higher (2.8°C≤MBE≤3.9°C) than the MODIS observations. The development of HIRLAM by increasing its horizontal and vertical resolution and including a lake parameterisation scheme improved the atmospheric forcing for HIGHTSI, especially the relative humidity and solar radiation. Challenges remain in accurate simulation of snowfall events and total precipitation