Mobilizing Medical Information and Knowledge: Some Insights from a Survey

The mobile medical information system investigated in the study is developed for mobilizing medical information and knowledge and for matching physicians’ multiple needs, including mobility, reliability and time efficiency. This paper is set to investigate physicians’ perceptions, intentions and actual use regarding the system in a pilot trial conducted in the Finnish health care sector started from April to September 2003. The results from this empirical survey (N=500, returned N=379) indicate that physicians have rather positive perceptions of the system and future intentions to use it in their work practice. Mobile evidence-based medical guidelines-EBMG and mobile textbooks were the most favourite information sources that physicians might use through a mobile device. Mostly, they would search information about certain treatments, drugs and diseases. Mobile EBMG, Pharmaca Fennica and ICD-10 were their most wanted mobile information contents in the system. The physicians were highly motivated to use mobile Internet in order to access the Internet-based EBMG as well as the Finnish Internet medical portal— Terveysportti. Mobile prescription also gained a high probability for being adopted. Individual differences do matter physicians’ perceptional assessments and future intentions to use the system. These findings indicate some potential to mobilize “personalized” medical information and knowledge in order to create knowledge freedom to physicians by taking full advantage of mobile technologies. Mobile prescription might be a step further towards mobilizing medical information but with political difficulty. Implications for future system improvement are discussed briefly

Estimating forest stand density and structure using Bayesian individual tree detection, stochastic geometry, and distribution matching

Errors in individual tree detection and delineation affect diameter distribution predictions based on crown attributes extracted from the detected trees. We develop a methodology for circumventing these problems. The method is based on matching cumulative distribution functions of field measured tree diameter distributions and crown radii distributions extracted from airborne laser scanning data through individual tree detection presented by Vauhkonen and Mehtatalo (2015). In this study, empirical distribution functions and a monotonic, nonlinear model curve are introduced. Tree crown radius distribution produced by individual tree detection is corrected by a method taking into account that all trees cannot be detected. The evaluation is based on the ability of the developed model sequence to predict quadratic mean diameter and total basal area. The studied data consists of 36 field plots in a typical boreal managed forest area in eastern Finland. The suggested enhancements to the model sequence produce improved results in most of the test cases. Most notably, in leaveone-out cross-validation experiments the modified models improve RMSE of basal area 13% in the full data and RMSE of quadratic mean diameter and basal area 69% and 11%, respectively, in pure pine plots. Better modeling of the crown radius distribution and improved matching between crown radii and stem diameters add the operational premises of the full distribution matching.Peer reviewe

Refining and evaluating a Horvitz-Thompson-like stand density estimator in individual tree detection based on airborne laser scanning

Horvitz-Thompson-like stand density estimation is a method for estimating the stand density from tree crown objects extracted from airborne laser scanning data through individual tree detection. The estimator is based on stochastic geometry and mathematical morphology of the (planar) set formed by the detected tree crowns. This set is used to approximate the detection probabilities of trees. These probabilities are then used to calculate the estimate. The method includes a tuning parameter, which needs to be known to apply the method. We present a refinement of the method to allow more general detection conditions than those of previous papers. We also present and discuss the methods for estimating the tuning parameter of the estimator using a functional k-nearest neighbors method. We test the model fitting and prediction in two spatially separate data sets and examine the plot-level accuracy of estimation. The estimator produced a 13% lower RMSE (root-mean-square error) than the benchmark method in an external validation data set. We also analyze the effects of similarity and dissimilarity of training and validation data on the results.Peer reviewe

Poor 10-year survivorship of hip resurfacing arthroplasty : 5,098 replacements from the Finnish Arthroplasty Register

Background and purpose In a previous registry report, short-term implant survival of hip resurfacing arthroplasty (HRA) in Finland was found to be comparable to that of total hip arthroplasty (THA). Since then, it has become evident that adverse reactions to metal debris (ARMDs) may also be associated with HRA, not only with large-diameter head metal-on-metal THA. The aim of the study was to assess medium- to long-term survivorship of HRA based on the Finnish Arthroplasty Register (FAR).Patients and methods 5,068 HRAs performed during the period 2001-2013 in Finland were included. Kaplan-Meier survival analysis was used to calculate survival probabilities and their 95% confidence intervals (CIs). Cox multiple regression, with adjustment for age, sex, diagnosis, femoral head size, and hospital volume was used to analyze implant survival of HRA devices with revision for any reason as endpoint. The reference group consisted of 6,485 uncemented Vision/Bimetric and ABG II THAs performed in Finland over the same time period.Results The 8-year survival, with any revision as an endpoint, was 93% (CI: 92-94) for Birmingham Hip Resurfacing (BHR), 86% (CI: 78-94) for Corin, 91% (CI: 89-94) for ReCap, 92% (CI: 89-96) for Durom, and was 72% (CI: 69-76) for the Articular Surface Replacement (ASR). The 10-year survival, with any revision as an endpoint, for reference THAs was 92% (CI: 91-92) and for all HRAs it was 86% (CI: 84-87%). Female HRA patients had about twice the revision risk of male patients. ASR had an inferior outcome: the revision risk was 4-fold higher than for BHR, the reference implant.Interpretation The 10-year implant survival of HRAs is 86% in Finland. According to new recommendations from NICE (The National Institute for Health and Care Excellence), an HRA/THA should have a revision rate of 5% or less at 10 years. None of the HRAs studied achieved this goal.Peer reviewe

Composition and lipid spatial distribution of HDL particles in subjects with low and high HDL-cholesterol

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Early Environment and Neurobehavioral Development Predict Adult Temperament Clusters

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A multi-centre randomized controlled trial comparing arthroscopic osteochondroplasty and lavage with arthroscopic lavage alone on patient important outcomes and quality of life in the treatment of young adult (18-50) Femoroacetabular impingement

Background: Several cross-sectional studies have estimated that the prevalence of femoroacetabular impingement (FAI) ranges from 14-17% among asymptomatic young adults to almost 95% among competitive athletes. With FAI, there is abnormal contact between the proximal femur and the acetabulum, resulting in abnormal mechanics with terminal motion such as hip flexion and rotation. This condition results from bony anomalies of the acetabular rim (Pincer) and or femoral head/neck junction (CAM) and typically causes hip pain and decreased hip function. The development of hip pain potentially serves as an indicator for early cartilage and labral damage that may result in hip osteoarthritis. Although surgical correction of the misshaped bony anatomy and associated intra-articular soft tissue damage of the hip is thought to improve hip pain and alter the natural history of degenerative disease, the supportive evidence is based upon low quality observational studies. The Femoroacetabular Impingement RandomiSed controlled Trial (FIRST) compares outcomes following surgical correction of the impingement morphology (arthroscopic osteochondroplasty) with/without labral repair versus arthroscopic lavage of the hip joint in adults aged 18 to 50 diagnosed with FAI. Methods and design: FIRST is a multi-centre, randomized controlled trial with a sample size of 220 patients. Exclusion criteria include the presence of hip syndromes, previous surgery or trauma to the affected hip, and significant medical comorbidities. The primary outcome is pain and the secondary outcomes include patient function, quality of life, complications, and cost-effectiveness - all within one year of follow-up. Patients are stratified based on centre and impingement sub-type. Patients, outcome assessors, data analysts, and the Steering Committee are blinded to surgical allocation. Using an intention-to-treat approach, outcome analyses will be performed using an analysis of covariance and descriptive statistics. Discussion: Symptomatic FAI is associated with chronic hip pain, functional limitations, and secondary osteoarthritis. Therefore, optimizing treatment has the potential to improve the lives millions of young, active persons who are diagnosed with this condition. Few orthopaedic surgical trials have similar potential to shift the paradigm of care dramatically towards (or away) from surgical bony and soft tissue interventions.Peer reviewe

Forced Oscillation and Inter-Area Mode Resonance-Effect of the Location of the Oscillation Source

Publisher Copyright: © 2022 IEEE.This paper investigates how the location of forced oscillation (FO) source affects the resonance phenomenon between the FO and inter-area oscillations. The analysis is performed in a simple two generator system and the full Nordic power system simulation model. The main finding is that when the FO source is moved from the 'center of the inter-area oscillation mode' towards the 'ends' of the system, the amplification of the FO increases approximately linearly as a function of the voltage angle difference (or electrical distance) from the center. This finding enables an easy evaluation of risks associated with FO sources in different locations. Such information is also valuable generally in transmission system planning and operation.Peer reviewe