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Objective
We aimed to investigate the proportion of young patients not returning to work (NRTW) at 1 year after ischemic stroke (IS) and during follow-up, and clinical factors associated with NRTW.
Methods
Patients from the Helsinki Young Stroke Registry with an IS occurring in the years 1994–2007, who were at paid employment within 1 year before IS, and with NIH Stroke Scale score ≤15 points at hospital discharge, were included. Data on periods of payment came from the Finnish Centre for Pensions, and death data from Statistics Finland. Multivariate logistic regression analyses assessed factors associated with NRTW 1 year after IS, and lasagna plots visualized the proportion of patients returning to work over time.
Results
We included a total of 769 patients, of whom 289 (37.6%) were not working at 1 year, 323 (42.0%) at 2 years, and 361 (46.9%) at 5 years from IS. When adjusted for age, sex, socioeconomic status, and NIH Stroke Scale score at admission, factors associated with NRTW at 1 year after IS were large anterior strokes, strokes caused by large artery atherosclerosis, high-risk sources of cardioembolism, and rare causes other than dissection compared with undetermined cause, moderate to severe aphasia vs no aphasia, mild and moderate to severe limb paresis vs no paresis, and moderate to severe visual field deficit vs no deficit.
Conclusions
NRTW is a frequent adverse outcome after IS in young adults with mild to moderate IS. Clinical variables available during acute hospitalization may allow prediction of NRTW.
Auch kleine und mittlere Unternehmen müssen aktive Öffentlichkeitsarbeit betreiben. Nur wenige können einen Profi einstellen, der diese Funktion übernimmt. Also muss jemand im Betrieb einspringen, Pläne entwickeln, die Pressemitteilungen schreiben und vergleichbare Aufgaben wahrnehmen. Dazu geben die Autoren praktische Hilfe mit vielen Checklisten. Sie zeigen Wege für den erfolgreichen Auftritt in der Öffentlichkeit und vor der Presse, führen in die aktuellen Themen der Öffentlichkeitsarbeit ein (Konzepte, Pressearbeit, interne Information, Krisen sowie Konflikte) und verzichten dabei auf allen Ballast, der in der Praxis des Klein- und Mittelbetriebs nicht interessiert.
Nitric oxide adsorption on a Au(100) single crystal has been investigated to identify the type of adsorption, the adsorption site, and the orientation and alignment of the adsorbed NO relative to the surface. This was done using a combination of 3D-surface velocity map imaging, near-ambient pressure X-ray photoelectron spectroscopy, and density functional theory. NO was observed to be molecularly adsorbed on gold at ~200 K. Very narrow angular distributions and cold rotational distributions of photodesorbed NO indicate that NO adsorbs on high-symmetry sites on the Au crystal, with the N–O bond axis close to the surface normal. Our density functional theory calculations show that NO preferentially adsorbs on the symmetric bridge (2f) site, which ensures efficient overlap of the NO π* orbital with the orbitals on the two neighbouring Au atoms, and with the N–O bond axis aligned along the surface normal, in agreement with our conclusions from the rotational state distributions. The combination of XPS, which reveals the orientation of NO on gold, with 3D-surface velocity map imaging and density functional theory thus allowed us to determine the adsorption site, orientation and alignment of nitric oxide adsorbed on Au(100).
Viele Unternehmen experimentieren mit Agilität. Gleichzeitig ist die Unsicherheit groß, wieviel Agilität ein QM-System nach ISO 9001 tatsächlich verträgt. Ein gemeinsames Forschungsprojekt der Hochschule Hannover und der DGQ hat sich zum Ziel gesetzt, hier mehr Sicherheit zu geben. Aus Interviews mit Vertretern von Unternehmen, welche teilweise agil arbeiten, entstand erstmals eine klare Definition von Agilität, agilen Praktiken und agilen Prozessen im Organisationskontext. Die daraus entwickelten Leitlinien für die Integration von agilen Vorgehensweisen in QM-Systeme beweisen schlüssig, dass agile Prozesse grundsätzlich nach den ISO 9001-Kriterien zertifizierungsfähig ausgestaltet werden können.
Agility is considered the silver bullet for survival in the VUCA world. However, many organisations are afraid of endangering their ISO 9001 certificate when introducing agile processes. A joint research project of the University of Applied Sciences and Arts Hannover and the DGQ has set itself the goal of providing more security in this area. The findings were based on interviews with managers and team members from various organisations of different sizes and industries working in an agile manner as well as on common audit practices and a literature analysis. The outcome presents a clear distinction of agility from flexibility as well as useful guidelines for the integration of agile processes in QM systems - for QM practitioners and auditors alike.
Viele Unternehmen experimentieren mit Agilität. Gleichzeitig ist die Unsicherheit groß, wieviel Agilität ein QM-System nach ISO 9001 tatsächlich verträgt. Ein gemeinsames Forschungsprojekt der Hochschule Hannover und der DGQ hat sich zum Ziel gesetzt, hier mehr Sicherheit zu geben. Aus Interviews mit Vertretern von Unternehmen, welche teilweise agil arbeiten, entstanden Leitlinien für die Integration von agilen Vorgehensweisen in QM-Systeme und erstmals eine klare Definition von Agilität.
Background
Uncomplicated urinary tract infections (UTI) are common in general practice and usually treated with antibiotics. This contributes to increasing resistance rates of uropathogenic bacteria. A previous trial showed a reduction of antibiotic use in women with UTI by initial symptomatic treatment with ibuprofen. However, this treatment strategy is not suitable for all women equally. Arctostaphylos uva-ursi (UU, bearberry extract arbutin) is a potential alternative treatment. This study aims at investigating whether an initial treatment with UU in women with UTI can reduce antibiotic use without significantly increasing the symptom burden or rate of complications.
Methods
This is a double-blind, randomized, and controlled comparative effectiveness trial. Women between 18 and 75 years with suspected UTI and at least two of the symptoms dysuria, urgency, frequency or lower abdominal pain will be assessed for eligibility in general practice and enrolled into the trial. Participants will receive either a defined daily dose of 3 × 2 arbutin 105 mg for 5 days (intervention) or fosfomycin 3 g once (control). Antibiotic therapy will be provided in the intervention group only if needed, i.e. for women with worsening or persistent symptoms. Two co-primary outcomes are the number of all antibiotic courses regardless of the medical indication from day 0–28, and the symptom burden, defined as a weighted sum of the daily total symptom scores from day 0–7. The trial result is considered positive if superiority of initial treatment with UU is demonstrated with reference to the co-primary outcome number of antibiotic courses and non-inferiority of initial treatment with UU with reference to the co-primary outcome symptom burden.
Discussion
The trial’s aim is to investigate whether initial treatment with UU is a safe and effective alternative treatment strategy in women with UTI. In that case, the results might change the existing treatment strategy in general practice by promoting delayed prescription of antibiotics and a reduction of antibiotic use in primary care.
Integrating distributional and lexical information for semantic classification of words using MRMF
(2016)
Semantic classification of words using distributional features is usually based on the semantic similarity of words. We show on two different datasets that a trained classifier using the distributional features directly gives better results. We use Support Vector Machines (SVM) and Multirelational Matrix Factorization (MRMF) to train classifiers. Both give similar results. However, MRMF, that was not used for semantic classification with distributional features before, can easily be extended with more matrices containing more information from different sources on the same problem. We demonstrate the effectiveness of the novel approach by including information from WordNet. Thus we show, that MRMF provides an interesting approach for building semantic classifiers that (1) gives better results than unsupervised approaches based on vector similarity, (2) gives similar results as other supervised methods and (3) can naturally be extended with other sources of information in order to improve the results.
The CogALex-V Shared Task provides two datasets that consists of pairs of words along with a classification of their semantic relation. The dataset for the first task distinguishes only between related and unrelated, while the second data set distinguishes several types of semantic relations. A number of recent papers propose to construct a feature vector that represents a pair of words by applying a pairwise simple operation to all elements of the feature vector. Subsequently, the pairs can be classified by training any classification algorithm on these vectors. In the present paper we apply this method to the provided datasets. We see that the results are not better than from the given simple baseline. We conclude that the results of the investigated method are strongly depended on the type of data to which it is applied.
In distributional semantics words are represented by aggregated context features. The similarity of words can be computed by comparing their feature vectors. Thus, we can predict whether two words are synonymous or similar with respect to some other semantic relation. We will show on six different datasets of pairs of similar and non-similar words that a supervised learning algorithm on feature vectors representing pairs of words outperforms cosine similarity between vectors representing single words. We compared different methods to construct a feature vector representing a pair of words. We show that simple methods like pairwise addition or multiplication give better results than a recently proposed method that combines different types of features. The semantic relation we consider is relatedness of terms in thesauri for intellectual document classification. Thus our findings can directly be applied for the maintenance and extension of such thesauri. To the best of our knowledge this relation was not considered before in the field of distributional semantics.
For indexing archived documents the Dutch Parliament uses a specialized thesaurus. For good results for full text retrieval and automatic classification it turns out to be important to add more synonyms to the existing thesaurus terms. In the present work we investigate the possibilities to find synonyms for terms of the parliaments thesaurus automatically. We propose to use distributional similarity (DS). In an experiment with pairs of synonyms and non-synonyms we train and test a classifier using distributional similarity and string similarity. Using ten-fold cross validation we were able to classify 75% of the pairs of a set of 6000 word pairs correctly.
Background: After kidney transplantation, immunosuppressive therapy causes impaired cellular immune defense leading to an increased risk of viral complications. Trough level monitoring of immunosuppressants is insufficient to estimate the individual intensity of immunosuppression. We have already shown that virus-specific T cells (Tvis) correlate with control of virus replication as well as with the intensity of immunosuppression. The multicentre IVIST01-trial should prove that additional steering of immunosuppressive and antiviral therapy by Tvis levels leads to better graft function by avoidance of over-immunosuppression (for example, viral infections) and drug toxicity (for example, nephrotoxicity).
Methods/design: The IVIST-trial starts 4 weeks after transplantation. Sixty-four pediatric kidney recipients are randomized either to a non-intervention group that is only treated conservatively or to an intervention group with additional monitoring by Tvis. The randomization is stratified by centre and cytomegalovirus (CMV) prophylaxis. In both groups the immunosuppressive medication (cyclosporine A and everolimus) is adopted in the same target range of trough levels. In the non-intervention group the immunosuppressive therapy (cyclosporine A and everolimus) is only steered by classical trough level monitoring and the antiviral therapy of a CMV infection is performed according to a standard protocol. In contrast, in the intervention group the dose of immunosuppressants is individually adopted according to Tvis levels as a direct measure of the intensity of immunosuppression in addition to classical trough level monitoring. In case of CMV infection or reactivation the antiviral management is based on the individual CMV-specific immune defense assessed by the CMV-Tvis level. Primary endpoint of the study is the glomerular filtration rate 2 years after transplantation; secondary endpoints are the number and severity of viral infections and the incidence of side effects of immunosuppressive and antiviral drugs.
Discussion: This IVIST01-trial will answer the question whether the new concept of steering immunosuppressive and antiviral therapy by Tvis levels leads to better future graft function. In terms of an effect-related drug monitoring, the study design aims to realize a personalization of immunosuppressive and antiviral management after transplantation. Based on the IVIST01-trial, immunomonitoring by Tvis might be incorporated into routine care after kidney transplantation.
Subject of this work is the investigation of universal scaling laws which are observed in coupled chaotic systems. Progress is made by replacing the chaotic fluctuations in the perturbation dynamics by stochastic processes.
First, a continuous-time stochastic model for weakly coupled chaotic systems is introduced to study the scaling of the Lyapunov exponents with the coupling strength (coupling sensitivity of chaos). By means of the the Fokker-Planck equation scaling relations are derived, which are confirmed by results of numerical simulations.
Next, the new effect of avoided crossing of Lyapunov exponents of weakly coupled disordered chaotic systems is described, which is qualitatively similar to the energy level repulsion in quantum systems. Using the scaling relations obtained for the coupling sensitivity of chaos, an asymptotic expression for the distribution function of small spacings between Lyapunov exponents is derived and compared with results of numerical simulations.
Finally, the synchronization transition in strongly coupled spatially extended chaotic systems is shown to resemble a continuous phase transition, with the coupling strength and the synchronization error as control and order parameter, respectively. Using results of numerical simulations and theoretical considerations in terms of a multiplicative noise partial differential equation, the universality classes of the observed two types of transition are determined (Kardar-Parisi-Zhang equation with saturating term, directed percolation).
Der Bachelor-Studiengang Mediendesigninformatik der Hochschule Hannover ist ein Informatikstudiengang mit dem speziellen Anwendungsgebiet Mediendesign. In Abgrenzung von Studiengängen der Medieninformatik liegt der Anwendungsfokus auf der kreativen Gestaltung etwa von 3D-Modellierungen, Animationen und Computerspielen. Absolvent*innen des Studiengangs sollen an der Schnittstelle zwischen Informatik und Mediendesign agieren können, zum Beispiel bei der Erstellung von Benutzungsschnittstellen und VR/AR-Anwendungen. Der Artikel stellt das Curriculum des interdisziplinären Studiengangs vor und reflektiert nach dem Abschluss der ersten beiden Studierendenkohorten die Erfahrungen, indem die ursprünglichen Ziele den Zahlen der Hochschulstatistik und den Ergebnissen zweier Studierendenbefragungen gegenübergestellt werden.
The network security framework VisITMeta allows the visual evaluation and management of security event detection policies. By means of a "what-if" simulation the sensitivity of policies to specific events can be tested and adjusted. This paper presents the results of a user study for testing the usability of the approach by measuring the correct completion of given tasks as well as the user satisfaction by means of the system usability scale.
Intrusion detection systems and other network security components detect security-relevant events based on policies consisting of rules. If an event turns out as a false alarm, the corresponding policy has to be adjusted in order to reduce the number of false positives. Modified policies, however, need to be tested before going into productive use. We present a visual analysis tool for the evaluation of security events and related policies which integrates data from different sources using the IF-MAP specification and provides a “what-if” simulation for testing modified policies on past network dynamics. In this paper, we will describe the design and outcome of a user study that will help us to evaluate our visual analysis tool.
For anomaly-based intrusion detection in computer networks, data cubes can be used for building a model of the normal behavior of each cell. During inference an anomaly score is calculated based on the deviation of cell metrics from the corresponding normality model. A visualization approach is shown that combines different types of diagrams and charts with linked user interaction for filtering of data.
Introduction:
Human Immunodeficiency Virus (HIV) infection remains prevalent co-morbidity, and among fracture patients. Few studies have investigated the role of exercise interventions in preventing bone demineralization in people who have fractures and HIV. If exercise exposed, HIV-infected individuals may experience improved bone health outcomes (BMD), function, quality of life (QoL). The study will aim to assess the impact of home based exercises on bone mineral density, functional capacity, QoL, and some serological markers of health in HIV infection among Nigerians and South Africans.
Methods and design:
The study is an assessor-blinded randomized controlled trial. Patients managed with internal and external fixation for femoral shaft fracture at the study sites will be recruited to participate in the study. The participants will be recruited 2 weeks post-discharge at the follow-up clinic with the orthopaedic surgeon. The study population will consist of all persons with femoral fracture and HIV-positive and negative (HIV-positive medically confirmed) aged 18 to 60 years attending the above-named health facilities. For the HIV-positive participants, a documented positive HIV result, as well as a history of being followed-up at the HIV treatment and care center. A developed home based exercise programme will be implemented in the experimental group while the control group continues with the usual rehabilitation programme. The primary outcome measures will be function, gait, bone mineral density, physical activity, and QoL.
Discussion:
The proposed trial will compare the effect of a home-based physical exercise-training programme in the management of femoral fracture to the usual physiotherapy management programmes with specific outcomes of bone mineral density, function, and inflammatory markers.
Objective
The study’s objective was to assess factors contributing to the use of smart devices by general practitioners (GPs) and patients in the health domain, while specifically addressing the situation in Germany, and to determine whether, and if so, how both groups differ in their perceptions of these technologies.
Methods
GPs and patients of resident practices in the Hannover region, Germany, were surveyed between April and June 2014. A total of 412 GPs in this region were invited by email to participate via an electronic survey, with 50 GPs actually doing so (response rate 12.1%). For surveying the patients, eight regional resident practices were visited by study personnel (once each). Every second patient arriving there (inclusion criteria: of age, fluent in German) was asked to take part (paper-based questionnaire). One hundred and seventy patients participated; 15 patients who did not give consent were excluded.
Results
The majority of the participating patients (68.2%, 116/170) and GPs (76%, 38/50) owned mobile devices. Of the patients, 49.9% (57/116) already made health-related use of mobile devices; 95% (36/38) of the participating GPs used them in a professional context. For patients, age (P < 0.001) and education (P < 0.001) were significant factors, but not gender (P > 0.99). For doctors, neither age (P = 0.73), professional experience (P > 0.99) nor gender (P = 0.19) influenced usage rates. For patients, the primary use case was obtaining health (service)-related information. For GPs, interprofessional communication and retrieving information were in the foreground. There was little app-related interaction between both groups.
Conclusions
GPs and patients use smart mobile devices to serve their specific interests. However, the full potentials of mobile technologies for health purposes are not yet being taken advantage of. Doctors as well as other care providers and the patients should work together on exploring and realising the potential benefits of the technology.
Objective: The study’s objective was to assess factors contributing to the use of smart devices by general practitioners (GPs) and patients in the health domain, while specifically addressing the situation in Germany, and to determine whether, and if so, how both groups differ in their perceptions of these technologies.
Methods: GPs and patients of resident practices in the Hannover region, Germany, were surveyed between April and June 2014. A total of 412 GPs in this region were invited by email to participate via an electronic survey, with 50 GPs actually doing so (response rate 12.1%). For surveying the patients, eight regional resident practices were visited by study personnel (once each). Every second patient arriving there (inclusion criteria: of age, fluent in German) was asked to take part (paper-based questionnaire). One hundred and seventy patients participated; 15 patients who did not give consent were excluded.
Results: The majority of the participating patients (68.2%, 116/170) and GPs (76%, 38/50) owned mobile devices. Of the patients, 49.9% (57/116) already made health-related use of mobile devices; 95% (36/38) of the participating GPs used them in a professional context. For patients, age (P<0.001) and education (P<0.001) were significant factors, but not gender (P>0.99). For doctors, neither age (P¼0.73), professional experience (P>0.99) nor gender (P¼0.19) influenced usage rates. For patients, the primary use case was obtaining health (service)-related information. For GPs, interprofessional communication and retrieving information were in the foreground. There was little app-related interaction between both groups.
Conclusions: GPs and patients use smart mobile devices to serve their specific interests. However, the full potentials of mobile technologies for health purposes are not yet being taken advantage of. Doctors as well as other care providers and the patients should work together on exploring and realising the potential benefits of the technology.
