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Text-based Person Re-Identification in Robotic Guiding Scenarios Using Captioning and Sentence Embeddings
No full textClinical and Radiological Outcomes of Hypofractionated Stereotactic Radiotherapy for Arteriovenous Malformations: A Retrospective Analysis
No full textBackground
The long-term efficacy of hypofractionated stereotactic radiotherapy (HSRT) for complex arteriovenous malformations (AVMs) remains uncertain. This study aimed to evaluate clinical and radiological outcomes following HSRT for AVMs.
Methods
A retrospective review was conducted of 59 patients treated with stereotactic radiotherapy between 2003 and 2020 at a tertiary center. Thirty-seven patients who received HSRT were included. AVM volumes were independently assessed by two radiologists using MRI. Radiological follow-up was available in 36 patients, clinical follow-up in 37. Treatment failure was defined as re-bleeding, re-treatment, or death.
Results
Median radiological follow-up was 4.6 years (range, 0.7–17.2), and clinical follow-up was 5.0 years (range, 0–18.0). Total obliteration was observed in 28 % (10/36) and partial obliteration in 39 % (14/36). Median AVM volumes were 3.8 cc (IQR 2.5–11.5) for total obliteration, 23.6 cc (IQR 11.1–45.1) for partial, and 17.1 cc (IQR 6.9–35.0) for no response (p = 0.004). Median biological effective dose (BED) was 146.4 Gy (IQR 73.0–146.4) for total obliteration, 54.1 Gy (IQR 35.2–56.4) for partial, and 54.1 Gy (IQR 28.4–56.4) for no response (p = 0.003). Treatment failure rates were 11 %, 36 %, 56 %, and 78 % at 2, 5, 10, and 15 years, respectively. Re-bleeding occurred in 0 % with total obliteration, 36 % with partial, and 30 % with no response (p = 0.13).
Conclusions
HSRT provided limited long-term efficacy in complex AVMs, with a high rate of treatment failure. Smaller AVM volumes and higher BED were associated with better outcomes
Implementing clinical practice guidelines into action: a qualitative study of managing knowledge translation in primary care organisations
No full textBackground
Clinical practice guidelines (CPGs) are essential for enhancing healthcare quality and informing evidence-based clinical practices. Despite the availability of strategies, their implementation remains challenging due to the complexities of managing translation CPGs into practice, such as barriers to change, resource limitations and high costs. This study examines management mechanisms that offer valuable insights into how healthcare organizations can manage CPG implementation at the organizational level to optimise high-quality care.
Methods
This qualitative study examines the management of CPG implementation using interview data (n = 33) from healthcare managers and clinicians in Finnish public primary care. The data were collected through seven focus group interviews across nine public primary care organizations. The interview transcripts were analysed using thematic analysis with a multidisciplinary approach.
Results
CPGs are considered important tools for improving care quality and promoting shared evidence-based practices. The obstacles to managing implementation included dissemination difficulties, motivation challenges and information overload. Managers and clinicians had contrary views on their roles and responsibilities in CPG implementation. To lead the knowledge translation processes, managers emphasised unit managers’ support, dissemination and communication channels, whereas clinicians viewed CPG implementation as a grassroots effort and the responsibility of each individual. The results illustrate the need for enhancing shared views on CPGs and managing social implementation activities within organizations.
Conclusions
Successful CPG implementation requires active managerial efforts and clinician dialogue to transform new evidence into locally viable practices. To inform more effective knowledge translation, the five identified management mechanisms included instructions; accountability structures; motivation, goal setting and feedback; communication strategies and participatory practices. In managing CPG implementation, a focus on interaction processes, motivation and feedback is essential for ensuring collective knowledge formation. This study improves the understanding of critical organizational knowledge translation processes by drawing attention to the previously underrepresented managerial aspects in CPG implementation studies. Future researchers, guideline developers, and policymakers should integrate managerial activities and clinician engagement in CPG implementation to ensure effective practices and healthcare quality
Kunnan sopimukset ja välityslauseke: välityslausekkeen käyttäminen kunnan sopimuksessa julkisoikeudellisessa viitekehyksessä
No full textAn overview of the effectiveness of kangaroo mother care – an umbrella review of meta-analyses
No full textRakenteellisesti erilaisten kasviproteiini-kuitu kompleksien vaikutus syömisen jälkeiseen glykemiaan
No full textMorphological processing in Alzheimer’s disease : A network analysis of word recognition and inflection in Finnish
No full textThis study investigated the degree to which cognitive mechanisms support word recognition and word inflection in aging and how this changes in Alzheimer’s disease (AD). We tested competing hypotheses regarding the functional organization of language within the broader cognitive system. One set of hypotheses, derived from dual-system theories like the Declarative/Procedural (DP) model, predicts a functional architecture segregated by linguistic function. An alternative set of hypotheses posits a more integrated architecture, organized by task demands and resource availability.
We analyzed participants’ performance on a lexical decision task and a word inflection task, alongside neuropsychological tests, using both behavioral and network analyses. In healthy controls (HC), the network analysis revealed a highly integrated architecture where language tasks were clustered by functional demands (e.g., speed vs. accuracy) rather than segregated along a strict lexicon/grammar divide. In the AD group, behavioral results showed a classic dissociation, with disproportionate impairment on irregular word inflection — a pattern traditionally seen as evidence for a modular memory failure. However, our network analysis revealed a different underlying mechanism. We observed a dramatic network reorganization where a core declarative memory module became functionally isolated, causing language tasks to form new, compensatory alliances with remaining frontal-executive resources. This provides clear evidence of a shift where executive functions are recruited to support language abilities when dedicated memory systems decline.
These findings suggest that the cognitive substrate for language is not static but adapts dynamically in neurodegeneration, shifting its reliance from failing declarative memory systems to domain-general executive control pathways
Lääkkeiden ja päihteiden yhteisvaikutuksiin liittyvät kysymykset Päihdelinkin neuvontapalvelussa
No full textIntravitreal Sustained Release of Dexamethasone from a Self-Healing Injectable Hydrogel: An In Vivo Safety and Release Study
No full textCorticosteroids, such as dexamethasone, are clinically used in intravitreal injections for the treatment of inflammatory and age-related ocular diseases; however, frequent injections can cause complications. To prolong the retention of dexamethasone in the eye after intravitreal administration, sustained-release drug delivery systems have previously been investigated. The aim of this study was to evaluate the in vivo release of dexamethasone from a self-healing thermosensitive hydrogel consisting of a thermosensitive ABA triblock copolymer and to investigate its safety after its injection into the eyes of rats and rabbits. The polymer building block for hydrogel preparation was synthesized by copolymerization of a methacrylated dexamethasone prodrug (mDEX) with N-isopropylacrylamide (NIPAM) and N-acryloxysuccinimide (NAS) through reversible addition–fragmentation chain transfer (RAFT) polymerization, using poly(ethylene glycol) (PEG; 6 kDa) functionalized at both ends with a chain transfer agent (CTA). This yielded a thermosensitive triblock copolymer (p(NIPAM-co-NAS-co-mDEX)-PEG-P(NIPAM-co-NAS-co-mDEX) with a cloud point of 23 °C. Upon incubation of an aqueous solution of this polymer at 37 °C, thermogelation occurs. The resulting thermogel is chemically stabilized by cross-linking with cystamine, a compound with two amino groups that react with the succinimide functionalities present in the polymer chains. Intravitreal injections of a preformed fluorescently labeled hydrogel into rats were carried out, and hydrogel degradation and retinal health were followed using optical coherence tomography (OCT) and fundus imaging. The hydrogel started to degrade 2–3 weeks post injection, and it was cleared from the eye after 5 weeks. Adverse effects, mainly cataract and mild retinal bleeding, were observed, which were probably caused by injection trauma. No histological differences were seen between the treated and untreated eyes. In rabbits, unlabeled hydrogel was injected into the vitreous, and no side effects were observed in the animals. After 3 weeks, the hydrogels could not be seen by fundus imaging, but released dexamethasone was quantifiable with LC-MS/MS in the aqueous humor for 9 weeks post injection. A compartmental model fit of the experimental data showed that the in vivo release of dexamethasone followed first-order kinetics with a half-life of 16.5 days. The good tolerance of the formulation and the sustained dexamethasone release for 2 months make this delivery system an interesting candidate for further preclinical testing
Navigating Market Constraints: Sustainable Startups Driving Transformative Change Through Venture Creation
No full textThis paper contributes to venture-creation research by examining how sustainable startups can overcome market constraints to drive transformative change through their business development. Conceptually, we address this question by identifying venture-creation narratives in the learning and experimental phases of sustainable startups that contribute to the creation of social, economic, and environmental value. Empirically, we conducted a qualitative case study of sustainable circular economy (CE) startups in Finland. Our findings reveal three overarching categories of entrepreneurial narratives through which CE startups drive transformative change through venture creation. Moreover, two main implications are discussed: a deeper understanding of the integrative approach to venture and business opportunity creation in sustainability transition and a comprehensive view of initiating a sustainable entrepreneurial journey that seeks to transform a linear market