Our Data, Our Question: Public-Centric Approaches to Administrative Data Analysis.

There is growing recognition of the importance of patient, public and community engagement in health research, which has not been used widely in analyzing health administrative datasets. In Ontario, health data are stewarded by ICES, whose strategic decision making is guided by a diverse Public Advisory Council (PAC). In a first foray into publicly led projects, the ICES PAC undertook an analysis project on mental health and addiction health service use. Public members guided the project through all stages of research. This generated critical lessons for ICES on improving participation, collaboration and trust.

Intersecting dilated convex polyhedra method for modeling complex particles in discrete element method.

This paper describes a new method for representing concave polyhedral particles in a discrete element method as unions of convex dilated polyhedra. This method offers an efficient way to simulate systems with a large number of (generally concave) polyhedral particles. The method also allows spheres, capsules, and dilated triangles to be combined with polyhedra using the same approach. The computational efficiency of the method is tested in two different simulation setups using different efficiency metrics for seven particle types: spheres, clusters of three spheres, clusters of four spheres, tetrahedra, cubes, unions of two octahedra (concave), and a model of a computer tomography scan of a lunar simulant GRC-3 particle. It is shown that the computational efficiency of the simulations degrades much slower than the increase in complexity of the particles in the system. The efficiency of the method is based on the time coherence of the system, and an efficient and robust distance computation method between polyhedra as particles never intersect for dilated particles.

50-year appraisal of gastrinoma: recommendations for staging and treatment.

BACKGROUND: Gastrinoma is a rare neuroendocrine tumor associated with ulcerogenic syndrome. The purpose of this study was to provide information on current controversies related to treatment, including staging, patient selection, and outcomes for surgical resection. STUDY DESIGN: A retrospective review of 106 patients with gastrinoma. Patients were classified as sporadic gastrinoma (SG) or MEN. End points of analysis included disease-free and disease-specific survival. Kaplan-Meier survival analysis was performed and significance (p < 0.05) was determined by Mantel-Haenszel log-rank test. RESULTS: Gastrinoma can be staged by TNM criteria into four groups (stage 0, I, II, and III), which had notably different survival curves, dependent on tumor size and distant metastases (p < 0.0001), but independent of lymph node metastases (p = 0.324). Surgical resection was possible in 72 patients (SG, n = 50; MEN, n = 22). Durable cure rate for SG was 26%, compared with 4% for MEN-1. Surgical resection achieving gross removal of all tumor resulted in improved survival in both SG and MEN patients (p < 0.0001). Improved survival was independent of a normal postoperative serum gastrin. Stage III was highly predictive of incomplete resection and the associated failure to improve survival (p = 0.0001). CONCLUSIONS: Staging provides a reliable method for the clinician to select patients for operation and to provide a prognosis, and should permit better comparisons of treatment between institutions. In the management of gastrinoma, it is recommended that SG and MEN patients with clinical stage I and II disease have surgical exploration, patients with stage III disease not have mandatory surgical treatment, and some stage 0 patients might not need routine surgical exploration.