Play and heal : randomized controlled trial of Ditto intervention efficacy on improving re-epithelialization in pediatric burns

BACKGROUND: The relationships between pain, stress and anxiety, and their effect on burn wound re-epithelialization have not been well explored to-date. The aim of this study was to investigate the effect of the Ditto (a hand-held electronic medical device providing procedural preparation and distraction) intervention on re-epithelialization rates in acute pediatric burns. METHODS/DESIGN: From August 2011 to August 2012, children (4-12 years) with an acute burn presenting to the Royal Children's Hospital, Brisbane, Australia fulfilled the study requirements and were randomized to [1] Ditto intervention or [2] standard practice. Burn re-epithelialization, pain intensity, anxiety and stress measures were obtained at every dressing change until complete wound re-epithelialization. RESULTS: One hundred and seventeen children were randomized and 75 children were analyzed (n=40 standard group; n=35 Ditto group). Inability to predict wound management resulted in 42 participants no longer meeting the eligibility criteria. Wounds in the Ditto intervention group re-epithelialized faster than the standard practice group (-2.14 days (CI: -4.38 to 0.10), p-value=0.061), and significantly faster when analyses were adjusted for mean burn depth (-2.26 days (CI: -4.48 to -0.04), p-value=0.046). Following procedural preparation at the first change of dressing, the Ditto group reported lower pain intensity scores (-0.64 (CI: -1.28, 0.01) p=0.052) and lower anxiety ratings (-1.79 (CI: -3.59, 0.01) p=0.051). At the second and third dressing removals average pain (FPS-R and FLACC) and anxiety scores (VAS-A) were at least one point lower when Ditto intervention was received. CONCLUSIONS: The Ditto procedural preparation and distraction device is a useful tool alongside pharmacological intervention to improve the rate of burn re-epithelialization and manage pain and anxiety during burn wound care procedures.

Modeling of protein signaling networks in clinical proteomics

Molecular interactions that underlie pathophysiological states are being elucidated using techniques that profile proteomicend points in cellular systems. Within the field of cancer research, protein interaction networks play pivotal roles in the establishment and maintenance of the hallmarks of malignancy, including cell division, invasion, and migration. Multiple complementary tools enable a multifaceted view of how signal protein pathway alterations contribute to pathophysiological states.One pivotal technique is signal pathway profiling of patient tissue specimens. This microanalysis technology provides a proteomic snapshot at one point in time of cells directly procured from the native context of a tumor micro environment. To study the adaptive patterns of signal pathway events over time, before and after experimental therapy, it is necessary to obtain biopsies from patients before, during, and after therapy. A complementary approach is the profiling of cultured cell lines with and without treatment. Cultured cell models provide the opportunity to study short-term signal changes occurring over minutes to hours. Through this type of system, the effects of particular pharmacological agents may be used to test the effects of signal pathway inhibition or activation on multiple endpoints within a pathway. The complexity of the data generated has necessitated the development of mathematical models for optimal interpretation of interrelated signaling pathways. In combination,clinical proteomic biopsy profiling, tissue culture proteomic profiling, and mathematical modeling synergistically enable a deeper understanding of how protein associations lead to disease states and present new insights into the design of therapeutic regimens.

Vision-based simultaneous localization and mapping in changing outdoor environments

For robots operating in outdoor environments, a number of factors, including weather, time of day, rough terrain, high speeds, and hardware limitations, make performing vision-based simultaneous localization and mapping with current techniques infeasible due to factors such as image blur and/or underexposure, especially on smaller platforms and low-cost hardware. In this paper, we present novel visual place-recognition and odometry techniques that address the challenges posed by low lighting, perceptual change, and low-cost cameras. Our primary contribution is a novel two-step algorithm that combines fast low-resolution whole image matching with a higher-resolution patch-verification step, as well as image saliency methods that simultaneously improve performance and decrease computing time. The algorithms are demonstrated using consumer cameras mounted on a small vehicle in a mixed urban and vegetated environment and a car traversing highway and suburban streets, at different times of day and night and in various weather conditions. The algorithms achieve reliable mapping over the course of a day, both when incrementally incorporating new visual scenes from different times of day into an existing map, and when using a static map comprising visual scenes captured at only one point in time. Using the two-step place-recognition process, we demonstrate for the first time single-image, error-free place recognition at recall rates above 50% across a day-night dataset without prior training or utilization of image sequences. This place-recognition performance enables topologically correct mapping across day-night cycles.

Recent advances in modeling the vulnerability of transportation networks

It is well known that, for major infrastructure networks such as electricity, gas, railway, road, and urban water networks, disruptions at one point have a knock on effect throughout the network. There is an impressive amount of individual research projects examining the vulnerability of critical infrastructure network. However, there is little understanding of the totality of the contribution made by these projects and their interrelationships. This makes their review a difficult process for both new and existing researchers in the field. To address this issue, a two-step literature review process is used, to provide an overview of the vulnerability of the transportation network in terms of four main themes - research objective, transportation mode, disruption scenario and vulnerability indicator –involving the analysis of related articles from 2001 to 2013. Two limitations of existing research are identified: (1) the limited amount of studies relating to multi-layer transportation network vulnerability analysis, and (2) the lack of evaluation methods to explore the relationship between structure vulnerability and dynamical functional vulnerability. In addition to indicating that more attention needs to be paid to these two aspects in future, the analysis provides a new avenue for the discovery of knowledge, as well as an improved understanding of transportation network vulnerability.

Dreiundsechzig 1933-2005

Irene Runge wrote 14 books so far. This one was written for the occasion of her 63rd birthday - instead of a speech, it was printed and delivered to 63 of her friends. The book is a memoir, and jumps back and forth in time. It consists mostly of personal memories and anecdotes, but there is also an essay-style to it, with very reflective passages and analyses. It is divided into many chapters, which also resemble diary entries. Irene Runge is a member of the "second generation". She was born in the New York exile, but her parents moved back to Germany after the war, during a climate in the USA, which made it very difficult for sympathisers with the communist party. Her memories give rich insight into the life as an emigrant in New York, but also as re-emigrant in Germany. She writes about the their disappointments with the evolving German Democratic Republic (GDR), Eastern Germany, experiences, which repeated again in 1989/1990, when the reunification with West Germany took place. The year 1989 had practical consequences for her private life--she lost her job at the university, because her past seemed not compatible. She discusses the PDS, the party which evolved from the communist party of Eastern Germany, Berlin after the "Wende" (reunification), and life in Berlin after the reunification. At one point she asks whether the current Turkish-Muslim community in Berlin could be comparable to the living conditions of the Jewish community in the 1930. This is a rare memoir documenting many recent aspects of German-speaking Jewry.

Syntheses and Self-Assembling Characteristics of Amphiphilic Star Diblock Copolymers

Uusien polymeeripohjaisten teknologioiden ja materiaalien myötä räätälöityjen polymeerien tarve on kasvanut. Viime vuosituhannen lopussa kehitetyt kontrolloidut polymerointimenetelmät ovat avanneet uusia mahdollisuuksia paitsi monimutkaisten polymeerien synteesiin, myös itsejärjestyvyyteen perustuvien funktionaalisten nanorakenteiden suunnitteluun ja valmistukseen. Nämä voivat jäljitellä luonnossa esiintyviä rakenteita, joita muodostavat esimerkiksi lipidit ja proteiinit. Itsejärjestyvät molekyylit ovat usein amfifiilisiä eli ne koostuvat hydrofiilisistä ja hydrofobisista osista ja polymeereissä nämä osat voivat olla omina lohkoinaan, jolloin puhutaan amfifiilisistä lohko- tai blokkikopolymeereistä. Riippuen järjestyneiden rakenteiden koostumuksesta ja muodosta, amfifiilisiä blokkikopolymeerejä on tutkittu tai jo käytetty nanoteknologiassa, elastomeereissä, voiteluaineissa, pinta-aktiivisina aineina, lääkkeenannostelussa, maaleissa, sekä elektroniikka-, kosmetiikka- ja elintarviketeollisuudessa. Tavallisimmin käytetyt amfifiiliset blokkikopolymeerit ovat olleet lineaarisia, mutta viime aikoina tutkimus on suuntautunut kohti monimutkaisempia rakenteita. Tällaisia ovat esimerkiksi tähtipolymeerit. Tähtimäisissä polymeereissä miselleille tyypillinen ydin-kuori-rakenne säilyy hyvin alhaisissakin polymeerikonsentraatioissa, koska polymeeriketjut ovat kiinni toisissaan yhdessä pisteessä. Siten ne ovat erityisen kiinnostavia tutkimuskohteita erilaisten hydrofobisten orgaanisten yhdisteiden sitomiseksi ja vapauttamiseksi. Tässä työssä on tarkasteltu amfifiilisten tähtipolymeerien itsejärjestymistä vesiliuoksissa sekä kokeellisesti ja tietokonesimulaatioin. Työ koostuu kahdesta osasta: tähtipolymeerien synteesistä makrosyklisillä initiaattoreilla ja amfifiilisten tähtimäisten blokkikopolymeerien ominaisuuksien tutkimisesta.

Development, reliability and validity of the queensland evaluation of wheelchair skills (QEWS)

- Objectives To develop and test a valid and reliable assessment of wheelchair skills for individuals with spinal cord injuries (SCI); the Queensland Evaluation of Wheelchair Skills (QEWS). - Setting Hospital, Australia. - Methods Phase 1: Four Delphi panel rounds with clinical experts were used to develop the QEWS. Phase 2: Intra-rater and inter-rater reliability of the QEWS items were examined in 100 people with SCI. Phase 3a: Concurrent validity was investigated by examining the association between QEWS total scores and physiotherapists’ global ratings of wheelchair skill performance. Phase 3b: Construct validity was tested in 20 people with recent SCI by examining change in QEWS total scores between when they first mobilised in a wheelchair and scores obtained 10 weeks later. - Results Phase 1: The QEWS was developed. Phase 2: The intra-class correlation coefficients reflecting the intra-rater reliability and the inter-rater reliability for the QEWS total score were 1.00 and 0.98, with scores being within one point of each other 96 and 91% of the time, respectively. Phase 3a: The QEWS total scores were comparable with the global rating of wheelchair skill performance (r2=0.93). Phase 3b: The QEWS scores changed by a median (interquartile range (IQR)) of 4 (1 to 6) points over the 10-week period following first wheelchair mobilisation. - Conclusion The QEWS is a valid and reliable tool for measuring wheelchair skills in individuals with SCI. The QEWS is efficient and practical to administer and does not require specialised equipment.

Tracking brand positioning for an emerging destination: 2003 to 2015

Few published studies have monitored destination brand image over time. This temporal aspect is an important gap in the literature, given consensus around the role perceptions play in consumers’ decision making, and the ensuing emphasis on imagery in destination branding collateral. Whereas most destination image studies have been a snapshot of perceptions at one point in time, this paper presents findings from a survey implemented four times between 2003 and 2015. Brand image is the core construct in modelling destination branding performance, which has emerged as a relatively new field of research in the past decade. Using the consumer-based brand equity (CBBE) hierarchy, the project has benchmarked and monitored destination brand salience, image and resonance for an emerging regional destination, relative to key competitors, in the domestic Australian market; and the survey instrument has been demonstrated to be reliable in the context of short break holidays by car. What is particularly interesting to date is there has been relatively little change in the market positions of the five destinations, in spite of over a decade of marketing communications by the regional tourism organisations and their stakeholders, and more recently the mass of user-generated travel content on social media. The project didn’t analyse the actual marketing communications for each of the DMOs. Therefore an important implication is that irrespective of the level of marketing undertaken the DMOs seem to have had little control over the perceptions held in their largest market during this time period. Therefore it must be recognised any improvement in perceptions will likely take a long period of time, and so branding needs to be underpinned by a philosophy of a long term financial investment as well as commitment to a consistency of message over time; which given the politics of DMO decision making represents a considerable challenge.

The curvature invariant for a class of homogeneous operators

For an operator T in the class B-n(), introduced by Cowen and Douglas, the simultaneous unitary equivalence class of the curvature and the covariant derivatives up to a certain order of the corresponding bundle E-T determine the unitary equivalence class of the operator T. In a subsequent paper, the authors ask if the simultaneous unitary equivalence class of the curvature and these covariant derivatives are necessary to determine the unitary equivalence class of the operator T is an element of B-n(). Here we show that some of the covariant derivatives are necessary. Our examples consist of homogeneous operators in B-n(). For homogeneous operators, the simultaneous unitary equivalence class of the curvature and all its covariant derivatives at any point w in the unit disc are determined from the simultaneous unitary equivalence class at 0. This shows that it is enough to calculate all the invariants and compare them at just one point, say 0. These calculations are then carried out in number of examples. One of our main results is that the curvature along with its covariant derivative of order (0, 1) at 0 determines the equivalence class of generic homogeneous Hermitian holomorphic vector bundles over the unit disc.

Conflicts when Competitors Cooperate: Exploring Elements of Conflicts from a Business Network Perspective

Most of the existing research within the business network approach is based on companies that are operating on different levels within the same value chain, as a buyer and a supplier. Intercompetitor cooperation, i.e. cooperation between companies occupying the same level within different value chains, has not been studied to the same extent. Moreover scholars within the business network approach have usually described industrial relationships as long term, consisting of mutual commitment and trust. Industrial relationships are not static, but dynamic, and they contain situations of both harmony and conflict. There is consequently a need for more research both concerning intercompetitor cooperation and conflicts. The purpose of this study is to develop our theoretical and empirical understanding of the nature of conflicts in intercompetitor cooperation from a business network perspective. The focus of the study lies on issue and intensity of conflict. The issue of a conflict can be divided into cause and topic, while the intensity comprises the importance and outcome of a conflict. The empirical part of the study is based on two case studies of groups of cooperating competitors from two different industries. The applied research method is interviews. According to the findings of this study causes of conflicts in intercompetitor cooperation can be divided into three groups: focus, awareness and capacity. Topics of conflict can be related to domain, delivery, advertising or cooperation. Moreover the findings show that conflict situations may be grouped into not important, important or very important. Some conflicts may also be of varying importance, meaning that the importance varies from one point of time to another. Based on the findings of the study the outcome or status of a conflict can be analyzed both on a concrete and general level. The findings also indicate that several conflicts are partly hidden, which means that only one or some of the involved actors perceive the conflict. Furthermore several conflict situations can be related to external network actors.

On the use of weather radar for mesoscale applications in northern conditions

Mesoscale weather phenomena, such as the sea breeze circulation or lake effect snow bands, are typically too large to be observed at one point, yet too small to be caught in a traditional network of weather stations. Hence, the weather radar is one of the best tools for observing, analyzing and understanding their behavior and development. A weather radar network is a complex system, which has many structural and technical features to be tuned, from the location of each radar to the number of pulses averaged in the signal processing. These design parameters have no universal optimal values, but their selection depends on the nature of the weather phenomena to be monitored as well as on the applications for which the data will be used. The priorities and critical values are different for forest fire forecasting, aviation weather service or the planning of snow ploughing, to name a few radar-based applications. The main objective of the work performed within this thesis has been to combine knowledge of technical properties of the radar systems and our understanding of weather conditions in order to produce better applications able to efficiently support decision making in service duties for modern society related to weather and safety in northern conditions. When a new application is developed, it must be tested against ground truth . Two new verification approaches for radar-based hail estimates are introduced in this thesis. For mesoscale applications, finding the representative reference can be challenging since these phenomena are by definition difficult to catch with surface observations. Hence, almost any valuable information, which can be distilled from unconventional data sources such as newspapers and holiday shots is welcome. However, as important as getting data is to obtain estimates of data quality, and to judge to what extent the two disparate information sources can be compared. The presented new applications do not rely on radar data alone, but ingest information from auxiliary sources such as temperature fields. The author concludes that in the future the radar will continue to be a key source of data and information especially when used together in an effective way with other meteorological data.

Effect of GPS on understanding relationship between mobile map and environment : A field experiment

Objectives: GPS technology enables the visualisation of a map reader s location on a mobile map. Earlier research on the cognitive aspects of map reading identified that searching for map-environment points is an essential element for the process of determining one s location on a mobile map. Map-environment points refer to objects that are visualized on the map and are recognizable in the environment. However, because the GPS usually adds only one point to the map that has a relation to the environment, it does not provide a sufficient amount of information for self-location. The aim of the present thesis was to assess the effect of GPS on the cognitive processes involved in determining one s location on a map. Methods: The effect of GPS on self-location was studied in a field experiment. The subjects were shown a target on a mobile map, and they were asked to point in the direction of the target. In order for the map reader to be able to deduce the direction of the target, he/she has to locate himself/herself on the map. During the pointing tasks, the subjects were asked to think aloud. The data from the experiment were used to analyze the effect of the GPS on the time needed to perform the task. The subjects verbal data was used to assess the effect of the GPS on the number of landmark concepts mentioned during a task (landmark concepts are words referring to objects that can be recognized both on the map and in the environment). Results and conclusions: The results from the experiment indicate that the GPS reduces the time needed to locate oneself on a map. The analysis of the verbal data revealed that the GPS reduces the number of landmark concepts in the protocols. The findings suggest that the GPS guides the subject s search for the map-environment points and narrows the area on the map that must be searched for self-location.

Kaupunkipurot Helsingissä - Veden laatu vuonna 2004

In recent years urban hydrology and individual urban streams have been in focus and subjects to research also in Helsinki. However, until now there has been lack of research covering simultaneously the whole area of the city of Helsinki. The aim of this study was to find out the general state of water quality in small urban streams in the city of Helsinki. 21 streams were studied: Mätäjoki, Korppaanoja, Mätäpuro, Näsinoja-Tuomarinkylänoja, Tuomarinkartanonpuro, Kumpulanpuro, Tapaninkylänpuro, Tapaninvainionpuro, Puistolanpuro, Longinoja, Säynäslahdenpuro, Viikinoja, Porolahdenpuro, Mustapuro, Marjaniemenpuro, Mellunkylänpuro, Vuosaarenpuro, Rastilanpuro, Ramsinkannaksenpuro, Skatanpuro and Yliskylänpuro. Water samples were collected from 48 sampling points, each stream having at least one point. Four water samples were collected from each point, sampling periods being 9.-11.2., 26.-28.4., 29.6.-1.7. and 25.-27.10.2004. Field measurements associated with water sampling included water temperature, oxygen concentration, pH and electrical conductivity. Water samples were analysed in the Laboratory of Physical Geography in the University of Helsinki and in the Environmental Laboratory of the City of Helsinki Environment Centre for following properties: suspended solids, dissolved substances, alkalinity, principal anions and cations (Na+, K+, Mg2+, Ca2+, F-, Cl-, NO3-, PO43- and SO42-), colour, turbidity, biological and chemical oxygen demand (BOD7 and CODMn-values), nutrient concentrations and bacterial indicators of hygienic quality. The main water quality issues found in this study were low oxygen levels in many streams and poor hygienic quality at least occasionally. E.g. in summer oxygen levels were under 60 % in every stream. Amount of total dissolved substances and nutrients were high in some of the streams studied. Compared to other Finnish streams the values of alkalinity and pH were higher. Although these problems were common, the variation between different streams and sampling points was significant. This was probably due to local conditions. Best overall water quality was found in Mätäpuro and Tuomarinkartanonpuro streams. Seasonal variation was evident in almost all water quality properties. For example the total amount of dissolved substances was largest in winter and decreased during the year. Colour and turbidity were smallest in winter and increased towards the end of the year. The same was true for suspended solids, which had smallest concentration in winter and greatest in autumn. It must be kept in mind that the spring samples were collected after the spring flood otherwise the largest suspended solid concentrations would have been expected in spring. Finnish general water quality classification was used to assess the quality of urban stream waters. Its suitability for small urban streams is not, however, completely trouble-free. This classification does not take into account the quick changes in such small streams but evaluates only the yearly mean values. This can oversimplify the picture of the water quality situation in the streams. Also in order to better reflect the urban environment the analysed water quality properties should also include total dissolved substances and e.g. concentrations of chloride and sodium.

A Compliant Mechanism Kit with Flexible Beams and Connectors

We present the concept, prototypes, and an optimal design method for a compliant mechanism kit as a parallel to the kits available for rigid-body mechanisms. The kit consists of flexible beams and connectors that can be easily hand-assembled using snap fits. It enables users, using their creativity and mechanics intuition, to quickly realize a compliant mechanism. The mechanisms assembled in this manner accurately capture the essential behavior of the topology, shape, size and material aspects and thereby can lead the way for a real compliant mechanism for practical use. Also described in this paper are the design of the connector to which flexible beams can be added in eight different directions; and prototyping of the spring steel connectors as well as beams using wire-cut electro discharge machining. It is noted in this paper that the concept of the kit also resolves a discrepancy in the finite element (FE) modeling of beam-based compliant mechanisms. The discrepancy arises when two or more beams are joining at one point and thus leading to increased stiffness. After resolving this discrepancy, this work extends the topology optimization to automatically generate designs that can be assembled with the kit. Thus, the kit and the accompanying analysis and optimal synthesis procedures comprise a self-contained educational as well as a research and pragmatic toolset for compliant mechanisms. The paper also illustrates how human creativity finds new ways of using the kit beyond the original intended use and how it is useful even for a novice to design compliant mechanisms.

Percolation and Connectivity in AB Random Geometric Graphs

Given two independent Poisson point processes ©(1);©(2) in Rd, the AB Poisson Boolean model is the graph with points of ©(1) as vertices and with edges between any pair of points for which the intersection of balls of radius 2r centred at these points contains at least one point of ©(2). This is a generalization of the AB percolation model on discrete lattices. We show the existence of percolation for all d ¸ 2 and derive bounds for a critical intensity. We also provide a characterization for this critical intensity when d = 2. To study the connectivity problem, we consider independent Poisson point processes of intensities n and cn in the unit cube. The AB random geometric graph is de¯ned as above but with balls of radius r. We derive a weak law result for the largest nearest neighbour distance and almost sure asymptotic bounds for the connectivity threshold.