348 research outputs found
On the definition of solution to the total variation flow
No full textFunding Information: The first author would like to thank Heikki Hakkarainen, Panu Lahti and Olli Saari for several useful discussions on this topic over the years. Publisher Copyright: © 2021, The Author(s).We show that the notions of weak solution to the total variation flow based on the Anzellotti pairing and the variational inequality coincide under some restrictions on the boundary data. The key ingredient in the argument is a duality result for the total variation functional, which is based on an approximation of the total variation by area-type functionals.Peer reviewe
Systems engineering in wireless communications / Heikki Koivo, Mohammed Elmusrati.
No full textIncludes bibliographical references and index.xiii, 341 pages
Escalating and de-escalating treatment in HER2-positive early breast cancer
No full textAbstractThe current standard adjuvant systemic treatment of early HER2-positive breast cancer consists of chemotherapy plus 12months of trastuzumab, with or without endocrine therapy. Several trials have investigated modifications of the standard treatment that are shorter and less resource-demanding (de-escalation) or regimens that aim at dual HER2 inhibition or include longer than 12months of HER2-targeted treatment (escalation). Seven randomized trials investigate shorter than 12months of trastuzumab treatment duration. The shorter durations were not statistically inferior to the 1-year duration in the 3 trials with survival results available, but 2 of the trials were small and 1 had a relatively short follow-up time of the patients at the time of reporting. The pathological complete response (pCR) rates were numerically higher in all 9 randomized trials that compared chemotherapy plus dual HER2 inhibition consisting of trastuzumab plus either lapatinib, neratinib, or pertuzumab with chemotherapy plus trastuzumab as neoadjuvant treatments, but the superiority of chemotherapy plus dual HER2-inhibition over chemotherapy plus trastuzumab remains to be demonstrated in the adjuvant setting. One year of adjuvant trastuzumab was as effective as 2years of trastuzumab in the HERA trial, and was associated with fewer side-effects. Extending 1-year adjuvant trastuzumab treatment with 1year of neratinib improved disease-free survival in the ExteNET trial, but the patient follow-up times are still short, and no overall survival benefit was reported. Several important trials are expected to report results in the near future and may modify the current standard
Acceptable quality of life and low disease activity achievable among transition phase patients with rheumatic disease
No full textObjectivesAcross diagnosis groups, transition of adolescents and young adults from children's hospitals to adult care associates with decreased treatment adherence and suboptimal treatment results. Our aim was to compare the health-related quality of life (HRQoL) and disease activity of juvenile idiopathic arthritis (JIA) patients after the transfer of care to the adult clinic and adult patients in the same outpatient clinic.MethodsAll consecutive JIA patients aged 16 to 20years who visited the transition clinic between September 2016 and August 2017 and all consecutive adult onset arthritis patients between December 2016 and August 2017 in the rheumatology outpatient clinic of Helsinki University Hospital were evaluated. HRQoL was measured by a generic instrument, 15D.ResultsA total of 291 patients, 130 JIA, and 161 adults were identified with respective median disease durations of 6.5 and 4.0years. Adults had lower HRQoL measured by 15D (median 0.90 vs. 0.96, PPeer reviewe
Patients with psychiatric diagnoses have lower quality of life than other patients with juvenile rheumatic disease : a prospective study
No full textObjectives. Transition of adolescents with chronic diseases from paediatric healthcare to adult care requires attention to maintain optimal treatment results. We examined changes in health-related quality of life (HRQoL) and disease activity among JIA patients with or without concomitant psychiatric diagnoses after transfer to an adult clinic. Methods. We prospectively followed 106 consecutive patients who were transferred from the New Children's Hospital to the Helsinki University Hospital Rheumatology outpatient clinic between April 2015 and August 2019 and who had at least one follow-up visit. HRQoL was measured using 15D, a generic instrument. Results. The patients' median age at transfer was 16 years and disease duration 4.0 years. Patients were followed for a median of 1.8 years. Disease activity and overall HRQoL remained stable, but distress (dimension 13 of 15D) increased during follow up (P=0.03). At baseline, patients with at least one psychiatric diagnosis had lower overall 15D scores [mean 0.89 (S.D. 0.14) vs 0.95 (S.D. 0.05), P Conclusion. Transition-phase JIA patients with psychiatric diagnoses had lower HRQoL than other JIA patients. Despite reduced disease activity and pain, HRQoL of patients with psychiatric diagnoses remained suboptimal at the end of follow-up. Our results highlight the necessity of comprehensive care and support for transition-phase JIA patients.Peer reviewe
Resolving the conflict between environmental damage and agricultural viability on less favoured areas
No full textProduction linked supports are paid for agriculture in less favoured areas (LFA) in Finland in order to maintain agricultural production and farms. The CAP reform increased the importance of LFA payments and other payments which are still partly coupled to production. We evaluate if any significant environmental damage can be avoided without risking maintenance agricultural production in less favoured areas. We also evaluate the relative effectiveness of alternative policy measures to decrease nutrient surplus, promote biodiversity, and maintain production and farm income. The policy options evaluated are full decoupling, fertiliser tax, both combined and explicit payments for reduced nutrient surpluses. The impacts of the options are compared to the baseline assuming milk quota abolition and continuation of production linked CAP beef premia. Sector model results suggest that decoupling of certain degree would improve the effectiveness of targeted agri-environmental support measures, and in some cases considerable reduction in nutrient surplus is possible with relatively minor reduction in agricultural production and farm income. Fertiliser tax appears to be efficient especially when combined to decoupling while explicit payments on nutrient surpluses as well as full decoupling have some negative side-effects.Agri-environmental policies, nutrient surplus, agricultural sector modelling, Environmental Economics and Policy,
Kuinka voin auttaa? : Yksilöllistetyn pianonsoiton opetusprojekti Valteri-koulu Mäntykankaalla
No full textKuinka voin auttaa? Yksilöllistetyn pianonsoiton opetusprojekti Valteri-koulu Mäntykankaalla -opinnätetyössä toteutettiin pianonsoitonopetusta Valteri-koulu Mäntykankaalla Kuopiossa kahdelle erityisen tuen tarpeiselle oppilaalle, joista toinen sairastaa lihastautia ja toisella on keskittymisen haasteita. Viikottaiset 45 minuutin yksilöllistetyt pianotunnit ajoittuivat vuoden 2018 syyskuusta aina joulukuuhun, ja opetuspäiväksi valikoitui torstai. Oppilaat esiintyivät projektin päätteeksi pianonsoitollaan Valteri-koulu Mäntykankaalla, jossa ohjaaja-na toimi koulun erityisluokanopettaja Heikki Koistinen.
Opinnäytetyössä esitellään inklusiivista musiikkipedagogiikkaa ja sen keskeistä terminologiaa, perehdytään lihastauteihin sekä tarkkaavaisuuden ja toiminnanohjauksen vaikeuksiin. Pääpainopiste opinnäytetyössä on oppilaiden kanssa toteutuneissa opetusprojekteissa ja niissä käytettävissä opetusmenetelmissä. Opinnäyte-työn käytännön osuutena oli kaksi opetusprojektia: Linnunsiivet ja Tarroja keskittymistaulukkoon. Raportointi sisältää pianotuntien tuntisuunnitelmat ja kuvaukset toteutuneista tunneista. Pianotuntien taltioinnit olivat projektien opettajan apuna raportoinnissa ja reflektoinnissa.
Opinnäytetyön nimi ”Kuinka voin auttaa?” kiteyttää kirjoittajan sekä musiikkikasvatuksellista että -terapeuttista ajatusmaailmaa. Opetusprojektissaan hän paitsi halusi auttaa oppilaita oppimaan pianonsoittoa, halusi hän myös auttaa heitä keskittymisen ja lihastaudin kanssa. Tekijällä ei ollut aiempaa kokemusta erityis-tä tukea tarvitsevien oppilaiden opettamisesta ja projektin tulokset osoittavat, ettei se ollut tarpeellistakaan. Kunnioittavalla kohtaamisella ja vuorovaikutustaidoilla opettaja onnistui luomaan opetukseen tarvittavan luot-tamuksen. Pedagoginen arviointikyky auttoi opettajaa miettimään oppilaille yksilöllistettyjä tehtäviä ja sopivia toimintatapoja keskittymisen ja lihasten toiminnan ylläpidon tueksi. Oppilaat kokivat oppimisen riemua ja kumpikin oppilas kehittyi pianonsoitossa omalla tasollaan.In the thesis “How Can I Help? Individualised Piano Teaching Project at Valteri School Mäntykangas “, piano teaching was conducted at Kuopio’s Valteri School for two pupils in need of special support, one of whom is suffering from muscle disease and the other has challenges with concentration. Weekly 45-minute-long per-sonalised piano lessons were held from September to December of 2018, and Thursday was chosen as the teaching day. At the end of the project, these pupils performed piano music at Valteri School Mäntykangas where special class teacher Heikki Koistinen worked as the project’s supervi-sor.
The thesis demonstrates inclusive music pedagogy and its key terminology, familiarises with muscle disease and the problems with attention and activity control. The main focus of the thesis is on the educational pro-jects implemented with the pupils and the teaching methods used in them. The practical part of the thesis consists of two teaching projects: Wings of a bird and Stickers to the concentration table. The report includes lesson plans and descriptions of the conducted lessons. Recordings of conducted piano lessons helped the projects’ teacher to report and reflect.
The thesis’ name “How can I help?” encapsulates the writer’s music educational thinking and her thoughts on the therapeutic use of music. In this teaching project she wanted to help her pupils with concentration and muscle disease with the aid of piano lessons. The author had no teaching experience with pupils with special needs prior to this project. Furthermore, as the project’s results proved: it was not even necessary. Encoun-tering the pupils respectfully and using existing interaction skills, the teacher managed to create the confi-dence needed in teaching. Pedagogical discernment helped the teacher to find individualised tasks and fitting approaches to uphold concentration and muscle activity for the pupils. In addition, music education results were also achieved: the pupils experienced the joy of learning and each pupil developed piano skills at their own level
Outcome of transition phase patients with juvenile idiopathic arthritis
No full textObjectives: Across diagnosis groups, successful transition of adolescent and young adults from children's hospitals to adult care is often associated with decreased treatment adherence and treatment results. The aim of this study was to characterize disease activity and anti-rheumatic medications following transfer of care of juvenile idiopathic arthritis (JIA) patients to the adult clinic.Method: All consecutive JIA patients aged 16-20 years who visited the specific transition clinic in the rheumatology outpatient clinic of Helsinki University Hospital between November 2012 and May 2013 and between April 2015 and April 2016 were evaluated.Results: A total of 214 patients were identified, and 23 appeared in both cohorts. Females had higher disease activity scores (DAS) than males (DAS28-CRP 1.90.7 versus 1.6 +/- 0.3, p=.019; and DAS44-CRP 1.0 +/- 0.7 versus 0.7 +/- 0.5, p=.005; respectively) in the latter cohort. Disease-modifying antirheumatic drugs (DMARDs) were prescribed to 86% of patients, and 48% were on biological DMARDs (bDMARDs), whereas 14% had no specific treatments.Conclusion: Disease activity and clinic attendance remained stable during the transition period. The proportion of transition phase JIA patients on bDMARDs was high and disease activity was low. Reasons for lower disease activity in males in the latter cohort require further investigation.Peer reviewe
Benvenuto Stracca "Tractatus de mercatura seu mercatore" ("Treatise on Commerce or on the Merchant")
No full textLa voce riguarda una descrizione dettagliata del "Tractatus de mercatura seu mercatore" di Benvenuto Stracca e del suo ruolo nella storia del diritto.This volume surveys 150 law books of fundamental importance in the history of Western legal literature and culture. The entries are organized in three sections: the first dealing with the transitional period of fifteenth-century editions of medieval authorities, the second spanning the early modern period from the sixteenth to the eighteenth century, and the third focusing on the nineteenth and twentieth centuries. The contributors are scholars from all over the world. Each ‘old book’ is analyzed by a recognized specialist in the specific field of interest. Individual entries give a short biography of the author and discuss the significance of the works in the time and setting of their publication, and in their broader influence on the development of law worldwide. Introductory essays explore the development of Western legal traditions, especially the influence of the English common law, and of Roman and canon law on legal writers, and the borrowings and interaction between them.
The book goes beyond the study of institutions and traditions of individual countries to chart a broader perspective on the transmission of legal concepts across legal, political, and geographical boundaries. Examining the branches of this genealogical tree of books makes clear their pervasive influence on modern legal systems, including attempts at rationalizing custom or creating new hybrid systems by transplanting Western legal concepts into other jurisdictions
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