bluuebunny/crossref_metadata_2025 huggingface dataset:
Differential Responses to Steroid Hormones in Fibroblasts From the Vocal Fold, Trachea, and Esophagus
Authors: Mukudai Shigeyuki , Matsuda Ken Ichi , Nishio Takeshi , Sugiyama Yoichiro , Bando Hideki , Hirota Ryuichi , Sakaguchi Hirofumi , Hisa Yasuo , Kawata Mitsuhiro
Published: December 2014

There is accumulating evidence that fibroblasts are target cells for steroids such as sex hormones and corticoids. The characteristics of fibroblasts vary among tissues and organs. Our aim in this study is to examine differences in responses to steroid hormones among fibroblasts from different cervicothoracic regions. We compared the actions of steroid hormones on cultured fibroblasts from the vocal folds, which are considered to be the primary target of steroid hormones, and the trachea and esophagus in adult male rats. Expression of steroid hormone receptors (androgen receptor, estrogen receptor α, and glucocorticoid receptor) was identified by immunofluorescence histochemistry. Androgen receptor was much more frequently expressed in fibroblasts from the vocal fold than in those from the trachea and esophagus. Cell proliferation analysis showed that administration of testosterone, estradiol, or corticosterone suppressed growth of all 3 types of fibroblasts. However, mRNA expression for extracellular matrix–associated genes, including procollagen I and III and elastin, and hyaluronic acid synthase I was elevated only by addition of testosterone to fibroblasts from the vocal fold. These results indicate that each steroid hormone exerts region-specific effects on cervicothoracic fibroblasts with different properties through binding to specific receptors.
Adrenal Androgen Excess and Body Mass Index in Polycystic Ovary Syndrome
Authors: Moran Carlos , Arriaga Monica , Arechavaleta-Velasco Fabian , Moran Segundo
Published: December 2014

Context:

Adrenal hyperandrogenism affects approximately 25% of polycystic ovary syndrome (PCOS) patients but its relation to obesity is not totally understood.

Objective:

This study aimed to assess dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEAS) levels in relation to body mass index (BMI) in PCOS.

Design and Setting:

This was a prospective observational study at an institutional practice at an obstetrics/gynecology hospital.

Participants:

The study included 136 PCOS patients, 20–35 years old, and 42 age-matched control women. The participants were classified with the BMI cutoff value of 27 kg/m2 as follows: 1) high-BMI PCOS patients; 2) low-BMI PCOS patients; 3) high-BMI control women; and 4) low-BMI control women. The data were reanalyzed with the BMI cutoff value of 30 kg/m2 to corroborate the findings in obese and nonobese patients.

Main Outcome Measure(s):

Blood samples were taken and LH, FSH, insulin, T, androstenedione (A4), DHEA, DHEAS, and glucose levels were determined. Homeostatic model assessment was calculated. Pelvic and abdominal ultrasound for ovarian morphology and adipose tissue, respectively, were performed.

Results:

Obese PCOS patients presented significantly more insulin resistance than nonobese PCOS patients. The LH levels and LH/FSH ratio were significantly higher in low-BMI than in high-BMI PCOS patients. The A4 and DHEAS levels were significantly higher in nonobese than in obese PCOS patients. A significant correlation between LH and A4 in nonobese PCOS patients was observed. The frequency of hyperandrogenism by increased A4, and DHEA along with DHEAS was significantly higher in low-BMI PCOS patients compared with high-BMI PCOS patients. Some findings observed with the BMI cutoff value of 27 kg/m2 changed with the cutoff value of 30 kg/m2.

Conclusions:

Low BMI more so than high BMI is associated with increased LH, high A4, DHEA, and DHEAS levels in PCOS patients. The BMI cutoff value of 27 kg/m2 classified better than 30 kg/m2 for hormonal and metabolic characteristics.
Molecular dissection of segment formation in the developing hindbrain
Authors: Labalette Charlotte , Wassef Michel Adam , Desmarquet-Trin Dinh Carole , Bouchoucha Yassine Xavier , Le Men Johan , Charnay Patrick , Gilardi-Hebenstreit Pascale
Published: December 2014

Although many components of the genetic pathways that provide positional information during embryogenesis have been identified, it remains unclear how these signals are integrated to specify discrete tissue territories. Here, we investigate the molecular mechanisms underlying the formation of one of the hindbrain segments, rhombomere (r) 3, specified by the expression of the gene krox20. Dissecting krox20 transcriptional regulation has identified several input pathways: Hox paralogous 1 (PG1) factors, which both directly activate krox20 and indirectly repress it via Nlz factors, and the molecular components of an Fgf-dependent effector pathway. These different inputs are channelled through a single initiator enhancer element to shape krox20 initial transcriptional response: Hox PG1 and Nlz factors define the anterior-posterior extent of the enhancer's domain of activity, whereas Fgf signalling modulates the magnitude of activity in a spatially uniform manner. Final positioning of r3 boundaries requires interpretation of this initial pattern by a krox20 positive-feedback loop, orchestrated by another enhancer. Overall, this study shows how positional information provided by different patterning mechanisms is integrated through a gene regulatory network involving two cis-acting elements operating on the same gene, thus offering a comprehensive view of the delimitation of a territory.
Enthesis fibrocartilage cells originate from a population of Hedgehog-responsive cells modulated by the loading environment
Authors: Schwartz Andrea G. , Long Fanxin , Thomopoulos Stavros
Published: December 2014

Tendon attaches to bone across a specialized tissue called the enthesis. This tissue modulates the transfer of muscle forces between two materials, i.e. tendon and bone, with vastly different mechanical properties. The enthesis for many tendons consists of a mineralized graded fibrocartilage that develops postnatally, concurrent with epiphyseal mineralization. Although it is well described that the mineralization and development of functional maturity requires muscle loading, the biological factors that modulate enthesis development are poorly understood. By genetically demarcating cells expressing Gli1 in response to Hedgehog (Hh) signaling, we discovered a unique population of Hh-responsive cells in the developing murine enthesis that were distinct from tendon fibroblasts and epiphyseal chondrocytes. Lineage-tracing experiments revealed that the Gli1 lineage cells that originate in utero eventually populate the entire mature enthesis. Muscle paralysis increased the number of Hh-responsive cells in the enthesis, demonstrating that responsiveness to Hh is modulated in part by muscle loading. Ablation of the Hh-responsive cells during the first week of postnatal development resulted in a loss of mineralized fibrocartilage, with very little tissue remodeling 5 weeks after cell ablation. Conditional deletion of smoothened, a molecule necessary for responsiveness to Ihh, from the developing tendon and enthesis altered the differentiation of enthesis progenitor cells, resulting in significantly reduced fibrocartilage mineralization and decreased biomechanical function. Taken together, these results demonstrate that Hh signaling within developing enthesis fibrocartilage cells is required for enthesis formation.
Use of restraint to manage challenging behaviour in children after traumatic brain injury
Authors: Dickson Holly , Pywell Alison
Published: December 2014

Traumatic brain injury is the most common cause of acquired disability in children. Behavioural problems that cause challenges to care such as aggression, confusion, agitation, refusal to cooperate, climbing out of bed, attempting to abscond from the ward, and removing invasive drains or intravenous lines are common after brain injuries. This can cause significant problems with maintaining the safety of the child and others, and can have significant negative effects on rehabilitation and recovery. This paper explores the literature around the use of restraint, defined as any intervention that restricts a child's voluntary movement or behaviour by any means, in such cases including physical, mechanical, technological, chemical and psychological. A paucity of relevant research and guidelines was found, putting children at risk of receiving poor care and nurses under professional, ethical and legal pressures.
Research Roundup
Authors: Harrison-Dening Karen
Published: December 2014

Karen Harrison-Dening provides a synopsis and brief review of a selection of recently published research articles of interest to neuroscience nurses, highlighting the key points to keep you up to date. A full reference is provided for those who wish to read the research in more detail.
Improving the management of urinary tract infection
Authors: Haddock Gail
Published: December 2014

Urinary tract infection is a common occurrence for many people, especially women. Gail Haddock advises that, as older patients may not present with typical symptoms, it is important that a diagnosis is based on a full clinical assessment
Supporting people to live well with dementia
Authors: Black Robert
Published: December 2014

In this case study, Robert Black discusses helping people with dementia to live well. He advises a combined approach that is dependent on staffing technique, as well as the physical environment, to maximise an individual's quality of life
Patient safety in anaesthesia
Authors: McMillan Sam
Published: December 2014

Anaesthesia is a complex process resulting in numerous steps in the assessment of veterinary patients, preparation of drugs and equipment, checking of the equipment and communication between team members at several points. It is imperative that within this veterinary professionals strive to ABOVE ALL uphold their declaration to ‘ensure the health and welfare of animals committed to their care’. The pursuit of patient safety in veterinary anaesthesia is in its infancy but must strive to reduce the gap between best practice and the care currently delivered in veterinary practices. This has to involve an evidence-based approach to veterinary anaesthesia and a realisation that preventable human errors occur every day. It must be recognised that not only do these errors occur but that they are inevitable and that only by the recognition and reporting of these errors can analysis and reflection occur to offer preventative strategies. By using veterinary specific tools such as checklists and reporting systems, weveterinary nurses can make a difference.
The use of oral nerve blocks
Authors: O'Dwyer Louise
Published: December 2014

The use of dental nerve blocks provides excellent analgesia for a variety of oral procedures, including dental extractions, as part of a multi modal approach to analgesia. They are relatively simple to perform, inexpensive, and have a rapid onset of action. Some of the more commonly used oral blocks include infraorbital, maxillary, mental and mandibular blocks which can easily, quickly and cheaply be performed providing excellent analgesia for patients undergoing oral procedures.
Parasites, politics and people: a meeting report
Authors: Stokes Laura
Published: December 2014

On 20th November 2014, ESCCAP UK & Ireland ran an afternoon of lectures at the London Vet Show. Four presentations examined the challenges associated with parasite control, particularly those presented by political or policy boundaries that go unrecognised by parasites.
Evaluation of enzymatic detergent efficiency in removing lipids from meat package
Authors: Buturi Ediani Pinho , Hort Adolfo Anselmo , Bona Evandro , Tanamati Ailey Aparecida Coelho , Gonçalves Odinei Hess
Published: December 2014

Food industry is increasingly concerned about their role in environmental responsibility. Recycling of meat package is a challenge since the presence of residual lipids limit the amount of recycled material that could be added to the pure material. In this work the efficiency of an enzymatic detergent in removing total lipids residues from discharged meat polyethylene package was evaluated. The experimental parameters were the enzymatic detergent concentration, temperature and the mass of package used during the detergent application. Soxhlet extraction (3 hours, 40 ºC,) was used to determine the amount of total lipids present in the package both before and after the use of the detergent. The solvent used was petroleum ether and the amount of total lipids was determined gravimetrically. The polyethylene meat package presented an initial amount of total lipids of (15.7± 0.7) %. Results demonstrated that the efficiency increased with the increase in temperature and detergent concentration as well as with the decrease in the mass of the polyethylene sample. Any decrease in the enzymatic activity was observed for the evaluated temperatures. Also there was a limit in the amount of polyethylene package that could be used probably because greater amounts of sample hindered stirring and homogenization. According to the experimental design the maximum efficiency is expected to be 81.72% when the following conditions are used: 54°C, enzymatic detergent concentration of 19g/L and a package sample amount of 4 grams.

DOI: 10.14685/rebrapa.v5i3.178
Information status and English relative constructions: A corpus-based study of Japanese learners in spoken language
Authors: Okugiri Megumi
Published: December 2014

This study investigates Japanese learners’ production of English relative constructions, focusing on the information preference of noun phrases in spoken discourse. The constructions of Japanese learners and of native speakers of English were extracted from a spoken corpus according to learners’ English proficiency levels. The information status (New, Given, and Identifiable) of head noun phrases modified by relative clauses were also examined. The results found that, in an attempt to keep spoken communication coherent, native speakers and learners of all levels prefer general grammatical and pragmatic configurations in their production of English relative constructions. This preference is called the Preferred Argument Structure (Du Bois 1987). However, Japanese learners and native speakers did not share the same preference of language-specific information status. The results suggest that first language information preference plays a crucial role in second language acquisition, especially during the early stages of acquisition. They also suggest that discoursal properties affect the mechanisms and motivations of relative clause constructions in second language acquisition.
German es – a Construction Grammar approach
Authors: Miyashita Hiroyuki
Published: December 2014

In German, neutral pronoun, es which corresponds to English it, is said to be used in addition to pronominal uses without any reference. In the tradition of German linguistics, non-referential es has been treated as a formal subject or an expletive that has only syntactic function and no meaning. In this paper, this view is challenged and es is regarded as a construction as a pair of syntactic form and meaning in the sense of Goldberg’s Construction Grammar. According to syntactic differences, non-referential es is classified into three types. In the analysis the semantic characteristics of these types are discussed. Type 1 expresses an objective indication of the existence/occurrence of a spontaneous event, Type 2 expresses an objective indication of the existence/occurrence of a spontaneous event for the experiencer expressed by dative, and Type 3 expresses an indication of the existence/occurrence of a new subject referent in a single episodic event. These constructions are sometimes extended to creative uses. Finally, a unitary account of these constructions is proposed and the correlation is summarized. German es with no specific reference is thus understood as a construction family which shares an objective construal.
Variation between singular and plural subject-verb agreement in German: A usage-based approach
Authors: Goschler Juliana
Published: December 2014

At first glance, subject-verb-agreement seems to be straightforward in German: In the case of simplex NPs, the subject always agrees with the verb syntactically in person and number. However, with coordinated NPs in subject position, there is considerable variation in usage. If both conjuncts are singular NPs, the verb may display singular agreement - as would be expected, since coordinated structures inherit their syntactic properties from their individual components - but much more frequently, the verb displays plural agreement. On the basis of the LIMAS-corpus, a one-million-word corpus of written German, I will show that there is systematic variation between the two options. Among the determining factors are the position of the verb (preceding or following the subject), the type of NP (pronoun, proper name, lexical NP) and the internal syntactic structure of the subject (coordination of full NPs vs. coordination of partial NPs sharing a determiner, and definiteness vs. indefiniteness of the coordinated parts of the subject). I will discuss the results from the perspective of usage-based approaches and argue for an integration of semantic, pragmatic, and frequency factors in any theoretical approach to grammar.
Idiosyncrasies and generalizations: Argument structure, semantic roles and the valency realization principle
Authors: Herbst Thomas
Published: December 2014

This article argues in favour of dealing with valency phenomena and collocations in terms of constructions. An attempt is made to combine Goldberg’s model of argument structure constructions with item-specific valency constructions. It is argued that it may be appropriate to distinguish not only between verb-specific participant roles and argument roles, but to introduce a further level of clausal roles to account for AGENTIVITY and AFFECTEDNESS typically associated with subjects and traditional direct objects. Finally, the issue of to what extent the syntactic behaviour of verbs can be predicted from their meaning is taken up and it is shown that Goldberg’s Semantic Coherence Principle and Correspondence Principle have to be supplemented by a Valency Realisation Principle.
Innovation aus Kontinuität. Hans-Ulrich Wehler (1931–2014) in der deutschen Geschichtswissenschaft
Authors: Nolte Paul
Published: December 2014

Mit dem Tod Hans-Ulrich Wehlers beginnt der Versuch, Motive, Werk und Wirkung des vermutlich einflussreichsten deutschen Historikers des letzten halben Jahrhunderts zu analysieren. Während Wehler selber den Gegensatz zu den Traditionen der deutschen Geschichtswissenschaft scharf betonte und performativ inszenierte, stand er doch in deutlicher Kontinuität zu vielen ihrer klassischen Fragestellungen und Darstellungsformen. Seinem Selbstverständnis nach wollte er das Fach weder spalten noch aus den Angeln heben, sondern sein Koordinatensystem ein Stück weit verschieben – bis zu Grenzen, die er oft ebenso polemisch markierte: nach politischer Position und intellektuellen Strömungen, in den Methoden und den Formen der Geschichtsschreibung. Mit der von ihm mitbeeinflussten, aber auch generations- und zeitbedingten Umprägung der Geschichtswissenschaft wurde er in den 1980er Jahren vom Außenseiter zum „Mainstreamer“, der sich dieser Rolle gleichwohl, nicht zuletzt im „Historikerstreit“, wieder verweigerte. Erst mit der „Deutschen Gesellschaftsgeschichte“ wandelte sich der Politikhistoriker Wehler zum Sozialhistoriker, doch auch mit diesem Hauptwerk schrieb er Traditionen fort: die Tradition des gelehrten Hauptwerks, die nationalgeschichtliche Rahmung, das syntheseorientierte „master narrative“, und überhaupt den „auktorialen“ Gestus von Geschichtswissenschaft. In seiner Kampfansage an die neue Kulturgeschichte verteidigte er weniger ein spezifisches sozialgeschichtliches Programm als solche allgemeineren Muster des Faches, die weiterhin zur Debatte stehen.
Historische Erkenntnis und juristische Bewertung. Die Berücksichtigung fachfremder Forschungsergebnisse durch die Sozial- und Verwaltungsgerichte am Beispiel der Rolle der Wehrmachtsgerichte im nationalsozialistischen System
Authors: Dietz Andreas
Published: December 2014

Mit ihrer Rechtsprechung zu Renten- und Entschädigungs­ansprüchen leisten deutsche Sozial- und Verwaltungsgerichte aller Instanzen auch fast siebzig Jahre nach Ende des nationalsozialistischen Unrechtsregimes noch wertvolle Beiträge zur Aufarbeitung der Verstrickung damaliger Personen und Organisationen in diese Diktatur. Sie wenden einen juristisch anerkannten zeitlosen Maßstab für die heutige Bewertung eines in der Vergangenheit weit zurückliegenden Ver­haltens an. Damaliges Verhalten wird nur soweit als rechtmäßig angesehen, als es nicht zu bereits zu jener Zeit anerkannten elementaren Rechtsprinzipien in Widerspruch stand, also in so unerträglichem Maß den Grundsät­zen formeller und materieller Gerechtigkeit widersprach, dass es nur als Unrecht bezeichnet werden kann.[89] Gerade den Wehrmachtsgerichten kann ungeachtet der zeitgenössischen Gesetzeslage[90] vielfach – aber ausnahmslos und typischerweise – ein Verstoß gegen die Grundsätze der Menschlichkeit und Rechtsstaatlichkeit vorgeworfen werden. Offen ist, ob sie diesen Widerspruch zu höherrangigen Prinzipen erkannten und billigend in Kauf nahmen, oder erkennen konnten, aber ignorierten. Gerade hierzu kann die historische Forschung noch wichtige Beiträge durch Auswertung von Archivalien und Aktenbeständen liefern. Aufgabe der Gerichte ist es dann, nicht nur das zeitgenössische Strafrecht, sondern auch die tatsächliche Strafzumessung und Strafvollstreckung der Wehrmachtsgerichte zu würdigen[91] und die individuelle Vorwerfbarkeit oder generelle Vermutungen im Einzelfall auf ihre sachliche Richtigkeit hin zu überprüfen und nötigenfalls ihre Rechtsprechung an neue Erkenntnisse anzupassen. Diese Erkenntnisse kann nur die historische Forschung liefern und so einen wertvollen Beitrag zur Weiterentwicklung des juristischen Blicks auf die Vergangenheit leisten.
An adolescent with asthma presenting with worsening cough
Authors: Brickner Joshua P. , Muenster Joseph E. , Pancoast Taylor H. , Tosh Aneesh K.
Published: December 2014

The diagnosis of systemic histoplasmosis may be delayed due to underlying pulmonary conditions in patients from an endemic area. An adolescent White male from the Midwestern United States with a history of moderate persistent asthma presented to the pulmonary clinic with a 10-day’s history of cough. The patient had no response to modifications of his asthma treatment regimen and proceeded to experience worsening symptoms, including pleuritic chest pain and dysphagia. Chest imaging revealed multiple pulmonary nodules, right mainstem bronchus narrowing, bilateral hilar adenopathy, and esophageal thickening. Ophthalmologic examination revealed an ocular “histo spot”, but the patient denied any ocular symptoms. Despite negative initial histoplasmosis antibody testing, the patient began oral itraconazole therapy for presumed histoplasmosis infection. Follow-up histoplasmosis antibody titers were positive, and the patient responded well to itraconazole. Disseminated histoplasmosis can have a wide range of presenting symptoms, which may delay its diagnosis among patients with pre-existing asthma.
Morphological changes in the pancreas and glucose reduction of the aqueous extract of Costus afer leaf on alloxan-induced diabetic rats
Authors: Ezejiofor Anthoneth Ndidi , Orish Chinna Nneka , Orisakwe Orish Ebere
Published: December 2014

Background: Considering the antihyperglycemic and antioxidant activities of herbs, this study has evaluated the morphological changes, hypoglycemic effect, and comparative ameliorating effects of Costus afer Ker Gawl leaf and glibenclamide on pancreatic injury induced by alloxan.

Methods: Thirty adult male albino rats that were divided into six groups of five weight-matched animals each were used in the study. Groups 1 and 2 served as controls, whereas groups 3–6 were alloxan-induced diabetic groups treated with different doses of the extract (375, 750, and 1125 mg/kg C. afer) and glibenclamide, respectively. The glucose level was measured daily, whereas the weight of the animal was monitored on a weekly basis for 21 days. The oral glucose tolerance test was measured on overnight fasted rats after glucose load at 0, 30, 60, 90, and 120 min. The histopathology of the pancreas was also investigated.

Results: The phytoconstituents of C. afer Ker Gawl leaves include glycosides, tannins, saponins, terpenoid, phenolic compound, flavonoids, and alkaloids. Costus afer possessed significant hypoglycemic (p<0.05) effect and reversed the histopathologic damage of pancreases in alloxan-induced diabetic rats comparable to those of glibenclamide.

Conclusions:
Costus afer leaves possess both antidiabetic and tissue protective properties on pancreases of investigated rats.
Determining abdominal obesity cut-offs and relevant risk factors for anthropometric indices in Turkish children and adolescents
Authors: Ozturk Ahmet , Cicek Betul , Mazicioglu M. Mumtaz , Kurtoglu Selim
Published: December 2014

To determine the ≥90th percentile values of waist circumference (WC) to calculate anthropometric measures, indices and relevant risk factors in 5358 Turkish children and adolescents.

This cross-sectional study was conducted in Kayseri, Turkey, from February to April 2005. Cut-offs for body weight, height, mid-upper arm circumference (MUAC), triceps skinfold thickness, body mass index (BMI), and fat percentages were calculated for ≥90th percentile of WC.

According to the results of binary multiple logistic regression analysis (the backward stepwise procedure), sleep duration (boys), maternal education (boys), elevator use (boys), and appetite (boys and girls) were revealed as significant predictors of abdominal obesity, adjusted for age. Appetite was the strongest variable to be associated with abdominal obesity for both genders.

According to receiver operating characteristic analysis, for all age groups within both genders, the best predictors to explain abdominal obesity were BMI and MUAC, respectively.
Effects of T3 treatment on brown adipose tissue and energy expenditure in a patient with craniopharyngioma and hypothalamic obesity
Authors: van Santen Hanneke M. , Schouten-Meeteren Antoinette Y. , Serlie Mireille , Meijneke Ruud W.H. , van Trotsenburg A.S. , Verberne Hein , Holleman Frits , Fliers Eric
Published: December 2014

Patients treated for childhood craniopharyngioma often develop hypothalamic obesity (HO), which has a huge impact on the physical condition and quality of life of these patients. Treatment for HO thus far has been disappointing, and although several different strategies have been attempted, all interventions had only transient effects. Since thyroid hormones increase energy expenditure metabolism (thyroid hormone induced thermogenesis), it was speculated that treatment with tri-iodothyronine (T3) may be beneficial. In 2002, a case report was published on reduction of body weight after T3 treatment for HO. No studies have been reported since. Recent experimental studies in rodents showed that T3 increases brown adipose tissue (BAT) activity via (pre)sympathetic pathways between the hypothalamus and BAT. Our aim was to investigate whether T3 treatment increases BAT activity in a patient with HO resulting from (treatment of) childhood craniopharyngioma.

Thyroxine treatment for central hypothyroidism was switched to T3 monotherapy. Serum T3 and free thyroxine (FT4) concentrations were measured twice weekly for 2 months.

No change in sympathetic and metabolic BAT activity, energy expenditure, or BMI was seen during T3 treatment despite the expected changes in thyroid hormone plasma concentrations.

We conclude that T3 monotherapy does not seem to be effective in decreasing HO in childhood craniopharyngioma.
Carathéodory solutions of Sturm-Liouville dynamic equation with a measure of noncompactness in Banach spaces
Authors: Yantir Ahmet , Kubiaczyk Ireneusz , Sikorska-Nowak Aneta
Published: December 2014

In this paper, we present the existence result for Carathéodory type solutions for the nonlinear Sturm- Liouville boundary value problem (SLBVP) in Banach spaces on an arbitrary time scale. For this purpose, we introduce an equivalent integral operator to the SLBVP by means of Green’s function on an appropriate set. By imposing the regularity conditions expressed in terms of Kuratowski measure of noncompactness, we prove the existence of the fixed points of the equivalent integral operator. Mönch’s fixed point theorem is used to prove the main result. Finally, we also remark that it is straightforward to guarantee the existence of Carathéodory solutions for the SLBVP if Kuratowski measure of noncompactness is replaced by any axiomatic measure of noncompactness.
Set-valued and fuzzy stochastic integral equations driven by semimartingales under Osgood condition
Authors: Malinowski Marek T.
Published: December 2014

We analyze the set-valued stochastic integral equations driven by continuous semimartingales and prove the existence and uniqueness of solutions to such equations in the framework of the hyperspace of nonempty, bounded, convex and closed subsets of the Hilbert space L2 (consisting of square integrable random vectors). The coefficients of the equations are assumed to satisfy the Osgood type condition that is a generalization of the Lipschitz condition. Continuous dependence of solutions with respect to data of the equation is also presented. We consider equations driven by semimartingale Z and equations driven by processes A;M from decomposition of Z, where A is a process of finite variation and M is a local martingale. These equations are not equivalent. Finally, we show that the analysis of the set-valued stochastic integral equations can be extended to a case of fuzzy stochastic integral equations driven by semimartingales under Osgood type condition. To obtain our results we use the set-valued and fuzzy Maruyama type approximations and Bihari’s inequality.
Strenge Aufmerksamkeit im 18. Jahrhundert. Ihre Ausdehnung von der Rhetorik zur Ästhetik
Authors: Asmuth Bernhard
Published: December 2014

In order to convince someone, you need to get their attention first. In Rhetorics, that usually ought to happen right at the beginning of a speech, as already Aristotle suggested. But that notion changed in the 18th century. With the onset of Aesthetics, attention, or attentiveness, became even more important. The focus shifted to a continuing attentiveness of the speaking and writing subject. Originally, Baumgarten established his theory of Aesthetics as the science of sensual cognition (scientia cognitionis sensitivae). His main objective was the intensity (intensio) or effort (»Anstrengung«) of attention, referencing Quintilian’s idea of fierce attentiveness (acris intentio). Baumgarten also mentions other variations, such as its extent (extensio) and its duration (protensio). But it was his disciple Meier who made the concept more comprehensible translating it from Latin into German. About 1770 the now famous notion of suspense (»Spannung«) was introduced as a by-product of attentiveness. Other aesthetic ideas connected to a heightened sense of attention are: the interesting, strength, and enthusiasm.
Gradatio / Crescendo – Eine Geschichte der Steigerung. Transformationen rhetorischer und musikalischer Gradationsfiguren im 18. Jahrhundert
Authors: Firges Janine
Published: December 2014

The rhetorical figure gradatio (or gr. climax) is generally understood as climactic or cumulative figure of speech. On the contrary, early usages lack this semantics of augmentation (or diminution in the case of an anti-climax). This article investigates the transformations of the figure which can not only be traced back to a semantic change but also to a general systematic change within the rhetorical system. A comparable transformation can be observed in music. The introduction of the crescendo-technique into 18th-century symphonic music is strikingly similar in terms of its dynamics, impact and effect and can be regarded as a ›transgression‹ of the musical-rhetorical figure of gradatio as it expresses the idea of climax with non-verbal means.
Das Gespräch in seiner Inszenierung und Darstellung. Emotionales Sprechen im Briefroman zwischen rhetorischer und poetischer Praxis
Authors: Lange Stella Marie
Published: December 2014

With regard to the historical »quarrel« between rhetoric and poetic concepts, this essay, firstly, reports the linguistic, literary and social innovations in letter-writing during the 18th-century. The letter writer’s fictitious role-play between the addressee and himself leads to a detailed description of body language as to further emotionalizing strategies. Thus, literary concepts linked to the letter are in demand which bring the epistolary novel into play. In a comparison of Johann Wolfgang Goethe’s The Sorrows of Young Werther (1787) and Ugo Foscolo’s Last Letters of Jacopo Ortis (1817) it will be shown that the staged conversation between letter writer and addressee and the represented conversation between the letter writer and another character follow the same conversational attitude for each novel: either the principle of sympathy or the principle of divergence. This can be partly explained by a different historical development of aesthetic concepts in Germany and Italy. Besides, the different way of communicating emotions can be also attributed to the epistemic presuppositions: a mimesis which refers to naturalness is in opposition with an autonomous mimesis that breaks with the former tradition.
Risk Factors for Exclusive E-Cigarette Use and Dual E-Cigarette Use and Tobacco Use in Adolescents
Authors: Wills Thomas A. , Knight Rebecca , Williams Rebecca J. , Pagano Ian , Sargent James D.
Published: December 2014

OBJECTIVE:

To describe electronic cigarette (e-cigarette) use and cigarette use among adolescents and determine whether established risk factors for smoking discriminate user categories.

METHODS:

School-based survey of 1941 high school students (mean age 14.6 years) in Hawaii; data collected in 2013. The survey assessed e-cigarette use and cigarette use, alcohol and marijuana use, and psychosocial risk and protective variables (eg, parental support, academic involvement, smoking expectancies, peer smoking, sensation seeking). Analysis of variance and multinomial regression examined variation in risk and protective variables across the following categories of ever-use: e-cigarette only, cigarette only, dual use (use of both products), and nonuser (never used either product).

RESULTS:

Prevalence for the categories was 17% (e-cigarettes only), 12% (dual use), 3% (cigarettes only), and 68% (nonusers). Dual users and cigarette-only users were highest on risk status (elevated on risk factors and lower on protective factors) compared with other groups. E-cigarette only users were higher on risk status than nonusers but lower than dual users. E-cigarette only users and dual users more often perceived e-cigarettes as healthier than cigarettes compared with nonusers.

CONCLUSIONS:

This study reports a US adolescent sample with one of the largest prevalence rates of e-cigarette only use in the existing literature. Dual use also had a substantial prevalence. The fact that e-cigarette only users were intermediate in risk status between nonusers and dual users raises the possibility that e-cigarettes are recruiting medium-risk adolescents, who otherwise would be less susceptible to tobacco product use.
Anaerobic Antimicrobial Therapy After Necrotizing Enterocolitis in VLBW Infants
Authors: Autmizguine Julie , Hornik Christoph P. , Benjamin Daniel K. , Laughon Matthew M. , Clark Reese H. , Cotten C. Michael , Cohen-Wolkowiez Michael , Benjamin Daniel K. , Smith P. Brian
Published: December 2014

OBJECTIVE:

To evaluate the effect of anaerobic antimicrobial therapy for necrotizing enterocolitis (NEC) on clinical outcomes in very low birth weight (≤1500 g) infants.

METHODS:

We identified very low birth weight infants with NEC from 348 US NICUs from 1997 to 2012. Anaerobic antimicrobial therapy was defined by antibiotic exposure on the first day of NEC. We matched (1:1) infants exposed to anaerobic antimicrobial therapy with infants who were not exposed by using a propensity score stratified by NEC severity (medical and surgical). The primary composite outcome was in-hospital death or intestinal stricture. We assessed the relationship between anaerobic antimicrobial therapy and outcome by using a conditional logistic regression on the matched cohort.

RESULTS:

A total of 1390 infants exposed to anaerobic antimicrobial therapy were matched with 1390 infants not exposed. Mean gestational age and birth weight were 27 weeks and 946 g, respectively, and were similar in both groups. We found no significant difference in the combined outcome of death or strictures, but strictures as a single outcome were more common in the anaerobic antimicrobial therapy group (odds ratio 1.73; 95% confidence interval, 1.11–2.72). Among infants with surgical NEC, mortality was less common with anaerobic antimicrobial therapy (odds ratio 0.71; 95% confidence interval, 0.52–0.95).

CONCLUSIONS:

Anaerobic antimicrobial therapy was not associated with the composite outcome of death or strictures but was associated with an increase in intestinal strictures. This higher incidence of intestinal strictures may be explained by the fact that death is a competing outcome for intestinal strictures, and mortality was slightly lower in the anaerobic cohort. Infants with surgical NEC who received anaerobic antimicrobial therapy had lower mortality.
Emerging Paradigm Shifts in Spiritual Care Services in Scotland
Authors: Clegg Cecelia
Published: December 2014

This article describes the profound re-focusing of spiritual care services in Scotland. The contemporary task of healthcare chaplains is about delivering strategic, relevant services which promote wellbeing in society; first, to shift the balance of care from acute institutions towards community-based work which reaches more people, and second, from un-wellness as deficit to promoting the assets of patients and their communities and so developing wellbeing and resilience. This article examines the contours of these paradigm shifts then identifies three discreet roots of these changes in emphasis: namely, the need to improve service delivery in the Health and Social Care sector; the need to promote healthy lifestyles and the need to reform the administration of public services in Scotland. A New Model of healthcare chaplaincy is outlined which requires reflective, flexible practitioners who first, in their own lives, are exploring how their values, beliefs, and experience influence their practice so they become safer and more effective. Second, help to strategically shape policy and systems to make sure that spiritual care is understood and integrated across Health and Social Services. And thirdly, carry specific leadership in connecting the drive to wellness and co-production in both primary and acute healthcare settings.
Exploring Midwives’ Understanding of Spiritual Care and the Role of the Healthcare Chaplain within a Maternity Unit
Authors: Evans Mark , Mitchell David
Published: December 2014

This study explores midwives’ understanding of spiritual care and the role of the healthcare chaplain within a maternity unit. The findings demonstrate that spiritual care is an integral part of midwifery care, rooted in personal experiences and clinical practice. Whilst recognizing that historically spiritual care and religious care were one and the same, there was a clear understanding that within the healthcare setting spiritual care is very separate from religiosity and the religious. The relationship between a midwife and the woman they care for is described as a key manifestation of spiritual care. There was a clear understanding of the chaplain’s role; staff valued their presence and support, and there was recognition that the chaplain had an important and unique role in relation to the provision of religious rituals and symbolic rites. The findings indicate a need to identify spiritual care training resources for staff; a need for the healthcare chaplain to have a “presence” in maternity units and a need for further research into the spiritual needs of women during childbirth.
PACIENTŲ GYVENIMO KOKYBĖS POKYTIS PRIEŠ IR PO PLAUČIŲ REZEKCINIŲ OPERACIJŲ
Authors: Kalibatienė Danutė , Zaksaitė Kristina , Cicėnas Saulius
Published: December 2014

Darbo tikslas. Įvertinti pacientų gyvenimo kokybės pokytį prieš ir po plaučių rezekcinių operacijų. Tyrimo medžiaga ir metodai. Tyrimas buvo atliktas 2013 m. vasario mėn.–2014 m. vasario mėn. Vilniaus universiteto Medicinos fakulteto Slaugos ir vidaus ligų katedroje ir Vilniaus universiteto Onkologijos instituto I onkochirurgijos skyriuje, krūtinės chirurgijos ir onkologijos poskyryje. Apklausoje dalyvavo 68 pacientai, kurie buvo apklausiami du kartus, likus dviem dienoms prieš operaciją ir praėjus savaitei po operacijos. Vidutinis tyrime dalyvavusių asmenų amžius sudarė 59 ± 10,09 metų. Jauniausias respondentas tyrimo metu buvo 40 metų, vyriausias – 79 metų. Tyrimui atlikti pasirinktas Europos vėžio tyrimų organizacijos gyvenimo kokybės klausimynas EORTC QLQ-C30 (3 versija) ir jo modulis, sudarytas sergantiems plaučių vėžiu QLQ-LC13. Rezultatai. Gauti tyrimo rezultatai rodo, kad gyvenimo kokybės ir sveikatos būklės vertinimas neženkliai pakito po plaučių rezekcinių operacijų (31,37 balo iš 100), apklausus respondentus po savaitės nei prieš (30,64 balo iš 100). Po plaučių rezekcinės operacijos respondentai pažymėjo, jog skausmas krūtinėje suintensyvėjo, palyginti su jaustu skausmu prieš operaciją, tačiau skausmas, plintantis į ranką ir petį, po operacijos buvo mažesnis nei prieš. Nuovargis tiriamuosius kankino ir buvo stipresnis po operacijos nei prieš ją. Pastebėta, jog vėmimas ir pykinimas pasitaikė dažniau po plaučių rezekcinių operacijų negu prieš. Gauti duomenys rodo, jog respondentai skundėsi suprastėjusiu apetitu po plaučių rezekcinių operacijų nei prieš. Kosulys ir dusulys vargino rečiau po plaučių rezekcinių operacijų nei prieš. Įvertinus gautus rezultatus galima teigti, kad iškelta hipotezė pasitvirtino, nes pagal gautus tyrimo rezultatus, respondentai gyvenimo kokybę po plaučių rezekcinių operacijų vertino nežymiai geriau nei prieš operaciją. Išvados. Tyrime gauti duomenys leidžia padaryti išvadą, kad prieš plaučių rezekcines operacijas didžioji dalis respondentų gyvenimo kokybę bei sveikatą vertina patenkinamai. Pagrindiniai simptomai, kurie labiausiai vargino visus respondentus – kosulys, skausmas krūtinėje bei rankose ir pečiuose, nemiga, nuovargis bei periferinė neuropatija (p0,05). Po plaučių rezekcinių operacijų respondentų sveikatos būklės ir gyvenimo kokybės vertinimas išlieka patenkinamas. Ryškiausi simptomai, kurie kankino po operacijos respondentus, buvo skausmas krūtinėje, nuovargis, kosulys, dusulys (p 0,05). Taip pat visi respondentai išreiškia stiprų emocijų funkcionavimą (92,16 balo iš 100). Vertinant respondentų sveikatos būklės ir gyvenimo kokybės pokytį pastebėta, jog po plaučių rezekcinių operacijų respondentų savo sveikatos būklės ir gyvenimo kokybės vertinimas ženkliai nepakito, palyginti su pirmos apklausos rezultatu (prieš vidurkis 30,64 balo, po vidurkis 31,37 balo, mediana 33,33 Z = 4,271, p 0,05)
LAZERINĖ PROKTOLOGIJA: MŪSŲ PATIRTIS
Authors: Narmontas Deividas , Gradauskas Audrius
Published: December 2014

Reikšminiai žodžiai: hemorojus, pilonidinė cista, išangės fistulė, lazerinis gydymas. Esant plačiam lazerio panaudojimui įvairiose medicinos srityje, reikėtų išskirti ir gana svarbų lazerio vaidmenį proktologijoje. Konkrečiai – hemorojaus ir išangės fistulių gydyme, nepamirštant ir galimybių gydant pilonidines cistas. Visoms minėtoms ligoms pasaulinėje medicinoje yra daugybė įvairių gydymo metodų. Visi šie metodai turi pooperacinių komplikacijų ir recidyvų. Mūsų tyrimo tikslas buvo apžvelgti mūsų patirtį gydant minėtas proktologines ligas su lazeriu. Šiame retrospektyviniame tyrime buvo įtraukti pacientai, gydyti dėl hemorojaus, pilonidinių cistų ir išangės fistulių Vilniaus miesto klinikinės ligoninės Dienos chirurgijos skyriuje. Pacientai ambulatoriškai stebėti pirmą parą, pirmą savaitę, po 6 savai- čių, po pusmečio ir po metų po chirurginio gydymo lazeriu. Į šį tyrimą buvo įtraukti 47 pacientai, gydyti lazeriu. Nuskausminimo po operacijų reikėjo labai minimaliai, po operacijų pacientai namo išleisti tą pačią dieną arba kitą pooperacinį rytą. Nereikėjo specialios pooperacinės priežiūros. Pacientai greitai grįžo prie jiems įprastos veiklos. Po lazerinės hemorojaus plastikos pasitaikė 1 (2,9 proc.) kraujavimas, 3 (8,8 proc.) išorinių mazgų edemos ir trombozės, 3 (8,8 proc.) pogleivio fistulės arba įplėšos. Recidyvų nepasitaikė nė vienam pacientui operuotam dėl hemorojaus. Po lazerinės pilonidinės cistos operacijos recidyvai pasitaikė 2 (33,4 proc.) pacientams. Po lazerinio fistulės kanalo uždarymo operacijos pasitaikė 2 (28,6 proc.) recidyvai. Po tyrimo galima daryti išvadą, kad proktologinių ligų gydymas lazeriu yra sukeliantis minimalų pooperacinį diskomfortą, išsaugantis natūralią anatomiją, leidžiantis greitai grįžti prie kasdienės veiklos ir darbo, neribojantis fizinio aktyvumo, turintis minimalų recidyvų skaičių, palyginti su tradiciniais tokių ligų gydymo metodais.
ĮGYTŲ DIAFRAGMINIŲ IŠVARŽŲ ĮSTRIGIMAS
Authors: Lasinskas Marius , Gradauskas Audrius , Činčikas Jonas , Kuliavas Justas
Published: December 2014

Reikšminiai žodžiai: paraezofaginė išvarža, diafragminė išvarža, diafragmos sužalojimai, įstrigusi diafragminė išvarža. Darbo tikslai. Įstrigusios paraezofaginės ir diafragminės išvaržos yra reta komplikacija tiek pilvo, tiek ir krūtinės chirurgų kasdienybėje. Esant šiai patologijai, labai svarbi greita diagnostika, nes įstrigę organai gali nekrotizuoti, o tai sąlygoja didelį pooperacinių komplikacijų bei mirštamumo dažnį. Mūsų tikslas – pateikti diafragminių išvaržų klasifikaciją, randamą literatūroje, epidemiologiją, galimą įstrigimą bei jo rizikos veiksnius, pateikti mūsų klinikos patirtį gydant šią patologiją. Tyrimo medžiaga ir metodai. Retrospektyviai analizuotos ligonių, kurie buvo gydyti 2006–2013 m. Vilniaus miesto klinikinės ligoninės (VMKL) Abdominalinės chirurgijos skyriuje dėl diafragminių išvaržų įstrigimo, ligos istorijos. Rezultatai. Buvo gydyti 7 ligoniai (3 moterys ir 4 vyrai). Amžiaus vidurkis 57,7 ± 21,2 metų. 2 moterys buvo gydytos dėl paraezofaginių išvaržų įstrigimo, 1 moteris ir 4 vyrai gydyti dėl potrauminių diafragmos išvaržų įstrigimo. 3 (60 proc.) ligoniams diafragmos išvarža atsirado po bukos traumos ir 2 (40 proc.) ligoniams – po durtinių krūtinės ląstos sužalojimų. Visais potrauminės diafragmos išvaržos atvejais išvaržos vartai lokalizavosi kairiajame diafragmos kupole ir buvo įstrigusi storoji žarna. Vienam ligoniui (20 proc.) su potraumine diafragmine išvarža buvo įstrigę skrandis ir storoji žarna. Visiems ligoniams buvo taikomas rentgenologinis tyrimas. Abi moterys gydytos dėl paraezofagnių išvaržų įstrigimo su skrandžio nekroze ir peritonitu, pirmą parą po operacijų mirė. Kitoje grupėje mirčių nebuvo. Vienam ligoniui, gydytam dėl potrauminės diafragminės išvaržos įstrigimo, buvo pūlingos pooperacinės komplikacijos. Vidutinė hospitalizacijos trukmė – 13,5 dienos. Išvados. 1. Įstrigusios diafragminės išvaržos pasitaiko labai retai. 2. Paraezofaginių išvaržų įstrigimas sąlygoja didelį mirštamumą. 3. Traumos atveju sunku diagnozuoti diafragmos sužalojimus, o tai sąlygoja diafragminių išvaržų atsiradimą ir didina jų komplikacijų tikimybę. 4. Diagnozavus diafragminės išvaržos įstrigimą, indikuotinas skubus operacinis gydymas.