The advent of hand surgery in India reads like a fortuitous saga, a continuum of the hand deformity correction on leprosy patients pioneered by Dr. Paul Wilson Brand at the Christian Medical College ...(CMC) Vellore, Madras State (Tamil Nadu TN), in 1948. The “Hand Research Unit,” established in 1951, became the largest repository for hand reconstructive surgeries and with its head-start drew in most hand dysfunctions in the country. Early industrialization and disorderly road traffic generated hand injuries that threatened workforce in India. Propitiously, a hand injury service was opened in 1971 at the Government Stanley Medical College Hospital, Chennai. The inexorable growth of hand surgery continued and incorporated the gamut of conditions that required hand care and rehabilitation, including brachial plexus injuries. Continuing Medical Education programs, Hand Surgery workshops, Indian Society for Surgery of the Hand meetings, Hand Fellowships, etc., increased the number of “hand surgery” practitioners, which drew the attention of the Medical Council of India to commence a postgraduate Hand Surgery program that it eventually gazetted. The sagacity of the members of the Board of Studies of TN Medical University honored the historical role of CMC Vellore in hand surgery and allowed it to commence the first Master of Chirurgiae Hand Surgery course in India in 2015. An intuitive understanding of 70 years of hand surgery accomplishments that redesigned and restored deformed and injured hands and protected livelihoods have made young surgeons increasingly take hand surgery as a career.
•Sound methodology is necessary to identify arrhythmias from one-lead ECG during PSG.•Classification of arrhythmias from such an ECG is feasible.•Excellent inter-observer agreement on premature ...ventricular and atrial complexes.•These established methods allow analysing all ECGs from PSG of the ADVENT-HF trial.
Sleep disordered breathing (SDB) may trigger nocturnal cardiac arrhythmias (NCA) in patients with heart failure with reduced ejection fraction (HFrEF). The NCA ancillary study of the ADVENT-HF trial will test whether, in HFrEF-patients with SDB, peak-flow-triggered adaptive servo-ventilation (ASVpf) reduces NCA. To this end, accurate scoring of NCA from polysomnography (PSG) is required.
To develop a method to detect NCA accurately from a single-lead electrocardiogram (ECG) recorded during PSG and assess inter-observer agreement for NCA detection.
Quality assurance of ECG analysis included training of the investigators, development of standardized technical quality, guideline-conforming semi-automated NCA-scoring via Holter-ECG software and implementation of an arrhythmia adjudication committee. To assess inter-observer agreement, the ECG was analysed by two independent investigators and compared for agreement on premature ventricular complexes (PVC) /h, premature atrial complexes/h (PAC) as well as for other NCA in 62 patients from two centers of the ADVENT-HF trial.
The intraclass correlation coefficients for PVC/h and PAC/h were excellent: 0.99 (95%- confidence interval CI: 0.99–0.99) and 0.99 (95%-CI: 0.97–0.99), respectively. No clinically relevant difference in inter-observer classification of other NCA was found. The detection of non-sustained ventricular tachycardia (18% versus 19%) and atrial fibrillation (10% versus 11%) was similar between the two investigators. No sustained ventricular tachycardia was detected.
These findings indicate that our methods are very reliable for scoring NCAs and are adequate to apply for the entire PSG data set of the ADVENT-HF trial.
This article resumes research on the so-called Rorate chants, that is to say on the chants connected with morning Votive Mass in honor of the Virgin Mary in Advent, otherwise known as the Rorate Mass ...after its incipit. The central aim of this article is to present the Rorate chants as an interesting topic for (Czech) literary historiography as well as comparative hymnology. One may well point out that the polymedial nature of Rorate chants directly suggests an interdisciplinary approach. In the case of the Czech tradition, however, this only puts into sharper relief the imbalance of scholarship across the hymnological disciplines. On the one hand, one is struck by the almost total absence of research on literary historiography; in the first part of the article, we analyze how and under what circumstances Czech literary historians have excluded Rorate chants from Czech literary studies. On the other hand, one finds a rather long history of musicological research, which, conversely, has carved out an important place for the Rorate chants in the history of Czech music, going so far as to establish them as a characteristically Czech musical form. What the Czech Rorate chants seem to offer Czech society, as we show in the second part of the article, is a certain potential for self-identification — a potential that has manifested itself, at various times and with varying intensity, in a tendency to identify the Rorate chants as a product of a national past and as one of the nation’s identifying features. However, the creation of a specific vocal repertoire for the Rorate Mass is also documented in other (Central) European regions. The third part of our essay seeks to answer the question: how significantly does the Czech Rorate tradition differ from its counterparts? The difference between the various Rorate traditions cannot be understood (merely) with respect to a language traditionally characterized by monolingually defined national philologies. It is therefore possible to study the Czech Rorate tradition in the context of a pan-European process made up of various church denominations in the early modern period — that is, by investigating the Czech Rorate chants from the perspective of denominational liturgies, in reference to a particular church polity or corresponding socio-cultural context.
The Earth was born as a dry planet without atmosphere and ocean components at 4.56 Ga,with subsequent secondary accretion of bio-elements,such as carbon（C）,hydrogen（H）,oxygen（O）,and nitrogen（N） which ...peaked at 4.37-4.20 Ga.This two-step formation model of the Earth we refer to as the advent of bio-elements model（ABEL Model） and the event of the advent of bio-elements（water component） as ABEL Bombardment.It is clear that the solid Earth originated from enstatite chondrite-like dry material based on the similarity in oxygen isotopic composition and among other isotopes.On the other hand,Earth＇s water derives primarily from carbonaceous chondrite material based on the hydrogen isotopic ratio.We present our ABEL model to explain this enigma between solid Earth and water,as well as secondary accretion of oxidizing bio-elements,which became a precursor to initiate metabolism to emerge life on a highly reductive planet.If ABEL Bombardment had not occurred,life never would have emerged on the Earth.Therefore,ABEL Bombardment is one of the most important events for this planet to evolve into a habitable planet.The chronology of ABEL Bombardment is informed through previous researches of the late heavy bombardment and the late veneer model.ABEL Bombardment is considered to have occurred during 4.37-4.20 Ga,which is the concept to redefine the standard late heavy bombardment and the late veneer models.Also,ABEL Bombardment is the trigger of the transition from stagnant lid tectonics to plate tectonics on this planet because of the injection of volatiles into the initial dry Earth.
Enquadramento: A prestação de cuidados de saúde aos utentes, deve contemplar como premissas, a qualidade e segurança. No seu desrespeito enquadra-se o evento adverso, entendido como doença ou dano. ...Objetivo: identificar a perceção dos enfermeiros acerca das iatrogenias na prestação de cuidados de enfermagem na área médico-cirúrgica. Metodologia: Estudo qualitativo, por entrevista semiestruturada a um grupo focal de enfermeiros. Resultados: Os enfermeiros associam ao conceito de iatrogenia em enfermagem o dano que o doente sofre, decorrente das atividades sob sua responsabilidade. Como ocorrências iatrogénicas em enfermagem mais comuns relataram: as quedas/fraturas, os efeitos adversos à administração de terapêutica medicamentosa, o inadequado manuseamento de dispositivos médicos. Como fatores potenciadores emergiram as condições de trabalho inadequadas. Enumeraram-se como estratégias para a minimização destes eventos: a formação contínua, a boa comunicação e liderança, implementação e cumprimento de protocolos. Conclusão: Na perceção da amostra as iatrogenias são uma realidade, cujos fatores potenciadores vão ao encontro aos descritos na literatura científica. A formação contínua nesta área é reconhecida como um pilar para a sua prevenção.
Living toward the end Sponheim, Paul R.
Dialog : a journal of theology,
December 2019, 2019-12-00, 20191201, Letnik:
58, Številka:
4
Journal Article
Recenzirano
Human beings look to the end as terminus, a passing away when the individual's life story will be complete. Against a cultural tendency to deny death, Christians—claiming a Creator God who does not ...die—can accept their finitude in principle and aspire to a “high definition” ending. That hope is threatened by the devastating reality of dementia. But Kierkegaard reminds us that the “positive third” of selfhood is not to be identified with mentality and Whitehead stresses that the reception of the inrushing world does not depend on conscious mentality. Against the prevalent culture of individualism, a person of faith can recognize the constitutive role of community past and present. She can find in her terminus a telos, a passing on of life to the others as she steps aside. Is there more? The Newer Testament proclaims a new creation in which life's ending is transformed by the sense of end as beginning, end as advent. This omega as alpha entails both continuity and discontinuity. As to discontinuity, the Christian envisions a life “beyond Eden,” where the perilous gift of freedom is transformed in an integrating knowledge of self, world, and God—fulfilling the calling given to all as created in God's image. This sense of end does not function as an “escape to a transcendent elsewhere,” but motivates and empowers the believer to care for the suffering victims of this volatile and violent age.
Las tecnologías, a lo largo de la historia, han sido empleadas para mejorar las habilidades y rendimiento de las diferentes acciones o actividades que se plantean las personas; pero este valor se ...incrementa cuando el individuo prescinde o tiene dificultades para utilizar alguna/s parte/s de su cuerpo; ya sea por dificultades funcionales, anatómicas o fisiológicas, o venga dado por un fallo neuronal que afecte a una, varias o todas las acciones que el ser humano pueda desarrollar. Ante esto, el arte puede ser un vehículo de expresión que canaliza sentimientos y emociones, que visibiliza los diferentes modos de vida y ayuda a mejorarlos; favoreciendo la inclusión y modificando la imagen, en ocasiones estereotipada, que recae sobre las personas con diversidad funcional.
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