Pårørendes forhandlinger med sundhedsprofessionelle i forbindelse med ældres akutte indlæggelse

Det indsendte er et resumé

Requirement for DNA Ligase IV during Embryonic Neuronal Development

The embryonic ventricular and subventricular zones (VZ/SVZ) contain the neuronal stem and progenitor cells and undergo rapid proliferation. The intermediate zone (IZ) contains nonreplicating, differentiated cells. The VZ/SVZ is hypersensitive to radiation-induced apoptosis. Ablation of DNA non-homologous end-joining (NHEJ) proteins, XRCC4 or DNA ligase IV (LigIV), confers ataxia telangiectasia mutated (ATM)-dependent apoptosis predominantly in the IZ. We examine the mechanistic basis underlying these distinct sensitivities using a viable LigIV (Lig4(Y288C)) mouse, which permits an examination of the DNA damage responses in the embryonic and adult brain. Via combined analysis of DNA breakage, apoptosis, and cell-cycle checkpoint control in tissues, we show that apoptosis in the VZ/SVZ and IZ is activated by low numbers of DNA double-strand breaks (DSBs). Unexpectedly, high sensitivity in the VZ/SVZ arises from sensitive activation of ATM-dependent apoptosis plus an ATM-independent process. In contrast, the IZ appears to be hypersensitive to persistent DSBs. NHEJ functions efficiently in both compartments. The VZ/SVZ and IZ regions incur high endogenous DNA breakage, which correlates with VZ proliferation. We demonstrate a functional G(2)/M checkpoint in VZ/SVZ cells and show that it is not activated by low numbers of DSBs, allowing damaged VZ/SVZ cells to transit into the IZ. We propose a novel model in which microcephaly in LIG4 syndrome arises from sensitive apoptotic induction from persisting DSBs in the IZ, which arise from high endogenous breakage in the VZ/SVZ and transit of damaged cells to the IZ. The VZ/SVZ, in contrast, is highly sensitive to acute radiation-induced DSB formation

Computer science in Afghanistan: a situational analysis of university lecturers

This thesis provides a detailed analysis of the development of computer science as an academic discipline in Afghanistan. Over the last few years, computer science, which has received much attention within the higher education system, has changed as a discipline. Academics have argued over what computer science is, what role it plays, and what it contributes to the development of the higher education system and the economy of the country. Although the discipline of computer science is well-established internationally, in Afghanistan it is relatively new. Its development in the US and other countries has been shown to be the result of robust social processes. This thesis builds on these illuminating studies to understand and examine the developments and processes of computer science in government universities in Afghanistan. To achieve this insight and analysis, this thesis takes the particular environment into account to analyse the interrelations between the local higher education system, international networks, private sector and non-governmental organisations. Following the work of Adele Clarke, the establishment of computer science is examined from a social worlds perspective, with her situational analysis as a conceptual and methodological approach. It focuses on the perspectives of the lecturers - they are the ones who teach in the universities and define what computer science is through their statements and practices. However, their actions are influenced by the complex environment in which they are embedded. Therefore, this study presents a broader interpretation of the higher education system by indicating that computer science is highly recognised and is heavily supported by international involvement. At the same time, the institutionalisation of the discipline is mostly based on local networks and relationships. The lecturers define what a computer scientist is in Afghanistan, and how their visions and orientations are shaped by their education, experiences, and expertise. When they implement their visions and change teaching methods, they are often limited by their socio-cultural identity as lecturers, which is much more entrenched with social structures than in Western countries. Further, the marginalisation of scientific competence and discovery impedes the flourishing of a scientific environment and hinders the establishment of a strong scientific community. Despite a challenging security situation, the development of formal institutional processes has taken place rapidly since 2001. Computer science faculties were opened and degree programmes established. Yet, there is a tension between these institutionalisation processes, which are informed heavily by international bodies of public and private institutions, and the lecturers’ capacity to create their own vision of computer science within the Afghan higher education system. Lecturers have found it necessary to mediate between technical and socio-cultural practices. Moreover, they act as translators between different social worlds. This influences how they perceive themselves, and it shapes their own identity as well as their disciplines’ identity

New methods for quantification of amoxicillin and clindamycin in human plasma using HPLC with UV detection

OBJECTIVES: We aimed to develop simple and rapid HPLC methods for determination of amoxicillin and clindamycin in human plasma. METHODS: Plasma samples were pretreated by direct deproteinization with acetonitrile and the analytical separation took place on a reverse phase Poroshell 120 EC-C18 column (2.7 μm, 2.1 × 100 mm) with a gradient of acetonitrile. UV detection at 229 nm for amoxicillin and 204 nm for clindamycin was used for determination of the antibiotics in plasma. RESULTS: The calibration curves were linear over the concentration ranges of 1–100 mg/L for amoxicillin and 1–15 mg/L for clindamycin with a correlation coefficient of ≥0.98. Intra-assay precisions were all ≤15% and the accuracies were within ±15%. The limit of quantification (LOQ) was found to be 0.5 mg/L for amoxicillin and 1 mg/L for clindamycin with inter-assay imprecision coefficient of variances (CVs) of 18.7% and 15.6%, respectively. The present HPLC methods were successfully applied on spike-in samples and on plasma samples collected 4–6 and 3.5–5.5 h after oral antibiotic administration of 500 mg of amoxicillin and 600 mg of clindamycin, respectively. CONCLUSIONS: We have developed HPLC methods with UV detection for quantification of amoxicillin and clindamycin in human plasma. The methods are fast, simple and suitable for use in routine settings and clinical studies

Ipl1/Aurora B kinase coordinates synaptonemal complex disassembly with cell cycle progression and crossover formation in budding yeast meiosis

Several protein kinases collaborate to orchestrate and integrate cellular and chromosomal events at the G2/M transition in both mitotic and meiotic cells. During the G2/M transition in meiosis, this includes the completion of crossover recombination, spindle formation, and synaptonemal complex (SC) breakdown. We identified Ipl1/Aurora B kinase as the main regulator of SC disassembly. Mutants lacking Ipl1 or its kinase activity assemble SCs with normal timing, but fail to dissociate the central element component Zip1, as well as its binding partner, Smt3/SUMO, from chromosomes in a timely fashion. Moreover, lack of Ipl1 activity causes delayed SC disassembly in a cdc5 as well as a CDC5-inducible ndt80 mutant. Crossover levels in the ipl1 mutant are similar to those observed in wild type, indicating that full SC disassembly is not a prerequisite for joint molecule resolution and subsequent crossover formation. Moreover, expression of meiosis I and meiosis II-specific B-type cyclins occur normally in ipl1 mutants, despite delayed formation of anaphase I spindles. These observations suggest that Ipl1 coordinates changes to meiotic chromosome structure with resolution of crossovers and cell cycle progression at the end of meiotic prophase

« Résistant(e)s » et « Malgré-nous » : parler de la violence de la Seconde Guerre mondiale en Moselle et au Luxembourg de 1953 aux années 1980

Depuis la fin de la Seconde Guerre mondiale jusqu’à nos jours, deux groupes d'acteurs marquaient les discours mémoriels en Moselle et au Luxembourg : les associations des « enrôlés de force » et des anciens résistants. En analysant l’énonciation verbale, graphique et performative de la violence de la guerre par ces deux groupes d'acteurs, cet article tente de détecter l'impact de cette énonciation ou au contraire du silence sur la violence passée. Il se penche sur trois questions : Dans quels contextes, les acteurs de mémoire parlent-ils d’actes de violence ? Quels actes décrivirent-ils ? Et pourquoi se drapèrent-ils dans le silence sur les mêmes actes de violence de la Seconde Guerre mondiale dans d'autres contextes ? En répondant à ces questions, l'article éclaire la relation entre l’énonciation de la violence, la lutte pour la reconnaissance des expériences passés et les discours victimaires.Since the end of the Second World War, two groups of actors have influenced memorial discourse in Moselle and Luxemburg : the associations of “forced conscripts” and those of former “resistance fighters”. By analyzing the verbal, graphical and performative statements of these two groups of actors regarding wartime violence, this article attempts to identify the impact of such statements regarding past violence as well as that of their absence –that is, silence. It looks into three questions : In what contexts do the actors of memory speak about acts of violence ? What acts do they describe ? And why do they cloak themselves in silence regarding the same acts of violence of the Second World War in other contexts ? By responding to these questions, the article sheds light on the relationship between the statement of violence, the struggle to win recognition of past experiences and victim discourse

Duration to Establish an Emergency Vascular Access and How to Accelerate It: A Simulation-Based Study Performed in Real-Life Neonatal Resuscitation Rooms

Objectives: To compare the duration to establish an umbilical venous catheter and an intraosseous access in real hospital delivery rooms and as a secondary aim to assess delaying factors during establishment and to provide recommendations to accelerate vascular access in neonatal resuscitation. Design: Retrospective analysis of audio-video recorded neonatal simulation training. Settings: Simulation training events in exact replications of actual delivery/resuscitation rooms of 16 hospitals with different levels of care (Austria and Germany). Equipment was prepared the same way as for real clinical events. Subjects: Medical teams of four to five persons with birth-related background (midwives, nurses, neonatologists, and anesthesiologists) in a realistic team composition. Interventions: Audio-video recorded mannequin-based simulated resuscitation of an asphyxiated newborn including the establishment of either umbilical venous catheter or intraosseous access. Measurements and Main Results: The duration of access establishment (time from decision to first flush/aspiration), preparation (decision to start of procedure), and the procedure itself (start to first flush/aspiration) was significantly longer for umbilical venous catheter than for intraosseous access (overall duration 199 vs 86 s). Delaying factors for umbilical venous catheter establishment were mainly due to the complex approach itself, the multitude of equipment required, and uncertainties about necessary hygiene standards. Challenges in intraosseous access establishment were handling of the unfamiliar material and absence of an intraosseous access kit in the resuscitation room. There was no significant difference between the required duration for access establishment between large centers and small hospitals, but a trend was observed that duration for umbilical venous catheter was longer in small hospitals than in centers. Duration for intraosseous access was similar in both hospital types. Conclusions: Vascular access establishment in neonatal resuscitation could be accelerated by infrastructural improvements and specific training of medical teams. In simulated in situ neonatal resuscitation, intraosseous access is faster to establish than umbilical venous catheter. Future studies are required to assess efficacy and safety of both approaches in real resuscitation settings

Containment of a fatal and highly infectious disease outbreak

This case study was designed based on several experience with several viral haemorrhagic fevers (VHFs) outbreaks responded to in Uganda between 2000 and 2016. Fictitious scenarios have been included to facilitate learning of the users. The major goal of the case study is to facilitate learners to appreciate incident detection and the incident management processes for control and containment of a fatal and highly infectious viral disease outbreak. This case study is targeted towards health scientists of medicine, nursing, biomedical laboratory and public health background. We specifically orient learners on clinical presentation of viral infections and laboratory tests considered for incident detection, conducting a risk assessment for an infectious disease, Infection Prevention and Control in the outbreak setting, skills of incident management, analysis and interpretation of epidemiological data to aid epidemic response and control decisions