Взаємозв'язок регуляції водно-сольового обміну і гемостазу

В работе установлено, что перестройка гормональной регуляции водносолевого обмена в ответ на острую постегеморрагическую гиповолемию направлена на задержку в организме воды и ионов натрия на фоне увеличения интенсивности вазоспастического регуляторного сигнала, что характеризуется увеличением содержания в крови ангиотензина II, антидиуретического гормона и уменьшением концентрации α-предсердного натрийуретического пептида (ПНП). Концентрация в крови а-ПНП выявляет отрицательную корреляционную взаимозависимость с параметрами функциональной активности тромбоцитов. Основным фактором, способствующим активации тромбоцитов в условиях острой изоосмолярной гипогидратации, является ангиотензин II, действие которого модулируется противоположными эффектами α-ПНП.It is found, that the hormonal regulation of a water-salt balance after sharp isoosmotic hyperhydration is directed to a delay in the body of water and sodium on the background of actirftion of vasoconstrictory mechanisms due to the increase of the blood content of angiotensin II, antydiuratic hormone and the reduction of concentration α-atrial natriuretic peptide (α-NUP) between them. Negative correlation concentration in blood α-NUP reveals and parameters of functional activity of thrombocytes. A major factor promoting activation of thrombocytes in conditions of a sharp isoosmotic hyperhydration is the angiotensin II action of which is balanced by opposite effects α-NUP

Divination: Exemplifying and Configuring Archetypes in Ceramics

Abstract/Summary Dissertation Divination: Exemplifying and Configuring Archetypes in Ceramics is a study of my research practice. The cards of the tarot can be used as a conceptual framework and source of inspiration for making ceramic sculptures. The cards can be used to understand the creative process as an expression of archetypes. My dissertation discusses these archetypes from the tarot cards, both in their historical operation, their manifestation in my art practice, as well as, examining approaches taken to these archetypes by other artists such as Salvador Dali and Niki de Saint Phalle. The theoretical basis for the dissertation is informed by the writings of Carl G. Jung who has proposed concepts dealing with creativity, coincidence, a collective unconscious and archetypes. These ideas form a model for the understanding of my studio work. As background, the dissertation examines examples of artworks that could be seen to be drawn from a collective unconscious. Studio Work The studio work consists of a series of ceramic sculptures formulating the archetypes that I have derived from the tarot cards. The three dimensional clay, with found inclusions, examines the idea of specific archetypes. These archetypes are titled in the works including: The Fool, Strength, The Magician, Tarot Sun, The Empress II, The Lovers, Empress l, The Chariot I and II The Angel Temperance, The Tarot Devil and The World. The ceramic objects have been created in clay using handbuilding techniques. The clay was such that it could include found ceramic pieces and be refired. The pieces have been re-fired many times to achieve a variety of glaze effects. The works range in size from 30-60 cms approximately and include freestanding sculptures and complementing flat wall works

Agreement of general practitioners with the guideline-based stepped-care strategy for patients with osteoarthritis of the hip or knee: A cross-sectional study

Background: To improve the management of hip or knee osteoarthritis (OA), a multidisciplinary guideline-based stepped-care strategy (SCS) with recommendations regarding the appropriate non-surgical treatment modalities and optimal sequence for care has been developed. Implementation of this SCS in the general practice may be hampered by the negative attitude of general practitioners (GPs) towards the strategy. In order to develop a tailored implementation plan, we assessed the GPs' views regarding specific recommendations in the SCS and their working procedures with regard to OA. Methods. A survey was conducted among a random sample of Dutch GPs. Questions included the GP's demographical characteristics and the practice setting as well as how the management of OA was organized and whether the GPs supported the SCS recommendations. In particular, we assessed GP's views regarding the effectiveness of 14 recommended and non-recommended treatment modalities. Furthermore, we calculated their agreement with 7 statements based on the SCS recommendations regarding the sequence for care. With a linear regression model, we identified factors that seemed to influence the GPs' agreement with the SCS recommendations. Results: Four hundred fifty-six GPs (37%) aged 30-65 years, of whom 278 males (61%), responded. Seven of the 11 recommended modalities (i.e. oral Non-Steroidal Anti-Inflammatory Drugs, physical therapy, glucocorticoid intra-articular injections, education, lifestyle advice, acetaminophen, and tramadol) were considered effective by the majority of the GPs (varying between 95-60%). The mean agreement score, based on a 5-point scale, with the recommendations regarding the sequence for care was 2.8 (SD = 0.5). Ten percent of the variance in GPs' agreement could be explained by the GPs' attitudes regarding the effectiveness of the recommended and non-recommended non-surgical treatment modalities and the type of practice. Conclusion: In general, GPs support the recommendations in the SCS. Therefore, we expect that their attitudes will not impede a successful implementation in general practice. Our results provide sev

Factors predicting cessation of status epilepticus in clinical practice: Data from a prospective observational registry (SENSE).

To investigate the initial termination rate of status epilepticus (SE) in a large observational study and explore associated variables. Data of adults treated for SE were collected prospectively in centers in Germany, Austria, and Switzerland, during 4.5 years. Incident episodes of 1,049 patients were analyzed using uni- and multivariate statistics to determine factors predicting cessation of SE within 1 hour (for generalized convulsive SE [GCSE]) and 12 hours (for non-GCSE) of initiating treatment. Median age at SE onset was 70 years; most frequent etiologies were remote (32%) and acute (31%). GCSE was documented in 43%. Median latency between SE onset and first treatment was 30 minutes in GCSE and 150 minutes in non-GCSE. The first intravenous compound was a benzodiazepine in 86% in GCSE and 73% in non-GCSE. Bolus doses of the first treatment step were lower than recommended by current guidelines in 76% of GCSE patients and 78% of non-GCSE patients. In 319 GCSE patients (70%), SE was ongoing 1 hour after initiating treatment and in 342 non-GCSE patients (58%) 12 hours after initiating treatment. Multivariate Cox regression demonstrated that use of benzodiazepines as first treatment step and a higher cumulative dose of anticonvulsants within the first period of treatment were associated with shorter time to cessation of SE for both groups. In clinical practice, treatment guidelines were not followed in a substantial proportion of patients. This underdosing correlated with lack of cessation of SE. Our data suggest that sufficiently dosed benzodiazepines should be used as a first treatment step. ANN NEUROL 2019;85:421-432

A problem-posing approach to teaching decision making about the waste issue

This thesis describes a study undertaken at the Centre for Science and Mathematics Education at Utrecht University during the 1990s. The study deals with the teaching and learning of decision making on the waste issue as an example of a science/ technology-related social issue in the physical science curriculum at the junior secondary level. A first motive for undertaking this study can be found in the introduction of decision making in the attainment targets for this type of education in the early 1990s – a ‘new’ attainment target that was considered to be in need of operationalisation in extension of my personal involvement in the centre’s two preceding curriculum development projects in the 1980s (the PLON project and the NME-VO project) in which decision making by students was intuitively developed but barely researched. A second motive concerned the centre’s emerging programme of developmental research about ‘didactical structures’ reflecting a problem-posing approach to teaching specific science topics – a programme that could be ‘enriched’ with an example of such an approach for the interrelated teaching/learning of (waste issue) knowledge and (decision-making) skill