Orthodoxy and heresy according to saint epiphanius of salamis

Heresy and Orthodoxy have been much discussed terms in theological studies from ancient times to the present day and various opinions and beliefs have been expressed on them. In this thesis, we have tried to gather the thought of Epiphanius on these terms on the basis of his works Panarion and Angyrotos. We have tried to let the texts of our author lead us to clear conclusions and this has meant that we made extensive use of the writings under examination. In this effort we are conscious that we have stood closer to Epiphanius' own methodology, namely his use of relevant texts, whereby the historical continuity of the faith of the Church, which lies at the root of her experience, is more adequately exposed. The thesis comprises three parts, dealing consecutively with a) Epiphanius' life and work, b) Epiphanius' views of Heresy and c) Epiphanius' views of Orthodoxy. In part a) we provide a brief account of Epiphanius' person and historical context, as well as his perception concerning his heresiology. In part b) we explore Epiphanius' sources for his account of heresy, his methodology, as well as his views on such central topics as the beginnings and development of heresy, the difference between schism and heresy, truth and heresy, church and heresy. Scripture and heresy, the devil and heresy and, finally the meaning of heresy suggested by the appelations which Epiphanius uses in his descriptions of it. In part c) we provide a general introduction on Epiphanius' understanding of orthodoxy, an account of the presuppositions of orthodoxy and the main contents of the orthodox faith as Epiphanius expounds them which comprise the topics of Theology/Triadology, Christology and Ecclesiology. In our conclusion we stress that, according to St. Epiphanius, Orthodoxy is the divinely provided and regulated truth which precedes the ecclesiastical life of the community and is expressed via all the manifestations of this life. By the same token. Heresy is any deviation from this divine and primordial truth as appropriated through and manifested in ecclesiastical life. As far as priority goes in respect to Orthodoxy and Heresy Epiphanius' view is contrary to that of Walter Bauer. For Epiphanius Orthodoxy precedes Heresy. The difference between these two views seems to lie in their choice of context. Bauer explores his topic in the context of historical and 'scientific' methods to which he subordinates his ecclesiastical data. Epiphanius develops his topic in the context of ecclesiastical tradition and life without neglecting the historical and scientific data. In Epiphanius' view ecclesiastical life and history do not constitute a field of fuction and confrontation between diverse ideologies and interpretations. Rather they constitute a living and unbreakable foundation of orthodoxy, which is expressed in the theory and practice of the Church

Screening for pre-eclampsia using sFlt-1/PlGF ratio cut-off of 38 at 30-37 weeks' gestation

Objective: To evaluate the soluble fms-like tyrosine kinase 1 (sFLT-1) to placental growth factor (PLGF) ratio cut-off of 38 for prediction of preeclampsia (PE) in routine assessment in singleton pregnancies at 30-37 weeks’ gestation. Methods: This was a prospective observational study in women attending for a third-trimester ultrasound scan at 30-37 weeks as part of routine pregnancy care. Serum sFlt-1 and PlGF were measured and their ratio calculated. We estimated the detection rate (DR), false positive rate (FPR), positive predictive value (PPV) and negative predictive value (NPV) of sFLT-1/PLGF >38 for prediction of delivery with PE at 4 weeks after assessment. Results: The study population of 12,305 singleton pregnancies was examined at a median of 32.4 (range 30.0-36.9) weeks and included 14 (0.11%), 77 (0.63%) and 227 (1.84%) that subsequently delivered with PE at 4 weeks’ after assessment, respectively. The DR, FPR, PPV and NPV of sFLT-1/PLGF >38 in the prediction of delivery with PE at 4 weeks were 20.7%, 4.3%, 8.3% and 98.47%. Conclusion: In routine screening of singleton pregnancies, the performance of sFLT 1/PLGF >38 is modest for prediction of delivery with PE at 38 predicted 79% of cases with PE at <1 week at FPR of 4.5%; consequently, a policy of hospitalizing patients with this ratio would potentially lead to unnecessary hospitalization in 4.5% of pregnancies and a ratio of <38 would falsely reassure one fifth of the women that will deliver with PE at <1 week from assessment

Proposed clinical management of pregnancies after combined screening for pre-eclampsia at 35-37 weeks' gestation

Objective: To estimate the patient-specific risk of preeclampsia (PE) at 35-37 weeks’ gestation by a combination of maternal characteristics and medical history with multiple of the median (MoM) values of mean arterial pressure (MAP), uterine artery pulsatility index (UTPI), serum placental growth factor (PLGF) and serum soluble fms-like tyrosine kinase-1 (sFLT-1) and stratify women into high-, intermediate- and low-risk management groups. Methods: This was a prospective observational study in women attending for a third-trimester ultrasound scan at 35-37 weeks as part of routine pregnancy care. Patient-specific risks of delivery with PE at 40 weeks’ gestation was estimated. Results: The study population of 3,703 singleton pregnancies included 38 (1.0%) with PE at 40 weeks. Using a risk cut-off for PE at <4 weeks of 1 in 50 to define the high-risk group and a risk cut-off of <1 in 100 for PE at <42 weeks’ gestation to define the low-risk group, the proportion of the population stratified into high-, intermediate- and low-risk was about 12.7%, 28.8% and 58.5%, respectively. The high-risk group contained 92% of pregnancies with PE at 40 weeks. The intermediate-risk group contained a further 27% of women with PE at >40 weeks. In the low-risk group, none of the women developed PE at 40 weeks’ gestation. Conclusion: The study presents risk stratification of PE by the combined test at 35-37 weeks aiming to identify a high-risk group in need of intensive monitoring from the time of the initial assessment and up to 40 weeks’ gestation, an intermediate-risk group in need of reassessment at 40 weeks’ gestation and a low-risk group which can be reassured that they are unlikely to develop PE

Proposed clinical management of pregnancies after combined screening for pre-eclampsia at 30-34 weeks' gestation

Objective: To estimate the patient-specific risk of preeclampsia (PE) at 30-34 weeks’ gestation by a combination of maternal characteristics and medical history with multiple of the median (MoM) values of mean arterial pressure, uterine artery pulsatility index, serum the median (MoM) values of mean arterial pressure, uterine artery pulsatility index, serum placental growth factor and serum soluble fmsm-like tyrosine kinase-1 and stratify women into high-, intermediate- and low-risk management groups. Methods: This was a prospective observational study in women attending for a third-trimester ultrasound scan at 30-34 weeks as part of routine pregnancy care. Patient-specific risks of delivery with PE at <4 weeks from assessment and at <40 weeks’ of delivery with PE at <4 weeks from assessment and at <40 weeks’ gestation were calculated using the competing risks model to combine the prior risk from maternal characteristics and medical history with MoM values of MAP, UTPI, PLGF and sFLT-1. On the basis of these risks the population was stratified into high-, intermediate- and low-risk groups. Different risk cut-offs were used to vary the proportion of the population stratified into each risk category and the performance of screening for delivery with PE at <4 weeks and delivery with PE from four weeks after assessment and up to 40 weeks’ gestation (PE 4w-40GW) was estimated. Results: The study population of 8,128 singleton pregnancies included 234 (2.9%) that subsequently developed PE. Using a risk cut-off for PE at <4 weeks of 1 in 50 and a risk cut-off of 1 in 150 for PE at <40 weeks’ gestation the proportion of the population stratified into high-, intermediate- and low-risk was about 3%, 26% and 71%, respectively. The high-risk group contained 90% of pregnancies with PE at at <4 weeks and 40% of those with PE at 4w-40GW. The intermediate-risk group contained a further 49% of women with PE at 4w-40GW. In the low-risk group, none of the women developed PE at <4 weeks and only 0.3% developed PE at 4w-40GW. Conclusion: The study presents risk stratification of PE by the combined test at 30-34 weeks aiming to identify a high-risk group in need of intensive monitoring from the time of the initial assessment and up to 40 weeks’ gestation and an intermediate-risk group, in need of monitoring starting from four weeks after the initial assessment and up to 40 weeks’ gestation. All pregnancies would need to be reassessed at 40 weeks’ gestation

Screening for preeclampsia

Background: Preeclampsia (PE) affects 2-3% of all pregnancies and is a major cause of maternal and perinatal morbidity and mortality. It is thought to occur due to abnormal placentation characterised by poor trophoblastic invasion resulting in oxidative stress and release of factors that promote endothelial dysfunction and inflammation. The current approach of screening for PE is to identify risk factors from maternal demographic characteristics and medical history. In the United Kingdom, the National Institute for Health and Clinical Excellence (NICE) has issued guidelines recommending that women should be considered to be at high risk of developing PE if they have any 1 high-risk factor or any 2 moderate-risk factors. With this approach, defined by NICE, at a screen positive rate of 11%, the detection rate (DR) for total PE is 35%. Such a screening approach has two main limitations. Firstly, it does not provide individualised, patient specific results and secondly, it does not allow the integration of biomarkers for improving the performance of the screening test. However, the integration of such biomarkers is essential in achieving an effective screening strategy for PE. Objectives: The aims of the papers included in this thesis are firstly, to identify and quantify the effects of variables from maternal characteristics and medical history on specific biochemical markers, secondly to present a model for standardising biochemical marker measurements in all three trimesters of pregnancy into multiples of the normal median (MoM) values, thirdly to summarize the distribution of MoM values in pregnancies with normal outcomes and those that subsequently develop PE and fourthly, to examine the potential improvement in performance of screening for PE at 30-34 weeks’ gestation by maternal factors alone with the addition of biophysical and biochemical markers. Methods: The data for this thesis were derived from prospective screening of women with singleton pregnancies attending for three routine hospital visits at 12, 22 and 32 or 36 weeks’ gestation. We have recorded a series of maternal characteristics and history, measured the maternal weight and height as well as the uterine artery pulsatility index (UTPI), mean arterial pressure (MAP), serum concentration of placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFLIT-1). The pregnancy outcomes were obtained from the hospital maternity records or the general medical practitioners of the women. Bayes theorem was used to combine the a priori risk from maternal factors with various combinations of biomarker MoM values. The potential value of biophysical and biochemical markers in improving the performance in screening for PE were evaluated. Results: Firstly, in pregnancies that developed PE, serum PlGF is decreased, while sFLIT-1, MAP and UTPI were increased, secondly, the separation in MoM values from normal is greater with earlier than later gestational age at which delivery for PE is necessary and thirdly, the slope of the regression lines of PlGF MoM with gestational age at delivery in pregnancies that develop PE increases with gestational age at screening. Combined screening at 30-34 weeks’ gestation by maternal factors, MAP, UTPI, PlGF, and sFLIT-1 predicted 98% (95% confidence interval, 88- 100%) of preterm PE and 49% (95% confidence interval, 42-57%) of term PE, at a false positive rate of 5%. Conclusions: This thesis has demonstrated that biophysical and biochemical markers increase significantly the performance of screening for PE and as a result the timing and content of clinical visits can be defined by the patient-specific risk of developing the disease. The vast majority of women would be screened low risk and these can follow the routine antenatal care, whereas those few who are high risk could be directed to a more specialized pathway, where early therapeutic interventions prophylactically may lead to the prevention of the disease and close follow-up will reduce the adverse consequences of PE

I feel your fear:shared touch between faces facilitates recognition of fearful facial expressions

Embodied simulation accounts of emotion recognition claim that we vicariously activate somatosensory representations to simulate, and eventually understand, how others feel. Interestingly, Mirror-Touch Synaesthetes, who experience touch when observing others being touched, show both enhanced somatosensory simulation and superior recognition of emotional facial expressions. We employed synchronous visuotactile stimulation to experimentally induce a similar experience of ‘mirror touch’ in non-synesthetic participants. Seeing someone else’s face being touched at the same time as one’s own face results in the ‘enfacement illusion’, which has been previously shown to blur self-other boundaries. We demonstrate that the enfacement illusion also facilitates emotion recognition, and, importantly, this facilitatory effect is specific to fearful facial expressions. Shared synchronous multisensory experiences may experimentally facilitate somatosensory simulation mechanisms involved in the recognition of fearful emotional expressions

Biophysical and biochemical markers at 30-34 weeks' gestation in the prediction of adverse perinatal outcome

Objective: To investigate the potential value of biophysical and biochemical markers at 30 34 weeks’ gestation in the prediction of adverse perinatal outcome. Methods: Screening study in 8,268 singleton pregnancies at 30 34 weeks. Estimated fetal weight (EFW), uterine artery pulsatility index (PI) PI), umbilical artery PI, fetal middle cerebral artery (MCA) PI, mean arterial pressure (MAP), serum placental growth factor (PLGF and soluble fms-like tyrosine kinase-1 (sFlt 1) were measured. The detection rate (DR) and false positive rate (FPR) of screening by each biomarker were estimated for stillbirth, preeclampsia, delivery of small for gestational age (SGA) neonate, cesarean section for fetal distress b efore or during labor, umbilical arterial cord blood pH <7.0 or umbilical venous blood pH <7.1, Apgar score <7 at 5 minutes and admission to the neonatal unit (NNU). Results: Multivariable regression analysis demonstrated that significant predict ion of P E was provided by PLGF, sFlt 1, MAP and MCA PI with DR of 98% of PE delivering at <37 weeks’ gestation and 56% of those delivering at 37 weeks , at 10% FPR. Prediction of SGA was provided by EFW, PLGF, sFlt 1, uterine artery PI, umbilical artery PI, and MC A PI with DR of 88% of SGA at <37 and 51% at 37 weeks’ gestation, at 10% FPR. Prediction of stillbirth was provided by EFW, uterine artery PI and MCA PI with DR of 30 % at 10% Prediction of cesarean section for fetal distress before labor was provided by EFW, sFlt 1, uterine artery PI and umbilical artery PI with DR of 90 %, at 10% FPR. Prediction of fetal distress in labor was provided by EFW and sFlt 1 with DR of 16 %, at 10% FPR. There were no significant differences from the normal outcome group in a ny of the biomarkers for low cord blood pH, low Apgar score or NNU admission for cases other than those with PE and / or SGA. Conclusion: At 30 34 weeks’ gestation, biomarkers of impaired placentation and fetal hypoxemia provide good prediction of PE , SGA and fetal distress before labor, but poor or no prediction of stillbirth and adverse events in labor or after birt