Weaning in der neurologischen Frührehabilitation (NFR)

Weaning in neurological early rehabilitation represents an important participation goal that can be achieved in up to 90% of cases after an average of two to three weeks of weaning through a combination of intensive care and rehabilitative interventions. The weaning process should be based on a standardized weaning protocol, with which a gradual expansion of spontaneous breathing phases can be achieved. The German Society for Neurorehabilitation (DGNR) has taken the special features of prolonged weaning in NFR into account in a separate guideline.

Forestry and taxation characteristics of Spruce (Piceetum oxalidosum) stands in Udmurt Republic

The results of a forestry and taxation study of spruce stands of the acidic type of two forest districts of the Udmurt Republic are presented. The death of the most productive spruce individuals (productivity class I–II according to B.D. Zhilkin) and pure spruce plantations (acidic forest types, I–II class of bonitet) was noted due to the mass spread of bark beetle typographus (Ips typographus). The most extensive processes of shrinking of plantings were noted in the forest area of coniferous-deciduous forests of Udmurtia. A decrease in completeness in some areas of spruce stands to 0,1...0,3 was revealed, as well as the accumulation of large volumes of dead wood. A change in environmental conditions was revealed due to a decrease in completeness in spruce stands, which led to the development of field grasses and the growth of soft-leaved species. Despite the fact that the peak of the bark beetle development occurred in 2013, a gradual expansion of its range was revealed both in the forest area of coniferous-deciduous forests and in the south taiga forest area of the Udmurt Republic.

A Case Report on Osborn Waves of Hypothermia Induced LV Systolic Dysfunction

Hypothermia, described as a core body temperature of < 95%, is associated with ECG alteration abnormalities. Sinus bradycardia occurs when the body temperature drops below 90°F, and is correlated with gradual prolongation of the PR interval, QRS complex, QT interval. It can progress to ventricular and atrial fibrillation at a temperature reaching 89°F, which can lead to left ventricular dysfunction. Hypothermia is connected to the osborn waves, which at the end of the QRS complex consist of additional deflection. The inferior and lateral precordial leads are seen by Osborn waves, also known as J waves, Camel hump waves and hypothermic waves. As the body temperature decreases, it becomes more pronounced and a gradual expansion of the QRS complex raises the likelihood of ventricular fibrillation causing ventricle dysfunction.

Research On The Fractal and Percolation Characteristics of Coal-Based Porous Media For Filtration and Impregnation

In order to distinguish the difference in the heterogeneous fractal structure of porous graphite used for filtration and impregnation, the fractal dimensions obtained through the mercury intrusion porosimetry (MIP) along with the fractal theory were used to calculate the volumetric FD of the graphite samples. The FD expression of the tortuosity along with all parameters from MIP test was optimized to simplify the calculation. In addition, the percolation evolution process of mercury in the porous media was analyzed in combination with the experimental data. As indicated in the analysis, the FDs in the backbone formation regions of sample vary from 2.695 to 2.984, with 2.923 to 2.991 in the percolation regions and 1.224 to 1.544 in the tortuosity. According to the MIP test, the mercury distribution in porous graphite manifested a transitional process from local aggregation, gradual expansion, and infinite cluster connection to global connection.

Flanders

This chapter considers a case, Flanders, where secessionism has not gained strength despite many episodes fuelling tensions between the two main communities and significant, though episodic, cynicism about the future of the country. The singular political development of the Belgian state, which has involved an incremental and open-ended process of decentralization, has meant that Flemish autonomy is dynamic. Belgium is famous for its seemingly incessant constitutional politics leading to reforms of the state that transform the country’s institutional architecture in innovative ways. For Flanders, these state reforms have meant a gradual expansion of autonomy. Moreover, the reforms are never meant to conclude a process of decentralization; they always leave issues to be dealt with at an ulterior date. State reforms are high-profile events that often occur to manage a crisis between the two communities and are subject to government formation agreements in the context of the country’s consociational practices. Flemish parties can typically have a state reform if most of them want one or else the country remains without a government, which is something Francophone parties want to avoid for fear it makes Belgium seem unworkable and therefore feeds Flemish secessionist arguments. As Flemings know there is a forthcoming state reform that will enhance their collective autonomy and address some issues perceived as important for their national identity and interests, there is little incentive to support secessionist positions.

Conversions

This chapter discusses the gradual expansion of the Christian movement into Ireland. Despite widespread fears, the fall of the Roman empire did not herald the end of Christianity. Instead, it encouraged its expansion. Christian missionaries in Ireland worked to ensure that an island with an unfamiliar language and culture beyond the edge of the western empire would accept Christianity more than 100 years before the Anglo-Saxons, and centuries before other northern European peoples. For the fall of Rome and the crisis of imperial Christianity were contexts for the emergence in Ireland, and elsewhere, of a new kind of faith. From the early fifth century, and over several hundred years, the Irish converted to Christianity, shaping their new faith, exporting their theological and missionary cultures, and working for the conversion of the Picts, the Northumbrians, and Anglo-Saxons, as their Christian culture expanded throughout Europe, saving souls, if not ‘saving civilization’, at the end of the Roman world.

Albania

This chapter offers an in-depth look at health politics and the compulsory health insurance system in Albania. It traces the development of the Albanian healthcare system, characterized by the introduction of a universal and state-run health system during communism, which since the 1970s suffered underfinancing and outdated technology. Since the early 1990s, when Albania experienced a tumultuous transition from a communist to a democratic system, Albanian health politics focused on the legalization of private medical practice, the establishment and gradual expansion of compulsory health insurance, and, recently, the introduction of free primary care—reforms which were facilitated by the support of international organizations. Notably, the contracting of private services in the public system was not allowed until 2011. The main healthcare issues have been insufficient financing and extremely high out-of-pocket costs, people refraining from paying insurance contributions, and shortages of medical staff especially in rural areas.

THE GIST OF THE WORLD CUSTOMS ORGANIZATION

In this article there is for the first time offered a theoretical justification for understanding the purpose (goals), tasks and functions of the World Customs Organization as interrelated categories. Emphasis is placed on the fact that the explanation of the essence of any international organization should begin with a description of its purpose (goals), objectives and functions. The position of the authors was formed taking into account the results of the generalization of doctrinal approaches of scientists to understand the essence of the World Customs Organization. Particular attention was paid to the characteristics of the provisions of the Convention establishing the Customs Cooperation Council of December 15, 1950, which is a constituent act of the World Customs Organization, as well as other international conventions, resolutions, declarations and recommendations adopted by this organization. It is emphasized that in contrast to the list of functions of the organization were specified in Art. III of the Convention establishing the Customs Cooperation Council of December 15, 1950, in its text there is no clear and unambiguous statement of the purpose (goals) and objectives of WCO. As a result of the study, the authors note that the purpose of WCO determines the desired result, the achievement of which should be aimed at the activities of the organization and is to promote cooperation between the governments of its members. And the achievement of this goal necessitates the solution of common tasks for WCO members, which specify the purpose of the organization. It was also investigated that the WCO objectives provided for in the Preamble to the Convention on the Establishment of Customs Cooperation Council do not exhaust their full list, the gradual expansion of which takes place through the adoption of legal acts by the WCO Council. It is also determined that objectives of WCO are subordinated to the functions of WCO.

The Skilful Origins of Human Normative Cognition

I briefly present and motivate a ‘skill hypothesis’ regarding the evolution of human normative cognition. On this hypothesis, the capacity to internally represent action-guiding norms evolved as a solution to the distinctive problems of standardizing, learning and teaching complex motor skills and craft skills, especially skills related to toolmaking. We have an evolved cognitive architecture for internalizing norms of technique, which was then co-opted for a rich array of social functions. There was a gradual expansion of the normative domain, with ritual playing an important role in bridging the gap between concrete, enacted norms and general, abstract norms, such as kinship norms. I conclude by stating nine predictions arising from the skill hypothesis.

Protecting antiquities in early modern Rome: the papal edicts as paradigms for the heritage safeguard in Europe

The edicts issued in Rome between the fifteenth and the eighteenth centuries are the earliest legislation conceived for the preservation and supervision of heritage in Europe. Not only did such regulations aim to protect monuments, antiquities, and – at a later stage – paintings from the risks of damage and deterioration, but also established a legal framework against their illegal exportation and excavation. In this study the gradual development of this vast corpus of legislation is considered within the variations of artistic scholarship, legal knowledge, artistic taste, and the art market in Europe between 1400s and 1700s. The mutual implications of juridical constructs and practices of supervision are evaluated together with interdisciplinary factors – such as the rise of collections and museums – to shed light on the development of the concepts of ‘heritage protection’ in early modern Rome. Specific analysis will also involve the gradual expansion of the definition of ‘antiquity’ and ‘artefact’ in papal legislation, as well as the establishment of innovative instruments to prevent and circumvent misdemeanours. One final consideration is given to the launch of local procedures of heritage protection in other states in Europe. Considering the cultural and historical backgrounds of each individual place, this study will demonstrate that the idea of safeguarding what was thought of as ‘collective heritage’ emerged consistently in eighteenth-century Europe following the paradigms of the papal edicts.