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Nors Lietuvos švietimo sistemoje įtraukiajam ugdymui skiriama vis daugiau dėmesio, tačiau, atsižvelgiant į tai, kad bet kokio ugdymo sėkmė labiausiai priklauso nuo pedagogo gebėjimo kokybiškai dirbti įvairiomis sąlygomis, įtraukusis ugdymas vis dar kupinas iššūkių. Straipsnyje apžvelgiamas mokslininkų požiūris į neformalųjį muzikinį ugdymą, kai klasėje yra specialiųjų ugdymosi poreikių turinčių vaikų, bei pristatomos empiriniu tyrimu paremtos įžvalgos, su kokiais iššūkiais susiduria pedagogai, mokydami muzikos įtraukioje klasėje. Remiantis tyrimo rezultatais, neformalaus muzikinio ugdymo kontekste įtraukusis ugdymas yra būtinas, tačiau iškyla tokių probleminių aspektų: nėra tinkamų sąlygų dirbti su specialiųjų ugdymosi poreikių turinčiais vaikais (kad būtų pagal individualius vaikų poreikius pritaikyta mokymosi aplinka, muzikos instrumentų įvairovė, mokytojo padėjėjo pagalba), ribotos muzikos pedagogų žinios apie specialiųjų ugdymosi poreikių turinčių vaikų raidos ir mokymosi ypatumus bei nepakankami pedagogų gebėjimai dirbti įtraukioje klasėje.

This article presents a study using qualitative research methods, including oral history and content analysis, to explore the value of compulsory military service in the Soviet Army (1967–1990). The investigation considers both the ideological context and the perspectives of the individuals who were serving. Periodicals such as Komjaunimo tiesa and Jaunimo gretos, published in the Lithuanian Soviet Socialist Republic (LSSR) between 1967 and 1990, focus on the soldier’s identity. However, these publications often present a superficial view, emphasizing qualities such as ‘fearlessness’, ‘toughening’, ‘physical strength’, and ‘masculinity’. In contrast, interviews with Lithuanian conscripts reveal a wide range of experiences and perspectives on the military service, shaped by their social environment, personal experiences, and education. While many view their military service as ‘lost years’, some men recognize positive outcomes, such as increased maturity and greater independence. The harsh conditions and difficult living environment during their service also led to feelings of alienation and caution, reinforcing certain Soviet lifestyle habits, such as dishonesty, theft, adaptation, and time-wasting. Although the length of service typically ranged from 2 to 3 years, for some men, it remains a significant life adventure or a troubling memory, often revisited through humorous stories or a desire to connect with others who share similar experiences.

Background: The rate of pathological complete response (pCR) after neoadjuvant chemotherapy (NACT) in triple-negative breast cancer (TNBC) varies, and adjuvant therapy treatment for residual cancer remains a challenge. The aim of our study was to assess the added value of FoundationOne®CDx (F1CDx) testing in the non-metastatic TNBC in predicting responses to NACT and disease outcomes. Methods: Ninety-three eligible patients with stage II-III TNBC were treated with NACT without immunotherapy. Response to NACT was evaluated postoperatively. Comprehensive genomic profiling with NGS-based molecular test F1CDx was performed on diagnostic biopsies (N = 93). Hierarchical clustering and logistic regression were applied for data analysis. Results: Genomic profiling and data clustering revealed heterogeneous genetic landscapes of TNBC with subsets displaying multilayered co-amplifications of oncogenes and overlapping changes in crucial signaling pathways. TP53 mutations were detected in 95 % of all TNBCs. BRCA1/BRCA2 mutations were significant molecular factors in predicting favorable responses to NACT (OR = 0.09, p = 0.002), while CCNDs co-mutations with FGFs (OR = 13.4, p = 0.016) and PI3Ks family mutations in AR-positive cases (OR = 6.1, p = 0.008) – poor responses. Low tumor mutational burden (TMB) ≤ 3 (OR = 9.4, p = 0.009) was a significant factor for the disease progression after NACT. Conclusions: This study suggests that comprehensive CDx testing can be explored as a prognostic tool in early-stage TNBC to predict responses to NACT and disease progression. Based on these results, genomic analysis should be performed early in the patient journey, possibly guiding adjuvant treatment choices and participation in randomized clinical trials, mainly when pCR is not achieved, as the ultimate goal is improving patient outcomes.

Book review of "Haller, Tobias, Karina Liechti, Martin Stuber, François-Xavier Viallon, and Rahel Wunderli (eds.). Balancing the Commons in Switzerland. Institutional Transformations and Sustainable Innovations. 2021. London: Routledge.

Abstract Background Short bowel syndrome (SBS) in adults is defined as having less than 180 to 200 cm of remaining small bowel. Many literature sources do not provide precise epidemiological data, and challenges in estimating the prevalence of SBS include its multifactorial etiology and varying definitions. The most common pathologies leading to SBS include Crohn disease, mesenteric ischemia, radiation enteritis, post-surgical adhesions, and post-operative complications. Case presentation This article presents a clinical case of a 76-year-old Lithuanian patient who underwent parenteral nutrition for four months due to SBS. Before the following diagnosis, the patient had undergone two surgeries. During the hospitalization, life-threatening conditions such as stercoral peritonitis, septic shock, and acute respiratory failure, were observed and treated. As a result of SBS, hypoproteinemia and hypoalbuminemia developed, leading to the prescription of full parenteral nutrition. After correcting the malnutrition, a third surgery was performed, resulting in the discontinuation of parenteral nutrition and the resumption of a regular diet. Conclusions Parenteral nutrition is the sole effective method for preserving the lives of patients with a short segment of the intestine. While on parenteral nutrition, patients can be prepared for reconstructive surgery.

Background and Objective: Unexplained infertility is a major challenge in reproductive medicine and requires advanced diagnostic approaches to identify the underlying factors accurately. This study aims to evaluate the utility of risk factor analysis and a gene panel in diagnosing unexplained infertility using the next-generation sequencing (NGS) technology. Our study aimed to characterize and identify risk and genetic factors associated with unexplained infertility. Materials and methods: A cohort of patients with unexplained infertility was comprehensively screened for risk factors and genetic variations using a targeted gene panel (10 couples with unexplained infertility (UI) and 36 fertile couples). 108 articles were selected (58 on female infertility and 50 on male infertility) presenting genes that may be associated with unexplained infertility. A gene panel for unexplained infertility was compiled based on the literature data. A customized virtual panel was created from the exome sequencing data. Results: In the female group, controls had a higher mean age, while in the male patients, both groups were similar in terms of age. Both gender groups had comparable BMI values. No significant associations (p > 0.05) between risk factors and unexplained infertility were found when evaluating anthropometric parameters and other sociodemographic characteristics. In two male patients (20%), a molecular defect was detected in NGS variants classified aspossible benign and probably benign In particular, missense variants were identified in the UGT2B7 and CATSPER2 genes, A molecular defect classified as probably damaging was found in five female patients (50%). In particular, missense variants were identified in the CAPN10, MLH3, HABP2, IRS1, GDF9, and SLC19A1 genes. Conclusions: The study emphasizes that unexplained infertility is often related to mechanisms beyond causative mutations and highlights the need for integrative genomic research involving broader gene panels and multi-faceted approaches, including transcriptomics and epigenetics, to uncover latent genetic predispositions.

Background: Correct inhaler technique is vital for managing respiratory conditions like asthma. Patients from culturally and linguistically diverse backgrounds are at higher risk of sub-optimal adherence and errors in inhaler technique. This study aimed to validate an Arabic version of the inhaler technique questionnaire for self-assessment of the metered-dose inhaler (MDI) technique by assessing agreement between observed and self-reported techniques among Arabic-speaking individuals with asthma in Australia. Methods: Observational assessments of 30 participants using an MDI, followed by completion of the translated inhaler technique questionnaire by the same participants. The questionnaire comprised nine questions pertaining to the inhaler technique. The level of agreement between the observed and self-reported technique for each of the nine MDI technique steps was subsequently determined using intraclass correlation. Results: The majority of participants were women, aged 25–44 years (70%). An overall Kappa score of 0.768 indicated good agreement between observed and self-reported datasets, with stepwise agreement ranging from 52.4–100%. Steps involving taking a big breath before inhaler use (step 2) and exhaling slowly (step 8) were the least well correlated. Conclusions: The preliminary validated MDI inhaler technique questionnaire may be used as a self-assessment tool by Arabic speakers, aiding healthcare professionals, and empowering individuals living with asthma to self-manage their condition.

We report the results we derived analyzing photometric measurements obtained at different phase angles for 15 Near-Earth Objects (NEOs), observed from Campo Imperatore observatory, and Observatório Astronômico do Sertão de Itaparica (OASI). The performed analysis allows us to taxonomically classify them using several independent techniques, thus constraining their surface composition. The majority of this sample is in agreement with a pristine carbonaceous composition (C-complex/D-type asteroids), while few NEOs are composed of more evolved (e.g. S/M/E-type bodies) material. With this work we made evident that a comprehensive characterization of a NEO can be achieved through the coupling of spectrophotometric data and phase curve assessment. This is crucial in case these objects become target of future rendez-vous, sample-return or mitigation missions. [ABSTRACT FROM AUTHOR]

The therapeutic landscape of plaque psoriasis has significantly changed over the past two decades due to the development of monoclonal antibodies that specifically target disease-relevant signaling pathways. Inhibitors of interleukins IL-17 and IL-23 play a crucial role in the treatment of moderate to severe forms of the disease. Zusammenfassung Die Therapielandschaft der Plaque-Psoriasis hat sich in den letzten zwei Jahrzehnten durch die Entwicklung monoklonaler Antikörper, die gezielt in krankheitsrelevante Signalwege eingreifen, deutlich verändert. Dabei spielen u.a. Inhibitoren der Interleukine IL-17 und IL-23 eine entscheidende Rolle bei der Behandlung mittelschwerer bis schwerer Formen der Erkrankung.

Su potencialiai traumuojančiais įvykiais bent kartą gyvenime susiduria daugelis. Tokie įvykiai, net jei nesukelia potrauminio streso sutrikimų, psichikoje gali palikti ryškius pėdsakus. Trauminių patirčių sukelti sunkumai dažnai iškyla psichoterapeuto kabinete, tad svarbu suprasti, kuo darbas su trauma ypatingas ir su kuo susiduria ne tik ją patyrusieji, bet ir pagalbą teikiantieji. Šio straipsnio tikslas – išgryninti ir aprašyti psichoterapinį darbą praktikuojančių specialistų požiūrius ir patirtis dirbant su trauminius išgyvenimus patyrusiais suaugusiais klientais. Tyrime dalyvavo 30 psichikos sveikatos specialistų. Kokybinės apklausos duomenų teminė analizė išryškino tris pagrindines temas: 1) terapinio proceso subtilumą; 2) darbo su trauma patyrimą; 3) pagalbą sau, kad padėtum kitam. Darbas su trauma apibūdinamas kaip lėtas, reikalaujantis kantrumo bei ypač atidaus ir atsargaus prisilietimo prie klientų skausmo. Dažnai susiduriama su klientų nepasitikėjimu ir ilgai dirbama stengiantis užmegzti saugų ryšį jam sumažinti. Specialistai patiria didelį emocinį krūvį, neretai aplanko beviltiškumo jausmas, tačiau taip pat ir suvokimas, koks apdovanojantis ir prasmingas šis darbas, jei pavyksta padėti. Dauguma specialistų akcentuoja būtinybę padėti ir sau: kryptingai mokytis ir ruoštis dirbti su trauma, pažinti asmenines traumas ir ypač atidžiai rūpintis savo psichologine gerove. Tyrimas atskleidė subjektyvų terapinio darbo su trauma kompleksiškumą. Gautos įžvalgos gali būti vertingos ruošiantiems ar peržiūrintiems naujų specialistų mokymo programas, supervizoriams bei patiems su psichologine trauma dirbantiems specialistams, ieškantiems informacijos apie patiriamus profesinius sunkumus.

Concerning an important event in the court of Emperor Frederick and other adventures which befall the knight San Alberto when he sets out to take away from Baron Miserabius his [...]

Background: Antibiotics are often overprescribed in children in general practice. We investigated whether the availability of C-reactive protein point-of-care testing (CRP POCT) in daily practice and general practitioner (GP) education reduces antibiotic prescribing for children with acute infections and whether GP education has a long-term effect on antibiotic prescribing. Methods: This was a randomized controlled intervention study with randomization at the GP practice level. Eligible patients were children aged 1 month to 17 years presenting to general practice with an acute infection. Interventions: In the first study period, one GP group received combined interventions (CRP POCT was provided for daily use in combination with a live educational session), while the second GP group continued usual care. During the second study period, the GP groups were switched. During this period, the long-term education effect was evaluated in the GP group, which had previously received both interventions: the CRP POCT was no longer available in their practices in accordance with the study protocol, but education could have a lasting effect. Primary outcome: Antibiotic prescribing at index consultation. Results: GP with combined intervention enrolled 1784 patients, GP with usual care enrolled 886 patients, and GP with long-term education effect enrolled 647 patients. Most of the patients had upper (76.8%) and lower (18.8%) respiratory infections. In total, 29.3% of the study patients received antibiotic prescriptions. Adjusted binary logistic regression analysis showed no differences for the primary outcome between GPs with usual care and GPs with combined intervention (aOR 0.89 (0.74–1.07), p = 0.20), but significantly lower antibiotic prescribing was observed for GPs with long-term education in comparison with GPs with usual care (aOR 0.75 (0.59–0.96), p = 0.02); however, after multilevel analyses, any differences in the antibiotic prescription between intervention groups became non-significant. GPs widely used CRP POCT when it was available in practice (for 69.1% of patients in the combined intervention group), but rarely measured CRP in the laboratory in the usual care group (8.8% (n = 78)) or long-term education group (14.8% (n = 98)). The majority of the tested patients had low CRP levels (below 20 mg/L); despite this, up to 35.4% of them received antibiotic prescriptions. Conclusions: Our results show that the availability of CRP POCT and educational training for GPs together did not reduce antibiotic prescribing, and one-time education did not have a long-term effect on antibiotic prescribing.

Straipsnyje apžvelgiama É. Jaques-Dalkroze muzikinio-ritminio ugdymo sistema, apibūdinamas euritmijos metodas ir pristatoma X progimnazijos 7 klasės muzikos pamokose atvejo analize įvertinta jo praktinė reikšmė ugdant mokinių ritmo pajautą. Kokybinio veiklos tyrimo rezultatai parodė, kad mokinių, turinčių gerą koordinaciją, reakciją, motoriką, gera ir ritmo pajauta. Silpnai jaučiančių rimtą tyrimo dalyvių ritmo pajauta po euritmijos pratybų pakito: pagerėjo dalyvių reakcija, vidinis laiko trukmės pojūtis, kūno judesiai ritmuojant tapo išraiškingesni, ritmavimo klaidų akivaizdžiai pradėjo mažėti. Be to, pastebėta, kad euritmijos pratimai turėjo poveikio ne tik mokinių ritmo pajautos kaitai, bet pagerėjo ir klasės mikroklimatas, mokiniai darėsi drąsesni, mėgavosi pratybomis.