DSpace-CRIS 8

Practices for controlling intracranial pressure (ICP) in traumatic brain injury (TBI) patients admitted to the intensive care unit (ICU) vary considerably between centres. To help understand the rational basis for such variance in care, this study aims to identify the patient-level predictors of changes in ICP management. We extracted all heterogeneous data (2008 pre-ICU and ICU variables) collected from a prospective cohort (n = 844, 51 ICUs) of ICP-monitored TBI patients in the Collaborative European NeuroTrauma Effectiveness Research in TBI study. We developed the TILTomorrow modelling strategy, which leverages recurrent neural networks to map a token-embedded time series representation of all variables (including missing values) to an ordinal, dynamic prediction of the following day's five-category therapy intensity level (TIL(Basic)) score. With 20 repeats of fivefold cross-validation, we trained TILTomorrow on different variable sets and applied the TimeSHAP (temporal extension of SHapley Additive exPlanations) algorithm to estimate variable contributions towards predictions of next-day changes in TIL(Basic). Based on Somers' Dxy, the full range of variables explained 68% (95% CI 65-72%) of the ordinal variation in next-day changes in TIL(Basic) on day one and up to 51% (95% CI 45-56%) thereafter, when changes in TIL(Basic) became less frequent. Up to 81% (95% CI 78-85%) of this explanation could be derived from non-treatment variables (i.e., markers of pathophysiology and injury severity), but the prior trajectory of ICU management significantly improved prediction of future de-escalations in ICP-targeted treatment. Whilst there was no significant difference in the predictive discriminability (i.e., area under receiver operating characteristic curve) between next-day escalations (0.80 [95% CI 0.77-0.84]) and de-escalations (0.79 [95% CI 0.76-0.82]) in TIL(Basic) after day two, we found specific predictor effects to be more robust with de-escalations. The most important predictors of day-to-day changes in ICP management included preceding treatments, age, space-occupying lesions, ICP, metabolic derangements, and neurological function. Serial protein biomarkers were also important and may serve a useful role in the clinical armamentarium for assessing therapeutic needs. Approximately half of the ordinal variation in day-to-day changes in TIL(Basic) after day two remained unexplained, underscoring the significant contribution of unmeasured factors or clinicians' personal preferences in ICP treatment. At the same time, specific dynamic markers of pathophysiology associated strongly with changes in treatment intensity and, upon mechanistic investigation, may improve the timing and personalised targeting of future care.

Background: During the Soviet era, higher education institutions in Lithuania operated under strict ideological control. However, students found ways to express themselves through informal cultural and social activities. The Faculty of Pharmacy at the Kaunas Medical Institute (KMI) was no exception, as students engaged in various extracurricular activities that allowed them to develop a sense of identity and freedom within the restrictive Soviet system. Aim(s): To explore the non-formal activities of pharmacy students at KMI from 1979 to 1989, highlighting their role in shaping a generation that later contributed to the development of an independent Lithuania. Methods: The research is based on archival records, personal testimonies, and interviews with former students who participated in extracurricular activities. It also includes an analysis of student publications, photographs, and event documentation from the late Soviet period. Results: Despite the limitations imposed by the Soviet regime, pharmacy students engaged in ethnographic expeditions, student evenings, and artistic performances, including poetry readings and theatrical presentations. The faculty's ethnographic ensemble played a significant role in preserving Lithuanian cultural traditions. Additionally, student-organized events fostered creativity and intellectual discussions that subtly challenged the Soviet ideological framework. Many students involved in these activities later became key figures in Lithuania’s academic, pharmaceutical, and cultural spheres. Conclusion: The non-formal activities of pharmacy students in the last decade of the Soviet era provided a platform for creative and intellectual self-expression. These activities not only enriched student life but also contributed to the broader movement of cultural and national awakening in Lithuania, which played a crucial role in the country’s path to independence.

Background: 100 years ago, the first Lithuanian pharmacy diploma was awarded. A graduation diploma opens new opportunities, making this event significant and widely celebrated throughout history. Traditionally, graduates have marked this milestone together with professors, students, and family members. Aim(s): To analyze the historical development of pharmacy diploma awarding traditions and their transformation under political, historical and cultural influences. Methods: The study employs a historical approach and a photographic analysis to examine the evolution of pharmacy diploma awarding traditions Results: Political changes have influenced the traditions of diploma awarding ceremonies. There is little information about how pharmacy graduates in interwar Lithuania celebrated this occasion. During the post-war period, economic hardships affected graduation events. However, over time, a tradition of the "last lecture" emerged, characterized by a student-organized artistic program, a symbolic will for future pharmacy students, and an abundant feast during the final lecture. The diploma ceremony took place in the Great Hall, where the rector awarded diplomas, and the dean delivered congratulatory speeches. In the years of regained independence, around the 2000s, the tradition of wearing academic regalia emerged. Students rented regalia, following a practice that likely originated in Western Europe or the United States. In interwar Lithuania, academic regalia were not used, although female graduates may have occasionally worn traditional national attire. Over time, the diploma awarding ceremony moved to Žalgiris arena. Certain traditions faded, such as the presence of alcohol, which had been a prominent element for many years, as well as the "last lecture" tradition and the symbolic student testament. Conclusion: Graduation traditions have evolved under the influence of political changes. In the years of independence, Western-style traditions gained prominence, shaping a modernized approach to pharmacy diploma awarding ceremonies.

Background: At all times, pharmacy students not only studied theoretical materials but also conducted various research studies. At Vytautas Magnus University, pharmacy students (pharmacy candidates) who studied between 1930 and 1940 had to pass exams and write a thesis to obtain the title of chemist-pharmacist [1]. Today, pharmacy students apply the latest analytical methodologies when preparing their master's thesis. However, it is important to examine which analytical methods were mentioned in the pre-war pharmacy candidates' theses. Aim: To find out the topics and analytical methods used in pharmacy candidates' theses from 1930 to 1940. Methods: A review of pharmacy candidates' theses stored at the Museum of the History of Lithuanian Medicine and Pharmacy of LSMU. Results: Pharmacy candidates conducted research on pharmaceutical preparations and household products. It was found that complex pharmaceutical preparations (ointments, powders, solutions), food products (sour cream, bread, apples, mineral water, alcoholic beverages), as well as cleaning agents, smoking tobacco, and church candles were analyzed. Students carried out synthesis work (extraction of trimethylamine from herring brine) and the isolation of active substances from biological samples (the thyroid gland, blood, and liver of animals). It was found that qualitative and quantitative methods of chemical analysis were used, but no instrumental methods were described. The theses documented the use of microscopic, volumetric, and gravimetric analysis methods; as well as a detailed process of sample preparation and the calculation of results. Test samples were analyzed for ash content, moisture, organic compounds (sugar, proteins, nicotine, pyridine, fusel oils, ethyl and methyl alcohols), as well as inorganic compounds and elements (carbonates, ammonium, iron, calcium, magnesium, sodium, potassium, etc.). Conclusion: Between 1930 and 1940, pharmacy candidates explored a variety of topics, and their theses were based on experimental research, demonstrating the broad scope expected of a chemist-pharmacist.

„Kardiologijos pagrindai studentams “ apima širdies ir kraujagyslių ligų sindrominę diagnostiką, paciento ištyrimo metodiką, kardiologijoje vartojamų vaistų klinikinę farmakologiją, vaizdinius tyrimo metodus, taip pat atskirų širdies ir kraujagyslių ligų diagnostiką bei gydymą. Jis skirtas medicinos specialybės studentų, taip pat kardiologijos ir kitų vidaus ligų specialybių gydytojų rezidentų mokymui, vidaus ligų, skubiosios pagalbos gydytojų, gydytojų kardiologų bei kitų specialybių gydytojų kvalifikacijos kėlimui.

Mokomoji knyga skirta pirmojo kurso Veterinarinės medicinos studentams, studijuojantiems „Atramos ir judėjimo“ modulį. Osteologija – mokslas apie kaulus – sudaro didelę šio modulio dalį. Šia mokomąja knyga galės naudotis ir studentai, studijuojantys modulio „Gyvybės mokslai – 1“ bendrosios anatomijos dalį. Knyga taip pat bus naudinga aukštesniojo kurso studentams, studijuojantiems chirurgijos ir ortopedijos studijų dalykus, žemės ūkio srities magistrantams bei doktorantams, veterinarijos gydytojams. Veterinarinės anatomijos literatūros studijoms lietuvių kalba labai trūksta, o vos keli išleisti vadovėliai mena praeitą šimtmetį. Manome, kad šis leidinys atitiks šiuolaikinės veterinarinės medicinos poreikius savo turiniu, struktūra bei iliustracijomis ir padės studentams geriau įsisavinti veterinarinės osteologijos žinias. Šiame naujame leidinyje išsamiai apžvelgta mėsėdžių griaučių struktūra, kuri iki šiol nebuvo labai akcentuojama, tačiau laikui bėgant tapo viena aktualiausių ir labiausiai tiriamų sričių veterinarinėje praktikoje. Studentams osteologija yra vienas pirmųjų prisilietimų prie veterinarinės anatomijos mokslo, todėl svarbu užtikrinti, kad šis įspūdis neišblėstų ir motyvuotų toliau semtis anatomijos žinių. Knygoje pateikiama išsami ašinių ir pridėtinių griaučių anatominė sandara, nagrinėjami visų aktualiausių naminių gyvūnų – atrajotojų (galvijų, avių, ožkų), arklių, kiaulių, mėsėdžių (šunų ir kačių) rūšiniai skirtumai. Knyga gausiai iliustruota geros kokybės nuotraukomis, kurių didžioji dalis yra nufotografuota pačių autorių. Pateikiami anatomijos terminai (lietuvių ir lotynų kalbomis) suderinti su „Veterinarinės anatomijos, histologijos ir embriologijos terminų žodynu“ (2013).

[...]. Tyrimo tikslas. Nustatyti neurosonografinių galvos ir kaklo arterijų parametrų vertę prognozuojant demenciją lengvą kognityvinį sutrikimą turintiems pacientams. Tyrimo uždaviniai. 1. Ištirti lengvą kognityvinį sutrikimą turinčių pacientų demografines ir klinikines charakteristikas ir įvertinti jų ir progresavimo į demenciją ryšį. 2. Ištirti lengvą kognityvinį sutrikimą turinčių pacientų ekstrakranijinės kraujotakos parametrus ir įvertinti jų ir progresavimo į demenciją ryšį. 3. Ištirti lengvą kognityvinį sutrikimą turinčių pacientų intrakranijinės kraujotakos parametrus ir įvertinti jų ir progresavimo į demenciją ryšį. 4. Ištirti lengvą kognityvinį sutrikimą turinčių pacientų miego arterijų sienelių parametrus ir įvertinti jų ir progresavimo į demenciją ryšį. 5. Ištirti lengvą kognityvinį sutrikimą turinčių pacientų miego arterijų aterosklerozinius požymius ir įvertinti jų ir progresavimo į demenciją ryšį. 6. Įvertinti bendrą tiriamųjų demografinių ir klinikinių charakteristikų bei neurosonografinių parametrų diagnostinę reikšmę prognozuojant progresavimą iš lengvo kognityvinio sutrikimo į demenciją. [...].