Speaking Wounds – Silence, Self-injury and Healing in Patricia McCormick‟s Cut

Pro gradu -tutkielmani käsittelee itsensä vahingoittamisen, hiljaisuuden ja toipumisen representaatioita Patricia McCormickin nuorille aikuisille suunnatussa teoksessa Cut. Tutkielman tarkoituksena on analysoida itsensä vahingoittamista kirjallisuudentutkimuksellisesta näkökulmasta. Vaikka itsensä vahingoittamisesta on englanninkielisillä markkinoilla olemassa runsaasti psykologista kirjallisuutta, ei sen representaatioita kirjallisuudessa ole vielä juurikaan tutkittu. Näiden representaatioiden analysointi on tärkeää, sillä 1990-luvun alkupuolella syntyi nuortenkirjallisuudessa genre, joka keskittyy juuri itsensä vahingoittamisen käsittelyyn. Patricia McCormickin Cut on edustava esimerkki tämän genren romaanista. Tutkimuksen teoreettinen viitekehys koostuu monitieteellisistä teksteistä. Ensisijaisina lähteinä ovat Patrick Fueryn teoreettiset käsitykset hiljaisuudesta ja poissa-olosta sekä Christine Wilkie-Stibbsin feministiset luennat yksittäisistä nuortenkirjoista. Armando R. Favazzan kliiniset määritelmät itsensä vahingoittamisesta luovat perustan käyttämilleni termeille. Pääpaino tutkielmassa on kuitenkin omalla luennallani romaanista. Tutkimustuloksena on, että sekä päähenkilön hiljaisuus että itsensä viiltely ovat monimerkityksisiä ja dynaamisia tiloja. Ne toimivat kommunikaation ja itsehoidon välineinä. Viiltelyyn sisältyy voimakkaasti hoivan käsite, sillä viiltämällä itseään päähenkilö yrittää käsitellä ja helpottaa henkistä ahdistustaan. Sekä hiljaisuus että viiltely auttavat eri tavoin päähenkilöä käsittelemään ja sisäistämään oman tilansa ja näin ollen myös edistävät paranemisprosessia, joka jatkuu puheen kautta perinteisessä psykoterapeuttisessa diskurssissa. Teos painottaa puheen roolia, mutta myös hiljaisuus ja viiltely muodostavat yhtäläiset kommunikaatio- ja hoitoväylät.

Cognitive Functions After Traumatic Brain Injury. A 30-year Follow-up Study

Many cognitive deficits after TBI (traumatic brain injury) are well known, such as memory and concentration problems, as well as reduced information-processing speed. What happens to patients and cognitive functioning after immediate recovery is poorly known. Cognitive functioning is flexible and may be influenced by genetic, psychological and environmental factors decades after TBI. The general aim of this thesis was to describe the long-term cognitive course after TBI, to find variables that may contribute to it, and how the cognitive functions after TBI are associated with specific medical factors and reduced survival. The original study group consisted of 192 patients with TBI who were originally assessed with the Mild Deterioration Battery (MDB) on average two years after the injury, during the years 1966 – 1972. During a 30-year follow-up, we studied the risks for reduced survival, and the mortality of the patients was compared with the general population using the Standardized Mortality Ratio (SMR). Sixty-one patients were re-assessed during 1998-2000. These patients were evaluated with the MDB, computerized testing, and with various other neuropsychological methods for attention and executive functions. Apolipoprotein-E (ApoE) genotyping and magnetic resonance imaging (MRI) based on volumetric analysis of the hippocampus and lateral ventricles were performed. Depressive symptoms were evaluated with the short form of the Beck depression inventory. The cognitive performance at follow-up was compared with a control group that was similar to the study group in regard to age and education. The cognitive outcome of the patients with TBI varied after three decades. The majority of the patients showed a decline in their cognitive level, the rest either improved or stayed at the same level. Male gender and higher age at injury were significant risk factors for the decline. Whereas most cognitive domains declined during the follow-up, semantic memory behaved in the opposite way, showing recovery after TBI. In the follow-up assessment, the memory decline and impairments in the set-shifting domain of executive functions were associated with MRI-volumetric measures, whereas reduction in information-processing speed was not associated with the MRI measures. The presence of local contusions was only weakly associated with cognitive functions. Only few cognitive methods for attention were capable of discriminating TBI patients with and without depressive symptoms. On the other hand, most complex attentional tests were sensitive enough to discriminate TBI patients (non-depressive) from controls. This means that complex attention functions, mediated by the frontal lobes, are relatively independent of depressive symptoms post-TBI. The presence of ApoE4 was associated with different kinds of memory processes including verbal and visual episodic memory, semantic memory and verbal working memory, depending on the length of time since TBI. Many other cognitive processes were not affected by the presence of ApoE4. Age at injury and poor vocational outcome were independent risk factors for reduced survival in the multivariate analysis. Late mortality was higher among younger subjects (age < 40 years at death) compared with the general population which should be borne in mind when assessing the need for rehabilitation services and long-term follow-up after TBI.

Evaluation of prognostic factors of decompressive craniectomy in the treatment of severe traumatic brain injury

OBJECTIVE: to determine predictive factors for prognosis of decompressive craniectomy in patients with severe traumatic brain injury (TBI), describing epidemiological findings and the major complications of this procedure.METHODS: we conducted a retrospective study based on analysis of clinical and neurological outcome, using the extended Glasgow outcome in 56 consecutive patients diagnosed with severe TBI scale treated in the emergency department from February 2004 to July 2012. The variables assessed were age, mechanism of injury, presence of pupillary changes, Glasgow coma scale (GCS) score on admission, CT scan findings (volume, type and association of intracranial lesions, deviation from the midline structures and classification in the scale of Marshall and Rotterdam).RESULTS: we observed that 96.4% of patients underwent unilateral decompressive craniectomy (DC) with expansion duraplasty, and the remainder to bilateral DC, 53.6% of cases being on the right 42.9% on the left, and 3.6% bilaterally, with predominance of the fourth decade of life and males (83.9%). Complications were described as transcalvarial herniation (17.9%), increased volume of brain contusions (16.1%) higroma (16.1%), hydrocephalus (10.7%), swelling of the contralateral lesions (5.3%) and CSF leak (3.6%).CONCLUSION: among the factors studied, only the presence of mydriasis with absence of pupillary reflex, scoring 4 and 5 in the Glasgow Coma Scale, association of intracranial lesions and diversion of midline structures (DML) exceeding 15mm correlated statistically as predictors of poor prognosis.

Natural history of extensive diaphragmatic injury on the right side: experimental study in rats

OBJECTIVE: To evaluate the natural healing of the rat diaphragm that suffered an extensive right penetrating injury.METHODS: Animals were submitted to an extensive penetrating injury in right diaphragm. The sample consisted of 40 animals. The variables studied were initial weight, weight 21 days after surgery; healing of the diaphragm, non-healing of the diaphragm, and herniated abdominal contents into the chest.RESULTS: Ten animals were used as controls for weight and 30 animals were operated. Two animals died during the experiment, so 28 animals formed the operated group; healing of the diaphragm occurred in 15 animals (54%), 11 other animals showed diaphragmatic hernia (39%) and in two we observed only diaphragmatic injury without hernia (7%). Among the herniated organs, the liver was found in 100% of animals, followed by the omentum in 77%, small bowel in 62%, colon in 46%, stomach in 31% and spleen in 15%. The control group and the diaphragmatic healing subgroup showed increased weight since the beginning of the study and the 21 days after surgery (p <0.001). The unhealed group showed no change in weight (p = 0.228).CONCLUSION: there is a predominance of spontaneous healing in the right diaphragm; animals in which there was no healing of the diaphragm did not gain weight, and the liver was the organ present in 100% the diaphragmatic surface in all rats with healed diaphragm or not.

Analysis of natural history of the diaphragmatic injury on the right in mice

Objective: to evaluate natural evolution of right diaphragmatic injury after the surgical removal of a portion from hemi diaphragm. Methods: the animals were submitted to a surgical removal of portion from right hemi diaphragm by median laparotomy. The sample consists of 42 animals being 2 animals from pilot project and 40 operated animals. And the variables of the study were herniation, liver protection, healing, persistent diaphragm injury, evaluation of 16 channels tomography and the variables "heart rate" and "weight". Results: we analyzed 40 mice, we had two post-operative deaths; we had 17 animals in this group suffered from herniation (42.5%) and 23 animals didn't suffer from herniation (57.5%). Analyzing the tomography as image method in the evaluation of diaphragmatic hernia, we had as a method with good sensitivity (78.6%), good specificity (90.9%), and good accuracy (86.1%) when compared to necropsy. Conclusion: there was a predominance of healing of right hemi diaphragm, the size of initial injury didn't have influence on occurrence of the liver protection or hernia in mice.

Detection of Pathologic Changes Following Traumatic Brain Injury Using Magnetic Resonance Imaging

Background: Approximately two percent of Finns have sequels after traumatic brain injury (TBI), and many TBI patients are young or middle-aged. The high rate of unemployment after TBI has major economic consequences for society, and traumatic brain injury often has remarkable personal consequences, as well. Structural imaging is often needed to support the clinical TBI diagnosis. Accurate early diagnosis is essential for successful rehabilition and, thus, may also influence the patient’s outcome. Traumatic axonal injury and cortical contusions constitute the majority of traumatic brain lesions. Several studies have shown magnetic resonance imaging (MRI) to be superior to computed tomography (CT) in the detection of these lesions. However, traumatic brain injury often leads to persistent symptoms even in cases with few or no findings in conventional MRI. Aims and methods: The aim of this prospective study was to clarify the role of conventional MRI in the imaging of traumatic brain injury, and to investigate how to improve the radiologic diagnostics of TBI by using more modern diffusion-weighted imaging (DWI) and diffusion tensor imaging (DTI) techniques. We estimated, in a longitudinal study, the visibility of the contusions and other intraparenchymal lesions in conventional MRI at one week and one year after TBI. We used DWI-based measurements to look for changes in the diffusivity of the normal-appearing brain in a case-control study. DTI-based tractography was used in a case-control study to evaluate changes in the volume, diffusivity, and anisotropy of the long association tracts in symptomatic TBI patients with no visible signs of intracranial or intraparenchymal abnormalities on routine MRI. We further studied the reproducibility of different tools to identify and measure white-matter tracts by using a DTI sequence suitable for clinical protocols. Results: Both the number and extent of visible traumatic lesions on conventional MRI diminished significantly with time. Slightly increased diffusion in the normal-appearing brain was a common finding at one week after TBI, but it was not significantly associated with the injury severity. Fractional anisotropy values, that represent the integrity of the white-matter tracts, were significantly diminished in several tracts in TBI patients compared to the control subjects. Compared to the cross-sectional ROI method, the tract-based analyses had better reproducibility to identify and measure white-matter tracts of interest by means of DTI tractography. Conclusions: As conventional MRI is still applied in clinical practice, it should be carried out soon after the injury, at least in symptomatic patients with negative CT scan. DWI-related brain diffusivity measurements may be used to improve the documenting of TBI. DTI tractography can be used to improve radiologic diagnostics in a symptomatic TBI sub-population with no findings on conventional MRI. Reproducibility of different tools to quantify fibre tracts vary considerably, which should be taken into consideration in the clinical DTI applications.

Quantifying seed production by volunteer canola (Brassica napus) and Sinapis arvensis

Volunteer canola (Brassica napus) and Sinapis arvensis are well identified weeds of different cropping systems. Quantitative information on regarding seed production by them is limited. Such information is necessary to model dynamics of soil seed banks. The aim of this work was to quantify seed production as a function of the size of those weeds. A wide range of plant size was produced by using a fan seeding system performed at two sowing dates (environments). Plant size varied from 3 to 167 g per plant for canola and from 6 to 104 g per plant for S. arvensis. Seed production ranged from 543 to14,773 seeds per plant for canola, and from 264 to 10,336 seeds per plant for S. arvensis. There was a close relationship between seed production per plant and plant size which was well-described by a power function (y = 130.6x0.94; R² = 0.93 for canola and y = 28x1.27; R² = 0.95 for S. arvensis). There was also strong relationships among the number of pods produced in individual plants and the quantity of seeds produced (g per plant) with the size of the plant. The relationships found in this study can be used in dynamic seed bank models of volunteer canola and S. arvensis.

Seed bank modelling of volunteer oil seed rape: from seeds fate in the soil to seedling emergence

Studies were conducted to estimate parameters and relationships associated with sub-processes in soil seed banks of oilseed rape in Gorgan, Iran. After one month of burial, seed viability decreased to 39%, with a slope of 2.03% per day, and subsequently decreased with a lower slope of 0.01 until 365 days following burial in the soil. Germinability remained at its highest value in autumn and winter and decreased from spring to the last month of summer. Non-dormant seeds of volunteer oilseed rape did not germinate at temperatures lower than 3.8 ºC and a water potential of -1.4 MPa ºd. The hydrothermal values were 36.2 and 42.9 MPa ºd for sub- and supra-optimal temperatures, respectively. Quantification of seed emergence as influenced by burial depth was performed satisfactorily (R² = 0.98 and RMSE = 5.03). The parameters and relationships estimated here can be used for modelling soil seed bank dynamics or establishing a new model for the environment.

Glyphosate tolerant volunteer corn control at two development stages

The loss of grains during the harvest of glyphosate tolerant corn may generate volunteer plants, which can interfere in the conventional or glyphosate crop in succession. The current work aim to evaluate the control of the volunteer corn glyphosate tolerant under two weed stages. Aimed to evaluate the control of volunteer glyphosate tolerant corn in two stages of development. There were conducted two experiments with hybrid 2B688 HR (lepidoptera and glyphosate tolerant), the application were at V5 and V8 stage. The experiment was randomized block design with four replicates, using the treatments: haloxyfop at 25, 50 and 62 g ha-1 alone and associated with 2,4-D at 670 g ha-1 or fluroxypyr at 200 g ha-1. The standard was clethodim at 84 g ha-1 with 2,4-D and fluroxypyr at same rates. The applications of haloxyfop and clethodim both isolated or in a mixture with 2,4-D and fluroxypyr at V5 stage showed total control (100%) at 32 and 39 days after the application, except for haloxyfop + 2,4-D (25 + 670 g ha-1) mixture, which did not provided adequate control. At V8 stage, haloxyfop + 2,4-D (50 + 670 g ha-1) and haloxyfop + 2,4-D (62 + 670 g ha-1) mixtures took up to 6 and 10 days or longer to reach adequate to excellent control, when compared to haloxyfop isolated applications in the same doses, respectively. Either isolated clethodim or mixed with 2, 4-D and fluroxypyr did not show adequate control. The treatments showed efficient control on volunteer corn plants at V5 stage, except for haloxyfop + 2, 4-D (25 + 670 g ha-1) mixture. At V8 stage applications, haloxyfop either isolated or mixture with fluroxypyr demonstrated excellent control on every evaluated dose. The mixture with 2, 4-D can reduce haloxyfop efficiency at low doses. Clethodim alone or mixed with 2,4-D or furoxypyr did not provide acceptable level of control.

Volunteer RR® corn management in roundup ready® soybean-corn succession system

The present study evaluated the effects of cover crops (Pennisetum glaucum, Crotalaria spectabilis and Urochloa ruziziensis) associated with the application of herbicides {glyphosate; (glyphosate + haloxyfop-R); (glyphosate + fluazifop-p-butyl); (glyphosate + imazethapyr) and (glyphosate + imazaquin)} in soybean desiccation management for volunteer RR® corn control. The experiment was conducted under field conditions at Sinop-MT, during the 2013/2014 crop season, in a randomized complete blocks design with factorial scheme and four replications. The following parameter were evaluated: dry matter of cover crops and ground coverage rate, control of volunteer RR® corn present at the time of desiccation, dry matter, height and intoxication level on soybean plants caused by herbicides at 7, 14 and 28 days after emergence (DAE), control of volunteer RR® corn derived from emergence fluxes subsequent to desiccation management and soybean yield. The joint application of (glyphosate + haloxyfop-R) provided the best level of volunteer RR® corn control present at the time of desiccation. Satisfactory control (80%) of volunteer corn was obtained with the application of (glyphosate + imazethapyr). This treatment displayed an additional residual effect of imazethapyr, which efficiently controled volunteer RR® corn derived from fluxes subsequent to desiccation management, especially in treatments performed under U. ruziziensis straw. None of the herbicides used in desiccation management caused any significant effect on dry matter, height and phytotoxicity of soybean plants at 7, 14 and 28 DAE nor on grain yield.

SELECTION OF HERBICIDES TARGETING THE USE IN CROP SYSTEMS CULTIVATED WITH SHOWY CROTALARIA

ABSTRACT The increase in the area planted with Crotalaria spectabilishas occurred by several factors, highlighting the potential to reduce the nematodes, nitrogen fixation and the high production of biomass. By becoming a species sown as a crop, it is necessary to control the weeds that coexist with showy crotalaria. This change in the use of this crop creates the possibility of this specie becoming a weed. The aim of this study was to assess the potential use of herbicides applied in preemergence and postemergence of C.spectabilisfor different purposes (control of volunteer and selectivity plants). Three experiments were installed in a greenhouse (two with herbicides applied in preemergence - in soils with distinct textural categories; and one experiment with herbicides applied in postemergence). The results of the experiments with herbicides applied in preemergence showed that: amicarbazone, atrazine, diuron, metribuzin, prometryn, fomesafen and sulfentrazone showed effectiveness for control of C.spectabilis in clayey soil. Besides these, flumioxazin and isoxaflutole also showed potential to be used in the control of showy crotalaria in soils with loam texture. In relation to the postemergence herbicides, atrazine, diuron, prometryn, flumioxazin, fomesafen, lactofen, saflufenacil, amonio-glufosinate and glyphosate can be used aiming the chemical control of C.spectabilis. Herbicides chlorimuron-ethyl, diclosulan, imazethapyr, pyrithiobac-sodium, trifloxysulfuron-sodium, clomazone, pendimethalin, S-metolachlor and trifluralin applied in preemergence, and imazethapyr, pyrithiobac-sodium, flumiclorac, bentazon and clethodim applied in postemergence caused low levels of injury to C.spectabilis plants, making necessary the development of new searches to ensure the selectivity of these products.

The role of cathepsin K in lung development and newborn chronic lung injury.

Chronic lung diseases, specifically bronchopulmonary dysplasia (BPD), are still causing mortality and morbidity amongst newborn infants. High protease activity has been suggested to have a deleterious role in oxygen-induced lung injuries. Cathepsin K (CatK) is a potent protease found in fetal lungs, degrading collagen and elastin. We hypothesized that CatK may be an important modulator of chronic lung injury in newborn infants and neonatal mice. First we measured CatK protein levels in repeated tracheal aspirate fluid samples from 13 intubated preterm infants during the first two weeks of life. The amount of CatK at 9-13 days was low in infants developing chronic lung disease. Consequently, we studied CatK mRNA expression in oxygen-exposed wild-type (WT) rats at postnatal day (PN) 14 and found decreased pulmonary mRNA expression of CatK in whole lung samples. Thereafter we demonstrated that CatK deficiency modifies lung development by accelerating the thinning of alveolar walls in newborn mice. In hyperoxia-exposed newborn mice CatK deficiency resulted in increased number of pulmonary foam cells, macrophages and amount of reduced glutathione in lung homogenates indicating intensified pulmonary oxidative stress and worse pulmonary outcome due to CatK deficiency. Conversely, transgenic overexpression of CatK caused slight enlargement of distal airspaces with increased alveolar chord length in room air in neonatal mice. While hyperoxic exposure inhibited alveolarization and resulted in enlarged airspaces in wild-type mice, these changes were significantly milder in CatK overexpressing mice at PN7. Finally, we showed that the expression of macrophage scavenger receptor 2 (MSR2) mRNA was down-regulated in oxygen-exposed CatK-deficient mice analyzed by microarray analysis. Our results demonstrate that CatK seems to participate in normal lung development and its expression is altered during pulmonary injury. In the presence of pulmonary risk factors, like high oxygen exposure, low amount of CatK may contribute to aggravated lung injury while sustained or slightly elevated amount of CatK may even protect the newborn lungs from excessive injury. Besides collagen degrading and antifibrotic function of CatK in the lungs, it is obvious that CatK may affect macrophage activity and modify oxidative stress response. In conclusion, pulmonary proteases, specifically CatK, have distinct roles in lung homeostasis and injury development, and although suggested, broad range inhibition of proteases may not be beneficial in newborn lung injury.

Paraquat poisoning: an experimental model of dose-dependent acute lung injury due to surfactant dysfunction

Since the most characteristic feature of paraquat poisoning is lung damage, a prospective controlled study was performed on excised rat lungs in order to estimate the intensity of lesion after different doses. Twenty-five male, 2-3-month-old non-SPF Wistar rats, divided into 5 groups, received paraquat dichloride in a single intraperitoneal injection (0, 1, 5, 25, or 50 mg/kg body weight) 24 h before the experiment. Static pressure-volume (PV) curves were performed in air- and saline-filled lungs; an estimator of surface tension and tissue works was computed by integrating the area of both curves and reported as work/ml of volume displacement. Paraquat induced a dose-dependent increase of inspiratory surface tension work that reached a significant two-fold order of magnitude for 25 and 50 mg/kg body weight (P<0.05, ANOVA), sparing lung tissue. This kind of lesion was probably due to functional abnormalities of the surfactant system, as was shown by the increase in the hysteresis of the paraquat groups at the highest doses. Hence, paraquat poisoning provides a suitable model of acute lung injury with alveolar instability that can be easily used in experimental protocols of mechanical ventilation