The overall goal of the field of natural language processing is to facilitate the communication between humans and computers, and to help humans with natural language problems such as translation. In this thesis, we focus on semantic language processing. Modelling semantics – the meaning of natural language – requires both a structure to hold the semantic information and a device that can enforce rules on the structure to ensure well-formed semantics while not being too computationally heavy. The devices used in natural language processing are preferably weighted to allow for comparison of the alternative semantic interpretations outputted by a device. The structure employed here is the abstract meaning representation (AMR). We show that AMRs representing well-formed semantics can be generated while leaving out AMRs that are not semantically well-formed. For this purpose, we use a type of graph grammar called contextual hyperedge replacement grammar (CHRG). Moreover, we argue that a more well-known subclass of CHRG – the hyperedge replacement grammar (HRG) – is not powerful enough for AMR generation. This is due to the limitation of HRG when it comes to handling co-references, which in its turn depends on the fact that HRGs only generate graphs of bounded treewidth. Furthermore, we also address the N best problem, which is as follows: Given a weighted device, return the N best (here: smallest-weighted, or more intuitively, smallest-errored) structures. Our goal is to solve the N best problem for devices capable of expressing sophisticated forms of semantic representations such as CHRGs. Here, however, we merely take a first step consisting in developing methods for solving the N best problem for weighted tree automata and some types of weighted acyclic hypergraphs.

Epidural analgesia causes a temporary cessation of nerve conduction via administration of low concentration of local anaesthesia, or opioid, into epidural space. The resulting temporary discontinuation of nerve conduction is called central neuroaxial anaesthesia and it facilitates the process of surgical intervention. An epidural catheter is usually inserted during epidural desensitisation. It helps to control the amount of administered anaesthesia and hence to respond to surgery progress, but it also enables to keep the catheter within the epidural space for the following postoperative analgesia, which will promote timely postoperative rehabilitation and pain management.The research project was conducted on basis of quantitative and qualitative investigation. The quantitative research was performed via questionnaires directed at the nursing staff, and the qualitative research took form of semi-structured interviews with patients. The quantitative investigation was conducted in fourteen health care facilities in the Czech Republic. Respondents of the quantitative research were nurses working in orthopaedic departments, multidisciplinary ICU or ARO (Anaesthesiology Resuscitation Dept.), who provided care to patients after TKR or THR with an epidural catheter insitu. Qualitative research respondents were patients hospitalised in orthopaedic departments for TKR or THR, with epidural catheter insitu and who agreed to participate at the interview. Quantitative research data were processed in Excel 2010 and presented in graphs, frequency and contingency tables, whereas the qualitative research data were processed using charts of the Smart Art program. After the agreement with the management of health care facilities, this dissertation will promote education and aid situation improvement. The Standard of Nursing Care Assisting a Patient with Epidural Catheter during Insertion and Care will be an outcome of this project. Moreover, we will design a patient information booklet and a quality of care indicator that will focus on monitoring of complications occurrence such as infections in patients with epidural catheter. The findings may help to design a training course specialised in nursing care provision to those patients and also to provide basis for further research.

A pós-menopausa é marcada por alterações fisiológicas hemodinâmicas e metabólicas. A terapia de reposição estrogênica é uma forma de amenizar as conseqüências da deficiência hormonal e o exercício físico contribui significativamente para a redução do risco cardiovascular. O objetivo desse estudo foi avaliar em mulheres pós-menopausadas os efeitos isolados e associados da terapia oral estrogênica (TRH) e do treinamento físico aeróbio (TF) nas respostas hemodinâmicas e neurais basais e durante os exercícios com handgrip. Quarenta e cinco mulheres (51±3 anos), histerectomizadas, com e sem ovários, saudáveis, realizaram uma sessão experimental e, posteriormente foram divididas em 4 grupos SED-PLA (n=11), SED-TRH (n=14), TF-PLA (n=12) e TF-TRH (n=8). Os grupos TRH e receberam valerato de estradiol 1mg/dia; PLA receberam placebo; TF, realizaram exercício aeróbio em cicloergômetro por 50 minutos, 3 vezes por semana e SED permaneceram sedentárias. Todas as voluntárias participaram de uma segunda sessão experimental após 6 meses de acompanhamento. Nas sessões experimentais foram avaliadas a atividade nervosa simpática periférica (ANSP - microneurografia), pressão arterial, freqüência cardíaca (FC - método oscilométrico Dixtal no membro inferior), fluxo sangüíneo do antebraço (FSA - pletismografia) em um período basal e durante exercícios estático e dinâmico com handgrip a 30% da força de contração máxima. Para análise estatística foi utilizada ANOVA. O TF isoladamente diminuiu ANSP de 40±7 a 34±4 impulsos/min, (P=0,01) e aumentou FSA de 1,92±0,96 a 2,65±1,34 ml(min.100ml), P=0,03 no período basal. TRH e TF associados reduziram a FC no período basal de 65±8 para 62±7 bpm (P=0,01) e durante o exercício estático e dinâmico com handgrip. A TRH de maneira isolada ou associada ao TF diminuiu as respostas de FC durante os exercícios estático e dinâmico com handgrip. Em conclusão, as intervenções de maneira isolada ou associada promovem alterações hemodinâmicas e neurais que podem contribuir para redução do risco cardiovascular de mulheres pós-menopausadas saudáveis. / The post-menopause is marked by physiological hemodynamic and metabolic changes. The estrogen replacement therapy is a way to reduce the consequences of hormone deficiency and physical exercise contributes significantly to the reduction of cardiovascular risk. The aim of this study was to evaluate in post-menopausal women the isolated and associated effects of oral estrogen therapy (TRH) and physical training (TF) in the neural and hemodynamic responses during baseline and \"handgrip\" exercises. Forty-five women (51 ± 3 years), hysterectomized, with or without ovaries, healthy, participated of an initial session and then they were divided into 4 groups SEDPLA (n = 11), SED-TRH (n = 14), TF-PLA (n = 12) and TF-TRH (n = 8). The TRH groups received estradiol valerate 1 mg / day; PLA placebo; TF, performed aerobic exercise on a cycle ergometer for 50 minutes, 3 times a week and SED remained sedentary. All subjects participated in a second experimental session after 6 months of follow-up. In the experimental sessions peripheral sympathetic nerve activity (ANSP - microneurography), blood pressure, heart rate (FC - oscillometry - Dixtal lower limb), forearm blood flow (FSA - plethysmography) were evaluated at the baseline period and during static and dynamic \"handgrip\" exercises at 30% of the maximum force. ANOVA was used for the statistica analysis. The TF alone decreased ANSP from 40 ± 7 to 34 ± 4 bursts/min, P = 0.01 and increased FSA 1.92 ± 0.96 to 2.65 ± 1.34 ml (min.100ml), P = 0.03 at the baseline. The association of TRH and TF reduced HR at the baseline from 65 ± 8 to 62 ± 7 bpm (P=0.01) and during exercise with static and dynamic \"handgrip\". HRT alone or associated with TF decreased the HR responses during static and dynamic \"handgrip exercises. In conclusion, the interventions alone or in an associated way promote neural and hemodynamic changes that may contribute to cardiovascular risk reduction in healthy postmenopausal women.

A pós-menopausa é marcada por alterações fisiológicas hemodinâmicas e metabólicas. A terapia de reposição estrogênica é uma forma de amenizar as conseqüências da deficiência hormonal e o exercício físico contribui significativamente para a redução do risco cardiovascular. O objetivo desse estudo foi avaliar em mulheres pós-menopausadas os efeitos isolados e associados da terapia oral estrogênica (TRH) e do treinamento físico aeróbio (TF) nas respostas hemodinâmicas e neurais basais e durante os exercícios com handgrip. Quarenta e cinco mulheres (51±3 anos), histerectomizadas, com e sem ovários, saudáveis, realizaram uma sessão experimental e, posteriormente foram divididas em 4 grupos SED-PLA (n=11), SED-TRH (n=14), TF-PLA (n=12) e TF-TRH (n=8). Os grupos TRH e receberam valerato de estradiol 1mg/dia; PLA receberam placebo; TF, realizaram exercício aeróbio em cicloergômetro por 50 minutos, 3 vezes por semana e SED permaneceram sedentárias. Todas as voluntárias participaram de uma segunda sessão experimental após 6 meses de acompanhamento. Nas sessões experimentais foram avaliadas a atividade nervosa simpática periférica (ANSP - microneurografia), pressão arterial, freqüência cardíaca (FC - método oscilométrico Dixtal no membro inferior), fluxo sangüíneo do antebraço (FSA - pletismografia) em um período basal e durante exercícios estático e dinâmico com handgrip a 30% da força de contração máxima. Para análise estatística foi utilizada ANOVA. O TF isoladamente diminuiu ANSP de 40±7 a 34±4 impulsos/min, (P=0,01) e aumentou FSA de 1,92±0,96 a 2,65±1,34 ml(min.100ml), P=0,03 no período basal. TRH e TF associados reduziram a FC no período basal de 65±8 para 62±7 bpm (P=0,01) e durante o exercício estático e dinâmico com handgrip. A TRH de maneira isolada ou associada ao TF diminuiu as respostas de FC durante os exercícios estático e dinâmico com handgrip. Em conclusão, as intervenções de maneira isolada ou associada promovem alterações hemodinâmicas e neurais que podem contribuir para redução do risco cardiovascular de mulheres pós-menopausadas saudáveis. / The post-menopause is marked by physiological hemodynamic and metabolic changes. The estrogen replacement therapy is a way to reduce the consequences of hormone deficiency and physical exercise contributes significantly to the reduction of cardiovascular risk. The aim of this study was to evaluate in post-menopausal women the isolated and associated effects of oral estrogen therapy (TRH) and physical training (TF) in the neural and hemodynamic responses during baseline and \"handgrip\" exercises. Forty-five women (51 ± 3 years), hysterectomized, with or without ovaries, healthy, participated of an initial session and then they were divided into 4 groups SEDPLA (n = 11), SED-TRH (n = 14), TF-PLA (n = 12) and TF-TRH (n = 8). The TRH groups received estradiol valerate 1 mg / day; PLA placebo; TF, performed aerobic exercise on a cycle ergometer for 50 minutes, 3 times a week and SED remained sedentary. All subjects participated in a second experimental session after 6 months of follow-up. In the experimental sessions peripheral sympathetic nerve activity (ANSP - microneurography), blood pressure, heart rate (FC - oscillometry - Dixtal lower limb), forearm blood flow (FSA - plethysmography) were evaluated at the baseline period and during static and dynamic \"handgrip\" exercises at 30% of the maximum force. ANOVA was used for the statistica analysis. The TF alone decreased ANSP from 40 ± 7 to 34 ± 4 bursts/min, P = 0.01 and increased FSA 1.92 ± 0.96 to 2.65 ± 1.34 ml (min.100ml), P = 0.03 at the baseline. The association of TRH and TF reduced HR at the baseline from 65 ± 8 to 62 ± 7 bpm (P=0.01) and during exercise with static and dynamic \"handgrip\". HRT alone or associated with TF decreased the HR responses during static and dynamic \"handgrip exercises. In conclusion, the interventions alone or in an associated way promote neural and hemodynamic changes that may contribute to cardiovascular risk reduction in healthy postmenopausal women.

Die vorliegende Arbeit widmet sich der Frage, welche Bedeutung Außenwanderungen für die Entwicklung von Zahl und Zusammensetzung (insbesondere nach Alter) und deren räumliche und siedlungsstrukturspezifische Differenzierung der Bevölkerung und der Erwerbspersonen in Deutschland haben (können). Hintergrund der Auseinandersetzung mit dieser Frage ist die These, dem demographischen Wandel bzw. dessen Folgen ließe sich durch verstärkte Zuwanderungen wirkungsvoll begegnen. Mittels Modellrechnungen auf der Basis eines Kohorten-Komponenten-Modells wurden vier unterschiedliche Szenarien der räumlich differenzierten Bevölkerungs- und Erwerbspersonenentwicklung bis zum Jahr 2040 erstellt, die sich durch Höhe und zeitliche Verteilung der Außenwanderungssalden unterscheiden. In zwei der Szenarien wurden die jährlichen Außenwanderungssalden modellextern vorgegeben – in Szenario 1 in Höhe von (fast) Null, in Szenario 2 annähernd in Höhe des Durchschnittswertes der Außenwanderungssalden der letzten Jahrzehnte. In den anderen beiden Szenarien wurden die jährlichen Außenwanderungssalden anhand vorgegebener demographischer Zielgrößen modellintern errechnet: In Szenario 3 sind sie so hoch, dass die Bevölkerungszahl Deutschlands dauerhaft konstant bleibt, in Szenario 4 wird auf ein zeitliches Konstanthalten des Altenquotienten abgezielt. Für die anderen demographischen Größen, die für die Modellrechnungen relevant sind (betreffend Fertilität, Mortalität, Binnenwanderungen und Erwerbsbeteiligung), wurden Annahmen zu ihrer weiteren Entwicklung gesetzt, die – mit Blick auf ihre vergangene Entwicklung – für plausibel gehalten werden. Bezüglich Fertilität und Erwerbsbeteiligung wurden allerdings jeweils alternative Entwicklungsvarianten formuliert. Als räumliches Analyseraster dienen 242 Prognoseräume, die Cluster von Kreisen jeweils gleichen siedlungsstrukturellen Kreistyps darstellen. Als zentrales Ergebnis der Modellrechnungen ist herauszustellen, dass (zumindest bei anhaltend niedriger Fertilität deutlich unterhalb des Bestandserhaltungsniveaus) Zuwanderungen in einer Größenordnung, die als gesellschaftlich vertretbar vermutet werden kann, den demographischen Wandel auch nicht annähernd stoppen, sondern bestenfalls partiell dämpfen können. Das gilt zum einen mit Blick auf die hohen Zuwanderungszahlen, die zur Vermeidung der weiteren demographischen Alterung und des langfristigen Rückgangs der Gesamtbevölkerung nötig wären. Das gilt aber zum anderen und vor allem auch hinsichtlich der regionalen Differenzierung der künftigen Bevölkerungsentwicklung: Die demographischen Folgen der Zuwanderungen schlagen sich nicht annähernd flächendeckend in gleicher Weise nieder. Selbst bei ausgesprochen hohen Zuwanderungszahlen, die eine Konstanz oder gar einen deutlichen Anstieg der Gesamtbevölkerungszahl nach sich ziehen würden, wären zahlreiche Regionen Deutschlands von weiterhin relativ starken Bevölkerungsabnahmen (und damit auch Minderungen des Erwerbspersonenpotenzials) sowie deutlich überdurchschnittlicher demographischer Alterung gekennzeichnet. In erster Linie betrifft dies große Teile der neuen Bundesländer, insbesondere ihrer ländlichen Räume. Regionen, die in demographischer Hinsicht von Außenzuwanderungen „profitieren“ würden (im Sinne von deutlicher Abschwächung von Bevölkerungsabnahme und demographischer Alterung oder gar von Bevölkerungswachstum), sind in diesem Landesteil nur inselhaft vertreten; es sind vornehmlich größere Kernstädte und deren (hoch)verdichtetes Umland. Die demographischen Brüche nach der Wende, namentlich der starke Geburtenrückgang und die umfangreichen Abwanderungen nach Westdeutschland, zeigen hier langfristig eine hohe demographische Wirkmächtigkeit. Auch in Westdeutschland sind es in erster Linie Agglomerationsräume und Stadtregionen, deren demographische Entwicklung von Zuwanderungen relativ günstiger beeinflusst wird.

During the so-called “Miljonprogrammet”, over a million homes were built in Stockholm. As the buildings mature, parts of the buildings reach their technical life times and it is time to renovate them. At a time when the environmental impact of humans is a hot topic, it is appropriate to take the environment into account when deciding upon which restoration method to use. The sewage pipes are one of the important building parts in need of repair. This can be achieved by for example traditional pipe replacement or Cure-In-Place-Pipes (CIPP-lining).The goal of this study is to investigate and compare the environmental impact of traditional pipe replacement versus the use of the relining method CIPP lining by conducting a comparative life cycle assessment (LCA). The methods differ in the way that traditional pipe replacement demolishes the outer layers of the bathrooms and remove the old pipes to replace with new and restore the surface layers while CIPP-lining renovates the pipes from the inside with the use of a flexible liner.The purpose of the study has been to clarify the differences in environmental impacts of the different methods in a clear and easily understood way and thereby also simplify the decision-making process of property owners in need of renovation.With aid of the guidelines in ISO standards 14040 and 14044 a correct methodology has been used to ensure that the level of this work will be as high as possible. In combination with the software SimaPro specifically developed to handle the creation of various forms of life cycle assessments and the ISO standards a complex system been analyzed in detail.The results of the study show that CIPP-lining generally cause less environmental impacts than the traditional pipe replacement method. The analysis of 14 selected impact categories show that CIPP lining is preferable in 13 categories and that the traditional pipe replacement is preferable in 1 category. The sensitivity analysis show that the results change drastically depending on how much of the materials and energy used to demolish and reconstruct the outer layers of the bathroom one chooses to allocate to the new sewer pipes.The results show that the CIPP-lining results are dependent on the consumables and the liner assembly processes while the energy usage of the production process does not have a large impact on the results. For the traditional pipe replacement the results show that the consumable process is clearly the biggest impact while the piping production inflicts the least impact on the result.

Background: Recent studies are changing the way physicians and patients view hormone replacement therapy (HRT). This study was performed at the East Tennessee State University (ETSU) internal medicine clinic to evaluate the current behaviors of university physicians and patients with respect to HRT. Methods: A retrospective chart review was conducted at the main internal medicine outpatient clinic at ETSU. Two hundred seventy-four postmenopausal female patients were randomly selected using a computerized systematic sampling technique of International Classification of Diseases, Ninth Revision (ICD-9) codes for menopause or postmenopause. The study period was from July 2002 until June 2004. Patients were postmenopausal women age 35 years or over who had been seen by their physicians at least twice a year during the study period. Patients who were noncompliant with HRT or physician's visits or had contraindications or side effects to HRT mandating discontinuation of the treatment were excluded. Data regarding physicians' patterns in discussion and discontinuation of the therapy and patients' responses were collected. Epi Info 2002 was used for statistical analysis. Results: One hundred seventy-seven patients met all of the criteria, of whom 140 were 35 to 75 years of age. Of this age group, 49 patients (35%) had coronary artery disease (CAD), 101 (72.1%) were on HRT prior to July 2002, and 30 (21.4%) had osteoporosis. Seventy-five patients (53.6%) had documented discussions with their physicians about HRT after July 2002. Most patients who were on HRT had no CAD (p = .0008). Of the patients who were on HRT, only 36 (35.6%) continued treatments (23 continued the same dose, and 13 had the dose modified), whereas 65 (64.3%) had treatments discontinued. HRT discussions were carried on mostly when patients had treatments stopped or modified (p = .0032). Of these patients who had discussions, 60 (80%) were advised to stop or modify the dose and agreed, and only 15 (20%) disagreed or received unbiased discussions from their physicians about HRT. Thiry-seven patients were over 75 years of age. This older group had a higher rate of HRT discontinuation (82%) but a lower rate of documented discussion (22%) than the younger group. Conclusion: Physicians should pay more attention to the importance of providing high-quality and well-balanced patient counseling when addressing uncertain treatments and adequately document discussions with patients in medical records.

Risk assessment models developed from administrative and clinical databases are used for clinical decision making. Since these models are derived from a database, they have an inherent limitation of being as good as the data they are derived from. Many of these models under or overestimate certain clinical outcomes particularly mortality in certain group of patients. Undeniably, there is significant variability in all these models on account of patient population studied, the statistical analysis used to develop the model and the period during which these models were developed. This review aims to shed light on development and application of risk assessment models for cardiac surgery with special emphasis on risk stratification in severe aortic stenosis to select patients for transcatheter aortic valve replacement.

Transcatheter aortic valve replacement is a well-established alternative to surgical aortic valve replacement in high-risk patients with severe symptomatic aortic stenosis. Currently, this technique is shifting towards younger patient groups with intermediate- and low-risk profile, which raises the question about long-term durability. Despite acceptable results up to 5 years, little is currently known about valve performance beyond 5 years. Since valve deterioration, thrombosis and endocarditis seem to be the main factors affecting valve durability, precise and widely accepted definitions of these parameters were stated by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) in 2017, followed by the Valve in Valve International Data (VIVID) group definitions in 2018 and the Valve Academic Research Consortium 3 (VARC-3) definitions in 2021. Until the introduction of these definitions, interstudy comparisons were difficult due to missing uniformity. Since the release of these recommendations, an increasing number of studies have reported their data on long-term durability using these new criteria. The aim of the present article is to discuss the current definitions on bioprosthetic valve durability, and to summarize the available data on long-term durability of transcatheter aortic valves.

Invasive plants can displace native species, deteriorate native forest, and change plant communities and ecosystem functions. Native plant populations are fundamentally impacted by invasive species because of the interactions between invasive species and native plants. This study focuses on understanding the extent, mechanisms and consequences of interaction between a non-indigenous invader Ailanthus altissima and its functionally similar native species Robinia pseudoacacia in the Mid-Appalachian region, from an individual scale to a regional scale. These two subject species are common and coexist in early-successional eastern deciduous forest. The interactions between these two common species are important to community structure and canopy tree regeneration. To address the type and extent of interactions of these two species, a greenhouse experiment utilizing various species proportions, nutrient levels and seed sources was performed. In addition, a common-garden experiment with various species densities and proportions over three consecutive growing seasons was performed in a more natural condition than that of the greenhouse experiment. We found at the seedling stage, the dominant interaction was competition, and R. pseudoacacia was the winner both above- and belowground. The allelopathic compounds of A. altissima may have inhibited nodulation of R. pseudoacacia. Ailanthus altissima seedlings from its native region had slightly stronger competitive abilities compared with the seedlings from its invaded range. In the common garden experiment, R. pseudoacacia plants grew quicker than A. altissima, but A. altissima inhibited the growth of R. pseudoacacia by interspecific competition. The negative impact of A. altissima on R. pseudoacacia became larger as time progressed. To assess the community-level consequences of the two species, we conducted a forest mapping and a complete target-tree-based forest survey, and analyzed regional-scale data from the Forest Inventory Analysis Data Base. The two target species were significantly associated with themselves and with each other. Community species composition and diversity were significantly different across sites. A negative impact of both species on the understory community diversity and tree regeneration at the neighborhood scale was detected; while at a regional level, tree diversity in the FIA plots with either A. altissima or R. pseudoacacia was higher than the reference plots. / Ph. D.