High concordance between trained nurses and gastroenterologists in evaluating recordings of small bowel video capsule endoscopy (VCE)

Background & Aims: The video capsule endoscopy (VCE) is an accurate and validated tool to investigate the entire small bowel mucosa, but VCE recordings interpretation by the gastroenterologist is time-consuming. A pre-reading of VCE recordings by an expert nurse could be accurate and cost saving. We assessed the concordance between nurses and gastroenterologists in detecting lesions on VCE examinations. Methods: This was a prospective study enrolling consecutive patients who had undergone VCE in clinical practice. Two trained nurses and two expert gastroenterologists participated in the study. At VCE pre-reading the nurses selected any abnormalities, saved them as “thumbnails” and classified the detected lesions as a vascular abnormality, ulcerative lesion, polyp, tumor mass, and unclassified lesion. Then, the gastroenterologist evaluated and interpreted the selected lesions and, successively, reviewed the entire video for potential missed lesions. The time for VCE evaluation was recorded. Results: A total of 95 VCE procedures performed on consecutive patients (M/F: 47/48; mean age: 63 ± 12 years, range: 27−86 years) were evaluated. Overall, the nurses detected at least one lesion in 54 (56.8%) patients. There was total agreement between nurses and gastroenterologists, no missing lesions being discovered at a second look of the entire VCE recording by the physician. The pre-reading procedure by nurse allowed a time reduction of medical evaluation from 49 (33-69) to 10 (8-16) minutes (difference:-79.6%). Conclusions: Our data suggest that trained nurses can accurately identify and select relevant lesions in thumbnails that subsequently were faster reviewed by the gastroenterologist for a final diagnosis. This could significantly reduce the cost of VCE procedure

Il dialogo di civiltà alla luce dell’esperienza kazakistana

La Repubblica del Kazakhstan, che ha acquisito l’indipendenza nel 1991 in seguito alla dissoluzione dell’URSS, è uno dei Paesi più variegati del mondo sotto il profilo della composizione nazionale e religiosa: sul suo vasto territorio si contano infatti oltre 130 gruppi etnici e 40 confessioni all’interno di una popolazione di circa 16 milioni di abitanti. Una realtà che si potrebbe definire tanto complessa quanto poco conosciuta, specialmente in Italia. Il testo si concentra sulla strategia perseguita dal governo kazako (la c.d. unità nella diversità, o in alcuni documenti l’unità attraverso la diversità), che a partire dall’indipendenza si è trovato a governare in piena autonomia su una realtà estremamente eterogenea. La scelta delle autorità è stata quella di puntare sulla costruzione di una identità “kazakistana”, ossia civile, laica e sovranazionale, che ambisce a garantire una convivenza pacifica proponendosi come modello di dialogo fra civiltà. La distinzione tra identità “kazaka” (cioè etnicamente e linguisticamente connotata) e identità “kazakistana” (chiamata ad accogliere popoli diversi sotto una cittadinanza esplicitamente multiculturale) costituisce il cuore di questa strategia

IL2 treatment for cancer: from biology to gene therapy.

In this review we shall discuss the biological rationale and the clinical findings obtained using Interleukin 2 (IL2)-based immunotherapy in the management of cancer patients. Objective and long-lived clinical responses have been documented in a proportion of cases, particularly renal cell carcinoma, melanoma and acute myeloid leukaemia. Though encouraging, the clinical use of IL2 has so far been limited by toxicity, as well as by the heterogeneous and unpredictable responses and by the lack of specific anti-tumour effect. These considerations have led to the belief that more sophisticated technologies aimed at introducing the IL2 gene into the neoplastic cells may potentially overcome some of the limitations coupled to the in vivo infusion of high doses of IL2. The data accumulated in animal models and, more recently, also with human tumour cells indicate that the IL2 gene may be successfully inserted into neoplastic cells. The constitutive secretion of IL2 by the tumour cells leads to a reduced or abrogated tumorigenicity in several different tumour models. The evidence that in some experimental tumours the transduction of the IL2 gene into the neoplastic cells may elicit a specific cytotoxic response and confer anti-tumour memory, suggests that vaccination protocols based on this innovative strategy may represent a potential new tool in the management of cancer patients

Eye-Movements in a Text Reading Task: A Comparison of Preterm Children, Children with Dyslexia and Typical Readers

Preterm birth is associated with weaknesses in reading skills that are usually less severe than those of children with dyslexia. To understand the characteristics of reading processes in preterm children, we adopted a cross-population and multi-modal approach comparing eye movements in reading tasks among three groups: children with preterm birth, children with a diagnosis of dyslexia, and children with typical development. The study involved 78 participants (10.5 years). Eye movements (number and duration of fixations, amplitude and number of saccades, number of regressions) were recorded during the silent reading of two texts; cognitive and reading standardized tasks were also administered. Children with dyslexia had more fixations and more frequent and smaller saccades compared to the preterm group and children with typical development. They also showed more regressions compared to the control group. Preterm children showed shorter fixations compared to the other groups. Cognitive and reading standardized tasks confirmed severe delays in reading in children with dyslexia and some weaknesses in text reading speed and comprehension in preterm children. These results are discussed with reference to candidate mechanisms that underlie reading processes in preterm children and considering possible implications for research

Effective coping with cyberbullying in boys and girls: the mediating role of self-awareness, responsible decision-making, and social support

There is sufficient evidence on the negative consequences of cyberbullying victimisation depending on the coping styles. Social support seeking is among the most effective strategies for coping with cybervictimisation, but it is scarcely used. The robust Maximum Likelihood (ML) method was used to test the potential mediating role of individual (self-awareness, and responsible decision-making) and contextual variables (self-perceived parental and peer support) in the relationship between cybervictimisation and social support seeking in boys and girls. This cross-sectional study collected data from 1,276 Spanish secondary school students (51.2% boys, 48.8% girls) aged 11-18 (M = 13.88, SD = 1.42). Structural equation modelling (SEM) results pointed out responsible decision-making and self-perceived parental support as relevant mediating factors for girls. By contrast, the model was not significant for boys. These findings highlight the importance of both individual and contextual variables in helping adolescents cope with cyberaggressions, considering gender differences

Comic Book (Extended Intellectual Output 2 of Blurred Lives Project: a Cross-National Co-Participatory Exploration of Cyberbullying, Young People and Socio-Economic Disadvantage)

Pupils aged 14-16 years from all over Europe have developed a comic book on the impact of cyberbullying and how to act against it. The comics are developed by the pupils and redrawn by a professional illustrator. Each story is aimed at raising awareness among young people of your age regarding the problem of cyberbullying and offers tools to combat it. In addition, the comic books include reflective questions and assignments to help you to better understand cyberbullying and think of effective solutions

Employment, innovation, and interfirm networks

This paper studies the employment impact of business network agreements, an innovative policy instrument introduced in Italy in 2010 to stimulate interfirm cooperation, with the aim of increasing innovative capacity and market competitiveness. We estimate the impact of these networks on employment for a panel of Italian firms using a system generalized method of moments and considering the literature on the employment impact of innovation. We find that networks, which can be interpreted as a form of open innovation, have a positive impact on employment; moreover, this impact appears positively influenced by sectoral and regional heterogeneity of firms and the region\u2019s innovation capacities. Overall, the results suggest that participation in networks where firms share industrial, commercial, and technical knowledge improves firm performance, creating synergies that help firms, especially small and medium-sized enterprises, to manage the growing complexity of knowledge and the fierce competition arising from increasingly globalized markets

Integrating gestures and words to communicate in full-term and low-risk preterm late talkers

Young children use gestures to practice communicative functions that foster their receptive and expressive linguistic skills. Studies investigating the use of gestures by late talkers are limited. This study aimed to investigate the use of gestures and gesture–word combinations and their associations with word comprehension and word and sentence production in late talkers. A further purpose was to examine whether a set of individual and environmental factors accounted for interindividual differences in late talkers’ gesture and gesture–word production. Sixty-one late talkers, including 35 full-term and 26 low-risk preterm children, participated in the study. Parents filled out the Italian short forms of the MacArthur–Bates Communicative Development Inventories (MB–CDI), “Gesture and Words” and “Words and Sentences” when their children were 30-months-old, and they were then invited to participate in a book-sharing session with their child. Children’s gestures and words produced during the book-sharing session were transcribed and coded into CHAT of CHILDES and analyzed with CLAN. Types of spontaneous gestures (pointing and representational gestures) and gesture–word combinations (complementary, equivalent, and supplementary) were coded. Measures of word tokens and MLU were also computed. Correlational analyses documented that children’s use of gesture–word combinations, particularly complementary and supplementary forms, in the book-sharing session was positively associated with linguistic skills both observed during the session (word tokens and MLU) and reported by parents (word comprehension, word production, and sentence production at the MB–CDI). Concerning individual factors, male gender was negatively associated with gesture and gesture–word use, as well as with MB–CDI action/gesture production. In contrast, having a low-risk preterm condition and being later-born were positively associated with the use of gestures and pointing gestures, and having a family history of language and/or learning disorders was positively associated with the use of representational gestures. Furthermore, a low-risk preterm status and a higher cognitive score were positively associated with gesture–word combinations, particularly complementary and supplementary types. With regard to environmental factors, older parental age was negatively associated with late talkers’ use of gestures and pointing gestures. Interindividual differences in late talkers’ gesture and gesture–word production were thus related to several intertwined individual and environmental factors. Among late talkers, use of gestures and gesture–word combinations represents a point of strength promoting receptive and expressive language acquisition

New development: The ethics of accounting information manipulation in the political arena

ABSTRACT This article explores ethical issues of accounting information manipulation (AIM) in the political arena. After conceptualizing AIM, including its drivers, techniques, contextualities and impacts, the authors discuss underlying tensions between various types of values that emerge as a trigger for applying AIM. In that respect a distinction is made between values at the societal, organizational and individual level, such as, respectively, sustainability, transparency and honesty, and additionally between private values related to personal gain and public values

Low Rates of Pointing in 18-Month-Olds at Risk for Autism Spectrum Disorder and Extremely Preterm Infants: A Common Index of Language Delay?

Infants with an older sibling with an Autism Spectrum Disorder diagnosis (Sibs ASD) are at high risk for language delay (LD) as well as infants born preterm, especially those with an extremely low gestational age (ELGA, GA 64 28 weeks). Gestures play a crucial role in language development and delays in gesture production may have negative cascading effects on it. The present exploratory study examined gesture production in 18-month-old infants with different underlying risks for LD. Seventy monolingual United States infants (41 Sibs ASD with no eventual ASD diagnosis and 29 infants with a typically developing older sibling -Sibs TD) and 40 monolingual Italian infants (20 ELGA without major cerebral damages, congenital malformations or sensory impairments and 20 full-term - FT infants, GA 65 37 weeks) were included. Both groups were followed longitudinally from 18 to 24, 30, and 36 months (corrected for ELGA infants). A 30-minute mother-infant play session with age-appropriate toys was video recorded at 18 months of age. Deictic (requesting, pointing, showing and giving), conventional, and representational gestures spontaneously produced by infants were coded; rate per 10 min was calculated. LD was defined as a score 6410th percentile on the American English or Italian version of the MacArthur-Bates CDI on at least two time points between 18 and 36 months. Fifteen Sibs ASD and 9 ELGA infants were identified as infants with LD. Sibs ASD-LD and Sibs ASD-no LD produced fewer pointing gestures compared to Sibs TD (p = 0.038; p = 0.004); ELGA-LD infants produced significantly fewer pointing gestures than ELGA-no LD (p = 0.024) and FT (p = 0.006) infants. Low rates of pointing at 18 months are a marker of LD in Sibs ASD and ELGA infants. The potential implications of reduced pointing production and characteristics of different populations at risk for LD should be considered for understanding the emergence of LD