Benefits and pitfalls of multimedia and interactive features in technology-enhanced storybooks:A meta-analysis

A meta-analysis was conducted on the effects of technology-enhanced stories for young children’s literacy development when compared to listening to stories in more traditional settings like storybook reading. A small but significant additional benefit of technology was found for story comprehension (g+ = 0.17) and expressive vocabulary (g+ = 0.20), based on data from 2,147 children in 43 studies. When investigating the different characteristics of technology-enhanced stories, multimedia features like animated pictures, music, and sound effects were found beneficial. In contrast, interactive elements like hotspots, games, and dictionaries were found to be distracting. Especially for children disadvantaged because of less stimulating family environments, multimedia features were helpful and interactive features were detrimental. Findings are discussed from the perspective of cognitive processing theories

Papillary fibroelastoma, unusual cause of stroke in a young man: a case report

Abstract Background Papillary fibroelastoma is the third most common primary benign tumor with an incidence of up to 0.33% in autopsy series; it accounts for approximately 75% of all cardiac valvular tumors. Case presentation We describe a rare case of a 28-Year-old man that while playing football, had a sudden onset of neurological deficit: aphasia, right hemiparesis and right facial numbness. Transthoracic echocardiography (TTE) showed a 10x10 mm mass attached to the anterior mitral valve leaflet. The patient was treated surgically for the prevention of further embolic complications. Histologic examination of the resected mass revealed a papillary fibroelastoma. It is the third most frequent primary cardiac tumor, after myxoma and fibroma, and the most common primary tumor of heart valves. Despite the benign nature of this tumor, it carries very high risk of embolic complications. The successful complete resection of the papillary fibroelastoma is curative and the long-term postoperative prognosis is excellent. Conclusions Differential diagnosis of cardiac masses requires clinical informations, laboratory tests, blood cultures and appropriate use of imaging modalities. Papillary fibroelastoma is a potential cause of embolic stroke in the young. The prompt surgical excision of papillary fibroelastoma is curative and the long-term postoperative prognosis is excellent

Lidar com substâncias psicoativas: o significado para o trabalhador de enfermagem

Neste estudo propus-me a compreender o significado do lidar com substâncias psicoativas para os trabalhadores de enfermagem que atuam em clínica médica de uma unidade hospitalar. Para alcançar tal propósito, foram utilizadas idéias do referencial metodológico fenomenológico. Foram feitas entrevistas a partir da questão norteadora "o que é para você lidar com substâncias psicoativas?". A análise das falas revelou que esse lidar se mostra aos trabalhadores, em sua essência, um trabalho "como qualquer outro", sendo significativa a ênfase dada ao fazer em detrimento da prática reflexiva; o receio de falar sobre "o proibido", o que "compromete", sendo a droga enfocada como uma possibilidade real de uso no cotidiano dos trabalhadores. Suas experiências reafirmam a necessidade de refletir e discutir sobre o fenômeno drogas, articulando as vivências intersubjetivas ao contexto das Políticas Nacionais e Internacionais de Saúde, favorecendo aos profissionais perceberem de forma mais crítica e questionadora o fenômeno

Lidar com substâncias psicoativas: o significado para o trabalhador de enfermagem El trabajo con substancias psicoactivas: el significado para el trabajador de enfermería Dealing with psychoactive substances: the meaning for nursing workers

Neste estudo propus-me a compreender o significado do lidar com substâncias psicoativas para os trabalhadores de enfermagem que atuam em clínica médica de uma unidade hospitalar. Para alcançar tal propósito, foram utilizadas idéias do referencial metodológico fenomenológico. Foram feitas entrevistas a partir da questão norteadora "o que é para você lidar com substâncias psicoativas?". A análise das falas revelou que esse lidar se mostra aos trabalhadores, em sua essência, um trabalho "como qualquer outro", sendo significativa a ênfase dada ao fazer em detrimento da prática reflexiva; o receio de falar sobre "o proibido", o que "compromete", sendo a droga enfocada como uma possibilidade real de uso no cotidiano dos trabalhadores. Suas experiências reafirmam a necessidade de refletir e discutir sobre o fenômeno drogas, articulando as vivências intersubjetivas ao contexto das Políticas Nacionais e Internacionais de Saúde, favorecendo aos profissionais perceberem de forma mais crítica e questionadora o fenômeno.<br>En este estudio yo me he propuesto a comprender el significado del trabajo con substancias psicoactivas para los trabajadores de enfermería de la clínica médica de un hospital. Para lograr tal intento, fueron utilizadas algunas ideas del referencial metodológico fenomenológico. Se realizó entrevistas a partir de la cuetión orientadora"lo que es para usted trabajar con substancias psicoactivas?". El análisis de los discursos revelo que tal labor se mostra a los obreros, en su esencia, un trabajo"como cualquier otro", siendo significativo el énfasis dado al hacer en detrimento de la práctica reflexiva; el temor de hablar sobre"el prohibido", lo que"compromete", siendo la droga enfocada como una posibilidad real de uso en el cotidiano de los obreros. Sus experiencias reafirman la necesidad de se reflexionar y discutir sobre el fenómeno drogas, articulando las vivencias intersubjetivas al contexto de las Políticas Nacionales e Internaconales de Salud, favorecendo a los profesionales la percepción del fenómeno de manera crítica e inquisidora.<br>This study i have proposed to understand the meaning of dealing with psychoactive substances for nursing workers who work at a medical clinic at a hospital unit. For that, some ideas of phenomenological methodological reference have been used. Interviews have been made from the guiding question" what is dealing with psychoactive substances for you?. The speeches analysis, revealing that this dealing shows itself to workers, in its essence, a job "as any other" ,being the emphasis given to doing regarding to reflexive praxis, significant; the fear of talking about" the forbidden", what "compromises" as drugs is focused as a real possibility of use in the workers daily life. This experiences re-affirm the need of reflecting about the drug phenomenon working the inter-subjective experiences to the context of National and International Health Policies favoring professionals to perceive this phenomenon under a more critical and questioning point of view

Upregulation of the oestrogen target gene SIX1 is associated with higher growth speed and decreased survival in HCV-positive women with hepatocellular carcinoma

The male/female ratio of patients with hepatocellular carcinoma (HCC) is often unbalanced towards the male sex, indicating a sex predisposition for HCC development. A possible explanation may be attributed to different hormonal statuses, including the pro-inflammatory action of androgens in men and the protective effects of oestrogen against excessive inflammation in women. Although several studies have studied gene expression in patients with HCC, very few have attempted to identify features that could be distinctive between male and female patients. The present study aimed to identify distinctive signalling mechanisms between men and women that may be associated with HCC progression. The present study analysed a detailed microarray database that was obtained from the prospective study of 78 patients with HCC to study gene expression according to sex. In addition, the present study aimed to evaluate whether the differentially expressed genes were known oestrogen targets. Moreover, RNAs from the HCC cohort were evaluated for microRNA (miRNA/miR) expression, and a relationship between miRNA and gene expression according to sex was investigated. One gene, sineoculis homeobox homolog 1 (SIX1), which is known to be an oestrogen target gene, was revealed to be highly upregulated in hepatitis virus C (HCV)-positive female patients with HCC but not in HCV-positive male patients. In addition, SIX1 upregulation had a significant relationship with tumour growth speed (assessed as tumour doubling time in two CTs performed 6 weeks apart) and survival (P=0.009 and P=0.042, respectively) in female patients only. Furthermore, SIX1 upregulation was related with miR-421 and miR-9-5p only in male patients; however, in female patients, SIX1 upregulation had a direct relationship with miR-181b, miR-503-5p and miR-125b (miRNAs with potential oncogenic capacity), and an inverse correlation with miR139-5p, miR-26b, let7c-3p and let7c-5p (putatively oncosuppressive microRNAs). These data suggested a distinctive model for liver carcinogenesis in HCV-positive women, with downregulation of protective mechanisms against tumour progression and the activation of potential oncogenes, in relation to the oestrogen target gene SIX1. (IRB10/08_CE_UniRer; ClinicalTrials ID: NCT01657695)

Current territorial organization for access to revascularization therapies for acute ischemic stroke in the Veneto region (Italy) from 2017 to 2021

IntroductionTo evaluate the access to treatments with intravenous thrombolysis (IVT) and/or mechanical thrombectomy (MT) in acute ischemic stroke patients admitted to stroke units (SUs) of Veneto region (Italy) according to current "hub-and-spoke" model from 2017 to 2021.Patients and methodsWe retrospectively analyzed data on treatments with IVT and/or MT for stroke patients admitted to the 23 SUs (6 Hubs and 17 Spokes) of the 6 macro-areas including 9 local sanitary units (LSUs) and 2 hospitals.ResultsWe reported 6093 treatments with IVT alone, 1114 with IVT plus MT, and 921 with MT alone. Number of stroke unit (SU) beds/100,000 inhabitants ranges from 2.3 to 2.8, and no difference was found among different macro-areas. Number of treatments/100,000 inhabitants/year ranges from 19 to 34 for IVT alone, from 2 to 7 for IVT plus MT, and from 2 to 5 for MT alone. Number of IVT alone/SU bed/year ranges from 9 to 21 in the Hub and from 6 to 12 in the Spokes. Rate of IVT plus MT in patients directly arrived in the same LSU's Hub ranges from 50 to 81%, likewise the one of MT alone ranges from 49 to 84%.ConclusionsTreatment target rates of IVT and MT set by Action Plan for Stroke in Europe 2018-2030 has been globally exceeded in the Veneto region. However, the target rate of MT and access revascularization treatments is heterogeneous among different macro-areas. Further efforts should be made to homogenize the current territorial organization