Training Prospective Primary and Kindergarten Teachers on Electric Circuits Using Conceptual Metaphors

The awareness and use of conceptual metaphors available in ordinary language should be a relevant part of teaching strategies, yet it is still rather neglected in teacher education. With a specific activity, we integrated a class of prospective kindergarten and primary school teachers on electric circuits with a reflection on the cognitive and linguistic aspects of metaphor. To understand how effective this integration proved to be, both in terms of learning and in terms of developing teaching skills, we conducted a single case study with a mixed qualitative–quantitative methodol-ogy. Student teachers were invited to analyze and discuss expressions on electric circuits selected from those they themselves had formulated at an earlier time. Here, we present some relevant results from the analysis of the students’ elaborations, highlighting how they worked with metaphors. They demonstrated a better understanding of the subject matter and greater awareness of teaching as well, in particular for what concerns the use of language and identifying and overcoming implicit ideas

The Therapeutic Dilemma of Cochlear Nerve Deficiency: Cochlear or Brainstem Implantation?

To compare the outcomes between 2 age-matched cohorts of children with cochlear nerve deficiency: those receiving auditory brainstem implants (group A) or cochlear implants (group B). Subjects were selected from a pool of 537 children fitted with cochlear implants (n = 443) or auditory brainstem implants (n = 94) over the past 14 years. Performance, examined with the Category of Auditory Performance scale, and complications were compared with a mean follow-up of 5 years. All children had bilateral profound sensorineural hearing loss and cochlear nerve deficiency. Magnetic resonance imaging documented an absent cochlear nerve (n = 12) and a small cochlear nerve (n = 8) in group A and an absent cochlear nerve (n = 11) and a small cochlear nerve (n = 9) in group B (P = 1.000). Children with cochlear implants had Category of Auditory Performance scores spanning from 0 to 3 levels of performance, and all required manual communication mode and visual supplementation. Children with auditory brainstem implants had Category of Auditory Performance scores spanning from 2 to 7, and most patients demonstrated behavioral responses irrespective of inner ear malformations and an absent cochlear nerve or small cochlear nerve (P < .001). In children with cochlear nerve deficiency, patients fitted with cochlear implants did not develop speech understanding and production. Those fitted with auditory brainstem implants had the opportunity to develop open-set speech perception, acquiring verbal language competence using oral communication exclusively and participating in mainstream education. The overall complication rate of auditory brainstem implants was not greater than that of cochlear implants

Vestibulotomy With Ossiculoplasty Versus Round Window Vibroplasty Procedure in Children With Oval Window Aplasia

To review the surgical procedures and outcomes in children with bilateral oval window aplasia (OWA). Study Design: Retrospective cohort review of a group of Children suffering from OWA between 1990 and 2010 who underwent to Vestibulotomy with ossiculoplasty (V-OPL) or round window vibroplasty (RWV). Main Outcome Measures: Findings at radiology and surgery, preoperative and postoperative bone conduction (BC), air conduction (AC), and RWV-air conduction (RWV-AC) thresholds and speech discrimination scores (SDSs). Results: Among 23 children, 11 underwent V-OPL and 8 RWV. Four children in the V-OPL group had aborted surgery and were excluded from the study. In all the remaining 19 children, the 6-month follow-up time showed postoperative AC and SDS values significantly better than the preoperative thresholds in both groups. At the 36-month long-term follow-up, AC and SDS were stable in the RWV group but showed a significant worsening in the V-OPL children compared with the 6-month follow-up results. Preoperative versus postoperative BC values showed a significant difference between the 2 groups at 36 months; 5 of the V-OPL group underwent revision following the same surgical principles, which did not result in improved outcome. Conclusion: In children with OWA, V-OPL provides modest long-term results and carries higher risks of BC degradation compared to RWV. Both procedures are technically challenging but considering the respective hearing results and morbidity of primary and revision surgery, we have abandoned the V-OPL procedure in favor of RWV. In infants and children younger than 5 years with OWA previously not considered candidates for hearing restoration, we consider RWV as the first-choice surgery. It has shown to provide significantly better hearing outcomes than traditional atresia surgery with minimal complication rate

Convergence of Wnt signalling on the HNF4a-driven transcription in controlling liver zonation

BACKGROUND & AIMS: In each hepatocyte, the specific repertoire of gene expression is influenced by its exact location along the portocentrovenular axis of the hepatic lobule and provides a reason for the liver functions compartmentalization defined "metabolic zonation." So far, few molecular players controlling genetic programs of periportal (PP) and perivenular (PV) hepatocytes have been identified; the elucidation of zonation mechanisms remains a challenge for experimental hepatology. Recently, a key role in induction and maintenance of the hepatocyte heterogeneity has been ascribed to Wnt/beta-catenin pathway. We sought to clarify how this wide-ranging stimulus integrates with hepatocyte specificity. METHODS: Reverse transcriptase polymerase chain reaction (RT-PCR) allowed the transcriptional profiling of hepatocytes derived from in vitro differentiation of liver stem cells. The GSK3beta inhibitor 6-bromoindirubin-3'-oxime (BIO) was used for beta-catenin stabilization. Co-immunoprecipitations were used to study biochemical protein interactions while ChIP assays allowed the in vivo inspection of PV and PP genes regulatory regions. RESULTS: We found that spontaneous differentiation of liver stem cells gives rise to PP hepatocytes that, after Wnt pathway activation, switch into PV hepatocytes. Next, we showed that the Wnt downstream player LEF1 interacts with the liver-enriched transcriptional factor HNF4alpha. Finally, we unveiled that the BIO induced activation of PV genes correlates with LEF1 binding to both its own and HNF4alpha consensus, and the repression of PP genes correlates with HNF4alpha displacement from its own consensus. CONCLUSION: Our data show a direct and hitherto unknown convergence of the canonical Wnt signaling on the HNF4alpha-driven transcription providing evidences of a mechanism controlling liver zonated gene expression

Long-term Outcome of Round Window Vibrant SoundBridge Implantation in Extensive Ossicular Chain Defects

To evaluate retrospectively the long-term safety and efficacy of the first 50 patients, all suffering from severe ossicular chain defects and with moderate to severe mixed hearing loss, who received the Vibrant SoundBridge with the floating mass transducer located on the round window membrane. To evaluate differences in outcome versus etiology and age of the patient population. Patients eligible for implantation of the floating mass transducer on the round window membrane ranged in age from 2 months to 74 years with a moderate to severe conductive or mixed hearing loss from different etiologies. For each adult patient, preoperative versus postoperative bone and air conduction thresholds, air-bone gaps, and speech understanding scores were evaluated at 24-month follow-up. At 60-month follow-up, data were available from 33 patients. Preoperative and postoperative freefield auditory brainstem responses were studied in infants and children. Intraoperative and short- and long-term postoperative complications are presented. There were significant improvements in speech perception and pure-tone audiometry in adults and auditory brainstem response thresholds in infants immediately after surgery and at follow-up examinations (12 to 71 months). No significant complications or device extrusions were observed in the present series. Infants, children, and adults with moderate to severe conductive or mixed hearing loss obtained substantial benefit from implantation of the floating mass transducer on the round window membrane regardless of the etiology of hearing loss and previous surgery

Auditory brainstem implantation after unsuccessful cochlear implantation of children with clinical diagnosis of cochlear nerve deficiency

Objectives: We compared the perceptual auditory abilities of 21 children with suspected cochlear nerve deficiency (CND) and a surgically verified absent cochlear nerve (CN) who first underwent cochlear implantation (CI) and subsequently underwent auditory brainstem implantation (ABI). Methods: In this retrospective cohort study, from 2000 to 2011, 21 children initially underwent CI at an outside institution and failed to progress in their perceptual auditory abilities. Before CI, all of the children had severe to profound sensorineural hearing loss and a diagnosis of CND. Magnetic resonance imaging (MRI) documented an absent CN in 13 children and a small CN in 8 children. We performed explantation of the cochlear implant and simultaneous ABI on the same side. We performed MRI if no previous MRI results were available. All surgical videos were reviewed to determine the presence or absence of the CN. Measures of the patients' perceptual auditory abilities obtained after CI and after ABI were converted to the Category of Auditory Performance (CAP) scale. Results: At surgery, all patients demonstrated an absent CN. After CI, all patients had a CAP score of 2 or less (mean, 0.52 \ub1 0.68). After ABI, all patients had a CAP score of 2 or more (mean, 4.33 \ub1 1.68); the improvement was statistically significant (p < 0.001). The complication rates were similar for CI and ABI. Conclusions: In this cohort of patients who had poor performance after CI, ABI achieved significantly improved performance as measured by the CAP and was shown to successfully rehabilitate hearing. Cases of a small CN may in reality represent an absent CN. Although this cohort was selected from patients with failed CI, the results have implications for the selection of device for patients with CND, in that ABI is a potential alternative to CI in select cases. In patients who fail to progress with intensive rehabilitation with CI or who have no progression in evoked auditory brainstem response, ABI must be considered early. \ua9 2013 Annals Publishing Company. All rights reserved

Long-term follow up of infants (4-11 months) fitted with cochlear implants

The aim of the present study was to investigate the efficacy of cochlear implants (CIs) in infants who were implanted at < 11 months of age versus children operated at later age (i.e. 12-36 months) and to document whether children who receive a CI below 11 months of age are able to achieve age-appropriate expected spoken language skills, at a follow-up time from 4 to 9 years. From November 1998 to November 2007, 185 children received CIs and 34 received auditory brainstem implants in our department. The present study focuses on 13 children implanted at ages younger than 12 months (4-11 months; mean, 8.2; SD = 2.4) and fitted with CIs between November 1998 and March 2004. To avoid bias these children were selected from a larger longitudinal cohort of pediatric CI recipients fitted with CIs because they all were implanted with the same cochlear device (Nucleus CI 24 M) during the same period. Postoperatively auditory abilities were evaluated at the latest follow-up, from 4 to 9 years after surgery, with CAP, PPVT-R, TROG, and SIR. The results obtained in this group of 13 children were compared with those obtained in two groups of children implanted at later ages (12-23 and 24-36 months, respectively). No complication has been observed so far. The highest score of CAP function was achieved in all the three groups but at different intervals from CI activation as function of age at CI implantation. The rate of receptive language growth (PPVT-R) provides distinctive evidence that only the scores of the first group overlap the line of normal-hearing children, whereas the second and third group never reached the values of normal peers even after 9 years of CI use. TROG outcomes clearly indicate that only children from the first group (77%) are in the 76-100 percentile at 5 years follow-up. At 9 years follow-up, 100% of children in the first group, 38% in the second group, and 20% in the third group are in the 76-100 percentile. The SIR outcomes at the 5 years follow-up indicate that none of children was identified within the first two categories, only children from the third group (18%) were identified in category 3, all infants of the first group, 80% of group 2, and 63% of the third group were identified in category 5. At the 9 years follow-up, the number of children from the third group identified in category 3 was reduced to 10%, the second and third groups displayed a slightly higher percentage of children in category 5, but the difference from the values observed at the 5-year follow-up is not significant. In this study the outcomes from several indices (Category of Auditory Performance, CAP; Peabody Picture Vocabulary Test (Revised), PPVT-R; Test of Reception of Grammar, TROG; and Speech Intellegibility Rating, SIR) in three groups of children with different ages at implantation (from 4 to 36 months) with a follow-up time from 4 to 9 years demonstrate that very early cochlear implantation (<11 months) provides normalization of audio-phonologic parameters with no complications

Surgery for Port-Wine Stains: A Systematic Review

Background: Port-wine stains (PWS) are congenital low-flow vascular malformations of the skin. PWS tend to become thicker and darker with time. Laser therapy is the gold standard and the first-line therapy for treating PWS. However, some resistant PWS, or PWS that have tissue hypertrophy, do not respond to this therapy. Our aim is to evaluate the role of surgery in the treatment of PWS birthmarks. Methods: A literature search was performed in PubMed, Scopus, Web of Science (WOS) and Google Scholar for all papers dealing with surgery for port-wine stains, from January 2010 to December 2020 using the search strings: (capillary vascular malformation OR port-wine stains OR Sturge Weber Syndrome OR sws OR pws) AND (surgical OR surgery). Results: Ten articles were identified and used for analysis. They were almost all case series with a short follow up period and lacked an objective–systematic score of evaluation. Conclusions: Delay in treatment of port wine stains may result in soft tissue and bone hypertrophy or nodules with disfiguring or destructive characteristics. The correction of PWS-related facial asymmetry often requires bone surgery followed by soft tissue corrections to achieve a more harmonious, predictable result

Valorisation of by-products from soybean (Glycine max (L.) Merr.) processing

In recent years, increased awareness of the health benefits associated with consuming soy-based foods, knowledge of milk-related allergies and a move towards more sustainable food production have led to an increase in the number of available soy-based products. The biggest producers in the world, the USA, South America and China, are from the Pacific region. This enormous production is accompanied by the accumulation of related by-products, in particular, a substance that is known as okara. Okara is a paste that is rich in fibre (50%), protein (25%), fat (10%), vitamins and trace elements. Its proper use would lead to economic advantages and a reduction in the potential for polluting the environment. Its high fibre content and low production costs mean that it could also be used as a dietary supplement to prevent diabetes, obesity and hyperlipidaemia. Chemical or enzymatic treatment, fermentation, extrusion, high pressure and micronisation can all increase the soluble fibre content, and thus improve nutritional quality and processing properties. However, the product also degrades rapidly due to its high moisture content (70&ndash;80%), which makes it difficult to handle and expensive to dry by conventional means. The aim of this paper is therefore to thoroughly study the existing literature on this subject in order to develop a general protocol for okara exploitation and valorisation. A cost/benefit analysis could drive the design of eco-friendly, sustainable protocols for the preparation of high-value nutritional products

The Fermion Monte Carlo revisited

In this work we present a detailed study of the Fermion Monte Carlo algorithm (FMC), a recently proposed stochastic method for calculating fermionic ground-state energies [M.H. Kalos and F. Pederiva, Phys. Rev. Lett. vol. 85, 3547 (2000)]. A proof that the FMC method is an exact method is given. In this work the stability of the method is related to the difference between the lowest (bosonic-type) eigenvalue of the FMC diffusion operator and the exact fermi energy. It is shown that within a FMC framework the lowest eigenvalue of the new diffusion operator is no longer the bosonic ground-state eigenvalue as in standard exact Diffusion Monte Carlo (DMC) schemes but a modified value which is strictly greater. Accordingly, FMC can be viewed as an exact DMC method built from a correlated diffusion process having a reduced Bose-Fermi gap. As a consequence, the FMC method is more stable than any transient method (or nodal release-type approaches). We illustrate the various ideas presented in this work with calculations performed on a very simple model having only nine states but a full sign problem. Already for this toy model it is clearly seen that FMC calculations are inherently uncontrolled.Comment: 49 pages with 4 postscript figure