ABILITÀ MOTORIE FONDAMENTALI E SVILUPPO: VALUTARE LA PRATICA DELL’ATTIVITÀ MOTORIA AL NIDO E IL SUO IMPATTO SUI DOMINI DI SVILUPPO DEL BAMBINO

ABILITÀ MOTORIE FONDAMENTALI E SVILUPPO: VALUTARE LA PRATICA DELL’ATTIVITÀ MOTORIA AL NIDO E IL SUO IMPATTO SUI DOI primi anni di vita di un bambino rappresentano un periodo critico per la promozione e il sostegno dello sviluppo motorio. I principali cambiamenti si esprimono nell’acquisizione di abilità motorie fondamentali, che tuttavia devono essere anche insegnate, praticate e sostenute nei contesti in cui il bambino cresce. La letteratura documenta, peraltro, come la pratica di attività psicomotoria possa avere un impatto positivo non solo sull’acquisizione delle abilità motorie fondamentali ma anche sulle abilità di tipo linguistico, sociale e sul benessere complessivo del bambino. Tuttavia, la maggior parte degli studi si concentra su fasce d’età superiori a quella del Nido. Alla luce di queste considerazioni, il presente progetto di ricerca si è proposto di: 1) esaminare la relazione tra abilità motorie e comportamento sociale 2) valutare possibili associazioni tra abilità motorie e abilità linguistiche; 3) valutare l’efficacia dell’intervento psicomotorio proposto all’interno dei Nidi N.E.Mo®. Metodo. Il numero di bambini coinvolti nel primo studio (obiettivo 1) è 104, nel secondo studio (obiettivo 2) è 100, e nel terzo studio (obiettivo 3) è 112 (55 bambini frequentanti Nidi con progetto N.E.Mo® e 57 frequentanti Nidi senza programma di attività psicomotoria). Tutti i bambini coinvolti hanno sviluppo tipico di età compresa tra i 12 e i 36 mesi. La ricerca ha utilizzato un approccio multi-metodo che si è avvalso di scale di valutazione standardizzate, questionari per insegnanti e genitori, e tecnica sociometrica (quest’ultima solo per i bambini più grandi: 30-36 mesi). In particolare, le abilità acquisite nei diversi domini di sviluppo motorio e linguistico sono state valutate attraverso le Griffiths Mental Development Scales (GMDS, 1996; 2006); la competenza sociale è stata valutata attraverso il Questionario di Valutazione dell’Interazione Sociale al Nido (D’Odorico, Cassibba, & Buono, 2000) sottoposto alle educatrici, e la nomina dei pari (McCandless, & Marshall, 1957). La capacità lessicale è stata inoltre valutata attraverso la forma breve del questionario ‘Primo Vocabolario del Bambino-PVB’ (Caselli, Pasqualetti, & 4 Stefanini, 2007) compilata dalle educatrici, e i bambini oltre i 18 mesi sono stati rivalutati dopo 6 mesi attraverso le prove standardizzate di comprensione e produzione lessicale ‘Parole in Gioco-PiNG’ (Bello et al., 2010). Infine, per il terzo obiettivo la ricerca ha adottato un disegno pre- e post- intervento. Risultati. Riguardo al primo obiettivo, l’analisi dei modelli di equazione strutturali (SEM) ha mostrato che nel secondo anno d’età il possesso di elevate abilità locomotorie impatta positivamente sul comportamento sociale dei bambini che frequentano il Nido. La path analysis ha evidenziato che i bambini tra i 30 e i 36 mesi che posseggono maggiori abilità locomotorie sono percepiti dalle educatrici come maggiormente competenti a livello sociale, mentre i bambini più piccoli (18-23 mesi) con elevate abilità locomotorie sono percepiti come più aggressivi. Riguardo al secondo obiettivo, il 23.1% dei bambini di 36 mesi mostra uno sviluppo lessicale al di sotto del 10° percentile associato a un basso punteggio nelle abilità di coordinazione oculo-manuale. Inoltre, nei bambini tra i 18 e i 30 mesi le abilità di coordinazione oculo-manuale predicono le abilità di comprensione. Riguardo al terzo obiettivo, i bambini tra i 12 e i 23 mesi frequentanti i Nidi N.E.Mo® che partecipano a programmi di attività psicomotoria al post-test hanno mostrato abilità di coordinazione oculo-manuale significativamente maggiori dei coetanei del gruppo di controllo. Conclusioni. Complessivamente, questi risultati suggeriscono l’importanza di praticare attività fisica e implementare programmi di attività psicomotoria fin dal secondo anno di vita per lo sviluppo di abilità motorie fondamentali, oltre che di abilità sociali e linguistiche

Heterogeneous indications and the need for viability assessment:An international survey on the use of machine perfusion in liver transplantation

Although machine perfusion (MP) is being increasingly adopted in liver transplantation, indications, timing, and modality are debated. To investigate current indications for MP a web-based Google Forms survey was launched in January 2021 and addressed to 127 experts in the field, identified among first and corresponding Authors of MP literature in the last 10 years. The survey presented 10 real-life cases of donor–recipient matching, asking whether the liver would be accepted (Q1), whether MP would be used in that particular setting (Q2) and, if so, by which MP modality (Q3) and at what timing during preservation (Q4). Respondents could also comment on each case. The agreement was evaluated using Krippendorff's alpha coefficient. Answers from 39 (30.1%) participants disclosed significant heterogeneity in graft acceptance, MP indications, technique, and timing. Agreement between respondents was generally poor (Q1, α = 0.11; Q2, α = 0.14; Q3, α = 0.12, Q4, α = 0.11). Overall, respondents preferred hypothermic MP and an end-ischemic approach in 56.3% and 81.1% of cases, respectively. A total of 18 (46.2%) participants considered only one MP approach, whereas 17 (43.6%) and 3 (7.7%) considered using alternatively 2 or 3 different techniques. Of 38 comments, 17 (44.7%) were about the use of MP for graft viability assessment before implantation. This survey shows considerable variability in MP indications, emphasizing the need to identify scenarios of optimal utilization for each technique. Viability assessment emerges as a fundamental need of transplant professionals when considering the use of MP.</p

Heterogeneous indications and the need for viability assessment:An international survey on the use of machine perfusion in liver transplantation

Although machine perfusion (MP) is being increasingly adopted in liver transplantation, indications, timing, and modality are debated. To investigate current indications for MP a web-based Google Forms survey was launched in January 2021 and addressed to 127 experts in the field, identified among first and corresponding Authors of MP literature in the last 10 years. The survey presented 10 real-life cases of donor–recipient matching, asking whether the liver would be accepted (Q1), whether MP would be used in that particular setting (Q2) and, if so, by which MP modality (Q3) and at what timing during preservation (Q4). Respondents could also comment on each case. The agreement was evaluated using Krippendorff's alpha coefficient. Answers from 39 (30.1%) participants disclosed significant heterogeneity in graft acceptance, MP indications, technique, and timing. Agreement between respondents was generally poor (Q1, α = 0.11; Q2, α = 0.14; Q3, α = 0.12, Q4, α = 0.11). Overall, respondents preferred hypothermic MP and an end-ischemic approach in 56.3% and 81.1% of cases, respectively. A total of 18 (46.2%) participants considered only one MP approach, whereas 17 (43.6%) and 3 (7.7%) considered using alternatively 2 or 3 different techniques. Of 38 comments, 17 (44.7%) were about the use of MP for graft viability assessment before implantation. This survey shows considerable variability in MP indications, emphasizing the need to identify scenarios of optimal utilization for each technique. Viability assessment emerges as a fundamental need of transplant professionals when considering the use of MP

Heterogeneous indications and the need for viability assessment:An international survey on the use of machine perfusion in liver transplantation

Although machine perfusion (MP) is being increasingly adopted in liver transplantation, indications, timing, and modality are debated. To investigate current indications for MP a web-based Google Forms survey was launched in January 2021 and addressed to 127 experts in the field, identified among first and corresponding Authors of MP literature in the last 10 years. The survey presented 10 real-life cases of donor–recipient matching, asking whether the liver would be accepted (Q1), whether MP would be used in that particular setting (Q2) and, if so, by which MP modality (Q3) and at what timing during preservation (Q4). Respondents could also comment on each case. The agreement was evaluated using Krippendorff's alpha coefficient. Answers from 39 (30.1%) participants disclosed significant heterogeneity in graft acceptance, MP indications, technique, and timing. Agreement between respondents was generally poor (Q1, α = 0.11; Q2, α = 0.14; Q3, α = 0.12, Q4, α = 0.11). Overall, respondents preferred hypothermic MP and an end-ischemic approach in 56.3% and 81.1% of cases, respectively. A total of 18 (46.2%) participants considered only one MP approach, whereas 17 (43.6%) and 3 (7.7%) considered using alternatively 2 or 3 different techniques. Of 38 comments, 17 (44.7%) were about the use of MP for graft viability assessment before implantation. This survey shows considerable variability in MP indications, emphasizing the need to identify scenarios of optimal utilization for each technique. Viability assessment emerges as a fundamental need of transplant professionals when considering the use of MP.</p

Heterogeneous Indications and the Need for Viability Assessment: An International Survey on the Use of Machine Perfusion in Liver Transplantation

Although machine perfusion (MP) is being increasingly adopted in liver transplantation, indications, timing, and modality are debated. To investigate current indications for MP a web-based Google Forms survey was launched in January 2021 and addressed to 127 experts in the field, identified among first and corresponding Authors of MP literature in the last 10 years. The survey presented 10 real-life cases of donor-recipient matching, asking whether the liver would be accepted (Q1), whether MP would be used in that particular setting (Q2) and, if so, by which MP modality (Q3) and at what timing during preservation (Q4). Respondents could also comment on each case. The agreement was evaluated using Krippendorff's alpha coefficient. Answers from 39 (30.1%) participants disclosed significant heterogeneity in graft acceptance, MP indications, technique, and timing. Agreement between respondents was generally poor (Q1, α = 0.11; Q2, α = 0.14; Q3, α = 0.12, Q4, α = 0.11). Overall, respondents preferred hypothermic MP and an end-ischemic approach in 56.3% and 81.1% of cases, respectively. A total of 18 (46.2%) participants considered only one MP approach, whereas 17 (43.6%) and 3 (7.7%) considered using alternatively 2 or 3 different techniques. Of 38 comments, 17 (44.7%) were about the use of MP for graft viability assessment before implantation. This survey shows considerable variability in MP indications, emphasizing the need to identify scenarios of optimal utilization for each technique. Viability assessment emerges as a fundamental need of transplant professionals when considering the use of MP. Keywords: ex situ organ perfusion; machine perfusion; normothermic regional perfusion; organ preservation; viability assessment

Quality control of B-lines analysis in stress Echo 2020

Background The effectiveness trial “Stress echo (SE) 2020” evaluates novel applications of SE in and beyond coronary artery disease. The core protocol also includes 4-site simplified scan of B-lines by lung ultrasound, useful to assess pulmonary congestion. Purpose To provide web-based upstream quality control and harmonization of B-lines reading criteria. Methods 60 readers (all previously accredited for regional wall motion, 53 B-lines naive) from 52 centers of 16 countries of SE 2020 network read a set of 20 lung ultrasound video-clips selected by the Pisa lab serving as reference standard, after taking an obligatory web-based learning 2-h module ( http://se2020.altervista.org ). Each test clip was scored for B-lines from 0 (black lung, A-lines, no B-lines) to 10 (white lung, coalescing B-lines). The diagnostic gold standard was the concordant assessment of two experienced readers of the Pisa lab. The answer of the reader was considered correct if concordant with reference standard reading ±1 (for instance, reference standard reading of 5 B-lines; correct answer 4, 5, or 6). The a priori determined pass threshold was 18/20 (≥ 90%) with R value (intra-class correlation coefficient) between reference standard and recruiting center) > 0.90. Inter-observer agreement was assessed with intra-class correlation coefficient statistics. Results All 60 readers were successfully accredited: 26 (43%) on first, 24 (40%) on second, and 10 (17%) on third attempt. The average diagnostic accuracy of the 60 accredited readers was 95%, with R value of 0.95 compared to reference standard reading. The 53 B-lines naive scored similarly to the 7 B-lines expert on first attempt (90 versus 95%, p = NS). Compared to the step-1 of quality control for regional wall motion abnormalities, the mean reading time per attempt was shorter (17 ± 3 vs 29 ± 12 min, p < .01), the first attempt success rate was higher (43 vs 28%, p < 0.01), and the drop-out of readers smaller (0 vs 28%, p < .01). Conclusions Web-based learning is highly effective for teaching and harmonizing B-lines reading. Echocardiographers without previous experience with B-lines learn quickly.info:eu-repo/semantics/publishedVersio

Vaccine breakthrough hypoxemic COVID-19 pneumonia in patients with auto-Abs neutralizing type I IFNs

Life-threatening `breakthrough' cases of critical COVID-19 are attributed to poor or waning antibody response to the SARS- CoV-2 vaccine in individuals already at risk. Pre-existing autoantibodies (auto-Abs) neutralizing type I IFNs underlie at least 15% of critical COVID-19 pneumonia cases in unvaccinated individuals; however, their contribution to hypoxemic breakthrough cases in vaccinated people remains unknown. Here, we studied a cohort of 48 individuals ( age 20-86 years) who received 2 doses of an mRNA vaccine and developed a breakthrough infection with hypoxemic COVID-19 pneumonia 2 weeks to 4 months later. Antibody levels to the vaccine, neutralization of the virus, and auto- Abs to type I IFNs were measured in the plasma. Forty-two individuals had no known deficiency of B cell immunity and a normal antibody response to the vaccine. Among them, ten (24%) had auto-Abs neutralizing type I IFNs (aged 43-86 years). Eight of these ten patients had auto-Abs neutralizing both IFN-a2 and IFN-., while two neutralized IFN-omega only. No patient neutralized IFN-ss. Seven neutralized 10 ng/mL of type I IFNs, and three 100 pg/mL only. Seven patients neutralized SARS-CoV-2 D614G and the Delta variant (B.1.617.2) efficiently, while one patient neutralized Delta slightly less efficiently. Two of the three patients neutralizing only 100 pg/mL of type I IFNs neutralized both D61G and Delta less efficiently. Despite two mRNA vaccine inoculations and the presence of circulating antibodies capable of neutralizing SARS-CoV-2, auto-Abs neutralizing type I IFNs may underlie a significant proportion of hypoxemic COVID-19 pneumonia cases, highlighting the importance of this particularly vulnerable population

Motor skills and language development in Italian toddlers: a longitudinal study

The association between specific components of language and motor abilities in toddlers with language developmen