Tutoria em leitura e escrita baseado no modelo de RTI – resposta à intervenção em crianças com dislexia do desenvolvimento

Purpose to analyze and compare the reading and writing performance of children with developmental dyslexia after tutoring based on response to intervention model. Methods fifteen children with the interdisciplinary diagnosis of developmental dyslexia participated in this study. They were attending 2nd to 6th year of elementary public school in Marilia-SP, ranging in age from 8 to 12 years, 75% males. The children were assigned into Group I – experimental group (7 children who received intervention) and Group II – control group matched for gender and age(8 children did not receive the intervention). The children were subjected to a diagnostic survey of reading and writing performance and tutoring intervention program based on the model of Response to intervention Model. The results were statistically analyzed by Wilcoxon and Kruskal-Wallis tests to check for possible differences in performance between the groups studied. Results the results showed a statistically significant difference between the Group I and Group II, where children with dyslexia of Group I showed higher performance than children of GII in word reading and reading the book I tasks. Conclusion group I presented significant advances compared to Group II, which had no tutoring intervention.Objetivo analisar e comparar o desempenho em tarefas de leitura e escrita em crianças com dislexia do desenvolvimento após tutoria baseado no modelo de resposta à intervenção. Métodos participaram deste estudo 15 crianças com o diagnóstico interdisciplinar de dislexia do desenvolvimento de 2º ao 6º ano do ensino fundamental da rede pública municipal da cidade de Marília-SP, com faixa etária de oito a 12 anos de idade, de ambos os sexos, sendo 75% do sexo masculino, divididos em Grupo I – grupo experimental (sete crianças que receberam intervenção) e Grupo II – grupo controle (oito crianças não receberam a intervenção, os mesmos foram pareados segundo sexo e faixa etária com o Grupo I). As crianças foram submetidas ao levantamento diagnóstico de Leitura e Escrita e ao programa de intervenção em tutoria baseado no Modelo de Resposta à Intervenção . Os resultados foram analisados estatisticamente por meio do teste de Wilcoxon e Teste de Kruskal-Wallis para verificar possíveis diferenças de desempenho nas tarefas entre os grupos estudados. Resultados os resultados revelaram diferença estatisticamente significante entre o Grupo I e o Grupo II, onde as crianças com dislexia do Grupo I apresentaram desempenho superior na tarefade leitura de palavras e leitura do livro I em relação às crianças do Grupo II. Conclusão grupo I apresentou avanços significantes comparados à Grupo II, que não recebeu intervenção de tutoria.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Universidade Estadual PaulistaUNESP Departamento de FonoaudiologiaUniversidade Estadual PaulistaUNESP Departamento de Fonoaudiologi

Febrile seizures and mechanisms of epileptogenesis: insights from an animal model.

Temporal lobe epilepsy (TLE) is the most prevalent type of human epilepsy, yet the causes for its development, and the processes involved, are not known. Most individuals with TLE do not have a family history, suggesting that this limbic epilepsy is a consequence of acquired rather than genetic causes. Among suspected etiologies, febrile seizures have frequently been cited. This is due to the fact that retrospective analyses of adults with TLE have demonstrated a high prevalence (20-->60%) of a history of prolonged febrile seizures during early childhood, suggesting an etiological role for these seizures in the development of TLE. Specifically, neuronal damage induced by febrile seizures has been suggested as a mechanism for the development of mesial temporal sclerosis, the pathological hallmark of TLE. However, the statistical correlation between febrile seizures and TLE does not necessarily indicate a causal relationship. For example, preexisting (genetic or acquired) 'causes' that result independently in febrile seizures and in TLE would also result in tight statistical correlation. For obvious reasons, complex febrile seizures cannot be induced in the human, and studies of their mechanisms and of their consequences on brain molecules and circuits are severely limited. Therefore, an animal model was designed to study these seizures. The model reproduces the fundamental key elements of the human condition: the age specificity, the physiological temperatures seen in fevers of children, the length of the seizures and their lack of immediate morbidity. Neuroanatomical, molecular and functional methods have been used in this model to determine the consequences of prolonged febrile seizures on the survival and integrity of neurons, and on hyperexcitability in the hippocampal-limbic network. Experimental prolonged febrile seizures did not lead to death of any of the seizure-vulnerable populations in hippocampus, and the rate of neurogenesis was also unchanged. Neuronal function was altered sufficiently to promote synaptic reorganization of granule cells, and transient and long-term alterations in the expression of specific genes were observed. The contribution of these consequences of febrile seizures to the epileptogenic process is discussed

Diagnosis and treatment of musculoskeletal chest pain: design of a multi-purpose trial

<p>Abstract</p> <p>Background</p> <p>Acute chest pain is a major health problem all over the western world. Active approaches are directed towards diagnosis and treatment of potentially life threatening conditions, especially acute coronary syndrome/ischemic heart disease. However, according to the literature, chest pain may also be due to a variety of extra-cardiac disorders including dysfunction of muscles and joints of the chest wall or the cervical and thoracic part of the spine. The diagnostic approaches and treatment options for this group of patients are scarce and formal clinical studies addressing the effect of various treatments are lacking.</p> <p>Methods/Design</p> <p>We present an ongoing trial on the potential usefulness of chiropractic diagnosis and treatment in patients dismissed from an acute chest pain clinic without a diagnosis of acute coronary syndrome. The aims are to determine the proportion of patients in whom chest pain may be of musculoskeletal rather than cardiac origin and to investigate the decision process of a chiropractor in diagnosing these patients; further, to examine whether chiropractic treatment can reduce pain and improve physical function when compared to advice directed towards promoting self-management, and, finally, to estimate the cost-effectiveness of these procedures. This study will include 300 patients discharged from a university hospital acute chest pain clinic without a diagnosis of acute coronary syndrome or any other obvious cardiac or non-cardiac disease. After completion of the clinic's standard cardiovascular diagnostic procedures, trial patients will be examined according to a standardized protocol including a) a self-report questionnaire; b) a semi-structured interview; c) a general health examination; and d) a specific manual examination of the muscles and joints of the neck, thoracic spine, and thorax in order to determine whether the pain is likely to be of musculoskeletal origin. To describe the patients status with regards to ischemic heart disease, and to compare and indirectly validate the musculoskeletal diagnosis, myocardial perfusion scintigraphy is performed in all patients 2–4 weeks following discharge. Descriptive statistics including parametric and non-parametric methods will be applied in order to compare patients with and without musculoskeletal chest pain in relation to their scintigraphic findings. The decision making process of the chiropractor will be elucidated and reconstructed using the CART method. Out of the 300 patients 120 intended patients with suspected musculoskeletal chest pain will be randomized into one of two groups: a) a course of chiropractic treatment (therapy group) of up to ten treatment sessions focusing on high velocity, low amplitude manipulation of the cervical and thoracic spine, mobilisation, and soft tissue techniques. b) Advice promoting self-management and individual instructions focusing on posture and muscle stretch (advice group). Outcome measures are pain, physical function, overall health, self-perceived treatment effect, and cost-effectiveness.</p> <p>Discussion</p> <p>This study may potentially demonstrate that a chiropractor is able to identify a subset of patients suffering from chest pain predominantly of musculoskeletal origin among patients discharged from an acute chest pain clinic with no apparent cardiac condition. Furthermore knowledge about the benefits of manual treatment of patients with musculoskeletal chest pain will inform clinical decision and policy development in relation to clinical practice.</p> <p>Trial registration</p> <p>NCT00462241 and NCT00373828</p

Forced Convection Heat Transfer from a Finite-Height Cylinder

[EN] This paper presents a large eddy simulation of forced convection heat transfer in the flow around a surface-mounted finite-height circular cylinder. The study was carried out for a cylinder with height-to-diameter ratio of 2.5, a Reynolds number based on the cylinder diameter of 44 000 and a Prandtl number of 1. Only the surface of the cylinder is heated while the bottom wall and the inflow are kept at a lower fixed temperature. The approach flow boundary layer had a thickness of about 10% of the cylinder height. Local and averaged heat transfer coefficients are presented. The heat transfer coefficient is strongly affected by the free-end of the cylinder. As a result of the flow over the top being downwashed behind the cylinder, a vortex-shedding process does not occur in the upper part, leading to a lower value of the local heat transfer coefficient in that region. In the lower region, vortex-shedding takes place leading to higher values of the local heat transfer coefficient. The circumferentially averaged heat transfer coefficient is 20 % higher near the ground than near the top of the cylinder. The spreading and dilution of the mean temperature field in the wake of the cylinder are also discussed.The simulation was carried out using the supercomputing facilities of the Steinbuch Centre for Computing (SCC) of the Karlsruhe Institute of Technology. MGV has been partially supported by grant TRA2012-37714 of the Spanish Ministry of Economy and Competitiveness.García Villalba, M.; Palau-Salvador, G.; Rodi, W. (2014). Forced Convection Heat Transfer from a Finite-Height Cylinder. Flow, Turbulence and Combustion. 93(1):171-187. https://doi.org/10.1007/s10494-014-9543-7S171187931Ames, F., Dvorak, L.: Turbulent transport in pin fin arrays: experimental data and predictions. J. Turbomach. 128(1), 71–81 (2006)Armstrong, J., Winstanley, D.: A review of staggered array pin fin heat transfer for turbine cooling applications. J. 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Transforming growth factor β receptor 1 is a new candidate prognostic biomarker after acute myocardial infarction

<p>Abstract</p> <p>Background</p> <p>Prediction of left ventricular (LV) remodeling after acute myocardial infarction (MI) is clinically important and would benefit from the discovery of new biomarkers.</p> <p>Methods</p> <p>Blood samples were obtained upon admission in patients with acute ST-elevation MI who underwent primary percutaneous coronary intervention. Messenger RNA was extracted from whole blood cells. LV function was evaluated by echocardiography at 4-months.</p> <p>Results</p> <p>In a test cohort of 32 MI patients, integrated analysis of microarrays with a network of protein-protein interactions identified subgroups of genes which predicted LV dysfunction (ejection fraction ≤ 40%) with areas under the receiver operating characteristic curve (AUC) above 0.80. Candidate genes included transforming growth factor beta receptor 1 (TGFBR1). In a validation cohort of 115 MI patients, TGBFR1 was up-regulated in patients with LV dysfunction (P < 0.001) and was associated with LV function at 4-months (P = 0.003). TGFBR1 predicted LV function with an AUC of 0.72, while peak levels of troponin T (TnT) provided an AUC of 0.64. Adding TGFBR1 to the prediction of TnT resulted in a net reclassification index of 8.2%. When added to a mixed clinical model including age, gender and time to reperfusion, TGFBR1 reclassified 17.7% of misclassified patients. TGFB1, the ligand of TGFBR1, was also up-regulated in patients with LV dysfunction (P = 0.004), was associated with LV function (P = 0.006), and provided an AUC of 0.66. In the rat MI model induced by permanent coronary ligation, the TGFB1-TGFBR1 axis was activated in the heart and correlated with the extent of remodeling at 2 months.</p> <p>Conclusions</p> <p>We identified TGFBR1 as a new candidate prognostic biomarker after acute MI.</p

Contribuições da consciência fonológica e nomeação seriada rápida para a aprendizagem inicial da escrita

RESUMO Objetivo: investigar a contribuição da consciência fonológica e nomeação seriada rápida para a aprendizagem inicial da escrita. Métodos: participaram do estudo 100 crianças, na faixa etária de três a seis anos e onze meses, matriculadas na educação infantil de uma creche e uma escola municipal da cidade do Recife. Utilizou-se como instrumentos de avaliação o Teste de Consciência Fonológica, a tarefa de Nomeação Seriada Rápida e um roteiro de avaliação da escrita. Os dados foram transcritos e analisados conforme a estatística descritiva e inferencial. Resultados: observou-se que o aumento da faixa etária está diretamente relacionado ao desenvolvimento dos níveis de consciência fonológica, assim como com a diminuição dos erros e do tempo para execução das tarefas de NSR. Verificou-se que as crianças com mais de quatro anos, tiveram um desempenho em consciência fonológica aquém do esperado para sua idade. Dentre as habilidades de consciência fonológica, a consciência silábica obteve melhores índices de pontuações, podendo-se observar grande dificuldade dos participantes nas tarefas de consciência fonêmica. Com relação a escrita, a maioria das crianças estavam na fase pré-silábica. Foi possível verificar correlações significantes entre as habilidades de consciência fonológica com a nomeação seriada rápida e escrita. Conclusão: a consciência fonológica e nomeação seriada rápida contribuem para a aprendizagem inicial da escrita, sendo importante o estímulo destas habilidades antes do ciclo de alfabetização, o que pode favorecer este processo e sinalizar, precocemente, eventuais problemas de aprendizagem. O baixo desempenho nas tarefas pode ser sugestivo da influência de fatores socioeducacionais, devendo-se considerar o contexto de vida da criança e as experiências educativas vivenciadas na família e escola

Intervenção precoce em escolares de risco para a dislexia: revisão da literatura

TEMA: intervenção precoce em escolares de risco para a dislexia. OBJETIVO: este estudo tem por objetivo geral mapear os artigos publicados sobre intervenção com escolares de risco para dislexia e, como objetivos específicos, analisar descritivamente aspectos específicos dos textos. CONCLUSÃO: as publicações na área em relação ao tema não são constantes, porém, os artigos científicos analisados evidenciam a preocupação dos pesquisadores em elaborar, desenvolver e validar instrumentos de avaliações e intervenções que contribuam para a identificação precoce da dislexia.BACKGROUND: early intervention in students at risk for dyslexia. PURPOSE: this study aims to map the general articles on intervention with students at risk for dyslexia and specific objectives, descriptively analyzing specific text aspects. CONCLUSION: there are few published data on this issue; however, the reviewed scientific articles highlight the concern of the researchers to elaborate, develop and validate assessments and interventions that contribute to the early identification of dyslexia.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Universidade Estadual Paulista Faculdade de Filosofia e CiênciasUniversidade Estadual Paulista Faculdade de Filosofia e Ciências Departamento de Fonoaudiologia e Programa de Pós-Graduação em EducaçãoUniversidade Estadual Paulista Faculdade de Filosofia e CiênciasUniversidade Estadual Paulista Faculdade de Filosofia e Ciências Departamento de Fonoaudiologia e Programa de Pós-Graduação em Educaçã