Eosinofilia tecidual na neoplasia intra-epitghelial oral (NIO) como um provável indicador de invasão

Dissertação para obtenção do grau de Mestre no Instituto Superior de Ciências da Saúde Egas MonizOBJETIVO: investigar a presença dos eosinófilos na neoplasia intraepitelial oral (NIO) e no carcinoma de células escamosas da cavidade bucal (CCEO) e a sua relação com a invasão. MATERIAL E MÉTODOS: Noventa e nove biópsias foram selecionadas e subdivididas em 6 grupos: NIO-1 (16 casos), NIO-2 (18 casos), NIO-3 (17 casos), CCEO microinvasivo (10 cases), CCEO invasivo não metastático (22 casos) e CCEO invasivo metastático (16 casos). As lâminas, contendo os cortes das diferentes lesões, foram coradas com hematoxilina e eosina (H/E), e os eosinófilos foram, então, quantificados. A primeira área selecionada foi constituída por um campo contendo o maior número de eosinófilos (eos/hpf) seguido por mais nove hpfs consecutivos (eos/10hpf), cobrindo uma área de 0.576mm2/10 hpf. RESULTADO: A distribuição dos eosinófilos foi associada à severidade do diagnóstico (p<0.01), porém, diferença significativa foi observada somente entre os grupos NIO-3 ou CCEO microinvasivo e CCEO não metastático e metastático (p<0.01). O limiar para a invasão foi de 7eos/10hpf com sensibilidade de 62,5% e especificidade de 96,1%. Nenhum eosinófilo foi observado no grupo NIO-1, enquanto que em NIO-2, apenas 2 (11.11%) dos 18 casos foram positivos. Em NIO-3, 5 (29.41%) dos 17 casos mostraram eosinofilia tecidual; 4 dos quais tiveram ≥3 eos/hpf ou ≥7 eos/10hpf. Três casos foram suspeitos de invasão; dois deles tiveram história prévia de CCEO e apresentaram 7 eos/hpf ou 16 eos/10hpf e 8 eos/hpf ou 26 eos/10hpf. Quatro (40%) dos 10 casos de CCEO microinvasivo foram positivos para eosinófilo e apresentaram ≥3 eos/hpf and ≥7 eos/10hpf. Apesar de não ter sido significativamente diferente, o grupo de CCEO invasivo não metastático teve maior número de casos (68.2%) com ≥22 eos/10hpf contrastando com 50% observados no CCEO invasivo metastático. CONCLUSÕES: Nossos resultados sugerem que os eosinófilos podem ser considerados um indicador de invasão nos casos de NIO, o que auxiliaria o diagnóstico principalmente nos casos difíceis e de biópsias pequenas

Lecture et entrée dans la culture écrite, quelle place pour le conte ? :: étude des pratiques enseignantes au cycle deux concernant le conte et les dispositifs qui lui sont liés

Dans le cadre de ma pratique, je me suis intéressée de près à l’apprentissage de la lecture-écriture, et je souhaite maintenant comprendre comment cet apprentissage se poursuit au cycle deux, afin de permettre aux élèves d’entrer dans la culture écrite en construisant du sens à partir d’un texte tel que le conte. À ce titre, cette recherche tend à comprendre la place donnée par les enseignants au conte dans leur classe et les différents dispositifs liés à ces apprentissages. La récolte de données consistera en des entretiens avec des enseignants du cycle deux pour comprendre leurs représentations du conte et de la lecture et voir par quels dispositifs ceux-ci sont travaillés dans leur classe. Cela me permettra de mettre en avant et de discuter certaines pratiques possibles dans le but de voir dans quelle mesure celles-ci vont permettre à l’enfant d’entrer dans la culture écrite

Virtual Reality as a Therapy Tool for Walking Activities in Pediatric Neurorehabilitation: Usability and User Experience Evaluation

Background: Many essential walking activities in daily life, such as crossing a street, are challenging to practice in conventional therapeutic settings. Virtual environments (VEs) delivered through a virtual reality (VR) head-mounted display (HMD) would allow training such activities in a safe and attractive environment. Furthermore, the game-like character and high degree of immersion in these applications might help maintain or increase children's motivation and active participation during the rehabilitation process. Objective: This study aimed to investigate the usability, user experience, and acceptability of an immersive VE experienced through a VR HMD to train everyday life walking activities in pediatric neurorehabilitation. Methods: In a cross-sectional study, 21 youths (median age 12.1 years; range 6.8-17.7 years) with a neuromotor impairment undergoing inpatient or outpatient neurorehabilitation tested a VE experienced through the VR HMD Oculus Quest. The participants, accompanied by their physiotherapists, moved freely around a 4.4 by 10-meter VE, displaying a magical forest and featuring various gamified everyday activities in different game designs. Using their hands, represented in the VE, the participants could interact with the virtual objects placed throughout the VE and trigger visual and auditory feedback. Symptoms of cybersickness were checked, and usability, user experience, and acceptability were evaluated using customized questionnaires with a visual analog scale for youths and a 5-point Likert scale for their therapists. Results: None of the participants reported any signs of cybersickness after 20 minutes of VR HMD exposure time. They rated comfort (median 10/10) and movement ability (median 10/10) with the VR HMD as high. The VE was perceived as being really there by the majority (median 8/10), and the participants had a strong feeling of spatial presence in the VE (median 9.5/10). They enjoyed exploring the virtual world (median 10/10) and liked this new therapy approach (median 10/10). Therapists' acceptance of the VR HMD was high (4/5). There were 5 patients that needed more support than usual, mainly for supervision, when moving around with the VR HMD. Otherwise, therapists felt that the VR HMD hardly affected their patients' movement behavior (median 4.75/5), whereas it seemed to increase their level of therapy engagement (median 4/5) compared to conventional physiotherapy sessions. Conclusions: This study demonstrates the usability of an immersive VE delivered through a VR HMD to engage youths in the training of everyday walking activities. The participants' and therapists' positive ratings on user experience and acceptance further support the promising application of this technology as a future therapeutic tool in pediatric neurorehabilitation. Keywords: adolescent; auditory; child; feasibility study; feedback; head-mounted display; pediatric; rehabilitation; therapy; tool; usability; user; virtual reality; visual; walking; youth

Das Goldpreis Paradoxon : was sind die Ursachen eines sinkenden Goldpreises in Krisenzeiten?

Seit 6000 Jahren fasziniert Gold den Menschen (Pieth, 2019, S. 28). Es fand Verwendung als globale Währung, als Rohstoff und als Investitionsanlage. Gold stiess auf Faszination aufgrund seiner Schönheit sowie der starken Nachfrage und des begrenzten Angebots (World Gold Council, 2011, S. 4). Blickt man in die Geschichte zurück, wurde dem Edelmetall bereits früher ein Wert beigemessen, welcher den eigentlichen Gebrauchswert überstieg (Pieth, 2019, S. 28). Viele Autoren kommen in ihrer Analyse zum Schluss, dass Gold im Anlagegeschäft eine Eigenschaft als sicherer Hafen aufweist. In diesem Zusammenhang benennt unter anderem Klein et al. (2018, S. 115) diese Eigenschaft von Gold als «flight-to-quality» (dt. Flucht in Qualitätsanlagen). Zu Beginn des Jahres 2020 wurde die globale Wirtschaft und Gesellschaft durch das Coronavirus hart getroffen. Die Mischung aus hohen Schulden, wenig Eigenkapital und der steigenden Spekulationen traf die Weltwirtschaft hart (Stelter, 2020, S. 33). Jedoch waren am Ende des Jahres 2021 die Prognosen positiv, dass sich die globale Wirtschaft von der Coronakrise erholen würde (Lübker & Janssen, 2022, S. 3). Die Weltlage veränderte sich durch den Angriff der russischen Streitkräfte vom 24. Februar 2022 auf die autonome Ukraine grundlegend (Lübker & Janssen, 2022, S. 3). In der Folge stiegen die globalen Energiepreise, was die Inflation anheizte, und die Kaufkraft der Löhne reduzierte. Dies erhöhte das Risiko von Armut und hemmte weitere Investitionen (Lübker & Janssen, 2022, S. 3). In der Folge stieg der «Global Geopolitical Risk Index» (GPR) nach Ausbruch des Krieges auf das höchste Niveau seit dem Einmarsch durch die USA in den Irak (Zhao, 2023, S. 7). Nach dem Rückblick auf verschiedene negative und unsichere Entwicklungen der letzten drei Jahre, drängt sich die Frage auf, warum sich der Goldpreis, anders als zu erwarten war, im Jahr 2022 entwickelt hatte. Die negative Korrelation des US-Dollars war einer der Haupttreiber. Der US-Dollar-Index (USDX) misst den Wert des US-Dollars im Vergleich zu den sechs wichtigsten Währungen (Mensi et al., 2023, S. 220). Nach einer längeren Aufschwungsphase begann dieser ab November 2022 wieder zu sinken. Zum gleichen Zeitpunkt stieg auch der Goldpreis wieder an (vergl. Abbildung 4 und Abbildung 26). Ein weiterer wichtiger Treiber waren die mehrmaligen Erhöhungen der Leitzinsen durch das Fed, welche früher und stärker erfolgten als bei anderen Zentralbanken. Deshalb waren US-Staatsanleihen auch attraktiver als andere, was den US-Dollar abermals aufwertete (Hofer, 2023)

Umgang mit erneuerbaren Ressourcen: Herausforderung Nachhaltigkeit

Die Welt(wirtschaft) ‐ und mit ihr der Umgang mit erneuerbaren Ressourcen ‐ hat sich in den letzten 300 Jahren grundlegend geändert; die Herausforderungen einer nachhaltigen Entwicklung bleiben</jats:p

Stakeholder dialogue for sustainability : the challenge of thinking between boxes

Between November 2014 and May 2015 saguf board members participated in the Stakeholder Dialogue for Sustainability initiated by the Swiss Federal Council (Bundesrat). The goal of this consultation process was to inform and jointly advance the elaboration of the Federal Council’s Sustainable Development Strategy 2016-2019 (Swiss Federal Council 2016) that was adopted in January 2016. This contribution presents and discusses the Stakeholder Dialogue from saguf’s point of view. Its aim is to reflect on this experience and on the question of how an academic society dedicated to strengthening environmental research and education as a cornerstone for sustainability can contribute to processes such as the federal Stakeholder Dialogue. We argue that one central contribution is to make the case for an integrative approach to tackling sustainable development issues. This contribution presents and discusses the Stakeholder Dialogue from saguf's point of view. Its aim is to reflect on this experience and on the question of how an academic society dedicated to strengthening environmental research and education as a cornerstone for sustainability can contribute to processes such as the federal Stakeholder Dialogue. We argue that one central contribution is to make the case for an integrative approach to tackling sustainable development issues

Nachhaltigkeit: Politik im 21. Jahrhundert: Der Weg von Rio: Für eine Welt mit Zukunft: Schweiz: Nachhaltigkeit in den Alpen

Schweift der Blick über das Berner Oberland mit seinen mit ewigem Schnee überzogenen Gipfeln, die im Alpenglühen unveränderlich erscheinen, spürt der Fuss den Nagelfluh unter sich, eigentlich ein Recyclingprodukt längst verschwundener geologischer Formationen und selbst seit Millionen von Jahren wieder Formation, dann könnte man glauben, Nachhaltigkeit sei ein Synonym für die Schweiz. Tatsächlich gibt es in diesem Land eine lebhafte Debatte, wie in der Moderne das natürliche Erbe, das die Qualität und die Dauerhaftigkeit des Lebens ausmacht, bewahrt werden kann. Von daher verwundert es nicht, dass Stephan Schmidheiny, der mit seiner Unternehmerinitiative für eine nachhaltige Entwicklung weltweit Furore gemacht hat und ein wichtiger Ratgeber in diesen Fragen für die Vereinten Nationen ist, aus dem süd-lichen Nachbarland Deutschlands stammt

Game-based training of selective voluntary motor control in children and youth with upper motor neuron lesions: protocol for a multiple baseline design study

Background Impairments of selective control of joint movements can have consequences for many activities of daily life, but there are only a few interventions to improve selective voluntary motor control (SVMC). We have developed a treatment option to specifically enhance SVMC exploiting the advantages of interactive computer play technology. It targets SVMC by training selective activation of a muscle or a selective joint movement while it provides immediate feedback about involuntary muscle activations/movements at an (unwanted) joint. This study aims to investigate the effectiveness of this game-based intervention to enhance SVMC in children and youth with upper motor neuron lesions. Methods We will conduct a randomized, non-concurrent, multiple baseline design study. Patients aged between 6 and 20 years with reduced SVMC due to an upper motor neuron lesion will be included. During the baseline phase of random length, participants will attend their regular intensive rehabilitation program, and in the intervention phase, they will additionally complete 10 therapy sessions (à 40 min) of the game-based SVMC training. The primary outcome will be a short SVMC assessment conducted repeatedly throughout both phases, which quantifies movement accuracy and involuntary movements. Changes in clinical SVMC measures, muscle strength, cortical excitability, motor control of the inhibited/unwanted movement, and functional independence will be assessed as secondary outcomes. We will use a mixed-effect model to determine the change in the course of the primary outcome when the intervention is introduced, and we will compare changes between phases for secondary outcomes with paired tests. Discussion This study will provide first evidence whether SVMC can be improved with our game-based training. The single-case design takes into account the individualization required for this intervention, and it can help to address the challenges of intervention trials in our setting. Trial registration German Clinical Trials Register: DRKS00025184, registered on 28.04.2021

Eosinophils and Oral Squamous Cell Carcinoma: A Short Review

The eosinophil cell has been related as a prognostic indicator for cancers. However, its exact function in tumour behaviour is still not clearly defined. In the oral cavity the presence of eosinophils can be a favourable prognostic indicator as well as it may be associated with a poor prognosis. In this short review, we briefly summarize the role of the eosinophils in the general context of immunoregulation and its relation to oral squamous cell carcinoma