Resting Energy Expenditure of Children With End-stage Chronic Liver Disease Before and After Liver Transplantation

Objectives: Our objective was to test the hypothesis that children with end-stage chronic liver disease (ESCLD) are hypermetabolic when compared to healthy children, and that this hypermetabolism persists for at least 6 months after liver transplant. Methods: Seventeen patients with end-stage chronic liver disease and 14 healthy controls had their resting energy expenditure measured (mREE) by indirect calorimetry. Weight, height, and body mass index were converted to standard deviation (SD) scores. Children older than 5 years had air displacement plethysmography and patients older than 5 years also had whole body dual-energy X-ray absorptiometry with characterization of fat mass (FM), fat-free mass (FFM), and bone-free fat free (lean) mass. Results: When compared to the prediction equation 44% of the patients and 50% of the healthy controls were hypermetabolic. The younger patients (0–5 years) had a lower mREE than the healthy controls but were significantly lighter and shorter than their healthy counterparts. mREE correlated strongly for all children with age, weight, height, and FFM. There was a strong negative correlation between age and mREE/kg in both patients (rs = −0.94, P < 0.01) and controls (rs = −0.91, P < 0.01). Almost 84% of the variance in mREE was explained by age (P < 0.001). There were no significant differences between resting energy expenditure (REE)/FFM between the 2 groups. mREE/kg before liver transplant correlated with mREE/kg after transplant (Pearson r = 0.83, P < 0.01). Conclusions: REE mostly reflected the size of the child. The patients were not hypermetabolic when compared to the healthy children. The main determinant of REE/kg after transplant was REE/kg before transplant

A percepção dos funcionários sobre a avaliação de desempenho : um estudo de caso na Agência Empresarial Curitiba Norte do Banco do Brasil S/A

Orientador: Neusa Vitola PasettoMonografia (Especialização) - Universidade Federal do Paraná, Setor de Ciências Sociais Aplicadas, Curso de Especialização em Administração de PessoasResumo: Na economia do conhecimento, onde as mudanças ocorrem em velocidades nunca antes imaginadas, as empresas para serem competitivas e assegurarem sua sobrevivência, necessitam transformar as pessoas que nelas trabalham, gerenciando o seu desenvolvimento. Para se adequar a estas mudanças, as empresas precisam estar muito bem preparadas, principalmente através de um planejamento, de um acompanhamento, de uma avaliação, e análise do desempenho que contribuem para a melhoria dos resultados organizacionais. A Avaliação de Desempenho se constitui em um meio para desenvolver os recursos humanos da organização. Buscou-se neste estudo, analisar a percepção dos funcionários de uma unidade de atendimento do Banco do Brasil S/ A, sobre o modelo de Avaliação de Desempenho em vigor na empresa. Os dados para o estudo foram coletados através de um questionário, junto o corpo funcional da agência Empresarial Curitiba Norte. Os resultados obtidos indicam que o sucesso ou não de um sistema de avaliação depende de diversos fatores (ambiente de trabalho, estilo gerencial, conhecimento do processo, dentre outros) e principalmente do envolvimento de todos no processo, tanto avaliado quanto avaliado

Language processing from the perspective of electrical stimulation mapping

Electrical Stimulation (ES) is a neurostimulation technique that is used to localize language functions in the brain of people with intractable epilepsy and/or brain tumors. We reviewed 25 ES articles published between 1984 and 2018 and interpreted them from a cognitive neuropsychological perspective. Our aim was to highlight ES as a tool to further our understanding of cognitive models of language. We focused on associations and dissociations between cognitive functions within the framework of two non-neuroanatomically specified models of language. Also, we discussed parallels between the ES and the stroke literatures and showed how ES data can help us to generate hypotheses regarding how language is processed. A good understanding of cognitive models of language is essential to motivate task selection and to tailor surgical procedures, for example, by avoiding testing the same cognitive functions and understanding which functions may be more or less relevant to be tested during surgery

Case report: the effects of cerebellar tDCS in bilingual post-stroke aphasia

Transcranial Direct Current Stimulation may be a useful neuromodulation tool for enhancing the effects of speech and language therapy in people with aphasia, but research so far has focused on monolinguals. We present the effects of 9 sessions of anodal cerebellar tDCS (ctDCS) coupled with language therapy in a bilingual patient with chronic post-stroke aphasia caused by left frontal ischemia, in a double-blind, sham-controlled within-subject design. Language therapy was provided in his second language (L2). Both sham and anodal treatment improved trained picture naming in the treated language (L2), while anodal ctDCS in addition improved picture naming of untrained items in L2 and his first language, L1. Picture description improved in L2 and L1 after anodal ctDCS, but not after sham

Treating lexical retrieval using letter fluency and tDCS in primary progressive aphasia:a single-case study

Background: In early stages, individuals with primary progressive aphasia (PPA) report language symptoms while scoring within norm in formal language tests. Early intervention is important due to the progressive nature of the disease. Method: We report a single-case study of an individual with logopenic variant PPA (lvPPA). We tested whether letter fluency, used as a therapy task, can improve lexical retrieval when combined with tDCS to either the left inferior-frontal gyrus (IFG) or the left inferior parietal lobe (IPL), administered in two separate therapy phases separated by a wash-out period of 3 months. Outcomes and results: We observed increases in number of words retrieved during a letter fluency task in trained and untrained letters, when letter fluency therapy (LeFT) was administered with anodal tDCS. When LeFT was combined with left IFG stimulation, words produced in a letter fluency task were lower frequency and higher age of acquisition after treatment, compared to before treatment and there was also an increase in accuracy and response times in an untrained picture-naming task. Conclusions: The results indicate that letter fluency therapy combined anodal tDCS is effective in improving lexical retrieval, particularly when left IFG stimulation was used. Effects generalize beyond the trained task, albeit slowing down of responses in picture naming. This task may provide a useful clinical intervention strategy for patients with mild anomia, who are not challenged enough by traditional naming therapies

Patterns of Decline on Language Testing in Primary Progressive Aphasia

The aim of this study was to investigate patterns of decline on language testing in subtypes of primary progressive aphasia (PPA) and to examine the effects of other variables on rate of decline. Forty-six patients with PPA (mean age = 66.9 + 6.6; 27 female; mean education = 16.4 + 2.8) completed language testing. PPA subtypes were not distinguishable by rapidity of decline; however, there were different patterns of performance on language testing. Age and education did not affect rate of decline on any test. These results have implications for patient/family education regarding language deterioration and future planning

Evaluation of sensory and biochemical changes in freshwater catfish stored under vacuum and different modified atmospheres.

The present study was carried out to compare the influence of six different packaging atmospheres (air, vacuum and MAPs including 5% O2 + 40% CO2 + 55% N2, 5% O2 + 60% CO2 + 35% N2, 5% O2 + 80% CO2 + 15% N2 and 100% CO2) on the biochemical and sensory attributes of freshwater catfish fillets stored at 4 °C. Fillets were monitored for biochemical parameters (pH, total volatile bases nitrogen (TVBN), lipid oxidation) and sensory attributes for 21 days. Proximate and fatty acid composition were also determined in fresh fillets. The sensory quality of all fillets was acceptable during the first 13 ± 1 days of storage in air, 16 ± 1 days of storage in vacuum and MAP1, 18 ± 1 days of storage in MAP2 and 20 ± 1 days of storage in MAP3. The overall sensory scores for fillets which were packed under 100% CO2 were higher than the acceptable limit at the end of storage. It was found that fillets consisted of 5.71 g lipid per 100 g which is susceptible to oxidation due to the high amount of unsaturated fatty acids (63.86%) versus saturated fatty acids (31.14%). Vacuum packed and 100% CO2 fillets showed the lowest TBARS values while air-stored samples showed the highest TBA values. TVBN increased negligibly during storage in all treatments and never exceeded the acceptability limit (35 mg N per 100 g). It can be concluded that 100% CO2 was the best evaluated atmosphere for storage of catfish fillets at 4 °C with superior biochemical and sensory attributes

The Role of Language Severity and Education in Explaining Performance on Object and Action Naming in Primary Progressive Aphasia

Despite the common assumption that atrophy in a certain brain area would compromise the function that it subserves, this is not always the case, especially in complex clinical syndromes such as primary progressive aphasia (PPA). Clinical and demographic information may contribute to PPA phenotypes and explain the manifested impairments better than atrophy. In the present study, we asked how much variance of the object and action naming impairments observed in PPA may be attributed to atrophy in the language network alone vs. additional clinical and demographic factors including language severity and education. Thirty-nine participants with PPA underwent magnetic resonance imaging (MRI) for volumetric analysis and a complete neuropsychological examination, including standardized tests of object and action naming. We used stepwise regression models to compare atrophy (volumetric model) to clinical/demographic variables (clinical-demographic model) for naming objects and actions. The clinical-demographic model was the best-fit model that explained the largest amount of variance in both object and action naming. Brain volume measurements alone explained little variance in both object and action naming. Clinical factors, particularly language severity, and demographic factors, particularly education, need to be considered in conjunction with brain volumes in PPA. The present study emphasizes the complexity of PPA as a syndrome and provides an example of how volumetric, clinical and demographic factors may interact in determining naming performance/deterioration

The on-line processing of unaccusativity in Greek agrammatism

We investigated the on-line processing of unaccusative and unergative sentences in a group of eight Greek-speaking individuals diagnosed with Broca aphasia and a group of language-unimpaired subjects used as the baseline. The processing of unaccusativity refers to the reactivation of the postverbal trace by retrieving the mnemonic representation of the verb’s syntactically defined antecedent provided in the early part of the sentence. Our results demonstrate that the Broca group showed selective reactivation of the antecedent for the unaccusatives. We consider several interpretations for our data, including explanations focusing on the transitivization properties of nonactive and active voice-alternating unaccusatives, the costly procedure claimed to underlie the parsing of active nonvoice-alternating unaccusatives, and the animacy of the antecedent modulating the syntactic choices of the patients