Pediatric liver diseases: current challenges and future perspectives

Chronic liver diseases in children represent a rising problem with significant effects on public health. In fact, several pediatric liver diseases are precursors of adult chronic hepatopathies, cirrhosis and hepatocellular carcinoma. The prevalence of liver diseases in children is unknown. In the USA, every year, 15,000 children are hospitalized for liver diseases, but these disorders continue to be under-recognized or diagnosed late. The main reason is due to the frequent absence of symptoms in the vast majority of liver diseases, especially in the early stages. In the last few decades several advances have been made in understanding the pathogenesis of liver diseases, permitting the discovery of new therapeutic targets to treat liver diseases, thus improving the natural history of these disorders. In this article we discuss the most recent advances in the understanding of the pathogenesis, diagnosis and treatment of the most frequent pediatric liver diseases

ADAPTIVE SWITCHING CONTROL OF QUADRATICALLY STABILIZABLE UNCERTAIN SYSTEMS WITH AN ANESTHESIA APPLICATION

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Using logistic redesigner (Lo.R.D.) software for designing and simulating a steel supply chain

This paper regards the analysis of the development of a logistics and transportation network concerning a steel plant. The main goal is to search for the best scenario that allows to supply the plant and to distribute all the finished products to final customers in the most efficient way. To this aim, a proper simulation model has been developed and implemented utilizing Logistics Re Designer (Lo. R. D.) software. More specifically, three different transportation networks have been created: two “single” modal choice scenarios - by road or by rail – and an “intermodal” one. Another system variable regards the production capacity of the steel plant: three different types of capacity have been considered; so in total nine scenarios have been taken into consideration. The results obtained indicate that the intermodal solution is the most suitable to be adopted both in terms of total time – and consequently costs - and resources required to perform all the necessary operations. Future research will focus on the improvement of the solution found and on the development of an economical analysis

Study of an emergency situation using 2D and 3D simulation models

Safety in motorway tunnels has become a critical issue in the last years, especially after the accident happened in 1999 inside the Mont Blanc tunnel, causing 39 deaths and several dozens of intoxications and wounded people. After this tragic event, the European Union imposed stricter regulations and procedures for emergency situations inside road tunnels longer than 1000 m. According to this situation, the authors propose the use of M&S (Modeling and Simulation) in order to manage a tunnel evacuation after a fire exploding in consequence to an accident, taking into account a series of significant factors like the road signs position (new criteria have been introduced with new regulation), but also human factors which significantly affect the procedure outcome. First a 2-D simulation model has been developed using Java™ Software, in which the user can analyze the behavior of the people escaping and the dynamics of the fire exploded and, consequently, assess the effectiveness of all the emergency procedures and infrastructures. In particular, regarding the state variables related to the human behavior, the model takes into account the main aspects of PECS (Physical Emotional Cognitive Social) reference models, in which physical, emotional, cognitive and social factors have to be studied. The model presented in this work is in fact quite similar to the one described by (Schmidt, 2000), called “Adam’s World” where Adam, a primitive man, lives in an environment having food sources where he can replenish his energy level, but also traps and danger points to be avoided in order not to consume his energy faster. The aim of the two models is the same: first of all preserve life and health, but the great difference between Schmidt’s model and the authors’ one is that in Adam’s World the social aspect is missing (Adam live alone in his world), while in the evacuation model social aspects can significantly affect the individual’s decisions. Upstream of the evacuation model, a weighted analysis needs to be considered, in fact the individual has to operate different choices considering several aspects, like health or goods preservation, familiar aspects, panic and so on. For this reason a suitable methodology has been detected: the Analytic Hierarchic Process (AHP), implemented by the American mathematician Thomas Saaty, which introduced this technique for Multi-Criteria Analysis. After the considerations on the individuals behavior based on the results of the analysis, the evacuation model and its results are described and analyzed in the following sections and, in the final part of the paper, a description of a 3-D tunnel model devoted to study in particular smoke dynamics is provided, thus it is possible to evaluate the impact of the smoke on the flow of the people escaping from the tunnel

Trabalho docente com alunos público-alvo da educação especial na educação infantil

O presente artigo teve por objetivo analisar o trabalho docente, na Educação Infantil, com alunos Público-Alvo da Educação Especial (PAEE), em sala de aula comum, particularmente no que se refere a alunos com transtorno do espectro autista. Para tal, foi realizada uma pesquisa de abordagem qualitativa com a participação de uma docente da Educação Infantil, que atua em uma escola da rede municipal, de uma cidade do interior do estado de São Paulo. Para alcançar o objetivo proposto, a professora participou de uma entrevista semiestruturada. Como resultado, constatou-se, quanto à inclusão de aluno com transtorno do espectro autista, barreiras atitudinais e confusões conceituais sobre o perfil desse público. Foi verificada a necessidade de adoção de práticas colaborativas que envolvam não apenas o professor generalista, que atua na sala regular, e o especialista, responsável pela oferta de Atendimento Educacional Especializado (AEE), na sala de recursos multifuncionais, mas também a escola, como um todo, a família e demais profissionais envolvidos. É premente a necessidade de discussão acerca do descompasso entre o discurso e a prática de professores da Educação Infantil frente à inclusão de alunos PAEE, principalmente no que diz respeito ao aspecto atitudinal, aqui ressaltado pelas contradições acerca da favorabilidade à inclusão e das práticas pedagógicas inclusivas

A formação de professores para a educação inclusiva: alguns aspectos de um trabalho colaborativo entre pesquisadores e professores da educação infantil

To contribute to formation of Childhood Education teachers for the Inclusive Education, this article had as its central objective describe how it was addressed the issue of learning difficulties and the impact of misdiagnosis assigned to a child in the initial phase formal learning of writing, in one of the theoretical-reflective meetings undertaken with 43 teachers for Pre II, of the ten schools of Childhood Education of the state of São Paulo. Such a description was guided through the of the collaborative approach taken subproject “understanding about the clinical diagnosis of dyslexia and its impact on the educational future of children enrolled in classes II Pre Childhood education”, developed as one of the phases and as part of larger project called “depathologization of the learning of the writing and Inclusive Education: Reflections and actions of the professor of Childhood Education”. At the and, was possible the identification by the reports arising from the participation of teachers mentioned, the need to resignification their didactical experiences for the systematization of new actions aimed at coping with learning difficulties that pervade the process of appropriation writing of the students, which may contribute to depathologization of the school environment to the extent that teachers can assist students in building a more positive relationship with writing, rather than adopting rigid and restricted procedures that do not consider the relationship of each subject with writing and the singularities present in this relationship.A fim de contribuir com a formação de professores da Educação Infantil para a Educação Inclusiva, neste artigo, tivemos como objetivo central descrever o modo como foi abordada a questão das dificuldades de aprendizagem e o impacto de um diagnóstico equivocado atribuído a uma criança em fase inicial de aprendizagem formal da escrita, em um dos encontros teórico-reflexivos empreendidosjunto a 43 professores de classes de Pré II, de dez escolas municipais de Educação Infantil, de um município do interior do Estado de São Paulo. Tal descrição foi norteada pelas etapas da abordagem colaborativa consideradas no subprojeto “Compreensão acerca do diagnóstico clínico da Dislexia e seu impacto no futuro escolar da criança matriculada em classes de Pré II da Educação Infantil”, desenvolvido como uma das etapas do projeto maior denominado “Despatologização da aprendizagem da escrita e Educação Inclusiva: reflexões e ações do professor de Educação Infantil”. Ao final, foi possível a identificação,mediante os relatos dos professores mencionados, da necessidade de ressignificação de suas vivências e experiências didáticas para a sistematização de novas ações direcionadas ao enfrentamento das dificuldades de aprendizagem que perpassam o processo de apropriação da escrita de parte dos alunos, o que poderá contribuir para a despatologização do ambiente escolar, na medida em que os professores poderão auxiliar seus alunos na construção deuma relação mais positiva com a escrita, em detrimento da adoção de procedimentos rígidos e restritos que não consideram a relação de cada sujeito com a escrita e as singularidades presentes em tal relação. Palavras-chave: Educação; Formação de professores; Educação Inclusiva

Effectiveness of citrate buffer-fluoride mixture in Terumo tubes as an inhibitor of in vitro glycolysis

Introduction: Glycolysis affects glucose determination in vitro. The placement of sample tubes in ice-water slurry with plasma separation within 30 minutes is recommended, or alternatively the use of a glycolysis inhibitor. The aim of our two-steps study was to evaluate which Terumo tube is best for glucose determination in routine clinical setting. Materials and methods: In the first study, blood from 100 volunteers was collected into lithium heparin (LH), NaF/Na heparin (FH) and NaF/citrate buffer/Na2EDTA (FC-Mixture) tubes. LH sample was treated as recommended and considered as reference, while FH and FC-Mixture samples were aliquoted, maintained at room temperature (RT) for 1, 2 and 4 hours; centrifuged and plasma analysed in triplicate. In the second study, samples from 375 volunteers were collected in LH, FH and FC-Mixture tubes and held at RT before centrifugation from 10 to 340 minutes, depending on each laboratory practice. Samples were analysed in one analytical run. Results: In the first study, FH glucose concentrations were 5.15 ± 0.66 mmol/L, 5.05 ± 0.65 mmol/L and 5.00 ± 0.65 mmol/L (P < 0.001) in tubes stored at RT for 1, 2 and 4 hours, respectively. Mean biases in all time points exceeded the analytical goal for desirable bias based on biological variation criteria. FC-Mixture glucose concentrations were 5.48 ± 0.65 mmol/L, 5.46 ± 0.6 mmol/L and 5.46 ± 0.64 mmol/L in tubes stored at RT for 1, 2 and 4 hours, respectively. Mean biases for FC-Mixture glucose in all time points reached optimal analytical goals. In the second study, the biases for LH and FH glucose compared to reference FC-Mixture glucose exceeded the preset analytical goals, regardless of the blood collection to centrifugation time interval. Conclusions: FC-mixture tubes glucose concentrations were preserved up to 4h storage at RT. We confirmed that NaF alone does not allow immediate glycolysis inhibition in real life pre-centrifugation storage conditions (up to 340 minutes). FC-Mixture should be used exclusively for glucose determination in laboratories unable to implement the recommended blood samples’ treatment

Identification of far-red light acclimation in an endolithic Chroococcidiopsis strain and associated genomic features: Implications for oxygenic photosynthesis on exoplanets

Deserts represent extreme habitats where photosynthetic life is restricted to the lithic niche. The ability of rock-inhabiting cyanobacteria to modify their photosynthetic apparatus and harvest far-red light (near-infrared) was investigated in 10 strains of the genus Chroococcidiopsis, previously isolated from diverse endolithic and hypolithic desert communities. The analysis of their growth capacity, photosynthetic pigments, and apcE2-gene presence revealed that only Chroococcidiopsis sp. CCMEE 010 was capable of far-red light photoacclimation (FaRLiP). A total of 15 FaRLiP genes were identified, encoding paralogous subunits of photosystem I, photosystem II, and the phycobilisome, along with three regulatory elements. CCMEE 010 is unique among known FaRLiP strains by undergoing this acclimation process with a significantly reduced cluster, which lacks major photosystem I paralogs psaA and psaB. The identification of an endolithic, extremotolerant cyanobacterium capable of FaRLiP not only contributes to our appreciation of this phenotype’s distribution in nature but also has implications for the possibility of oxygenic photosynthesis on exoplanets

Survival kinase-dependent pathways contribute to gender difference in the response to myocardial ischemia–reperfusion and ischemic post-conditioning

The response to ischemia/reperfusion and the effects of ischemic post-conditioning (IPC) are sex-dependent, but the mechanisms have not been clarified. Male (M) and female (F) rat hearts isolated and perfused using the Langendorff technique were subject to 30 min of global ischemia (GI) and 60 min reperfusion (R). In IPC hearts, three cycles of 30-sec GI/30-sec R were applied at the beginning of R. Infarct size and myocardial function were assessed. Superoxide production, antioxidant systems, and expressions of phosphorylated forms of serine/threonine kinase (Akt), glycogen synthase kinase 3β (GSK-3β), protein kinase C ε (PKCε), endothelial nitric oxide synthase (eNOS), and apoptosis were measured. In the basal state, superoxide production and apoptosis were lower, and antioxidant systems and phospho-kinase expressions were higher in F rather than in M hearts. After ischemia–reperfusion, infarct size was less in F hearts, and post-ischemic recovery of myocardial function was higher in F rather than in M hearts. Superoxide production, phospho-kinase activity, phospho-eNOS, and apoptosis increased in both sexes while antioxidants decreased in both sexes. After IPC, infarct size, superoxide production, and apoptosis decreased and phospho-eNOS increased in F and M hearts but phospho-kinase expressions and post-ischemic recovery of myocardial function improved only in M hearts. These results show that Akt/GSK-3β/PKCε/eNOS-dependent pathways-mediated superoxide production and apoptosis appear as important factors involved in the observed gender differences.Centro de Investigaciones Cardiovasculare