Language re-discovered: A death education intervention in the net between kindergarten, family and territory

The article presents the positive results of a death education experience, realized owing to a collaboration between school, family and territory. The project, with the scope of reflecting on topics of death and spirituality, included 46 children of 5 from kindergarten and 50 parents, and then mobilizing the entire community. Social services and public administration had a special role in this, aiming to guarantee the necessary support for the families in the existential reflections. The experience was monitored with participatory observation, via interviews and questionnaires. The children answered questions regarding death and spirituality during an open and sincere conversation with the teachers. The parents, who at home talked about certain pre-defined teams with the children, were asked to give their informed consent and were given a questionnaire with open questions ex-ante/ ex-post. All data were processed via qualitative analysis of the texts. The results are truly positive, showing that children are capable of facing the problem of death and are able to acquire a certain representation of the spiritual dimension. The parents, who in the beginning demonstrated some anxiety, eventually were greatly satisfied and expressed their willingness to continue to search for the connection between death and transcendence

Estimating Fiscal Multipliers: News From A Non-linear World

We estimate non-linear VARs to assess to what extent fiscal spending multipliers are countercyclical in the US. We deal with the issue of non-fundamentalness due to fiscal foresight by appealing to sums of revisions of expectations of fiscal expenditures. This measure of anticipated fiscal shocks is shown to carry valuable information about future dynamics of public spending. Results based on generalised impulse responses suggest that fiscal spending multipliers in recessions are greater than one, but not statistically larger than those in expansions. However, non-linearities arise when focusing on 'extreme' events, that is, deep recessions versus strong expansionary periods

Home range dynamics of mountain hares (Lepus timidus) in the Swiss Alps.

Little is known on the ecology and behaviour of the alpine mountain hare (Lepus timidus). Between 1996 and 1997, we analysed by radiotracking the pattern of space use of 8 mountain hares from the Swiss Alps. We estimated home range size using both the kernel density estimator and the minimum convex polygon. We found smaller ranges (38 ha) compared to those reported for the species in boreal or arctic habitats, but similar to ranges in Scotland. Hares did not use a centre of major activity (core area) and showed high home range overlap, confirming their non-territorial behaviour. Smaller ranges were used during winter compared to the other seasons, whilst no difference in size was found between sexes

Primary Absence of Type II Endoleak is A Positive Prognostic Factor against the Risk of Late Conversion of EVAR for AAA

Introduction: The aim of this study is to analyze 12 late conversion to open surgery after Endovascular Repair of Abdominal Aortic Aneurysms (EVAR) while comparing the follow up of these cases to that of the definitely successful procedures (absence of surgical conversion, type I or III endoleaks, or presence of type II endoleaks without any aneurysmal sac enlargement) . Methods: From a series of over 300 EVAR procedures performed at our department we have selected 215 cases with a follow up ≥ 6 month and primary technical success (successful deployment of the devices and discharge of patients without neither type I nor III endoleaks). Based on the final data recorded at the end of the follow up (mean+ IQR: 38.16 months + 41), these cases were divided into three groups: group 1, with 12 cases (5.6%) which needed surgical conversion in a later stage (5 to 55 months from EVAR); group 2, with 39 cases (18.1%) with type II endoleaks without aneurysmal sac enlargement; group 3, with 164 cases (76.5%) without endoleaks. The groups were compared in relation to the following parameters: a) personal data and common atherogenic risk factor, b) diameter of the aneurysm, c) kind of the proximal fixation of the endograft (suprarenal or infrarenal), d) presence of endoleaks at the first postoperative check. We have compared the data from the three groups and we have analyzed them with chi-square test (Χ2). Results: Personal data and common atherogenic risk factor have proved no significant difference among the three groups. The incidence of the other three parameters of group 1 was compared with the incidence of these in groups 2 and 3: the mean pre-operative diameter of the aneurysm results 51 mm in group 1, 54 mm in group 2 and 55 mm in group 3 (not significant); suprarenal fixation of the prosthesis accounts for 50% in group 1, 51% in group 2 and 60% in group 3 (not significant); presence of type II endoleak at the first post-operative check was 41.6% in group 1, 56.4% in group 2 (not significant) and 9.7% in group 3 (p<0.001, compared to groups 1 and 2). Conclusion: In the EVAR procedures with primary technical success, the absence of type II endoleak at the first post-operative check represents a favorable prognostic factor against the risk of late conversion to open repair. Personal data, common atherogenic risk factor, diameter of the aneurysm and fixing type of the prosthesis don’t seem to influence the onset of this complication

Raised homocystein plasma concentration in patients with Heart Failure: clinical significance

Elevated plasma levels of homocysteine is associated with increased risk of thrombotic and atherosclerotic vascular disease. Several studies have demonstrated that hyperhomocysteinemia is an indipendent risk factor for vascular disease and is associated to heart failure. However there are no data regarding the association between homocysteine and various objective as well as subjective measures of heart failure. We hypothesized that plasma homocysteine is associated with clinical and echocardiographic signs of heart failure. On this ground we have analysed levels of homocysteine in patients with heart failure and possible correlation between these levels and clinical-functional pattern (NYHA class and ejection fraction). Methods: Plasma homocysteine levels were determined in 123 patients with dilated cardiomyopathy (59 males, 64 females, mean age 67±10 years, mean EF 31±11% and mean NYHA 2.4±0.9, 47 idiopatic and 76 postischemic cardiomyopathy) and 85 healthy control subjects (homogeneus group for sex and age). Patients with chronic renal failure, vitamin B12 and folate deficiency or factors affecting homocysteine plasma levels were escluded from this study. Homocysteine levels were determined in coded plasma samples by immunoenzimatic methods. Results: Patients with heart failure had a higher homocysteine level (mcg/L) than control subjects (21.72±10.28 vs 12.9±6.86, p<0,001) both postischemic (20.89±9.6 vs 12.9±6.86, p<0,001) and idiopatic cardiomiopathy (23.0±11.2 vs 12.9±6.86, p<0,001). A significant correlation was observed between homocysteine and NYHA functional class (p<0,001), age (p<0,001), creatinine (p<0,001), colesterol (p<0,05) while no correlations were observed with hemodynamic (HR, BP), functional (ejection fraction) and other metabolic parameters (triglycerides). Serum homocysteine was lowest in control and increased with increasing NYHA class. In idiopatic cardiomiopathy the correlation between homocysteine and NYHA functional class, creatinine (p<0,001), fibrinogen (p<0,05) was confirmed; in postischemic cardiomiopathy a significant correlation with creatinine and NYHA class (p<0,001) and with triglycerides (p<0,05) was also found. Conclusion: Plasma homocysteine was directly related to NYHA class. This observation may underline the strong relations of plasma homocysteine to congestive heart failure. Further research is indicated to evaluate a causal or noncausal mechanism for this association

Development of broad-spectrum human monoclonal antibodies for rabies post-exposure prophylaxis

Currently available rabies post-exposure prophylaxis (PEP) for use in humans includes equine or human rabies immunoglobulins (RIG). The replacement of RIG with an equally or more potent and safer product is strongly encouraged due to the high costs and limited availability of existing RIG. In this study, we identified two broadly neutralizing human monoclonal antibodies that represent a valid and affordable alternative to RIG in rabies PEP. Memory B cells from four selected vaccinated donors were immortalized and monoclonal antibodies were tested for neutralizing activity and epitope specificity. Two antibodies, identified as RVC20 and RVC58 (binding to antigenic site I and III, respectively), were selected for their potency and broad-spectrum reactivity. In vitro, RVC20 and RVC58 were able to neutralize all 35 rabies virus (RABV) and 25 non-RABV lyssaviruses. They showed higher potency and breath compared to antibodies under clinical development (namely CR57, CR4098, and RAB1) and commercially available human RIG. In vivo, the RVC20-RVC58 cocktail protected Syrian hamsters from a lethal RABV challenge and did not affect the endogenous hamster post-vaccination antibody response

Transplantation of clinical-grade human neural stem cells reduces neuroinflammation, prolongs survival and delays disease progression in the SOD1 rats.

Abstract Stem cells are emerging as a therapeutic option for incurable diseases, such as Amyotrophic Lateral Sclerosis (ALS). However, critical issues are related to their origin as well as to the need to deepen our knowledge of the therapeutic actions exerted by these cells. Here, we investigate the therapeutic potential of clinical-grade human neural stem cells (hNSCs) that have been successfully used in a recently concluded phase I clinical trial for ALS patients (NCT01640067). The hNSCs were transplanted bilaterally into the anterior horns of the lumbar spinal cord (four grafts each, segments L3–L4) of superoxide dismutase 1 G93A transgenic rats (SOD1 rats) at the symptomatic stage. Controls included untreated SOD1 rats (CTRL) and those treated with HBSS (HBSS). Motor symptoms and histological hallmarks of the disease were evaluated at three progressive time points: 15 and 40 days after transplant (DAT), and end stage. Animals were treated by transient immunosuppression (for 15 days, starting at time of transplantation). Under these conditions, hNSCs integrated extensively within the cord, differentiated into neural phenotypes and migrated rostro-caudally, up to 3.77 ± 0.63 cm from the injection site. The transplanted cells delayed decreases in body weight and deterioration of motor performance in the SOD1 rats. At 40DAT, the anterior horns at L3–L4 revealed a higher density of motoneurons and fewer activated astroglial and microglial cells. Accordingly, the overall survival of transplanted rats was significantly enhanced with no rejection of hNSCs observed. We demonstrated that the beneficial effects observed after stem cell transplantation arises from multiple events that counteract several aspects of the disease, a crucial feature for multifactorial diseases, such as ALS. The combination of therapeutic approaches that target different pathogenic mechanisms of the disorder, including pharmacology, molecular therapy and cell transplantation, will increase the chances of a clinically successful therapy for ALS

Predicting heart failure outcome from cardiac and comorbid conditions: The 3C-HF score

Background: Prognostic stratification in heart failure (HF) is crucial to guide clinical management and treatment decision-making. Currently available models to predict HF outcome have multiple limitations. We developed a simple risk stratification model, based on routinely available clinical information including comorbidities, the Cardiac and Comorbid Conditions HF (3C-HF) Score, to predict all-cause 1-year mortality in HF patients. Methods: We recruited in a cohort study 6274 consecutive HF patients at 24 Cardiology and Internal Medicine Units in Europe. 2016 subjects formed the derivation cohort and 4258 the validation cohort.Weentered information on cardiac and comorbid candidate prognostic predictors in amultivariablemodel to predict 1-year outcome