Verso la prevenzione della dislessia evolutiva: uno studio clinico, longitudinale e riabilitativo

Reading is a unique, cognitive human skill crucial to life in modern societies, but, for about 10% of the children, learning to read is extremely difficult. They are affected by a neurodevelopmental disorder called developmental dyslexia. It is widely believed that impaired phonological processing characterizes individuals with developmental dyslexia. These phonological deficits would interfere with one of the most critical skills for successful reading acquisition, the phonological decoding ability. However, reading by phonological decoding also requires rapid selection of sublexical orthographic units through serial attentional orienting. Letters have to be precisely selected from irrelevant and cluttering letters by rapid orienting of visual attention before the correct letter-to-speech sound integration. In the first part of this dissertation, with a 3 year longitudinal study we show that prereading attentional abilities — assessed by serial search performance and spatial cueing facilitation — capture future reading acquisition skills in grades 1 and 2 after controlling for age, nonverbal IQ, speech-sound processing, and nonalphabetic crossmodal mapping. These evidences show that the etiology of dyslexia is multifactorial, and visuo-spatial attention abilities play a fundamental role in the reading acquisition. We know from literature that the simple act of playing action video game could change many aspects of visuo-spatial attention abilities, enhancing attentional capacity and resolution. In the second part of the dissertation, we show that testing two samples of adults video game players and non video game players on their diffused and focused spatial attention abilities — the same functions that are deficient in children with dyslexia — resulted enhanced in people that use video game. Starting from these evidence, and the fact that current treatments are high resource demanding, we tested the hypothesis that action video games could increase attentional and reading abilities. We demonstrate that only 12 hours of playing action video games — not involving any direct phonological or orthographic training — improve the reading abilities of children with dyslexia. We tested reading, phonological, and attentional skills in two matched groups of children with dyslexia before and after playing action or non-action video games for 9 daily sessions of 80 minutes. We found that only the group playing action video games improved their reading abilities, more so than after one year of spontaneous reading development and more or equal to highly-demanding traditional reading treatments. Attentional skills also improved during video game training. Individual differences in visual-spatial and cross-modal, temporal-attention improvements accounted for about 50% of the unique variance in the reading enhancement after controlling for age, IQ, and changes in phonological skills. In the last part of the dissertation, we present a new instrument, a serious game, developed to be used to increase all the cognitive functions that proved their influences on future reading abilities. We show that comparing the serious game scores obtained after a single session evalutation of a sample of preschooler children with and without familial risk for developmental dyslexia, we found differences in the mini games where attentional and phonological performances where tested. These results suggest that the future realization of a treatment based on this serious game could lead to the strengthening of these functions and the decrease in the severity and the incidence of developmental dyslexia in at risk childre

Simulation of TALL-3D experimental facility with a multiscale and multiphysics computational platform

This work details the development of a computational platform in joint collaboration between the Italian National Agency for New Technologies, Energy and Sustainable Economic Development (enea) and the University of Bologna (unibo). The platform is based on the open-source SALOME software that integrates the CATHARE system code for nuclear safety, FEMUS and OpenFOAM CFD codes in a unique framework, with efficient methods for data exchange. The computational platform has been used to simulate complex multiscale and multiphysics systems, such as the tall-3d facility, with a defective boundary condition approach on overlapping domains. The tall-3d experimental facility has been realized with the purpose of providing reference results to be used for both standalone and coupled System Thermal-Hydraulic (STH) and Computational Fluid Dynamic (CFD) code validation. The transient phenomenon of unprotected loss of lead-bismuth eutectic (LBE) flow that has been experimentally simulated at tall-3d is here studied. The system code is used to simulate the tall-3d apparatus while the CFD code is used to get a better insight into the fluid streaming occurring in the main tank component and improve the system code predictions. A flow transition from forced to natural convection is used to validate the codes and the platform ability to reproduce the experimental data

Pneumocystis jirovecii pneumonia in patients with decompensated cirrhosis: a case series

Objectives: Pneumocystis jirovecii pneumonia (PCP) incidence is increasing in people without HIV. Decompensated liver cirrhosis is not currently considered a risk factor for PCP. The aim of this paper is to describe a case series of patients with decompensated liver cirrhosis and PCP. Methods: All consecutive patients hospitalized with decompensated cirrhosis and microbiology-confirmed PCP at Policlinico Modena University Hospital from January 1, 2016 to December 31, 2021 were included in our series. Results: Eight patients were included. All patients had advanced-stage liver disease with a model for end-stage liver disease score above 15 (6/8 above 20). Four were on an active orthotopic liver transplant waiting list at the time of PCP diagnosis. Five patients did not have any traditional risk factor for PCP, whereas the other three were on glucocorticoid treatment for acute-on-chronic liver failure. All patients were treated with cotrimoxazole, except two who died before the diagnosis. Five patients died (62.5%), four of them within 30 days from PCP diagnosis. Of the remaining three, one patient underwent liver transplantation. Conclusion: Although further studies are needed, liver cirrhosis can be an independent risk factor for PCP in patients with decompensated cirrhosis that is mainly due to severe alcoholic hepatitis and who are on corticosteroids therapy, and primary prophylaxis for PCP should be considered

ESTUDO ETNOBOTÂNICO DE CIPÓS COMERCIALIZADOS COMO MEDICINAIS POR RAIZEIROS DE CUIABA, MATO GROSSO, BRASIL

A UTILIZAÇÃO DAS PLANTAS MEDICINAIS É UMA PRÁTICA COMUM ENTRE AS POPULAÇÕES DO MUNDO

ASTRI Mini-Array core science at the Observatorio del Teide

The ASTRI (Astrofisica con Specchi a Tecnologia Replicante Italiana) Project led by the Italian National Institute for Astrophysics (INAF) is developing and will deploy at the Observatorio del Teide a mini-array (ASTRI Mini-Array) composed of nine telescopes similar to the small-size dual-mirror Schwarzschild-Couder telescope (ASTRI-Horn) currently operating on the slopes of Mt. Etna in Sicily. The ASTRI Mini-Array will surpass the current Cherenkov telescope array differential sensitivity above a few tera-electronvolt (TeV), extending the energy band well above hundreds of TeV. This will allow us to explore a new window of the electromagnetic spectrum, by convolving the sensitivity performance with excellent angular and energy resolution figures. In this paper we describe the Core Science that we will address during the first four years of operation, providing examples of the breakthrough results that we will obtain when dealing with current open questions, such as the acceleration of cosmic rays, cosmology and fundamental physics and the new window, for the TeV energy band, of the time-domain astrophysics

Verso la prevenzione della dislessia evolutiva: uno studio clinico, longitudinale e riabilitativo

Reading is a unique, cognitive human skill crucial to life in modern societies, but, for about 10% of the children, learning to read is extremely difficult. They are affected by a neurodevelopmental disorder called developmental dyslexia. It is widely believed that impaired phonological processing characterizes individuals with developmental dyslexia. These phonological deficits would interfere with one of the most critical skills for successful reading acquisition, the phonological decoding ability. However, reading by phonological decoding also requires rapid selection of sublexical orthographic units through serial attentional orienting. Letters have to be precisely selected from irrelevant and cluttering letters by rapid orienting of visual attention before the correct letter-to-speech sound integration. In the first part of this dissertation, with a 3 year longitudinal study we show that prereading attentional abilities — assessed by serial search performance and spatial cueing facilitation — capture future reading acquisition skills in grades 1 and 2 after controlling for age, nonverbal IQ, speech-sound processing, and nonalphabetic crossmodal mapping. These evidences show that the etiology of dyslexia is multifactorial, and visuo-spatial attention abilities play a fundamental role in the reading acquisition. We know from literature that the simple act of playing action video game could change many aspects of visuo-spatial attention abilities, enhancing attentional capacity and resolution. In the second part of the dissertation, we show that testing two samples of adults video game players and non video game players on their diffused and focused spatial attention abilities — the same functions that are deficient in children with dyslexia — resulted enhanced in people that use video game. Starting from these evidence, and the fact that current treatments are high resource demanding, we tested the hypothesis that action video games could increase attentional and reading abilities. We demonstrate that only 12 hours of playing action video games — not involving any direct phonological or orthographic training — improve the reading abilities of children with dyslexia. We tested reading, phonological, and attentional skills in two matched groups of children with dyslexia before and after playing action or non-action video games for 9 daily sessions of 80 minutes. We found that only the group playing action video games improved their reading abilities, more so than after one year of spontaneous reading development and more or equal to highly-demanding traditional reading treatments. Attentional skills also improved during video game training. Individual differences in visual-spatial and cross-modal, temporal-attention improvements accounted for about 50% of the unique variance in the reading enhancement after controlling for age, IQ, and changes in phonological skills. In the last part of the dissertation, we present a new instrument, a serious game, developed to be used to increase all the cognitive functions that proved their influences on future reading abilities. We show that comparing the serious game scores obtained after a single session evalutation of a sample of preschooler children with and without familial risk for developmental dyslexia, we found differences in the mini games where attentional and phonological performances where tested. These results suggest that the future realization of a treatment based on this serious game could lead to the strengthening of these functions and the decrease in the severity and the incidence of developmental dyslexia in at risk childrenLa lettura è una capacità prettamente umana, una funzione cruciale per vivere nella società moderna, ma per circa il 10% dei bambini, imparare a leggere risulta estremamente difficile. Questi bambini soffrono di un disturbo neuroevolutivo chiamato dislessia. E’ largamente condivisa l’idea che le persone affette da dislessia evolutiva siano caratterizzate da un difetto nei processi di elaborazione fonologica. Tali deficit interferirebbero con la competenza fondamentale per l’acquisizione della lettura, l’abilità di decodifica fonologica. Tuttavia, leggere utilizzando la decodifica fonologica, richiede di selezionare rapidamente ciascuna unità ortografica attraverso un orientamento seriale dell’attenzione. Ciascuna lettera deve essere individuata distinguendola dalle altre lettere circostanti attraverso un rapido orientamento dell’attenzione, che agirà precedendo l’esecuzione di una corretta associazione grafema-fonema. Nella prima parte di questa tesi, attraverso l’utilizzo di uno studio longitudinale di 3 anni, si dimostra che le abilità attentive possedute in periodo prescolare — valutate attraverso le performance in una ricerca visiva ed un compito Posner — risultano determinare le abilità di lettura sviluppate durante i primi due anni di Scuole Primarie, indipendentemente dalle influenze derivanti dall’età, dal QI non verbale, dalle abilità nel processare i suoni della lingua e dalle abilità di mappaggio cross-modale. Queste evidenze mostrano che l’eziologia della dislessia evolutiva è multifattoriale e che le abilità attentive visuo-spaziali giocano un ruolo fondamentale nell’acquisizione delle abilità di lettura. Sappiamo dalla letteratura che l’utilizzo di action video game può modificare molti aspetti delle abilità attentive, migliorandone l’ampiezza e la risoluzione. Nella seconda parte della tesi, si dimostra che testando le abilità di attenzione focalizzata e diffusa in due campioni formati da soggetti adulti videogiocatori e non videogiocatori, le stesse funzioni attentive che sappiamo essere carenti nei bambini con dislessia evolutiva, risultano potenziate nei soggetti che utilizzano i video game. Sulla base di queste evidenze e conoscendo l’elevato costo, in termini di risorse cognitive ed economiche, degli attuali trattamenti per la dislessia, si è testata l’ipotesi che gli action video game potessero incrementare le abilità attentive e di lettura. Si dimostra così che 12 ore di gioco — che non prevedono alcun training diretto delle abilità fonologiche o ortografiche — aumentano le abilità di lettura dei bambini con dislessia evolutiva. Si sono testate le abilità attenzionali, fonologiche e di lettura in due campioni di bambini con dislessia appaiati per età e gravità del disturbo, prima e dopo l’utilizzo di due tipologie di gioco, action e non action, per 9 incontri giornalieri di 80 minuti. Si è osservato che soltanto il gruppo che aveva utilizzato i video game action incrementava le proprie abilità, più di quanto non accadesse in 8760 ore di sviluppo spontaneo e con un livello superiore o equivalente a quello ottenuto con trattamenti tradizionali. Anche le abilità attentive risultano incrementate dal trattamento con i video game action. Le variazioni individuali rilevate nelle funzioni attentive visuo-spaziali e cross-modali, spiegano circa il 50% della varianza relativa ai miglioramenti nella lettura, anche controllando per età, QI e modifiche nelle abilità fonologiche. Nell’ultima parte della tesi si presenta un nuovo strumento, un serious game, sviluppato per essere utilizzato al fine di incrementare le funzioni cognitive che influenzano la successiva acquisizione delle abilità di lettura. Si è chiesto ad un campione di bambini prescolari a rischio e non a rischio di sviluppo di dislessia evolutiva, di giocare per una singola sessione al serious game. Si è dimostrato che i punteggi ottenuti nei mini game che coinvolgono le abilità attentive e fonologiche risultano discriminare le prestazioni dei due gruppi. Questi risultati suggeriscono che la futura realizzazione di un trattamento basato sull’utilizzo del serious game potrebbe portare ad un rafforzamento di queste funzioni ed un conseguente decremento della gravità o dell’incidenza della dislessia nei bambini a rischi

Spatial attention and learning to read: Evidence from a 3-years longitudinal study

Developmental dyslexia is a neurobiological disorder that a\ufb00ects about 10% of the children. Although impaired auditory and speech sound processing is widely assumed to characterize dyslexic individuals, emerging evidence suggests that dyslexia could arise from a more basic cross-modal letter-to-speech sound integration de\ufb01cit. Nevertheless, letters must be precisely selected from irrelevant and cluttering letters by rapid shifting of visual attention before the correct letter-to-speech sound integration is applied. Thus, is prereading visual parietal-attention functioning able to explain future reading emergence and development? The present 3-years longitudinal study shows that prereading attentional shifting ability\u2014assessed by serial search performance and spatial cueing facilitation\u2014captures not only future basis of reading skills (ie, rapid letter naming and pseudoword length e\ufb00ect) but also words and text reading abilities in grades 1 and 2 after controlling for speech-sound processing as well as nonalphabetic crossmodal mapping. Our results provide evidence that visual spatial attention e\ufb03ciency in preschoolers speci\ufb01cally predicts future reading acquisition, suggesting new approaches for early identi\ufb01cation and a more e\ufb03cient prevention of developmental dyslexia