Oral ondansetron versus domperidone for acute gastroenteritis in pediatric emergency departments: Multicenter double blind randomized controlled trial

The use of antiemetics for vomiting in acute gastroenteritis in children is still a matter of debate. We conducted a double-blind randomized trial to evaluate whether a single oral dose of ondansetron vs domperidone or placebo improves outcomes in children with gastroenteritis. After failure of initial oral rehydration administration, children aged 1-6 years admitted for gastroenteritis to the pediatric emergency departments of 15 hospitals in Italy were randomized to receive one oral dose of ondansetron (0.15 mg/kg) or domperidone (0.5 mg/kg) or placebo. The primary outcome was the percentage of children receiving nasogastric or intravenous rehydration. A p value of 0.014 was used to indicate statistical significance (and 98.6% CI were calculated) as a result of having carried out two interim analyses. 1,313 children were eligible for the first attempt with oral rehydration solution, which was successful for 832 (63.4%); 356 underwent randomization (the parents of 125 children did not give consent): 118 to placebo, 119 to domperidone, and 119 to ondansetron. Fourteen (11.8%) needed intravenous rehydration in the ondansetron group vs 30 (25.2%) and 34 (28.8%) in the domperidone and placebo groups, respectively. Ondansetron reduced the risk of intravenous rehydration by over 50%, both vs placebo (RR 0.41, 98.6% CI 0.20-0.83) and domperidone (RR 0.47, 98.6% CI 0.23-0.97). No differences for adverse events were seen among groups. In a context of emergency care, 6 out of 10 children aged 1-6 years with vomiting due to gastroenteritis and without severe dehydration can be managed effectively with administration of oral rehydration solution alone. In children who fail oral rehydration, a single oral dose of ondansetron reduces the need for intravenous rehydration and the percentage of children who continue to vomit, thereby facilitating the success of oral rehydration. Domperidone was not effective for the symptomatic treatment of vomiting during acute gastroenteritis

`I'm a consumer, I'm not a scientist': Cultivating Student Domain Identification, Agency, and Affect through Engagement in Scientific Practices

Thesis (Ph.D.)--University of Washington, 2015University of Washington Abstract `I'm a consumer, I'm not a scientist': Cultivating Student Domain Identification, Agency, and Affect through Engagement in Scientific Practices Giovanna Scalone Chair of the Supervisory Committee: Professor Philip Bell College of Education, Learning Sciences and Human Development This study investigates the potential benefits of redesigning hands-on, commercial inquiry science kits for fifth grade that afford agency and the development of science identities by leveraging youth's interests, personal or shared concerns, challenges or desires. Science identification is considered in relation to learning processes of being, becoming, knowing and doing. As identities are constructed dialogically through engagement, emotion, intentionality, innovation, and solidarity, students' agency is mediated and conceptualized as it develops in practice. The study is introduced in Chapter 1 by acknowledging how agency and identity are constructed from an ideological frame, thus problematizing the current neo-liberal policies undergirding educational reform. The conceptual argument in Chapter 2 outlines a theoretical synthesis of agency and learning. Subsequently, I leveraged a theory of semiosis to highlight how these perspectives on agency and identity contribute to the meaning-making processes of language, culture, and mind. Finally, conceptualizations of agency and identity are mapped to the sociology of scientific knowledge perspective. Chapter 3 situates the study context within a design-based implementation research model where the existing science curriculum units serve as comparisons (Inquiry group) to the experimental units (Agency group). The findings first demonstrate how student and teacher positioning are revealed during the turns of exchange by using functional grammar as a method to analyze how discourse works to construe experience and enact social relationships. Secondly, I analyze youth positioning across conditions highlighting the importance of raising student consciousness to the variegated ways scientists practice science and inducts students into how scientists intentionally and purposefully employ genres to engage in scientific ways of communicating. Student's perspectives, positioning, and emotional investments are then analyzed using appraisal analysis to show how students talking about their images of science yield different ways of knowing and dispositions in science. Thirdly, by tracing the inclination and obligation of doing science, I illustrate how subjectivity versus materiality/objectivity in science impact how students perceive science. Fourth, student images of science, ways of identifying with science and having agency in science are analyzed using a thematic analysis to identify patterns and emerging themes. Next, I assess students' developing understanding of scientific inquiry using HLM to determine whether the Agency units versus the Inquiry units predicted students' learning outcomes based on the inquiry assessment. Finally, I discuss the implications of these analyses. This study accounts for how youth develop practice-linked identities in science entails the fleeting identity performances and language choices made for and by youth in the science classroom. Central to this notion of identity is agency where positionality as well as material and symbolic, interactional and situational resources constrain or enable identity development. In a learning context, these choices and values inherent in language use are relational to learner agency outside of language, but ensouled in performative curating where solidarity, intention, creativity, emotion, accountability, anticipation, cognition, and rewards enable the capacity to transform the self, others, and communities. This dissertation demonstrates how design features embedded in curriculum related to personal relevance and the societal context for science affords teachers to engage youth in agentic science learning in the classroom in ways that become more meaningful and supportive of science identification than traditional inquiry approaches to teaching science

La geografia del fenomeno turistico e la mobilit\ue0 dei turisti in Sardegna

Questo lavoro si sviluppa intorno al tema della mobilit\ue1 turistica in Sardegna, della geografia dei flussi esterni ed interni ed, in generale, delle relazioni che legano i turisti al territorio

Gender and Engineering Identity among Upper-Division Undergraduate Students

The construction industry’s long-term health depends upon continued efforts to understand historically excluded students’ attrition from engineering programs. For women, lack of identification with engineering may motivate their departure. Because professional persistence relates to engineering identity, it benefits attrition interventions to understand this identity development. Focusing upon students demonstrating some persistence in engineering, this research examines if and how engineering identity differs across gender among upper-division undergraduates. Surveying 11 American public university civil and construction engineering programs, the authors capture how central engineering is to self-concept, how positively students view engineers and perceive others to view engineers, and how students feel they belong. Using structural equation modeling, the authors find that among upper-division students and compared with cis men, cis women more strongly define themselves as engineers, are more confident of their place among fellow engineers, and feel more positively about engineers. A stronger engineering identity may help cis women cope with marginalization and may be limited to the upper-division undergraduate years. This study offers guidance for sustaining upper-division cis women’s strong engineering identity.This is a manuscript of the article Published as Hamlet, Leigh C., Arkajyoti Roy, Giovanna Scalone, Regina Lee, Cristina Poleacovschi, and Jessica Kaminsky. "Gender and engineering identity among upper-division undergraduate students." Journal of Management in Engineering 37, no. 2 (2021): 04020113. doi: https://doi.org/10.1061/(ASCE)ME.1943-5479.0000876. © 2020 American Society of Civil Engineers

Identification of new epidemiological molecular markers by comparative proteomics of serogroup A meningococcal isolates from three pandemic waves

We previously described the first reference map for the proteome of one strain of serogroup A Neisseria meningitidis (MenA), a major cause of epidemic meningitis in humans. As a preliminary finding, in that work we noted that 2-DE protein maps of closely related MenA isolates from different epidemics spreads could be easily compared to detect minor differences and that 2-DE phenotypes attributable to the well-known epidemiological marker tbpB agreed with the genoclouds model of MenA epidemiological variation during pandemic waves. We explored here the possibility that an extended comparative study of 2-DE maps of isolates representative of the nine genoclouds described by Achtman and collaborators could be used to discriminate between strains otherwise undistinguishable. We showed the example of 14 proteins with different 2-DE spot patterns in different genoclouds that could be considered as putative tracers for alike-strains discrimination. We introduce the novel concept that comparative proteomics can be useful in identifying new epidemiological markers for N. meningitidis

Mitochondrial DNA diversity and genetic structure of striped dolphin Stenella coeruleoalba in the Northern Ionian Sea

In the framework of global and EU policies focused on stopping the loss of biodiversity process, deepening the genetic variability, especially of populations species identified as threatened, is crucial for defining conservation units and developing appropriate conservation strategies. This is more urgent for cetacean species in the Mediterranean because they assume a key ecological role in the marine food web and are severely affected by numerous and different anthropogenic pressures. This study aims to increase information on the genetic variability of striped dolphin in the Northern Ionian Sea by investigating the population structure, phylogenetic relationships and phylogeographic patterns using two mtDNA markers. From October 2020 to August 2021, a total of 88 skin tissue samples were collected from free-ranging dolphins in the Gulf of Taranto by applying the non-invasive technique of skin swabbing. An acceptable amount of DNA was extracted from 86 samples and used for subsequent genetic analysis conducted on the partial sequences of 421 and 704 bp in length of the cytb gene and D-loop control region, respectively. In addition, the sequences of the two mtDNA markers were joined together to compose a mtDNA concatenated sequence of 1125 bp for each sampled dolphin in order to investigate the genetic variability of the species population in the study area. Genetic analysis highlighted a low nucleotide diversity and high haplotypic diversity of the striped dolphin of the Gulf of Taranto, suggesting a population in rapid expansion after a period of reduction in size and diversity of the initial population. The phylogenetic analyses revealed the presence of at least two different lineages of Stenella coeruleoalba in the Mediterranean Sea, one specific to the Northern Ionian Sea and one shared with the Mediterranean population, confirming results already obtained for the local unit in the Gulf of Taranto. The results point out a potential problem of hybridization between striped and common dolphins which needs to be further investigated. Therefore, increasing the analysis of several markers may increase understanding of the genetic diversity of the population in the Ionian Sea and represent a useful tool to support the implementation of future effective conservation measures

Lipoprotein (a) is related to coronary atherosclerotic burden and a vulnerable plaque phenotype in angiographically obstructive coronary artery disease

Background: Lipoprotein Lp(a) has been shown to be an independent risk factor for coronary artery disease (CAD). However, its association with CAD burden in patients with ACS is largely unknown, as well as the association of Lp(a) with lipid rich plaques prone to rupture. Aim: We aim at assessing CAD burden by coronary angiography and plaque features including thin cap fibroatheroma (TCFA) by optical coherence tomography (OCT) in consecutive patients presenting with acute coronary syndrome (ACS) and obstructive CAD along with serum Lp(a) levels. Methods: This study comprises an angiographic and an OCT cohort. A total of 500 ACS patients (370 men, average age 66 +/- 11) were enrolled for the angiographic cohort and 51 ACS patients (29 males, average age 65 +/- 11) were enrolled for the OCT cohort. Angiographic CAD severity was assessed by Sullivan score and by Bogaty score including stenosis score and extent index. OCT plaque features were evaluated at the site of the minimal lumen area and along the culprit segment. Results: In the angiographic cohort, at multivariate analysis, Lp(a) was a weak independent predictor of Sullivan score (p < 0.0001), stenosis score (p < 0.0001) and extent index (p < 0.0001). In the OCT cohort, patients with higher Lp(a) levels (-30 md/ dl) compared to patients with lower Lp(a) levels (< 30 md/ dl) exhibited a higher prevalence of lipidic plaque at the site of the culprit stenosis (67% vs. 27%; P = 0.02), a wider lipid arc (135 +/- 114 vs 59 +/- 111; P = 0.03) and a higher prevalence of TCFA (38% vs. 10%; P = 0.04)

Allergic Inflammation Is Associated With Coronary Instability and a Worse Clinical Outcome After Acute Myocardial Infarction

The role of allergic inflammation in acute coronary syndromes (ACS) has not been clearly defined to date. Aim of this study was to assess eosinophil and basophil activation in ACS and the prognostic role of eosinophil cationic protein in ST-segment-elevation myocardial infarction