La musica e il potenziamento dei prerequisiti di apprendimento

La música se utiliza como materia optativa en la prevención de los trastornos del aprendizaje. El DSA es una discapacidad específica de aprendizaje, de origen neurobiológico, que afecta a un dominio específico de habilidades (lectura, escritura, cálculo). El curso de introducción en la música fue dirigido a niños de 4 a 6 años de edad, grupo en el que el diagnóstico de DSA no se puede todavía realizar, pero sí podemos identificar aquellos niños en situación de riesgo a través de la evaluación de los requisitos previos de aprendizaje. Objetivo: intervenir de manera preventiva sobre las dificultades de aprendizaje, a través del fortalecimiento de los requisitos previos necesarios, con actividad musical preparatoria en el jardín de infantes. Método: la muestra analizada se compone de 50 niños que pertenecen a una población con edades comprendidas entre los 4 y 6 años. Como muestra se administró la prueba para la evaluación de los requisitos previos de aprendizaje, la PRCR-2 de Cornoldi (2009), antes y después del tratamiento, que abarca un método de introducción de música específico con la pre-escritura y pre-lectura de 7 notas (en el personal) se prolongó durante 4 meses. Conclusión: Los datos obtenidos muestran que la actividad musical se correlaciona positivamente con la mejora de los requisitos previos de aprendizaje.The music is used as an elective channel in the prevention of learning disorder.SLD (Specific Learning Disorder) is a specific learning disability of neurobiological origin, characterized by a lack in a specific learning ability (reading , writing, computing). The preparatory music course was intended for children aged 4 to 6 years, that is the age in which the diagnosis of DSA cannot yet be done but we can still identify children at risk through the evaluation of the prerequisites for learning. Objective: preventative intervention on learning difficulties through the enhancement of prerequisites for reading and writing using preparatory music, during preschool years. Method: The examined sample consists of 50 preschooler aged 4 to 6. The Prcr2 Cornoldi test (2010) had been administered to the sample, before and after the treatment, which consisted in a 4 months Project of preparatory musical activities based on pre-writing and pre-reading the 7 notes (on the staff). Conclusions: The data obtained show that the musical activities correlates positively with the positive evolution of the pre-requisites of learning.La musica viene utilizzata come canale elettivo nella prevenzione dei disturbi di apprendimento. Il DSA è una disabilità specifica dell’apprendimento, di origine neurobiologica, che interessa uno specifico dominio di abilità (lettura, scrittura, calcolo). Il corso di propedeutica musicale è stato rivolto a bambini dai 4 ai 6 anni, fascia di età in cui la diagnosi di DSA non può ancora essere effettuata ma si possono individuare i bambini a rischio attraverso la valutazione dei prerequisiti di apprendimento. Obiettivo: intervenire in maniera preventiva sulle difficoltà di apprendimento, attraverso il potenziamento dei prerequisiti necessari, con attività propedeutica musicale nella scuola d’infanzia. Metodo: il campione esaminato è composto da 50 bambini appartenenti ad una popolazione d’età compresa dai 4 ai 6 anni. Al campione è stato somministrato il test per la valutazione dei prerequisiti di apprendimento, il Prcr-2 di Cornoldi (2009), prima e dopo il trattamento, riguardante uno specifico metodo di propedeutica musicale con attività di pre-scrittura e pre-lettura delle 7 note (nel pentagramma) durato per 4 mesi. Conclusioni: i dati ottenuti evidenziano come l’ attività musicale correli positivamente col miglioramento dei prerequisiti di apprendimento.peerReviewe

Different behaviour of BK-virus infection in liver transplant recipients

Polyomavirus BK (BKV) infects up to 90% of the general population. After primary infection, occurring early during childhood, a state of non-replicative infection is established in the reno-urinary tract, without complications for immunocompetent hosts. In immunocompromised individuals, particularly transplanted patients, asymptomatic BKV viremia and/or viruria can be observed. Renal grafts may also be sources of infection as BKV prefers kidneys rather than other solid organs for transplantation such as the liver. The mechanism behind the higher incidence of BKV infection in kidney transplant patients, compared to liver or heart transplantation, is unclear and the prevalence of BKV infection in non-renal solid organ transplants has not been yet thoroughly investigated. We evaluated the prevalence of Polyomavirus BK infection among liver transplant recipients. A PubMed search was conducted using the terms BKV infection AND liver transplant recipients; BKV AND non-renal solid organ transplant*; BKV infection AND immunosuppression; the search was limited to title/abstract and English-language articles published from 2000, to March 2015. Eleven relevant studies suggest that the prevalence of BKV viruria and/or viremia among liver transplant recipients is less than that reported in kidney or heart transplant recipients, except when chronic kidney disease (CKD) is present at the same time. Data also suggest that viruric and viremic patients have higher levels of serum creatinine than BKV negative patients. Moreover, no specific immunosuppressive drugs are associated with the onset of BKV nephropathy. The comorbidity of transplantation and CKD could play a major role in promoting BKV replication

La musica e lo sviluppo linguistico in età prescolare

Rhythmic skills and linguistic development are strongly connected and already evident in preschool age for children between 4 and 6 years old. The rhythm organizes events and plays a fundamental role in music, phonology and prosody of language. Verbal language and music are based on: inflections, intonations, time, rhythm and melody. Children with linguistic difficulties have a wrong perception of the rhythmic structure but on the other hand the children who don’t present linguistic difficulties they present a high degree of correlation between phonological awareness and rhythmic abilities, connection highlighted by specific rhythmic tests.Le abilità ritmiche e lo sviluppo linguistico sono fortemente correlati ed evidenziabili già in età prescolare, nei bambini tra i 4 e i 6 anni. Il ritmo organizza eventi e gioca un ruolo fondamentale nella musica, nella fonologia e nella prosodia del linguaggio. Il linguaggio verbale come la musica è: inflessioni, intonazioni, tempo, ritmo e melodia. Bambini con difficoltà linguistiche hanno un’errata percezione della struttura ritmica; al contrario, con i Bambini che non presentano difficoltà linguistiche si evidenzia un alto grado di correlazione tra consapevolezza fonologica e abilità ritmiche, correlazione evidenziata da specifici test ritmici

Biliary complications in liver transplantation: role of the hepatic ischaemia-reperfusion injury

Introduction Liver transplantation is currently the only effective therapy for patients with end stage acute or chronic liver failure. The increasing request of organs has led to the more extensive use of the so-called marginal donors, in particular donors after circulatory death (DCD). Within this model of donation, a more severe degree of ischaemia-reperfusion injury (IRI) is occurring, that seems to play a role on the pathogenesis of local and remote organ complications. This research will focus on the influence of liver graft injury on the pathogenesis of local and remote organ complications, evidencing the role of IRI leading to biliary complications and development of systemic inflammatory response associated with the occurrence of acute kidney injury (AKI). Aim of the study was to assess the role of IRI in two different models of ischaemia, DCD and donation after brain death (DBD), in liver transplanted grafts, on the pathogenesis of local and remote organ complications. We evaluated the development of biliary complications and its association with the degree of donor liver graft bile duct injury after liver reperfusion. Moreover, the development of AKI after liver transplantation was considered, as consequence of IRI and systemic inflammatory response. Methods Retrospective single-centre study of adult patients who underwent liver transplantation at University Hospital Birmingham (UHB) National Health Service (NHS) Foundation Trust from January 2007 to December 2014. Characteristics of recipient at transplant, recipient renal and liver function in the immediate pre-transplant period, donor and graft variables, intra-operative parameters, indicators of initial graft function and renal function in the post-transplant period were considered. Primary end points were the occurrence of biliary complications, in particular ischaemic cholangiopathy (IC), and development of AKI. Secondary end point was the evaluation of IRI damage on the basis of transaminases, bilirubin and INR over the first week post-transplant and the appearance of bile duct retrieved after liver reperfusion on histological examination. Severity of donor bile duct injury was assessed and scored on the basis of biliary epithelial cell loss, mural stroma necrosis, inflammation, peribiliary vascular plexus (PVP) damage, arteriolonecrosis, thrombosis, periluminal and deep peribiliary glands (PBGs) damage. Cholangiocyte apoptosis in periluminal and deep PBGs was evaluated by quantitative terminal deoxy-nucleotidyl transferase dUTP-mediated nick-end labeling (TUNEL) analysis on bile duct sections. Cholangiocyte proliferation was studied in bile duct sections by PCNA immunohistochemical expression. Results One thousand and 60 liver transplant recipients (813 from DBD and 247 from DCD) were considered. Recipients from DCD had higher ALT and AST in the first 7 days after transplant, compared to DBD. The occurrence of biliary complications was higher in DCD liver transplant recipients (85/247; 34%) compared to DBD (166/813; 20%) (p<0.001), in particular IC incidence was significantly higher in DCD. The incidence of AKI was 59.3% (629/1060 recipients) and was significantly higher in DCD (160/247, 64.8%) compared to DBD (469/813, 57.7%) recipients (p=0.047). Sixty-two patients comparable with the entire cohort, had the bile duct sample available for histological evaluation. A significantly higher number of DCD patients presented necrosis >50% of the bile duct wall [DCD 14/28 (50%), DBD 9/34 (26.5%) p=0.056], PVP damage [DCD 8/28 (29%), DBD 3/34 (9%); p=0.053] and periluminal PBGs damage [DCD 20/28 (71%), DBD 14/34 (41%); p=0.016]. These features defined the occurrence of severe histological injury, that was significantly more frequent in DCD liver transplant patients [15/28 (53.6%)] compared to DBD [7/34 (20.6%)] (p=0.007). A significant increased apoptosis and decreased proliferation was evidenced in both periluminal (Tunel assay p=0.029; PCNA expression p=0.029) and deep PBGs (Tunel assay p=0.002; PCNA expression p=0.006) from bile duct sample with severe histological injury. Discussion A more severe degree of IRI is occurring within DCD, as evidenced by greater graft dysfunction and increasing peak perioperative transaminases, likely related to the added donor warm ischaemia time. The IRI seems to play a role on the pathogenesis of local and remote organ complications, evidencing the role exerted in DCD leading to biliary complications and development of systemic inflammatory response associated with the occurrence of AKI. This study also shows an early picture of microscopic damage at the level of the bile duct soon after reperfusion of liver graft during transplantation. Bile duct samples retrieved from DCD grafts expressed more severe injury at the histological level, as evidenced by the increased incidence of mural stroma necrosis, PBP damage and PBG damage, defining the new feature of severe histological injury. Bile ducts with severe histological injury showed increased apoptosis and reduced proliferation, as evaluated by Tunel assay and PCNA expression, both on periluminal and deep PBG cholangiocytes. The higher incidence of IC development in DCD strongly suggests a relation between the occurrence of severe histological injury and alteration in bile duct repair mechanisms, raising hypothesis to further evaluate those mechanisms leading to the development of bile duct non-anastomotic strictures

La musica e il potenziamento dei prerequisiti di apprendimento

The music is used as an elective channel in the prevention of learning disorder.SLD (Specific Learning Disorder) is a specific learning disability of neurobiological origin, characterized by a lack in a specific learning ability (reading , writing, computing). The preparatory music course was intended for children aged 4 to 6 years, that is the age in which the diagnosis of DSA cannot yet be done but we can still identify children at risk through the evaluation of the prerequisites for learning. Objective: preventative intervention on learning difficulties through the enhancement of prerequisites for reading and writing using preparatory music, during preschool years. Method: The examined sample consists of 50 preschooler aged 4 to 6. The Prcr2 Cornoldi test (2010) had been administered to the sample, before and after the treatment, which consisted in a 4 months project of preparatory musical activities based on pre-writing and pre-reading the 7 notes (on the staff). Conclusions: The data obtained show that the musical activities correlates positively with the positive evolution of the pre-requisites of learning.Riassunto: Premessa: La musica viene utilizzata come canale elettivo nella prevenzione dei disturbi di apprendimento. Il DSA è una disabilità specifica dell'apprendimento, di origine neurobiologica, che  interessa uno specifico dominio di abilità (lettura, scrittura, calcolo). Il corso di propedeutica musicale è stato rivolto a bambini dai 4 ai 6 anni, fascia di età in cui la diagnosi di DSA non può ancora essere effettuata ma si possono individuare i bambini a rischio attraverso la valutazione dei prerequisiti di apprendimento. Obiettivo: intervenire in maniera preventiva sulle difficoltà di apprendimento, attraverso il potenziamento dei prerequisiti necessari, con attività propedeutica musicale nella scuola d'infanzia. Metodo: il campione esaminato è composto da 50 bambini appartenenti ad una popolazione d'età compresa dai 4 ai 6 anni. Al campione è stato somministrato il test per la valutazione dei prerequisiti di apprendimento, il Prcr-2 di Cornoldi (2009), prima e dopo il trattamento, riguardante uno specifico metodo di propedeutica musicale con attività di pre-scrittura e pre-lettura delle 7 note (nel pentagramma) durato per 4 mesi. Conclusioni: i dati ottenuti evidenziano come l' attività musicale correli positivamente col miglioramento dei prerequisiti di apprendimento.

Latin, Old English and documentary practice at Worcester from Wærferth to Oswald

This article analyses the uses of Latin and Old English in the charters of Worcester cathedral, which represents one of the largest and most linguistically interesting of the surviving Anglo-Saxon archives. Specifically focused on the period encompassing the episcopates of Wærferth and Oswald (c. 870 to 992), this survey examines a time of intense administrative activity at Worcester, contemporaneous with significant transformations in the political and cultural life of Anglo-Saxon England more generally. In doing so, this article argues that when writing in either Latin or the vernacular, charter draftsmen responded to a number of variables; language choice did not simply reflect varying levels of literacy. Furthermore, the frequent cases of code-switching found in tenth-century Worcester documents mark this community out as exceptional, suggesting that attitudes towards the interaction between the two languages could vary considerably between institutions

Signalling Language Choice in Anglo-Saxon and Frankish Charters, c.700–c.900

Though Germanic vernaculars enjoyed different statuses in relation to Latin in England and on the continent, authors of documents in both regions made specific choices concerning their use of language. This chapter explores how these linguistic decisions were sometimes signalled and what they imply through a comparative study of self-conscious language-use in Anglo-Saxon and Frankish legal documents, including both royal diplomas and ‘private’ (i.e. non-royal) charters, between c.700 and c.900. The enquiry focuses on significant cases of code-switching between Latin and Germanic vernacular. We identify and compare how charter scribes signalled a switch in language, as for instance in documents where Latin prose is interrupted with a qualifying phrase to describe something in a Germanic language. In addition, we examine instances of specific linguistic awareness in charters, including explicit references to the theodisca (usually continental Germanic language) and saxonica (usually Old English) languages. These code switches and identifications of language reveal an acute linguistic consciousness on the part of the draftsmen and offer an opportunity for direct comparison between two cultures whose diplomatic practices have often seemed to be markedly different. In both regions the most frequent use of Germanic vernacular in charters came in descriptions of land and boundaries (though in England, Old English could also be employed for other purposes and in different sections of a charter). While acknowledging the pragmatism of transmitting certain pieces of information in the vernacular, we argue that the use of the vernacular in descriptions of landscape and property was often also an assertion of territoriality and a meaningful representation of identity. The status of Latin as the standard language of written communication in both regions has hitherto tended to lead scholars to suppose that Germanic insertions and qualifying phrases were included in charters purely to facilitate communication in societies with relatively low Latin literacy. Our study, by contrast, shows that the vernacular could be invoked quite deliberately, that it could be exploited as a means of engendering social inclusion or exclusion, and that it ultimately conveyed intentions and meanings which went far beyond simple clarification

Acute kidney injury and post-reperfusion syndrome in liver transplantation

In the past decades liver transplantation (LT) has become the treatment of choice for patients with end stage liver disease (ESLD). The chronic shortage of cadaveric organs for transplantation led to the utilization of a greater number of marginal donors such as older donors or donors after circulatory death (DCD). The improved survival of transplanted patients has increased the frequency of long-term complications, in particular chronic kidney disease (CKD). Acute kidney injury (AKI) post-LT has been recently recognized as an important risk factor for the occurrence of de novo CKD in the long-term outcome. The onset of AKI post-LT is multifactorial, with pre-LT risk factors involved, including higher Model for End-stage Liver Disease score, more sever ESLD and pre-existing renal dysfunction, either with intra-operative conditions, in particular ischaemia reperfusion injury responsible for post-reperfusion syndrome (PRS) that can influence recipient’s morbidity and mortality. Post-reperfusion syndrome-induced AKI is an important complication post-LT that characterizes kidney involvement caused by PRS with mechanisms not clearly understood and implication on graft and patient survival. Since pre-LT risk factors may influence intra-operative events responsible for PRS-induced AKI, we aim to consider all the relevant aspects involved in PRS-induced AKI in the setting of LT and to identify all studies that better clarified the specific mechanisms linking PRS and AKI. A PubMed search was conducted using the terms liver transplantation AND acute kidney injury; liver transplantation AND post-reperfusion syndrome; acute kidney injury AND post-reperfusion syndrome; acute kidney injury AND DCD AND liver transplantation. Five hundred seventy four articles were retrieved on PubMed search. Results were limited to title/abstract of English-language articles published between 2000 and 2015. Twenty-three studies were identified that specifically evaluated incidence, risk factors and outcome for patients developing PRS-induced AKI in liver transplantation. In order to identify intra-operative risk factors/mechanisms specifically involved in PRS-induced AKI, avoiding confounding factors, we have limited our study to “acute kidney injury AND DCD AND liver transplantation”. Accordingly, three out of five studies were selected for our purpose