Surrogate endpoints and non-inferiority trials in chronic viral hepatitis.

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L’educazione civica nella scuola per educare i giovani alla convivenza civile e democratica

Society today asks the school to educate future citizens according to theprinciples of planetary citizenship and democratic coexistence. Therefore,the school is called to question what to do about the educational action tobe activated, in order to make effective the educational offer put in place, inthis case in the field of civic education, active citizenship and civil coexistence.In this sense, civic education through its transversality can be assumedas a model of reference for its peculiar pedagogical system, it can representthe discipline that gives unity and organicity to all educational design, thussubstantiating of new significance the field of education to civil coexistenceand active citizenship, in relation to an emancisocial and democratic educationalpractice. Of course, study and research must substantiate scientificityin the actual realization of what is supposed that in this contribution findsin nuce a first theoretical and practical explicitness that will have to takeshape in subsequent research and experimentation activities.La società chiede oggi alla scuola di educare i futuri cittadini secondo i principidella cittadinanza planetaria e della convivenza democratica. Pertanto,la scuola è chiamata a interrogarsi sul da farsi in ordine all’azione educativada attivare, al fine da rendere efficace l’offerta formativa posta in essere, nellafattispecie nell’ambito dell’educazione civica, della cittadinanza attiva e dellaconvivenza civile. In tal senso, l’educazione civica attraverso la sua trasversalitàpuò essere assunta come modello di riferimento, per il suo peculiareimpianto pedagogico può rappresentare la disciplina che dà unità e organicitàa tutta la progettazione didattica, sostanziando così di significanza nuoval’ambito dell’educazione alla convivenza civile e della cittadinanza attiva, inrelazione a una prassi didattica emancipativa e democratica. Ovviamente lostudio e la ricerca devono sostanziare di scientificità la fattiva realizzazionedi quanto supposto che nel presente contributo trova in nuce una primaesplicitazione teorica e pratica che dovrà prendere forma in successive attivitàdi ricerca e sperimentazione

La convivenza democratica: idee e prospettive degli studenti, degli insegnanti e dei genitori. I risultati di un’indagine-ricerca

The utmost goal of human existence is happiness, man is, by his own nature, a being who tends to enduring, eternal happiness. Advocates of the “Global Community” wish for a better coexistence among peoples, better conditions for development and well-being for all. Daily life, instead, gives us back a sad reality and a partial truth of well-being and global citizenship. There is no full realization of that principle of integration, capable of bringing people to live democratically in the respect of universal rights. Everyday chronicles arouse bitterness, disappointment, fear, feeding distrust, a general sense of insecurity, and continuous anxiety. The principles of citizenship, democracy, human rights seem to be constantly threatened. The same educational work of the school with regard to ethics of democratic values and citizenship appears to have been nullified by a competitive and educative logic that seems to leave no room for an education to democratic and global citizenship. Faced with the ongoing dehumanization of didactic processes, the social community still invokesthe educational work of the school so that it gets back to be a forge-laboratoryfor the formation of the 21st century’s democratic citizen.Lo scopo ultimo dell’esistenza umana è la felicità, l’uomo per natura è un essere che tende alla felicità duratura, eterna. I fautori della “Comunità Globale” hanno auspicato una migliore convivenza tra i popoli, migliori condizioni di sviluppo e benessere per tutti. La quotidianità, invece, ci restituisce una triste realtà e una parziale verità di benessere e di cittadinanza globale. Non si assiste a una piena realizzazione di quel principio d’integrazione, capace di portare gli uomini a convivere democraticamente nel rispetto dei diritti universali. Le cronache quotidiane suscitano amarezza, delusione, paura, alimentando la diffidenza, un generale senso di insicurezza e una continua inquietudine. I principi di cittadinanza, di democrazia, dei diritti umani, sembrano essere continuamente minacciati. La stessa opera educativa della scuola, in merito all’etica dei valori e della cittadinanza democratica appare vanificata da una logica competitiva e istruzionista che sembra non lasciare spazio a un’educazione alla cittadinanza democratica e globale.Di fronte alla continua disumanizzazione dei processi didattici, la comunità sociale invoca ancora l’opera educativa della scuola, affinché torni a essere laboratoriofucina per la formazione del cittadino democratico del XXI secolo

Le questioni poste dall’integralismo islamico e i principi della cittadinanza planetaria

The first part of this new millennium presents us a political and economic context inwhich the so-called globalized society is rising from the ranks setting as its first foundationthe constitution of planetary citizenship, considered the first principle for the affirmationof human rights and of civil co-habitation, in order to realise pacification, solidarityand equality among peoples. Unfortunately this rising “Global Village” is still continuouslytormented by so many conflicts, destructiveness, inequalities and injustices.Among peoples a climate of generalised violence and creeping terror prevails, causingin the “citizens” of the planet bewilderment, distrust, insecurity and anxiety. Therefore,the planetary citizenship is continually threatened by a strong competitiveness and individualismmaking human beings threatening and threatened, it follows that many layersof the world population do not feel ensured their fundamental rights. In such a direction,the educational action can represent the keystone that works as a critical forceof emancipation of consciences and avoids the flattening on ideological positions thatundermine at the base the ongoing process of promotion of civil co-habitation, safeguardof human rights and the constitution of a planetary citizenship as guarantee ofglobal peace and fundamental rights of the human being.La prima parte di questo inizio millennio ci presenta un panorama politico ed economicodove si fa strada la cosiddetta società globalizzata che pone come suo primo fondamentola costituzione della cittadinanza planetaria, considerata principio primo per l’affermazionedei diritti umani e della convivenza civile, al fine di realizzare la pacificazione,la solidarietà e l’uguaglianza tra i popoli. Purtroppo questo nascente “VillaggioGlobale” è ancora continuamente travagliato da tanti conflitti, distruttività, disuguaglianzee ingiustizie. Aleggia tra i popoli un clima di violenza generalizzata e un terrorestrisciante, causando nei “cittadini” del pianeta smarrimento, diffidenza, insicurezzae inquietudine. Dunque, la cittadinanza planetaria è continuamente minacciata dauna forte competitività e individualismo che rendono gli uomini minacciosi e minacciati,ne consegue che molti strati della popolazione mondiale non si sentono garantiti neiloro diritti fondamentali. In tale direzione, l’azione educativa può rappresentare la chiavedi volta per operare come forza critica di emancipazione delle coscienze ed evitarel’appiattimento su posizioni ideologiche che minano alla base il processo in atto di promozionedella convivenza civile, di salvaguardia dei diritti umani e della costituzione diuna cittadinanza planetaria come garanzia della pace globale e dei diritti fondamentalidella persona umana

Il processo storico di mondializzazione e le idee unificanti che conducono alla cittadinanza planetaria

Today we live in a complex society, where social, ethical and political dynamism bring out various difficulties in the management of educational and relational dynamics. The phenomenonof globalization brings into being various questions related to social, political and educational dynamics. First to emerge is the question of the relationship between people and political institutions, whereby experts ask themselves whether the ongoing process of globalization is truly realizing the cosmopolitan ideal sustained by the Enlightenment intellectuals pre andpost-World War II. Globalization, the theme of citizenship, the sense of belonging and active participation in society resonates strongly. One wonders if we can really consider ourselvesas full citizens of the world. “Planetary” citizenship is such because as a member of a community, not only for moral connotations but also for what concerns the rights of the humanbeing; first of all, the right to well-being, and access to all that allows man to emancipate himself and to live in the world with dignity. Today, globalization highlights an idea of citizenshipand that of a person tending to take on new forms within the changing scenarios of the world. Everything seems to revolve around a global thought. It is in this context that education is requiredto meet the challenges of forming citizens of a new world. According to the prospect of globalization that therefore requires a new Paideia (Salmeri 2015) for authentic planetary citizenship.Oggi viviamo in una società complessa, dove il dinamismo sociale, etico e politico fanno emergere diverse difficoltà nella gestione delle dinamiche educative e relazionali. Il fenomenodella mondializzazione pone in essere diverse questioni relative alle dinamiche sociali, politiche, educative. Emerge prima di tutto la questione delle relazioni tra le persone e tra le istituzioni politiche, per cui gli esperti si chiedono se il processo di globalizzazione in atto sta realizzando veramente l’ideale cosmopolita sostenuto dagli intellettuali illuministi e da quelli del secondo dopoguerra. Nell’essere della mondializzazione torna con forza il tema della cittadinanza, dell’appartenenza e della partecipazione attiva, ci si chiede se realmente possiamo ritenerci a pieno titolo cittadini del mondo. Il cittadino “planetario” è tale in quanto membro di una comunità, non solo per i connotati morali ma anche per ciò che attiene ai diritti dell’essere umano; diritto al benessere, prima di tutto, e all’accesso a tutto ciò che gli consente di emanciparsi per vivere con dignità il suo essere al mondo. Oggi la mondializzazione evidenzia un’idea di cittadinanza e di persona tendenti ad assumere nuove forme all’interno dei mutevoli scenari del globo. Tutto sembra ruotare attorno un pensiero globale, è in quest’ambito che l’educazione è interpellata per raccogliere la sfida di formare cittadini di un nuovo mondo, secondo la prospettiva di una nuova mondializzazione che richiede pertanto una nuova Paideia (Salmeri 2015) per un’autentica cittadinanza planetaria

Educare alle relazioni e alla convivenza civile nella scuola al tempo del Covid-19

Faced with the pandemic situation, the school tried to react, ensuring a minimum of education and a certain relational interaction even if at a distance and with all the limitations of ICT for the management of distance learning. The school is now called upon to manage a didactic process that ensures complete training for students, even if they are still at a distance, therefore it is necessary to find new practices to educate and train in an integral way, in this case the distance must not give up that education to civil coexistence and active citizenship which, with the inclusion of Civic Education, we hope to be able to consolidate better. Consequently, at present, in the time of Covid-19 the school is called to innovate in terms of the educational action to be implemented, in order to make the educational offer effective in general and, in particular, for what concerns education to relationships and civil coexistence, through a significant didactic and pedagogical action that must find its concretization in the teaching of Civic Education.Di fronte alla situazione pandemica la scuola ha cercato di reagire, assicurando un minimo di istruzione e una certa interazione relazionale anche se a distanza e con tutti i limiti delle TIC per la gestione dell’apprendimento a distanza. La scuola adesso è chiamata a gestire un processo didattico che assicuri una formazione completa agli studenti, anche se si è ancora a distanza, quindi è necessario trovare pratiche nuove per educare e formare in maniera integrale, nella fattispecie la distanza non deve fare rinunciare a quell’educazione alla convivenza civile e alla cittadinanza attiva che con l’inserimento dell’Educazione Civica si spera di poter meglio consolidare. Di conseguenza, allo stato attuale, in tempo di Covid-19 la scuola è chiamata a innovare in ordine all’azione educativa da mettere in essere, al fine di rendere efficace l’offerta formativa in generale e, in particolare, per ciò che attiene l’educazione alla relazione e alla convivenza civile, attraverso una significativa azione didattica e pedagogica che deve trovare la sua concretizzazione nell’insegnamento dell’Educazione Civica

Tenofovir and its potential in the treatment of hepatitis B virus

Recent literature is reviewed about treatment of chronic hepatitis B virus (CHB), focusing on tenofovir disoproxil fumarate (TDF; Viread®), among the nucleotide and nucleoside analogs. TDF pharmacokinetics and pharmacodynamics, activity in respect of hepatitis B virus (HBV) multi-drug-resistant mutations, efficacy in treatment-naïve and treatment-experienced patients, and side effects are described. The most predictive response factors to TDF therapy are discussed and all available combination therapies to optimize clinical outcome in the various patient profiles are analyzed, such as compensated and/or decompensated cirrhotic patients. The use of TDF in pregnancy, and prophylaxis after exposure to HBV and post-liver transplantation are also evaluated

Vitamin D deficiency is a risk factor for infections in patients affected by HCV-related liver cirrhosis

Objectives: To evaluate the prevalence of vitamin D deficiency and its impact on infections in HCV-related liver cirrhosis. Methods: We enrolled 291 patients affected by HCV-related liver cirrhosis. Serum vitamin D levels were dosed at enrolment. The presence of infection was assessed at baseline and during follow-up based on physical examination and laboratory analyses. Results: Vitamin D deficiency (15 (p = 0.003), Child-Pugh class B/C vs A (p < 0.001), and active hepatocellular carcinoma (HCC) (p < 0.001). At multivariate analysis, vitamin D deficiency (p < 0.01), HCC (p < 0.05), hospitalization (p < 0.001) and exposure to immunosuppressant agents (p < 0.05) were independent risk factors for infection at baseline. Conclusions: Vitamin D may play a role in the development of infections in patients affected by liver cirrhosis, and preventive strategies with vitamin D supplementation are to be evaluated in randomized controlled trials

Anti-HBc positivity was associated with histological cirrhosis in patients with chronic hepatitis C

Introduction. In patients with chronic hepatitis C it is still debated whether previous exposure to the hepatitis B virus, diagnosed from the presence of the anti-HBc antibody, is linked to a greater risk of severe hepatitis. The aim of the study was to evaluate whether the presence of anti-HBc antibodies is associated with cirrhosis in patients with HBsAg-negative chronic hepatitis C. Material and methods. Two hundred twenty-two consecutive HBsAg-negative patients with HCV-related chronic hepatitis were enrolled at their first liver biopsy. Ishak's scoring system was used to grade necroinflammation and fibrosis and the patients with stage 5 or 6 were considered as having histological cirrhosis. Results. Patients with histological cirrhosis had a higher mean age, AST, ALT, a lower platelet count and prothrombin activity compared to those with milder fibrosis. The presence of anti-HBc was identified in 21 (63.6%) of the 33 patients with fibrosis score 5 or 6 and in 56 (29.6%; p < 0.001) of the 189 with score ≤ 4. Patients with cirrhosis had a significantly higher grading than those without cirrhosis (median = 8, IQR 6-11 vs. Median = 6, IQR = 4-8, respectively, p < 0.001). A multivariate logistic regression analysis showed that age, sex and anti-HBc positivity were independent predictors of histological cirrhosis. Conclusion. Our data support the idea that in patients with chronic hepatitis C the presence in serum of anti-HBc is associated with histological cirrhosis and is therefore a marker of clinical value

PET criteria by cancer type from imaging interpretation to treatment response assessment: beyond FDG PET score

Background: in recent years, the role of positron emission tomography (PET) and PET/computed tomography (PET/CT) has emerged as a reliable diagnostic tool in a wide variety of pathological conditions. This review aims to collect and review PET criteria developed for interpretation and treatment response assessment in cases of non-[18F]fluorodeoxyglucose ([18F]FDG) imaging in oncology. Methods: A wide literature search of the PubMed/MEDLINE, Scopus and Google Scholar databases was made to find relevant published articles about non-[18F]FDG PET response criteria. Results: The comprehensive computer literature search revealed 183 articles. On reviewing the titles and abstracts, 149 articles were excluded because the reported data were not within the field of interest. Finally, 34 articles were selected and retrieved in full-text versions. Conclusions: available criteria are a promising tool for the interpretation of non-FDG PET scans, but also to assess the response to therapy and therefore to predict the prognosis. However, oriented clinical trials are needed to clearly evaluate their impact on patient management