Plasma and red blood cell pufas in home parenteral nutrition paediatric patients—effects of lipid emulsions

Background: Mixed lipid emulsions (LE) containing fish oil present several advantages compared to the sole soybean oil LE, but little is known about the safety of essential fatty acids (EFA) profile in paediatric patients on long-term Parenteral Nutrition (PN). Aim of the study: to assess glycerophosfolipid polyunsaturated fatty acids (PUFA) levels on plasma and red blood cell (RBC) membrane of children on long term PN with composite LE containing fish oil (SMOF), and to compare it with a group receiving olive oil LE (Clinoleic®) and to the reference range for age, previously determined on a group of healthy children. Results: A total of 38 patients were enrolled, median age 5.56 (0.9–21.86) years, 15 receiving Clinoleic®, 23 receiving SMOF. Patients on SMOF showed significantly higher levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), lower levels of arachidonic acid (ARA) and Mead acid (MEAD)/ARA ratio in plasma and RBC compared with patients on Clinoleic® and with healthy children. Triene:tetraene (T:T) ratio of both groups of patients did not differ from that of healthy children-median plasma (MEAD/ARA: 0.01, interquartile rage (IQR) 0.01, p = 0.61 and 0.02, IQR 0.02, p = 0.6 in SMOF and Clinoleic® patients, respectively), and was considerably lower than Holman index (>0.21). SMOF patients showed no statistically significant differences in growth parameters compared with Clinoleic® patients. Patients of both groups showed stiffness class F0-F1 of liver stiffness measure (LSM) 5.6 (IQR 0.85) in SMOF patients and 5.3 (IQR 0.90) in Clinoleic® patients, p = 0.58), indicating absence of liver fibrosis. Conclusions: Fatty acids, measured as concentrations (mg/L), revealed specific PUFA profile of PN patients and could be an accurate method to evaluate nutritional status and eventually to detect essential fatty acid deficiency (EFAD). SMOF patients showed significantly higher EPA, DHA and lower ARA concentrations compared to Clinoleic® patients. Both LEs showed similar hepatic evolution and growth

Ultrasonography of quadriceps femoris muscle and subcutaneous fat tissue and body composition by BIVA in chronic dialysis patients

Protein Energy Wasting (PEW) in hemodialysis (HD) patients is a multifactorial condition due to specific pathology-related pathogenetic mechanisms, leading to loss of skeletal muscle mass in HD patients. Computed Tomography and Magnetic Resonance Imaging still represent the gold standard techniques for body composition assessment. However, their widespread application in clinical practice is difficult and body composition evaluation in HD patients is mainly based on conventional anthropometric nutritional indexes and bioelectrical impedance vector analysis (BIVA). Little data is currently available on ultrasound (US)-based measurements of muscle mass and fat tissue in this clinical setting. The purpose of our study is to ascertain: (1) if there are differences between quadriceps rectus femoris muscle (QRFM) thickness and abdominal/thigh subcutaneous fat tissue (SFT) measured by US between HD patients and healthy subjects; (2) if there is any correlation between QRFM and abdominal/thigh SFT thickness by US, and BIVA/conventional nutritional indexes in HD patients. We enrolled 65 consecutive HD patients and 33 healthy subjects. Demographic and laboratory were collected. The malnutrition inflammation score (MIS) was calculated. Using B-mode US system, the QRFM and SFT thicknesses were measured at the level of three landmarks in both thighs (superior anterior iliac spine, upper pole of the patella, the midpoint of the tract included between the previous points). SFT was also measured at the level of the periumbilical point. The mono frequency (50 KHz) BIVA was conducted using bioelectrical measurements (Rz, resistance; Xc, reactance; adjusted for height, Rz/H and Xc/H; PA, phase angle). 58.5% were men and the mean age was 69 (SD 13.7) years. QRFM and thigh SFT thicknesses were reduced in HD patients as compared to healthy subjects (p < 0.01). Similarly, also BIVA parameters, expression of lean body mass, were lower (p < 0.001), except for Rz and Rz/H in HD patients. The average QRFM thickness of both thighs at top, mid, lower landmarks were positively correlated with PA and body cell mass (BCM) by BIVA, while negatively correlated with Rz/H (p < 0.05). Abdominal SFT was positively correlated with PA, BCM and basal metabolic rate (BMR) (p < 0.05). Our study shows that ultrasound QRFM and thigh SFT thicknesses were reduced in HD patients and that muscle ultrasound measurements were significantly correlated with BIVA parameters

L'educazione ai generi. Riflessioni

Nonostante la svolta culturale introdotta dai gender studies (che ha aperto il dibattito sulla categoria di genere e ha dimostrato il carattere socio-culturale del femminile e del maschile, intesi come costrutti concettuali/modelli concettuali di riferimento), una seria riflessione sull’identità di genere e sulle differenze di genere (di potere, di opportunità) appare tutt’altro che scontata. Di qui, l’educazione ai generi e al rispetto delle differenze (di tutte le differenze) rappresenta per gli educatori e i professionisti della cura una sfida ineludibile, in grado di sollecitare interrogativi nuovi e dis-velare comportamenti, stili e saperi non ancora ( o non del tutto) entrati a far parte delle routine e delle prassi “intenzionalmente educative” dei servizi 0-6. È dunque lecito chiedersi il perché di di questa disattenzione e di questo ostinato silenzio, seppure nel magma delle emergenze del “fare scuola” quotidiano. M. Gallerani introduce, inoltre, la tematica della prossemicità, affermando che l’educazione ai generi può rappresentare uno straordinario strumento per l'emancipazione individuale e collettiva - intervenendo su più contesti e a più livelli - in prospettiva di una reale società educante all’insegna della prossemicità. Il paragrafo 3, l'ideazione la supervisione di tutto l'articolo e l'abstract sono di M. Gallerani

Predicting the human behaviour in human-robot co-assemblies: An approach based on suffix trees

Prediction of the human behaviour is essential for allowing an efficient human-robot collaboration. This was confirmed recently showing how scheduling approaches can significantly increase the productivity of a robotic cell by planning the robotic actions in a way as much as possible compliant with the human predicted behaviour. This work proposes an innovative approach for human activity prediction, exploiting both a-priori information and knowledge revealed during operation. The resulting approach is proved to achieve good performance through both off-line simulated sequences and in a realistic co-assembly involving a human operator and a dual arm collaborative robot