273 research outputs found

    Intracranial tuberculous mass lesions treated with thalidomide in an immunocompetent child from a low tuberculosis endemic country: A case report

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    Rationale: Tuberculous meningitis is a highly morbid, often fatal disease. Patient concern: We describe a case of an Italian child. Diagnoses: we diagnosed early a Tuberculous meningitis complicated by the occurrence of hydrocephalus, stroke, and paradoxical reaction with brain pseudo-abscesses. Interventions: The child started readily a specific therapy associated with steroids and thalidomide was introduced few month later. Outcomes: the patient had a favorable outcome without neurologic sequelae. Lessons: Despite the prompt specific anti-tubercular and adjuvant corticosteroid therapies, only the addition of thalidomide to the treatment allow to a favorable clinical outcome

    O meio exterior da escola no ensino do estudo do meio

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    O presente relatório apresenta os resultados de um processo investigativo sobre uma intervenção pedagógica desenvolvida numa escola Básica da cidade de Setúbal, no âmbito da unidade curricular de “Estágio IV” do curso de Mestrado em Educação Pré Escolar e Ensino do 1º ciclo do Ensino Básico da ESE/IPS. Pretende-se refletir sobre as potencialidades da utilização do meio exterior da escola para as aprendizagens na área do Estudo do Meio. A intervenção pedagógica desenvolvida e que foi objeto do estudo centrou-se na abordagem com os alunos do tema das atividades produtivas nacionais, através da utilização do meio exterior como contexto e recurso das estratégias de ensino / aprendizagem adotadas. Assim, o espaço exterior à sala de aula, o meio local, enquanto espaço vivido pelos alunos, possibilitaram partir das suas conceções prévias para processos de construção do conhecimento desenvolvidos em atividades de contacto direto e de exploração das realidades locais. Este estudo insere-se no paradigma interpretativo/qualitativo e numa perspetiva metodológica de “Investigação sobre a Prática”. Consequentemente, a observação participante, o inquérito por questionário e por entrevista e a análise documental e de conteúdo foram as técnicas de investigação privilegiadas.This report presents the results of an investigative process on a pedagogical intervention carried out in a Basic School in the city of Setúbal, within the scope of the “Stage IV” curricular unit of the ESE / IPS Master's Degree in Pre-School Education and Primary Education. It is intended to reflect on the potential of using the outside environment of the school for learning in the area of Environment Study. The pedagogical intervention developed, as the object of the study, focused on the approach of the theme of national productive activities, through the use of the external environment as the context and the resource of the adopted teaching / learning strategies. Thus, the space outside the classroom, the local environment, as a space lived by the students, made possible to start from their previous conceptions to processes of knowledge construction developed in activities of direct contact and exploration of local realities. This study is part of the interpretative / qualitative paradigm and a methodological perspective of “Research on Practice”. Consequently, participant observation, questionnaire and interview inquiry and content analysis were the preferred investigative techniques

    A new method for discovering disease-specific miRNA-target regulatory networks

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    Genes and their expression regulation are among the key factors in the comprehension of the genesis and development of complex diseases. In this context, microRNAs (miRNAs) are post-transcriptional regulators that play an important role in gene expression since they are frequently deregulated in pathologies like cardiovascular disease and cancer. In vitro validation of miRNA - targets regulation is often too expensive and time consuming to be carried out for every possible alternative. As a result, a tool able to provide some criteria to prioritize trials is becoming a pressing need. Moreover, before planning in vitro experiments, the scientist needs to evaluate the miRNA-target genes interaction network. In this paper we describe the miRable method whose purpose is to identify new potentially relevant genes and their interaction networks associate to a specific pathology. To achieve this goal miRable follows a system biology approach integrating together general-purpose medical knowledge (literature, Protein-Protein Interaction networks, prediction tools) and pathology specific data (gene expression data). A case study on Prostate Cancer has shown that miRable is able to: 1) find new potential miRNA-targets pairs, 2) highlight novel genes potentially involved in a disease but never or little studied before, 3) reconstruct all possible regulatory subnetworks starting from the literature to expand the knowledge on the regulation of miRNA regulatory mechanisms

    Valproate induces the unfolded protein response by increasing ceramide levels

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    Bipolar disorder (BD), which is characterized by depression and mania, affects 1–2% of the world population. Current treatments are effective in only 40–60% of cases and cause severe side effects. Valproate (VPA) is one of the most widely used drugs for the treatment of BD, but the therapeutic mechanism of action of this drug is not understood. This knowledge gap has hampered the development of effective treatments. To identify candidate pathways affected by VPA, we performed a genome- wide expression analysis in yeast cells grown in the presence or absence of the drug. VPA caused up-regulation of FEN1 and SUR4, encoding fatty acid elongases that catalyze the synthesis of very long chain fatty acids (C24 to C26) required for ceramide synthesis. Interestingly, fen1Δ and sur4Δ mutants exhibited VPA sensitivity. In agreement with increased fatty acid elongase gene expression, VPA increased levels of phytoceramide, especially those containing C24–C26 fatty acids. Consistent with an increase in ceramide, VPA decreased the expression of amino acid transporters, increased the expression of ER chaperones, and activated the unfolded protein response element (UPRE), suggesting that VPA induces the UPR pathway. These effects were rescued by supplementation of inositol and similarly observed in inositol-starved ino1Δ cells. Starvation of ino1Δ cells increased expression of FEN1 and SUR4, increased ceramide levels, decreased expression of nutrient transporters, and induced the UPR. These findings suggest that VPA-mediated inositol depletion induces the UPR by increasing the de novo synthesis of ceramide

    Exploring actors roles in formulation of the human resources for health policy in Nigeria

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    BACKGROUND: Most policies in Nigeria are deliberate choices based on political mechanism, oversight, and lack of appropriate information. However in recent times there has been a global shift towards evidence based policy making. Thus Actors' views on evidence and their role in policy development appear critical to the use of evidence.OBJECTIVE: This study aimed to examine how actors' perception, roles and levels of power influenced Human Resources for Health policy development in Nigeria.METHOD: The research was conducted using a case study approach. Systematic reviews of relevant policy documents and reports, in-depth interviews of twelve respondents comprising government policymakers, academia, civil society organizations, health-workers and development partners were done. Interviews were analysed using NVivo 10 software for qualitative analysis.FINDINGS: Most respondents perceived evidence to be factual and concrete to support a given decision. The government policymakers wielded a high level of power and spearheaded the policy process. Development partners were major decision makers because they had financial and technical power. Civil society groups had the power of advocacy and generated evidence. The academia had medium power level of power and also generated evidence.CONCLUSION: The actors' with the highest level of power greatly influenced policy use and type of evidence used in formulating the Human Resources for Health policy. Stakeholders with coercive, financial or group power influenced the type of evidence finally used in formulating the Human Resources for Health policy.KEY WORDS: Human Resource for Health; Health policy making; Role of actors in policy makin

    Impact of the COVID-19 pandemic on paediatric otolaryngology: a nationwide study

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    Objective: The COVID-19 pandemic profoundly modified the work routine in healthcare; however, its impact on the field of paediatric otorhinolaryngology (ORL) has been rarely investigated. The aim of this study was to assess the impact of COVID-19 on paediatric ORL. Methods: A questionnaire was developed by the Young Otolaryngologists of the Italian Society of ORL-Head and Neck Surgery (GOS). The questionnaire consisted of 26 questions related to workplace and personal paediatric ORL activities. The link was advertised on the official social media platforms and sent by e-mail to 469 Italian otolaryngologists. Results: The questionnaire was completed by 118 responders. During the pandemic, the main reduction was observed for surgical activity (78.8%), followed by outpatient service (16.9%). The conditions that were mostly impacted by a delayed diagnosis were respiratory infections in 45.8% of cases and sensorineural hearing loss in 37.3% of cases. Conclusions: Paediatric ORL was highly impacted by the COVID-19 pandemic, with a significant reduction of surgical and outpatient activities and a delay in time-sensitive diagnosis. Therefore, the implementation of new strategies, such as telemedicine, is recommended

    First evaluation of pesticides occurrence in groundwater of Tidone Valley, an area with intensive viticulture.

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    Abstract Agricultural practice often involves an intensive and incorrect use of pesticides and fertilizers. These chemicals can leach through the soil profile and contaminate groundwater, including drinking water. For this reason, an effective groundwater monitoring is strongly advisable. The aim of this study was to investigate the groundwater contamination by plant protection products (PPPs) on a hilly area situated in the Tidone Valley, North-West of Italy, a region characterized by an intensive viticulture production. This area is not included in the national groundwater monitoring plan and therefore scarce information is available regarding the quality of groundwater, even though the local Environmental Agency previously revealed the occurrence of PPPs at values higher than the Environmental Quality Standard downstream this area. Hence, a monitoring wells network was developed following an upstream-downstream criterion, a list of pesticides to be monitored, based on a multi-actor approach, and an analytical method for PPPs detection and quantification. The analytical approach involved solid phase extraction followed by High-Performance Liquid Chromatography tandem mass spectrometry. The results of three monitoring campaigns revealed the occurrence of seven PPPs at a level higher than EQS for groundwater (0.1 ÎĽg/L) in 30% of the wells. The main pesticides detected were Chlorantraniliprole, Dimethomorph, Fluopicolide, Metalaxyl-M, Penconazole, and Tetraconazole, all commonly used in viticulture, together with S-metolachlor, authorized for cereal cropping. Statistical analysis revealed a significant influence of the sampling time, slope of the soil surrounding the wells, wells depth and wells location on the concentration of five PPPs. Therefore, the results obtained show that the improper use of PPPs for grapevine cultivation may cause groundwater contamination and suggest the need for a deeper analysis of territorial reality, including hydrology studies and farmer behavior and for an urgent introduction of best management practices and mitigation measures to promote a sustainable use of PPPs in viticulture

    Multi-actor approach and engagement strategy to promote the adoption of best management practices and a sustainable use of pesticides for groundwater quality improvement in hilly vineyards.

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    The adoption of pesticide mitigation measures and innovation at farm level, are seen as a drivers to reach the sustainable water policy objectives. With the aim to prevent the pesticide pressure of hilly vineyards on groundwater contamination, a stepwise approach in Tidone Valley was applied using different consultation mechanisms and involvement strategies throughout the overall process. Face to face meetings, direct surveys, participatory monitoring and planning of several activities aiming to inform, educate, improve skills, change of individual behaviour or raise awareness, or even initiatives to build institutional trust or support for new investment in innovation are some examples. These activities allowed us to involve key actors of water use and governance (such as farmers, advisors, representatives of drinking water management, farmer's associations, Winemaking cooperatives, local Health Authority), and to have a deeper knowledge of the context agricultural practices, of farmer's knowledge and skills concerning factors influencing water contamination and also to promote the most suitable Best Management Practices aimed at limiting the pesticide occurrence in groundwater. Indeed, the surveys results highlighted that the majority of the farms are small (64% of vineyards10 ha), that most of the farmers (62%) are not aware of the current legislation on water, even if 64% of them declare to participate regularly to training courses for the prevention of water contamination and that there is a low to moderate level of adoption of Best Practices able to prevent contamination by pesticides. At the end of the overall process, it can be stated that the multi-actor approach and engagement strategy adopted were successful in improving attitudes to more sustainable practices. This is supported also by the monitoring data that show in 2019 a decrease by 44% of pesticides occurrences and a fall by 68% of values above EQ

    Cholesteatoma vs granulation tissue: a differential diagnosis by DWI-MRI apparent diffusion coefficient

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    To diagnose cholesteatoma when it is not visible through tympanic perforation, imaging techniques are necessary. Recently, the combination of computed tomography and magnetic resonance imaging has proven effective to diagnose middle ear cholesteatoma. In particular, diffusion weighted images have integrated the conventional imaging for the qualitative assessment of cholesteatoma. Accordingly, the aim of this study was to obtain a quantitative analysis of cholesteatoma calculating the apparent diffusion coefficient value. So, we investigated whether it could differentiate cholesteatoma from other inflammatory tissues both in a preoperative and in a postoperative study

    Insight into Hypoxia Stemness Control

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    Recently, the research on stemness and multilineage differentiation mechanisms has greatly increased its value due to the potential therapeutic impact of stem cell-based approaches. Stem cells modulate their self-renewing and differentiation capacities in response to endogenous and/or extrin- sic factors that can control stem cell fate. One key factor controlling stem cell phenotype is oxygen (O2). Several pieces of evidence demonstrated that the complexity of reproducing O2 physiological tensions and gradients in culture is responsible for defective stem cell behavior in vitro and after transplantation. This evidence is still worsened by considering that stem cells are conventionally incubated under non-physiological air O2 tension (21%). Therefore, the study of mechanisms and signaling activated at lower O2 tension, such as those existing under native microenvironments (referred to as hypoxia), represent an effective strategy to define if O2 is essential in preserving naĂŻve stemness potential as well as in modulating their differentiation. Starting from this premise, the goal of the present review is to report the status of the art about the link existing between hypoxia and stemness providing insight into the factors/molecules involved, to design targeted strategies that, recapitulating naĂŻve O2 signals, enable towards the therapeutic use of stem cell for tissue engineering and regenerative medicine
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