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The paper aims at investigating the relationship between Trumpism and the European far-right parties. The combination of shared ideological cores with the confrontation of similar “enemies” has resulted in the creation of an unprecedented relationship, wherein Trump takes the role of “international godfather” and inspiration for the European far right. To examine this relation, the paper focuses on references to Donald Trump and his policies and statements from 2016 to 2020 in the discourse of Alternative für Deutschland (AfD), Hungarian Civilian Alliance (Fidesz), and Lega Nord (Lega). The examination of the discourse of the three parties about security, immigration, foreign policy, and corruption shows that these parties have utilised Trumpism in three manners. Firstly, they have employed Trumpism to normalise certain pre-existing far-right ideologies and practices within their national and European context. Secondly, they have emulated Trump’s discourse and policies to capitalise on his popularity and support their national endeavours. Thirdly, they have used Trump’s fight and ideas to justify national measures, beliefs, criticism, or political goals. This paper thus aims to establish the leitmotifs governing the use of Trumpism by European far right to set the framework for future more critical analyses and a better understanding of this unprecedented relationship. Celem artykułu jest zbadanie relacji między Trumpizmem a skrajnie prawicowymi partiami politycznymi w Europie. Połączenie wspólnych rdzeni ideologicznych i konfrontacji z podobnymi „wrogami” doprowadziło do powstania niespotykanej dotąd relacji, w której Trump odgrywa rolę „międzynarodowego ojca chrzestnego” i inspiratora europejskiej skrajnej prawicy. W celu zbadania tej relacji praca skupia się na odniesieniach do aktywności Donalda Trumpa, jego polityki i wypowiedzi w latach 2016–2020 w dyskursie Alternative für Deutschland (AfD), Węgierskiej Partii Obywatelskiej (Fidesz) i Lega Nord (Lega). Analiza dyskursu trzech partii w zakresie bezpieczeństwa, imigracji, polityki zagranicznej i korupcji pokazuje, że partie te wykorzystały Trumpizm jako inspirację w trzech aspektach. Po pierwsze, użyły go do normalizacji wcześniej istniejących skrajnie prawicowych ideologii i praktyk w kontekście narodowym i europejskim. Po drugie, naśladowali dyskurs Trumpa i jego polityki do zwiększenia jego popularności i wsparcia własnych dążeń narodowościowych. Po trzecie, wykorzystali walkę i idee Trumpa do uzasadnienia narodowych metod, wierzeń, krytyk i celów politycznych. W związku z tym artykuł ma ustalić główne motywy do wykorzystania Trumpizmu przez europejską skrajną prawicę do ustanowienia podwalin dla przyszłych analiz krytycznych i lepszego zrozumienia tej niespotykanej relacji.

The severity of fatty liver at ultrasound has been associated with QT length, a finding invoked to explain the excess cardiovascular risk of patients with fatty liver. However, the ability of ultrasound to stage accurately the severity of fatty liver is limited, with fibrosis a major confounder. Here, we aimed to verify the alleged relationship between fat liver content and QT length using a technique apt at discriminating steatosis from fibrosis noninvasively, i.e., transient elastography (TE) with measure of liver stiffness (LS) and controlled attenuation parameter (CAP). A prospectively collected derivation cohort of 349 patients with chronic liver disease (CLD) of any etiology (N=105 with nonalcoholic fatty liver) was studied to identify clinical, laboratory, and instrumental predictors of the corrected QT interval (QTc) and QTc prolongation, including LS and CAP. The results were validated on a subgroup of patients belonging to the derivation cohort (out of sample validation), as well as on a completely different group of N=149 subjects with CLD (out of time validation). QTc values were directly related to liver stiffness (LS; ρ=0.137; p=0.011), heart rate (HR; ρ=0.307; p<0.001), and age (ρ=0.265; p<0.001) and were significantly longer in females (p<0.001). In contrast, QTc was not associated with the value of controlled attenuation parameter (ρ=0.019; p=0.718); moreover, no discernible differences in QTc length were noted based on CLD etiology. QTc was prolonged in 24/349 patients (6.9%); age, HR, and LS were independent predictors of QTc prolongation (χ2=23.7, p<0.001). Furthermore, QTc values (after logarithmic transformation) were predicted by a model including age, gender, HR, and LS (F=14.1, R2=0.198, p<0.001). These latter results were validated by both out-of-sample and out-of-time methods. In conclusion, TE findings strongly suggest that among patients with CLD, fibrosis, not steatosis, is a major determinant of QTc length.

Electronic books (e-books) are an alternative to traditional books and have some advantages over it. For example, they present dictionary function, allow searching for words in texts, are ecologically correct, among others. Moreover, research indicates e-books can improve the learning process. The learning process is also improved with the use of enhanced e-books, which includes multimedia resources (e.g., images, videos, sounds) to stimulate adapted and interactive learning. Similarly, multisensorial media (MulSeMedia) research presents the possibility of expanding the senses with additional media components, like haptic or gustatory devices, which can enhance the learner quality of experience. In this scenario, this work proposes a new model to combine enhanced e-books and MulSeMedia to improve the learning process. This model is named Multisensorial Electronic Books, or Multisensorial Books, for short. A prototype with auditory, haptic and olfactory effects is also created. This initial prototype showed promising results, indicating the present study may open avenues for further researches.

The universal introduction of technology in the educational process has been an ally to overcome some deficits in the educational system. Ceibal en Ingles program was a solution to the lack of teachers in Uruguay. This study aims to investigate the quality of teaching English through videoconference in 4th, 5th and 6th grade students of Public Primary Education in Uruguay. The characteristics and teaching practices that are associated with good results in student learning are identified. The study finds evidence about the effect of the remote teachers, evidencing that they have a different degree of effectiveness. The factors associated with the learning were analyzed, finding that the observable characteristics of the teachers are weakly related to the teaching quality mediated through the performance of their students. Finally, evidence was found that the practices analyzed in the classroom observation account, in part, for the effectiveness of the remote teachers.

Agradecimentos: RCF participou da concepção e do delineamento do estudo, coleta, análise, interpretação dos dados e redação final; DCCS participou da concepção e do delineamento do estudo, análise, interpretação dos dados e redação final, bem como da aprovação final da versão a ser publicada; MMFG participou da concepção e do delineamento do estudo, análise, interpretação dos dados e redação final bem como da aprovação final da versão a ser publicada; MPCO participou da coleta e da análise dos dados; CTMS participou da análise e da interpretação dos dados bem como da aprovação final da versão a ser publicada; VD participou da coleta, análise e interpretação dos dados; MCMPL participou da concepção e do delineamento do estudo, análise, interpretação dos dados e redação final bem como da aprovação final da versão a ser publicada Contém 2 arquivos (português e inglês) Resumo: Triar o desenvolvimento global de crianças com e sem hipotireoidismo congênito e investigar a associação entre as habilidades motora fina e de linguagem expressiva nesses dois grupos. Trata-se de um estudo prospectivo de uma coorte de crianças com hipotireoidismo congênito, diagnosticadas e acompanhadas em um serviço de referência em triagem neonatal de um hospital público e de crianças sem essa disfunção. A triagem foi realizada por meio das Escalas Bayley de Desenvolvimento Infantil III, nos domínios cognitivo, motor grosso e fino e de linguagem receptiva e expressiva. O desempenho das crianças foi expresso em competente e não competente. Foram triadas 117 crianças com Hipotireoidismo Congênito diagnosticado pelo teste do pezinho, com o nível de Hormônio Tireotrófico (TSH) normalizado no momento da avaliação e 51 sem essa doença, ambos os grupos com idade média de 21 meses. As crianças com Hipotireoidismo Congênito apresentaram um desempenho pior nas habilidades motora grossa e fina quando realizada a comparação entre os dois grupos e não houve diferença nas áreas cognitiva e de linguagem receptiva e expressiva. A associação entre motricidade fina e linguagem persiste no grupo com a doença, demonstrando que há uma inter-relação dessas habilidades, sendo que o grupo com hipotireoidismo apresenta duas vezes mais chances de alterações na linguagem expressiva quando a motricidade fina já estiver comprometida. No processo de desenvolvimento, ambas as habilidades, linguagem expressiva e motricidade fina, podem estar associadas e/ou dependentes uma da outra nesta amostra avaliada. Abstract: To screen the global development of children with and without congenital hypothyroidism and to investigate the association between fine motor skills and expressive language development in both groups. This is a prospective study of a cohort of children diagnosed with Congenital Hypothyroidism and monitored in a reference service for congenital hypothyroidism of a public hospital and of children without this disorder. The screening was performed using the Bayley Scales of Infant Development III in the cognitive, gross and fine motor skills, and receptive and expressive language domains. The children's performance was expressed in three categories: competent, and non-competent. We screened 117 children with average age of 21 months diagnosed with Congenital Hypothyroidism at birth, with the Thyroid Stimulating Hormone (TSH) level normalized during screening, and 51 children without the condition. The children with Congenital Hypothyroidism presented lower performance in gross and fine motor skills upon comparison between the two groups, and no differences were found in the cognitive and receptive and expressive language domains. The association between fine motor skills and language persisted in the group with Hypothyroidism, demonstrating that the interrelationship of skills is present in all individuals, although this group is two times more likely to present expressive language impairment when fine motor skills are already compromised. In the development process, both skills – motor and expressive language – might be associated and/or dependent on each other in the sample assessed CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQ Aberto

Background Cirrhotic cardiomyopathy is characterized by a set of cardiovascular modifications observed in advanced chronic liver disease. The aim of this study was to investigate cardiovascular alterations in chronic liver disease with different stages of fibrosis and to correlate cardiac involvement with endoscopic complications of portal hypertension. Methods Seventy patients with chronic hepatitis C-related chronic liver disease and 20 sex- and age-matched controls underwent clinical evaluation, hepatic transient elastography, and echocardiography. Forty-nine of the 70 patients underwent an esophagogastroduodenoscopy for screening of esophageal and gastric varices. Results According to the value of liver stiffness (LS), patients were divided in 2 groups: non-cirrhotics (LS 12.5 kPa; n=40; median LS=19.4 kPa, 95%CI 17-22 kPa). Compared to non-cirrhotics, cirrhotics showed a significant dilatation of the left atrium (P=0.007 and P=0.003 for area and volume index, respectively). In patients with chronic liver disease, peak systolic wave velocity (S′) measured by tissue Doppler imaging (TDI) was lower (P=0.004), but ejection fraction was not reduced. Left atrial volume, left ventricular mass index and TDI S′-wave velocity, but not liver stiffness, correlated with endoscopic signs of portal hypertension. Conclusions Left atrial enlargement and peak S′-wave systolic velocities are echocardiographic markers of diastolic and systolic dysfunction in liver cirrhosis. Cardiac alterations closely correlate to endoscopic portal hypertension; further studies could elucidate the potential role of echocardiography in the early identification of cirrhotic patients at higher risk for endoscopic complications of portal hypertension. Keywords Cirrhotic cardiomyopathy, portal hypertension, echocardiography, hepatitis C Ann Gastroenterol 2017; 30 (6): 675-681

Aim: To evaluate serum growth arrest-specific gene 6 (Gas6) concentration as a biomarker of liver fibrosis progression. Materials & methods: One hundred and thirteen consecutive patients affected by chronic liver disease underwent transient elastography, Gas6 measurement and, if clinically indicated, liver biopsy. Results: Gas6 concentration was directly correlated to liver stiffness (r = 0.67; p < 0.0001) and was significantly higher in patients with advanced fibrosis (Ishak 4–5; p < 0.001). A plasma concentration 42 ng/ml identified severe fibrosis with a sensitivity of 64% and a specificity of 95%; the diagnostic accuracy was comparable to that of transient elastography. Conclusion: Gas6 is a novel biomarker of liver fibrosis, with a potential clinical and pathophysiological relevance.

Atriagem auditiva, a identificação e intervenção precoces da perda auditiva possibilitam um bom prognóstico para o desenvolvimento infantil. OBJETIVO: Analisar os resultados obtidos pelo Programa de Saúde Auditiva em neonatos que permaneceram em Unidade de Terapia Intensiva-UTI. MÉTODO: Estudo de corte transversal prospectivo. A amostra foi constituída por recém-nascidos, internados em unidade neonatal do CAISM/Unicamp, por pelo menos 48 horas, no período de 13 meses. O procedimento utilizado para triagem auditiva foi o Potencial Evocado Auditivo de Tronco Encefálico Automático-Madsen Accuscreen, próximo à alta hospitalar. As crianças que falharam na triagem foram encaminhadas para diagnóstico audiológico, otorrinolaringológico e genético. RESULTADOS: Fizeram a triagem auditiva 84,7% dos neonatos vivos, sendo realizada em 39,7% dos casos após 30 dias de vida. O diagnóstico mostrou que 63,8% das crianças apresentaram audição normal. A incidência da perda auditiva foi de 4%, sendo de 1,4% para perda do tipo neurossensorial, 0,24% com Espectro da Neuropatia Auditiva e 2,2% do tipo condutiva. CONCLUSÃO: Concluiu-se que a triagem auditiva neonatal não foi universal e nem aplicada, em muitos casos, no primeiro mês de vida. Deve ser realizada antes da alta hospitalar e em de mais de uma etapa. A incidência da perda auditiva foi elevada.

To determine the prevalence of mouth breathing and to associate the history of breastfeeding with breathing patterns in children. This was an observational study with 252 children of both genders, aged 30 to 48 months, who participated in a dental care program for mothers and newborns. As an instrument of data collection, a semi-structured questionnaire was administered to the children's mothers assessing the form and duration of breastfeeding and the oral habits of non-nutritive sucking. To determine the breathing patterns that the children had developed, medical history and clinical examination were used. Statistical analysis was conducted to examine the effects of exposure on the primary outcome (mouth breathing), and the prevalence ratio was calculated with a 95% confidence interval. Of the total sample, 43.1% of the children were mouth breathers, 48.4% had been breastfed exclusively until six months of age or more, and 27.4% had non-nutritive sucking habits. Statistically significant associations were found for bottle-feeding (p < 0.001) and oral habits of non-nutritive sucking (p = 0.009), with an increased likelihood of children exhibiting a predominantly oral breathing pattern. A statistically significant association was also observed between a longer duration of exclusive breastfeeding and a nasal breathing pattern presented by children. An increased duration of exclusive breastfeeding lowers the chances of children exhibiting a predominantly oral breathing pattern Resumo: Determinar a prevalência da respiração bucal e associar o histórico de amamentação com os padrões de respiração em crianças. Este foi um estudo observacional com 252 crianças de ambos os sexos, com idades entre 30-48 meses, que participaram de um programa de assistência odontológica para mães e recém-nascidos. Como um instrumento de coleta de dados, foi entregue um questionário semiestruturado para as mães das crianças com perguntas sobre a forma e a duração da amamentação e os hábitos bucais de sucção não nutritiva. Para determinar os padrões de respiração desenvolvidos nas crianças, foram utilizados o histórico médico e o exame clínico. Foi realizada uma análise estatística para determinar os efeitos de exposição no principal resultado (respiração bucal), e o índice de prevalência foi calculado com um intervalo de confiança de 95%. Do total da amostra, 43,1% das crianças apresentaram respiração bucal, 48,4% foram amamentados exclusivamente até os seis meses de idade ou mais e 27,4% apresentaram hábitos de sucção não nutritiva. Foram encontradas associações estatisticamente significativas para uso de mamadeira (p < 0,001) e hábitos bucais de sucção não nutritiva (p = 0,009), com um aumento da probabilidade de as crianças apresentarem um padrão de respiração predominantemente bucal. Também foi observada uma associação estatisticamente significativa entre uma maior duração do aleitamento materno exclusivo e um padrão de respiração bucal apresentado pelas crianças. Uma maior duração do aleitamento materno exclusivo diminui as chances de as crianças apresentarem um padrão de respiração predominantemente bucal. Aberto

Background In hypertension clinics, screening patients for the metabolic syndrome (MetS) is common practice, while performing the cumbersome oral glucose tolerance test (OGTT) is not. How large is the underestimation of diabetes and prediabetes that ensues is unknown. Methods We recruited N = 1397 patients with essential arterial hypertension who underwent a 75-g OGTT and were classified as normally glucotolerant (NGT) or having impaired glucose metabolism (IGM), and as affected or not by MetS (ATPIII criteria). The agreement between the OGTT and the ATPIII criteria in attributing a high cardiovascular risk was estimated by matching the categories of MetS and no-MetS with NGT and IGM. Results n = 677/1397 patients (48%) satisfied criteria for MetS, while n = 757/1397 (54%) had an IGM. MetS and IGM were both present in n = 512/1397 patients (36.6%), and both absent in n = 475/1397 (34%). Further n = 410/1397 patients (29%) were discordant for the two conditions: n = 165/410 (40%) had the MetS but were NGT, and n = 245/410 (60%) had IGM but no MetS. Among IGM patients, n = 168/757 (22%; of which 45 had no MetS) received a new diagnosis of diabetes based on OGTT criteria. Among all discordant patients, those with IGM and no MetS were more commonly males (p Conclusions Among patients with hypertension, the estimate of the prevalence of diabetes and prediabetes, hence of the global cardiovascular risk, can be seriously flawed unless an OGTT is performed. Our results support a wider use of the OGTT in the management of hypertension.

The proinflammatory state of metabolic disorders encompasses the alterations in leukocyte counts and acute-phase reactants, and thus, predisposes to acute and chronic cardiovascular events linked to fat accumulation. Leptin is a marker of adiposity and also yields regulatory effects on innate and adaptive immunity; however, its role on the immune function of obese subjects remains to be elucidated. The aim of this study is to determine the influence of obesity and the role of leptin concentrations on lymphocyte counts and immunoglobulin levels as broad markers of immune function. Cross-sectional analysis in 147 obese (64 M, BMI 43 ± 8.1 kg/m2) and 111 age- and sex-matched controls (36 M, BMI 22.5 ± 2.6 kg/m2) by assessment of peripheral leukocyte counts, immunoglobulin (Ig) A, G, M levels, leptin, glucose and lipid homeostasis, and acute-phase reactants. Compared to controls, all the leukocyte components were significantly increased in obesity (p < 0.0001 for all) except for basophils and eosinophils. While IgA and IgG levels were similar between groups, IgM levels were lower (p < 0.001) in obese individuals. A significant relationship was evident between leptin and leukocyte counts (p < 0.001), with this latter being correlated to insulin resistance, adiposity, and lipid profile. At the stepwise multiple regression analysis, leukocytes were best predicted by leptin (β = 0.43, p < 0.0001) and male gender (β = 0.15, p < 0.05), yet when obesity entered the equation, it acted as an independent predictor of leukocytes (β = 0.51, p < 0.0001). Leptin also acted as a predictor of IgA levels (β = 0.20, p < 0.01). Current results show that IgM levels are significantly decreased in patients with obesity in association to significant increments in leukocyte counts. These latter are markedly correlated to leptin levels, insulin resistance, lipid profile, and adiposity. This circumstance, and the significant correlation seen between leptin and IgA levels, may suggest an indirect intervention of leptin in the immunologic alterations consequent to obesity and related to its cardiovascular risk.

Hearing is one of the main ways with which one person can contact the external world; it plays a key role in their integration with society.The objective of this study was to analyze the results of the hearing, medical and genetic evaluation of high-risk infants who failed the newborn hearing screening.Clinical and experimental study. We assessed thirty-eight neonates, with ages between one and six months. The infants underwent the following procedures: medical interview; immittance testing; Brainstem Auditory Evoked Potential; Transient Evoked Otoacoustic Emission and otorhinolaryngological evaluation. DNA extraction from the oral mucosa was performed for genetic studies using the protocol method adapted from the Human Genetics Lab of the CBMEG/UNICAMP.Regarding gender and presence of risk factors, significant statistically differences were not found in normal hearing infants and in those with hearing loss. Concerning gestational age, term infants were more affected by hearing loss. Hearing loss was identified in 58% of the sample, conduction hearing loss represented 31.5% (12/38) and neurossensory 28.9% of cases. There were none of the genetic mutations most commonly seen in cases with a genetic etiology.Hearing loss was identified in the majority of High-risk infants.