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Functional movement disorders (FMD) refer to a heterogeneous group of manifestations incongruent with known neurological diseases. Functional neuroimaging studies in FMD indicate the overlap between cerebral regions in which abnormal activation occurs and those considered crucial for theory of mind (ToM), the ability to attribute mental states. The aim of this study was to explore whether FMD might be related to ToM disorders to the extent that they reduce the ability to make inferences about the mental states underlying motor behaviour during social interaction.Eighteen subjects with FMD and 28 matched healthy controls (HC) were given a ToM battery. The severity of FMD was rated by the Simplified-FMD Rating Scale (S-FMDRS). Dissociative symptoms were evaluated by the Dissociative Experiences Scale (DES-II).FMD scored worse than the HC in most ToM tasks: second-order False Beliefs (p = .005), Faux-Pas Recognition Test (p .001) and Reading the Mind in the Eyes Test (p = .020); control questions elicited normal scores. The DES-II indicated dissociative-borderline psychopathology and negatively correlated with accuracy on the second-order False Belief (Spearman's rho = -.444; p = .032); the positive correlation between DES-II and severity of motor symptoms (S-FMDRS) approached significance (Spearman's rho test = .392; p = .054). ToM disorders were not correlated with S-FMDRS, due to the typical variability in FMD over time with regard to the severity of symptoms and the district of body involved.Our results are consistent with the hypothesis that FMD are related to ToM deficits, and future studies are needed to define the specific nature of this relationship.

Objetivo: Analisar o desempenho das Comissões Intra-Hospitalares de Doação de Órgãos e Tecidos para Transplantes da Macrorregional Norte do Paraná, Brasil. Método: Estudo de avaliação realizado com 7.383 notificações de 16 hospitais sobre potenciais doadores, cujos óbitos ocorreram em 2015. Os dados fornecidos pela Central Estadual de Transplantes foram analisados por meio dos indicadores de desempenho da Portaria 2600/2009. Resultados: Cerca de metade dos doadores elegíveis por morte encefálica se tornaram efetivos nas comissões tipos II e III, não havendo diferenças significativas entre seus desempenhos (p=0,579). A efetivação das doações nos óbitos por parada cardiorrespiratória foi de 33,6% nas comissões do tipo III, 18,8% nas do tipo II e 5,3% nas do tipo I; e indicou que quanto maior a sua classificação, maior foi o número de tecidos doados (p

Background and Sex and cognitive profile may be related to the laterality of motor symptoms in idiopathic Parkinson's disease. Introduction Parkinson's disease (PD) is well recognised as an inherently asymmetric disease with unilateral onset of motor symptoms. The laterality of motor symptoms may be linked to sex, clinical and demographic variables, and neuropsychological disorders. However, the available data are inconsistent. This study aimed to explore the potential association between the laterality of motor symptoms and clinical and demographic variables and deficits in specific cognitive domains. Material and methods We retrospectively recruited 97 participants with idiopathic PD without dementia; 60 presented motor symptoms on the left side and 37 on the right side. Both groups were comparable in terms of age, age at disease onset, disease duration, and severity of the neurological deficits according to the Unified Parkinson's Disease Rating Scale and the Hoehn and Yahr scale. Results Participants with left-side motor symptoms scored lower on the Schwab and England Activities of Daily Living scale. Our sample included more men than women (67% vs. 33%). Both sexes were not equally represented in the 2 groups: there were significantly more men than women in the group of patients with left-side motor symptoms (77% vs. 23%), whereas the percentages of men and women in the group of patients with right-side motor symptoms were similar (51% vs. 49%). Both groups performed similarly in all neuropsychological tasks, but women, independently of laterality, performed better than men in the naming task. Conclusion We found a clear prevalence of men in the group of patients with left-side motor symptoms; this group also scored lower on the Schwab and England Scale. Female sex was predictive of better performance in the naming task. Sex should always be considered in disorders that cause asymmetric involvement of the brain, such as PD.

Con capacità di sintesi e con invidiabile padronanza espressiva, Sestini riesce a mettere in relazione geologia, clima, vegetazione, variazione dell'ambiente fisico durante il corso dell'anno, popolazione, insediamento: questi sono i livelli più alti che la letteratura geografica italiana abbia raggiunto nel produrre analisi di paesaggi secondo i canoni della geografia classica., Semestrale di studi e ricerche di geografia, N. 2 (1993)

Da Fiuggi, dopo circa 20 km, superato il Passo della Sella (931 m), si raggiungono gli Altipiani di Arcinazzo., Semestrale di studi e ricerche di geografia, N. 2 (1991)

La tematica turistica, e in particolar modo quella della "seconda casa", hanno visto fiorire in questi ultimi anni un'ampia letteratura. Paradigmi sistemici e modelli generali di organizzazione dello spazio turistico sono stati alla base di studi e di valutazioni, che hanno riconosciuto al turismo un ruolo di attività motrice nelle trasformazioni economiche e territoriali. Sempre più si va delineando uno scenario nuovo, ricco di relazioni e di interdipendenze culturali, sociali e di costume, coniugate a iniziative imprenditoriali in grado di favorire l'ingresso e l'affermazione di variegate forme turistiche. Infatti, la necessità, da parte del mercato, di un continuo e costante aggiornamento del prodotto, diversificando e variegando l'offerta, in seguito ad una domanda crescente di alloggi per vacanze, si è recentemente concretizzata nella realizzazione di nuove "strutture di accoglienza" ad uso turistico-residenziale. Proprio in tale ambito si colloca quest'indagine volta ad esaminare una particolare forma di "occupazione" turistica del suolo: la multiproprietà., Semestrale di studi e ricerche di geografia, N. 1 (1996)

Sebbene, oggi, si sia consolidata l'idea della montagna quale sistema fragile e sensibile, gli interventi per la tutela e la valorizzazione di questa risorsa non sempre risultano appropriati e mirati. Ideare strategie veramente vincenti non è semplice e tale difficoltà nasce proprio dal fatto che "l'evoluzione della montagna va inquadrata in rapporto all'ambiente esterno, con tutte le opportunità che esso può offrire e con tutte le sfide che può lanciare, ma anche con tutti i pericoli che da questo possono derivare" (De Vecchis, 1998, p. 16)., Semestrale di studi e ricerche di geografia, N. 2 (2002)

Objective: to know the nurses' perception in the process of organ and tissue donation for transplants. Methods: qualitative research with data collection performed through a semistructured interview with 16 nurses from a hospital. The data were submitted to Bardin content analysis. Results: categories emerged after content analysis were as follows: Organ donation process: nurses' experience; Nursing care for potential donors; Family approach; Main difficulties in the donation process. Conclusion: the research demonstrated the real difficulties of the professionals during the donation process, such as lack of human resources, extensive protocols, and lack of awareness of the society to understand the donation process and the family approach. Keywords: Transplantation of Organs; Obtaining Tissues and Organs; Nursing care.

Neste estudo, objetivou-se avaliar o desempenho das Comissões Intra-Hospitalares de Doação de Órgãos e Tecidos para Transplantes (CIHDOTT) da Macrorregional Norte do Paraná. Pesquisa de avaliação, transversal e de abordagem quantitativa, realizada com dados de CIHDOTT de 16 instituições hospitalares da Macrorregional Norte do Paraná, cadastradas para notificar os óbitos por morte encefálica (ME) e parada cardiorrespiratória (PCR) à Central Estadual de Transplante. A fonte de dados do estudo foi composta por 7.383 relatórios de óbitos e as respectivas notificações e doações realizadas no ano de 2015. Os dados foram analisados no programa Statistical Package for the Social Sciences, versão 20.0, utilizando estatística descritiva e inferencial, considerando o nível de significância de 5% e intervalo de confiança de 95%. A maioria dos hospitais era filantrópico e possuía equipe de remoção de órgãos/tecidos. As equipes das CIHDOTT do tipo III apresentaram o maior número de membros e carga horária destinada à comissão. Nas notificações de óbitos por ME, metade dos doadores elegíveis tornaram-se doadores efetivos nas CIHDOTT tipos II e III, enquanto a CIHDOTT tipo I não apresentou notificação. A efetivação das doações nos óbitos por PCR foi de 5,3% na CIHDOTT tipo I, 18,8% na do tipo II e 33,6% na do tipo III. Em relação aos óbitos por PCR viáveis à doação e não entrevistados, a CIHDOTT tipo I apresentou 71,1% de escapes nas entrevistas familiares. A prevalência de doações efetivas foi de 23,4%, e entre os 582 órgãos e tecidos doados, predominou a captação de córneas. A efetivação das doações esteve relacionada aos óbitos por ME (RP=2,482), ocorridos nas CIHDOTT do tipo III (RP=2,016), nas unidades de terapia intensiva (RP=1,471) e as entrevistas realizadas por enfermeiro (RP=1,324); o consentimento para a doação foi menor quando os familiares entrevistados foram os cônjuges e/ou filhos (RP=0,469). Os resultados demonstraram que as CIHDOTT tipo III apresentaram desempenho melhor comparado com as do tipo I e II. O estudo fornece subsídios aos gestores da Central Estadual de Transplantes, para que estimulem e capacitem os membros das CIHDOTT, com a finalidade de melhorar os indicadores de eficiência das doações e, por consequência, o número de transplantes. In this study, it was aimed to evaluate the performance of Intra-hospital Committees of organ and tissue donation for transplantation (CIHDOTT) the Regional Norte do Paraná. Evaluation research, and quantitative approach, carried out with data from CIHDOTT of 16 hospitals of Regional Norte do Paraná, registered to notify the deaths by brain death (ME) and cardiopulmonary arrest (PCR) the State Transplant Center. The data source of the study was composed of 7,383 reports of deaths and their notifications and donations made in the year 2015. The data were analyzed in the p programme Statistical Package for the Social Sciences, 20.0 version, using descriptive statistics and inferential statistics, considering the level of significance of 5% and 95% confidence interval. Most hospitals and philanthropic team was removing organs/tissues. The staff of CIHDOTT of type III presented the largest number of members and workload for the Commission. In notifications of deaths for ME, half of eligible donors become actual donors in CIHDOTT types II and III, while the type I CIHDOTT not submit notification. The effectuation of the donations in the deaths by PCR was 5.3% in CIHDOTT type I, type II 18.8% and 33.6% in type III. In relation to the deaths by PCR to donation and non-viable respondents, the CIHDOTT type I presented 71.1% escapes on family interviews. The prevalence of effective donations was 23.4%, and between the organs and tissues donated 582, predominated the corneas. The effectuation of the donations was related the deaths by ME (RP = 2.482), occurring in the CIHDOTT of type III (RP = 2.016), in intensive care units (RP = 1.471) and the interviews conducted by nurse (RP = 1.324); the consent for the donation was lower when the families interviewed were the spouse and/or children (RP = 0.469). The results showed that the CIHDOTT type III showed higher performance compared to type I and II. The study provides subsidies to Central State managers of transplants, to encourage and enable members of the CIHDOTT, with the purpose to improve the indicators of efficiency of donations and, consequently, the number of transplants.

Background: The preoperative assessment involves the process of evaluating the patient’s clinical condition, which is intended to define the physical status classification, eligibility for anesthesia, and the risks associated with it, thus providing elements to select the most appropriate and individualized anesthetic plan. We obtained evidence concerning pediatric preoperative evaluation on specific conditions and clinical problems: upper respiratory infections, asthma and bronchial hyperresponsiveness, bronchopulmonary dysplasia, allergies, heart murmurs, and vaccination. We produce a set of recommendations, with emphasis on the level of evidence, clinical relevance, and the risk/benefit ratio.

Summary objective The diagnosis of GH insufficiency (GHI) in childhood is not straightforward. Our aim was to test the sensitivity and specificity of height velocity (HV), IGF-I, IGFBP-3 and GH stimulation tests alone or in combination in the diagnosis of GHI. design A retrospective review of patients with GHI and idiopathic short stature (ISS) diagnosed in our centre and followed up to the completion of linear growth. patients Thirty-three GHI children and 56 children with ISS were evaluated. GHI diagnosis was based on fulfilment of anthropometric, endocrine and neuroradiological criteria: stature ≤ −2 z-score, delayed bone age (at least 1 year), GH peak response to at least two different provocative tests 10 µg/l (20 mU/l) were diagnosed as ISS. measurements All subjects underwent standard anthropometry. GH secretory status was assessed by clonidine, arginine and GHRH plus arginine stimulation tests. IGF-I and IGFBP-3 circulating levels were measured by immunoradiometric assay (IRMA). The following cut-off values were chosen to discriminate between GHI and nonGHI short children: HV

O s?culo XII foi marcado por uma discuss?o filos?fica prof?cua pr?pria da filosofia ?tica e que se mostra presente em v?rios escritos de Pedro Abelardo. Esse pensador, seguindo uma tend?ncia que por alguns te?ricos foi chamada de humanista, defendia um debate necess?rio e l?cito entre filosofia e teologia e entre raz?o e f?. Neste sentido, ele ? considerado um dos pensadores que deram base para a futura produ??o filos?fica chamada de escol?stica. No campo ?tico, seguindo ensinamentos de fil?sofos pag?os e crist?os como Santo Agostinho, Bo?cio, C?cero e Arist?teles, Abelardo defendia que um ato, para ser julgado de forma ?tica, deve ser analisado segundo a inten??o e o consentimento do sujeito que o executa, negando quaisquer propostas cujo fundamento seja apenas baseado nos atos. Assim, Abelardo acabou propondo uma indispens?vel an?lise do significado de justi?a, separando a no??o t?cnica de Direito do aspecto Moral, sem, com isso, deixar de cobrar das pessoas a responsabilidade por suas m?s escolhas. Cr?tico feroz das penit?ncias executadas devido a interesses pessoais e ego?stas, dos atos religiosos que se confundiam com meras trocas com Deus e da perspectiva de uma moralidade apenas dependente de um temor em rela??o a Deus, o Palatino criou um debate muito rico que ? importante para o entendimento de v?rios conceitos ?ticos e jur?dicos contempor?neos

The diagnosis of GH insufficiency (GHI) in childhood is not straightforward. Our aim was to test the sensitivity and specificity of height velocity (HV), IGF-I, IGFBP-3 and GH stimulation tests alone or in combination in the diagnosis of GHI.A retrospective review of patients with GHI and idiopathic short stature (ISS) diagnosed in our centre and followed up to the completion of linear growth.Thirty-three GHI children and 56 children with ISS were evaluated. GHI diagnosis was based on fulfilment of anthropometric, endocrine and neuroradiological criteria: statureor = -2 z-score, delayed bone age (at least 1 year), GH peak response to at least two different provocative tests10 micro g/l (20 mU/l), brain MRI positive for hypothalamus-pituitary abnormalities, catch-up growth during the first year of GH replacement therapyor = 75th centile, peak GH response to a third provocative test after growth completion10 micro g/l (20 mU/l). Children with anthropometry resembling that of GHI but with peak GH responses10 micro g/l (20 mU/l) were diagnosed as ISS.All subjects underwent standard anthropometry. GH secretory status was assessed by clonidine, arginine and GHRH plus arginine stimulation tests. IGF-I and IGFBP-3 circulating levels were measured by immunoradiometric assay (IRMA). The following cut-off values were chosen to discriminate between GHI and nonGHI short children: HV25th centile over the 6-12 months prior to the initiation of GH therapy, peak GH responses10 or7 micro g/l (20 or14 mU/l) and IGF-I and IGFBP-3-values-1.9 z-score. Sensitivity (true positive ratio) and specificity (true negative ratio) were evaluated.Taking 10 micro g/l (20 mU/l) as the cut-off value, sensitivity was 100% and specificity 57% for GH provocative tests, whereas taking 7 as the cut-off value, sensitivity was 66% and specificity rose to 78%. Sensitivity was 73% for IGF-I and 30% for IGFBP-3 measurement, whilst specificity was 95% for IGF-I and 98% for IGFBP-3 evaluation. HV assessment revealed a sensitivity of 82% and a specificity of 43%. When HV and IGF-I evaluations were used in combination, sensitivity reached 95% and specificity 96%. When both HV and IGF-I are normal (26% of our subjects) GHI may be ruled out, whereas when both the indices are subnormal (23%) GHI is so highly likely that the child may undergo only one GH provocative test and brain MRI and, thereafter, may begin GH therapy without any further test. In case of discrepancy, when IGF-I is normal and HV25th centile (44% of children), due to the relatively low sensitivity of IGF-I assessment and low specificity of HV, the patient should undergo GH tests and brain MRI. Finally, in the rare case of HV25th centile and subnormal IGF-I-values (7%), due to the high specificity of IGF-I measurement, the child should undergo one provocative test and brain MRI for the high suspicion of GHI.Our results suggest that a simple assessment of HV and basal IGF-I may exclude or, in association with only one stimulation test, confirm the diagnosis of GH insufficiency in more than half of patients with short stature.

The elimination of transuranium (TRU) elements by neutron absorption has been investigated in an actual power liquid-metal fast breeder reactor (LMFBR) (of the Superphenix type). Special fuel elements containing TRU oxides were considered in different core locations. The effects on design parameters have also been evaluated. The results show that the advantages of TRU elimination by means of LMFBRs, compared with using a thermal reactor, consist mainly of the small perturbation of the integral properties and design parameters of the reactor for the large amount of TRU that can be introduced. However, from the point of view of the TRU transmutation reaction rates, thermal reactors seem to be better. The choice of a compromise between the variation of design parameters and the TRU amount to be transmutated depends on the actual reactor design.

Damage caused by neutrons in the first wall of a fusion reactor is studied in detail for two different structural materials (Type 316 stainless steel and nimonic PE-16) in a fusion power plant design. The first-wall neutron spectrum is calculated by the ANISN code, and a dosimetric analysis is performed for both materials. Moreover, a complete study of damage (swelling and creep) during reactor life is done for type 316 stainless steel. On the basis of 1% creep strain, the lifetime of a type 316 stainless steel first wall is calculated to be {approximately} 2 yr, compared with the {approximately} 22-yr lifetime obtained for nimonic in the power plant design. In this way, the economic advantage of a superalloy, compared to stainless steel, has been confirmed.

A procedure exploiting time-dependent generalized perturbation theory applied to the nuclide field is proposed for cases of interest, namely for fuel burnup and buildup problems during the reactor ...