Eco-design and tunable structure-properties of chitosan-epoxy-glycerol-silicate biohybrids using integrated crosslinking.

Tunable structure-properties were achieved for chitosan-epoxy-glycerol-silicate (CHTGP) biohybrids, eco-designed via integrated amine-epoxy and waterborne sol-gel crosslinking reactions. Medium molecular weight chitosan (CHT), with 83 % degree of deacetylation was prepared by microwave-assisted alkaline deacetylation of chitin. The amine group of chitosan was covalently bonded to the epoxide of 3-glycidoxypropyltrimethoxysilane (G) for further crosslinking with a sol-gel derived glycerol-silicate precursor (P) from 0.5 % to 5 %. The impact of crosslinking density on the structural morphology, thermal, mechanical, moisture-retention and antimicrobial properties of the biohybrids were characterized by FTIR, NMR, SEM, swelling and bacterial inhibition studies and contrasted with a corresponding series (CHTP) without epoxy silane. Water uptake was significantly reduced in all biohybrids with a 12 % window of variation between the two series. Properties observed in biohybrids with only epoxy-amine (CHTG) or sol-gel crosslinking reactions (CHTP), were reversed in the integrated biohybrids (CHTGP) to impart improved thermal and mechanical stability and antibacterial activity.

Incidence of childhood type 1 diabetes mellitus in Gomel, Belarus.

BACKGROUND: The importance of genetic and environmental factors in causing type 1 diabetes mellitus (DM1) in many European countries is unknown. We studied this question by assessing the incidence of the disease in children in Gomel, Belarus, in the years subsequent to the Chernobyl disaster, comparing it to the antecedent period. METHODS: We identified all new patients with DM1 under 15 years at onset who presented between 1976 and 1999; we used as denominator the number of children aged 0-14 born in Gomel, to calculate the incidence. All data were validated by using the capture-recapture method. We compared the incidence rate between the periods before and after 1986; we also calculated the average increment of incidence in the latter period (1987-1999). RESULTS: In the whole period, 438 new patients presented, with an average crude rate of incidence of 4.6/100,000 but with a net difference between the former (before 1986) and latter (after 1986) periods. The average standard incidence in the latter period was 5.7 (C.I. 4.5-7.0), with a significant increase in the 10-14 year age group. The average yearly increase of incidence in the same period was 8.9%, highly significant (p < 0.001). CONCLUSIONS: The results seem to confirm the hypothesis of the influence of environmental pollution subsequent to the Chernobyl accident.

Establishment of a pediatric surgery center: increasing anesthetic efficiency.

STUDY OBJECTIVE: To examine whether the establishment of dedicated pediatric operating rooms (ORs) staffed exclusively by pediatric anesthesiologists has had a significant impact on anesthetic efficiency during surgery. STUDY DESIGN: Before and after design. SETTING: General and pediatric operating rooms at Yale-New Haven Hospital. MEASUREMENTS AND MAIN RESULTS: Using Operating Room Information System data (1991 to 1997), we examined whether the anesthesia-controlled time, the time it takes for induction and emergence of anesthesia of a selected surgical procedure (tonsillectomy and adenoidectomy), was affected by the change of practice from general to pediatric ORs. The average length of anesthesia induction decreased by 30% (p = 0.0007). Similarly, the average length of emergence from anesthesia decreased by 42% (p = 0.01) and anesthesia-controlled time decreased by 31% (p = 0.0008). Of particular importance is the decrease by 75% in the anesthesia-controlled time range (maximum-minimum). CONCLUSIONS: The establishment of dedicated pediatric ORs resulted in significantly shorter anesthesia induction and emergence times. Furthermore, the decreased variability of anesthesia-controlled time may allow for better scheduling of surgical cases and for better surgeon and patient satisfaction.

Evaluation of glucose tolerance and insulin secretion in cystic fibrosis patients.

UNLABELLED: Blood glucose profile and insulin levels during the oral glucose tolerance test were retrospectively analyzed in 52 cystic fibrosis (CF) patients aged 10-33 years (mean 18 years). Thirty-seven subjects (71.1%) had normal glucose tolerance; 6 patients (11.5%) had impaired glucose tolerance and 9 patients (17.3%), with fasting blood glucose levels below 7.2 mmol/l were classified as diabetic, according to WHO diagnostic criteria. No significant differences in the total amount of secreted insulin (expressed as area under the curve) were detected in CF patients with or without glucose intolerance, but a significant delay in the insulin peak time appeared to be related to a compromised nutritional status. Our data indicate a significantly increased risk of glucose metabolism impairment related to poor nutritional condition (RR 5.40; 95% CI: 1.5-19.7) and worse clinical status (RR 4.27; 95% CI: 1.05-17.2). In particular, glucose tolerance abnormalities were found in 50% of CF patients with an unsatisfactory nutritional condition versus 15.6% of CF patients with good nutritional status. CONCLUSIONS: Since CF-related diabetes is often underdiagnosed and associated with deterioration in patients' overall clinical status, it is very important to identify subjects at risk of developing diabetes by strict monitoring of glucose metabolism when deterioration in nutritional and clinical conditions is seen which cannot be otherwise explained.

Rhetorical intentionality attribution: its ontogenesis in ordinary conversation.

This paper addresses the assumption that the epistemological dichotomy between reality and its construction is an everyday rhetorical tool children and adults use in their explanations and arguments. Within a discursive psychology perspective, the phenomenon of attribution of rhetorical intentionality (AIR) is theoretically defined developing the notion of prepackaged interest attribution technique (Edwards & Potter, 1992). AIR consists in an explanation of others' discursive moves in terms of a rhetorical-argumentative activity; that is, in terms of a deliberate attempt aimed at construing and presenting reality as a function of the speaker's point of view, perspective and interests, in order to affect the listeners mental state (belief, knowledge, intention) or action. Theoretical links are made to the theory of mind paradigm in the study of intentionality attribution, particularly to the form of life approach which defines intentionality attribution in terms of language games. On this basis, the present study examines the structures and functions of AIR used by children and their parents in everyday conversation. Qualitative discourse analysis of transcripts of 22 dinner conversations from eight Italian families shows explicit and implicit AIR in children from three and a half to seven years of age. Moreover, parents attribute rhetorical intentionality to their children, contributing to their social construction as rhetorical speakers. AIR is used as a rhetorical strategy within disputes and argumentative contexts, often achieving topic closure. Results are discussed with reference to the ontological status of intentionalist talk.

[Epidemiologic data on breast feeding in Florence and the province. Survey carried out in 1364 children born between 1985 and 1987]. / Dati epidemiologici sull'allattamento al seno in Firenze e provincia. Indagine condotta su 1364 bambini nati tra il 1985 ed il 1987.

We have studied the breast-feeding frequency in Florentine Area. We investigate a group of 1364 children born between January 1985 and June 1987. We collected following data: 1) Kind of feeding at birth. 2) Duration of breast-feeding related with birth-weight, kind of delivery, mother's age, mother's working activity. 3) Growth in relation to feeding practices from birth to 3rd month. The percentage of infants breast-feed in the hospital was 81.6%, 50.5% at the end of third month, 21.9% at the end of sixth month. We have found that children weighing more than 3000 g at birth had an higher frequency of breast-feeding at birth and last longer than children weighing less than 3000 g (p less than 0.01). Maternal age had a clear effect on both the incidence and the duration of breast-feeding. Mother aged 30 years or more begin to breast-feed in lower percentage but they continue breast-feeding for a longer time. One of the factors that has a negative influence on breast-feeding at birth is caesarean section since it precludes early mother-infant contact and early initiation of breast-feeding. Mother's resume working has a negative influence on breast-feeding duration. With regard to growth in first three months of life related with different kind of feeding we have found no differences between breast-feeding and artificial-fed infants.

Glycosilated fetal hemoglobin in neonates of diabetic mothers.

In diabetic patients, the correlation between glycosilated adult hemoglobin (HbA1c) levels and average glucose concentration over the preceding weeks is well known. We have, therefore, sought the possibility to identify newborns at risk measuring cord blood levels of fetal glycosilated hemoglobin (HbF1) in neonates of diabetic mothers. HbF1 was tested by the isoelectrofocusing method. Mean values of HbF1 have been proven to be higher in in infants born to diabetic mothers as compared to normal newborns. The highest levels were encountered in those babies whose mothers had shown a poor glycemic control during the last few weeks of pregnancy.

[Mucocutaneous lymph node syndrome]. / La sindrome linfomucocutanea.

Authors describe two new cases of mucocutaneus lymphonode syndrome (MCLS). These are the tenth and eleventh in Italy since 1977, confirming that this syndrome, known also as Kawasaki disease, is world-wide spread. More attention is therefore required to diagnosis particularly for possible coronary artery involvement. Echocardiography may be useful in doing that. A survey of recent literature indicates that salicylate therapy may be useful not only for symptoms relief but also in preventing life threatening of coronary artery vasculitis.