bluuebunny/crossref_metadata_2025 huggingface dataset:
A Preliminary Assessment of Ethiopian Sacred Grove Status at the Landscape and Ecosystem Scales.
Authors: Cardelús Catherine , Scull Peter , Hair Joshua , Baimas-George Maria , Lowman Margaret , Eshete Alemaheyu
Published: April 2013

The northern Ethiopian landscape is dotted with small patches of church forests that are religious centers for the Ethiopian Orthodox Tewahido Church (EOTC). These sacred groves are what remain of the once vast tropical Afromontane dry forest. Herein we review the landscape pattern of sacred groves in the Amhara region of Ethiopia, and their local scale nutrient status at two sites, Zahara and Debresena. A total of 1,488 sacred groves were inventoried within the study area, yielding an overall density of one sacred grove for every twenty square kilometers. Sacred groves averaged a little over five hectares and were separated from one another by more than two kilometers. At the local scale we found that soil carbon and nitrogen stocks have decreased significantly between the forest interior and the clearing indicating decreased soil fertility. Together our data indicate that these sacred groves are vulnerable to loss because of their small average size, isolation from seed sources, and decreasing soil status.
Torsional Stiffness Effects on the Dynamic Stability of a Horizontal Axis Wind Turbine Blade
Authors: Jeong Min-Soo , Lee In , Yoo Seung-Jae , Park Kwang-Choon
Published: April 2013

Aeroelastic instability problems have become an increasingly important issue due to the increased use of larger horizontal axis wind turbines. To maintain these large structures in a stable manner, the blade design process should include studies on the dynamic stability of the wind turbine blade. Therefore, fluid-structure interaction analyses of the large-scaled wind turbine blade were performed with a focus on dynamic stability in this study. A finite element method based on the large deflection beam theory is used for structural analysis considering the geometric nonlinearities. For the stability analysis, a proposed aerodynamic approach based on Greenberg’s extension of Theodorsen’s strip theory and blade element momentum method were employed in conjunction with a structural model. The present methods proved to be valid for estimations of the aerodynamic responses and blade behavior compared with numerical results obtained in the previous studies. Additionally, torsional stiffness effects on the dynamic stability of the wind turbine blade were investigated. It is demonstrated that the damping is considerably influenced by variations of the torsional stiffness. Also, in normal operating conditions, the destabilizing phenomena were observed to occur with low torsional stiffness.
Toxic Emissions from a Military Test Site in the Territory of Sardinia, Italy
Authors: Cristaldi Mauro , Foschi Cristiano , Szpunar Germana , Brini Carlo , Marinelli Fiorenzo , Triolo Lucio
Published: April 2013

This work assesses the environmental impact from chemical emissions due to military tests and routine activities in the area occupied by the Italian Inter-force Test Range (PISQ), located at Salto di Quirra, Sardinia, Italy. After reviewing the military activities carried out at PISQ, such as rocket launching, blasting and armament destruction, projectile and mortar fire impact, the associated pollution is evaluated. Chemical analyses were performed by means of Scanning Electronic Microscopy and Energy Dispersion Spectrometry on biotic and abiotic matrices. Residues of Rb, Tl, W, Ti and Al were found in matrices collected in the PISQ areas and environs. A review of experimental data on air, water, soil, milk, forage and animal tissues obtained by various Public Agencies of Sardinia proved that toxic element residues often exceeded the legal limits. PM10 and PM2.5 air concentrations also exceeded the legal limits after military blasting. Cd and Pb contents in the liver and kidneys of sheep living in farms at PISQ and in control farms that were located more than 20 km away from PISQ were higher than the legal limits. This work was performed to investigate concentration of xenobiotics in ecosystems emitted from PISQ activities. This assessment could be useful to focus future epidemiological studies carried out in PISQ and its neighbouring areas.
A Series of Asymmetrical Phthalocyanines: Synthesis and Near Infrared Properties
Authors: Huang Guoqing , Li Jianxi , Cong Fangdi , Li Chao , Chu Xixi , Meng Yanyan , Du Guotong , Du Xiguang
Published: April 2013

We report here the preparation of asymmetrical phthalocyanine dimers 1a–3a, which are endowed with novel charge transfer bands at 1,151–1,154 nm and strong NIR luminescences at 840–860 nm and 1,600–1,650 nm. Through H-bonding interaction, 1a–3a are inclined to self-assemble into hexrod nanotubes at the interface of CHCl3 and CH3OH. Our results provide further insights into the interaction in molecular dimers, and suggest that 1a–3a have potential application in magnets and supramolecular architectures.
Arabinoxylan Microspheres: Structural and Textural Characteristics
Authors: Martínez-López Ana , Carvajal-Millan Elizabeth , Miki-Yoshida Mario , Alvarez-Contreras Lorena , Rascón-Chu Agustín , Lizardi-Mendoza Jaime , López-Franco Yolanda
Published: April 2013

The aim of this research was to study the structural and textural characteristics of maize bran arabinoxylan (MBAX) microspheres. The laccase-induced cross-linking process was monitored by storage (G') and loss (G'') moduli changes in a 4% (w/v) MBAX solution. The G' and G'' values at the plateau region were 215 and 4 Pa, respectively. After gelation, the content of ferulic acid dimers decreased from 0.135 to 0.03 µg/mg MBAX, suggesting the formation of ferulated structures unreleased by mild alkaline hydrolysis. MBAX microspheres presented an average diameter of 531 µm and a swelling ratio value (q) of 18 g water/g MBAX. The structural parameters of MBAX microspheres were calculated from equilibrium swelling experiments, presenting an average mesh size of 52 nm. Microstructure and textural properties of dried MBAX microspheres were studied by scanning electron microscopy and nitrogen adsorption/desorption isotherms, respectively, showing a heterogeneous mesoporous and macroporous structure throughout the network.
Comparison between Calcitriol and Calcitriol Plus Low-Dose Cinacalcet for the Treatment of Moderate to Severe Secondary Hyperparathyroidism in Chronic Dialysis Patients
Authors: Lee Yueh-Ting , Ng Hwee-Yeong , Kuo Chien-Chun , Chen Te-Chuan , Wu Chien-Shing , Chiu Terry , Lee Wen-Chin , Lee Chien-Te
Published: April 2013

Aim: Uremic hyperparathyroidism (UHPT) has been shown to contribute to the development and progression of chronic kidney disease—mineral bone disorder. UHPT is frequently observed in chronic dialysis patients, and patients with UHPT are associated with increased risk of all-cause and cardiovascular mortality. Cinacalcet is a novel agent that increases sensitivity to the calcium-sensing receptor and is approved for control of UHPT. Nevertheless, cinacalcet is costly and information regarding efficacy of low-dose cinacalcet on UHPT is limited. Methods: We conducted a retrospective study to evaluate treatment with either low-dose calcitriol combined with low-dose cinacalcet (25 mg) (d-Cinacalcet) or calcitriol alone (VitD) in dialysis patients with moderate to severe UHPT. A total of 81 dialysis patients were enrolled (40 subjects in d-Cinacalcet group and 41 subjects in VitD group). Demographic data including age, gender, duration on dialysis and biochemical data were reviewed and recorded. Results: At the end of the study, the intact parathyroid hormone (iPTH) levels of the d-Cinacalcet group declined significantly (from 1166.0 ± 469.3 pg/mL to 679.8 ± 421.6 pg/mL, p < 0.0001), while there was no significant change in the VitD group. Significant decrease of serum calcium (Ca: 9.9 ± 0.6 mg/dL vs. 9.6 ± 0.8 mg/dL, p = 0.002), phosphorus (P: 5.9 ± 1.3 mg/dL vs. 4.9 ± 0.9 mg/dL, p < 0.0001) and calcium phosphate product (Ca × P: 58.7 ± 15.0 mg2/dL2 vs. 46.9 ± 8.9 mg2/dL2, p < 0.0001) were observed in the d-Cinacalcet group. In addition, the subjects in the d-Cinacalcet group had a greater proportion to achieve Kidney Disease Outcomes Quality Initiative (KDOQI)-recommended biochemical targets than the subjects in the VitD group (Ca: 48% vs. 24%; P: 78% vs. 32%; Ca × P: 85% vs. 37%; iPTH: 15% vs. 0%). Conclusions: We conclude that combination therapy of low-dose cinacalcet and calcitriol is more effective than calcitriol alone as a treatment for moderate and severe UHPT in chronic dialysis patients. Furthermore, this therapy is associated with improvement in hyperphosphatemia and hypercalcemia.
Selenium Supranutrition: Are the Potential Benefits of Chemoprevention Outweighed by the Promotion of Diabetes and Insulin Resistance?
Authors: Rocourt Caroline , Cheng Wen-Hsing
Published: April 2013

Selenium was considered a toxin until 1957, when this mineral was shown to be essential in the prevention of necrotic liver damage in rats. The hypothesis of selenium chemoprevention is principally formulated by the observations that cancer incidence is inversely associated with selenium status. However, recent clinical and epidemiological studies demonstrate a role for some selenoproteins in exacerbating or promoting other disease states, specifically type 2 diabetes, although other data support a role of selenium in stimulating insulin sensitivity. Therefore, it is clear that our understanding in the role of selenium in glucose metabolism and chemoprevention is inadequate and incomplete. Research exploring the role of selenium in individual healthcare is of upmost importance and possibly will help explain how selenium is a double-edged sword in the pathologies of chronic diseases.
At-Risk Serum Cholesterol Profile at Both Ends of the Nutrition Spectrum in West African Adults? The Benin Study
Authors: Delisle Hélène , Ntandou Gervais , Sodjinou Roger , Couillard Charles , Després Jean-Pierre
Published: April 2013

Low HDL-cholesterol (HDL-C), using as cut-offs 1.03 mmol/L in men and 1.29 mmol/L in women, was observed in more than 25% apparently healthy adults (n = 541) in a cross-sectional study on nutrition transition and cardiometabolic risk factors (CMRF) in Benin, West Africa. Both overweight/obesity (35.3%) and underweight (11.3%) were present, displaying the double burden of malnutrition. We examined in more depth the association of low HDL-C with nutrition and with other CMRF. Metabolic syndrome components were assessed, plus the ratio of total cholesterol (TC)/HDL-C and serum homocysteine. Insulin resistance was based on Homeostasis Model Assessment. We also measured BMI and body composition by bio-impedance. Dietary quality was appraised with two non-consecutive 24 h recalls. Low HDL-C was associated with much higher TC/HDL-C and more abdominal obesity in men and women and with more insulin resistance in women. The rate of low HDL-C was highest (41.9%) among the overweight/obese subjects (BMI ≥ 25), but it also reached 31.1% among the underweight (BMI < 18.5), compared with 17.3% among normal-weight subjects (p < 0.001). Lower dietary micronutrient adequacy, in particular, in vitamins A, B3, B12, zinc and calcium, was associated with low HDL-C when controlling for several confounders. This suggests that at-risk lipoprotein cholesterol may be associated with either underweight or overweight/obesity and with poor micronutrient intake.
The Size of Forest Holding/Parcelization Problem in Forestry: A Literature Review
Authors: Hatcher John , Straka Thomas , Greene John
Published: April 2013

In the early nonindustrial private forest (family forest) research literature, size of forest holding was identified as a critical variable impacting the propensity of family forest owners to invest in and manage small forest properties. This literature discusses relationships between size of forest holding and variables like forest owners’ financial and asset positions, forest management objectives, use of a forest management plan and professional forestry advice, and use of forestry cost-share funding. Since then, the literature has expanded and now relates to the major problem of forest parcelization. We reviewed this literature for historical themes, technical considerations, and continuing ownership problems, emphasizing the current circumstances of forest parcelization and its historical roots in the size of forest holding problem. Many of the sociological, economic, financial, and technical relationships identified earlier as foundations of the size of forest holding problem are shown to be also fundamental to the parcelization problem in forestry. We suggest that today’s parcelization issues are partially a continuation of the size of forest holding problem and that earlier research may be relevant to parcelization problems. We provide a detailed literature review that relates parcelization to the size of forest holding problem.
Development of Robust and Standardized Cantilever Sensors Based on Biotin/Neutravidin Coupling for Antibody Detection
Authors: Zhang Jiayun , Lang Hans , Battiston Felice , Backmann Natalija , Huber Francois , Gerber Christoph
Published: April 2013

A cantilever-based protein biosensor has been developed providing a customizable multilayer platform for the detection of antibodies. It consists of a biotin-terminated PEG layer pre-functionalized on the gold-coated cantilever surface, onto which NeutrAvidin is adsorbed through biotin/NeutrAvidin specific binding. NeutrAvidin is used as a bridge layer between the biotin-coated surface and the biotinylated biomolecules, such as biotinylated bovine serum albumin (biotinylated BSA), forming a multilayer sensor for direct antibody capture. The cantilever biosensor has been successfully applied to the detection of mouse anti-BSA (m-IgG) and sheep anti-BSA(s-IgG) antibodies. As expected, the average differential surface stress signals of about 5.7 ± 0.8 ´ 10−3 N/m are very similar for BSA/m-IgG and BSA/s-IgG binding, i.e., they are independent of the origin of the antibody. A statistic evaluation of 112 response curves confirms that the multilayer protein cantilever biosensor shows high reproducibility. As a control test, a biotinylated maltose binding protein was used for detecting specificity of IgG, the result shows a signal of bBSA layer in response to antibody is 5.8 ´ 10−3 N/m compared to bMBP. The pre-functionalized biotin/PEG cantilever surface is found to show a long shelf-life of at least 40 days and retains its responsivity of above 70% of the signal when stored in PBS buffer at 4 °C. The protein cantilever biosensor represents a rapid, label-free, sensitive and reliable detection technique for a real-time protein assay.
A PARALIND Decomposition-Based Coherent Two-Dimensional Direction of Arrival Estimation Algorithm for Acoustic Vector-Sensor Arrays
Authors: Zhang Xiaofei , Zhou Min , Li Jianfeng
Published: April 2013

In this paper, we combine the acoustic vector-sensor array parameter estimation problem with the parallel profiles with linear dependencies (PARALIND) model, which was originally applied to biology and chemistry. Exploiting the PARALIND decomposition approach, we propose a blind coherent two-dimensional direction of arrival (2D-DOA) estimation algorithm for arbitrarily spaced acoustic vector-sensor arrays subject to unknown locations. The proposed algorithm works well to achieve automatically paired azimuth and elevation angles for coherent and incoherent angle estimation of acoustic vector-sensor arrays, as well as the paired correlated matrix of the sources. Our algorithm, in contrast with conventional coherent angle estimation algorithms such as the forward backward spatial smoothing (FBSS) estimation of signal parameters via rotational invariance technique (ESPRIT) algorithm, not only has much better angle estimation performance, even for closely-spaced sources, but is also available for arbitrary arrays. Simulation results verify the effectiveness of our algorithm.
Société et Institutions dans les monarchies de Grèce septentrionale au IVe siècle
Authors: Cabanes Pierre
Published: April 2013

La royauté en Macédoine et en Épire, comme l'organisation sociale et économique de ces régions, étonne les habitants des cités grecques à l'époque classique : climat, végétation, pratique de la communauté familiale des biens, rôle plus marqué de la femme, organisation en ethné différencient ces terres de la Grèce méridionale. L'unification des royaumes, de part et d'autre du Pinde, se réalise dans le deuxième tiers du ive siècle, mais alors que la monarchie des Éacides, de type contractuel, passe pour modérée, Philippe II et Alexandre bouleversent les traditions macédoniennes qui ne sont restaurées qu'avec la dynastie antigonide.
L'expression αἰδώς καὶ νέμεσις et les «Actes du langage »
Authors: Turpin Jean-Claude
Published: April 2013

Cette expression doit se traduire par « le respect de l'honneur et du devoir ». Remarques sur la coexistence, pour νέμεσις, d'un sens ancien et d'une dérivation sémantique ultérieure.
The Application of Prophylactic Antibodies for Rhinovirus Infections
Authors: Privolizzi Riccardo , Solari Roberto , Johnston Sebastian L , McLean Gary R
Published: April 2013

Rhinoviruses are extremely common pathogens of the upper respiratory tract with adults experiencing on average 2–5 infections per year and children up to 12 infections. Although infections are not life threatening, except in cases of chronic lung disease where rhinoviruses are the major precipitant of acute exacerbations of disease, there is a high associated economic cost resulting from lost productivity due to absence from work or school. Treatment of infections focuses on symptom relief with anti-pyretics/analgesics as there are no antiviral therapies available and vaccine strategies face difficulties because of the large number of viral serotypes. Here, we assess the potential for prophylactic antibody intervention for these ubiquitous human pathogens.
Les constructions causatives avec mouvement en allemand : d'une saisie phraséologique à une explication constructionnelle
Authors: Dalmas Martine , Gautier Laurent
Published: April 2013

Cet article propose une analyse constructionnelle de certaines structures de l’allemand (du type Sie sang das Kind in den Schlaf ) en les situant par rapport aux constructions causatives avec mouvement (caused motion constructions) analysées en anglais par Goldberg (1995). La thèse centrale repose sur l’idée d’un continuum de causativité partant d’un côté de mini-systèmes plus ou moins grammaticalisés et/ou lexicalisés (locutions à verbe fonctionnel) pour se clore sur des structures au premier abord difficilement explicables en termes de constructions régulières. La démonstration vise à mettre en évidence l’existence d’un schéma, relativement abstrait, commun aux différents types d’énoncés envisagés qui, dans les cas les moins attendus et à première vue les moins figés/lexicalisés, nécessite tout de même de revenir aux notions de restrictions et, dans une certaine mesure, de figuration propres aux approches phraséologiques classiques.
Les greffes phraséologiques – ou quand la syntaxe se compromet
Authors: Legallois Dominique
Published: April 2013

L’article vise à distinguer deux modes d’innovation en syntaxe ; le premier mode, généralement bien décrit, est fondé sur l’analogie et la productivité. Le second mode, qui fait l’objet d’une discussion développée, est fondé sur « l’interception » d’une forme par une autre, phénomène désigné sous le terme de « greffe syntaxique ». Par exemple, la manifestation s’annonce pour être exceptionnelle est composé d’un mélange entre la manifestation s’annonce exceptionnelle et la manifestation est partie pour être exceptionnelle . L’article souligne le rôle joué par la phraséologie dans le phénomène de greffe, phénomène en œuvre également au niveau lexcical (les mots porte-manteaux) et collocationnel (greffe collocationnelle).
Students' Attitudes in Colleges of Education at the Jordanian Universities towards Mobile Phone Usage in University Education
Authors: Qudah Khalid Yousef , Hussain Jebreen A , Al Matari Reem
Published: April 2013

The aim of this study was to investigate the students' attitudes in the colleges of education at the Jordanian universities toward the use of mobile phones in education, according to the University which is attended by the student, gender, and academic level of the student. The study sample consisted of (363) students selected randomly cluster from the colleges of education at the Jordanian universities: The Hashemite University, Yarmouk and University of Jordan for the academic year 2010-2011. The instrument was a questionnaire developed by the researchers. The results showed that the percentage of students who indicated positive attitudes towards mobile phone use in university education is high. The results also showed that there were significant differences in the attitudes of students of the colleges of education in Jordanian universities towards mobile phone use in university education attributed to the variable of the university and in favor of the Hashemite University. The results showed no significant differences in students' attitudes toward mobile phone use in university education attributed to gender. Findings also revealed that there presence of statistically significant differences in students' attitudes toward mobile phone use in university education attributed to the variable of academic level in favor of master degree students.
Guidelines on Implementing Successful Seamless Learning Environments: a Practitionersâ?? Perspective
Authors: Uosaki Noriko , Ogata Hiroaki , Li Mengmeng , Hou Bin , Mouri Kousuke
Published: April 2013

This paper describes implementation guidelines for ubiquitous seamless mobile learning featuring the learning-log system named SCROLL (System for Capturing and Reminding of Learning Log). This system helps users to share and remind ubiquitous learning experiences. We review recent researches on mobile assisted learning in order to set pedagogically-based guidelines for instructors, learning environment designers and the administrative end or decision makers including ICT coordinator, and local authorities. Main foci in our guidelines are for language teachers to practice SROLL-based mobile learning in their classes for both in-class and out-class learning according to their situation or conditions. Our goal is to help educators to implement an effective seamless mobile learning environment with SCROLL.
Enhanced Practical Wireless Communications Education via Blended Instructional Tools
Authors: Tahat Ashraf , Jamal Ahmad , Kalbouneh Mohammad
Published: April 2013

Today's graduating telecommunications engineers need marketable skills that are typically developed beyond the traditional classrooms. These skills set can be acquired by experimenting for hands-on experience that resembles the professional field workplace. In this paper, we address blending of methodologies, applications, and the use of the Internet for delivery of knowledge, and instruction in an undergraduate wireless communications engineering course. This solution combines several different delivery methods, such as face-to-face, team collaboration, field measurements, in conjunction with high-end professional simulation software. Two examples of handover in a dual-mode cellular network and radio frequency (RF) signal propagation modeling are considered. Demonstrations and verification of theoretical models are presented based-on blending of instructional means. Lessons are learned to enhance hands-on experiments beyond traditional laboratories to strengthen in-depth analysis, learning skills of students, in addition to promoting proper team collaboration on projects.
Extending access to remote labs from mobile devices in educational contexts
Authors: Rochadel Willian , Bento da Silva Juarez , Simão José Pedro , Ribeiro Alves Gustavo , Marcelino Roderval , Gruber Vilson
Published: April 2013

This paper describes how to extend the access to remote experiments from mobile devices, aiming to better engage digital native students who expect a more interactive and ubiquitous access mode. The extension is based on features of HTML5 and the jQuery Mobile framework, which allow accessing the experiments from different operating systems via the browser or native applications. As a result, users have a richer interaction mode with the experiments, which includes access from simple hand-held devices such as smartphones and PDAs. Extending the access to remote experiments, from simple devices, enables its use in other educational stages, such as high schools, where teachers struggle to engage students in STEM learning. By enabling students to use their everyday "technological companions", e.g. cellular phones, to access remote experiments, we seek to increase the educational value of this technology-enhanced learning resource.
Measurements in Concentrated Sun using a Remote Controlled Robot
Authors: Floroian Dan , Floroian Laura , Rubin Rachamim , Lieberman Doron , Cotfas Petru , Cotfas Daniel , Ursutiu Doru , Samoila Cornel
Published: April 2013

Nowdays, using the concentrated sunlight is a big issue because the amount of energy is very high and the light is concentrated in a very small area. The main problem in this situation is the heating, and in order to make safe measurements a remote controlled robot is needed. After that, a remote controlled robot will assume the duty of protect the measured sample and to expose it for a precise time to the concentrated sun in order to reduce heating of the sample. For easy operating, and for automatize the process, all the duties, starting with initial conditions, continuing with triggering the measurements, and conditioning the signals and finalizing with data saving must be assured by the robot.
Landscape-level Factors Influencing Bog Turtle Persistence and Distribution in Southeastern New York State
Authors: Myers Andrew T. , Gibbs James P.
Published: April 2013

The bog turtle Glyptemys muhlenbergii is a highly endangered species inhabiting freshwater wetlands of the eastern United States. Habitat degradation is considered one of the chief causes of bog turtle declines. Most of the studies investigating habitat requirements of bog turtles focus on intrawetland influences on bog turtle habitat, but few have explored landscape-level drivers of bog turtle distribution. To better understand causes of bog turtle declines, we combined bog turtle occurrence records with geographic data to contrast 12 landscape variables among wetlands containing extant populations of bog turtles (n  =  65) and 500 nearby and 500 distant, randomly located wetlands in southeastern New York State. In contrast to randomly chosen wetlands, bog turtles have persisted in relatively large, open-canopy wetlands (typically >0.42 ha) within large watersheds (typically >13.54 ha), in wetlands with more numerous stream connections, and more often in wetlands positioned atop carbonaceous rock types. Wetlands occurring within carbonaceous surficial geological settings may be more resistant to bog turtle habitat degradation and hence likely to support more persistent populations of bog turtles. Our findings that geomorphic features and intrawetland vegetation are the most useful predictors of bog turtle occurrence and persistence in southeastern New York State are important for generating more detailed hypotheses regarding drivers of bog turtle declines and are also helpful for prioritizing sites for bog turtle conservation and guiding surveys to discover new populations.
Integrin Regulation during Leukocyte Recruitment
Authors: Herter Jan , Zarbock Alexander
Published: April 2013

Integrins are recognized as vital players in leukocyte recruitment. Integrin malfunction causes severe disease patterns characterized by the inability to fight pathogens. Although inflammatory reactions are beneficial and necessary for host defense, these reactions have to be controlled to prevent tissue destruction and harmful sequelae. In this review, we discuss the different signaling pathways leading to the change of integrin adhesiveness in neutrophils, monocytes, and lymphocytes. We thereby focus on the importance of integrin activation for the different steps of the leukocyte recruitment cascade, including rolling, adhesion, postadhesion strengthening, intravascular crawling, and transmigration, as each step necessitates the proper functioning of a distinct set of integrin molecules that has to be activated specifically. Additionally, we discuss endogenous mechanisms that balance and counteract integrin activation and limit leukocyte recruitment at the site of inflammation. Further insight into these complex mechanisms may provide new approaches for developing new anti-inflammatory therapies.
Innate Immunity and Its Regulation by Mast Cells
Authors: St. John Ashley L. , Abraham Soman N.
Published: April 2013

Mast cells (MCs), which are granulated tissue-resident cells of hematopoietic lineage, constitute a major sensory arm of the innate immune system. In this review we discuss the evidence supporting the dual role of MCs, both as sentinels for invading pathogens and as regulatory cells throughout the course of acute inflammation, from its initiation to resolution. This versatility is dependent on the ability of MCs to detect pathogens and danger signals and release a unique panel of mediators to promote pathogen-specific clearance mechanisms, such as through cellular recruitment or vascular permeability. It is increasingly understood that MCs also contribute to the regulated contraction of immune activation that occurs within tissues as inflammation resolves. This overarching regulatory control over innate immune processes has made MCs successful targets to purposefully enhance or, alternatively, suppress MC responses in multiple therapeutic contexts.
Genital diseases awareness in young male students: Is information necessary to protect them?
Authors: Mondaini Nicola , Silvani Mauro , Zenico Teo , Gallo Fabrizio , Rosso Franco , Cai Tommaso , Ughi Gianni , Scarano Pasquale , Orlando Vincenzo , Bartoletti Riccardo
Published: April 2013

Introduction: Few studies on the prevalence of male sexual diseases are currently available due to difficult application of observational studies or andrological disease prevention campaigns on large series of apparently healthy subjects. The medical check-up linked to compulsory military service represented in Italy a valid tool for epidemiological and observational study for 18 year old boys from 1861 to 2004. The stopping of compulsory military service and its related medical check-up could have determined an important social impact in terms of a lower level of attention and care on male genital/sexual diseases. The aim of the present observational study was to check the prevalence of genital/ sexual diseases among young male high-school students and promote an alternative campaign of information among young students. Methods: A prospective observational analytical study on young male students was conducted by 6 urological centres. Genital and sexually transmitted diseases were presented with slides to students in a general assembly. Some students were then counselled and filled out a short questionnaire on their lifestyle. Results: 12,535 students (10,432 males-83.6%) followed the presentation. and 4,897 males (46.7%) decided to be checked-up by the urologist and out of them 1554 (31.7%) presented relevant andrological diseases. Five-hundred students completed the questionnaire concerning their lifestyle. Many of them had not yet experienced condom use during sexual intercourse (27.8%). Drug abuse was reported by 39.6% of subjects and alcohol consumption in 80.8% of them. Conclusions: These data suggest the need for a national information campaign on male sexual disorders to promote sexual health.
Ultrasound diagnosis of unusual extratesticular mass: Case report and review of the literature
Authors: Dell’Atti Lucio
Published: April 2013

The adenomatoid tumor of the epididymis (EAT) is a neoplasm located in the paratesticular region. Mesothelial origin has been mentioned and inflammation has played some role in the development of these tumors. Physical examination and testicular ultrasound constituted important tools in the diagnosis. Some reports have mentioned malignant behavior, but it is very rare. Surgical treatment is the procedure of choice. We present the case of a 46-year-old patient with an adenomatoid tumour located in the head of the left epididymis that referred to our department with gradually enlarged intrascrotal mass.
Freedom for physicians
Authors: D’Amore Francesco
Published: April 2013

Not available
The influence of physical activity performed at 20-40 years of age on cardiovascular outcomes in medical patients aged 65-75
Authors: Cipollini Francesco , Gussoni Gualberto , Pacifici Roberta , Rossi Silvia , Bonizzoni Erminio , Valerio Antonella , Iacopino Adolfo , D’Angelo Audenzio , Panuccio Domenico , Iori Ido , Mazzone Antonino , Zuccaro Piergiorgio , The FADOI-ISS Study Group On behalf of
Published: April 2013

Introduction: Several studies show that physical activity can reduce the risk of cardiovascular disease, but the vast majority of these focus on the short- to intermediate-term benefits or refer to very specific populations. This observational study was conducted to determine whether physical activity performed during the third or fourth decade of life influences the occurrence of cardiovascular events in patients aged 65-75 years. Materials and methods: We studied a cohort of 2191 unselected patients admitted to Internal Medicine Departments. Data were collected on the patients’ medical history and their physical activity level when they were 20 to 40 years old. For the latter purpose, we used a specific questionnaire to assess the levels of physical activity related to the patients’ job, daily life, leisure time, and sports. Results: Almost half (44.2%) of the patients we evaluated reported moderate-intense physical activity when they were 20-40 years old. Around one third (35.8%) of the patients had experienced at least one major cardiovascular event, and there was a slight trend towards fewer cardiovascular events in patients with histories of physical activity (mean risk reduction: 4%, multivariate analysis). More evident benefits were observed in the subgroup of patients with diabetes, where cardiovascular outcomes were much better in patients who had been physically active than in those with sedentary life-styles (mean risk reduction: 24%). Conclusions: Given its design, our study may have underestimated the cardiovascular benefits of physical activity. Nonetheless, our results suggest that moderate-intense exercise during young adulthood may have limited beneficial effects on cardiovascular disease in old age, except in specific high-risk populations (diabetic patients). More evident benefits are probably associated with regular physical activity throughout life.
The J curve in hypertension. Physiopathologic speculation or a relevant issue in clinical practice?
Authors: Pinna Giuliano , Pascale Claudio
Published: April 2013

Introduction: The J curve phenomenon in the treatment of hypertension refers to the view that reducing blood pressure below a certain critical point (diastolic pressure in particular) is no longer beneficial and may actually increase the risk of cardiovascular events. The existence of this phenomenon has been debated for many years. Many autors deny that it exists, at least within the range of pressure values commonly observed in clinical practice. Aim of the study: The aim of this article is to verify whether in 2010 it is still possible to talk about a J curve or whether the inverse relationship between diastolic pressure and cardiovascular events depends on pre-existent diseases. Materials and methods: The authors carried out a search of the PubMed database for articles published in 2004 or later with the following Keywords J-curve, antihypertensive treatment, and blood pressure goals. Results: Most of the studies reviewed confirmed the existence of a J curve, but the role played by serious comorbidities is still unclear. In most cases, patients with major diseases have lower blood pressures. Moreover, cardiac patients already have impairments involving the coronary circulation. It is quite obvious that these patients are more exposed to pressure drops, especially those occurring during diastole, when the vast majority of blood flow to the coronary circulation is delivered. Conclusions: A J curve certainly exists: there is obviously a threshold value under which an excessively low blood pressure can no longer guarantee adequate perfusion of vital organs. The problem lies in the identification of this threshold value. Furthermore, considering the undeniable impact on this phenomenon of concurrent diseases, timely intervention is essential to avoid transforming low-risk patients (those less likely to experience J curve-related complications) into high-risk patients (more likely to experience these complications).
The new concept of total cardiovascular risk management
Authors: Seravalle Gino , Grassi Guido , Mancia Giuseppe
Published: April 2013

Introduction: Cardiovascular risk factors, such as hypertension, hypercholesterolemia, and diabetes mellitus, often cluster together and can also be seen with other pathophysiological conditions that greatly increase an individual’s risk for cardiovascular morbidity and death. Aim of the study: This article emphasizes the importance of assessing and managing the total cardiovascular risk in an individual patient. Materials and methods: Suggestions and recommendations from the most current hypertension management guidelines have been integrated with results from the major clinical trials published in the last decade. Results: Based on a review of the epidemiological data on cardiovascular disease, this paper expands the concept of stratification of hypertensive patients according to the approximate added risk of major cardiovascular events in the next 10 years and stresses the importance of subclinical target-organ damage. Conclusions: Although common in clinical practice, high-risk patients are often undiagnosed. Intensive hypertensive therapy is recommended for high-risk patients, and this treatment strategy will require combination therapy to control or reverse subclinical organ damage and prevent the progression of cardiovascular risk in subjects at low risk or medium risk.
The role of red blood cell scintigraphy in the multiple-modality imaging diagnosis of a rare case of diffuse hepatic hemangiomatosis in an adult
Authors: Cason Ernesto , Treglia Giorgio , Orlandi Paolo , Fagioli Giorgio
Published: April 2013

Introduction: Angiomas are one of the most common primary tumors of the liver. Diffuse hepatic angiomatosis, however, is quite rare and usually observed in pediatric patients. We report a rare case of diffuse hepatic hemangiomatosis in a 33-year-old woman. Case report: The patient presented with abdominal pain and a palpable upper abdominal mass. Abdominal CT and magnetic resonance imaging (MRI) findings suggested diffuse hepatic hemangiomatosis, but this finding was not confirmed by subsequent contrast-enhanced abdominal ultrasonography (US). The patient then underwent single photon emission computed tomography (SPECT)/CT scintigraphy with Tc-99m-labeling of red blood cells (RBC). This examination revealed increased uptake of labeled erythrocytes in several of the hepatic lesions corresponding to CT and RM findings, thereby confirming the clinical hypothesis of diffuse hepatic hemangiomatosis. Discussion: RBC scintigraphy with SPECT/CT can facilitate the comparison of other crosssectional imaging methods such as CT and MRI. This case highlights the importance of a multiple-modality approach in the imaging diagnosis of this condition.
The 100th anniversary of the invention of pH (1909-2009) - Part II. Was it really necessary to replace the Henderson equation with that of Henderson-Hasselbalch?
Authors: Sgambato Francesco , Prozzo Sergio , Sgambato Ester , Sgambato Rosa , Milano Luca
Published: April 2013

Introduction: The year 2009 marked the centenary of the ‘‘invention’’ of the concept of pH by the Danish chemist-mathematician Søren Peder Lauritz Sørensen (1868-1939), who was working at the time in the chemistry laboratories of the Carlsberg Brewery in Copenhagen. The occasion provides an opportunity to re-examine a concept that is crucial for the understanding of human life–—namely, acid-base balance. This article provides an overview of acid-base pathophysiology and the historical events that led from the simple equation of Henderson to the much more complex one developed by Hasselbalch. Conclusions: The authors conclude that the issue of acid-base balance would be easier to understand, more exciting, and even more pleasant if it were taught without recourse to the infamously abstruse Henderson-Hasselbalch equation. Unquestionably, the whole rationale underlying the understanding and clinical application of this vital concept is already inherent in the simpler, more manageable formula of Henderson (without logs), which is both useful and sufficient for use in medical school curricula.
Thrombotic thrombocytopenic purpura (TTP) or Moschowitz syndrome: a true hematologic emergency
Authors: Melis Deborah , Michelis Gianluca , Brignone Marcello , Cavaliere Marina , Tassara Rodolfo
Published: April 2013

Introduction: Thrombotic thrombocytopenic purpura (TTP) is a thrombotic microangiopathy caused by congenital or inherited disorders involving the processing of the ultra-large forms of von Willebrand factor. As a result, platelet-rich microthrombi form in the small arterial vessels of various organs, particularly those of the brain, heart, and kidneys. The idiopathic autoimmune form of TTP is the most common. There are various subgroups of acquired TTP associated with HIV infection, sepsis, pregnancy, autoimmune disease, various disseminated malignancies, and drugs. If not promptly treated, TTP is associated with high mortality, making it a true medical emergency. Materials and methods: The article is based on a review of the literature published between January and October of 2009. Its aim is to clarify the diagnosis, treatment, and follow-up of TTP. Results: Diagnostic criteria include the presence of microangiopathic hemolytic anemia associated with thrombocytopenia in the absence of other obvious causes. Assays of ADAMTS13 activity and titration of acquired antibodies against this enzyme are indicated in the follow-up of disease and as prognostic indicators. Treatment centers around daily plasma exchange associated with immunosuppressant drug therapy, particularly steroids and more recently the monoclonal anti-CD20 antibody rituximab. Discussion: Despite improved treatment, TTP is still associated with significant mortality (10—20%), particularly when plasma exchange is initiated late. Relapse also occurs in a substantial proportion of patients (10—40%) although the frequency of this outcome may be reduced by rituximab therapy.
Depressive symptoms and disability in acute patients with comorbidities in departments of internal medicine
Authors: La Carrubba Salvatore , Manna Loredana , Rinollo Carmelina , Mazzone Antonino , Gussoni Gualberto , Di Rosa Salvatore , Of FADOI On behalf of the DIMIS Study
Published: April 2013

Introduction: There are few data on the prevalence of depression among acute patients with comorbidities. The current study aimed to determine the prevalence of depressive symptoms in hospitalized patients admitted to Internal Medicine Units and the correlation between these symptoms and comorbidities and disability indexes. Materials and methods: All consecutive patients admitted to 26 Internal Medicine Units of the Italian National Public Health System in Sicily, Italy, from September 2001 to March 2002 were screened. Within 24 hours of admission, patients were administered the Geriatric Depression Scale (GDS), Mini-Mental State Examination, Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL) and Charlson’s Comorbidity Index. Results: 1,947 subjects were included in the analyses. Of the patients, 509 (26.1%) showed depressive symptoms (indicated by GDS score > 15). Depression was significantly associated (univariate analyses) with hypertension (OR 1.45; CI 95% 1.18-1.79), diabetes (OR 1.48, CI 95% 1.17-1.87), cerebrovascular disease (OR 1.50, CI 95% 1.08-2.07), cirrhosis (OR 1.49, CI 95% 1.01- 2.19), ADL score (OR 0.72: CI 95% 0.63-0.82), and IADL score (OR 0.83; CI 95% 0.78-0.87), but not with Charlson’s Comorbidity Index (OR 1.04; CI 95% 0.98-1.10). Multivariate analysis showed that independent predictive factors for depression were age (OR 1.02, CI 95% 1.01-1.02), female gender (OR 2.29, CI 95% 1.83 - 2.87), and IADL score (OR 0.86, CI 95% 0.81 - 0.93). Conclusions: The data suggest that depressive symptoms are not linked to worse clinical conditions but are associated with the loss of autonomy in Instrumental Activities of Daily Living.
HBsAg loss with HBsAg/anti-HBs seroconversion and non-detectable HCV-RNA in a patient with chronic HBV e-minus/HCV hepatitis treated with two cycles of antiviral therapy
Authors: Salvio Antonio , Varriale Maria , D’Errico Tito , De Siena Gennaro , Visconti Mario
Published: April 2013

Introduction: Loss of HBsAg is observed in only 3-4% of patients who receive interferon for chronic HBV+HCV hepatitis, and there are few reports of HBsAg loss induced by treatments other than interferon. We report a case of chronic HBV+HCV hepatitis, in which a positive outcome was achieved with a new therapeutic strategy. Case report: The patient was a 49-year-old Caucasian woman found to be HBsAg+ in 1978 and HCVAb+ in 1997. During 2000-2003, the patient had markedly increased AST/ALT, histology grade 5, stage 1 (Ishak) disease with HBsAg positivity, HBV-DNA 1,450 cp/mL, HCV-RNA 7.57x105 IU/mL (genotype 1b). In May 2003 she began a 48-week course of PEG-IFNa2b (80 mg/week) without ribavirin. The latter drug was not used because it had recently been observed that in some HBV/HCV-coinfected patients treated with the two drugs, the hepatic flares preceding the seroconversion to HBsAb caused fulminant liver failure. Neither the HBV and HCV infections responded to this treatment, but during follow-up the HBV-DNA dropped to 40 cp/mL and the patient presented persistently normal transaminase values (6th month) followed by loss of HBsAg (24th month) and the appearance of anti-HBs (36th month). By December 2008, the HBV negativity and HBsAg/anti-HBs seroconversion were well-established, but HCV replication persisted. The decision was therefore made to administer PEG-IFNa2a (180 mg/week) and ribavirin (1,000 mg/day). There was no evidence of an RVR or EVR, so therapy was continued for 48 weeks. At the scheduled 12-month treatment, the patientwas found to be HCV-RNA negative by TaqMan PCR. Conclusions: In our opinion this case is of great interest because: 1) it is the first report of a virological response in a HBV/HCV-coinfected CH patient treated with PEG-IFN; 2) control of the two viral infections was achieved with a new therapeutic strategy that included two phases: a) HBV-DNA loss at 6 months and HBsAg/anti-HBs seroconversion between months 24 and 36, after PEG-IFNa2b mono-therapy, which was administered when the HCV replication seemed to prevail over that of HBV; b) ETR for HCV after 72 weeks of PEG-IFNa2a+ribavirin, which was continued in spite of the lack of an EVR, as this does not preclude the possibility of a SVR.
Erratum a: Le iponatremie [Italian Journal of Medicine 2011;5(3):156-68.]
Authors: Elmi Giovanna , Faustini-Fustini Marco , Zaccaroni Stefania , Zoni Roberto
Published: April 2013

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