bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating Sustainability on Projects Using Indicators
Authors: Talbot Jude , Venkataraman Ray
Published: May 2013

The objectives of this chapter are: (1) identify different sustainability indicator sets and their strengths and weaknesses; (2) explain what a multi-level analytical hierarchy project is and why it is important to integrating sustainability into such projects; and (3) state the steps in a procedure to integrate sustainability into project baselines.
Experimenting with Project Stakeholder Analysis
Authors: Weninger Claudia , Huemann Martina , Cardoso de Oliveira Jairo , Filho Luis Fernando Mendonça Barros , Weitlaner Erwin
Published: May 2013

The chapter reports on the case study project of the Engineering, Procurement, and Construction (EPC) of a wind park farm in Brazil from the supplier perspective of Siemens Ltd. In the case study, researchers, together with practitioners, further developed project stakeholder analysis by explicitly integrating Sustainable Development (SD) principles. The chapter offers an operative approach and describes the working form systemic board to better handle the increasing dynamics and complexity in contemporary projects and contexts. For project stakeholder management, the consideration of SD principles means in particular: applying a more comprehensive stakeholder management approach with underpinning values that support sustainable development; integrating economic, ecologic, and social interests of project stakeholders into the project objectives to create shared benefit for the project investor and other project stakeholders; broadening the time perspective to consider not only current stakeholders but also future stakeholders of the investment initialized by the project; broadening the spatial perspective to consider local, regional as well as global impacts of the project for stakeholders; using systemic working forms to allow for making the dynamics and complexities of the project and the project contexts better visible to the project manager, the project team, and the project owner; taking consequences in the project organization which lead to more integrative project organization structures to support cooperation on a project and with its stakeholders.
Selective Liberalization
Authors: Skjerdal Terje S.
Published: May 2013

This chapter discusses recent developments in Ethiopian media governance. The developments point in two directions: Formally speaking, media policy is liberalized, exemplified by improved media legislation, better access to public information, and issuing of private broadcasting licences. However, informally speaking, Ethiopian media governance shows signs of coercion. This is seen for example in increased government control with the official news agency, use of anti-terrorism legislation against journalists, and obstruction of political websites. The chapter suggests that the paradoxes in Ethiopian media governance may be explained as a case of selective liberalization, implying that liberalization is primarily found in areas where the risk of losing control with the flow of information is less for the government. Alongside selective liberalization, there is an undercurrent of unofficial policy in Ethiopia that may represent a return to informal coercion towards the media industry.
Looking Beyond Elections
Authors: Akpojivi Ufuoma
Published: May 2013

Media freedom is pivotal to the sustenance and consolidation of democracy, as the quality of democracy in any society depends on the level of freedom accorded the media and the plurality of views entertained (Diamond, 2008). The ability of the mass media to carry out their traditional functions of educating, entertaining and enlightening the public about their democratic rights, and holding governments accountable, will subsequently lead to the establishment of a strong democratic institution. Hence there is need to protect media freedom in any democratic society (Baker, 2007; Norris, 2008). The Nigerian media environment, however, is characterised by a series of laws such as sedition law, official secret act, amongst others, which have directly and indirectly hindered the freedom of the mass media and their responsibility of promoting and advancing democracy. This is made worse by the incomprehensive nature of the 1999 Constitution. Using interviews and policy analysis, this chapter critically examines the policy framework of media freedom in Nigeria and its impact on the operation of the mass media. The ability of the media to live up to their responsibility of promoting and advancing the democratisation process in Nigeria within the available framework is also examined.
Revolution 2.0
Authors: Khamis Sahar
Published: May 2013

This chapter analyzes the role of new media, especially Internet-based communication, in accelerating the process of political transformation and democratization in Egypt. It analyzes the Egyptian media landscape before, during and after the 2011 revolution which toppled the regime of President Hosni Mubarak. In the pre-revolutionary phase, the eclectic and paradoxical political and communication landscapes in Egypt, and the role that new media played in paving the way for the revolution, is discussed. During the 2011 revolution, the role of new media, especially social media, such as Facebook, Twitter, and YouTube, is highlighted in terms of the multiple roles they play as catalysts for change, avenues for civic engagement, and platforms for citizen journalism. In the post-revolutionary phase, the multiple changes and challenges exhibiting themselves after the revolution are analyzed, especially the divisiveness between different players in the Egyptian political arena and how it is reflected in the communication landscape.
Social Media and Youth Interest in Politics in Kenya
Authors: Otieno Auma Churchill Moses , Mukhongo Lusike Lynete
Published: May 2013

The youth in Kenya are by far the majority age-group, yet their role in politics is hampered by their inability to access mainstream political information. The objective of the study is to determine whether there is any relationship between the level of youth engagement on social media and their level of interest in politics. The study uses the post-test quasi experiment to compare political interest between a naturally occurring group of Facebook users and a naturally occurring group of non-Facebook users. The findings of the study reveal that Facebook has provided the youth with a platform where they can access political information in formats that are appealing to them. Consequently, young people have been able to mobilise themselves online and push for a political agenda. There is, therefore, need to open up online exchanges in order to create a place for young people in mainstream political discourse in Kenya.
Twitter as Virtual Battleground
Authors: Furlow R. Bennett
Published: May 2013

Somalia has been plagued by political instability and ongoing conflict for over two decades. Yet, that does not mean Somalia has been completely isolated from modern technologies and new media. The construction of cell phone towers and other means of communication is a popular and profitable business in Somalia. One of the more recent additions to Somali new media is the use of microblogging. On December 7, 2011, Somalia’s al-Shabaab began a Twitter feed in both English and Arabic. In its first two months of tweeting, al-Shabaab promoted its successes on the ground, condemned what they see as unjustified acts of violence perpetrated against them, and engaged in a Twitter war with the Kenyan Defense Forces. This chapter seeks to analyze these first few months of al-Shabaab’s Twitter activity. What are the main goals of al-Shabaab’s use of Twitter? How effective have they been? How does their use of microblogging compare to other extremists’ (such as the Taliban) use of Twitter? As Somalia is largely considered a failed state and internet penetration is not particularly dense, who is the intended audience?
The Impact of Social Media on the Social, Political and Economic Environments in Africa
Authors: Adelaja Oluwabukola
Published: May 2013

The purpose of this chapter is to evaluate the effect and potentials of social media as a tool for social, political, and economic change in Africa. This chapter argues that social media has become so entrenched in various facets of society that it has become a mechanism impacting social, political, and economic life in Africa. This chapter looks at the 2011 Nigerian elections and the worldwide Kony Movement against Kony the Ugandan warlord, as tools/examples of analysis. These are some of the developments that have driven the debate about the ability of social media in bringing about social, economic, and political change and participation in the African continent. The research method adopted in this chapter involves an analysis of a growing scholarship addressing the various arguments proffered on this topic. The chapter concludes by establishing the impact of social media on social, economic, and political life in Africa as well as identifying challenges posed by this development and making recommendations for the regulatory framework required to effectively harness these potentials in Africa.
Rethinking the Democratization Role of Online Media
Authors: Chari Tendai
Published: May 2013

Online publications have become critical sites for the expression of views alternative to those of the state. This is true in Zimbabwe as in many developing states where the mainstream media operate under onerous legislative frameworks. However, the real impact of these ‘new public spheres’ on the country’s democratization agenda is subject to contestation. This chapter examines the impact of online publications run by exiled Zimbabwean journalists on the country’s democratization process. The chapter evaluates the extent to which these online publications constitute genuine alternative spaces for the mediation of national discourses. Data is elicited through focus group interviews, in-depth interviews, and textual analysis. The chapter argues that a combination of technical, social, and economic factors which limit Internet access and professional shortcomings conspire against online publications becoming genuine alternative public spheres, thus minimizing their role in the democratization of the Zimbabwean state.
William Paterson University of New Jersey
Authors: Weiner Nancy J.
Published: May 2013

This chapter is an overview of the reference and instruction services provided by librarians at David & Lorraine Cheng Library at William Paterson University of New Jersey. Included will be a brief history of the University and the library along with an overview of the reference and instruction services currently provided and the relationship to past practices, how they have evolved through the years, and what impact these services have on student learning. Cheng Library has retained the traditional reference desk that is staffed by professional librarians which continues to work well for students, although assistance is also available via email, chat and during individual research appointments. Librarians from other departments serve as reference adjuncts which allows for double coverage at the desk during peak hours on weekdays and all librarians, including the Dean, are required to conduct instruction sessions for First Year Seminar classes during the fall semester. While the FYS classes provide a cohort for assessing information literacy skills, additional assessment activities have become a component of the instruction program and reflect national trends in terms of demonstrating the value of library services and resources. All full time librarian positions are tenure track and librarians have faculty status. While budget constraints have hampered some projects, Cheng Library remains committed to providing students with the highest level of service possible, and it has been able to make significant changes to the physical space of the library in response to student needs and as a result of technology.
Utah State University
Authors: Fagerheim Britt Anna
Published: May 2013

Utah State University is rapidly expanding its distance education program, bringing changing reference and instruction needs. The rise of distance education classes and classes at the regional campuses has contributed to changes within reference and instruction, and a closer integration between the two services and between the work with on-campus students and students at a distance. The Coordinator of Regional Campus and Distance Education Library Services and the subject librarians work closely to bring reference and instruction services to students at the main campus, at the regional campuses, and via distance education.
California State University, East Bay
Authors: Soules Aline
Published: May 2013

At California State University, East Bay, reference is one component of a comprehensive instructional program in information literacy. Based on this approach, the focus of reference is on teachable moments on a just-in-time basis rather than a means by which users, primarily students, are simply provided with answers to their questions. This chapter provides a description of the role of reference within that context and describes the various services offered.
Reference and Instruction Services as an Integrated Approach
Authors: Cordell Rosanne M
Published: May 2013

Reference and instruction services in academic libraries were indistinguishable in their early development but were separated administratively as libraries and their programs grew. This organizational separation is not conducive to the coordination of these services, but steps can be taken which will benefit the functioning of each area.
Effects of a Technology-Enriched, Task-Based Language Teaching Curriculum on Chinese Elementary Students’ Achievement in English as a Foreign Language
Authors: Li Guofang , Ni Xiaopeng
Published: May 2013

Despite the great potential technologies bring to TBLT, few studies have examined the effects of technology-enhanced TBLT curriculum on students’ language development, especially among young learners. This paper addresses this need by reporting the impact of a technology-enhanced TBLT curriculum on Chinese elementary students’ English as a Foreign Language (EFL) learning using a Non-equivalent Groups Design. A total of 471 fourth grade students from 4 low-SES schools outside Beijing participated in the study. Students’ growth in their English achievement was assessed using pre and post-tests before and after the intervention. A descriptive analysis was first conducted after completion of data collection, and then a t-test was conducted to determine the effect of the intervention. Results indicate that students who received the intervention progressed much more quickly in overall language proficiency than those who did not receive the treatment. The study points to the great potential of implementing comprehensive technology-enhanced TBLT at the curricular level.
The French Digital Kitchen
Authors: Seedhouse Paul , Preston Anne , Olivier Patrick , Jackson Dan , Heslop Philip , Plötz Thomas , Balaam Madeline , Ali Saandia
Published: May 2013

This paper reports on the French Digital Kitchen, a design-based project which drew on digital sensor technology to take the principles of Task-Based Language Teaching (TBLT) out of the classroom and into the real-world environment of a kitchen. The project aimed to produce a situated language learning environment where learners could learn aspects of French language and cuisine whilst performing a real-world task. The article describes the blend of TBLT, human-computer interaction (HCI) and user-centred design (UCD) principles the authors adopted in constructing and trialling the kitchen, using multiple data sources. An example of a task cycle is then presented to illustrate (by using CA analysis of transcripts) how learners have used the resources of the kitchen to accomplish the task. The authors’ findings show how the integration of the pedagogical and technological design enabled learners to notice and manipulate new vocabulary items.
TBLT in Business English Communication
Authors: Thomas Michael
Published: May 2013

Research on the use of task-based language teaching (TBLT) with digital technologies has increased over the last few years but few studies have focused specifically on its use with blended learning involving international undergraduate learners studying in a UK higher education context. This paper explores the role of a task-based approach with international students learning business communication in English with a focus on the use of two collaborative digital technologies to aid blended learning: the video conferencing software Adobe Connect and the virtual world of Second Life. The study was guided by two research questions: What are the strengths and challenges presented by each application in terms of aiding authentic task completion? How can the applications be used to support task-based learning in a blended format? A year-long study with students at a UK university utilised semi-structured interviews, observations and in-world ethnography. The research highlights the importance of a number of design principles necessary for effective task-based learning in a blended approach and calls for more research on the type of support required by international undergraduates to aid them fulfil their potential in foreign language environments.
Perceived Technical Service Quality and Information Satisfaction at the Ministry of Communications, Kuwait
Authors: Khalil Omar E. M. , Ghanim Haitham G. A.
Published: May 2013

Information technology (IT) has become the backbone for many of today’s organizations in the private and public sectors. However, identifying users’ information satisfaction as well as their perception of the strengths and weaknesses of IT service represents a major challenge for IT management. This research explored the perceived IT service quality (SQ) and user satisfaction (US), the effect of SQ on US, and the impact of a number of demographic and situational characteristics on SQ and US in the Ministry of Communications (MOC) of Kuwait. Three SQ dimensions have emerged, including empathy/assurance, reliability, and tangibles. Users, however, are not certain about the quality of the provided IT service. They are also somewhat satisfied with the systems they regularly use. Age, nationality, job type, sector type, and system use varyingly affect SQ and US. SQ has also emerged as an important determinant of US. These findings as well as their implications are further discussed in the paper.
Impact of Product Characteristics on Supply Chains
Authors: Bask Anu , Tinnilä Markku
Published: May 2013

Supply chains are typically considered to consist of many stages across several organizations starting from raw material sources through component production to manufacturing and further on via distribution operations to B-to-B customers and consumers. This paper focuses on analyzing product-related characteristics: what the characteristics mentioned in the literature are, and the impact they have on the structure and design of supply chains. The authors look at how product characteristics in general influence the design of supply chains, and their effect on different stages of supply chains. In the literature analysis, the focus is on examining the impact of product characteristics on supply chain strategy and structures, purchasing, manufacturing, distribution, and logistics services. Finally, they draw conclusions on the above. The contribution of this paper is twofold. Firstly, based on supply chain management literature, the authors propose a framework for analyzing the impact of product characteristics on supply chains. Secondly, at the end of the paper, they extend the framework by summarizing the key results pertaining to each supply chain management area under analysis. These include the characteristics of the main frameworks used in previous studies and the generic product characteristics used.
Fostering Knowledge Transfer for Space Technology Utilization in Disaster Management
Authors: Neisser Florian M.
Published: May 2013

Disaster Management is an issue of global importance which requires timely and accurate information as well as clear and suitable communication technology to guarantee coordinated efforts to save lives and property. Thus, technology for gathering, retaining, managing and transferring information and the ability of linking experts plays an eminent role. This study is an observation of the setting of the web-based UN-SPIDER (United Nations Platform for Space-based Information for Disaster Management and Emergency Response) Knowledge Portal based on the Actor-Network Theory. The theory treats the Knowledge Portal as an assemblage of heterogeneous entities. The observation is focused on the configuration and the processes which form this actor-network with the aim to bring together the space technology and the disaster management community to support and nurture virtual Communities of Practice and enable knowledge transfer.
Murphy’s Law in Action
Authors: Spöhrer Markus
Published: May 2013

This paper explores the possibilities of Actor-Network-Theory as a methodological approach to Production Studies. On the basis of a detailed production log written by producer Paul Lazarus III, the coming-into-being of the film Barbarosa (1982) is described. By using Bruno Latour’s and Michel Callon’s approach, the assemblies of the film production, the hybrid networks and interconnections which are established by human as well non-human actors, are dealt with. Thus film production is not a one sided process of inscriptions by human actors on non-human actors. Rather it is thought as a reciprocal process of inscribing and acting. Consequently the “effects” are discussed which are produced by approaching the production of Barbarosa with ANT and conclusions are drawn as to how the theoretical scope of Production Studies needs to be modified: Films can be understood as “quasi-objects” or “epistemic things” which are produced and produce themselves in reciprocal processes. They translate themselves into other networks after postproduction and are thus constantly subject to translational processes and not endlessly stable, but should rather be considered metastable.
Searching for Herbert Simon
Authors: Gorman Michael F. , Wynn Donald E. , Salisbury William David
Published: May 2013

Since Herbert Simon’s seminal work (Simon, 1957) on bounded rationality researchers and practitioners have sought the “holy grail” of computer-supported decision-making. A recent wave of interest in “business analytics” (BA) has elevated interest in data-driven analytical decision making to the forefront. While reporting and prediction via business intelligence (BI) systems has been an important component to business decision making for some time, BA broadens its scope and potential impact in business decision making further by moving the focus to prescription. The authors see BA as the end-to-end process integrating the production through consumption of the data, and making more extensive use of the data through heavily automated, integrated and advanced predictive and prescriptive tools in ways that better support, or replace, the human decision maker. With the advent of “big data”, BA already extends beyond internal databases to external and unstructured data that is publicly produced and consumed data with new analytical techniques to better enable business decision makers in a connected world. BI research in the future will be broader in scope, and the challenge is to make effective use of a wide range of data with varying degrees of structure, and from sources both internal and external to the organization. In this paper, we suggest ways that this broader focus of BA will also affect future BI research streams.
Civic and Political E-Participation of Young Immigrants
Authors: Malafaia Carla , Fernandes-Jesus Maria , Ribeiro Norberto , Neves Tiago , Coimbra Joaquim Luís , Menezes Isabel
Published: May 2013

The internet is considered as an important forum to empower and engage groups outside the traditional political systems. However, the ‘digital divide’ might imply several disparities and even reinforce exclusion of those with low economic and cultural capital. This article intends to question how democratic and inclusive this virtual public sphere is and in which terms the new dynamics in contemporary societies encourage mobility by excluded groups. Through quantitative methodology, we sought to analyse the differences between migrant (Angolans and Brazilians) and non-migrant groups in Portugal, as well as the e-participation forms adopted by them and the factors that could predict such participation. This is essential towards a wider knowledge about this field, strengthening the understanding concerning the ambivalence about the potential of the internet as a space for the inclusion of groups at risk of exclusion from participation and, consequently from real citizenship.
Adoption of Mobile Commerce
Authors: Ghobakhloo Morteza , S.H. Tang , Zulkifli Norzima
Published: May 2013

Although voluntary individual usage behavior of information system and technology is well studied in the literature, further theoretical development is needed to account for the specific characteristics of the mobile commerce. This study presents an extended technology acceptance and satisfaction model presented by Wixom and Todd (2005) that integrates technology acceptance and technology satisfaction into unified model to investigate what determines user mobile commerce acceptance and usage. The contributions of this paper are to extend and adapt the user satisfaction and technology acceptance model in an empirical study of 503 mobile commerce users, shedding light on the significance and relative importance of specific acceptance and satisfaction factors. This study validates the user satisfaction and technology acceptance model in business to customer mobile commerce context. The implication of this study to both researchers and practitioners is discussed.
Conceptualising mLearning Literacy
Authors: Ng Wan
Published: May 2013

Research into the educational application of mobile technologies has increased dramatically in recent years. Much has been written about mobile learning and its various pedagogical practices and issues as well as the theoretical frameworks that have been developed to underpin the studies in the reports. However, little has been written about the literacy associated with learning with mobile devices and whether there is a place for its development in education. This conceptual paper seeks to explore mLearning literacy, the digital literacy associated with learning with mobile devices, and asks the question: What is mLearning literacy and what are its implications for educators? In the paper, the author will argue that fundamental to learning with mobile devices is the need to develop the associated digital literacy in students. The author proposes that being mLearning literate would empower students to learn more independently and more safely when using mobile devices and their applications.
Development of a Browser-Based Mobile Audience Response System for Large Classrooms
Authors: Andergassen Monika , Guerra Victor , Ledermüller Karl , Neumann Gustaf
Published: May 2013

Didactical advantages of audience response systems (ARS) have been discussed extensively ever since they have been used in classes. However, conventional ARS bear some drawbacks, such as requiring specific hardware, generating costs (text messaging based and web service fees) and creating a dependency on external hosts. In this paper we present a browser-based ARS, which provides a platform-independent channel for the interaction between students and teachers. The authors provide a solution of an ARS for potentially large and spatially distributed classes, where the audience can provide feedback via PCs and mobile devices such as smart phones and tablets. The proposed system has been integrated into the e-learning system of the Vienna University of Economics and Business (WU), one of the largest business universities worldwide. The server side implementation of an ARS brings some challenges, such as the integration into an e-learning environment, the technical feasibility due to a broad variety of possible end user devices, and user acceptance issues. This paper documents the experiences and findings of the stepwise development and deployment in large classrooms. This resulted in an enhancement of the information policy with students and an optimization of the WLAN network settings. Finally, a new, unanticipated usage scenario emerged for mobile, browser-based response systems.
An Artifact Switching Model for User Acceptance of eBooks
Authors: Sanford Clive
Published: May 2013

This study theorizes and validates a model of user switching from non-IT artifacts to IT artifacts by integrating and extending prior findings from IT acceptance and adoption streams of research and using migration theory as the theoretical bridge. The proposed model examines different types of switching predictors such as push and pull factors, intervening obstacles, and individual differences, as well as interdependencies between these factors as moderating effects. Empirical data from a longitudinal field survey of users’ switching from traditional hard copy books to eBooks validates most of the hypothesized associations. This study alerts publishers, academics, and educational institutions to the challenges and opportunities of artifact switching in general and suggests strategies that can help these stakeholders enable artifact switching within their target populations.
Optimal Detection and Estimation of Marine Oil Spills Through Coherent Pluralism
Authors: Bassey Kufre , Chigbu Polycarp
Published: May 2013

An important area of environmental science involves the combination of information from diverse sources relating to a similar endpoint. Majority of optical remote sensing techniques used for marine oil spills detection have been reported lately of having high number of false alarms (oil slick look-a-likes) phenomena which give rise to signals which appear to be oil but are not. Suggestions for radar image as an operational tool has also been made. However, due to the inherent risk in these tools, this paper presents the possible research directions of combining statistical techniques with remote sensing in marine oil spill detection and estimation.
Chromatin Architecture, CCCTC-Binding Factor, and V(D)J Recombination: Managing Long-Distance Relationships at Antigen Receptor Loci
Authors: Shih Han-Yu , Krangel Michael S.
Published: May 2013

The rearrangement of T and B lymphocyte Ag receptor loci occurs within a highly complex chromosomal environment and is orchestrated through complex mechanisms. During the past decade, a large body of literature has highlighted the significance of chromatin architecture at Ag receptor loci in supporting the genomic assembly process: in preparation for recombination, these loci tend to contract and form multiple loops that shorten the distances between gene segments and facilitate recombination events. CCCTC-binding factor, CTCF, has received much attention in this regard since it has emerged as an important regulator of chromatin organization and transcription. In this review, we summarize recent work outlining conformational dynamics at Ag receptor loci during lymphocyte development and we discuss the role of CTCF in Ag receptor locus conformation and repertoire development.
Internal Medicine: past, present and future
Authors: Cataldi Amatriain R.M.
Published: May 2013

Not available
Gastric syphilis: a case-report
Authors: Del Duca P. , Amini M. , Fiore S. , Maida R. , Monardo F. , Moriconi L. , Patrizi C. , Vitale M.A. , Cerqua G.
Published: May 2013

CLINICAL CASE A 43-year-old Romanian woman was referred with the clinical suspicion of gastric lymphoma; she had complained from two months nausea, vomiting and weight loss (7 kg); 3 esophagogastroduodenoscopic examinations had evidenced reduced distensibility of stomach body and antrum, ulcered and congestive mucosa, the histopathological examinations revealed a non specific inflammation. There was no response to therapy with omeprazolo. A computer-assisted tomoghraphy scan of the thorax and abdomen, obtained after the oral and intravenous administration of contrast material, showed diffuse thickening of the gastric wall, lymphadenopathies were seen in the retrocrural space, lesser curvature, and paraaortic region. It was performed another upper endoscopy with “deep” biopsy specimen, comprehensive of spirochetal immunohistochemistry, that was diagnostic for gastric syphilis. DISCUSSION Even though gastritis is a rare clinical manifestations of the secondary stage of syphilis, it must be considered in the differential diagnosis of erosive gastritis unresponsive to medical therapy, especially in young patients; screening tests like VDRL (routinely used until few years ago in internal medicine divisions) may be useful to identify those patients needing a further diagnostic evaluation.
Trial update: the Diabetes REduction Approaches with ramipril and rosiglitazone Medications (DREAM) trial
Authors: Gulli G.
Published: May 2013

BACKGROUND Diabetes (T2DM) is a worldwide medical and social emergency in the westernized societies. Lifestyle changes, diet and physical activity, have shown a protective effect on the likelihood of developing T2DM and are strongly recommended for primary prevention in people at increased risk for T2DM. However, maintaining adherence to these nonpharmacologic strategies is dishearteningly challenging, and the possible use of drugs to prevent T2DM remains of keen interest. Metformin, glitazones, acarbose and orlistat can reduce the risk of developing T2DM. Recently, post hoc analyses of several clinical studies suggested that ACE-I as well might reduce the risk of T2DM. AIM OF THE STUDY Since none of these trials was designed with this primary end-point, the Diabetes REduction Assessment with ramipril and rosiglitazone Medication (DREAM) Investigators studied the effects of ramipril or rosiglitazone on the risk of T2DM in a randomized trial designed with T2DM as a primary outcome. METHOD Subjects with fasting impaired plasma glucose levels or impaired glucose tolerance, without cardiovascular disease, were randomly assigned, in a 2-by-2 factorial design, to receive either ramipril (up to 15 mg daily) or placebo and either rosiglitazone or placebo. They were followed for a median of 3 years. RESULTS Rates of the primary end points, T2DM or death, were not significantly lower in the ramipril group than in the placebo group. In contrast to ramipril, the use of rosiglitazone resulted in a significant reduction in T2DM or death. DISCUSSION Disappointingly, 14 participants on rosiglitazone developed non-fatal heart failure, compared with 2 cases in the placebo group, and the group gained 3% (2.2 kg) more in body weight than the placebo group. Moreover, we still do not know whether the effect of rosiglitazone on the incidence of T2DM will persist after drug washout. CONCLUSIONS We believe that the high cost of the drug and the study’s negative cardiovascular and body weight outcomes favour a lifestyle strategy in preventing T2DM.
Guidelines and management of hospitalized patients with community-acquired pneumonia: the Italian experience of the FASTCAP study
Authors: Iori I. , Gussoni G. , Blasi F. , Bulfoni A. , Costantino S. , Legnani D. , FASTCAP Study Group On behalf of the
Published: May 2013

BACKGROUND Nowadays few data are available addressing the validation of guidelines concerning diagnosis and treatment of Community-Acquired Pneumonia (CAP) in clinical practice. AIM OF THE STUDY To evaluate the impact of compliance to the recommendations issued by the Italian Federation of Internal Medicine (FADOI) in 2002 on the management of hospitalised CAP. METHODS National, multicentre, interventional, “before-after” survey, performed in 31 hospitals in Italy. All patients with CAP of Fine class IV or V (excluding those who were directly admitted to intensive care units) were included. The study was composed of three consecutive periods: 1) a retrospective phase (RP); 2) guideline implementation; 3) a prospective phase (PP). Results were expressed as Odds Ratios (OR) with 95% confidence intervals (95% CI) adjusted for risk factors and corrected for multiple comparisons in subgroups. RESULTS A significant increase in use of combinations was observed in the PP (p = 0.006). Moreover, a shift of prescription from β-lactams to fluoroquinolones as initial monotherapy was recorded. Therapies adherent to FADOI recommendations increased by 10.9% in the PP (p < 0.001). Therapeutic success improved after implementation of recommendations (73.9 vs 71.5%; OR = 0.83; 95% CI = 0.69-1.00; p = 0.049). The difference was particularly evident in Fine class V (58.0 vs 52.5%; OR = 0.71; 95% CI = 0.51-0.98; p = 0.036), where a trend towards a lower mortality occurred (23.1 vs 26.3%; OR = 0.71; 95% CI = 0.48-1.05; p = 0.090). Therapies compliant with FADOI recommendations showed a higher success rate in both study phases (76.6% vs 70.3%; OR = 0.74; 95% CI = 0.60-0.90; p = 0.004). Levofloxacin was the most clinically effective first-cycle therapy with 79.1% of success, the least effective being an antipneumococcal cephalosporin alone with 68.6% (OR = 0.72; 95% CI = 0.51-1.01; p = 0.053). Etiologic diagnosis was obtained in less than 12% of patients in both study phases. Mean lengths of hospital stay were 12.2 and 11.9 days in the RP and PP, respectively. CONCLUSIONS Implementation of FADOI therapeutic recommendations led to a significantly better outcome in terms of clinical success, especially in more severe cases of CAP. Possibly, more “aggressive” approaches towards implementation may result in further improvement in the overall management of CAP.
When the position of a stent is incorrect
Authors: Zoboli P. , Cottafavi L. , Desimoni G. , Boni F. , Chesi G.
Published: May 2013

Gut perforation, secondary to the insertion of a biliary stent, is an uncommon but potentially life-threatening complication. The authors present the case of a patient with biliary stent dislocation and intestinal perforation. The diagnosis was suspected on the description on direct abdomen X-ray of a stent inserted in a right iliac artery.
About pathognomonic images: an infrequent case of acute encephalopathy
Authors: Grasso Alessandro , Nurra Pietro , Cavallo Luigia , Menardo Giorgio
Published: May 2013

BACKGROUND The occurrence of acute encephalopathy is a dramatic clinical dilemma when usual diagnostic techniques (blood tests, cerebral CT and cerebrospinal fluid analysis) show no abnormalities. CLINICAL CASE We describe a case of a 73 years old man admitted in our Internal Medicine Unit for acute diarrhoea with vomiting and fever who developed a prolonged gastrointestinal dysmotility syndrome with poor nutritional intake. Although a parenteral support was provided, he developed acute encephalopathy followed by hypotension and lactic acidosis without evidence of renal and hepatic disease or glycemic alterations. Likewise, no cerebral CT and cerebrospinal fluid alterations were found. Conversely, cerebral MRI showed marked and diffuse DP-2 and FLAIR hyperintensity of the mesencephalic tectal plate, of the periaqueductal area, and of the periventricular region of the third ventricle including the median thalamic area. These MRI descriptions were considered pathognomonic of Wernicke encephalopathy. Thus, the immediate use of ev thiamine was followed by a prompt and complete recovery of neurological, hemodinamic and metabolic conditions. CONCLUSIONS Non-alcoholic Wernicke encephalopathy is a rare and dramatic clinical event with high mortality. In this context, brain MRI is the best diagnostic tool providing a typical picture.
A young woman with headache and seizures
Authors: Pizzini A.M. , Silingardi M. , Iori I.
Published: May 2013

CASE REPORT We describe a 31 year-old woman with headache and acute onset of seizures. Medical history and physical examination were unremarkable. She has been on therapy with oral contraceptives for many years for dysmenorrhea. A CT scan was negative, but MRI and MR-angiography showed left transverse sinus thrombosis. Screening for thrombophilia revealed hyperhomocysteinemia and Factor V Leiden heterozigousity. The patient received unfractionated heparin, followed by long-term anticoagulation with warfarin (INR 2-3). CONCLUSIONS Cerebral venous thrombosis is a rare cerebrovascular disorder, frequently in young adult (about 75% are women). The diagnosis might be difficult with consequent high long-term morbidity and mortality rate. New neuroimaging techniques (MRI and MR-angiography) and more effective treatment (anticoagulation and endovascular thrombolysis) have improved the prognosis and the natural history. The risk factors, the clinical presentation, the diagnostic evaluation and the management of cerebral venous thrombosis are reviewed.
Limited stage small cell carcinoma of the gastrointestinal tract: a clinicopathologic and prognostic analysis of 27 cases
Authors: Peng Chunyan , Shen Shanshan , Zhang Xiaoqi , Zou Xiaoping
Published: May 2013

Small cell carcinoma of the gastrointestinal tract is a rare and aggressive neuroendocrine tumor. This study aims to analyze the clinical characteristics and potential prognostic factors for patients with limited stage small cell carcinoma of the gastrointestinal tract. The records of 27 patients with limited stage small cell carcinoma of the gastrointestinal tract, who all received surgery with lymphadenectomy, were retrieved and analyzed retrospectively. The median age of patients was 60 years old (range 38–79). The primary locations of tumor were the esophagus (74.1%) and stomach (14.8%). The rate of preoperative accurate diagnosis (16.7%) was low for small cell carcinoma of the esophagus and stomach. 40.7% of all the patients had regional lymph node metastases. Five patients underwent surgery alone, and the other 22 were treated with surgery + postoperative chemotherapy. All patients had disease progression or recurrence. The overall median survival time was 10 months and the 1-year survival rate was 37.0%. Patients who received postoperative chemotherapy had a median survival time of 12 months, which was superior to the 5-month survival of for those who only had surgery (P<0.0001). TNM stage (P=0.02) and postoperative chemotherapy (P<0.0001) were considered as two prognostic factors in uni-variate analysis. Postoperative chemotherapy was a significant independent prognostic factor in multivariate analysis (P=0.01). The prognosis for patients with limited stage small cell carcinoma of the gastrointestinal tract remains dismal, however, postoperative chemotherapy may have the potential to improve the outcome for these patients.
The Reformed tradition as public theology
Authors: Vellem Vuyani S.
Published: May 2013

This article is a South African perspective of a Black African reflection on the publicity of Reformed faith. Whilst the notion of public theology is fairly new, the article argues, it is important to define the ‘public’ of the type of public theology to which Reformed faith and tradition could be linked. As a confessional tradition, Reformed faith is intrinsically public, the article demonstrates. The publicity of this tradition is however ambivalent and tainted. I attempt to show this by discussing two important tenets of the Reformed Tradition: sola scriptura and sola fide, within the festering wounds of Black African colonialism, apartheid and the hegemony of the neoliberal paradigm in the 21st century.
Introduction of online adaptive radiotherapy for bladder cancer through a multicentre clinical trial (Trans-Tasman Radiation Oncology Group 10.01)
Authors: Pham Daniel , Roxby Paul , Kron Tomas , Rolfo Aldo , Foroudi Farshad
Published: May 2013

Online adaptive radiotherapy for bladder cancer is a novel radiotherapy technique that was found feasible in a pilot study at a single academic institution. In September 2010 this technique was opened as a multicenter study through the Trans-Tasman Radiation Oncology Group (TROG 10.01 bladder online adaptive radiotherapy treatment). Twelve centers across Australia and New-Zealand registered interest into the trial. A multidisciplinary team of radiation oncologists, radiation therapists and medical physicists represented the trial credentialing and technical support team. To provide timely activation and proper implementation of the adaptive technique the following key areas were addressed at each site: Staff education/training; Practical image guided radiotherapy assessment; provision of help desk and feedback. The trial credentialing process involved face-to-face training and technical problem solving via full day site visits. A dedicated “help-desk” team was developed to provide support for the clinical trial. 26% of the workload occurred at the credentialing period while the remaining 74% came post-center activation. The workload was made up of the following key areas; protocol clarification (36%), technical problems (46%) while staff training was less than 10%. Clinical trial credentialing is important to minimizing trial deviations. It should not only focus on site activation quality assurance but also provide ongoing education and technical support.
Antioxidative and radioprotective potential of rutin and quercetin in Swiss albino mice exposed to gamma radiation
Authors: Patil Shrikant L. , Mallaiah Somashekarappa Hiriyur , Patil Rajashekar K.
Published: May 2013

The radioprotective potential of bioflavonoid, rutin (RUT) and quercetin (QRT) was investigated in Swiss albino mice exposed to gamma radiation. The radioprotective potential of RUT and QRT was assessed in pre-treatment group of mice followed on radiation-induced changes in glutathione (GSH), glutathione-S-transferase (GST), superoxide dismutase (SOD), catalase (CAT), and lipid peroxidation (LPO) levels were also analyzed. Elevation in the GSH, GST, SOD, CAT, and decreased LPO levels were observed in RUT and QRT pretreated group when compared to the irradiated animals. Furthermore, it was observed that RUT and QRT treatment was found to inhibit various free radicals generated in vitro, viz., 2,2-diphenyl-1-picrylhydrazyl(DPPH), O2, 2,2’-azino-bis(3-ethylbenzothiazoline-6-sulphonic acid) (ABTS)·+, and OH· in a concentration-dependent manner. This study clearly demonstrates the free radical scavenging action of RUT and QRT, indicating that it may have its potential as a radioprotective agent. Furthermore, the presence of a phenolic group in RUT and QRT is known to contribute to scavenging the radiation-induced free radicals and inhibition of oxidative stress. Present findings demonstrate the potential of RUT and QRT in mitigating radiation-induced oxidative stress, which may be attributed to the inhibition of radiation-induced decline in the endogenous antioxidant levels and scavenging of radiation-induced free radicals.
Natural radionuclide and radiological assessment of building materials in high background radiation areas of Ramsar, Iran
Authors: Bavarnegin Elham , Moghaddam Masoud Vahabi , Fathabadi Nasrin
Published: May 2013

Building materials, collected from different sites in Ramsar, a northern coastal city in Iran, were analyzed for their natural radionuclide contents. The measurements were carried out using a high resolution high purity Germanium (HPGe) gamma-ray spectrometer system. The activity concentration of 226Ra, 232Th, and 40K content varied from below the minimum detection limit up to 86,400 Bqkg-1, 187 Bqkg-1, and 1350 Bqkg-1, respectively. The radiological hazards incurred from the use of these building materials were estimated through various radiation hazard indices. The result of this survey shows that values obtained for some samples are more than the internationally accepted maximum limits and as such, the use of them as a building material pose significant radiation hazard to individuals.