bluuebunny/crossref_metadata_2025 huggingface dataset:
A vast retroperitoneal mass and autoimmune haemolytic anemia
Authors: Di Stefano Fabio , Nicolai Salvatore , Pesa Oscar
Published: April 2013

CLINICAL CASE We report a 64 year-old patient with fatigue and intermittent fever. Laboratory investigations revealed autoimmune haemolytic anemia. An abdomen CT scan showed a retroperitoneal mass near the left kidney. The CT scan guided mass biopsy was performed and its histology was diagnostic for a non Hodgkin B cell lymphoma. CONCLUSIONS The case describes autoimmume haemolytic anemia as a paraneoplastic syndrome associated with lymphoma. Autoimmume haemolytic anemia is a frequent paraneoplastic syndrome of lymphoproliferative disorders. The onset can be concomitant to the diagnosis of leukemia/lymphoma or follows the course of these neoplastic diseases or less frequently occurs years in advance.
Old hypertensive patient: a hard challenge
Authors: Rossetti Giuseppe , Solari Diana , Rainoldi Maria Laura , Carugo Stefano
Published: April 2013

BACKGROUND High blood pressure is one of the most important cardiovascular risk factor and its incidence is continuously increasing: on 2025 1/3 of adult world population will suffer of it. Moreover, the therapy of elderly hypertension sufferer patient is still growing up in importance for the continuous increase of world population average life. With ageing, the cardiovascular system suffers neurohormonal and haemodinamic modifications which determine the onset of isolate systolic hypertension, which is characteristic of the elderly. This pathology results linked to a higher cardiovascular risk. AIM OF THE STUDY This review aims to analyze and evaluate present and future therapeutic opportunities about anti-hypertensive therapy in elderly people. DISCUSSION AND CONCLUSIONS Also in elderly people systolic blood pressure values must be lower than 150 mmHg, but it’s also important to maintain diastolic pressure not under 70 mmHg, to avoid phenomenons of cerebral and coronary hypo-perfusion (J curve). The benefits of an effective anti-hypertensive therapy are achieved thanks to both blood pressure lowering “per se” and to the decrease of cardiovascular mortality and morbility. Blood pressure control in the elderly is a hard challenge for the low compliance to the therapy, for the importance of the comorbidity and for the supplementary risk factors. ESH-ESC 2007 guidelines recommend for elderly highblood pressure sufferer patient the use first of all of calcium-antagonists and thiazides diuretics, and for second line ACE-inhibitors, ARB and beta-blockers. In several patients combinations of two or more drugs are necessary to obtain pressure control.
Is the lung a target organ in diabetes?
Authors: Marvisi Maurizio , Bassi Emanuele
Published: April 2013

BACKGROUND The lung is not considered a target organ in diabetes mellitus. In English language literature there are many papers showing the opposite. DISCUSSION Many studies demonstrated a thickened alveolar epithelial and pulmonary capillary basal lamina and a reduced lung elasticity, others showed that these histopathological alterations develop into functional abnormalities such as reduced lung volumes, pulmonary diffusion capacity and elastic recoil. The diabetes related pulmonary disease has not an impact on normal life in otherwise “healthy” patients, but it is possible that in specific pathologic (such as heart, kidney and lung comorbidities) or paraphysiologic (such as physical exercise, smoking or exposure to high altitude) conditions, diabetes could contribute to the clinical manifestation of a restricitive lung disease. On the other hand, diabetic patients have an increased propensity to acquire infections. The prevalence of pulmonary tuberculosis is reported to be four times than in healthy subjects; there is a predilection for the lower lobes and the disease is more aggressive in poorly controlled diabetes mellitus.
Italian Journal of Medicine now online in ScienceDirect
Authors: Nardi Roberto , Mazzone Antonino
Published: April 2013

Not available
Internal medicine, complexity, evidence based medicine, almost ‘‘without evidences’’
Authors: Nardi Roberto , Fabbri Tatiana , Belmonte Gelorma , Leandri Paolo , Mazzetti Magda , Pasquale Angelo , Reta Massimo , Rizzi Claudia , Scanelli Giovanni , Iori Ido , Gussoni Gualberto , Pedace Claudio , Mathieu Giovanni , Mazzone Antonino
Published: April 2013

Background: Internal medicine has been defined as the specialty of the adult medical complex patients. Complexity science suggests that illness (and health) results from complex, dynamic, and unique interactions between different components of the overall system. In a patient, complexity involves the intricate entanglement of two or more systems (e.g.; body-diseases, family, socioeconomic status, therapies). Aim of the study: To evaluate the real applicability of Evidence Based Medicne (EBM) in clinical Departments of Internal Medicine and its critical perspectives. Discussion: Habitually the internist takes decisions in these situations: a) certainty (the ideal decision is adopted and the corresponding strategy follows), b) risk (the more suitable alternative selected can be the determination of the probable value or mathematical hope) and c) uncertainty, in which decisions linked to triple agents: beliefs and personal values of the doctors (I) for their patients (II) in the society (III). In the medical decisions there are often different factors that go beyond the field of technical and scientific knowledge (family, social, economic problems, etc.) and demanding an ethical analysis of the decision. Conclusions: The ‘‘evidence-based medicine’’, as other models of care, has — in itself — some limitations. ‘‘No evidence in medicine’’ matters that the postulates of the EBM are not always applicable to the real patients of Internal Medicine wards, mostly elderly, frail, complex, with comorbidities and polipharmacy, often with cognitive dysfunction and limitation of autonomy, with psycho-emotional, social and economic problems. The interacting effects of overall involved diseases/factors and their management require more complex and individualised care than simply the sum of separate guideline components. Further innovation is required to resolve the need to enhance integration of evidence with our patients’ values at the ‘‘bedside and/or clinic’’ management.
Internal Medicine wards overcrowding and clinical risk management: structural or systemic interventions needed?
Authors: Nardi Roberto , Gardellini Aldina , Iori Ido
Published: April 2013

Not available
Von Hippel-Lindau disease associated with myasthenia gravis not related to thymoma
Authors: Pozzato Paolo , Sorrenti Giovanni , Salvi Fabrizio , Ventrucci Maurizio
Published: April 2013

BACKGROUND Von Hippel-Lindau disease (VHL) is a rare autosomal dominant inherited disorder characterized by an increased risk of tumours in a number of locations (eyes, brain, adrenal gland, pancreas, liver, kidneys, or other areas of the body). It is caused by germline mutation in the VHL gene. The VHL gene is a tumour suppressor gene that has been identified on the short arm of chromosome 3. CASE REPORT We report a case of a 60 year-old female with the clinical diagnosis of VHL type 1 (cerebellar haemangioblastoma, pancreatic cysts with subsequent steatorrhoea, and bilateral renal carcinoma) who developed weakness and fatigability of skeletal muscles, left lid ptosis, snarling expression and nasal timbre speech. Acetylcholine receptor antibodies were negative in serum, while the electrodiagnostic test demonstrated an alteration of neuromuscolar junction which was consistent with the diagnosis of myasthenia gravis. Contrast-enhanced TC scan of the anterior mediastinum was performed, which excluded thymus enlargement. VHL gene evaluation in this patient identified a new mutation (c279delC9) and polymorphism c291C>G. At present the patient still suffers from ataxia and dysmetria due to cerebellar involvement in VHL, while fatigue and lid ptosis improved after the treatment with oral pyridostigmine 60 mg tid. DISCUSSION AND CONCLUSIONS To our knowledge this is the first report of a case of VHL associated with myasthenia gravis without thymoma. A case of VHL associated with a form of myasthenia gravis related to thymoma has been recently reported. In our case the absence of acetylcholine receptor antibodies may suggest a genetic origin also for the myasthenia gravis.
Intramural hematoma of the esophagus in a woman with chronic renal failure and prophylactic heparin therapy
Authors: Serafini Francesco , Fantin Giuseppe , Zancanaro Andrea , Gurrieri Carmela , Bonanni Luca , Bittolo Bon Gabriele
Published: April 2013

CASE REPORT An 86 year-old woman experienced chest pain, dyspnea, and dysphagia two days following orthopaedic surgery for a bimalleolus fracture of the right ankle. The patient was on prophylactic low weight molecular heparin and was affected by chronic renal failure. The chest computed tomography (CT) ruled out a pulmonary embolism but showed an intramural esophageal mass involving the entire esophagus. The lesion exhibited a blood like CT attenuation content that did not enhance after contrast administration. The esophagogram with gastrografin did not reveal filling defects nor communications between lumen and mucosa. Magnetic resonance confirmed CT results and excluded an aortic dissection. All radiological findings were suggestive of intramural hematoma of the esophagus. DISCUSSION AND CONCLUSIONS Intramural hematoma of the esophagus (IHE) is part of the spectrum of esophageal injuries that includes Mallory-Weiss tear and Boerhaave’s syndrome. IHE is the result of a hemorrhage within the submucosal layer. Predisposing conditions are abnormal hemostasis, traumatic events, aortic diseases. It can also occur spontaneously (idiopathic). Treatment should be conservative and includes risk factors withdrawal. The hematoma usually resolves in 1 to 3 weeks.
Knowledge, mistakes, communication with patients and informed consent
Authors: De Palma Alessandra
Published: April 2013

BACKGROUND Communication is very important in medical activity, particularly to maintain or re-establish trust-based relationships between patients, doctors, nurses and all the people who work in Hospital or for the Italian National Health Service. Health services include the relationship between doctors and patients: the partnership is important as much as the technical ability in Medicine. But it is difficult to learn empathy: doctors are not taught about that at University, nor afterwards, at least not sufficiently. CONCLUSIONS The informed consent form, even if it is very detailed, is not the real answer to that problem.
Treatment of lipid disorders: targets and thresholds
Authors: Gulli Giovanni
Published: April 2013

Not available
Severe acute pancreatitis: clinical findings and therapeutic tools in Internal Medicine practice
Authors: Uomo Generoso , Rabitti Pier Giorgio
Published: April 2013

BACKGROUND Recent advances in pathophysiology and therapeutic measures suggest that patients suffering from acute pancreatitis (AP) should undergo an early evaluation and treatment in Internal Medicine wards. Severe AP, usually associated with pancreatic necrosis and peripancreatic fluid collections, may be frequently complicated by distant organ(s) involvement. RESULTS The dreadful multi-organ failure may occur as an early event (during the first week of the disease) or in association with the infection of pancreatic necrosis in a later stage. So, during the clinical outcome, physicians may be compelled to counteract cardio-circulatory, pulmonary, renal, hepatic, haematological and hydro-electrolytic complex derangements. Arterial hypotension and shock may be consequence of hypovolemia and/or hearth failure or septic shock syndrome. Pleural effusions are frequent in the early phase of the disease as well as pulmonary densifications and renal insufficiency. Urinary, pulmonary, and biliary infections may intervene during all phases of the disease whereas pancreatic necrosis and fluid collections infections are more frequent after the second week of hospitalization. Prognostic evaluation should be obtained by simple and precise scoring system such as the modified Marshall score and CT-scan severity index. CONCLUSIONS Treatment must be initiated as soon as possible with special focusing on fluid and nutritional supplementation, pain control, cardio-respiratory support, antiproteases and antibiotics. Invasive procedures such as endoscopic sphincterotomy in biliary AP with cholangitis and/or obstruction and percutaneous drainage should be utilized in specific cases. Surgical necrosectomy is mandatory in patients with documented infection of pancreatic necrosis.
In memory of Professor Serafino Mansueto
Authors: Di Rosa Salvatore
Published: April 2013

Not available
Hospitalizations for hyponatremia and syndrome of inappropriate antidiuretic hormone hypersecretion at the Policlinic of Modena, Italy from January 2006 to September 2008
Authors: Brugioni Lucio , Dareggi Daniela , Ognibene Chiara , Gozzi Cristina , Amorotti Elisa , Zandomeneghi Renato
Published: April 2013

Introduction: Hyponatremia is the most common electrolyte imbalance among hospitalized patients. The cause is not always identified, but 30-40% of cases are the result of the syndrome of inappropriate antidiuretic hormone hypersecretion (SIADH). The aim of this study was to determine the frequency of hyponatremia in our hospital, its underlying causes (in particular the proportion of cases caused by SIADH), and approaches to treatment. Materials and methods: We retrospectively analyzed all nonpediatric hospitalizations occurring between 1 January 2006 and 30 September 2008 in which the discharge diagnosis was hyponatremia or SIADH. Results: A total of 64 cases were reviewed; 56 of the patients were aged > 60. The hyponatremia was classified as severe (< 125 mEq/L) in 36/64 cases (56%) (most involving patients aged >70); moderate (129-125 mEq/L) in 22 (34%); and mild (134-130 mEq/L) in 6 (9%). Neurologic symptoms were present in 11 patients with severe hyponatremia (confusion, hallucinations, coma) and 9 with moderate hyponatremia (weakness, impaired memory). Thirteen had hypovolemic hypotonic hyponatremia, 16 had hypervolemic hypotonic hyponatremia, and 35 had normovolemic hypotonic hyponatremia, including 23 who met the criteria for SIADH: 5 patients with neoplastic disease, 6 with pulmonary disorders, 3 with drug-related hyponatremia (a selective serotonin reuptake inhibitor in 1 case, a tricyclic antidepressant in 1, carbamazepine in 1), 2 whose SIADH developed after surgery, 4 with head trauma, 1 receiving noninvasive ventilatory support, and 2 elderly patients whose SIADH appeared idiopathic. Thirteen patients had hyponatremia related to the use of diuretics (thiazides in 7 cases), and one other had long-standing untreated hypothyroidism. In most cases, treatment consisted of infusion of hypertonic saline (sometimes with fluid restriction and/or furosemide administration). Discussion: Over one third (36%) of the adults hospitalized in the Policlinic of Modena for hyponatremia during the 3-year study had SIADH, a figure that is consistent with literature data. In most cases, the cause of hyponatremia can be identified on the basis of simple laboratory tests and complete patient histories.
Pain at the crossroads between nature and culture
Authors: Gaspa Francesco N. , Pinna Giuliano
Published: April 2013

Pain and suffering represent unavoidable experiences that have left a deep mark on the history of mankind. In this review, pain is examined from an anthropological point of view, because there is no pain without suffering, and every biophysical event is brought to the consciousness of an individual by an emotional signal. The body is an entity that changes from culture to culture and operates within particular historical and social contexts. Each society incorporates the concept of pain into its particular worldview, assigning it a specific meaning and value. Few human experiences can be read in as many different keys: from neuroscience to linguistic research, perspective selection, and emotional and cognitive functions. Although pain is currently regarded as a destructive force that is per se pathological, it is actually a form of protection. In today’s society, pain is experienced as a problem in itself, a disease within a disease, and its physiopathological aspects have been extensively characterized. But pain must also be analyzed within its anthropological, sociological, political, and economic contexts. The phenomenon of pain lies at the crossroads between nature and culture, and analysis from this perspective is essential for explaining the multiplicity of related data. The ‘‘anthropology of pain’’ explains, among other things, the assortment of reactions to identical pain stimuli among individuals and groups: for example, the higher opposition to pain observed among individuals living in poverty, the phenomenon of ‘‘combat analgesia’’, and the wide variety of analgesics used by traditional populations.
Safety and effectiveness of drug therapy for the acutely agitated patient (Part 2)
Authors: Airoldi Gianluca
Published: April 2013

Acute agitation occurs in a variety of medical and psychiatric conditions, and the management of agitated, abusive, or violent patients is a common problem in the emergency department. Rapid control of potentially dangerous behaviors by physical restraint and pharmacologic tranquillization is crucial to ensure the safety of the patient and health-care personnel and to allow diagnostic procedures and treatment of the underlying condition. The purpose of this article (the second in a 2-part series) is to review published data on the efficacy and safety of antipsychotic medications currently available for managing situations of this type. Arrhythmias caused by QT-prolonging drugs occur infrequently, and multiple factors are often involved, including concomitant use of other drugs affecting the same pathway (most antipsychotic drugs prolong the QT interval by blocking potassium IKr current in HERG channels of myocardial cells), electrolyte disorders and, possibly, genetic predisposition. Judicious use of typical antipsychotics (mainly haloperidol) and benzodiazepines (mainly lorazepam), given intramuscularly alone or in combination, has proved to be safe and effective for controlling acute motor agitation related to psychiatric illness; cocaine, methamphetamine, and ethanol toxicity; ethanol withdrawal; and other factors. They are still widely used and are particularly useful when limited data are available on the patient’s history of cardiovascular disease, current use of medication, and/or the likelihood of illicit drug or alcohol intoxication; when the diagnosis involves medical comorbidity or intoxication; or when there is no specific treatment (e.g., personality disorders, learning disabilities, mental retardation, organic brain damage). If rapid tranquillization is necessary before a formal diagnosis can be made and there are uncertainties regarding the patient’s medical history, lorazepam is often considered the first-line drug of choice. In patients with primary psychiatric disease, the second-generation atypical antipsychotics, mainly risperidone and olanzapine, were shown to be at least as effective, and possibly safer, than traditional agents.
Health Technology Assessment: Principi, dimensioni e strumenti
Authors: Descovich Carlo , Siena Annunziata
Published: April 2013

Book review of: Walter Ricciardi, Giuseppe La Torre Health Technology Assessment: Principi, dimensioni e strumenti. Torino: Edizioni SEED, 2010 140 pagg., 20,00 euro.
Life of an internist
Authors: Portioli Italo
Published: April 2013

Not available
Adult-onset Still’s disease, the most internistic of the rheumatic diseases: current concepts and a report of six cases
Authors: Boni Roberto , Rabitti Pier G.
Published: April 2013

Adult-onset Still’s disease (AOSD) is a rare systemic inflammatory disorder of unknown origin. It is characterized by spiking fever, evanescent rash, arthralgia/arthritis, and leukocytosis. The differential diagnosis includes a number of other conditions, and management is complicated by the lack of course predictors and the risks associated with complications and treatments. This report examines recent advances in our understanding of adult-onset Still’s disease (pathogenesis, diagnosis, complications, treatment). Current research in this field is focused on the significance of serum ferritin in AOSD, mechanisms underlying the hemophagocytic syndrome, and use of biologic therapies in patients who are refractory to conventional treatment. Six cases of AOSD diagnosed by our staff between 2002 and 2009 are also analyzed and compared with other cases reported in the literature. This analysis showed that Still’s rash and serum ferritin levels were not essential elements for diagnosis. In addition, the course of the disease showed little relation to the severity / characteristics of the presenting picture, but the evolution worsened with the age of the patient at diagnosis.
Focus on the spondyloarthritides. Can earlier diagnosis change the course of the disease?
Authors: Galasso Domenico , Forte Giovanni , Marigliano Norma
Published: April 2013

The spondyloarthritides (or spondyloarthropathies) (SPAs) are chronic, inflammatory, rheumatic diseases of unknown origin, which share certain clinical, epidemiological, and genetic characteristics. They include ankylosing spondylitis, reactive arthritis (also known as the Reiter Syndrome), psoriatic arthritis, enteropathic spondyloarthropathy (ulcerative colitis, Crohn’s disease), undifferentiated spondyloarthritis, juvenile spondyloarthritis, and formes frustes such as acute anterior uveitis, spondyloarthritic carditis, and balanitis circinata. In the past, the SPAs were considered variants of rheumatoid arthritis, but it is now clear that they differ from the latter disease in terms of the pattern of articular and extra-articular involvement, their lack of association with seropositivity for rheumatoid factor, and their strong association with sacro-iliac joint bacino= pelvis sacro-iliac joint sacro-iliac joint sacro-iliac joint sacro-iliac joint sacro-iliac joint the class I human leukocyte antigen B27. sacro-iliac joint bacino= pelvis sacro-iliac joint sacro-iliac joint sacro-iliac joint sacro-iliac joint sacro-iliac joint Their general characteristics are axial involvement; enthesitis; peripheral arthritis involving the lower limbs, which is usually asymmetric; dactylitis; extra-articular manifestations involving the skin, eyes, bowel, and genitals. The musculoskeletal manifestations of the SPAs are due to inflammation at the level of the entheses. It is important to distinguish between the numerous clinical SPA variants based on analysis of symptoms, laboratory tests, and instrumental studies. Thanks to a greater understanding of the pathogenesis of the SPAs and the widespread availability of highly sensitive imaging modalities for their diagnosis, it is now possible to identify these diseases early and modify their course with effective therapy. This approach offers benefits to patients in terms of reduced morbidity and mortality and improved quality of life.
Compilation of abstracts of case reports or case series and their evaluation: ‘‘guidelines’’ from FADOI Emilia Romagna
Authors: Mascella Fabio , Ballardini Giorgio
Published: April 2013

Not available
Nutrition and malnutrition in elderly patients
Authors: Tozzuoli Daniela , Ceccherini Emanuele , Pedace Claudio
Published: April 2013

Protein-energy undernutrition is a very common problem among elderly patients. It is promoted by age-related decreases in the basal metabolic rate, physiological change in body composition, progressive dysphagia, physical and/or cognitive impairments, depression, socioeconomic factors, effects of drugs on absorption and utilization of nutrients, and other factors. Several studies suggest that nutritional support can lower the risk of adverse outcomes among undernourished elderly patients. Monitoring food intake in patients with dysphagia may be useful in deciding between oral supplementation or artificial nutrition. The decision to provide nutritional support and the route to be used will depend on the clinical conditions of the patient, the severity of the dysphagia, the expected course of any underlying diseases, and several other patient-specific considerations. In geriatric patients, the main objectives of this type of therapy are usually the maintenance of function and improvement of the quality of life.
Buckling of 2D-FG Cylindrical Shells under Combined External Pressure and Axial Compression
Authors: Mohammadzadeh R. , Najafizadeh M. M. , Nejati M.
Published: April 2013

This paper presents the stability of two-dimensional functionally graded (2D-FG) cylindrical shells subjected to combined external pressure and axial compression loads, based on classical shell theory. The material properties of functionally graded cylindrical shell are graded in two directional (radial and axial) and determined by the rule of mixture. The Euler’s equation is employed to derive the stability equations, which are solved by GDQ method to obtain the critical mechanical buckling loads of the 2D-FG cylindrical shells. The effects of shell geometry, the mechanical properties distribution in radial and axial direction on the critical buckling load are studied and compared with a cylindrical shell made of 1D-FGM. The numerical results reveal that the 2D-FGM has a significant effect on the critical buckling load.
Household Environmental Conditions Are Associated with Enteropathy and Impaired Growth in Rural Bangladesh
Authors: Lin Audrie , Arnold Benjamin F. , Afreen Sadia , Goto Rie , Huda Tarique Mohammad Nurul , Haque Rashidul , Raqib Rubhana , Unicomb Leanne , Ahmed Tahmeed , Colford John M. , Luby Stephen P.
Published: April 2013

We assessed the relationship of fecal environmental contamination and environmental enteropathy. We compared markers of environmental enteropathy, parasite burden, and growth in 119 Bangladeshi children (≤ 48 months of age) across rural Bangladesh living in different levels of household environmental cleanliness defined by objective indicators of water quality and sanitary and hand-washing infrastructure. Adjusted for potential confounding characteristics, children from clean households had 0.54 SDs (95% confidence interval [CI] = 0.06, 1.01) higher height-for-age z scores (HAZs), 0.32 SDs (95% CI = −0.72, 0.08) lower lactulose:mannitol (L:M) ratios in urine, and 0.24 SDs (95% CI = −0.63, 0.16) lower immunoglobulin G endotoxin core antibody (IgG EndoCAb) titers than children from contaminated households. After adjusting for age and sex, a 1-unit increase in the ln L:M was associated with a 0.33 SDs decrease in HAZ (95% CI = −0.62, −0.05). These results are consistent with the hypothesis that environmental contamination causes growth faltering mediated through environmental enteropathy.
ECOCLIMAP-II/Europe: a twofold database of ecosystems and surface parameters at 1 km resolution based on satellite information for use in land surface, meteorological and climate models
Authors: Faroux S. , Kaptué Tchuenté A. T. , Roujean J.-L. , Masson V. , Martin E. , Le Moigne P.
Published: April 2013

Abstract. The overall objective of the present study is to introduce the new ECOCLIMAP-II database for Europe, which is an upgrade for this region of the former initiative, ECOCLIMAP-I, already implemented at global scale. The ECOCLIMAP programme is a dual database at 1 km resolution that includes an ecosystem classification and a coherent set of land surface parameters that are primarily mandatory in meteorological modelling (notably leaf area index and albedo). Hence, the aim of this innovative physiography is to enhance the quality of initialisation and impose some surface attributes within the scope of weather forecasting and climate related studies. The strategy for implementing ECOCLIMAP-II is to depart from prevalent land cover products such as CLC2000 (Corine Land Cover) and GLC2000 (Global Land Cover) by splitting existing classes into new classes that possess a better regional character by virtue of the climatic environment (latitude, proximity to the sea, topography). The leaf area index (LAI) from MODIS and normalized difference vegetation index (NDVI) from SPOT/Vegetation (a global monitoring system of vegetation) yield the two proxy variables that were considered here in order to perform a multi-year trimmed analysis between 1999 and 2005 using the K-means method. Further, meteorological applications require each land cover type to appear as a partition of fractions of 4 main surface types or tiles (nature, water bodies, sea, urban areas) and, inside the nature tile, fractions of 12 plant functional types (PFTs) representing generic vegetation types – principally broadleaf forest, needleleaf forest, C3 and C4 crops, grassland and bare land – as incorporated by the SVAT model ISBA (Interactions Surface Biosphere Atmosphere) developed at Météo France. This landscape division also forms the cornerstone of a validation exercise. The new ECOCLIMAP-II can be verified with auxiliary land cover products at very fine and coarse resolutions by means of versatile land occupation nomenclatures.
Multi-variable evaluation of hydrological model predictions for a headwater basin in the Canadian Rocky Mountains
Authors: Fang X. , Pomeroy J. W. , Ellis C. R. , MacDonald M. K. , DeBeer C. M. , Brown T.
Published: April 2013

Abstract. One of the purposes of the Cold Regions Hydrological Modelling platform (CRHM) is to diagnose inadequacies in the understanding of the hydrological cycle and its simulation. A physically based hydrological model including a full suite of snow and cold regions hydrology processes as well as warm season, hillslope and groundwater hydrology was developed in CRHM for application in the Marmot Creek Research Basin (~ 9.4 km2), located in the Front Ranges of the Canadian Rocky Mountains. Parameters were selected from digital elevation model, forest, soil, and geological maps, and from the results of many cold regions hydrology studies in the region and elsewhere. Non-calibrated simulations were conducted for six hydrological years during the period 2005–2011 and were compared with detailed field observations of several hydrological cycle components. The results showed good model performance for snow accumulation and snowmelt compared to the field observations for four seasons during the period 2007–2011, with a small bias and normalised root mean square difference (NRMSD) ranging from 40 to 42% for the subalpine conifer forests and from 31 to 67% for the alpine tundra and treeline larch forest environments. Overestimation or underestimation of the peak SWE ranged from 1.6 to 29%. Simulations matched well with the observed unfrozen moisture fluctuation in the top soil layer at a lodgepole pine site during the period 2006–2011, with a NRMSD ranging from 17 to 39%, but with consistent overestimation of 7 to 34%. Evaluations of seasonal streamflow during the period 2006–2011 revealed that the model generally predicted well compared to observations at the basin scale, with a NRMSD of 60% and small model bias (1%), while at the sub-basin scale NRMSDs were larger, ranging from 72 to 76%, though overestimation or underestimation for the cumulative seasonal discharge was within 29%. Timing of discharge was better predicted at the Marmot Creek basin outlet, having a Nash–Sutcliffe efficiency (NSE) of 0.58 compared to the outlets of the sub-basins where NSE ranged from 0.2 to 0.28. The Pearson product-moment correlation coefficient of 0.15 and 0.17 for comparisons between the simulated groundwater storage and observed groundwater level fluctuation at two wells indicate weak but positive correlations. The model results are encouraging for uncalibrated prediction and indicate research priorities to improve simulations of snow accumulation at treeline, groundwater dynamics, and small-scale runoff generation processes in this environment. The study shows that improved hydrological cycle model prediction can be derived from improved hydrological understanding and therefore is a model that can be applied for prediction in ungauged basins.
SIMULATION OF CLOSE-RANGE PHOTOGRAMMETRIC SYSTEMS FOR INDUSTRIAL SURFACE INSPECTION
Authors: Becker T. , Özkul M. , Stilla U.
Published: April 2013

Abstract. Close-range photogrammetric measurement systems are increasingly used for high-precision surface inspection of car body parts. These measurement systems are based on an active light source, the projector, and one or more cameras. Many systems use a sequence of fringe projection, mostly a combination of the gray code and phase shift technique. Basically the quality of the measurement result depends on best possible positions of these sensors, which requires human expert knowledge and experience. But is it possible to use computer-based algorithms to find optimal measuring positions? Simulation processes are discovered as part of a research project aimed at the evaluation of the quality of measuring positions concerning to visibility, the attainable accuracy and realizable feature extraction. One approach is the simulation of the photogrammetric sensor using ray tracing techniques to create photorealistic pictures from the sensor cameras view. This image sequence could be processed with the evaluation software of the system manufacturer in order to calculate a three dimensional point cloud. Following an actual/target comparison should indicate differences that trace back to insufficient measuring positions. In this paper we show how to build up a virtual close range photogrammetric sensor using POV Ray, a free ray tracing software. After introducing the simulation concept, the design of a virtual close range photogrammetric sensor is presented. Based on practical examples of sampled scenes the potential of photorealistic ray tracing is shown. Finally the usability of this simulation approach is discussed.
CHANGE DETECTION IN A TOPOGRAPHIC BUILDING DATABASE USING SUBMETRIC SATELLITE IMAGES
Authors: Le Bris A. , Chehata N.
Published: April 2013

Abstract. Submetric satellite imagery (Pleiades, GeoEye) offers advantages for map update purposes, e.g. an interesting ground resolution, a good reactivity and the ability to capture wide areas. Experiments on the use of such stereoscopic images for 2D change detection among building objects of GIS topographic database are presented in this paper. Two approaches have been tested. The first one extracts land cover from satellite ortho-images and additional information (correlation DSM-DTM, database) and compares building objects of this classification to those of the database. The second one creates a pseudo-DSM from height information of database building objects combined with a DTM and compares it to a correlation DSM computed from satellite images. Obtained results are quite encouraging even if the correctness rate remains too low for an operational use.
“New Year's Dream”: A Chinese Anarcho-cosmopolitan Utopia
Authors: Li Guangyi
Published: April 2013

This article is an in-depth analysis of “New Year's Dream” (1904), a utopian story by Cai Yuanpei, one of the most prominent Chinese intellectuals in the twentieth century. In combination with the story's late Qing milieu, it explores how Cai Yuanpei maps his contemporary world and designs a better one. Based on detailed discussions of the linear progressive future history in the story, this article values “New Year's Dream” for its landmark importance in the transition of Chinese utopian thought and critically analyzes its theme of dual revolution—a national revolution leading to a world revolution, which is significant for our understanding of world utopianism and anarchism.
Los efectos vinculantes de la publicidad comercial en la contratación con consumidores en el Derecho de Nicaragua
Authors: Acedo Penco Ángel
Published: April 2013

El trabajo analiza los precedentes del Derecho comunitario europeo en materia de protección de los consumidores y se adentra en el problema de la vinculación publicitaria de la oferta del empresario y su integración en el contrato, primero en el Derecho de España, con sus antecedentes legislativos y jurisprudenciales, y luego en el Derecho de Nicaragua, particularmente, en las normas vigentes de protección jurídica de los consumidores. Se estudia el principio de veracidad de la publicidad comercial desarrollada por los empresarios y profesionales. Se analiza el ámbito que abarca la responsabilidad civil del proveedor, en su más amplio sentido, fabricante, importador, o comerciante, es decir, empresario o profesional, como consecuencia de la vulneración de su deber de ofrecer una publicidad que se ajuste al principio de veracidad. La responsabilidad civil exigible al obligado, empresario o profesional, por incumplimiento de su obligación de veracidad publicitaria alcanza tanto la responsabilidad contractual con el consumidor que celebró el contrato, como la responsabilidad extracontractual con los consumidores que, aún sin celebrar el contrato, se han visto perjudicados por la publicidad inveraz. Se realiza una aproximación a la vinculación publicitaria en el Código civil de Nicaragua, se repasa la denominada promesa contractual, como uno de sus derivados, y algunas otras fi guras clásicas, como el dolo, la buena fe y la doctrina de los actos propios, siempre desde la óptica de la protección jurídica de los consumidores, ya sea con las normas codifi cadas o con las especiales de reciente aparición. DOI: http://dx.doi.org/10.5377/derecho.v0i15.1027 Revista de Derecho No.15 2011 pp.9-44
Estudio de la primer autorización de concentración de empresas en Nicaragua bajo el régimen de la ley 601 y su reglamento
Authors: Villagra Gutiérrez Enrique
Published: April 2013

El trabajo de investigación que usted tiene en sus manos es un análisis exhaustivo sobre la primera concentración empresarial que se da en Nicaragua, cuya singularidad es que fue autorizada por la Administración Pública, en sede administrativa y responde a los criterios que establece la Ley 601 y su reglamento, Ley de Promoción de la Competencia. Este “estudio de casos y análisis jurisprudencial” como lo nomina la normativa interna de esta Universidad en su artículo 8 inc. f), tiene un particular interés para determinar si en la práctica se logró alcanzar las metas que se fijó la norma que consagra al Derecho de Competencia, que es nuevo en nuestro Ordenamiento Jurídico. El caso concreto estriba en la fusión de dos empresas avícolas, Tip Top y Pipasa, las cuales tienen participación accionaria de dos grandes transnacionales como es Cargill y Rica Foods. El monto de esta operación fue de aproximadamente 80 millones de dólares americanos con un impacto en el mercado relevante de un 61%. Utilizando un análisis estructural y otro jurídico, determinamos que Nicaragua se ubica en los países que ejercen un control previo a las concentraciones empresariales en aras de salvaguardar el bien común y el interés social. Igualmente señalamos un alto grado de satisfacción por parte de PROCOMPETENCIA en el cumplimiento de la ley, pero igualmente puntualizamos los errores en que incurrieron. Este es el primer antecedente que marca una tendencia para todas aquellas empresas que en el futuro pretendan fusionarse. Queda de manifiesto en el estudio de esta Resolución Administrativa que no existe derogación tácita de normas sino una complementación legal al tratamiento que prescribe el Código de Comercio en la figura de la fusión, que la Ley 601 fortalece para que el Estado asuma una conducción de la economía nacional con un papel de mayor protagonismo, sin menoscabar los derechos a la libre empresa que consagra nuestra Constitución. DOI: http://dx.doi.org/10.5377/derecho.v0i15.1032 Revista de Derecho No.15 2011 pp.145-190
On the Analytic Solution for a Steady Magnetohydrodynamic Equation
Authors: Soltanalizadeh Babak , Ghehsareh Hadi Roohani , Yıldırım Ahmet , Abbasbandy Saeid
Published: April 2013

The purpose of this study is to apply the Laplace-Adomian Decomposition Method (LADM) for obtaining the analytical and numerical solutions of a nonlinear differential equation that describes a magnetohydrodynamic (MHD) flow near the forward stagnation point of two-dimensional and axisymmetric bodies. By using this method, the similarity solutions of the problem are obtained for some typical values of the model parameters. For getting computational solutions, we combined the obtained series solutions by LADM with the Padé approximation. The method is easy to apply and gives high accurate results. The presented results through tables and figures show the efficiency and accuracy of the proposed technique.
For the Pseudoacceptance or Theoretical Bases of one Undescribed Defense Mechanism
Authors: Karabelyov Svetoslav Borisov
Published: April 2013

Много изследователи изтъкват, че това, което знаем за защитните механизми, е, в действителност, резултат от събрани клинични данни. За някои защитни механизми като класическата проекция няма никакви емпирични данни, потвърждаващи тяхното съществуване. Съществуват многобройни психологически школи, всяка от които има собствен възглед за природата, типовете, характеристиките и ефектите от защитните механизми. Няма една единствена теория за защитните механизми. Тази статия поставя теоретичните основи на псевдоприемането като един неописван защитен механизъм, така че разширяването на интрапсихичната защитна система е основната цел на този теоретичен анализ. Представени са природата и характеристиките на псевдоприемането, както и механизмът на разгръщането му, неговата диференциация и взаимовръзки с другите защитни механизми. Един пример за псевдоприемане също е представен и анализиран.
Ultrasound Guided FNAC for Evaluation of Neck Lumps to Improve Inadequacy Rates; A Complete Audit Cycle
Authors: Richard James Green  , Nick Dawe  , Debra Milne  , Ursula Schierle  , James W. Moor
Published: April 2013

We present a completed audit cycle evaluating inadequacy rates in neck lump and thyroid fine needle aspiration cytology with and without ultrasound scan guidance. The first cycle of the audit was from January to July 2010 comparing free hand fine needle aspiration cytology (FNAC) with ultrasound guided fine needle aspiration cytology (USS+FNAC). Changes to practice were made, firstly all thyroid FNAC would be performed with USS+FNAC and a reduced threshold for referral for USS+FNAC for non-thyroid neck masses. The second audit cycle was completed sixteen months later to assess for an improvement in practice. 1st phase; 155 patients, 70 freehand, 85 USS+FNAC. 50% of the thyroid FNAC freehand were inadequate compared to 18% of the thyroid USS+FNAC. 2nd phase; 196 patients, USS+FNAC 134, freehand 62. Thyroid FNAC 105 (USS+FNAC-104, freehand-1). Inadequate USS+FNAC = 21/104 (20%). The completed audit cycle shows an increased proportion of thyroid FNACs performed by ultrasound guidance, improving from 82% to 99%, with an overall reduction of inadequate thyroid FNACs from 24% to 21%. There was a noticeable variability in the inadequacy rates from radiologist to radiologist with the head and neck senior radiologist demonstrating the lowest inadequacy rate at 9.6% in the second cycle. Although ultrasound guidance for FNAC is important for the reasons of increased sensitivity, specificity and accuracy, we have demonstrated that the operator experience and skill are just as important.
Dietary Ascorbic Acid-Mediated Augmentation of Antitumor Activity and Protection Against Toxicities Induced by Cis-Diamminedichloroplatinum-(II) in Daltons Lymphoma-Bearing Mice -
Authors: Amenla  , Akalesh Kumar Verma  , Surya Bali Prasad
Published: April 2013

Cis-Diamminedichloroplatinum-(II) (CDDP) commonly known as cisplatin is considered as a major anticancer drug against a broad spectrum of malignancies. This study evaluates the modulatory effect of dietary ascorbic acid (AA) on the therapeutic efficacy of CDDP against murine ascites Daltons lymphoma (DL) and some tissue toxicities in tumor-bearing mice. As compared to CDDP alone, the combination treatment with ascorbic acid (AA) plus CDDP showed better therapeutic efficacy against murine ascites Daltons lymphoma. DL cells treated with CDDP showed the appearance of apoptotic features involving fragmentation of nucleus into discrete masses and plasma membrane blebbing. As compared to CDDP alone, combination treatment caused an increase in the number of apoptotic DL cells. Reduced glutathione (GSH) level was noted to decrease in DL cells while it increased in kidney after combination treatment. Blood haemoglobin (Hb), red blood cells (RBCs) and white blood cells (eosinophils, basophils and lymphocytes) were also decreased after CDDP treatment while overall betterment in hematological parameters was noted after combination treatment. The analysis of renal function tests (RFT) and liver function tests (LFT) suggest an improvement against CDDP-induced liver and kidney toxicities after combination treatment. The decrease in GSH levels particularly in DL cells and an increase in kidney and liver after combination treatment may have a role in the antitumor activity and decrease in CDDP-induced toxicity in the tumor-bearing host. Improvement in the LFT, RFT and hematological toxicities after combination treatment may have a beneficial effect in the improved survival of tumor-bearing mice.
Brazilian Young Offenders: Profile and Risk Factors for Criminal Behavior
Authors: Gallo Alex Eduardo
Published: April 2013

This paper presents a study that belongs to a research program, driving at the development of adequate social repertoire, which could decrease offences by youth. Adolescents attended in community services and probation programs in a mid-size Brazilian city were characterized, under objective of assessing the major number of variables and its correlation to criminal behavior. Data were collected in a survey design and major results showed that: 87.8% were male, and age average was 15.9 years; about the offences, theft was the most common one (36.7%) followed by robbery (15.4%) and drug-dealing (9%). Most of themwere not attending school and 61.8% had only the elementary degree. The results suggest that not attending school was associated to increasing number of re-incidences, use of drugs and use of weapons.
La gestion de relations asymétriques au sein d’un réseau composite
Authors: Rispal Martine Hlady
Published: April 2013

Comment de petites entités peuvent-elles repérer et gérer des relations asymétriques dans un secteur complexe tel que celui de l’insertion par l’activité économique (IAE) ? Au moyen de cinq études de cas encastrés, l’article examine l’interdépendance de différentes entités oeuvrant en faveur de la réinsertion de personnes en grande difficulté et permet de constater la nature asymétrique des relations nouées. L’enjeu est de taille, car de telles asymétries, si elles ne sont pas correctement identifiées et gérées, conduisent à des dysfonctionnements inter-organisationnels graves, préjudiciables à la cause de la réinsertion. Les travaux relatifs à l’examen des relations asymétriques sont mobilisés, notamment le cadre conceptuel élaboré par Mouzas et Ford (2007), pour diagnostiquer les relations et proposer des points de repère aux petites entités de l’IAE en vue de mieux gérer les relations asymétriques au sein de leur réseau.