bluuebunny/crossref_metadata_2025 huggingface dataset:
Hospital post-intensive management of major trauma: a pilot study in Internal Medicine
Authors: Verdiani Valerio , Lombardo Chiara , Catini Elisabetta , Camaiti Alberto , Conti Alberto , Spina Rosario , Peris Adriano , Nozzoli Carlo
Published: April 2013

BACKGROUND Major trauma is the fourth cause of death in Western countries, and the first one in patients aged 35 years or younger. In-hospital post-intensive care represents a crucial step in the comprehensive medical assistance for these patients, but no data is available. AIM OF THE STUDY To evaluate an hospital post-intensive clinical pathway for patients with major trauma discharged from Intensive Care Unit (ICU). PATIENTS AND METHODS We designed a clinical pathway project for patients with major trauma discharged from an ICU at Careggi Hospital, in Florence. Patients were admitted in two Internal Medical wards of the same hospital. Nurses and physicians were trained to the management of devices and essential critical problems. We analysed characteristics of patients, APACHE score, devices, clinical and biochemical parameters. We determined medical complicances, ICU readmissions and hospital mortality. After a three months follow-up we evaluated hospital readmission, mortality and residual disability. RESULTS AND DISCUSSION We studied 92 patients (mean age 41 ± 20 years; 70 male) with major trauma discharged from ICU (82.6% of patients underwent invasive mechanic ventilation). On admission, tracheotomy tube was present in 21 patients (22.8%). During internal wards stay, tracheotomy tube was removed in 16 patients. Medical complicances were identified and treated in more than 80% of patients. Four patients (4.3%) were readmitted to ICU, one patient (1.1%) died. Mean internal medical ward stay was 13 ± 9.6 days. After three months follow-up: three patients (3.2%) died; the rate of planned hospital readmission for orthopedic or surgery interventions was 14.7%; 70% of patients did not have any disability. CONCLUSIONS Patients with major trauma discharged from ICU often have medical complications and are managed by the use of multiple devices. Results of our pilot study suggest that a post-intensive clinical pathway in internal wards for patients with major trauma is feasible and could reduce ICU readmissions and hospital mortality.
The stethoscope: a status symbol or a physician’s tool? The need of retrieving the internist’s skill and art
Authors: Chesi Giuseppe
Published: April 2013

Not available
Spinal cord infarction: a rare cause of admission to Internal Medicine Departments but a condition with relevant systemic complications
Authors: Galimberti Daniela , Casali Annamaria , Arioli Dimitriy , Silingardi Mauro , Pizzini Attilia Maria , Iori Ido
Published: April 2013

BACKGROUND Spinal cord infarction is a rare cause of admission to Internal Medicine Departments as it is of infrequent occurrence and it is usually addressed to Neurologic Units. Diagnosis at admission however may be challenging expecially in the elderly because of several co-morbidities and variable presentation. Clinical course is often complicated by autonomic, infective and cardiovascular problems as well as a long stay-in-bed period. Outcome is poor in case of severe motor, autonomic (bladder and bowel) and sensitive impairment at presentation, it’s related to anatomic damage site and extension and it’s worse in case of anterior bilateral infarcts. CLINICAL CASE The authors describe the case of an 81- year-old woman who was admitted to an Internal Medicine Department because of cervical spinal cord infarction. The diagnostic evaluation as well as the management of cardiovascular, infective, rheumatologic and autonomic complications needed skillful internistic competence and a long in-hospital period. MR allowed a correct diagnosis a few hours after presentation, but the pathogenesis was never clearly established. The most invalidating symptoms were loss of bowel control lasting for several weeks during hospitalization and neuropathic pain still present at discharge. As for the outcome, the patient was able to go home after 3 months from admission able to walk with aids, with full bowel and bladder control and no sensitive impairment.
Recent applications of nuclear medicine in diagnostics: II part
Authors: Treglia Giorgio , Cason Ernesto , Fagioli Giorgio
Published: April 2013

Introduction: Positron-emission tomography (PET) and single photon emission computed tomography (SPECT) are effective diagnostic imaging tools in several clinical settings. The aim of this article (the second of a 2-part series) is to examine some of the more recent applications of nuclear medicine imaging techniques, particularly in the fields of neurology, cardiology, and infection/inflammation. Discussion: A review of the literature reveals that in the field of neurology nuclear medicine techniques are most widely used to investigate cognitive deficits and dementia (particularly those associated with Alzheimer disease), epilepsy, and movement disorders. In cardiology, SPECT and PET also play important roles in the work-up of patients with coronary artery disease, providing accurate information on the state of the myocardium (perfusion, metabolism, and innervation). White blood cell scintigraphy and FDG-PET are widely used to investigate many infectious/inflammatory processes. In each of these areas, the review discusses the use of recently developed radiopharmaceuticals, the growth of tomographic nuclear medicine techniques, and the ways in which these advances are improving molecular imaging of biologic processes at the cellular level.
Severe exacerbations of chronic obstructive pulmonary disease: management with noninvasive ventilation on a general medicine ward
Authors: Fiorino Sirio , Detotto Eugenio , Battilana Michele , Bacchi-Reggiani Letizia , Moretti Renzo , Benfenati Furio , Caselli Adriana , Marchi Serena , Testi Maria R. , Gallo Claudio G. , Cuppini Andrea , Kindt Giuseppe , Moretti Maurizio
Published: April 2013

Introduction: Recent evidence suggests that, with a well-trained staff, severe exacerbations of chronic obstructive pulmonary disease (COPD) with moderate respiratory acidosis (pH > 7.3) can be successfully treated with noninvasive mechanical ventilation (NIMV) on a general respiratory care ward. We conducted an open prospective study to evaluate the efficacy of this approach on a general medicine ward. Material and methods: This study population consisted in 27 patients admitted to a general medicine ward (median nurse:patient ratio 1:12) December 1, 2004 May 31, 2006 for acute COPD exacerbation with hypercapnic respiratory failure and acidosis (arterial pH < 7.34, PaC02 > 45 mmHg). All received assist-mode NIMV (average 12 h / day) via oronasal masks (inspiratory pressure 10-25 cm H2O, expiratory pressure 4-6 cm H2O) to maintain O2 saturation at 90-95%. Treatment was supervised by an experienced pulmonologist, who had also provided specific training in NIMV for medical and nursing staffs (90-day course followed by periodic refresher sessions). Arterial blood pressure, O2 saturation, and respiratory rate were continuously monitored during NIMV. Based on baseline arterial pH, the COPD was classified as moderate (7.25-7.34) or severe (< 7.25). Results: In patients with moderate and severe COPD, significant improvements were seen in arterial pH after 2 (p < 0.05) and 24 h (p< 0.05) of NIMV and in the PaC02 after 24 hours (p < 0.05). Four (15%) of the 27 patients died during the study hospitalization (in-hospital mortality 15%), in 2 cases due to NIMV failure. For the other 23, mean long-term survival was 14.5 months (95% CI 10.2 to 18.8), and no significant differences were found between the moderate and severe groups. Over half (61%) the patients were alive 1 year after admission. Conclusions: NIMV can be a cost-effective option for management of moderate or severe COPD on a general medicine ward. Its proper use requires: close monitoring of ventilated subjects, optimum staff:patient ratio, well-trained staff dedicated to NIMV, and supervision by a pulmonologist with experience in NIMV. The treatment was effective at improving arterial blood gases in both groups of COPD patients. The severity of the COPD did not significantly affect length of hospital stay, in-hospital mortality, or long-term survival.
Patients at risk for contrast-induced acute kidney injury
Authors: Meschi Michele , Detrenis Simona , Saccò Marcella , Bertorelli Marcello , Fiaccadori Enrico , Caiazza Alberto , Savazzi Giorgio
Published: April 2013

Subjects with hypovolemia and/or dehydration and pre-existing renal failure are considered at highest risk for radiocontrast-medium-induced acute kidney injury (RCI-AKI), and this risk increases in the presence of glomerular filtration rate or creatinine clearance rates lower than 60 mL/min (stage 3-5 chronic kidney disease according to the National Kidney Foundation). The authors critically review the evidence-based literature on RCI-AKI, its diagnosis, epidemiological aspects, predisposing conditions, and markers of risk, including advanced age. Procedures requiring the use of iodinated contrast media are increasingly performed in patients over 70 years of age, and there is no definitive consensus regarding the role of advanced age as a marker of risk for RCI-AKI.
Risk factors for venous thromboembolism and prophylaxis in medical inpatients: data from the FADOI ‘‘GEMINI’’ study
Authors: Campanini Mauro , Gussoni Gualberto , Silingardi Mauro , Scannapieco Gianluigi , Buniolo Carlo , Valerio Antonella , Ageno Walter , Iori Ido , Mazzone Antonino , FADOI ‘‘GEMINI’’ study On behalf of the
Published: April 2013

Background: Though venous thromboembolism (VTE) frequently occurs in non-surgical setting, epidemiology and risk factors for VTE in unselected medical inpatients have not been extensively studied, and uncertainties remain about the prophylactic strategy in these patients. Materials and methods: In a prospective, observational, multicenter study we aimed to contemporarily assess the epidemiology of symptomatic VTE in consecutive patients hospitalized in Internal Medicine, to evaluate the impact of potential risk factors, and the attitude of internists towards thromboprophylaxis. A total of 4,846 patients were included, during the period March-September 2006. Results: Symptomatic VTE was registered in 177 (3.65%) patients; of these, 26 cases (0.55%) occurred with onset of symptoms > 48 hours after admission (‘‘hospital-acquired’’ events, primary study end-point). Previous VTE and bed resting were significantly associated with venous thromboembolism, while a trend for increased risk was documented in cancer patients. During hospital stay antithrombotic prophylaxis was globally administered in 41.6% of patients, and in 58.4% of those for which prophylaxis was recommended according to 2004 guidelines by the American College of Chest Physicians. The choice of administering tromboprophylaxis appeared qualitatively adherent to indications from randomized trials and international guidelines, and bed rest was the strongest determinant of the use of prophylaxis. Conclusions: Data from our real-world study confirm that VTE is a quite common finding in patients admitted to Internal Medicine departments, and recommended tromboprophylaxis is still underused, in particular in some patients groups. Further efforts are needed to better define the risk profile and to optimize prophylaxis in the heterogeneous setting of medical patients.
Collagenous colitis presenting with bloody diarrhea and rectal erosions in a patient with celiac disease: a case report
Authors: Carroccio Antonio , Catalano Tiziana , Fiorino Marilena , Bongiovì Accursia , Napoli Giuseppe , Di Prima Lidia , Ambrosiano Giuseppe , Pace Michele , Scaturro Antonino , Di Fede Gaetana
Published: April 2013

Introduction: Collagenous colitis (CC) is a rare condition that is known to complicate inflammatory bowel diseases, but its relationship with celiac disease (CD) is more controversial. Aims: To report a case of CC that developed in a patient with CD and was manifested by rectal erosions at onset. Case report: A 46-year-old woman was diagnosed with CD and placed on a gluten-free diet. After an initial phase of improvement, her diarrhea resumed, and she began to lose weight. Despite strict adherence to the diet, the patient's diarrhea worsened. One year after diagnosis, colonoscopy was performed and mucosal biopsies were collected, but the findings were inconclusive. Two months later, the previously watery diarrhea became bloody, and a second colonoscopy was performed. Histological examination of the biopsy specimens revealed rectal erosions and CC. The patient was treated with oral prednisone plus mesalazine for 6 weeks, and her symptoms immediately disappeared. Mesalazine was continued, and the prednisone was then gradually replaced with budesonide. Six months after the CC diagnosis, the patient was asymptomatic, and a second colonoscopy revealed no macroscopic or microscopic signs of CC. She continues to take mesalazine and budesonide. An attempt to taper the dosage of the latter drug from 6 to 3 mg/day caused the reappearance of the diarrhea. Conclusion: CC is rarely associated to CD and can cause bloody diarrhea. Excellent results were obtained in this case with prednisone plus mesalazine followed by maintenance therapy with budesonide plus mesalazine.
Skin signs in acute pancreatitis: a case report
Authors: Bassi Marco , Belmonte Gelorma , Billi Paola , Pasquale Angelo , Reta Massimo , Leandri Paolo , Ferrara Francesco , Ghersi Stefania , D’Imperio Nicola , Nardi Roberto
Published: April 2013

Introduction: Subcutaneous manifestations of severe acute pancreatitis (Cullen’s sign, Gray- Turner’s sign, Fox’s sign, and Bryant’s sign) are often discussed in journals and textbooks, but seldom observed. Although historically associated with acute pancreatitis, these clinical signs have been described in various other conditions associated with retroperitoneal hemorrhage. Case report: We describe the case of a 61-year-old male with no history of alcohol intake, who was admitted for epigastric pain, vomiting, and increasing serum amylase and lipase levels. Five days after admission, ecchymotic skin discoloration was noted over both flanks (Gray-Turner’s sign) and the upper third of the thighs (Fox’s sign). Ten days later, he developed multiorgan failure and was transferred to the ICU for 5 days. Computed tomography revealed a large pancreatic fluid collection, which was subjected to EUS-guided drainage. Cholecystectomy was later performed for persistent obstructive jaundice. After more than 4 months of hospitalization, he died as a result of severe gastrointestinal bleeding. Discussion and conclusions: Skin manifestations of retroperitoneal hemorrhage in a patient with acute pancreatitis indicate a stormy disease course and poor prognosis. The severity of acute pancreatitis is currently estimated with validated scoring systems based on clinical, laboratory, and imaging findings. However, skin signs like the ones discussed above can represent a simple and inexpensive parameter for evaluating the severity and prognosis of this disease.
Prevention of venous thromboembolism in hospitalized patients with chronic kidney disease
Authors: Mandreoli Marcora , Santoro Antonio
Published: April 2013

Despite the high morbidity and mortality associated with venous thromboembolism in hospitalized medical patients with a number of risk factors, and large evidence that prophylaxis is effective, prophylaxis rates remain elusive in medically ill patients. Furthermore, in patients with renal failure, prophylaxis often is omitted or sub-optimal, due to fear of provoking hemorrhage. Patients with end-stage renal disease often have platelet deficits. Low molecular weight heparin (LMWH) therapy may also be difficult to manage in these cases because LMWH clearance is largely dependent on the kidneys. Administration of LMWH to patients with some degree of renal failure may lead to bioaccumulation of anti-Xa activity with an increased risk of bleeding. In recent years, LMWH has largely replaced unfractionated heparin (UFH) for the treatment and prophylaxis of thromboembolic disease. LMWHs have been shown to be superior to UFH in the prevention of venous thromboembolism. They are also easier to administer and do not require laboratory monitoring. However, several case reports and a metaanalysis indicate that the use of LMWHs at therapeutic doses in patients with advanced renal failure can be associated with major bleeding with serious adverse effects. In this paper, we review recent evidence supporting the safety of LMWHs at prophylactic doses in patients with mild or moderate renal disease. Current evidence suggests that bioaccumulation of enoxaparin (the most widely used LMWH) can occur when the drug is used at standard therapeutic doses in patients with severely impaired renal function. This risk can be reduced by empiric dose reduction or monitoring of anti-Xa heparin levels.
Posterior reversible encephalopathy syndrome (PRES), an acute neurological syndrome due to reversible multifactorial brain edema: a case report
Authors: Cicognani Camilla , Vezzadini Chiara , Battaglia Stella , Marliani Anna F. , Zoni Roberto
Published: April 2013

Background: The essential features of Posterior Reversible Encephalopathy Syndrome (PRES) are headache, mental changes, seizures, visual symptoms and often arterial hypertension. Brain RMN typically shows cortico-sottocortical parieto-occipital edema, with a bilateral and symmetric distribution. PRES develops in clinical conditions as hypertensive encephalopathy, preeclampsia/ eclampsia, autoimmune diseases, after transplantation, infections and as an adverse effect of immunosuppressive drugs or chemotherapy. It usually completely reverses with treatment, although permanent sequelae are possible in case of delayed or missed diagnosis. Case report: We describe the case of a transsexual (M!F) and tetraplegic patient, admitted for neck and low back pain. She suddenly developed headache, confusion, seizures and severe hypertension with normal blood tests. RMN showed multiple cortico-sottocortical areas of vasogenic and citotoxic edema in temporo-occipital, parietal, frontal, and cerebellar regions. Soon after the beginning of the antihypertensive therapy, clinical recovery was observed, as well as the disappearance of edema at RMN. Discussion and conclusions: Although PRES is usually associated with definite pathological conditions, it is not always the case, as was for the patient here described, who had no predisposing factors in her past clinical history, and presented hypertension only in the acute phase of the syndrome. Since, moreover, PRES usually presents with acute non specific features and it can be misdiagnosed with other serious diseases, the clinician will be helped by the knowledge of this syndrome to promptly start diagnostic workup and treatments, and avoid permanent neurological deficits.
Pickwickian syndrome: who lays first claim to this eponym?
Authors: Sgambato Francesco , Milano Luca , Sgambato Ester , Piscitelli Giovanni Leone
Published: April 2013

Not available
Recent applications of nuclear medicine in diagnostics (I part)
Authors: Treglia Giorgio , Cason Ernesto , Fagioli Giorgio
Published: April 2013

Introduction: Aim of this review is to describe the recent applications of nuclear medicine techniques in diagnostics, particularly in oncology. Materials and methods: We reviewed scientific literature data searching for the current role of tomographic nuclear medicine techniques (SPECTand PET) in oncology and summarized the main applications of these techniques. Results: Nuclear medicine techniques have a key role in oncology allowing early diagnosis of many tumours, an accurate staging of disease and evalutation of treatment response. Hybrid SPECT/CT and PET/CT imaging systems now provide metabolic and functional information from SPECTor PETcombined with the high spatial resolution and anatomic information of CT. The most frequent applications of SPECT/CT in oncology concern thyroid tumours, neuroendocrine tumours, bone metastases and lymph node mapping. Furthermore the evaluation of many tumours may benefit from PET/CT imaging. Discussion: The recent development of new radiopharmaceuticals and the growth of hybrid tomographic devices, such as SPECT/CT and PET/CT, now permits molecular imaging of biologic processes at the cellular level to improve both the diagnosis and treatment of many tumours.
The remarkable cell: Intelligently designed or by evolutionary process?
Authors: Pretorius Mark
Published: April 2013

The objective of this article was to deal with the challenging theme of the Origin of Life. Science has been arguing the when and how of the beginning of life for centuries. It is a subject which remains perplexing despite all the technological advances made in science. The first part of the article dealt with the idea of a universe and earth divinely created to sustain life. The second part dealt with the premise that the first life forms were the miraculous work of an intelligent designer, which is revealed by the sophisticated and intricate design of these first life forms. The article concluded with an explanation that these life forms are in stark contrast to the idea of a random Darwinian type evolution for life�s origin, frequently referred to as abiogenesis or spontaneous generation.
Stable isotopes reveal that chironomids occupy several trophic levels within West Greenland lakes: Implications for food web studies
Authors: Reuss Nina S. , Hamerlík Ladislav , Velle Gaute , Michelsen Anders , Pedersen Ole , Brodersen Klaus P.
Published: April 2013

Stable isotope analyses of nitrogen (δ15N) and carbon (δ13C) were conducted on individual chironomid taxa from low arctic lakes to investigate the range in trophic levels covered by this diverse insect group. Five lakes were sampled, including two freshwater, two oligosaline, and one glacier influenced lake, representing the major lake types in southwest Greenland. There was a large difference in the offset of isotopic values among the different lake types. In the oligosaline lakes, we ascribe low δ13C values to the use of recycled CO2, while the high δ15N signal is possibly controlled by microbial processes. In order to compare among lakes, the δ15N signal of the chironomid taxa was normalized to common primary consumers (Psectrocladius sordidellus group and Psectrocladius limbatellus groups) that show consistently low δ15N values and belong to the subfamily Orthocladiinae. Normalized δ15N values spanned more than 5‰, indicating that the chironomid community covered at least two trophic levels in these low arctic lakes. The δ15N values of different chironomid taxa within a single habitat differed by 1‰ to 5‰. The results suggest that chironomids should not be considered as one group in food web studies. Even interpretation of trophic position on subfamily level can be problematic as a result of the large differences observed in their δ15N values. The level of detailed trophic information on individual chironomid taxa presented here has not previously been reported. Chironomids are an abundant and important group of organisms in arctic lakes, and the observed variation in their trophic level indicates a high complexity of the food web structure of arctic lakes.
Jelly biomass sinking speed reveals a fast carbon export mechanism
Authors: Lebrato Mario , Mendes Pedro de Jesus , Steinberg Deborah K. , Cartes Joan E. , Jones Bethan M. , Birsa Laura M. , Benavides Roberto , Oschlies Andreas
Published: April 2013

Sinking of gelatinous zooplankton biomass is an important component of the biological pump removing carbon from the upper ocean. The export efficiency, e.g., how much biomass reaches the ocean interior sequestering carbon, is poorly known because of the absence of reliable sinking speed data. We measured sinking rates of gelatinous particulate organic matter (jelly‐POM) from different species of scyphozoans, ctenophores, thaliaceans, and pteropods, both in the field and in the laboratory in vertical columns filled with seawater using high‐quality video. Using these data, we determined taxon‐specific jelly‐POM export efficiencies using equations that integrate biomass decay rate, seawater temperature, and sinking speed. Two depth scenarios in several environments were considered, with jelly‐POM sinking from 200 and 600 m in temperate, tropical, and polar regions. Jelly‐POM sank on average between 850 and 1500 m d−1 (salps: 800–1200 m d−1; ctenophores: 1200–1500 m d−1; scyphozoans: 1000–1100 m d−1; pyrosomes: 1300 m d−1). High latitudes represent a fast‐sinking and low‐remineralization corridor, regardless of species. In tropical and temperate regions, significant decomposition takes place above 1500 m unless jelly‐POM sinks below the permanent thermocline. Sinking jelly‐POM sequesters carbon to the deep ocean faster than anticipated, and should be incorporated into biogeochemical and modeling studies to provide more realistic quantification of export via the biological carbon pump worldwide.
A method to represent ozone response to large changes in precursor emissions using high-order sensitivity analysis in photochemical models
Authors: Yarwood G. , Emery C. , Jung J. , Nopmongcol U. , Sakulyanotvittaya T.
Published: April 2013

Abstract. Photochemical grid models (PGMs) are used to simulate tropospheric ozone and quantify its response to emission changes. PGMs are often applied for annual simulations to provide both maximum concentrations for assessing compliance with air quality standards and frequency distributions for assessing human exposure. Efficient methods for computing ozone at different emission levels can improve the quality of ozone air quality management efforts. This study demonstrates the feasibility of using the decoupled direct method (DDM) to calculate first- and second-order sensitivity of ozone to anthropogenic NOx and VOC emissions in annual PGM simulations at continental scale. Algebraic models are developed that use Taylor series to produce complete annual frequency distributions of hourly ozone at any location and any anthropogenic emission level between zero and 100%, adjusted independently for NOx and VOC. We recommend computing the sensitivity coefficients at the mid-point of the emissions range over which they are intended to be applied, in this case with 50% anthropogenic emissions. The algebraic model predictions can be improved by combining sensitivity coefficients computed at 10% and 50% anthropogenic emissions. Compared to brute force simulations, algebraic model predictions tend to be more accurate in summer than winter, at rural than urban locations, and with 100% than zero anthropogenic emissions. Equations developed to combine sensitivity coefficients computed with 10% and 50% anthropogenic emissions are able to reproduce brute force simulation results with zero and 100% anthropogenic emissions with mean bias less than 2 ppb and mean error less than 3 ppb averaged over 22 US cities.
AREA BASED STEREO IMAGE MATCHING TECHNIQUE USING HAUSDORFF DISTANCE AND TEXTURE ANALYSIS
Authors: Joglekar J. , Gedam S. S.
Published: April 2013

Abstract. A conventional image matching techniques may be classified as either area based or feature based methods. In this paper an area based image matching method is proposed for dense disparity map. The method is a composite technique where first the similarity measure between template window and search window is found by normalized cross correlation technique. Few best matches are selected for the template window from the search sub windows, considering the largest normalized cross correlation coefficient. Further edge map is obtained for stereo image pair using canny edge detector. The matches for the template window are filtered using Hausdorff distance technique. Further texture analysis of the same template window and selected search windows is the third measure to decide the accurate match. Texture analysis is done with the co-occurrence matrices which is a two dimensional histogram of the occurrence of pair of intensity value in a given spatial relationship. With this composite method dense point to point correspondence can be achieved with greater accuracy. This method is tolerant to radiometric distortions and parallel processing of the three techniques will improve the speed.
QUALITY ASSESSMENT OF LANDMARK BASED POSITIONING USING STEREO CAMERAS
Authors: Hofmann S. , Schulze M. J. , Sester M. , Brenner C.
Published: April 2013

Abstract. Driving autonomously requires highly accurate positioning. Therefore, alternative positioning systems to GPS are required especially to increase the accuracy, and to have a complementary data source in areas where GPS is not available. As more and more on-board sensors are used for safety reasons, information gathered about their environment can be used for positioning based on relative measurements to landmarks along the road. This paper investigates the accuracy potential of positioning using a stereo camera system and landmark maps. Therefore, we simulated several stereo camera systems with variable opening angle and base length to compute the positioning accuracy in a test area. In the first step, localization was calculated based on single positions, in the second step we used a Kalman filter additionally. While positioning in the first case was not successful along the entire trajectory, the Kalman filter led to far better results.
Reforming the Way: The Palace and the Village in Daoist Paradise
Authors: Walker Nathaniel Robert
Published: April 2013

Like any major religion, Daoism has a complex history and multiple branches, but among its most persistent elements are secluded mountain paradises populated both by divinities and by human beings. Ideas regarding the means of access to these transcendent abodes have been less consistent: Should Daoist adepts strive to be virtuous, or should they labor to “restore” themselves through esoteric, elite magic? A provocative answer to this question was given by the poet Tao Qian (a.d. 365–427), who sided with Daoism's most ancient authority by suggesting that Daoist harmony could not be achieved through mere individual study but, rather, could be found only in an uncorrupted social fabric, in his case defined as a humble lost village. This utopian vision, brought to life in the poem Peach Blossom Spring, not only rejected the esoteric values of the Daoist elite but also called into question imperial hegemonic structures in general. The fact that the poem's rustic utopian enclave was understood in these terms by generations of Chinese scholars and artists is revealed by the contrasting architectural forms used to represent these alternative concepts of the Daoist ideal: the palace and the village, the garden of leisure and the working farm.
Multi-detector CT (MDCT) in bowel and mesenteric injury
Authors: Nelliyulla Parambath Arif , Ali Al Hilili Shatha , Ravikumar Vajjalla
Published: April 2013

Objectives: To evaluate multi-detector CT (MDCT) findings in bowel and mesenteric injury due to blunt abdominal trauma. Method: Retrospective evaluation of MDCT scan reports of patients admitted in Hamad Medical Corporation, Doha, Qatar with bowel and mesenteric injury during the period of January 2005 to April 2008. Results: MDCT, without using oral contrast, clearly demonstrated various specific and less specific findings of bowel and mesenteric injury. Conclusion: Multi-detector CT is an excellent diagnostic modality in bowel and mesenteric injury. Routine administration of oral contrast agent is not mandatory for initial evaluation of these patients.
Generation of Broadband Supercontinuum and Isolated Attosecond Pulse in a Chirped Two-Colour Laser Field
Authors: Zhang Gang-Tai
Published: April 2013

We present a theoretical investigation of high-order harmonic generation in a chirped two-colour laser field, which is synthesized by an 800 nm fundamental chirped pulse and a 1200 nm subharmonic chirped pulse. With the introduction of a polarization angle, both the harmonic cutoff is significantly extended and the spectrum intensity is effectively enhanced compared with the orthogonally polarized chirped two-colour field. When the polarization angle between the two chirped pulses is less than or equal to 0:27p, the broadband supercontinuum with a single quantum path contribution is achieved, and then isolated attosecond pulses with the duration of about 40 as are directly obtained, which are all linearly polarized. In addition, the influences of other laser parameters on the supercontinuum are also investigated.
Karpman–Washimi Ponderomotive Magnetization and Radiated Power: Streaming and Resonant Effects
Authors: Ki Dae-Han , Jung Young-Dae
Published: April 2013

The electron streaming and resonance effects on the non-stationary Karpman-Washimi nonlinear ponderomotive magnetization and radiated power are investigated in a quantum plasma. The ponderomotive Karpman-Washimi magnetization and radiation power due to the ponderomotive force are obtained as functions of the electron streaming velocity, Fermi velocity, wave frequency, and wave number. In small wave numbers, it is found that the electron streaming effect enhances the Karpman-Washimi ponderomotive magnetization. It is found that the electron streaming effect shifts the resonant wave number to the smaller wave number domain. It is also found that the quantum effect reduces the electron streaming velocity for the ponderomotive magnetization near the resonant wave number. In addition, the wave frequency for the resonant Karpman-Washimi radiated power is found to be increased with increasing wave number.
Stratification in the Medical profession: Non-Western Physicians in Norway
Authors: Drange Ida , Vågan Andre
Published: April 2013

Previous studies of internal stratification in medicine suggest that non-White foreign-trained physicians fill the bottom level of the specialist hierarchy. However, in this study we use administrative registers for majority and non-Western physicians in Norway and find that non-Western physicians acquire spe-cialisation in the same volume as majority colleagues, are equally likely to enter several of the high prestige specialties and are not delayed in their careers. The equal distribution is discussed as a consequence of strong professional closure, bureaucratisation of hiring procedures and hospital organisation and governmental influence. Identified patterns, however, are not unequivocal. First, immigrant phys-icians have a significantly higher chance of becoming specialists compared to majority physicians. Second, foreign-educated non-Western physicians have a significantly lower likelihood of specialising in surgery fields. The exception from the overall equality may result from exclusionary practices previously identified in surgery, but it could also result from differences in motivation.
Local Tomography Study of the Fracture of an ERG Metal Foam
Authors: Zhang Tao , Maire Eric , Adrien Jerome , Onck Patrick R. , Salvo Luc
Published: April 2013

As one of the most important analysis techniques for non‐destructive imaging, X‐ray tomography has been widely used in materials science, medical science, and industry to evaluate the behavior of porous materials. By using this method, a three dimensional volume can be inspected in order to visualize in situ the progress of damage in materials and this can be analyzed qualitatively and quantitatively. In the present study, we have used X‐ray tomography to investigate the fracture behavior of an ERG open cell aluminum foam. The process of damage development of a sample undergoing tension and the relation between the inter‐metallics and the cracks can be observed totally by the X‐ray tomography set‐up. Local tomography has in particular been used to image the microstructure at high resolution. A finite element model has also been developed in order to simulate this process of the damage using the 3D data obtained by the tomography.
Bio‐Inspired Superoleophobic Fluorinated Wax Crystalline Surfaces
Authors: Pechook Sasha , Kornblum Noga , Pokroy Boaz
Published: April 2013

A novel, single‐step and single‐component bio‐inspired fabrication method of hierarchical superoleophobic surfaces is presented. The method consists in thermal deposition of self‐assembling ultra‐low‐surface‐energy fluorinated wax on diverse surfaces. The thermal deposition results in crystalline, oriented, three‐dimensional hierarchical structures with high surface roughness and re‐entrant curvature, which in combination with the low surface energy of the fluorinated wax results in high contact angles of low‐surface‐tension liquids and low contact‐angle hysteresis (CAH) values (Δθ). The values achieved for Δθ are below 10° even for ethanol, which exhibits a surface tension as low as 22.4 mN·m−1. In addition to their superoleophobic properties our substrates exhibit extreme superhydrophobic qualities (CAH as low as 2° and contact angle >170°) with exceptional surface stability over many months. The proposed fabrication method may be utilized for a variety of applications where non‐wetting of low‐surface‐tension liquids is required, for example non‐staining surfaces and antifouling. The ease of fabrication and the variety of substrates that can be modified will undoubtedly widen its use.
Light‐Switchable Single‐Walled Carbon Nanotubes Based on Host–Guest Chemistry
Authors: Guo Zanru , Feng Yujun , Zhu Dingwei , He Shuai , Liu Hanbin , Shi Xiangrong , Sun Jing , Qu Meizhen
Published: April 2013

A new type of light‐switchable “smart” single‐walled carbon nanotube (SWNTs) is developed by the reversible host–guest interaction between azobenzene‐terminal PEO (AzoPEO) and pyrene‐labeled host attached on the sidewalls of nanotubes via π–π stacking. The SWNTs hybrids not only are well dispersed in pure water, but also exhibit switchable dispersion/aggregation states upon the alternate irradiation of UV and visible light. Moreover, the SWNTs hybrids dispersion is preliminarily used as coating fluid to form transparent conductive films. The dispersant AzoPEO is removed by the contamination‐free UV treatment, decreasing the resistance of the films. This kind of light‐switchable SWNTs hybrids, possessing a ‘‘green’’ trigger and intact structure of the nanotube, may find potential applications in sensor of biomedicines, device fabrication, etc. Additionally, such a reversible host–guest interaction system may open up the possibility to control the dispersion state of SWNTs by other common polymers.
The Formation of Performance Enhancing Pseudo‐Composites in the Highly Active La1–xCaxFe0.8Ni0.2O3 System for IT‐SOFC Application
Authors: Ortiz‐Vitoriano Nagore , de Larramendi Idoia Ruiz , Cook Stuart N. , Burriel Mónica , Aguadero Ainara , Kilner John A. , Rojo Teófilo
Published: April 2013

The La1–xCaxFe0.8Ni0.2O3–δ (0 ≤ x ≤ 0.9) system is investigated for potential application as a cathode material for intermediate temperature solid oxide fuel cells (IT‐SOFCs). A broad range of experimental techniques have been utilized in order to elucidate the characteristics of the entire compositional range. Low A‐site Ca content compositions (x ≤ 0.4) feature a single perovskite solid solution. Compositions with 40% Ca content (x = 0.4) exhibit the highest electrical and ionic conductivities of these single phase materials (250 and 1.9 × 10−3 S cm−1 at 800 °C, respectively), a level competitive with state‐of‐the‐art (La,Sr)(Fe,Co)O3. Between 40 and 50% Ca content (0.4 > x > 0.5) a solubility limit is reached and a secondary, brownmillerite‐type phase appears for all higher Ca content compositions (0.5 ≤ x ≤ 0.9). While typically seen as detrimental to electrochemical performance in cathode materials, this phase brings with it ionic conductivity at operational temperatures. This gives rise to the effective formation of pseudo‐composite materials which feature significantly enhanced performance characteristics, while also providing the closest match in thermal expansion behavior to typical electrolyte materials. This all comes with the advantage of being produced through a simple, single‐step, low‐cost production route without the issues associated with typical composite materials. The highest performing pseudo‐composite material (x = 0.5) exhibits electronic conductivity of 300–350 S cm−1 in the 600–800 °C temperature range while the best polarisation resistance (Rp) values of approximately 0.2 Ω cm2 are found in the 0.5 ≤ x ≤ 0.7 range.
A de novo GLI3 mutation in a patient with acrocallosal syndrome
Authors: Speksnijder Leonie , Cohen‐Overbeek Titia E. , Knapen Maarten F.C.M. , Lunshof Simone M. , Hoogeboom A. Jeannette M. , van den Ouwenland Ans M. , de Coo Irenaneus F.M. , Lequin Maarten H. , Bolz Hanno J. , Bergmann Carsten , Biesecker Leslie G. , Willems Patrick J. , Wessels Marja W.
Published: April 2013

Acrocallosal syndrome is characterized by postaxial polydactyly, macrocephaly, agenesis of the corpus callosum, and severe developmental delay. In a few patients with this disorder, a mutation in the KIF7 gene has been reported, which was associated with impaired GLI3 processing and dysregulaton of GLI3 transcription factors. A single patient with acrocallosal syndrome and a de novo p.Ala934Pro mutation in GLI3 has been reported, whereas diverse and numerous GLI3 mutations have also been described in syndromes with overlapping clinical manifestations, including Greig cephalopolysyndactyly syndrome, Pallister–Hall syndrome, trigonocephaly with craniosynostosis and polydactyly, oral–facial‐digital syndrome, and non‐syndromic polydactyly. Here, we describe a second patient with acrocallosal syndrome, who has a de novo, novel c.2786T > C mutation in GLI3, which predicts p.Leu929Pro. This mutation is in the same domain as the mutation in the previously reported patient. These data confirm that mutations in GLI3 are a cause of the acrocallosal phenotype. © 2013 Wiley Periodicals, Inc.
Development of the human heart
Authors: Sylva Marc , van den Hoff Maurice J.B. , Moorman Antoon F.M.
Published: April 2013

Molecular and genetic studies around the turn of this century have revolutionized the field of cardiac development. We now know that the primary heart tube, as seen in the early embryo contains little more than the precursors for the left ventricle, whereas the precursor cells for the remainder of the cardiac components are continuously added, to both the venous and arterial pole of the heart tube, from a single center of growth outside the heart. While the primary heart tube is growing by addition of cells, it does not show significant cell proliferation, until chamber differentiation and expansion starts locally in the tube, by which the chambers balloon from the primary heart tube. The transcriptional repressors Tbx2 and Tbx3 locally repress the chamber‐specific program of gene expression, by which these regions are allowed to differentiate into the distinct components of the conduction system. Molecular genetic lineage analyses have been extremely valuable to assess the distinct developmental origin of the various component parts of the heart, which currently can be unambiguously identified by their unique molecular phenotype. Despite the enormous advances in our knowledge on cardiac development, even the most common congenital cardiac malformations are only poorly understood. The challenge of the newly developed molecular genetic techniques is to unveil the basic gene regulatory networks underlying cardiac morphogenesis. © 2013 Wiley Periodicals, Inc.
Ring chromosome 9 in a girl with developmental delay and dysmorphic features: Case report and review of the literature
Authors: Sibbesen Else la Cour , Jespersgaard Cathrine , Alosi Daniela , Bisgaard Anne‐Marie , Tümer Zeynep
Published: April 2013

In this report, we describe a female child with dysmorphic features and developmental delay. Chromosome microarray analysis followed by conventional karyotyping revealed a ring chromosome 9 with a 12 Mb deletion at 9pter‐p23 and a 540 kb deletion at 9q34.3‐qter. Four percent of the analyzed cells had monosomy 9. The patient has the features of both the Kleefstra syndrome and the chromosome 9p‐syndrome, including trigonocephaly, long philtrum, hypertelorism, and retro‐/micronagthia. The deletion of the patient overlaps with several of the proposed critical regions for the 9p deletion syndrome. © 2013 Wiley Periodicals, Inc.
A novel inverted 17p13.3 microduplication disrupting PAFAH1B1 (LIS1) in a girl with syndromic lissencephaly
Authors: Classen Sabrina , Goecke Timm , Drechsler Matthias , Betz Beate , Nickel Natalie , Beier Manfred , Schaper Jörg , Karenfort Michael , Royer‐Pokora Brigitte
Published: April 2013

We describe a female patient with mild lissencephaly (pachygyria), severe intellectual disability, and facial dysmorphisms with an inverted 1.4 Mb microduplication of chromosome 17p13.3. The 17p13.3 microduplication syndrome is associated with mild intellectual disabiltiy and contains, among others, the PAFAH1B1 (LIS1) gene, whereas microdeletions of the same segment cause Miller–Dieker syndrome (MDS) with severe to profound retardation. The duplication identified in our patient encompasses 29 genes, including CRK and YWHAE. The proximal breakpoint of the duplication is located in the first intron of the PAFAH1B1 gene. Analysis of total RNA showed that only one PAFAH1B1 allele is expressed. Therefore, this patient has a unique alteration: a duplication including YWHAE and CRK and haploinsufficiency of PAFAH1B1. Overexpression of YWHAE is associated with macrosomia, mild developmental delay, autism and facial dysmorphisms, and deletion of PAFAH1B1 alone leads to isolated lissencephaly (ILS). The patient described here shares features with MDS, but she is affected to a lesser degree. Her facial features are similar to MDS, and she has manifestations seen in other cases with YWHAE duplication. © 2013 Wiley Periodicals, Inc.
Data mining using regularized adaptive B‐splines regression with penalization for multi‐regime traffic stream models
Authors: Sun Lu , Pan Yiyong , Gu Wenjun
Published: April 2013

This paper presents a new data mining method that integrates adaptive B‐spline regression and traffic flow theory to develop multi‐regime traffic stream models (TSMs). Parameter estimation is implemented adaptively and optimally through a constrained bi‐level programming method. The slave programming determines positions of knots and coefficients of the B‐spline by minimizing the error of B‐spline regression. The master programming model determines the number of knots through a regularized function, which balances model accuracy and model complexity. This bi‐level programming method produces the best fitting to speed–density observations under specific order of splines and possesses great flexibility to accommodate the exhibited nonlinearity in speed–density relationships. Jam density can be estimated naturally using spline TSM, which is sometimes hardly obtainable in many other TSM. Derivative continuity up to one order lower than the highest spline degree can be preserved, a desirable property in some application. A five‐regime B‐spline model is found to exist for generalized speed–density relationships to accommodate five traffic operating conditions: free flow, transition, synchronized flow, stop and go traffic, and jam condition. A typical two‐regime B‐spline form is also explicitly given, depending only on free‐flow speed, optimal speed, optimal density, and jam density. Copyright © 2013 John Wiley & Sons, Ltd.