bluuebunny/crossref_metadata_2025 huggingface dataset:
Peripheral Red Blood Cell Split Chimerism as a Consequence of Intramedullary Selective Apoptosis of Recipient Red Blood Cells in a Case of Sickle Cell Disease
Authors: Marziali Marco , Isgrò Antonella , Sodani Pietro , Gaziev Javid , Fraboni Daniela , Paciaroni Katia , Gallucci Cristiano , Alfieri Cecilia , Roveda Andrea , De Angelis Gioia , Cardarelli Luisa , Ribersani Michela , Andreani Marco , Lucarelli Guido
Published: October 2014

Allogeneic cellular gene therapy through hematopoietic stem cell transplantation is the only radical cure for congenital hemoglobinopathies like thalassemia and sickle cell anemia. Persistent mixed hematopoietic chimerism (PMC) has been described in thalassemia and sickle cell anemia. Here, we describe the clinical course of a 6-year-old girl who had received bone marrow transplant for sickle cell anemia. After the transplant, the patient showed 36% donor hematopoietic stem cells in the bone marrow, whereas in the peripheral blood there was evidence of 80%  circulating donor red blood cells (RBC). The analysis of apoptosis at the Bone Marrow  level suggests that Fas might contribute to the cell death of host erythroid precursors. The increase in NK cells and the regulatory T cell population observed in this patient suggests that these cells might contribute to the condition of mixed chimerism.
IMPORTANCE OF HYPERBILURUBINEMIA IN DIFFERENTIATION OF PRIMARY AND SECONDARY HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS IN PEDIATRIC CASES
Authors: Ozen Seval , Dai Alper , Coskun Enes , Oztuzcu Serdar , Ergun Sercan , Aktekin Elif , Yavuz Sibel , Bay Ali
Published: October 2014

Background and objective: Hemophagocytic lymphohistiocytosis (HLH) is a life threatening hyper inflammatory disease. It is difficult to differentiate between primary and secondary HLH based on clinical findings at the onset of disease. We aimed to find parameters that can help to differentiate primary and secondary HLH at initial diagnosis especially for physicians working in developing countries.Patient and Method: We retrospectively analyzed data of 38 HLH patients who were admitted to the Pediatric Hematology Department of Gaziantep University between January 2009 and December 2013.Results: Of 38 patients, 20 were defined as primary and 18 were secondary HLH. The average age of primary and secondary HLH patients was 31±9 and 81±14 months, respectively (p=0.03). We found consanguinity rates significantly higher in primary HLH patients compared to secondary HLH patients (p=0.03). We found that total and direct bilirubin levels significantly increased in primary HLH patients compared to secondary HLH patients (p=0.006, p=0.044). Also, CRP levels were found markedly increased in secondary HLH patients compared to primary ones (p=0.017).Conclusion: We showed that cholestasis and hyperbilurubinemia findings of HLH patients at the initial diagnosis should be considered in favor of primary HLH and increased level of CRP should be considered in favor of secondary HLH.
TUBERCULOSIS: EPIDEMIOLOGY AND CONTROL
Authors: Sulis Giorgia , Roggi Alberto , Matteelli Alberto , Raviglione Mario C.
Published: October 2014

Tuberculosis (TB) is a major public health concern worldwide: despite a regular, although slow, decline in incidence over the last decade, as many as 8.6 million new cases and 1.3 million deaths were estimated to have occurred in 2012. TB is by all means a poverty-related disease, mainly affecting the most vulnerable populations in the poorest countries. The presence of multidrug-resistant strains of M. tuberculosis in most countries, with some where prevalence is high, is among the major challenges for TB control, which may hinder recent achievements especially in some settings. Early TB case detection especially in resource-constrained settings and in marginalized groups remains a challenge, and about 3 million people are estimated to remain undiagnosed or not notified and untreated. The World Health Organization (WHO) has recently launched the new global TB strategy for the “post-2015 era” aimed at “ending the global TB epidemic” by 2035, based on the three pillars that emphasize patient-centred TB care and prevention, bold policies and supportive systems, and intensified research and innovation.This paper aims to provide an overview of the global TB epidemiology as well as of the main challenges that must be faced to eliminate the disease as a public health problem everywhere.
SPECTRUM OF BETA GLOBIN GENE MUTATIONS IN EGYPTIAN CHILDREN WITH β- THALASSEMIA
Authors: El-Shanshory MR , Hagag Adel Abd Elhaleim
Published: October 2014

Background: The molecular defects resulting in β-thalassemia phenotype, in the Egyptian population show a clear heterogenic mutations pattern. PCR based techniques, including direct DNA sequencing are effective on the molecular detection and characterization of these mutations. The molecular characterization of β-thalassemia is absolutely necessary for carrier screening, for genetic counseling, and to offer prenatal diagnosis.The aim of the work: was to evaluate the different β-globin gene mutations in one hundred Egyptian children with β-thalassemia. Patients and Methods: One hundred of β-thalassemic Egyptian children, covering most Egyptian Governorates. All patients were subjected to meticulous history taking, clinical examinations, complete blood count, complete blood count, hemoglobin electrophoresis, serum ferritin and direct fluorescent DNA sequencing of β-globin gene to detect the frequency of different mutations in studied patients. Results: The most common mutations among patients were IVS I-110(G>A) 48%, IVS I-6(T>C) 40%, IVS I-1(G>A)19%,IVS I-5(G>C)10%, IVS II-848 (C>A) 9%, IVS II-745(C>G) 8%, IVS II-1(G>A) 7%, codon"Cd"39(C> T) 4%,-87(C>G) 3% and the rare mutations were: Cd37 (G>A), Cd8 (-AA), Cd29(-G), Cd5 (-CT), Cd6(-A), Cd8/9(+G), Cd 106/107(+G), Cd27(C>T), IVS II-16(G> C), Cd 28 (-C), Cap+1(A>C), -88(C>A), all of these rare mutations were present in 1%. There was considerable variation in phenotypic severity among patients resulting from interaction of different β° and β+mutations, 79(79%) patients were thalassemia major (TM) and 21(21%) were thassemia intermedia (TI), without genotype phenotype association. Conclusion: Direct DNA sequencing provides insights for the frequency of different mutations in β- thalassemic patients including rare and /or unknown ones.
HbD Punjab/HbQ India compound heterozygosity: An unusual association.
Authors: Colaco Stacy , Surve Reema , Sawant Pratibha , Nadkarni Anita , Ghosh Kanjaksha , Colah Roshan
Published: October 2014

Background: Haemoglobinopathies are the commonest hereditary disorders in India and pose a major health problem. Both beta thalassaemia and structural haemoglobin variants are relatively common in north western India. Here we report a 29 year old Sindhi female who was referred to us for a haemoglobinopathy work up and genetic counseling since her spouse was a classical beta thalassaemia carrier. Method: A complete blood count was done on an automated cell counter. Haemoglobin analysis was carried out using HPLC Variant Haemoglobin Testing System.  The cellulose acetate electrophoresis was carried out [pH 8.9]. Confirmation of mutations was done by automated DNA sequencing. Results: HPLC analysis showed four major peaks, HbA0, a peak in the HbD window, an unknown peak [retention time 4.74 minutes] and a peak in the HbC window. The HbA2 level was 2.2% and the HbF level was 0.7%.Cellulose acetate electrophoresis at alkaline pH, a slow moving band was seen at the HbS/D position along with a prominent band at the HbA2 position. DNA sequencing of the β and α genes showed presence of the 2 hemoglobin variants :Hb D [b 121GAA à CAA] and Hb Q [a 64 AAG à GAG]. The δ globin gene was normal. The additional peak in the HbC window was due to the formation of a heterodimer hybrid. Conclusion: Both HbD Punjab and HbQ India are relatively common in India but their co-inheritance has not been described in the country. This is the second report of compound heterozygosity for HbQ India/HbD Punjab haemoglobinopathy globally, and the first one from India.
Measures of Functional Performance and Their Association With Hip and Thigh Strength
Authors: Kollock Roger , Van Lunen Bonnie L. , Ringleb Stacie I. , Oñate James A.
Published: October 2014

Context:

Insufficient hip and thigh strength may increase an athlete's susceptibility to injury. However, screening for strength deficits using isometric and isokinetic instrumentation may not be practical in all clinical scenarios.

Objective:

To determine if functional performance tests are valid indicators of hip and thigh strength.

Design:

Descriptive laboratory study.

Setting:

Research laboratory.

Patients or Other Participants:

Sixty-two recreationally athletic men (n = 30, age = 21.07 years, height = 173.84 cm, mass = 81.47 kg) and women (n = 32, age = 21.03 years, height = 168.77 cm, mass = 68.22 kg) participants were recruited.

Intervention(s):

During session 1, we measured isometric peak force and rate of force development for 8 lower extremity muscle groups, followed by an isometric endurance test. During session 2, participants performed functional performance tests.

Main Outcome Measure(s):

Peak force, rate of force development, fatigue index, hop distance (or height), work (joules), and number of hops performed during the 30-second lateral-hop test were assessed. The r values were squared to calculate r 2. We used Pearson correlations to evaluate the associations between functional performance and strength.

Results:

In men, the strongest relationship was observed between triple-hop work and hip-adductor peak force (r2 = 50, P ≤ .001). Triple-hop work also was related to hip-adductor (r2 = 38, P ≤ .01) and hip-flexor (r2 = 37, P ≤ .01) rate of force development. For women, the strongest relationships were between single-legged vertical-jump work and knee-flexor peak force (r2 = 0.44, P ≤ .01) and single-legged vertical-jump height and knee-flexor peak force (r2 = 0.42, P ≤ .01). Single-legged vertical-jump height also was related to knee-flexor rate of force development (r2 = 0.49, P ≤ .001). The 30-second lateral-hop test did not account for a significant portion of the variance in strength endurance.

Conclusions:

Hop tests alone did not provide clinicians with enough information to make evidence-based decisions about lower extremity strength in isolated muscle groups.
Pelvic Pheochromocytoma Mimicking as Urinary Bladder Pheochromocytoma: Looking Beyond the Obvious
Authors: Kumar Santosh , Parmar Kalpesh Mahesh , Singh Shivanshu , Rani Jyotsna
Published: October 2014

Pheochromocytomas located outside the adrenal glands are called paragangliomas. A pelvic location is rare, the most common location for a paraganglioma being the retroperitoneal space. Paragangliomas arise from neural crest cells. Pelvic pheochromocytomas may mimic urinary bladder pheochromocytomas on imaging studies. Patients may present with hypertensive crisis during micturition. We present a 26-year-old female who presented to us with accelerated hypertension with episodes of severe headache and palpitation during micturition. Based on imaging studies, she was diagnosed to have a urinary bladder pheochromocytoma. However, on exploration, the patient was found to have an extravesical pheochromocytoma arising from the left posterolateral pelvic wall, which was excised while preserving the bladder. We present this case report as pelvic pheochromocytomas can mimic bladder pheochromocytomas and are difficult to differentiate on radiological imaging and can lead to inadvertent cystectomy.
Jamming transition in a two-dimensional open granular pile with rolling resistance
Authors: Magalhães Caio F. M. , Atman Allbens P.F. , Combe Gaël , Moreira José G.
Published: October 2014

We present a molecular dynamics study of the jamming/unjamming transition in two-dimensional granular piles with open boundaries. The grains are modeled by viscoelastic forces, Coulomb friction and resistance to rolling. Two models for the rolling resistance interaction were assessed:  one considers a constant rolling friction coefficient, and the other one a strain dependent coefficient. The piles are grown on a finite size substrate and subsequently discharged through an orifice opened at the center of the substrate. Varying the orifice width and taking the final height of the pile after the discharge as the order parameter, one can devise a transition from a jammed regime (when the grain flux is always clogged by an arch) to a catastrophic regime, in which the pile is completely destroyed by an avalanche as large as the system size. A finite size analysis shows that there is a finite orifice width associated with the threshold for the unjamming transition, no matter the model used for the microscopic interactions. As expected, the value of this threshold width increases when rolling resistance is considered, and it depends on the model used for the rolling friction.Received: 14 June 2014,  Accepted: 7 October 2014; Reviewed by: R. Arévalo, School of Physical and Mathematical Sciences, Nanyang Technological University, Singapore; Edited by: L. A. Pugnaloni; DOI: http://dx.doi.org/10.4279/PIP.060007Cite as: C F M. Magalhaes, A P F Atman, G Combe, J G Moreira, Papers in Physics 6, 060007 (2014)
An Unsafe Foreign Body at an Unsafe Site of Airway
Authors: Mohanty Sidhartha , Behera Ishwar Chandra
Published: October 2014

Aspiration of foreign bodies into the airway is a serious problem in childhood. Children with less attention at an early age are more prone to ingest or inhale foreign bodies. Diagnosis is often difficult due to parental ignorance and lack of a clear history. The present authors have come across a rare case of an open safety pin with its blunt end inside the larynx and sharp end penetrating the interarytenoid membrane and entering the upper part of esophagus. The foreign body was removed successfully without any complications.

How to cite this article

Swain SK, Mohanty S, Behera IC. An Unsafe Foreign Body at an Unsafe Site of Airway. Int J Phonosurg Laryngol 2014;4(1):17-19.
A Rare Case of Internal Laryngopyocele presenting with Stridor
Authors: Bhat Vinay S , Sobhan Yanamadala , Ravi KS
Published: October 2014

A laryngocele is an abnormal elongation and expansion of the saccule of the laryngeal ventricle. When the neck of the laryngocele is obstructed, it becomes filled with mucus of glandular secretion and is altered to a laryngomucocele. When this lesion becomes infected, laryngopyocele is formed. In view of the general rarity of laryngopyoceles and even more so, one causing acute airway obstruction, it was decided to report an instance of the latter type. The clinical features and management of this rare case has been described.

How to cite this article

Bhat VS, Sobhan Y, Ravi KS. A Rare Case of Internal Laryngopyocele presenting with Stridor. Int J Phonosurg Laryngol 2014;4(1):20-22.
A Rare Cause of Hoarseness of Voice: Lipoid Proteinosis of the Larynx
Authors: Sahu Mahesh Chandra , Panda Maitreyee , Patro Nibedita
Published: October 2014

Lipoid proteinosis (LP) is a rare genetic disease with autosomal recessive inheritance. It most often involves deposition of periodic acid Schiff positive hyaline material in skin, oral mucosa, larynx and other tissues. But it also involves the central nervous system, lungs, lymph nodes and striated muscles. Hoarseness, small papules on the eyelid border (moniliform blepharosis), enlarged tongue, waxy skin, and diffuse verrucous skin colored or yellowish papules and plaques on traumatized areas and oral mucosa are the most common features leading to the clinical diagnosis of LP. We present the case report of a 12-year-old boy with significant hoarseness, inability to protrude the tongue, beaded papules along the eyelid margins, and scarring of the skin. Of his two sisters, one had the same symptoms but with less clinical severity and the other had no features of LP.

How to cite this article

Swain SK, Panda M, Patro N, Sahu MC. A Rare Cause of Hoarseness of Voice: Lipoid Proteinosis of the Larynx. Int J Phonosurg Laryngol 2014;4(1):23-26.
Relative Profit Maximization and Bertrand Equilibrium with Convex Cost Functions
Authors: Satoh Atsuhiro , Tanaka Yasuhito
Published: October 2014

This study derives pure strategy Bertrand equilibria in a duopoly in which two firms produce a homogeneous good with convex cost functions and seek to maximize the weighted sum of their absolute and relative profits. The study shows that there exists a range of equilibrium prices in duopolistic equilibria. This range of equilibrium prices is narrower and lower than the range of equilibrium prices in duopolistic equilibria under pure absolute profit maximization. Moreover, the larger the weight on the relative profit, the narrower and lower the range of equilibrium prices. In this sense, relative profit maximization is more aggressive than absolute profit maximization.
Evaluating the effects of China's pollution control on inter-annual trends and uncertainties of atmospheric mercury emissions
Authors: Zhao Y. , Zhong H. , Zhang J. , Nielsen C. P.
Published: October 2014

Abstract. China's atmospheric mercury (Hg) emissions of anthropogenic origin have been effectively restrained through the national policy of air pollution control. Improved methods based on available field measurements are developed to quantify the benefits of Hg abatement through various emission control measures. Those measures include increased use of flue gas desulfurization (FGD) and selective catalyst reduction (SCR) systems for power sector, precalciners with fabric filter (FF) for cement production, machinery coking with electrostatic precipitator (ESP) for iron and steel production, and advanced manufacturing technologies for nonferrous metal smelting. Declining trends in emissions factors for those sources are revealed, leading to a much slower growth of national total Hg emissions than that of energy and economy, from 679 in 2005 to 750 metric tons (t) in 2012. In particular, nearly half of emissions from the above-mentioned four types of sources are expected to be reduced in 2012, attributed to expansion of technologies with high energy efficiencies and air pollutant removal rates after 2005. The speciation of Hg emissions keeps stable for recent years, with the mass fractions of around 55, 39 and 6% for Hg0, Hg2+ and Hgp, respectively. The lower estimate of Hg emissions than previous inventories is supported by limited chemistry simulation work, but middle-to-long term observation on ambient Hg levels is further needed to justify the inter-annual trends of estimated Hg emissions. With improved implementation of emission controls and energy saving, 23% reduction in annual Hg emissions for the most optimistic case in 2030 is expected compared to 2012, with total emissions below 600 t. While Hg emissions are evaluated to be gradually constrained, increased uncertainties are quantified with Monte-Carlo simulation for recent years, particularly for power and certain industrial sources. The uncertainty of Hg emissions from coal-fired power plants, as an example, increased from −48~ +73% in 2005 to −50~ +89% in 2012 (expressed as 95% confidence interval). This is attributed mainly to swiftly increased penetration of advanced manufacturing and pollutant control technologies. The unclear operation status or relatively small sample size of field measurements on those technologies results in lower but highly varied emission factors. To further confirm the benefits of pollution control polices with reduced uncertainty, therefore, systematic investigations are recommended specific for Hg pollution sources, and the variability of temporal trends and spatial distributions of Hg emissions need to be better tracked for the country under dramatic changes in economy, energy and air pollution status.
Characterization of forest fire smoke event near Washington, DC in Summer 2013 with multi-wavelength lidar
Authors: Veselovskii I. , Whiteman D. N. , Korenskiy M. , Suvorina A. , Kolgotin A. , Lyapustin A. , Wang Y. , Chin M. , Bian H. , Kucsera T. L. , Perez-Ramirez D. , Holben B.
Published: October 2014

Abstract. The multi-wavelength lidar technique was applied to the study of a smoke event near Washington DC on 26–28 August 2013. Satellite observations combined with transport model predictions imply that the smoke plume originated mainly from Wyoming/Idaho forest fires and its transportation to Washington DC took approximately 5 days. The NASA/GSFC multi-wavelength Mie–Raman lidar was used to measure the smoke particle intensive parameters such as extinction and backscatter Ångström exponents together with lidar ratios at 355 and 532 nm wavelengths. For interpretation of the observed vertical profiles of the backscatter Ångström exponents γβ at 355–532 nm and 532–1064 nm, numerical simulation was performed. The results indicate that for fine mode dominant aerosols, the Ångström exponents γβ (355–532) and γβ (532–1064) have essentially different dependence on the particle size and refractive index. Inversion of 3 β + 2 α lidar observations on 27–28 August provided vertical variation of the particle volume, effective radius and the real part of the refractive index through the PBL and the smoke layer. The particle effective radius decreased with height from approximately 0.27 μm inside the PBL to 0.15 μm in the smoke layer, which was situated above the PBL. Simultaneously the real part of the refractive index in the smoke layer increased to mR ≈ 1.5. The retrievals demonstrate also that the fine mode is predominant in the particle size distribution, and that the decrease of the effective radius with height is due to a shift of the fine mode toward smaller radii.
Organic N and P in eutrophic fjord sediments – rates of mineralization and consequences for internal nutrient loading
Authors: Valdemarsen T. , Quintana C. O. , Flindt M. R. , Kristensen E.
Published: October 2014

Abstract. Nutrient release from the sediments in shallow eutrophic estuaries may counteract reductions of the external nutrient load and prevent or prolong ecosystem recovery. The magnitude and temporal dynamics of this potential source, termed internal nutrient loading, is poorly understood. We quantified the internal nutrient loading driven by microbial mineralization of accumulated organic N (ON) and P (OP) in sediments from a shallow eutrophic estuary (Odense Fjord, Denmark). Sediments were collected from 8 stations within the system and nutrient production and effluxes were measured over a period of ~ 2 years. DIN effluxes were high initially but quickly faded to low and stable levels after 50–200 d, whereas PO43− effluxes were highly variable in the different sediments. Mineralization patterns suggested that internal N-loading would quickly (< 200 days) fade to insignificant levels whereas PO43−release could be sustained for extended time (years). When results from all stations were combined, internal N-loading and P-loading from the fjord bottom was up to 121 x 103 kg N yr−1 (20 kg N ha−1 yr−1) and 22 x 103 kg P yr−1 (3.6 kg P ha−1 yr−1) corresponding to 6% (N) and 36% (P) of the external nutrient loading to the system. We conclude that the internal N-loading resulting from degradation of accumulated ON is low in shallow eutrophic estuaries, whereas microbial mineralization of accumulated OP is a potential source of P. Overall it appears that in N-limited eutrophic systems, internal nutrient resulting from mineralization of ON and OP in sediments is of minor importance.
Technical challenges and solutions in representing lakes when using WRF in downscaling applications
Authors: Mallard M. S. , Nolte C. G. , Spero T. L. , Bullock O. R. , Alapaty K. , Herwehe J. A. , Gula J. , Bowden J. H.
Published: October 2014

Abstract. The Weather Research and Forecasting (WRF) model is commonly used to make high resolution future projections of regional climate by downscaling global climate model (GCM) outputs. Because the GCM fields are typically at a much coarser spatial resolution than the target regional downscaled fields, inland lakes are often poorly resolved in the driving global fields, if they are resolved at all. In such an application, using WRF's default interpolation methods can result in unrealistic lake temperatures and ice cover at inland water points. Prior studies have shown that lake temperatures and ice cover impact the simulation of other surface variables, such as air temperatures and precipitation, two fields that are often used in regional climate applications to understand the impacts of climate change on human health and the environment. Here, alternative methods for setting lake surface variables in WRF for downscaling simulations are presented and contrasted.
1D-Var multilayer assimilation of X-band SAR data into a detailed snowpack model
Authors: Phan X. V. , Ferro-Famil L. , Gay M. , Durand Y. , Dumont M. , Morin S. , Allain S. , D'Urso G. , Girard A.
Published: October 2014

Abstract. The structure and physical properties of a snowpack and their temporal evolution may be simulated using meteorological data and a snow metamorphism model. Such an approach may meet limitations related to potential divergences and accumulated errors, to a limited spatial resolution, to wind or topography-induced local modulations of the physical properties of a snow cover, etc. Exogenous data are then required in order to constrain the simulator and improve its performance over time. Synthetic-aperture radars (SARs) and, in particular, recent sensors provide reflectivity maps of snow-covered environments with high temporal and spatial resolutions. The radiometric properties of a snowpack measured at sufficiently high carrier frequencies are known to be tightly related to some of its main physical parameters, like its depth, snow grain size and density. SAR acquisitions may then be used, together with an electromagnetic backscattering model (EBM) able to simulate the reflectivity of a snowpack from a set of physical descriptors, in order to constrain a physical snowpack model. In this study, we introduce a variational data assimilation scheme coupling TerraSAR-X radiometric data into the snowpack evolution model Crocus. The physical properties of a snowpack, such as snow density and optical diameter of each layer, are simulated by Crocus, fed by the local reanalysis of meteorological data (SAFRAN) at a French Alpine location. These snowpack properties are used as inputs of an EBM based on dense media radiative transfer (DMRT) theory, which simulates the total backscattering coefficient of a dry snow medium at X and higher frequency bands. After evaluating the sensitivity of the EBM to snowpack parameters, a 1D-Var data assimilation scheme is implemented in order to minimize the discrepancies between EBM simulations and observations obtained from TerraSAR-X acquisitions by modifying the physical parameters of the Crocus-simulated snowpack. The algorithm then re-initializes Crocus with the modified snowpack physical parameters, allowing it to continue the simulation of snowpack evolution, with adjustments based on remote sensing information. This method is evaluated using multi-temporal TerraSAR-X images acquired over the specific site of the Argentière glacier (Mont-Blanc massif, French Alps) to constrain the evolution of Crocus. Results indicate that X-band SAR data can be taken into account to modify the evolution of snowpack simulated by Crocus.
Once by the Mississippi
Authors: Kruse Horst H.
Published: October 2014

This essay presents a stylistic as well as contextual analysis of the opening paragraphs of Mark Twain's “Old Times on the Mississippi” (1875). It concentrates on the pivotal sentence of the passage, “The great Mississippi, the majestic, the magnificent Mississippi, rolling its mile-wide tide along, shining in the sun,” to assess the author's contribution to the literary iconography of America. Words such as “rolling” and “shining” in their denotative and connotative meanings (as much as in their phonetic properties) help to define the place of Mark Twain's panegyric to the river among other texts that use similar devices to praise the beauty and the magnitude of America (such as Bryant's “The Prairies” and Fitzgerald's The Great Gatsby).
Beneath Mark Twain
Authors: Roark Jarrod
Published: October 2014

A paragraph written by David S. Reynolds, buried in the middle of his Introduction for the 1995 edition of the George Lippard's The Quaker City; or, The Monks of Monk Hall (1845), offers a question relevant for Twain studies: Had Lippard's sensational novel influenced Mark Twain's writing? If so, how can we trace this influence? In that paragraph, Reynolds conjectures about Twain's familiarity with Lippard and his work. This essay offers a response that extends beyond Twain's reading of Lippard and advances a larger idea about Twain's interaction with sensational literature. Twain had read Lippard's 1847 fictionalized account of Washington and mentioned Lippard and his book in an 1853 letter to his brother. But Twain also mentioned, satirized, and was influenced by Lippard and other sensational writers. This paper detects residues of sensationalism in Twain's early writing and places Twain's western writing in the lineage of sensation.
Twice-Told Tales
Authors: Morris Linda A.
Published: October 2014

“Twice-Told Tales” offers a rereading of the character of Aunt Sally Phelps throughout the “Evasion” chapters at the conclusion of Adventures of Huckleberry Finn. I argue that she is a character in whom Twain invested considerable energy and affection, that she should not be confused with the two characters who truly did try to “sivilize” Huck Finn: the Widow Douglas and Miss Watson. I show that she is a character of considerable spunk who can hold her own against Tom Sawyer. I also argue that she gains additional stature at the conclusion of the novel because of her particular association with Jim by virtue of the fact that he escapes captivity cross-dressed in one of her calico dresses. Finally, I show that she ultimately takes control of her own narrative, and in her own voice, through spirited exchanges with her gossiping neighbors.
The N-Word in Adventures of Huckleberry Finn Reconsidered
Authors: Sloane David E. E.
Published: October 2014

The n-word in Adventures of Huckleberry Finn is a significant contribution to Twain's message, as digital analysis reveals, leading us to understand Twain's methods and targets as somewhat different from what many critics assume, exposing the racism in otherwise “kind” people.
Análisis de los abusos cometidos por los socios mayoritarios contra las minorías societarias en la sociedad anónima; algunas alternativas de solución
Authors: Palacios Bragg Felix
Published: October 2014

En el presente trabajo de investigación se realiza un análisis de los principales abusos que cometen los socios que ostentan la mayoría de capital en perjuicio de las minorías accionarias en la sociedad anónima nicaragüense. En tal sentido, se plantea como principal objetivo el formular algunas vías de soluciones al conflicto, tomando en cuenta las alternativas que existen en la legislación nacional, el derecho comparado y la jurisprudencia, en el interés de proponer algunos mecanismos de protección a las minorías en la práctica societaria mercantil nicaragüense, profundizando sobre los derechos de los accionistas minoritarios que actualmente tienen una mayor relevancia en el marco de la inversión extranjera y de la globalización.DOI: http://dx.doi.org/10.5377/derecho.v0i16.1487 Revista de Derecho No.16 2013 pp.35-76
Cuestiones elementales sobre los tributos ambientales
Authors: Salassa Boix Rodolfo
Published: October 2014

En la actualidad no resulta nada extraño que los Estados hagan uso del sistema fiscal para llevar adelante políticas de carácter intervencionista. De hecho, es cada vez más asiduo encontrar gravámenes cuya finalidad principal va más allá de la mera obtención de recursos, configurándose como verdaderos mecanismos reguladores de conducta. Así las cosas, estos tributos conviven armónicamente con aquéllos que tienen una finalidad orientada eminentemente a la obtención de recursos. Los tributos reguladores o extrafiscales presentan un abanico de posibilidades muy variado, con lo cual, sería prácticamente imposible enumerarlos sin dejar algún caso fuera de la lista. Entre los más comunes podemos citar los tributos ambientales, en los cuales centraremos nuestra atención en el presente estudio. A estos fines estructuramos el trabajo en base a dos grandes partes: en una primera parte, y a modo de cuestión preliminar, daremos una noción genérica de los tributos con fines extrafiscales; en la segunda parte nos avocaremos de lleno en los tributos ambientales, tratando su terminología, definición y relación con el principio de capacidad contributiva. Finalmente, exponemos las conclusiones finales.DOI: http://dx.doi.org/10.5377/derecho.v0i16.1489 Revista de Derecho No.16 2013 pp.125-146
Derivaciones laborales de las empresas ideológicas o de tendencia en Nicaragua
Authors: Zelaya Flor de María
Published: October 2014

A la empresa se le confía en cierto grado la satisfacción de necesidades de la comunidad, y de ella depende en cierto modo el nivel de empleo y bienestar. Los trabajadores con su labor comparten la responsabilidad de generar riqueza al país y a la vez tratan de obtener una vida digna. Tanto el derecho de crear empresas y el de ejercer la profesión u oficio que se desee y la estabilidad laboral son derechos constitucionales, los que en determinado momento podrían enfrentarse. El presente trabajo permite demostrar cómo las empresas ideológicas o de tendencia, denominadas así por darse a conocer ante los demás con una ideología o tendencia determinada, pueden caer en la limitación y transgresión del ejercicio de los derechos fundamentales de sus trabajadores, cuando a criterio de la institución deban limitar y condicionar comportamientos de sus empleados para el funcionamiento organizacional y exteriorización de la empresa. Queda demostrado que el poder de dirección del empresario no es absoluto, tiene sus límites y uno de ellos es el respeto de derechos fundamentales de los trabajadores. Con la presente investigación se concluyó que para solucionar los conflictos entre dos derechos fundamentaleses necesario realizar una ponderación de derechos decidiendo cuál tiene preferencia sobre el otro en las determinadas circunstancias en las que se debe tomar la decisión.DOI: http://dx.doi.org/10.5377/derecho.v0i16.1490 Revista de Derecho No.16 2013 pp.147-192
La administración desleal societaria en el Derecho penal español
Authors: Luzón Peña Diego Manuel , Roso Cañadillas Raquel
Published: October 2014

El trabajo analiza, dentro de la regulación del CP de 1995 de los delitos societarios, todos los elementos, objetivos y subjetivos, del tipo delictivo de la administración desleal societaria del art. 295, repasando críticamente las diversas posiciones doctrinales con respecto al bien jurídico, que se mantiene en este trabajo que es doble, del sujeto activo y de las modalidades comisivas, ofreciendo interpretaciones de sus elementos desde nuevos planteamientos, que influyen en la delimitación de los casos comprendidos en el tipo y en las relaciones concursales con la apropiación indebida. Defendemos la posición no mayoritaria de que en algunos casos excepcionales la comisión omisiva es equiparable a la activa tanto en la disposición de bienes como en la asunción de obligaciones perjudiciales. Se examina, lo que no está muy tratado en la doctrina española, la posible concurrencia de causas de justificación o exclusión de la tipicidad, como el consentimiento, el riesgo permitido en los negocios de riesgo o la insignificancia. En cuanto a la relación concursal con el delito de apropiación indebida, se fundamenta y sostiene, a diferencia de la doctrina y jurisprudencia dominantes, que no hay concurso de leyes o de normas, sino concurso de delitos, normalmente ideal.DOI: http://dx.doi.org/10.5377/derecho.v0i16.1492 Revista de Derecho No.16 2013 pp.193-230
Transmisibilidad del derecho a la reparación del daño moral
Authors: Orozco Gadea Germán Antonio
Published: October 2014

La doctrina partidaria de la transmisión del Derecho a la reparación del daño moral ha enfrentado una dura polémica. Dentro de esta controversia encontramos tres posturas: una plantea que el derecho a la reparación del daño moral se extinguiría con el fallecimiento de la víctima; la otra, establece que los familiares del interfecto están legitimados iure hereditario para solicitar la reparación, porque dicho derecho es un crédito que ingresa en el patrimonio de la víctima y luego lo transmite a sus herederos; por último, para un tercera postura, las personas pueden exigir la reparación de estos perjuicios por vía iure proprio, porque han tenido estrechos vínculos afectivos con el interfecto y el dolor y sufrimiento que padecen por su muerte merece ser compensado. Sin embargo, todos estos autores coinciden en admitir la transmisión del Derecho a la reparación del daño moral, cuando la víctima había incoado la demanda y muere antes de ser indemnizada. Dentro de este contexto, no podemos soslayar, el tema de la enajenación del derecho a la reparación de esta clase de daños por actos entre vivos. Según nuestro criterio, es muy difícil admitir ésta última clase de enajenación porque se distorsiona la función que cumple la reparación del daño moral.DOI: http://dx.doi.org/10.5377/derecho.v0i17.1578
Ex-vivo nephron-sparing surgery and autotransplantation for renal tumours: Revisited
Authors: Abraham George P , Siddaiah Avinash T , Ramaswami Krishnamohan , George Datson , Das Krishanu
Published: October 2014

Introduction: We studied the feasibility of ex-vivo nephron-sparing surgery and autotransplantation for complex renal tumours. We also studied the role of laparoscopy in these situations.Methods: All patients who underwent renal autotransplantation for renal tumour at our centre were included in this retrospective study. Patient profiles were recorded in detail. Operative and postoperative details were also recorded.Results: Our series includes 3 patients. Two patients had complex renal cell carcinoma and 1 patient had bilateral large angiomyolipoma. In the first 2 patients, laparoscopic approach was used for nephrectomy. Operative time for case 1, 2 and 3 was 5.5, 4.5, 8 (right side) and 6 (left side) hours, respectively. Cold ischemia time was 110, 90, 150 and 125 minutes, respectively. One patient required temporary postoperative hemodialysis.Conclusion: Ex-vivo nephron-sparing surgery and autotransplantation still remain a viable option for complex renal tumours. It offers satisfactory renal functional outcome with acceptable morbidity. The laparoscopic approach should be used whenever possible to reduce morbidity.
Intravesical treatment with highly-concentrated hyaluronic acid and chondroitin sulphate in patients with recurrent urinary tract infections: Results from a multicentre survey
Authors: Cicione Antonio , Cantiello Francesco , Ucciero Giuseppe , Salonia Andrea , Torella Marco , De Sio Marco , Autorino Riccardo , Romancik Martin , Tomaskin Roman , Damiano Rocco
Published: October 2014

Introduction: We assess the effectiveness of intravesical instillation of hyaluronic acid (HA) and chondroitin sulphate (CS) as a non-antibiotic treatment option for prophylaxis of recurrent urinary tract infections (UTIs) in female patients.Methods: This was a retrospective cohort study involving 7 European institutions. We included patients with recurrent UTIs who received intravesical instillations of Ialuril (IBSA International) (50 mL HA 1.6% and CS 2% solution) between January 2010 and March 2012. Medication schedule, length of follow-up, recurrence infection time, number of UTIs/patients/year, patient quality of life, subjective symptoms score, and treatment-emergent side effects were recorded and analyzed.Results: In total, 157 women (mean age: 54.2 ± 4.1 years) were included in the analysis. All patients had at least 12 months follow-up. After 4 weekly and 5 monthly HA-CS bladder instillations, UTI episodes decreased from 4.13 ± 1.14 to 0.44 ± 0.50 (p = 0.01) at 12 months, while recurrent UTI time prolonged from 94.8 ± 25.1 days to 178.4 ± 37.3 days (p = 0.01) at 12 months. An improvement in symptoms and quality of life was achieved. A medium-depth pain after medication instillation was the most reported side effect. Regression model analysis showed significant risk factors in developing new UTI episodes: being more than 50 years old and having more than 4 UTI episodes per year (OR 3.41; CI 95%; 1.51-7.71, p = 0.003 and OR 3.31; CI 95% 1.51-7.22; p = 0.003, respectively). Retrospective design and lack of a control group represent two main limitations of the study.Conclusions: Restoring glycosaminoglycans bladder layer therapy is a promising non-antibiotic therapy to prevent recurrent UTIs.
Pediatric procedures in urology residency training: An analysis of the experience of Canadian urology residents
Authors: Gustafson Paul , MacNeily Andrew
Published: October 2014

Introduction: We sought to determine if the exposure to pediatric urologic procedures by graduates of Canadian urological programs is congruent with the objectives of training (OTR) put forward by the Royal College of Physicians and Surgeons of Canada (RCPSC).Methods: The Canadian T-Res (Resiliance Software Inc., Vancouver, BC) database for pediatric surgical procedures logged from 2003 to 2009 was interrogated. The number of cases logged for each of the A, B and C lists of procedures (least complex to most complex) as outlined in the RCPSC OTR in Urology were recorded for the 6 participating programs across the country.Results: A total of 48 residents submitted data to T-Res from the 6 participating programs. Of the A-list procedures, Canadian urology residents (PGY 1-5) from the 6 participating programs participated in an annual average of 53 hypospadias repairs, 30 orchidopexies for inguinal testes, 26 circumcisions, 7 hernia/hydrocele repairs, 7 pyeloplasties, 7 ureteral reimplants, 6 endoscopic injections for vesicoureteral reflux, 3 meatoplasties/meatotomies, 1 transurethral incision of ureterocele, 2 endoscopic procedures for stone management, and 1 transurethral incision of ureterocele, during the years in question. Of the B-list procedures, residents participated in an annual average of 1 transurethral resection of a posterior urethral valve, 3 continent diversions, 2 augmentation cystoplasties and 1 vesicostomy. Of the data available for the C-list procedures, residents participated in an annual average of less than 1 exstrophy repair and less than 1 pediatric renal transplant.Conclusions: The RCPSC objectives set out by the specialty committee are a useful framework for guiding graduating residents on which procedures they might reasonably perform once they enter practice. Ongoing revisions to these objectives, which reflect changing trends in the management of core pediatric urology procedures, are supported by our study based on the number of cases in which residents participate. Improvements in the assessment of trainee surgical experience and competence, as it relates to the objectives of training in pediatric urology, are required as we migrate towards a competency-based model of postgraduate medical education.
ECF chemotherapy for liver metastases due to castration-resistant prostate cancer
Authors: Gupta Shruti , Potvin Kylea , Ernst D. Scott , Whiston Frances , Winquist Eric
Published: October 2014

Introduction: Most men with metastatic castration-resistant prostate cancer (CRPC) have biochemical response to docetaxel, but the objective response rate is low. Liver metastases are uncommon with CRPC and associated with shorter survival. More active treatment might benefit these patients. Epirubicin, cisplatin and flurouracil (ECF) is a standard regimen for gastric cancer and response in CRPC liver metastases has been reported. We reviewed our experience with ECF in CRPC with the primary objective of determining its anti-tumour activity in patients with liver metastatic CRPC.Methods: Men with CRPC treated with ECF were identified from electronic databases and data were extracted from medical records. Men with tumours showing neuroendocrine features were excluded.Results: In total, we identified 14 CRPC patients treated with ECF, of which 8 had liver metastases. The median age was 56 (range: 42-76) and all had multiple poor prognostic features. A median of 6 cycles of ECF were administered (range: 1-10) and toxicities were similar to previous reports. Of the 8 patients with liver metastases, 5 had partial remission.Conclusions: ECF was highly active in this small selected group of younger men with liver metastases from CRPC and multiple poor prognostic features. Despite important limitations, this is the third report of high objective response rates with ECF in CRPC. Objective response rates are low with current monotherapies. A higher probability of ORR is preferred for critical organ disease, therefore the anti-tumour activity should encourage testing of ECF in comparison to the most active current therapies.
Leiomyosarcoma of the inferior vena cava with renal metastasis: An unusual case and diagnostic challenge
Authors: Chan Garson , Kroczak Tadeusz , Drachenberg Darrel
Published: October 2014

Leiomyosarcomas are exceedingly rare malignant tumours with a very poor prognosis. We present a 78-year-old patient with a small renal and paracaval mass. Surgery included right open partial nephrectomy and resection of the paracaval mass to treat the presumed renal cell carcinoma. Pathology revealed the tumour tobe leiomyosarcoma (LMS). This is only the second documented report of an inferior vena cava LMS presenting along with an ipsilateral renal mass.
Active surveillance in patients with a PSA >10 ng/mL
Authors: Toren Paul , Wong Lih-Ming , Timilshina Narhari , Alibhai Shabbir , Trachtenberg John , Fleshner Neil , Finelli Antonio
Published: October 2014

Introduction: The use of prostate-specific antigen (PSA) in active surveillance (AS) for prostate cancer is controversial. Some consider it an unreliable marker and others as sufficient evidence to exclude patients from AS. We analyzed our cohort of AS patients with a PSA over 10 ng/mL.Methods: We included patients who had clinical T1c–T2a Gleason ≤6 disease, and ≤3 positive cores with ≤50% core involvement at diagnostic biopsy and ≥2 total biopsies. Patients were divided into 3 groups: (1) those with baseline PSA >10 ng/mL, (2) those with a PSA rise >10 ng/mL during follow-up; and (3) those with a PSA <10 ng/mL throughout AS. Adverse histology was defined as biopsy parameters exceeding the entry criteria limits. We further compared this cohort to a concurrent institutional cohort with equal biopsy parameters treated with immediate radical prostatectomy.Results: Our cohort included 698 patients with a median follow-up of 46.2 months. In total, 82 patients had a baseline PSA >10 ng/mL and 157 had a PSA rise >10 ng/mL during surveillance. No difference in adverse histology incidence was detected between groups (p = 0.3). Patients with a PSA greater than 10 were older and had higher prostate volumes. Hazard ratios for groups with a PSA >10 were protective against adverse histology. Larger prostate volume and minimal core involvement appear as factors related to this successful selection of patients to be treated with AS.Conclusion: These results suggest that a strict cut-off PSA value for all AS patients is unwarranted and may result in overtreatment. Though lacking long-term data and validation, AS appears safe in select patients with a PSA >10 ng/mL and low volume Gleason 6 disease.