Assessing Restoration Effects on River Hydromorphology Using the Process-based Morphological Quality Index in Eight European River Reaches.

The Morphological Quality Index (MQI) and the Morphological Quality Index for monitoring (MQIm) have been applied to eight case studies across Europe with the objective of analyzing the hydromorphological response to various restoration measures and of comparing the results of the MQI and MQIm as a morphological assessment applied at the reach scale, with a conventional site scale physical-habitat assessment method. For each restored reach, the two indices were applied to the pre-restoration and post-restoration conditions. The restored reach was also compared to an adjacent, degraded reach. Results show that in all cases the restoration measures improved the morphological quality of the reach, but that the degree of improvement depends on many factors, including the initial morphological conditions, the length of the restored portion in relation to the reach length, and on the type of intervention. The comparison with a conventional site scale physical-habitat assessment method shows that the MQI and MQIm are best suited for the evaluation of restoration effects on river hydromorphology at the geomorphologically-relevant scale of the river reach.

New tools for the hydromorphological assessment and monitoring of European streams.

Hydromorphological stream assessment has significantly expanded over the last years, but a need has emerged from recent reviews for more comprehensive, process-based methods that consider the character and dynamics of the river with greater accuracy. With this as a focus, a series of hydromorphological tools have been developed and/or further extended in Europe within the context of the REFORM (REstoring rivers FOR effective catchment Management) project. The aim of this paper is to present the set of REFORM hydromorphological assessment methods and, based on some examples of their application, to illustrate and discuss their synergic use, specific features, limitations and strengths. This assessment and monitoring includes three tools: the Morphological Quality Index (MQI), the Morphological Quality Index for monitoring (MQIm), and the Geomorphic Units survey and classification System (GUS). These tools constitute the assessment phase of an overall multi-scale, process-based hydromorphological framework developed in REFORM. The MQI is aimed at an assessment, classification and monitoring of the current morphological state; the MQIm aims at monitoring the tendency of morphological conditions (enhancement or deterioration); the GUS provides a characterization, classification and monitoring of geomorphic units. A series of examples are used to illustrate the potential range of application, including: (i) an assessment of morphological conditions; (ii) an assessment of the morphological effects of restoration projects; (iii) an evaluation of the geomorphic impacts of interventions for risk mitigation; and (iv) an integrated use of MQI and GUS to assess and characterise morphological conditions. Finally, some of the main features, strengths and peculiarities of the three hydromorphological tools are discussed with the support of examples of their application.

Eperisone versus tizanidine for treatment of chronic low back pain.

AIM: Many therapies exist for treatment of chronic low-back pain (LBP) including the use of muscle relaxant and analgesic drugs. The aim of this paper was to compare efficacy and tolerability of eperisone and tizanidine in combination treatment with tramadol in chronic LBP. METHODS: Sixty patients affected by chronic LBP associated with contractures of paravertebral muscles were randomized in two groups: Group E (30 patients) treated with eperisone; Group T (30 patients) treated with tizanidine. Both groups received tramadol retard 100 mg/day. VAS at rest and with effort were used at baseline (T0) and after 5 (T5), 10 (T10), 15 (T15) and 30 (T30) days of treatment. The Summed Pain Intensity Difference (SPID), the SPID percentage (SPID%) and the Total Pain Relief (TOTPAR), at rest (-r) and with effort (-e) were calculated. RESULTS: In both groups a statistically significant reduction in VAS-r and VAS-e was observed during the treatment; similar reductions occurred in both groups at every timepoint. SPID-r and -e, SPID%-r and -e and TOTPAR-r and -e resulted similar between groups. A significant difference between groups occurred for incidence of somnolence: 16.6% for Group E versus 43.3% for Group T. Treatment was stopped due to adverse events in 5 patients of Group E and in 9 patients of Group T, without statistically significant difference. CONCLUSION: Both associations assumed for one month, have shown effective for LBP at rest and with effort. Eperisone/tramadol, reducing discontinuation and allowing a better adherence to the therapy, may be considered a viable option for the treatment of chronic LBP.

Amino acids change liver growth factors gene expression in malnourished rats.

BACKGROUND: Glutamine and proline are metabolized the liver and may collaborate on its regeneration. Parenteral nutrition (PN) containing either glutamine or proline was given to partially hepatectomized rats. The total RNA content and growth factor gene expression in hepatic remnants was measured, to determine the effects of these amino acid supplementation on the expression of growth factors during liver regeneration. METHODS: Wistar rats nourished (HN) and malnourished (HM) were hepatectomized and divided in two groups: 20 receiving PN enriched with Alanyl-Glutamine (HN-Gln and HM-Gln) and 20 PN enriched with proline+alanine (HN-Pro and HM-Pro). The control groups comprised 7 nourished (CN) and 7 malnourished (CM) rats that didn't undergo surgery. Growth factor and thymidine kinase mRNA levels were measured by RT-PCR. RESULTS: In nourished rats, total hepatic RNA levels were lower in the HN-Gln and HN-Pro groups (0.75 and 0.63 microg/mg tissue, respectively) than in control group (1.67 microg/mg tissue) (P<0.05). In malnourished rats, total hepatic RNA content was higher in the HM-Pro group than HN-Pro, HM-Gln, and CM (3.18 vs. 0.63, 0.93 and 1.10 microg/mg, respectively; P<0.05). Hepatocyte growth factor mRNA was more abundant in the HM-Gln group when compared to CM (0.31 vs. 0.23 arbitrary units) and also in HM-Pro in relation to HM-Gln, HN-Pro, and CM(0.46 vs. 0.33 and 0.23, respectively, P<0.05). CONCLUSIONS: Proline or glutamine supplementation in malnourished rats improves total RNA content in the remnant hepatic tissue. Amino acids administration increased HGF gene expression after partial hepatectomy in malnourished rats, with a greater effect of proline than glutamine.

Amino acids change liver growth factors gene expression in malnourished rats / Los aminoácidos alteran la expresión genética de factores de crecimiento hepático en ratas macho desnutridas

Background: Glutamine and proline are metabolized the liver and may collaborate on its regeneration. Parenteral nutrition (PN) containing either glutamine or proline was given to partially hepatectomized rats. The total RNA content and growth factor gene expression in hepatic remnants was measured, to determine the effects of these amino acid supplementation on the expression ofgrowth factors during liver regeneration. Methods: Wistar rats nourished (HN) and malnourished (HM) were hepatectomized and divided in two groups: 20 receiving PN enriched with Alanyl-Glutamine (HN-Gln and HM-Gln) and 20 PN enriched with proline+alanine (HN-Pro and HM-Pro). The control groups comprised 7 nourished (CN) and 7 malnourished (CM) rats that didn't undergo surgery. Growth factor and thymidine kinase mRNA levels were measured by RT-PCR. Results: In nourished rats, total hepatic RNA levels were lower in the HN-Gln and HN-Pro groups (0.75 and 0.63 μg/mg tissue, respectively) than in control group (1.67 μg/mg tissue) (P < 0.05). In malnourished rats, total hepatic RNA content was higher in the HM-Pro group than HN-Pro, HM-Gln, and CM (3.18 vs. 0.63, 0.93 and 1.10 μg/mg, respectively; P < 0.05). Hepatocyte growth factor mRNA was more abundant in the HM-Gln group when compared to CM (0.31 vs. 0.23 arbitrary units) and also in HM-Pro in relation to HM-Gln, HN-Pro, and CM(0.46 vs. 0.33 and 0.23, respectively, P < 0.05). Conclusions: Proline or glutamine supplementation in malnourished rats improves total RNA content in the remnant hepatic tissue. Amino acids administration increased HGF gene expression after partial hepatectomy in malnourished rats, with a greater effect of proline than glutamine (AU)

Introducción: La glutamina y la prolina de metabolizan en el hígado y pueden contribuir a la regeneración de este. Se administró nutrición parenteral con glutamina o prolina a ratas sometidas a hepatectomía parcial. Se midieron el contenido de ARN total así como la expresión genética del factor de crecimiento en el tejido hepático remanente, con el objetivo de determinar los efectos que provocaban estos aminoácidos en la expresión genética de factores de crecimiento durante el proceso de regeneración del hígado. Métodos: ratas macho Wistar nutridas (HN) y desnutridas (HM) se sometieron a hepatectomía parcial y se dividieron en dos grupos: 20 recibieron nutrición parenteral enriquecida con Alanil-Glutamina (HN-Gln y HM-Gln) y 20 nutrición parenteral enriquecida con prolina+alanina (HNPro y HM-Pro). Los grupos de control estaban formados por 7 ratas nutridas (CN) y 7 desnutridas (CM) que no se sometieron a la cirugía. Los niveles de factor de crecimiento y timidina quinasa mRNA se midieron por RT-PCR. Resultados: En las ratas nutridas, lo niveles de ARN hepático total fueron inferiores en los grupos que recibieron HNGln y HN-Pro (0,75 y 0,63 mg/mg tejido, respectivamente) que en el grupo control (1,67 mg/mg tejido) (P < 0,05). En las ratas desnutridas, el contenido total de ARN hepático fue superior en el grupo que recibió HM-Pro que el que recibió HN-Pro, HM-Gln y CM (3,18 vs 0,63, 0,93 y 1,10 mg/mg, respectivamente; P < 0,05). El mRNA del factor de crecimiento de hepatocitos fue más abundante en el grupo que recibió HM-Gln con respecto a CM (0,31 vs 0,23 unidades arbitrarias), así como en HM-Pro con relación a HM-Gln, HN-Pro y CM (0,46 vs 0,33 y 0,23, respectivamente, P < 0,05). Discusión: La suplementación de prolina o glutamina en ratas macho desnutridas mejora el contenido total de ARN en el tejido hepático remanente. Al administrarse aminoácidos aumentó la expresión genética del HGF tras someter las ratas desnutridas a una hepatectomía parcial, obteniéndose un resultado mejor con prolina que con glutamina (AU)

[General organizational issues in disaster health response]. / Aspetti organizzativi generali dell'assistenza sanitaria nei disastri.

Recent studies show how in the 2004-2005 period there has been an increase in natural disasters of 18% worldwide. According to a renowned author planning for disaster response is as valid as the starting hypothesis. The study of an inductive mental process in disaster response planning is the key to avoiding the invention and re-invention of the wheel for each emergency. Research in this field however is hampered by different factors one of which is data collection that during disaster response requires specific training. Standardization of data collection models with limitation of the number of variables is required as is taking into account problems related to people migration and subsequent sampling problems and retrospective analysis. Moreover poor attention to the training of the volunteers employed on the field is an issue to be considered.

[New global challenges: the role of international organizations]. / Nuove sfide globali: il Ruolo delle Organizzazioni Internazionali.

Facing the numerous humanitarian emergencies that upset the international balances, the International Organisations (IO) who intervene are: the Agencies of the United Nations (UN), the International Federation of the Red Cross (IFRC) and NGOs. In the sector of international health cooperation, the World Health Organization (WHO) has elaborated a document, the International Health Regulations (IHR), that regulates the health workers' activity during a health emergency. In this paper different International Organizations employed in international humanitarian crisis are described.

[Laws relevant to international missions of health cooperation]. / Le norme applicabili a missioni di cooperazione sanitaria internazionale.

Both medical doctors and humanitarian operators engaged in health relief or development missions abroad, are called to respect the general principles of international law, that is to say, customary law that is legally compulsory for the International Community and rules deriving from Treaties and International Conventions. Humanitarian operators have to observe also the rules and regulations of the hosting country. They have to respect all rules applying to their humanitarian action and they have to take responsibility towards beneficiaries and donors alike.

[Psychological perception of risk, infections and catastrophes. The greatest danger is human nature]. / La percezione psicologica del rischio: il contagio in una catastrofe. Il pericolo maggiore insito nella natura umana.

Risk perception is due to a subjective evaluation of reality and depends on a number of factors such as: individual coherence and flexibility, the set of social values and rules that contributed to the definition of the individuals' interior world - this does not always make proper risk perception possible. Even though the way common people set-up their own judgment is based on their own interpretation tracks, surely different from expert criteria, we cannot label their approach as irrational. Over time, through an evolutionary process, people have decided what is safe and what is dangerous; this personal awareness was not based on the science but on experiences, images, feelings and emotions. Most of the time, neither social nor economical conditions can prevent people to feel an epidemic risk in the same way as it was felt during the plague of 1350. Most of the time, after a disaster, victims experience a regression so, for example, even if it is known that corpses do not always cause infections, after the tsunami disaster, most of the bodies were quickly cremated by scared survivors; this made the identification and burial of the victims impossible.

[Optimizing international humanitarian assistance through the definition of personal profiles: the role of graphology]. / Definizione dei profili personali per ottimizzare l'assistenza umanitaria internazionale: contributo della grafologia.

The authors illustrate the frequent applications of the modern science of graphology after having evoked its birth and development. Regarding the relationship between major catastrophes and graphology they specify that the latter is useful both in the definition of the personality profiles of the staff that is sent on relief missions and in evaluating the reactions of the victims in order to simplify the work of psychologists.

[Infectious diseases and population assistance: general issues]. / Assistenza infettivologica alla popolazione: problemi generali.

Actually the infectious diseases are a predominant cause of morbidity and mortality in limited resource countries and, of course, not unimportant in industrialized countries where the social phenomena of immigration and increased internal and international mobility of people may facilitate the reemergence of infectious diseases considered overcome. It is becoming more and more important to consider the actual role of assistance of people for infectious diseases: a careful consideration needing of concretes example for becoming medical practices and social languages appropriates to the local context and useful for promoting more efficacious cares and prevention of infectious diseases.

[Epidemiological surveillance for infectious diseases and humanitarian emergencies]. / Sorveglianza epidemiologica per malattie infettive ed emergenze umanitarie.

A disaster both natural and man made is managed in time according to separate phases that respond to specific requirements and needs. In the late and post emergency phases problems of public health are priority and in particular the identification and containment of epidemic clusters. Epidemiological surveillance is the main instrument used and in this paper it is analysed both in theory and in its application in the Italian Red Cross mission in Sri Lanka devastated by the 2004 Tsunami.

Bivariate flow cytometry DNA/BrdUrd analysis of plant cell cycle.

We describe a protocol for flow cytometry analysis of cell cycle in plants using indirect immunolabelling staining and Vicia faba, Pisum sativum and Zea mays root tip cells as model systems. The protocol is based on simultaneous analysis of two fluorescent signals. The first, obtained after staining with propidium iodide, is used to quantify nuclear DNA content. The second, obtained after indirect immunofluorescent staining of bromodeoxyuridine (BrdUrd), is used to quantify the amount of BrdUrd incorporated into nuclear DNA. In an attempt to standardize the procedure, the effects of various conditions for partial DNA denaturation using HCl, as well as of BrdUrd concentration and incorporation time on flow cytometry DNA/BrdUrd content analysis have been studied. Maximum BrdUrd-linked fluorescence was observed after a 30 min pulse with 10 microM BrdUrd and after DNA denaturation with 1.5 N HCl (final concentration) for 30 min at 25 degrees C. Under these conditions, DNA content histograms with relatively small coefficient of variation (< 4%, full peak) could be obtained. To avoid non-specific staining of cytoplasm and cell walls, the protocol involves the use of nuclei isolated from formaldehyde-fixed tissues. Fixed isolated nuclei are stable and may be stored in hexylene glycol 0.75 M at 4 degrees C for prolonged periods prior to actual staining and analysis.

[Intraoperative awareness: a true or false problem?]. / Il risveglio intraoperatorio: un problema vero o falso?

The authors base their remark on a few cases of awareness which have been reported in their hospital and on the history a patient who experienced intraoperative awareness during cesarean section. Attention is focused on the ethical, social and medico-legal aspects of this phenomenon. Awareness may severely affect the patient's psychic equilibrium with the consequent onset of severe neuroses leading to the possibility of legal action and claims for compensation. Clinical experience has shown that the use of halogenate anesthetics, even in low concentrations, may help to avoid this phenomenon. Correct relations between the anesthetist and patient before and after surgery may also, even in the event of awareness, reduce the incidence and severity of consequent psychological sequelae.

[Operative risk. Patient evaluation, informed consent]. / Rischio operatorio. Valutazione del paziente, consenso informato.

It is mandatory, the Authors say, to obtain a previous and definite consent before the patient undergoes the operation. Moreover the patient shall be well acquainted about the risk connected to the operation before he gives his consent. On the contrary, as already confirmed by the Italian Supreme Court of Justice, the consent shall not be valid and the Doctors could be found guilty of "psychic violence". Finally the Authors, to evaluate the probable risks liked to the operation, use scales as ASA and prognostic indexes as SAPS to avoid appraisage too subjective.

Recirculation: review, techniques for measurement and ability to predict hemoaccess stenosis before and after angioplasty.

The measurement of recirculation during two-needle hemodialysis has been shown to provide valuable information concerning distal hemoaccess stenosis and the loss of effective dialysis. Reference sources have suggested that levels of recirculation above 20% call for further investigation. We proposed a technique for routine recirculation measurement and studied 20 stable hemodialysis patients using this method. We found that all patients had recirculations of less than 10%. We also studied 2 patients with angiographically proven stenosis and found 1 patient with a recirculation of less than 20%. Routine recirculation testing provides valuable information about hemoaccess integrity and using our techniques, recirculation greater than 10% is an indication for further study.