Signaling Fiscal Regime Sustainability

This paper proposes a signaling model of fiscal stabilizations that offers a new perspective on why governments deviate from optimal tax smoothing. In our model, dependable - but not fully credible - governments have an incentive to tighten the fiscal regime when the signaling effect on credit ratings is larger (that is, when a sufficiently large stock of debt has been accumulated). At this point, they may deviate from tax smoothing in order to avoid being mimicked by weak governments. We show that a testable prediction of our model is that primary balances and debt stocks are complementary inputs in the credit rating function and we successfully test it on Irish, Belgian, and Danish data from the late 1970s to the early 1990s.fiscal policy, taxation, debt, credit, economic models

Locally vascularized pelvic accessory spleen

Il polisplenismo e la milza accessoria sono anomalie congenite generalmente asintomatiche. Riportiamo un raro caso di polisplenismo con milza pelvica ectopica in una donna bianca di 67 anni. Nella pelvi di sinistra all’ecografia transvaginale è stata ritrovata una massa soffice, ben definita, omogenea e vascolarizzata. La paziente è stata quindi sottoposta a valutazione con RM e TC addominale con contrasto: sono state ottenute immagini con aspetto parenchimale simile alla milza. E’ stata eseguita una scintigrafia addominale con albumina umana colloidale radiomarcata con tecnezio sulla regione pelvica con scansioni planari e SPECT. I risultati hanno mostrato la presenza di un’area di captazione del radiofarmaco nella pelvi, mentre la milza è stata normalmente visualizzata. Questi ritrovamenti hanno confermato la presenza di una milza accessoria con una arteria originante dall’aorta ed una vena che si anastomizzava con la vena mesenterica superiore. Alla nostra conoscenza, nella letteratura, esiste solo un caso di vera milza ectopica localmente vascolarizzata nella pelvi.Polysplenism and accessory spleen are congenital, usually asymptomatic anomalies. A rare case of polysplenism with ectopic spleen in pelvis of a 67-year-old, Caucasian female is reported here. A transvaginal ultrasound found a soft well-defined homogeneous and vascularized mass in the left pelvis. Patient underwent MRI evaluation and contrast-CT abdominal scan: images with parenchymal aspect, similar to spleen were obtained. Abdominal scintigraphy with 99mTc-albumin nanocolloid was performed and pelvic region was studied with planar scans and SPECT. The results showed the presence of an uptake area of the radiopharmaceutical in the pelvis, while the spleen was normally visualized. These findings confirmed the presence of an accessory spleen with an artery originated from the aorta and a vein that joined with the superior mesenteric vein. To our knowledge, in the literature, there is just only one case of a true ectopic, locally vascularized spleen in the pelvis

Diagnostic imaging and CEUS findings in a rare case of Desmoid-type fibromatosis. A case report

Desmoid-type fibromatosis (DF), also known as aggressive fibromatosis, is a locally aggressive benign fibroblastic neoplasm that can infiltrate or recur but cannot metastasize. It is rare, with an estimated annual incidence of two to four new cases per million people. Most DFs occur sporadically, but it may also be associated with the hereditary syndrome familial adenomatous polyposis. Treatment is necessary when the disease is symptomatic, especially in case of compression of critical structures. When possible, surgical resection is the treatment of choice; however, recurrence is common. Due to the high rate of recurrence, imaging plays an important role not only in diagnosis, but also in the management of DF. Although there are a number of studies describing CT and MRI findings of DF, there is no description of contrast-enhanced ultrasound findings

Analysis of tissue surrounding thyroid nodules by ultrasound digital images

Since US is not easily reproducible, the digital image analysis (IA) has been proposed so that the image evaluation is not subjective. In fact, IA meets the criteria of objectivity, accurateness, and reproducibility by a matrix of pixels whose value is displayed in a gray level. This study aims at evaluating via IA the tissue surrounding a thyroid nodule (backyard tissue, BT) from goitres with benign (b-BT) and malignant (m-BT) lesions. Sixty-nine US images of thyroid nodules surrounded by adequate thyroid tissue was classified as normoechoic and homogeneous were enrolled as study group. Forty-three US images from normal thyroid (NT) glands were included as controls. Digital images of 800 × 652 pixels were acquired at a resolution of eight bits with a 256 gray levels depth. By one-way ANOVA, the 43 NT glands were not statistically different (P = 0.91). Mean gray level of normal glands was significantly higher than b-BT (P = 0.026), and m-BT (P = 0.0001), while no difference was found between b-BT and m-BT (P = 0.321). NT tissue boundary external to the nodule was found at 6.0 ± 0.5 mm in cancers and 4.0 ± 0.5 mm in benignancies (P = 0.001). These data should indicate that the tissue surrounding a thyroid nodule may be damaged even when assessed as normal by US. This is of interest to investigate the extranodular effects of thyroid tumors

An unusual location of hand, foot and mouth disease

Hand, foot, and mouth disease (HFMD) is a childhood febrile disease. Oral lesions and papulovesicular lesions on the hands and feet are the clinical signs of the disease. In our case, a 17-year-old boy presented to the emergency department, where he was diagnosed with HFMD. After 6days, he felt intense pain in his right testicle, and therefore an ultrasound (US) examination was performed. US detected a hypoechoic mass-like area in the right testis. Viral etiology was suspected, and no therapy was prescribed. After a little more than 3months, US examination showed a reduced lesion size. Viral epididymo-orchitis should be suspected in young men with a recent history of HFMD and testicular pain

Is contrast-enhanced US alternative to spiral CT in the assessment of treatment outcome of radiofrequency ablation in hepatocellular carcinoma?

Purpose: The present study was conducted to assess the efficacy of contrast-enhanced ultrasound with low mechanical index in evaluating the response of percutaneous radiofrequency ablation treatment of hepatocellular carcinoma by comparing it with 4-row spiral computed tomography. Materials and Methods: 100 consecutive patients (65 men and 35 women; age range: 62 – 76 years) with solitary hepatocellular carcinomas (mean lesion diameter: 3.7cm± 1.1cm SD) underwent internally cooled radiofrequency ablation. Therapeutic response was evaluated at one month after the treatment with triple-phasic contrast-enhanced spiral CT and low-mechanical index contrast-enhanced ultrasound following bolus injection of 2.4 ml of Sonovue (Bracco, Milan). 60 out of 100 patients were followed up for another 3 months. Contrast-enhanced sonographic studies were reviewed by two blinded radiologists in consensus. Sensitivity, specificity, NPV and PPV of contrast-enhanced ultrasound examination were determined. Results: After treatment, contrast-enhanced ultrasound identified persistent signal enhancement in 24 patients (24%), whereas no intratumoral enhancement was detected in the remaining 76 patients (76%). Using CT imaging as gold standard, the sensitivity, specificity, NPV, and PPV of contrast enhanced ultrasound were 92.3% (95% CI = 75.9 – 97.9%), 100% (95% CI = 95.2 – 100%), 97.4% (95% CI = 91.1 – 99.3%), and 100% (95% CI = 86.2 – 100%). Conclusion: Contrast-enhanced ultrasound with low mechanical index using Sonovue is a feasible tool in evaluating the response of hepatocellular carcinoma to radiofrequency ablation. Accuracy is comparable to 4-row spiral CT

Role of brain perfusion SPECT with 99mTc HMPAO in the assessment of response to drug therapy in patients with autoimmune vasculitis: a prospective study

Abstract BACKGROUND: The diagnosis of vasculitis in the brain remains a quite difficult achievement. To the best of our knowledge, there is no imaging method reported in literature which is capable of reaching to a diagnosis of vasculitis with very high sensitivity. AIM: The aim of this study was to determine whether perfusion brain single photon emission computed tomography (SPECT) can be usefully employed in monitoring the treatment of vasculitis, allowing treating only potentially responder patients and avoiding the side effects on patients who do not respond. MATERIALS AND METHODS: Twenty patients (two males and 18 females) suffering from systemic lupus erythematosus (SLE; n = 5), Behcet's disease (BD; n = 5), undifferentiated vasculitis (UV; n = 5), and Sjogren's syndrome (SS; n = 5) were included in the study. All patients underwent a wide neurological anamnestic investigation, a complete objective neurological examination and SPECT of the brain with 99mTc-hexamethyl-propylene-aminoxime (HMPAO). The brain SPECT was then repeated after appropriate medical treatment. The neurological and neuropsychiatric follow-up was performed at 6 months after the start of the treatment. RESULTS: Overall, the differences between the scintigraphic results obtained after and before the medical treatment indicated a statistically significant increase of the cerebral perfusion (CP). In 19 out of 200 regions of interest (ROI) studied, the difference between pre- and post treatment percentages had negative sign, indicating a worsening of CP. This latter event has occurred six times (five in the same patients) in the UV, 10 times (eight in the same patients) in the SLE, never in BD, and three times (two in the same patient) in the SS. CONCLUSION: The reported results seem to indicate the possibility of identifying, by the means of a brain SPECT, responder and nonresponder (unchanged or worsened CP) patients, affected by autoimmune vasculitis, to the therapy

Corporate finance in the euro area – including background material

This report analyses the financial position of non-financial enterprises in the euro area, in particular the amount of external financing, the choice between debt and equity and the composition and maturity structure of debt. It aims at identifying the main features of the euro area, as well as the peculiarities that depend on the country of origin and the sector of activity. Attention is also devoted to assessing whether a country’s institutional eatures are correlated with different financial structures by firms. In light of the particular interest in the access of small and medium-sized enterprises (SMEs) to financing, the report also analyses how financing patterns differ across large, medium-sized and small enterprises. Finally, the report discusses the recent trends observed in the corporate finance landscape of the euro area over the past few years. Although it is still too early to pass final judgement, vast structural changes are underway that could have already influenced in a positive way in the availability of external funds for firms. All in all, a comprehensive understanding of corporate finance in the euro area is important from a monetary policy perspective, given its impact on the transmission mechanism and for productivity and economic growth. Moreover, such an understanding is also relevant from a financial stability perspective. A first assessment is now possible eight years into the third stage of Economic and Monetary Union (EMU), given that sufficient data have been accumulated during this period. This assessment is particularly important as the introduction of the single currency has had significant structural effects on the working of financial markets, increasing their size and liquidity, and fostering cross-border competition. The data available for this report generally cover the period 1995-2005, and the cut-off date for the statistics included is 10 March 2007.

The Copernicus Marine Service ocean forecasting system for the Mediterranean Sea

The Mediterranean Monitoring and Forecasting Center (MED-MFC) is part of the Copernicus Marine Environment and Monitoring Service (CMEMS) and provides regular and systematic information on the time-evolving Mediterranean Sea physical (including waves) and biogeochemical state. The systems consist of 3 components: 1) Med-Physics, a numerical ocean prediction systems, based on NEMO model, that operationally produces analyses, reanalysis and short term forecasts of the main physical parameters; 2) Med-Biogeochemistry, a biogeochemical analysis, reanalysis and forecasting system based on the Biogeochemical Flux Model (BFM) which provides information on chlorophyll, phosphate, nitrate, primary productivity, oxygen, phytoplankton biomass, pH and pCO2; 3) Med-Waves based on WAM model and providing analysis, forecast and reanalysis products for waves. The systems have been recently upgraded at a resolution of 1/24 degree in the horizontal and 141 vertical levels. The Med-Physics analysis and forecasting system is composed by the hydrodynamic model NEMO 2-way coupled with the third-generation wave model WaveWatchIII and forced by ECMWF atmospheric fields. The model solutions are corrected by the 3DVAR data assimilation system (3D variational scheme adapted to the oceanic assimilation problem) with a daily assimilation cycle of sea level anomaly and vertical profiles of temperature and salinity. The model has a non-linear explicit free surface and it is forced by surface pressure, interactive heat, momentum and water fluxes at the air-sea interface. The biogeochemical analysis and forecasts are produced by means of the MedBFM v2.1 modeling system (i.e. the physical-biogeochemical OGSTM-BFM model coupled with the 3DVARBIO assimilation scheme) forced by the outputs of the Med-Physics product. Seven days of analysis/hindcast and ten days of forecast are bi-weekly produced on Wednesday and on Saturday, with the assimilation of surface chlorophyll concentration from satellite observations. In-situ data are mainly used to estimate model uncertainty at different spatial scales. The Med-Waves modelling system is based on the WAM Cycle 4.5.4 wave model code. It consists of a wave model grid covering the Mediterranean Sea at a 1/24° horizontal resolution, nested to a North Atlantic grid at a 1/6° resolution. The system is forced by ECMWF winds at 1/8°. Refraction due to surface currents is accounted by the system which assimilates altimeter along-track significant wave height observations. On a daily basis, it provides 1-day analysis and 5-day forecast hourly wave parameters. Currently, wave buoy observations of significant wave height and mean wave period along with satellite observations are used to calibrate and validate the Med-waves modelling system.PublishedHalifax, Nova Scotia, Canada4A. Oceanografia e clim