Guest editorial

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An Integrated Decision Support Toolbox (DST) for the Management of Mountain Protected Areas

New tools and methodologies are required in systemic planning and management of mountain protected areas. Among others we propose here a decision support toolbox (DST) conceived as an integrated collection of both soft and hard system methodologies, consisting of participatory and computer-based modules to provide a set of integrated, self-contained tools and approaches to support decision-making processes in the management of mountain protected areas. The Sagarmatha National Park and Buffer Zone (SNPBZ) in Nepal was taken as a pilot case. A number of participatory exercises such as participatory 3-dimensional modeling, scenario planning, and qualitative modeling were carried out to understand social-ecological processes and generate a systemic view over space and time. The qualitative models were then converted into computer-based system dynamics models. The design and development of DST software were carried out with an incremental and modular approach. This process involved stakeholder analysis and decision-making processes through a series of consultations. The software was developed with the main modules including scenario analysis, spatial analysis, and knowledge base. The scenario analysis module runs system dynamics models built in Simile software and provides functions to link them with spatial data for model inputs and outputs. The spatial analysis module provides the basic geographic information system functions to explore, edit, analyze, and visualize spatial information. The knowledge base module was developed as a metadata management system for different categories of information such as spatial data, bibliography, research data, and models. The development of DST software, especially system dynamics modeling and its linkage with spatial components, provided an important methodological approach for spatial and temporal integration. Furthermore, training and interactions with park managers and concerned stakeholders showed that DST is a useful platform for integrating data and information and better understanding ecosystem behavior as a basis for management decisions

Glacier surface-area changes in Sagarmatha national park, Nepal, in the second half of the 20th century, by comparison of historical maps

AbstractWe investigate variations in the surface area of glaciers in Sagarmatha national park, Nepal, during the second half of the 20th century through comparison of a map applicable to the late 1950s with the official map of Nepal in the early 1990s. The comparison reveals a slight overall decrease in glacier area (by 4.9%, from 403.9 to 384.6 km2), a result which, though potentially subject to errors arising from cartographic interpretation, is in line with the area reductions found by other studies of Asian glaciers. We find that the areas of some individual glaciers, the largest situated at higher altitudes, increased during the study period. This was most apparent for the glaciers oriented to the south, with the increase occurring mainly in the glacier accumulation zones while the fronts tended to recede. Meanwhile, the smaller glaciers, situated lower and on steep basins, experienced a reduction. For the smaller glaciers, the sections most affected by change were the accumulation zones, and these glaciers showed a tendency for the front to advance. In this region there is a lack of climate data for high altitudes. Nevertheless, observations from stations situated around the park suggest that, alongside temperature variations which are often considered the primary factor eliciting glacier response, changes in precipitation play a significant role

Prevalence and prevention of venous thromboembolism in patients with acute exacerbations of COPD

Abstract BACKGROUND: Little information exists on the prevalence and prevention of deep vein thrombosis (DVT) and pulmonary embolism (PE) in patients admitted for acute exacerbations of chronic obstructive pulmonary disease (COPD). OBJECTIVE: To review available literature, we performed a Medline search on papers published on this topic between 1966 and 2003. DATA SYNTHESIS: Pulmonary emboli have been frequently found (up to 30% of cases) in autoptic series that included patients who died from acute exacerbation of COPD, while the real incidence of PE during exacerbation has never been prospectively evaluated by large-scale clinical studies. Diagnosis of concomitant PE in these patients is often missed because symptoms of acute exacerbation of COPD may mimic PE, and non-invasive evaluation by pulmonary scintigraphy or CT scan is less specific. Even if not fatal, undetected and untreated PE may lead to long-term morbidity from pulmonary hypertension and predispose to recurrent venous thromboembolism (VTE). DVT of the lower extremities affects about 10% of patients with acute exacerbation of COPD at admission, but the rate is likely to be underestimated. The results of clinical trials conducted on general medical patients, including COPD patients, indicate that unfractionated heparin (UH) and low molecular weight heparin (LMWH) significantly reduce VTE rates. However, subgroup data on COPD patients are generally not available. In a single randomised, controlled trial specifically conducted on COPD patients, nadroparin reduced the rate of DVT from 28% to 15% without affecting mortality. CONCLUSIONS: Despite a substantial lack of consistent data, VTE appears as a major threat to patients admitted for acute exacerbation of COPD, and pharmacologic prophylaxis should be considered in all high risk situations. However, methodologically rigorous studies in this setting are still needed

Climate change and water abstraction impacts on the long-term variability of water levels in Lake Bracciano (Central Italy): A Random Forest approach

Abstract Study Region Lake Bracciano has been historically used as a strategic water reservoir for the city of Rome (Italy) since ancient times. However, following the severe water crisis of 2017, water abstraction has been completely stopped. Study Focus The relative impact of the various drivers of change (climatological and management) on fluctuations in lake water level is not yet clear. To quantify this impact, we applied the Random Forest (RF) machine learning approach, taking advantage of a century of observations. New Hydrological Insights for the Region Since the late 1990s the monthly variation in lake water levels has doubled, as has variation in monthly abstraction. Increased variation in annual cumulated precipitation and a rise in mean air temperature have also been observed. The RF machine learning approach made it possible to confirm the marginal role of temperature, the increasing role of abstraction during the last two decades (from 24 % to 39 %), and the key role played by the increased precipitation variability. These results highlight the notable prediction and inference capabilities of RF in a complex and partially unknown hydrological context. We conclude by discussing the limits of this approach, which are mainly associated with its capacity to generates scenarios compared to physical based models

Preimplantation biopsy predicts delayed graft function, glomerular filtration rate and long-term graft survival of transplanted kidneys

Background The predictive value of preimplantation biopsies for long-term graft function is often limited by conflicting results. The aim of this study was to evaluate the influence of time-zero graft biopsy histological scores on early and late graft function, graft survival and patient survival, at different time points. Methods We retrospectively analyzed 284 preimplantation biopsies at a single center, in a cohort of recipients with grafts from live and deceased donors (standard and nonstandard), and their impact in posttransplant renal function after a mean follow-up of 7 years (range 1–16). Implantation biopsy score (IBS), a combination score derived from 4 histopathological aspects, was determined from each sample. The correlation with incidence of delayed graft function (DGF), creatinine clearance (1st, 3rd and 5th posttransplant year) and graft and patient survival at 1 and 5 years were evaluated. Results Preimplantation biopsies provided somewhat of a prognostic index of early function and outcome of the transplanted kidney in the short and long term. In the immediate posttransplantation period, the degree of arteriolosclerosis and interstitial fibrosis correlated better with the presence of DGF. IBS values between 4 and 6 were predictive of worst renal function at 1st and 3rd years posttransplant and 5-year graft survival. The most important histological finding, in effectively transplanted grafts, was the grade of interstitial fibrosis. Patient survival was not influenced by IBS. Conclusions Higher preimplantation biopsy scores predicted an increased risk of early graft losses, especially primary nonfunction. Graft survival (at 1st and 5th years after transplant) but not patient survival was predicted by IBS

Forensic considerations on violent parasomnias during lifespan

Nocturnal parasomnias are a group of sleep complex manifestation that don't alter the sleep macrostructure, but when persistent during adulthood may be assume violent aspects with relevant forensic implications about the guiltiness

ADDICTIONS SUBSTANCE FREE DURING LIFESPAN

The addictions substance free is an umbrella definition comprises internet addiction, sexual addiction, gambling pathological, workholism, videogames and computer addiction. Actually, the technological addictions is frequent in young adolescents. The term Digital Natives indicates the children born in an information system of learning and communication different from that of the generations previous. This temporal range was strongly characterized by growing presence of technological communication toolsin daily life. The effects of hyper-exposition to technological tools tend to create a relational virtuality without a body is born,therefore, already within the family ties and during adolescence he moved to the digital socialization network. The technological object it interacts between the adolescent and the world of peers and adults, becoming the facilitator object that as the psychotropic substance, it conveys new modes of communicatio