WorldWideScience

Sample records for externalities case studies

  1. Electricity generation and environmental externalities: Case studies, September 1995

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-09-28

    Electricity constitutes a critical input in sustaining the Nation`s economic growth and development and the well-being of its inhabitants. However, there are byproducts of electricity production that have an undesirable effect on the environment. Most of these are emissions introduced by the combustion of fossil fuels, which accounts for nearly 70 percent of the total electricity generated in the United States. The environmental impacts (or damages) caused by these emissions are labeled environmental ``externalities.`` Included in the generic term ``externality`` are benefits or costs resulting as an unintended byproduct of an economic activity that accrue to someone other than the parties involved in the activity. This report provides an overview of the economic foundation of externalities, the Federal and State regulatory approaches, and case studies of the impacts of the externality policies adopted by three States.

  2. Nanomaterial Case Studies: Nanoscale Titanium Dioxide (External Review Draft)

    Science.gov (United States)

    This draft document presents two case studies of nanoscale titanium dioxide (nano-TiO2) used (1) to remove arsenic from drinking water and (2) as an active ingredient in topical sunscreen. The draft case studies are organized around a comprehensive environmental asses...

  3. ISO 9000 case study: the role of the external consultant.

    Science.gov (United States)

    Nevalainen, D E

    1998-01-01

    Increasingly, blood centers worldwide are turning toward the ISO (International Organization for Standardization) 9000 Quality System Standards to meet regulatory demands of public authorities, competitive demands within their industry, and cost requirements from their customers. The South Texas Blood and Tissue Center is the first blood center in North America to achieve registration to the ISO 9002 Quality System Standards. The role of the external consultant in initiating the process and as a facilitator during the implementation process is examined. To ensure the long-term success and viability of any quality system, it is necessary for an organization to develop and implement its own program. External consultants can assist in many ways, but it is important that their role be a supporting one rather than one of direct implementation.

  4. Externalizing behavior and impulsivity in the children of alcoholics: A case-control study

    Directory of Open Access Journals (Sweden)

    Ayyanar Sugaparaneetharan

    2016-01-01

    Full Text Available Context: Reduced behavioural inhibition, characterized by impulsivity and disruptive behaviour disorders, has been identified as a developmental precursor of alcoholism with a considerable genetic component. Aims: The present study aimed to assess whether children of fathers with alcohol dependence have high impulsivity and externalizing behaviours. Setting and Design: Observational case-control study, done in a tertiary care teaching hospital of Southern India. Materials and Methods: The present case-control study recruited 50 children aged 7 to 14 years of fathers with alcohol dependence and 50 age- and gender-matched children of fathers without alcohol dependence. The two groups were compared using the DSM-IV-TR criteria for ADHD, the Barratt Impulsivity Scale (BIS and the Child Behaviour Checklist (CBCL. Statistical Analysis Used: Descriptive statistics used to summarise the study findings. Cases and controls were compared on BIS and CBCL scores using a general linear model (GLM. All analyses were two tailed and test P value <0.05 was considered significant. Results: The children of fathers with alcohol dependence were more likely to meet criteria for ADHD (30% versus 10%, χ2 = 6.250, P = 0.012. After controlling for age and gender, impulsivity scores on the BIS tended to be higher in the cases (F = 2.410, P = 0.055 than controls, mainly in the non-planning domains (F = 3.650, P = 0.008. Similarly, externalizing behaviours on CBCL were more common in the cases than controls (F = 2.817, P = 0.029. Conclusions: Children of fathers with alcohol dependence had greater impulsivity and externalizing behaviours. This may represent a behavioural phenotype as well as a potential target for early intervention.

  5. Evaluation of a new semiautomated external defibrillator technology: a live cases video recording study.

    Science.gov (United States)

    Maes, Frédéric; Marchandise, Sébastien; Boileau, Laurianne; Le Polain de Waroux, Jean-Benoît; Scavée, Christophe

    2015-06-01

    To determine the effect of a new automated external defibrillator (AED) system connected by General Packet Radio Service (GPRS) to an external call centre in assisting novices in a sudden cardiac arrest situation. Prospective, interventional study. Layperson volunteers were first asked to complete a survey about their knowledge and ability to give cardiopulmonary resuscitation (CPR) and use an AED. A simulated cardiac arrest scenario using a CPR manikin was then presented to volunteers. A telephone and semi-AED were available in the same room. The AED was linked to a call centre, which provided real-time information to 'bystanders' and emergency services via GPRS/GPS technology. The scene was videotaped to avoid any interaction with examiners. A standardised check list was used to record correct actions. 85 volunteers completed questionnaires and were recorded. Mean age was 44±16, and 49% were male; 38 (45%) had prior CPR training or felt comfortable intervening in a sudden cardiac arrest victim; 40% felt they could deliver a shock using an AED. During the scenarios, 56 (66%) of the participants used the AED and 53 (62%) successfully delivered an electrical shock. Mean time to defibrillation was 2 min 29 s. Only 24 (28%) participants dialled the correct emergency response number (112); the live-assisted GPRS AED allowed alerted emergency services in 38 other cases. CPR was initiated in 63 (74%) cases, 26 (31%) times without prompting and 37 (44%) times after prompting by the AED. Although knowledge of the general population appears to be inadequate with regard to AED locations and recognition, live-assisted devices with GPS-location may improve emergency care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  6. External Reporting Lines of Academic Special Libraries: A Health Sciences Case Study

    Science.gov (United States)

    Buhler, Amy G.; Ferree, Nita; Cataldo, Tara T.; Tennant, Michele R.

    2010-01-01

    Very little literature exists on the nature of external reporting lines and funding structures of academic special libraries. This study focuses on academic health sciences libraries. The authors analyze information gathered from statistics published by the Association of Academic Health Sciences Libraries (AAHSL) from 1977 through 2007; an…

  7. Impact of External Debt on Economic Growth: a Case Study of Pakistan

    Directory of Open Access Journals (Sweden)

    Farrukh Shahzad

    2014-12-01

    Full Text Available Since 1980s, the mounting debts and debt payment service of Pakistan due focus and consideration from the Policy makers and economists. This study was additionally done to audit and investigate the effect of external debt overhauling on the development and growth of Pakistan's economy. To hunt the target of research, five variables i.e. Growth, external debt servicing, saving, net export, Foreign Direct Investment were taken to focus their fact association with the GDP or development of the Pakistan's economy. Annual panel data was taken from the source World Bank indicator from the period of 1980 to 2013 and was manipulated through least square multiple regression models. The main variable external debt has significantly negative impact on dependent variable GDP so it’s concluded that Pakistan should go for the option of debt forgiveness and must invite FDI but not much as their overloading may hurt the economy. Adjusting saving (ADS highly significant positive relation with GDP reveals that habit of saving extremely boost up economy growth. Exports is basically good to helping hand for economy so they must be lifted up. The impact of external debt is quite hostile on growth so steps must be taken to abolish it in order to growth of economy.

  8. Increasing Absorptive Capacity to Improve Internal and External Knowledge Transfer in Multinational Companies: A Multiple Case Study Approach

    Directory of Open Access Journals (Sweden)

    Béla-Gergely RÁCZ

    2016-12-01

    Full Text Available This study investigates how the absorptive capacity could be increased to improve internal and external knowledge transfer in subsidiaries of multinational companies. We look at the way in which the literature on absorptive capacity has evolved, and how it links the internal and external knowledge transfer. Based on 3 case studies conducted at Romanian subsidiaries of multinational companies, we find some patterns, which could explain how the successful knowledge flows should be managed within the multinational company and outside of it, in the supply chain network.

  9. Nanomaterial Case Study: Nanoscale Silver in Disinfectant Spray (External Review Draft)

    Science.gov (United States)

    This draft document presents a case study of engineered nanoscale silver (nano-Ag), focusing on the specific example of nano-Ag as possibly used in disinfectant sprays. This case study is organized around a comprehensive environmental assessment (CEA) framework, which combines a ...

  10. Internalizing external environmental costs of agriculture into product prices, Case study for milk and potatoes

    NARCIS (Netherlands)

    Masselink, Dirk Jan

    2007-01-01

    Society has to pay large amounts of money to compensate for the environmental damages caused by farm emissions. These external costs are not fully accounted for in product prices and internalization of these external costs into the cost price of agricultu

  11. BASINS and WEPP Climate Assessment Tools (CAT): Case Study Guide to Potential Applications (External Review Draft)

    Science.gov (United States)

    This draft report supports application of two recently developed water modeling tools, the BASINS and WEPP climate assessment tools. The report presents a series of short case studies designed to illustrate the capabilities of these tools for conducting scenario based assessments...

  12. Effects of External Digital Elevation Model Inaccuracy on StaMPS-PS Processing: A Case Study in Shenzhen, China

    Directory of Open Access Journals (Sweden)

    Yanan Du

    2017-11-01

    Full Text Available External Digital Elevation Models (DEMs with different resolutions and accuracies cause different topographic residuals in differential interferograms of Multi-temporal InSAR (MTInSAR, especially for the phase-based StaMPS-PS. The PS selection and deformation parameter estimation of StaMPS-PS are closely related to the spatially uncorrected error, which is directly affected by external DEMs. However, it is still far from clear how the high resolution and accurate external DEM affects the results of the StaMPS-PS (e.g., PS selection and deformation parameter calculation on different platforms (X band TerraSAR, C band ENVISAT ASAR and L band ALOS/PALSAR1. In this study, abundant synthetic tests are performed to assess the influences of external DEMs on parameter estimations, such as the mean deformation rate and the deformation time-series. Real SAR images, covering Shenzhen city in China, are also selected to analyze the PS selection and distribution as well as to validate the results of synthetic tests. The results show that the PS points selected by the 5 m TanDEM-X DEM are 10.32%, 4.25% and 0.34% more than those selected by the 30 m SRTM DEM at X, C and L bands SAR platforms, respectively, when a multi-look geocoding operation is adopted for X band in the SRTM DEM case. We also find that the influences of external DEMs on the mean deformation rate are not significant and are inversely proportional to the wavelength of the satellite platforms. The standard deviations of the mean deformation rate difference for the X, C and L bands are 0.54, 0.30 and 0.10 mm/year, respectively. Similarly, the influences of external DEMs on the deformation time-series estimation for the three platforms are also slight, except for local artifacts whose root-mean-square error (RMSE ≥ 6 mm. Based on these analyses, some implications and suggestions for external DEMs on StaMPS-PS processing are discussed and provided.

  13. External ophthalmomyiasis caused by Dermatobia hominis. A retrospective study of nine cases and a review of the literature.

    Science.gov (United States)

    Denion, Eric; Dalens, Pierre-Henri; Couppié, Pierre; Aznar, Christine; Sainte-Marie, Dominique; Carme, Bernard; Petitbon, Jean; Pradinaud, Roger; Gérard, Max

    2004-10-01

    To report nine cases of external ophthalmomyiasis caused by Dermatobia hominis. Retrospective, non-comparative, interventional case series. Participants consisted of patients (n = 9) presenting at Cayenne Hospital between 1968 and 2003. The location and number of larvae, the larval stage, and the medical and surgical procedures applied were studied in each case. Seven patients had palpebral myiasis (including one with three larvae) and two had conjunctival myiasis. Every patient had palpebral oedema. The larval respiratory pore was located on the palpebral skin or free margin or on the conjunctiva. Movements were present within the lesion in at least three patients. Petroleum ointment or ivermectine solution was used in at least four patients to smother or kill the larvae. Extraction under local anaesthesia was possible in six patients, while three required general anaesthesia. Several larvae may be present in a patient. Topical ivermectine may help to kill the larvae before extraction is attempted.

  14. External change and its impact on nurse management: a case study.

    Science.gov (United States)

    Tilley, H; Tilley, I G

    1999-01-01

    This paper sets out to identify major changes in the tasks and responsibilities of the nurse manager at a small postgraduate unit in central London as it and its parent hospital group became subject to major changes in the policy and financial environment. What happened to the nurse manager's function could well make transparent some of the important changes still affecting nurse management more generally today. The article adds to the somewhat meagre academic literature which considers the middle management role in nursing. The paper is based on a single yet detailed case study and the data were gathered by one of the authors over the period of change. The pros and cons of the dual researcher/participant role need to be considered along with the possibly wider significance of the case study. The overriding conclusion is that nurse management in the specialist unit is evolving from a classic bureaucratic mode in which managerial authority, information and decision making were highly centralized to a much more devolved set of arrangements. Clearly a host of factors--e.g. the culture and history of the organization, and the personality types of the key players--could affect such change. However, this article concentrates on showing how the earlier, more centralized style was increasingly problematic in the rapidly changing circumstances faced by the unit. In understanding the wider significance of this particular case study, it seems important to understand the strengths and weaknesses of the methodology. If such changes in nurse management are widespread, they represent a new era for nursing in action and one perhaps more consonant with a profession whose status is being enhanced by developments such as diploma and graduate education and the development of specialist roles.

  15. The impact of external costs in transport. Case study in maritime transport

    OpenAIRE

    Cristea Viorela-Georgiana; Dragan Cristian; Berescu Serban

    2014-01-01

    It is clear that transport costs are an important element which influence the final cost of a product, due to the fact that they represent a more complex area than in many other industries. Beside the internal costs (time and operation), representing costs incurred by individuals or operators for providing services required by the market, the external costs, which were seriously taken in consideration in the last few years, are considered to be a negative impact of transport. Thru this paper ...

  16. External cost internalisation of urban transport: a case study of Dublin.

    Science.gov (United States)

    Gibbons, E; O'Mahony, M

    2002-04-01

    Transport users do not currently pay all costs associated with their transport activities and in particular do not pay the costs they impose on the environment. Case studies on Dublin, Amsterdam, Brussels and London have been conducted to evaluate how best to meet the requirement of the European Commission in its fair and efficient pricing aims in the transport sector, i.e. where transport users are made to pay all costs they impose. The paper presents the results of Do Nothing (DN) and Do Something (DS) scenarios for 2005 where in the latter case each transport user pays for all costs they impose including pollution, noise, accidents etc. The Dublin results, from an economics model used in the study, are examined in detail; the findings are compared with those of parallel studies conducted in the other cities to demonstrate the international relevance of this work. The comparison between the DN and DS scenarios indicates that taxes on all transport modes should be increased substantially, particularly in the morning and evening peak periods. As a result of the price increases, travel demand is reduced. A practical example where transport users could be made to pay for all their costs is road use pricing, i.e. charging individuals for the use of road space. The taxation levels suggested in the DS scenario have been used in a road use pricing trial in Dublin, the results of which were published in O'Mahony, Geraghty and Humphreys (Transportation 27, 269-283, 2000), to see if the reductions in the travel requirements of individuals proposed by the economics model are in fact true. The principles of the work presented in this paper are not only relevant to environmental impact management in the transport sector but can also be applied to other sectors.

  17. Statistical external validation and consensus modeling: a QSPR case study for Koc prediction.

    Science.gov (United States)

    Gramatica, Paola; Giani, Elisa; Papa, Ester

    2007-03-01

    The soil sorption partition coefficient (log K(oc)) of a heterogeneous set of 643 organic non-ionic compounds, with a range of more than 6 log units, is predicted by a statistically validated QSAR modeling approach. The applied multiple linear regression (ordinary least squares, OLS) is based on a variety of theoretical molecular descriptors selected by the genetic algorithms-variable subset selection (GA-VSS) procedure. The models were validated for predictivity by different internal and external validation approaches. For external validation we applied self organizing maps (SOM) to split the original data set: the best four-dimensional model, developed on a reduced training set of 93 chemicals, has a predictivity of 78% when applied on 550 validation chemicals (prediction set). The selected molecular descriptors, which could be interpreted through their mechanistic meaning, were compared with the more common physico-chemical descriptors log K(ow) and log S(w). The chemical applicability domain of each model was verified by the leverage approach in order to propose only reliable data. The best predicted data were obtained by consensus modeling from 10 different models in the genetic algorithm model population.

  18. [Pain flare following palliative external beam radiotherapy: Prospective study of 41 cases].

    Science.gov (United States)

    Lachgar, A; Sahli, N; Benjaafar, N

    2017-08-01

    Radiotherapy plays a major role in relieving pain caused by bone metastases; paradoxically initial flare of symptom is common. Our objectives were to assess prospectively the incidence, and to identify predictor's factors of this acute complication. Forty-one patients treated with analgesic external beam radiotherapy were followed prospectively. Patients recorded pain severity and analgesic intake was documented. Pain flare was defined as an increase of two points in the intensity of pain on the numerical scale with no reduction in analgesic intake and/or 25% increase of the analgesic intake without decreasing pain intensity. Primary cancer was the breast, lung and prostate in 49%, 29% and 22% of patients respectively. Twelve patients (29%) had a pain flare. No factor was significantly associated with the occurrence of this complication. A favorable analgesic response was observed in 27 patients. The pain flare was not related to subsequent analgesic response. Radiotherapy is an effective treatment of pain related to bone metastasis, but with a high incidence of painful exacerbation. Copyright © 2017 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  19. Minimizing external indirect health costs due to aerosol population exposure: a case study from Northern Italy.

    Science.gov (United States)

    Carnevale, Claudio; Finzi, Giovanna; Pisoni, Enrico; Volta, Marialuisa

    2011-12-01

    Environmental Agencies require Decision Support Systems, in order to plan Air Quality Policies considering the cost of emission reduction measures and the human health effects (with related social costs). The use of Decision Support Systems is also useful to spread information to general public, explaining the effectiveness of proposed air quality plans. In this paper, a multi-objective approach to control PM10 concentration at a regional level is presented. The problem considers both the internal costs (due to the implementation of emission reduction measures) and the external costs (due to population exposure to high PM10 concentrations). To model PM10 concentrations, a single surrogate model is used for the entire domain, allowing the implementation of a very efficient optimization procedure. The surrogate model is derived through a set of 10 simulations, performed using a Chemistry Transport Model fed with different emission reduction scenarios. The methodology is applied to Northern Italy, a region affected by very high PM10 concentrations that exceed the limit values specified by the EU legislation. Copyright © 2011 Elsevier Ltd. All rights reserved.

  20. HD 106906: A Case Study for External Perturbations of a Debris Disk

    Science.gov (United States)

    Nesvold, Erika R.; Naoz, Smadar; Fitzgerald, Michael P.

    2017-03-01

    Models of debris disk morphology are often focused on the effects of a planet orbiting interior to or within the disk. Nonetheless, an exterior planetary-mass perturber can also excite eccentricities in a debris disk, via Laplace-Lagrange secular perturbations in the coplanar case or Kozai-Lidov perturbations for mutually inclined companions and disks. HD 106906 is an ideal example of such a a system, as it harbors a confirmed exterior 11 {M}{Jup} companion at a projected separation of 650 au outside a resolved, asymmetric disk. We use collisional and dynamical simulations to investigate the interactions between the disk and the companion, and to use the disk’s observed morphology to place constraints on the companion’s orbit. We conclude that the disk’s observed morphology is consistent with perturbations from the observed exterior companion. Generalizing this result, we suggest that exterior perturbers, as well as interior planets, should be considered when investigating the cause of observed asymmetries in a debris disk.

  1. Extra-axial cerebrospinal fluid spaces in children with benign external hydrocephalus: A case-control study.

    Science.gov (United States)

    Hussain, Zaamin B; Hussain, Amaani B; Mitchell, Patrick

    2017-10-01

    Background The distinction between normal and pathological extra-axial cerebrospinal fluid (CSF) spaces is unclear, with the use of the term benign external hydrocephalus (BEH) not being well defined in clinical practice. This study aimed to establish a distribution of metrics of the subarachnoid space in a population of children diagnosed as normal, and investigate the clinical use of the term BEH. Methods A retrospective case-control study on magnetic resonance image scans was performed on 150 children diagnosed as normal and 10 children diagnosed with BEH. Measurements were taken in the axial plane for CSF width (CSFW), and interhemispheric width (IHW). Results Normal controls had a mean age of 11.1 ± 7.6 months (78 male, 72 female) and the BEH sample had a mean age of 10.6 ± 7.8 months (six male, four female). Mean CSFW was 7.96 ± 4.79 mm in the BEH sample compared to 4.58 ± 2.25 mm in the normal sample ( p < 0.05). Mean IHW was 6.30 ± 2.79 mm in the BEH sample compared to 3.89 ± 1.83 mm in the normal sample ( p < 0.05). However, a substantial overlap between the two distributions of CSFW was found, with 50% of BEH patients lying within a single standard deviation of the mean of normal individuals. Conclusion The absence of diagnostic criteria for BEH means reporting is variable. Patients being diagnosed with BEH who have no other clinical defects may represent the extreme of the normal population rather than a distinct clinical entity.

  2. External And Internal Work Of A T-6 Paraplegic Propelling A Wheelchair And Arm Cranking A Cycle Ergometer: Case Study

    Science.gov (United States)

    Novak, Charles W.

    1982-02-01

    In this, the International Year of the Disabled, attention is directed among other areas toward rehabilitation and sports participation of wheelchair users. As an application of movement analysis in medicine and rehabilitation and as an application of sports research using biomechanics, this investigation was performed to compare the results of two methods of gathering data on the stress of wheelchair propelling at equivalent work loads and to account for differences in physiological responses with a mechanical analysis of wheelchair propelling. Physiological data collected were heart rate, systolic blood pressure, and rate-pressure product. A biomechanical cinematography analysis was used to determine external work in wheelchair propelling and to determine the extent to which modifications in segment actionsoccurred during increasing magnitude of work. A cycle ergometer was adjusted to replicate external work loads performed during wheelchair propelling. A t-test of equivalent external work loads indicated that heart rate was not different between the two exercise modes at the .05 level of significance. The t-test did indicate a significant difference in systolic blood pressure and rate-pressure product at the .05 level of significance. The biomechanical analysis of wheelchair propelling established that an increase in external work was accomplished by a decrease in the range of motion and an increase in the speed of movement. During cycle ergometry the range and speed of movement remained the same while resistance was increased. Results of the study established that while heart rate for equivalent external work loads was the same for wheelchair propelling and arm cranking cycle ergometry, systolic blood pressure and rate-pressure product were not the same. The suggestion was that some means of propelling a wheelchair other than that which is con-sidered "standard" might be considered which produces less stressful responses in wheelchair users.

  3. A Rare Conjunctivitis Case: External Ophthalmomyiasis

    Directory of Open Access Journals (Sweden)

    Murat Köksal

    2014-08-01

    Full Text Available Oestrus ovis is the most common cause of external ophthalmomyiasis. This infection typically occurs in shepherds and farmers in rural areas. Ophthalmomyiasis occurs usually during spring or summer. It is often misdiagnosed as acute viral or allergic conjunctivitis. The definitive diagnosis is based on the detection of oestrus ovis larvae at clinical examination. In our country, this infection should be kept in mind by ophthalmologist in unilateral cases of conjunctivitis. (Turk J Ophthalmol 2014; 44:316-8

  4. Organizational Adaptation to the Rapidly Changing External Environment: A Case Study of Strategic Marketing at Notre Dame College in Ohio

    Science.gov (United States)

    Brown, Shawn M.

    2012-01-01

    This thesis examined the role of strategic marketing in organizational adaptation to a rapidly changing and competitive external environment among institutions of higher education. Colleges and universities adapt to external pressures as open systems operating within a broader external environment (Bess & Dee, 2008; Keller, 1983). How does…

  5. On the applicability of analysis of internal and external factors: A case study of Imam Khomeini Relief Foundation in Ardabil

    Directory of Open Access Journals (Sweden)

    Houshang Sharifi Namin

    2015-03-01

    Full Text Available Recognition and prioritization of environmental factors affecting the performance of organizations is one of the most important steps in developing long-term plans and organizational strategies. The present study investigates the current status of head office of Ardabil Imam Khomeini Relief Foundation through analyzing internal and external environmental factors. To this end, a sequential mixed method design was used for collecting, analyzing, and interpreting research question. Sixty-eight employees participated in the study. This study was carried out through a survey method using research-made questionnaire and interview as the main instruments. The results demonstrated that Ardabil Imam Khomeini Relief Foundation had some strengths and weaknesses regarding internal and external environmental factors and this organization appeared to have relatively good position considering organization’s internal factors which were supposed to affect it. The findings of the study showed that Ardabil Imam Khomeini Relief Foundation can overcome and neutralize some of its organizational threats and weaknesses using the current organizational opportunities and strengths and applying strategic planning.

  6. Measuring the Externality Effects of Commercial Land Use on Residential Land Value: A Case Study of Seoul

    Directory of Open Access Journals (Sweden)

    Hee Jin Yang

    2016-04-01

    Full Text Available Two contrasting theories purport to explain the effects of neighborhood non-residential use on residential property values. In traditional zoning theory, separating land from commercial land use is considered to protect residential environments from negative externalities such as noise, litter, and congestion. By contrast, contemporary planning principles including Smart Growth emphasize positive impacts of mixed land use on residential environment, which lead to more walkable and sustainable communities. This study attempts to empirically investigate how positive and negative externalities of commercial land use, referred to as “proximity effects” and “disamenity effects” respectively, affect residential land values. Using data gathered in Seoul, we pay attention to two particular aspects of commercial land use: spatial concentration and neighborhood scale. Spatial concentration is determined by the number of commercial employees present in the buffer zone around an individual residential parcel. We model four geographically distinct neighborhood scales as we compare spatial concentrations in and across commercial zones. Quadratic regression analyses of our data show the trade-off relationship that a higher spatial concentration of commercial land use in a neighborhood initially results in increased residential land values, but drops off beyond a threshold level by excessive noise or crowding.

  7. Assessing sustainability of low-external-input farm management systems with the nutrient monitoring approach: a case study in Kenya

    NARCIS (Netherlands)

    Jager, de A.; Onduru, D.; Wijk, van M.S.; Vlaming, J.; Gachini, G.N.

    2001-01-01

    In the search for Integrated Nutrient Management practices in response to the widely observed soil fertility decline in Sub-Saharan Africa, the potential of low-external-input and organic farming remains to be systematically examined. The nutrient monitoring concept was used to assess the impact of

  8. Monetization of External Costs Using Lifecycle Analysis—A Comparative Case Study of Coal-Fired and Biomass Power Plants in Northeast China

    OpenAIRE

    Lingling Wang; Tsunemi Watanabe; Zhiwei Xu

    2015-01-01

    In this study, the structures of external costs are built in line with coal-fired and biomass power plant life cycle activities in Northeast China. The external cost of coal-fired and biomass power plants was compared, using the lifecycle approach. In addition, the external costs of a biomass power plant are calculated for each stage for comparison with those of a coal-fired power plant. The results highlight that the external costs of a coal-fired plant are 0.072 US $/kWh, which are much hig...

  9. Unilateral external ophthalmoplegia in Miller Fisher syndrome: case report

    Directory of Open Access Journals (Sweden)

    Severn Philip

    2007-04-01

    Full Text Available Abstract Background A description of the diagnostic features of Miller Fisher syndrome. Case presentation The clinical presentation, investigation, and subsequent progress of our patient with clinical unilateral external ophthalmoplegia. Conclusion Our case demonstrates the presentation of clinical unilateral external ophthalmoplegia as part of the full triad of Miller Fisher syndrome.

  10. [Case-control study on close reduction and plaster slab fixation combined with plaster external traction for the treatment of pediatric Gartland type III supracondylar humerus fractures].

    Science.gov (United States)

    Kang, Yu-Xiang; Wei, Xiao-Chun; Li, Hai-Ming

    2014-07-01

    To compare the therapeutic effects between close reduction and plaster slab fixation combined with plaster external traction and operation for the treatment of pediatric closed Gartland type III supracondylar humerus fractures without neurovascular injury complications. From June 2009 to June 2012, 151 children with closed Gartland III supracondylar humerus fractures were retrospectively studied and divided into two groups, including 87 boys and 64 girls, ranging in age from 1 to 12 years old with an average of 5.3 years old. Among them, 76 children (conservative group) were treated with close reduction and plaster slab fixation combined with plaster external traction; 75 children (operation group) underwent surgical operation. The time of elbow joint function exercise, the healing time of fracture, the function recovery of elbow joint and carrying angle was recorded and analyzed. The therapeutic effects were evaluated by the Flynn criteria system. All patients were followed up from 6 to 36 months (18.3 months on average). The average time of fracture healing and elbow joint functional exercise of the conservative group was shorter than those of operation group (P 0.05). According to Flynn criteria system, in conservative group, the result was excellent in 31 cases, good in 35, fair in 7, and poor in 3; in operation group, 27 in excellent, 30 in good, 17 in fair and 1 in poor; there was no significant difference between two groups in therapeutic effects (P > 0.05). Close reduction and plaster slab fixation combined with plaster external traction in treatment of pediatric closed Gartland type III supracondylar humerus fractures without neurovascular injury complications,which has similar effect to surgical treatment, and the time of fracture healing and elbow joint function exercise are significantly shorter.

  11. Monetization of External Costs Using Lifecycle Analysis—A Comparative Case Study of Coal-Fired and Biomass Power Plants in Northeast China

    Directory of Open Access Journals (Sweden)

    Lingling Wang

    2015-02-01

    Full Text Available In this study, the structures of external costs are built in line with coal-fired and biomass power plant life cycle activities in Northeast China. The external cost of coal-fired and biomass power plants was compared, using the lifecycle approach. In addition, the external costs of a biomass power plant are calculated for each stage for comparison with those of a coal-fired power plant. The results highlight that the external costs of a coal-fired plant are 0.072 US $/kWh, which are much higher than that of a biomass power plant, 0.00012 US$/kWh. The external cost of coal-fired power generation is as much as 90% of the current price of electricity generated by coal, while the external cost of a biomass power plant is 1/1000 of the current price of electricity generated by biomass. In addition, for a biomass power plant, the external cost associated with SO2, NOX, and PM2.5 are particularly lower than those of a coal-fired power plant. The prospect of establishing precise estimations for external cost mechanisms and sustainable energy policies is discussed to show a possible direction for future energy schemes in China. The paper has significant value for supporting the biomass power industry and taxing or regulating coal-fired power industry to optimize the energy structure in China.

  12. Predictors of Cephalic Vaginal Delivery Following External Cephalic Version: An Eight-Year Single-Centre Study of 447 Cases.

    Science.gov (United States)

    Kew, Natalie; DuPlessis, Jacobus; La Paglia, Domenic; Williams, Katherine

    2017-01-01

    Introduction. Our study aims to investigate and evaluate (1) rates of success of ECV for breech presentation at term at the Royal Women's Hospital in comparison to international standards; (2) mode of delivery following ECV; (3) factors influencing success rates of ECV at the Royal Women's Hospital. Methods. An audit of all women who underwent ECV between the years 2007 and 2014 at the Royal Women's Hospital as public patients was completed. Data parameters were collected from paper and electronic patient files at the Women's Hospital. Data was collected to analyse the effect of the following parameters on ECV success and birth outcome: age, parity, gestational age, BMI, AFI, and tocolytic use. These parameters were analysed to determine their effect on ECV outcome and birth outcome. Results. The Women's Hospital, Melbourne, has an ECV success rate of approximately 37%. Of the patients undergoing ECV, 29% proceeded to normal vaginal delivery. Predictors of successful ECV included low BMI, multiparity, and AFI more than 16 (P ECV was multiparity. Negative predictors of cephalic delivery were low AFI and nulliparity. Conclusions. The success rate of ECV at the Women's Hospital, Melbourne, is in line with global standards.

  13. Predictors of Cephalic Vaginal Delivery Following External Cephalic Version: An Eight-Year Single-Centre Study of 447 Cases

    Directory of Open Access Journals (Sweden)

    Natalie Kew

    2017-01-01

    Full Text Available Introduction. Our study aims to investigate and evaluate (1 rates of success of ECV for breech presentation at term at the Royal Women’s Hospital in comparison to international standards; (2 mode of delivery following ECV; (3 factors influencing success rates of ECV at the Royal Women’s Hospital. Methods. An audit of all women who underwent ECV between the years 2007 and 2014 at the Royal Women’s Hospital as public patients was completed. Data parameters were collected from paper and electronic patient files at the Women’s Hospital. Data was collected to analyse the effect of the following parameters on ECV success and birth outcome: age, parity, gestational age, BMI, AFI, and tocolytic use. These parameters were analysed to determine their effect on ECV outcome and birth outcome. Results. The Women’s Hospital, Melbourne, has an ECV success rate of approximately 37%. Of the patients undergoing ECV, 29% proceeded to normal vaginal delivery. Predictors of successful ECV included low BMI, multiparity, and AFI more than 16 (P<0.05. The only predictor of cephalic vaginal delivery following ECV was multiparity. Negative predictors of cephalic delivery were low AFI and nulliparity. Conclusions. The success rate of ECV at the Women’s Hospital, Melbourne, is in line with global standards.

  14. External ophthalmomyiasis by Oestrus ovis: A case report from Davangere

    Directory of Open Access Journals (Sweden)

    Sridhar Rao

    2018-01-01

    Full Text Available External ophthalmomyiasis is an infestation of the eye with larvae of Dermatobia hominis or Oestrus ovis (sheep bot fly. We describe a case of ophthalmomyiasis in a 38-year-old male, who presented with ocular foreign body sensation, redness, pain, and watering of the eye. The causative larvae were removed and sent to the laboratory for identification. By studying morphological features, it was identified as the first instar larvae of O. ovis. The patient was put on topical and oral antibiotics but was lost to follow-up. This is probably the first report from this part of Karnataka.

  15. Melanoacanthoma of external ear: Report of two cases

    Directory of Open Access Journals (Sweden)

    Rashmi Patnayak

    2013-01-01

    Full Text Available Melanoacanthoma is a rare lesion. Melanoacanthoma of external ear is still rarer . We present two cases of melanoacanthoma of external ear in adults which presented as pigmented growths and clinically were suspected as malignant lesions. Histopathology was diagnostic as it demonstrated the characteristic elevated lesion with abundant melanin pigment. No recurrence of the lesion was reported after four years of initial diagnosis. These cases have been presented because of their uncommon location, highlighting the differential diagnoses.

  16. Two Unusual Cases of External Rotator Muscle Pathology ...

    African Journals Online (AJOL)

    Two unusual cases of inflammation of the external rotator muscles of the hip are presented. In each case, the patient presented with acute hip pain. The diagnoses of acute calcific periarthritis involving the gluteus medius muscle, and pyomyositis of the obturator internus muscle secondary to a perianal fistula, were made ...

  17. Two unusual cases of external rotator muscle pathology producing ...

    African Journals Online (AJOL)

    2015-05-08

    May 8, 2015 ... Two unusual cases of inflammation of the external rotator muscles of the hip are presented. In each case, the patient presented with acute hip pain. The diagnoses of acute calcific periarthritis involving the gluteus medius muscle, and pyomyositis of the obturator internus muscle secondary to a perianal ...

  18. Cutaneous human papillomavirus types detected on the surface of male external genital lesions: A case series within the HPV Infection in Men Study

    Science.gov (United States)

    Pierce Campbell, Christine M.; Messina, Jane L.; Stoler, Mark H.; Jukic, Drazen M.; Tommasino, Massimo; Gheit, Tarik; Rollison, Dana E.; Sichero, Laura; Sirak, Bradley A.; Ingles, Donna J.; Abrahamsen, Martha; Lu, Beibei; Villa, Luisa L.; Lazcano-Ponce, Eduardo; Giuliano, Anna R.

    2013-01-01

    Background Cutaneous human papillomaviruses (HPVs) may be associated with cutaneous epithelial lesions and non-melanoma skin cancers. No study has systematically evaluated the presence of genus beta [β]-HPV in male genital skin or external genital lesions (EGLs). Objectives To examine cutaneous β-HPV types detected on the surface of EGLs in men and describe their presence prior to EGL development. Study design A retrospective case series was conducted among 69 men with pathologically confirmed EGLs (n=72) who participated in the HPV Infection in Men Study. Archived exfoliated cells collected from the surface of each EGL and normal genital skin specimens 6–12 months preceding EGL development were tested for β-HPV DNA using a type-specific multiplex genotyping assay. Results β-HPV DNA was detected on 61.1% of all EGLs, with types 38 (16.7%), 5 (15.3%), and 12 (12.5%) most commonly identified. HPV prevalence differed across pathological diagnoses, with the largest number of β-HPV types detected on condylomas. Most β-HPV types were detected on normal genital skin prior to EGL development, though the prevalence was lower on EGLs compared to preceding normal genital skin. Conclusions EGLs and the normal genital skin of men harbor a large number of β-HPV types; however, it appears that β-HPVs are unrelated to EGL development in men. Despite evidence to support a causal role in skin carcinogenesis at UVR-exposed sites, cutaneous HPV appears unlikely to cause disease at the UVR-unexposed genitals. PMID:24210970

  19. Effect of external airflow resistive load on postural and exercise-associated cardiovascular and pulmonary responses in pregnancy: a case control study.

    Science.gov (United States)

    Kim, Jung-Hyun; Roberge, Raymond J; Powell, Jeffrey B

    2015-02-22

    Facial coverings (e.g., balaclavas, niqabs, medical/surgical masks, respirators, etc.), that impose low levels of airflow resistive loads, are worn by millions of pregnant women worldwide, but little data exist addressing their impact on pregnancy-associated cardiovascular and pulmonary responses. 16 pregnant and 16 non-pregnant women were monitored physiologically (heart rate, blood pressure, mean arterial pressure, total peripheral resistance, stroke volume, cardiac output, oxygen saturation, transcutaneous carbon dioxide, fetal heart rate) and subjectively (exertion) for 1 h of mixed sedentary postural activity (sitting, standing) and moderate exercise (bicycle ergometer) with and without wearing N95 filtering facepiece respirators with filter resistive loads of 94.1 Pa (9.6 mm H2O) - 119.6 Pa (12.2 mm H2O) pressure. The external airflow resistive loads were associated with increases in diastolic pressure (p = 0.004), mean arterial pressure (p = 0.01), and subjective exertion score (p external resistive loads between the pregnant and non-pregnant groups for any cardiovascular, pulmonary and subjective variable over 1 h. Low external airflow resistive loads, during combined sedentary postural activity and moderate exercise over 1 h, were associated with increases in the diastolic and mean arterial pressures of all study subjects, but pregnancy itself was not associated with any significant differences in physiologic or subjective responses to the external airway resistive loads utilized in the study.

  20. LCP external fixation--external application of an internal fixator: two cases and a review of the literature.

    Science.gov (United States)

    Woon, Colin Yi-Loong; Wong, Merng-Koon; Howe, Tet-Sen

    2010-03-20

    The locking compression plate (LCP) is an angle-stable fixator intended for intracorporeal application. In selected cases, it can be applied externally in an extracorporeal location to function as a monolateral external fixator. We describe one patient with Schatzker V tibial plateau fracture and one patient with Gustillo IIIB open tibia shaft fracture treated initially with traditional external fixation for whom exchange fixation with externally applied LCPs was performed. The first case went on to bony union while the second case required bone grafting for delayed union. Both patients found that the LCP external fixators facilitated mobilization and were more manageable and aesthetically acceptable than traditional bar-Schanz pin fixators.

  1. [Case-control study on T-shaped locking internal fixation and external fixation for the treatment of dorsal Barton's fracture].

    Science.gov (United States)

    Chen, Huan-qing; Wen, Xi-le; Li, Yang-ming; Wen, Cong-you

    2015-06-01

    To compare clinical effect of T-shaped locking internal fixation and external fixation in treating dorsal Barton's fracture,and investigate selective strategy of internal fixation. From January 2008 to January 2013, 100 patients with dorsal Barton's fracture were randomly divided into two groups. In treatment group, there were 30 males and 20 females with an average age of (33.8±3.6) years old;30 cases were type B, 20 cases were type C;and treated with T-shaped locking internal fixation. In control group, there were 32 male and 18 females with an average age of (32.9±3.4) years old; 29 cases were type B, 21 cases were type C; and treated with external fixation. Volar tilt, ulnar deviation and radial height at 3 months after operation were detected and compared between two groups. Mechara functional evaluation were used to evaluate postoperative clinical effects. Clinical cure time, postoperative complications,joint mobility and function score were recorded and compared between two groups. In treatment group,volar tilt was (11.9±2.7)°, ulnar deviation was (20.8+ 2.9)°,and radial height was (10.9±1.8) mm; while volar tilt was (9.1±1.6)°, ulnar deviation was (17.1±2.9)°, and radial height was (8.1±1.5) mm in control group. Treatment group was better than control group in volar tilt, ulnar deviation and radial height. Clinical cure time in treatment group was(12.0±2.3) weeks, shorter than control group (18.0±4.1) weeks. The incidence of complications in treatment group was lower than control group. According to Mehara functional evaluation,20 cases got excellent results, 25 good, 3 moderate and 2 poor in treatment group; 16 cases got excellent results, 14 good, 10 moderate and 10 poor in control group. Treatment group was better than control group in clinical effects. T-shaped locking internal fixation with postoperative functional exercise for the treatment of dorsal Barton's fracture fits for biomechanics demands,and has advantages of stable fixation

  2. Lupus vulgaris of external nose--a case report.

    Science.gov (United States)

    Arunkumar, J S; Naveen, K N; Prasad, K C; Santhosh, S G; Hegde, J S

    2013-02-01

    Lupus vulgaris is the most common morphological variant of cutaneous tuberculosis accounting for approximately 59% of cases of cutaneous tuberculosis in India. We present a case of lupus vulgaris of external nose diagnosed early and treated with CAT-3 RNTCP regimen for six months without any nasal deformity except for a small scar over the dorsum of the nose. Patient followed up for one year after completion of the prescribed regimen, there being no recurrence of the lesion.

  3. LCP external fixation - External application of an internal fixator: two cases and a review of the literature

    OpenAIRE

    Wong Merng-Koon; Woon Colin; Howe Tet-Sen

    2010-01-01

    Abstract The locking compression plate (LCP) is an angle-stable fixator intended for intracorporeal application. In selected cases, it can be applied externally in an extracorporeal location to function as a monolateral external fixator. We describe one patient with Schatzker V tibial plateau fracture and one patient with Gustillo IIIB open tibia shaft fracture treated initially with traditional external fixation for whom exchange fixation with externally applied LCPs was performed. The first...

  4. A score to predict and stratify risk of tuberculosis in adult contacts of tuberculosis index cases: a prospective derivation and external validation cohort study.

    Science.gov (United States)

    Saunders, Matthew J; Wingfield, Tom; Tovar, Marco A; Baldwin, Matthew R; Datta, Sumona; Zevallos, Karine; Montoya, Rosario; Valencia, Teresa R; Friedland, Jon S; Moulton, Larry H; Gilman, Robert H; Evans, Carlton A

    2017-11-01

    Contacts of tuberculosis index cases are at increased risk of developing tuberculosis. Screening, preventive therapy, and surveillance for tuberculosis are underused interventions in contacts, particularly adults. We developed a score to predict risk of tuberculosis in adult contacts of tuberculosis index cases. In 2002-06, we recruited contacts aged 15 years or older of index cases with pulmonary tuberculosis who lived in desert shanty towns in Ventanilla, Peru. We followed up contacts for tuberculosis until February, 2016. We used a Cox proportional hazards model to identify index case, contact, and household risk factors for tuberculosis from which to derive a score and classify contacts as low, medium, or high risk. We validated the score in an urban community recruited in Callao, Peru, in 2014-15. In the derivation cohort, we identified 2017 contacts of 715 index cases, and median follow-up was 10·7 years (IQR 9·5-11·8). 178 (9%) of 2017 contacts developed tuberculosis during 19 147 person-years of follow-up (incidence 0·93 per 100 person-years, 95% CI 0·80-1·08). Risk factors for tuberculosis were body-mass index, previous tuberculosis, age, sustained exposure to the index case, the index case being in a male patient, lower community household socioeconomic position, indoor air pollution, previous tuberculosis among household members, and living in a household with a low number of windows per room. The 10-year risks of tuberculosis in the low-risk, medium-risk, and high-risk groups were, respectively, 2·8% (95% CI 1·7-4·4), 6·2% (4·8-8·1), and 20·6% (17·3-24·4). The 535 (27%) contacts classified as high risk accounted for 60% of the tuberculosis identified during follow-up. The score predicted tuberculosis independently of tuberculin skin test and index-case drug sensitivity results. In the external validation cohort, 65 (3%) of 1910 contacts developed tuberculosis during 3771 person-years of follow-up (incidence 1·7 per 100 person-years, 95

  5. Management of the proximal tibia fractures by mini external fixation: A case series of 30 cases

    Directory of Open Access Journals (Sweden)

    Samar K Biswas

    2014-01-01

    Full Text Available Background: Management of high velocity trauma is a challenging problem because of morbidity of trauma and sometime residual problems of failure of proper healing of fractures with the restriction of movements of knee, shortening, and added risk of compartment syndrome in the proximal tibia fracture. There is always risk of post-operative infection and infected non-union in extensive open surgical procedure and internal fixation. Hence, there is always look out for the middle path procedure for a solution to the above said problems with the added advantage of less hospital stay and early return to work by minimal invasive procedure and stabilization of fracture reduction by multiple K-wire fixation with a frame applied externally. Stabilization of fracture with reduced pain allows early movements of neighbouring joint knee and ankle; hence, reduces the chances of fracture diseases. With this we have been stimulated to take-up the study of managing the proximal tibia fracture by mini external fixator. Aim: The aim of this study was to manage proximal tibia fractures by mini external fixator and evaluate the results and efficacy of this method. Material and Method: A total of 30 patients having proximal tibial fractures admitted at our center between 2008 and 2010 were taken and the procedure carried out was closed manipulative reduction and stabilization with mini external fixator. All acute proximal tibia fractures including tibial plateau fractures above 17 years of age of either sex were included in the study. Fracture more than 3 weeks old were excluded from the study. Result: Out of 30 cases 13 were excellent, 14 cases good, and 3 showed fair. It was found that type 5 and 6 of Schatzker′s classification have lesser outcome type of fractures Conclusion: We have found that management of the proximal tibia fractures by mini external fixation method has a better outcome. Early mobilization of knee in the proximal tibia fractures after

  6. Nanomaterial Case Study: A Comparison of Multiwalled Carbon Nanotube and Decabromodiphenyl Ether Flame-Retardant Coatings Applied to Upholstery Textiles (External Review Draft)

    Science.gov (United States)

    The draft document is intended to be used as part of a process to identify what is known and, more importantly, what is not yet known that could be of value in assessing the broad implications of specific nanomaterials. Like previous case studies (see History/ Chronology below), ...

  7. LCP external fixation - External application of an internal fixator: two cases and a review of the literature

    Directory of Open Access Journals (Sweden)

    Wong Merng-Koon

    2010-03-01

    Full Text Available Abstract The locking compression plate (LCP is an angle-stable fixator intended for intracorporeal application. In selected cases, it can be applied externally in an extracorporeal location to function as a monolateral external fixator. We describe one patient with Schatzker V tibial plateau fracture and one patient with Gustillo IIIB open tibia shaft fracture treated initially with traditional external fixation for whom exchange fixation with externally applied LCPs was performed. The first case went on to bony union while the second case required bone grafting for delayed union. Both patients found that the LCP external fixators facilitated mobilization and were more manageable and aesthetically acceptable than traditional bar-Schanz pin fixators.

  8. LCP external fixation - External application of an internal fixator: two cases and a review of the literature

    Science.gov (United States)

    2010-01-01

    The locking compression plate (LCP) is an angle-stable fixator intended for intracorporeal application. In selected cases, it can be applied externally in an extracorporeal location to function as a monolateral external fixator. We describe one patient with Schatzker V tibial plateau fracture and one patient with Gustillo IIIB open tibia shaft fracture treated initially with traditional external fixation for whom exchange fixation with externally applied LCPs was performed. The first case went on to bony union while the second case required bone grafting for delayed union. Both patients found that the LCP external fixators facilitated mobilization and were more manageable and aesthetically acceptable than traditional bar-Schanz pin fixators. PMID:20302664

  9. External fuel vaporization study, phase 1

    Science.gov (United States)

    Szetela, E. J.; Chiappetta, L.

    1980-01-01

    A conceptual design study was conducted to devise and evaluate techniques for the external vaporization of fuel for use in an aircraft gas turbine with characteristics similar to the Energy Efficient Engine (E(3)). Three vaporizer concepts were selected and they were analyzed from the standpoint of fuel thermal stability, integration of the vaporizer system into the aircraft engine, engine and vaporizer dynamic response, startup and altitude restart, engine performance, control requirements, safety, and maintenance. One of the concepts was found to improve the performance of the baseline E(3) engine without seriously compromising engine startup and power change response. Increased maintenance is required because of the need for frequent pyrolytic cleaning of the surfaces in contact with hot fuel.

  10. Adult-onset juvenile xanthogranuloma of the external auditory canal: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Hur, Joon Ho; Kim, Jae Kyun; Seo, Gi Young; Choi, Woo Sun; Byun, Jun Soo; Lee, Woong Jae; Lee, Tae Jin [Chung-Ang University College of Medicine, Chung-Ang University Hospital, Seoul (Korea, Republic of); Kim, Na Ra [Dept. of Radiology, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul (Korea, Republic of)

    2016-05-15

    Juvenile xanthogranuloma (JXG) is a benign, spontaneously regressing lesion that usually occurs during the first year of life, but may also occur in adulthood. Although the most common presentation of JXG is the cutaneous lesion, it can also manifest in various visceral organs. JXG of the external auditory canal is extremely rare, and there have been only a few reports of those cases in the English literature. In this study, we present a case of pathologically proven JXG that occurred in the external auditory canal with a symptomatic clinical presentation.

  11. External fixation by Joshi′s external stabilizing system in cases of proximal humerus fractures in elderly subjects

    Directory of Open Access Journals (Sweden)

    Soumya Ghosh

    2013-01-01

    Full Text Available Fracture of the proximal humerus is a common and debilitating injury occurring mainly in elderly females and accounts for 4-5% of all adult fractures. Patients with displaced, unstable proximal humeral fractures may have improved outcomes if managed operatively. Objectives: To study the effect of using Joshi′s external stabilizing system (JESS for the management of fractures of proximal humerus in elderly. Materials and Methods: This prospective study was conducted in a tertiary care hospital in West Bengal on 28 subjects with proximal humerus fractures. As per Neer′s classification, 3- and 4-part fractures were included and prepared for JESS fixation. The results of the treatment were evaluated as per Neer′s criteria. Patients were followed up for 10 − 12 months. Results: Among 18 females and 10 males, 22 had 3-part fracture and 6 had 4-part fracture. Mean duration of JESS application was 10 weeks. Among patients with 3-part fractures 4 cases had excellent result, 12 had satisfactory result, 4 had unsatisfactory result and treatment failed in 2 cases. With 4-part fractures, 2 cases had unsatisfactory result and 4 cases were failures. Conclusion: JESS is an alternative option for the treatment of proximal humerus fractures, especially in elderly patients with osteoporosis, showing excellent to good results in cases of Neer′s type 3-part fracture.

  12. External fuel vaporization study, phase 2

    Science.gov (United States)

    Szetela, E. J.; Chiappetta, L.

    1981-01-01

    An analytical study was conducted to evaluate the effect of variations in fuel properties on the design of an external fuel vaporizaton system. The fuel properties that were considered included thermal stability, critical temperature, enthalpy a critical conditions, volatility, and viscosity. The design parameters that were evaluated included vaporizer weight and the impact on engine requirement such as maintenance, transient response, performance, and altitude relight. The baseline fuel properties were those of Jet A. The variation in thermal stability was taken as the thermal stability variation for Experimental Referee Broad Specification (ERBS) fuel. The results of the analysis indicate that a change in thermal stability equivalent to that of ERBS would increase the vaporization system weight by 20 percent, decrease oprating time between cleaning by 40 percent and make altitude relight more difficult. An increase in fuel critical temperature of 39 K would require a 40 percent increase in vaporization system weight. The assumed increase in enthalpy and volatility would also increase vaporizer weight by 40 percent and make altitude relight extremely difficult. The variation in fuel viscosity would have a negligible effect on the design parameters.

  13. Study on external beam radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Sook; Yoo, Seoung Yul; Yoo, Hyung Jun; Ji, Young Hoon; Lee, Dong Han; Lee, Dong Hoon; Choi, Mun Sik; Yoo, Dae Heon; Lee, Hyo Nam; Kim, Kyeoung Jung

    1999-04-01

    To develop the therapy technique which promote accuracy and convenience in external radiation therapy, to obtain the development of clinical treatment methods for the global competition. The contents of the R and D were 1. structure, process and outcome analysis in radiation therapy department. 2. Development of multimodality treatment in radiation therapy 3. Development of computation using networking techniques 4. Development of quality assurance (QA) system in radiation therapy 5. Development of radiotherapy tools 6. Development of intraoperative radiation therapy (IORT) tools. The results of the R and D were 1. completion of survey and analysis about Korea radiation therapy status 2. Performing QA analysis about ICR on cervix cancer 3. Trial of multicenter randomized study on lung cancers 4. Setting up inter-departmental LAN using MS NT server and Notes program 5. Development of ionization chamber and dose-rate meter for QA in linear accelerator 6. Development on optimized radiation distribution algorithm for multiple slice 7. Implementation on 3 dimensional volume surface algorithm and 8. Implementation on adaptor and cone for IORT.

  14. STUDY ON SPANNING EXTERNAL FIXATORS FOR PERIARTICULAR OPEN FRACTURES

    Directory of Open Access Journals (Sweden)

    Prasanth Maddila

    2017-04-01

    Full Text Available BACKGROUND Open fractures which occur close to any fracture need immobilisation for the soft tissues to heal. Some open fractures are even fixed with provisional fixations to maintain the alignment of the fractures. The provisional fixation needs to be augmented with external support, which can be given by spanning external fixators across a joint. MATERIALS AND METHODS Our study consists of 38 open fractures of the lower limbs, which are of Gustilo-Anderson’s type IIIB, an MT4 of AO-ASIF soft tissue injury classification essentially requiring open wound management as well as fracture fixation. Wound lavage and debridements are carried out till the soft tissues show granulations. The position in which joint is immobilised is functional and with access to open wound for dressings and inspection without any displacement of the fracture as well as creeping granulation tissue. RESULTS All the cases in our study are maintained with functional position till soft tissue cover is achieved and provisional fixation is done with definitive fixation after soft tissue cover with skin grafting. CONCLUSION Spanning external fixators are useful in maintaining functional positions as well as augmenting the provisional fixation of the compound fractures.

  15. Fold interference pattern in thick-skinned tectonics; a case study from the external Variscan belt of Eastern Anti-Atlas, Morocco

    Science.gov (United States)

    Baidder, L.; Michard, A.; Soulaimani, A.; Fekkak, A.; Eddebbi, A.; Rjimati, E.-C.; Raddi, Y.

    2016-07-01

    Conflicting views are expressed in literature concerning fold interference patterns in thick-skinned tectonic context (e.g. Central Anti-Atlas and Rocky Mountains-Colorado areas). Such patterns are referred to superimposed events with distinct orientation of compression or to the inversion of paleofaults with distinct strike during a single compressional event. The present work presents a case study where both types of control on fold interference are likely to be combined. The studied folds occur in the Tafilalt-Maider area of eastern Anti-Atlas, i.e. in the E-trending foreland fold belt of the Meseta Variscan Orogen in the area where it connects with the SE-trending, intracontinental Ougarta Variscan belt. Detail mapping documents unusual fold geometries such as sigmoidal and croissant- or boomerang-shaped folds associated with a complex major fault pattern. The folded rock material corresponds to a 6-8 km-thick Cambrian-Serpukhovian sedimentary pile that includes alternating competent and incompetent formations. The basement of the Paleozoic succession is made up of rhomboedric tilted blocks that formed during the Cambrian rifting of north-western Gondwana and the Devonian dislocation of the Sahara platform. The latter event is responsible for an array of paleofaults bounding the Maider and South Tafilalt Devonian-Early Carboniferous basins with respect to the adjoining high axes. The Variscan Orogeny began during the Bashkirian-Westphalian with a N-S direction of shortening that converted the NW-trending Ougnat-Ouzina paleogeographic high into a mega dextral shear zone. Folds developed on top of a moving mosaic of basement blocks, being oriented en echelon on the inverted paleofaults or above intensely sheared fault zones. However, a dominantly NE-SW compression responsible for the building of the Ougarta belt also affected the studied area, presumably during the latest Carboniferous-Early Permian. The resulting fold interference pattern and peculiar geometries

  16. Shaped by asymmetrical interdependence: a qualitative case study of the external influences on international non-governmental organizations' implementation of equity principles in HIV/AIDS work.

    Science.gov (United States)

    Dyke, Elizabeth; Edwards, Nancy; McDowell, Ian; Muga, Richard; Brown, Stephen

    2014-10-08

    Addressing inequities is a key role for international non-governmental organizations (INGOs) working in health and development. Yet, putting equity principles into practice can prove challenging. In-depth empirical research examining what influences INGOs' implementation of equity principles is limited. This study examined the influences on one INGO's implementation of equity principles in its HIV/AIDS programs. This research employed a case study with nested components (an INGO operating in Kenya, with offices in North America). We used multiple data collection methods, including document reviews, interviews (with staff, partners and clients of the INGO in Kenya), and participant observation (with Kenyan INGO staff). Participant observation was conducted with 10 people over three months. Forty-one interviews were completed, and 127 documents analyzed. Data analysis followed Auerbach and Silverstein's analytic process (2003), with qualitative coding conducted in multiple stages, using descriptive matrices, visual displays and networks (Miles and Huberman, 1994). There was a gap between the INGO's intent to implement equity principles and actual practice due to multiple influences from various players, including donors and country governments. The INGO was reliant on donor funding and needed permission from the Kenyan government to work in-country. Major influences included donor agendas and funding, donor country policies, and Southern country government priorities and legislation. The INGO privileged particular vulnerable populations (based on its reputation, its history, and the priorities of the Kenyan government and the donors). To balance its equity commitment with the influences from other players, the INGO aligned with the system as well as pushed back incrementally on the donors and the Kenyan government to influence these organizations' equity agendas. By moving its equity agenda forward incrementally and using its reputational advantage, the INGO avoided

  17. Demodex treatment in external ocular disease: the outcomes of a Tasmanian case series.

    Science.gov (United States)

    Nicholls, Stephen G; Oakley, Carmen L; Tan, Andrea; Vote, Brendan J

    2016-10-01

    Demodex species (spp.) have previously been implicated in the pathogenesis of blepharitis. This study aims to correlate improvement in symptoms of external ocular disease with treatment of underlying Demodex spp. This is a prospective, observational case series of patients with chronic external ocular disease. Demodicosis was confirmed by microscopic examination of epilated eyelashes. The main outcome measure was response to the treatment (5 % tee tree oil) in regard to change in subjective symptoms utilising a symptom-based patient questionnaire assessment. Overall patients had a good response to the treatment in terms of improvement or resolution of symptoms, with 91 % of patients reporting at least some improvement in symptoms. The treatment of underlying Demodex spp. appears to result in improvement of symptoms in patients with long standing external ocular disease and underlying Demodex spp. infestation.

  18. CASE STUDY

    African Journals Online (AJOL)

    BY TOXOPLASMOSIS. CASE STUDY. Christine Katusiime1, MB ChB, PGDPPM. Ponsiano Ocama2, MB ChB, MMed. Andrew Kambugu1, MB ChB, MMed. 1Makerere University, College of Health Sciences, Infectious Diseases Institute, Kampala, Uganda. 2Makerere University, College of Health Sciences, Department of ...

  19. CASE STUDY

    African Journals Online (AJOL)

    2011-06-02

    AIDS Control Programme, Sri Lanka. CASE STUDY. A 49-year-old male security supervisor was admitted to hospital with recurrent chest infections. He was found to be HIV positive with a CD4 count of 60 cells/µl, and was.

  20. Review on studies for external cost of nuclear power generation

    Energy Technology Data Exchange (ETDEWEB)

    Park, Byung Heung [Korea National University of Transportation, Chungju (Korea, Republic of); Ko, Won Il [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2015-12-15

    External cost is cost imposed on a third party when producing or consuming a good or service. Since the 1990s, the external costs of nuclear powered electricity production have been studied. Costs are a very important factor in policy decision and the external cost is considered for cost comparison on electricity production. As for nuclear fuel cycle, a chosen technology will determine the external cost. However, there has been little research on this issue. For this study, methods for external cost on nuclear power production have been surveyed and analyzed to develop an approach for evaluating external cost on nuclear fuel cycles. Before the Fukushima accident, external cost research had focused on damage costs during normal operation of a fuel cycle. However, accident cost becomes a major concern after the accident. Various considerations for external cost including accident cost have been used to different studies, and different methods have been applied corresponding to the considerations. In this study, the results of the evaluation were compared and analyzed to identify methodological applicability to the external cost estimation with nuclear fuel cycles.

  1. A prospective study of dynamic treatment of fracture phalanx and metacarpals of the hand with Kirschner-wire fixation/external fixator and finger splint: Daycare management (30 cases

    Directory of Open Access Journals (Sweden)

    Rahul Madhukar Salunkhe

    2016-01-01

    Full Text Available Introduction: Fractures of the phalanx and metacarpals are some of the most frequently encountered orthopedics injuries and constitute between 14-28% of all visits to emergency department which comprises 46% of the hand fracture and out of that mostly involved are the proximal phalanx and metacarpal neck fracture are most common and then the middle and distal phalanx and the base of metacarpal. The commonest complication with surgical treatment were stiff painful joints due to prolonged immobilization at fracture sites. This prospective study was undertaken to evaluate the functional outcome after surgical stabilization of metacarpal and phalanx fracture on day care basis. Materials And Methods: In our study we treated 30 patients who came to our hospital by fixation either with K wire or external fixation or hybrid fixation under local anaesthesia depending on the type of fracture between 2013 to 2014 with the average age 28 years with the youngest being 18 years and the oldest being 41 years with transverse, spiral, oblique closed fracture, grade 1 compound fracture, intraarticular, extraarticular, comminuted and non comminuted fracture of phalanx and metacarpals.These were day care treatment. Patient was allowed to begin his daily routine work from post operative day l. During this course the operated site was protected with splinting. Results: Clinical Outcomes were assessed as Excellent, Good, Satisfactory and Poor. Radiological assessment was done by taking x-ray to check radiological union.There were 24 cases had excellent outcome, 5 cases had good outcome and only 1 case had satisfactory outcome which occurred due to mal-union. There were 3 cases of pin-tract infection which subsided with oral antibiotics, and 3 cases of malunion. Conclusion: This was a day care procedure, patient were admitted, treated and discharged on the same day & encouraged to begin mobilization of the joints of hands from day 1.

  2. Pneumocystis jirovecii infection of the external auditory canal : case ...

    African Journals Online (AJOL)

    primaquine, atovaquone and pentamidine isethionate.1,3 Although there is usually resolution of symptoms after medical therapy, surgical excision of lesions in the external auditory canal may be clinically indicated. Disseminated pneumocystosis, like ...

  3. Sustaining School Improvement through an External and Internal Focus: A Case Study of a High-Need Secondary School in Nepal

    Science.gov (United States)

    Gautam, Chetanath; Alford, Betty J.; Khanal, Manju

    2015-01-01

    A study of a high-need school in Nepal was conducted by members of the International School Leadership Development Network (ISLDN) using the interview protocol developed by members of the high-need school strand of ISLDN. The International School Leadership Development Network is sponsored by the University Council for Educational Administration…

  4. Is the internal training load different between starters and nonstarters volleyball players submitted to the same external load training? A case study

    Directory of Open Access Journals (Sweden)

    Thiago Andrade Goulart Horta

    2017-11-01

    Full Text Available DOI: http://dx.doi.org/10.5007/1980-0037.2017v19n4p395   The same training stimulus can provide different physiological adaptations for athletes of the same team. Thus, the aim of this study was to analyze and compare the load training of starters and nonstarters players, athletes of a men’s volleyball team at different times of the season. The sample consisted of fifteen men’s volleyball superleague athletes who were divided into two groups of starters and nonstarters players. The training load of the ten weeks of the team’s preparation period for the main championship season in which no games were performed was selected for the study. The method of subjective perceived of effort (session-RPE proposed by Foster et al. (2001 was used to quantify the training load. The group of starters players had higher total weekly training load (TWTL and RPE values in the average of the ten weeks of training (p<0.05. Higher TWTL values for starters players in the preparatory and pre-competitive period compared to nonstarters players was also demonstrated (p<0.05. When different weeks were analyzed separately, weeks three and seven presented higher TWTL and RPE values for starters players compared with nonstarters players (p<0.05. The results presented in this study showed that starters players showed greater internal training load compared to nonstarters players.

  5. Branchial cleft anomaly of external auditory canal: a case report ...

    African Journals Online (AJOL)

    A 15 year old male with a first branchial cleft anomaly seen at the Usmanu Danfodiyo University Teaching Hospital Sokoto is presented. He had recurrent preauricular swelling, which was continuous with three fistulous openings in the left external auditory meatus confirmed by sinogram. It may be mistaken for chronic ...

  6. Casing study

    Energy Technology Data Exchange (ETDEWEB)

    Roche, P.

    2000-12-01

    An unorthodox method of casing drilling used by Tesco Corporation at a gas well in Wyoming to drill deeper using casings as drillpipe is discussed. The process involves either rotating the casing as drill string or using a downhole mud motor to rotate the bit. In this instance, the surface hole and the production hole were casing-drilled to a record 8,312 feet by rotating the casing. The 8 1/2-inch surface hole was drilled with 7-inch casing to 1,200 feet using a Tesco underreamer and a polycrystalline pilot bit; drilling and cementing was completed in 12 1/2 hours. The 6 1/4-inch production hole was drilled with 4 1/2-inch casing and the bottomhole assembly was retrieved after 191 hours rotating. This case was the first in which the entire well was casing-drilled from surface to TD. Penetration rate compared favorably with conventional methods: 12 1/2 hours for casing-drilling to 18.9 hours for conventional drilling, despite the fact that the casing-drilling technology is still in its infancy. It is suggested that casing-drilling has the potential to eliminate the need for the drillpipe entirely. If these expectations were to be realised, casing-drilling could be one of the most radical drilling changes in the history of the oil and gas industry. 1 photo.

  7. Transconjunctival retinopexy with active external drainage of subretinal fluid: a prospective pilot study of eight consecutive cases Retinopexia transconjuntival com drenagem externa do fluido sub-retiniano: um estudo piloto prospectivo de oito casos consecutivos

    Directory of Open Access Journals (Sweden)

    Rubens Camargo Siqueira

    2007-08-01

    Full Text Available PURPOSE: To describe an alternative surgical technique for the management of retinal detachment with no or minimal proliferative vitreoretinopathy (grade B using transconjunctival retinopexy with active external drainage of subretinal fluid. METHODS: In a prospective, interventional study, eight consecutive patients with retinal detachment with no or minimal proliferative vitreoretinopathy (grade B underwent transconjunctival retinopexy with active external drainage of subretinal fluid. Transconjunctival external drainage of subretinal fluid was achieved by using a 29 gauge needle placed in the subretinal space under indirect ophthalmoscopic monitoring. Active suction was performed (500 mmHg vacuum using a vitrectomy line coupled to the needle. After retinal reattachment, cryotherapy was applied to the scleral region corresponding to the area of the retinal break(s. RESULTS: In all cases there was retinal attachment at the end of surgery. Retinal redetachment occurred in four pseudophakic patients who then underwent pars plana vitrectomy. The four phakic patients maintained retinal attachment during follow-up (13-20 months. CONCLUSION: Transconjunctival retinopexy with active external drainage of subretinal fluid represents a useful, faster, and cheaper alternative to scleral buckling for retinal detachments with no or minimal proliferative retinopathy in phakic patients and, unlike scleral buckling, is not associated with induced myopia.OBJETIVO: Descrever uma técnica cirúrgica alternativa para o tratamento de descolamento da retina sem ou com mínima vitreorretinopatia proliferativa (grau B usando uma retinopexia transconjuntival com drenagem externa do fluido sub-retiniano. MÉTODOS: Prospectivo estudo intervencional, com oito pacientes consecutivos com descolamento da retina com nenhum ou mínima vitreorretinopatia proliferativa (grau B que foram submetidos a retinopexia transconjuntival com drenagem externa ativa do fluido sub

  8. Prediction of 60-Day Case Fatality After Aneurysmal Subarachnoid Hemorrhage : External Validation of a Prediction Model

    NARCIS (Netherlands)

    Dijkland, Simone A.; Roozenbeek, Bob; Brouwer, Patrick A.; Lingsma, Hester F.; Dippel, Diederik W.; Vergouw, Leonie J.; Vergouwen, Mervyn D.; van der Jagt, Mathieu

    OBJECTIVE:: External validation of prognostic models is crucial but rarely done. Our aim was to externally validate a prognostic model to predict 60-day case fatality after aneurysmal subarachnoid hemorrhage developed from the International Subarachnoid Aneurysm Trial in a retrospective unselected

  9. Numerical studies of a plasma diode with external forcing

    Science.gov (United States)

    Rekaa, V. L.; Pécseli, H. L.; Trulsen, J. K.

    2012-08-01

    With reference to laboratory Q-machine studies we analyze the dynamics of a plasma diode under external forcing. Assuming a strong axial magnetic field, the problem is analyzed in one spatial dimension by a particle-in-cell code. The cathode is assumed to be operated in electron rich conditions, supplying an abundance of electrons. We compare different forcing schemes with the results obtained by solving the van der Pol equation. In one method of forcing we apply an oscillation in addition to the DC end plate bias and consider both amplitude and frequency variations. An alternative method of perturbation consists of modelling an absorbing grid at some internal position. Also in this case we can have a constant frequency with varying amplitude or alternatively an oscillation with chirped frequency but constant amplitude. We find that the overall features of the forced van der Pol equation are recovered, but the details in the plasma response need more attention to the harmonic responses, requiring extensions of the model equation. The analysis is extended by introducing collisional effects, where we emphasize charge exchange collisions of ions, since these processes usually have the largest cross sections and give significant modifications of the diode performance. In particular we find a reduction in oscillator frequency, although a linear scaling of the oscillation time with the system length remains also in this case.

  10. A COMPARATIVE STUDY OF CONSERVATIVE MANAGEMENT VS. EXTERNAL FIXATION OF COMMINUTED DISTAL RADIUS FRACTURES

    Directory of Open Access Journals (Sweden)

    Sanjeev Kumar Kare

    2016-12-01

    Full Text Available BACKGROUND Fracture of the distal radius (‘broken wrist’ is a common clinical problem. It can be treated conservatively usually involving wrist immobilisation in a plaster cast or surgically. A key method of surgical fixation is external fixation. MATERIALS AND METHODS A prospective study was carried out on 66 patients admitted between June 2014 to May 2016 for evaluation of conservative and surgical management of distal radius fractures. RESULTS Excellent, fair or good result was noticed in around 85% of cases managed conservatively and in above 90% of cases managed by external fixator. CONCLUSION There is some evidence to support the use of external fixation for dorsally displaced fractures of the distal radius in adults. Though, there is insufficient evidence to confirm a better functional outcome, external fixation reduces redisplacement gives improved anatomical results and most of the excess surgically-related complications are minor.

  11. Low level termination of external carotid artery and its clinical significance: A case report

    Directory of Open Access Journals (Sweden)

    Surekha Devadasa Shetty

    2015-09-01

    Full Text Available The external carotid arterial system is a complex vascular system providing nourishment to the territorial areas of the head and neck. The branches of the external carotid artery are the key landmarks for adequate exposure and appropriate placement of cross-clamps on the carotid arteries during carotid endarterectomy. Knowledge of anatomical variation of the external carotid artery is important in head and neck surgeries. Variations in the branching pattern of the external carotid artery are well known and documented. We report a rare case of low-level termination of the external carotid artery. It terminated by dividing into maxillary and superficial temporal arteries deep into the posterior belly of the digastric muscle, one inch below the angle of the mandible. The occipital and posterior auricular arteries arose from a common trunk given off by the external carotid artery. [Arch Clin Exp Surg 2015; 4(3.000: 160-163

  12. Treatment of neglected elbow dislocations with the help of hinged external fixator: Report of two cases

    Directory of Open Access Journals (Sweden)

    Özgür Karakoyun

    2014-06-01

    Full Text Available Elbow dislocations are cases that have to be treated in emergency conditions. Neglected elbow dislocations are seen very rarely and the treatment of such cases are more complicated than acute cases. We present two cases of neglected elbow dislocations treated with open reduction and hinged external fixators. Case 1: 23 year old female patient had a neglected posterior dislocation of left elbow with ipsilateral humeral shaft fracture caused by car accident. The patient was treated after 3 months of initial trauma. We have performed open reduction for the joint. After that we fixed the joint whit a hinged external fixator. The humeral shaft fracture was also fixed with the components of the external fixator. Case 2: 33 year male patient had a large bone and soft tissue defect around the left elbow accompanying with neglected medial elbow dislocation. He presented to our clinic with a delay of 2 months. The patient was treated with open reduction and hinged external fixator after reconstruction of bone defect of distal humerus. Conclusion: The treatment of neglected cases is quite challenging. Open reduction and external fixation has satisfactory results in treatment of late cases of elbow dislocation with the possibility of early rehabilitation. This method can be considered as an option for such cases. J Clin Exp Invest 2014; 5 (2: 443-446

  13. Aetiology of thrombosed external haemorrhoids: a questionnaire study

    Directory of Open Access Journals (Sweden)

    Rohde Henning

    2009-10-01

    Full Text Available Abstract Background It is important to better understand the aetiology of thrombosed external haemorrhoids (TEH because recurrence rates are high, prophylaxis is unknown, and optimal therapy is highly debated. Findings We conducted a questionnaire study of individuals with and without TEH. Aetiology was studied by comparison of answers to a questionnaire given to individuals with and without TEH concerning demography, history, and published aetiologic hypotheses. Participants were evaluated consecutively at our institution from March 2004 through August 2005. One hundred forty-eight individuals were enrolled, including 72 patients with TEH and 76 individuals without TEH but with alternative diagnoses, such as a screening colonoscopy or colonic polyps. Out of 38 possible aetiologic factors evaluated, 20 showed no significant bivariate correlation to TEH and were no longer traced, and 16 factors showed a significant bivariate relationship to TEH. By multivariate analysis, six independent variables were found to predict TEH correctly in 79.1% of cases: age of 46 years or younger, use of excessive physical effort, and use of dry toilet paper combined with wet cleaning methods after defaecation were associated with a significantly higher risk of developing TEH; use of bathtub, use of the shower, and genital cleaning before sleep at least once a week were associated with a significantly lower risk of developing TEH. Conclusion Six hypotheses on the causes of TEH have a high probability of being correct and should be considered in future studies on aetiology, prophylaxis, and therapy of TEH.

  14. Rated salience of internal and external cues in cases of self-reported hunger and illness.

    Science.gov (United States)

    Barklamb, Kelly; Cassaday, Helen J

    2007-09-01

    An event contingent diary method compared the rated salience of ambient external and internal cues reported in association with instances of feeling hungry and ill, to test whether environmental and psychological factors might be differentially identified in conjunction with these states. In cases of hunger but not illness, external and internal events were equally salient cues. However, within the general category of external cues, for those feeling hungry, smells were rated more salient than sounds. Within the category of internal cues, in both cases of hunger and illness, cognitions were rated as more salient than moods. We consider Pavlovian conditioning as a mechanism for these effects.

  15. Radial nerve injury following elbow external fixator: report of three cases and literature review.

    Science.gov (United States)

    Trigo, Luis; Sarasquete, Juan; Noguera, Laura; Proubasta, Ignacio; Lamas, Claudia

    2017-07-01

    Radial nerve palsy is a rare but serious complication following elbow external fixation. Only 11 cases have been reported in the literature to date, but the incidence may be underreported. We present three new cases of this complication. We analyzed the three cases of radial palsy seen in our center following the application of an external fixator as treatment for complex elbow injuries. Mean patient age at surgery was 50 years. Two patients were female and one was male. In the three cases, the initial lesion was a posterior elbow dislocation, associated with a fracture of the radial shaft in one and a radial head fracture and coronoid fracture, respectively, in the other two. Due to persistent elbow instability, an external fixator was applied in all three cases. The fixator pins were introduced percutaneously in two cases and under direct vision in an open manner in the third case. Radial palsy was noted immediately postoperatively in all cases. It was permanent in two cases and temporary in the third. Radial nerve palsy after placement of an external elbow fixator was resolved in only 1 of our 3 cases and in 6 of the 11 cases in the literature to date. Although the event is rare, these alarming results highlight the need for recommendations to avoid this complication.

  16. Case Study: Testing with Case Studies

    Science.gov (United States)

    Herreid, Clyde Freeman

    2015-01-01

    This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue discusses using case studies to test for knowledge or lessons learned.

  17. What motivates money donation? A study on external motivators

    Directory of Open Access Journals (Sweden)

    Nivea Coelho Degasperi

    Full Text Available Abstract The objective of this study is to identify external motivating factors that favor individual money donation. Methodologically, we adopted a descriptive and quantitative cross-sectional study. In order to collect data, we prepared a questionnaire containing 49 statements based on external motivating variables of regular individual money donation found in the literature on the subject. After testing the questionnaire, we applied it to 1073 Brazilians, regular money donors and we performed an exploratory factor analysis. Conclusively, we identified 8 external factors that motivate individual money donation: Trust, Reward, Leadership influences, Characteristics of the organization, Environmental influences, Personal benefits, Characteristics of beneficiaries and Future Interests. We expect that these 8 factors combined, could become a useful tool to improve the management of charitable organizations, especially in defining campaigns or other marketing strategies to attract new donors and raise funds on occasions that are favorable to individual money donation.

  18. Xanthogranuloma of the External Auditory Canal Mimicking a Benign Tumor: A Case Report

    Directory of Open Access Journals (Sweden)

    Keisuke Yoshihama

    2012-01-01

    Full Text Available Exostosis, osteoma, and adenoma are the most commonly encountered benign lesions in the external auditory canal. Herein, we report a case of the mass arising from the external auditory canal in a 24-year-old Japanese man. CT revealed the soft tissue mass without bony erosion, and MRI revealed that the mass showed a homogenous, iso signal intensity on a both T1- and T2-weighted image, suggesting that the mass is a benign tumor such as adenoma. Pathological examination showed that the specimen demonstrated xanthogranuloma in the external auditory canal. Although xanthogranuloma of the external auditory canal is extremely rare, otolaryngologists should recognize this condition during the inspection of the external auditory canal.

  19. Rigidity of unilateral external fixators - A biomechanical study

    NARCIS (Netherlands)

    P.T.P.W. Burgers (Paul); M.P.J.M. Riel (Marcel); L.M.M. Vogels (Lucas); R.W. Stam (Ronald); P. Patka (Peter); E.M.M. van Lieshout (Esther)

    2011-01-01

    textabstractIntroduction: External fixation is the primary choice of temporary fracture stabilisation for specific polytrauma patients. Adequate initial fracture healing requires sufficient stability at the fracture site. The purpose of this study was to compare the rigidity of the Dynafix

  20. [Obstructive anuria secondary to left external iliac artery aneurysm. Case report].

    Science.gov (United States)

    Ochoa Urdangarain, Otto; Hermida Pérez, José A; Montes de Oca, Johannes Ochoa

    2006-04-01

    To report one case of obstructive anuria due to ureteral compression by an external iliac artery aneurysm in a patient with a single kidney. We report the case of a 76-year-old male with a single kidney presenting at the emergency department with left lumbar pain and anuria for several days. Hydronephrosis of the solitary left kidney due to an aneurysmatic tumor of the external iliac artery was diagnosed after performing various tests (ultrasound, arteriography). Emergency percutaneous nephrostomy was performed with subsequent vascular repair of the aneurysm. The outcome was favourable. Aorto-iliac aneurysm constitutes a rare cause of obstructive anuria. Patients affected are usually males over 50 years of age, smokers, with a history of diabetes mellitus, arterial hypertension (AHT), chronic obstructive pulmonary disease (COPD), etc. Diagnosis is based on clinical symptoms, outstandingly lumboabdominal pain, and the finding of a beating abdominal tumor, as well as signs of a renal failure. Useful complementary studies for diagnosis include ultrasound, intravenous urography (IVU), arteriography and computerised axial tomography (CT). Surgical treatment of the aneurysm generally relieves the obstruction.

  1. Leiomyosarcoma of the external ear--case report.

    Science.gov (United States)

    Rysz, Maciej; Jaworowski, Janusz; Krajewski, Romuald; Barańska, Joanna

    2014-01-01

    In head and neck region leiomyosarcoma is a very rare finding. This tumor is usually located in abdominal cavity. We report a case of 78-year-old man with tumor of the auricle that was resected with 0.7 cm margin. Histological and immunohistochemical analysis revealed the leiomyosarcoma. Adjuvant therapy was not advised. During 3 years of follow-up there are no signs of recurrence. Review of the literature shows that the survival of patients with leiomyosarcoma in head and neck region seems to be similar to other kinds of sarcomas in this localization. It is not clear, how large surgical margins should be to achieve satisfactory local control. Copyright © 2012 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.

  2. Clinical-scintigraphy discordance in a case of malignant external otitis.

    Science.gov (United States)

    Morales-Avellaneda, T; González-Ramírez, A I; Rodríguez-Alfonso, B; Mucientes-Rasilla, J; García-Berrocal, J R; De Diego, B

    2012-09-01

    We report the case of an immunocompromised female patient with external otitis, who developed a picture of external otitis with poor response to conventional treatment and subsequent isolation of Pseudomona Aeruginosa in the ear secretion culture. The final diagnosis was malignant external otitis. Our objective is to describe the scintigraphic findings as well as to analyze their correlation with the clinical pattern and to evaluate the possible causes of the discordance found. Copyright © 2011 Elsevier España, S.L. y SEMNIM. All rights reserved.

  3. Mycotic Aneurysm of External Carotid Artery following Traumatic Brain Injury: Case Report and Review of Literature

    OpenAIRE

    Khalili, Hosseinali; Derakhshan, Nima; Malekmohammadi, Zahed; Ghaffarpasand, Fariborz

    2014-01-01

    Mycotic aneurysm of external carotid artery is extremely rare. We herein report a case of external carotid artery (ECA) aneurysm following severe traumatic brain injury. A 24-year-old man with severe traumatic brain injury (TBI) following a car accident was referred to Rajaee Trauma Center Emergency Room affiliated to Shiraz University of Medical Sciences in Shiraz, Iran. He underwent ventriculostomy on arrival for intracerebral pressure (ICP) monitoring and for a second time due to hydroceph...

  4. Worst-case efficient external-memory priority queues

    DEFF Research Database (Denmark)

    Brodal, Gerth Stølting; Katajainen, Jyrki

    1998-01-01

    data structure handles any intermixed sequence of Insert and DeleteMin operations such that in every disjoint interval of B consecutive priorityqueue operations at most clogM/B N/M I/Os are performed, for some positive constant c. These I/Os are divided evenly among the operations: if B ≥ clogM/B N....../M, one I/O is necessary for every B/(clogM/B N/M)th operation and if B I/Os are performed per every operation. Moreover, every operation requires O(log2 N) comparisons in the worst case. The best earlier solutions can only handle a sequence of S operations with O(σ i=1 S 1....../B log M/B Ni/M) I/Os, where N i denotes the number of elements stored in the data structure prior to the ith operation, without giving any guarantee for the performance of the individual operations...

  5. Case Report: Management of unusual site for contrast media extravasation in right external jugular vein

    Directory of Open Access Journals (Sweden)

    Magdy Imam Abdel Aleem Taha Mohamed

    2015-12-01

    Full Text Available Contrast media extravasation is well known complication during power/pressure injection of contrast material. Despite reports of many cases of extravasation few consequences have been reported. We present a very rare case of contrast media extravasation in the neck after right external jugular vein cannulation which mandated early surgical intervention. On literature search, we did not find any similar report of such unique case.

  6. Case Study: Writing a Journal Case Study

    Science.gov (United States)

    Prud'homme-Genereux, Annie

    2016-01-01

    This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue describes incorporating a journal article into the classroom by first converting it into a case study.

  7. Multicenter study of principles-based waveforms for external defibrillation.

    Science.gov (United States)

    Bain, A C; Swerdlow, C D; Love, C J; Ellenbogen, K A; Deering, T F; Brewer, J E; Augostini, R S; Tchou, P J

    2001-01-01

    The efficacy of a shock waveform for external defibrillation depends on the waveform characteristics. Recently, design principles based on cardiac electrophysiology have been developed to determine optimal waveform characteristics. The objective of this clinical trial was to evaluate the efficacy of principles-based monophasic and biphasic waveforms for external defibrillation. A prospective, randomized, blinded, multicenter study of 118 patients undergoing electrophysiologic testing or receiving an implantable defibrillator was conducted. Ventricular fibrillation was induced, and defibrillation was attempted in each patient with a biphasic and a monophasic waveform. Patients were randomly placed into 2 groups: group 1 received shocks of escalating energy, and group 2 received only high-energy shocks. The biphasic waveform achieved a first-shock success rate of 100% in group 1 (95% confidence interval [CI] 95.1% to 100%) and group 2 (95% CI 94.6% to 100%), with average delivered energies of 201+/-17 J and 295+/-28 J, respectively. The monophasic waveform demonstrated a 96.7% (95% CI 89.1% to 100%) first-shock success rate and average delivered energy of 215+/-12 J for group 1 and a 98.2% (95% CI 91.7% to 100%) first-shock success rate and average delivered energy of 352+/-13 J for group 2. Using principles of electrophysiology, it is possible to design both biphasic and monophasic waveforms for external defibrillation that achieve a high first-shock efficacy.

  8. Action in External Studies. Division of External Studies Occasional Papers No. 2.

    Science.gov (United States)

    Riverina Coll. of Advanced Education, Wagga Wagga, New South Wales (Australia).

    Developments in distance education are addressed in four papers. In "A Practical Winery Experience," Malcolm Allen discusses Riverina College of Advanced Education's Bachelor of Applied Science (wine science) course, which is vocationally oriented, mainly enrolls students from the wine industry, and primarily uses correspondence study.…

  9. Two cases of arteriovenous fistula formation between the external iliac vessels following endovenous laser therapy.

    Science.gov (United States)

    Wheatcroft, M D; Lindsay, T F; Lossing, A

    2014-12-01

    Minimally invasive treatment of varicose veins is becoming increasingly popular with both patients and physicians. Endovenous laser therapy has been shown to be safe and effective but the rare complication of iatrogenic creation of arteriovenous fistulas has been described. One case of fistulation between the external iliac artery and vein has been published. We report two further cases and describe their management. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  10. Two unusual cases of external rotator muscle pathology producing hip pain

    Directory of Open Access Journals (Sweden)

    Graeme Thompson

    2015-03-01

    Full Text Available Two unusual cases of inflammation of the external rotator muscles of the hip are presented. In each case, the patient presented with acute hip pain. The diagnoses of acute calcific periarthritis involving the gluteus medius muscle, and pyomyositis of the obturator internus muscle secondary to a perianal fistula, were made with the aid of diagnostic imaging and histology. The importance of reviewing the pelvic viscera is highlighted.

  11. External foam and the post-mortem period in freshwater drowning; results from a retrospective study in Amsterdam, the Netherlands.

    Science.gov (United States)

    Reijnen, G; Buster, M C; Vos, P J E; Reijnders, U J L

    2017-11-01

    Determining the time of death of bodies recovered from water can be difficult. A feature of drowning is the presence of external foam. This study describes the presence of external foam in relation to the post-mortem period. The study utilizes a database of death reports dated between January 2011 and July 2016. For bodies recovered from fresh water, the presence or absence of external foam was noted. In this study, 112 death reports are included. Of these reports, 18 mentioned external foam, which account for 16.1% of the entire study population. In the population with a post-mortem period of less than 24 h, external foam was detected in 27.7% of cases. All 18 incidents with external foam had an estimated post-mortem period of less than 24 h. In our study, external foam was only present in freshwater drowning cases with a post-mortem period of less than 24 h. Based on this finding, the presence of external foam may be useful as an additional indicator when estimating the time of death in freshwater drowning. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  12. Foreign-body in external auditory meatus: evaluation of 462 cases

    Directory of Open Access Journals (Sweden)

    Fornazieri, Marco Aurélio

    2010-03-01

    Full Text Available Introduction: Since 1950, a numberless of studies of the foreign-bodies in ears and upper airways were executed. They are usual cases in the emergency rooms and, if they are not rightly addressed, they can bring about several complications as trauma and tympanic membrane perforation, auditory meatus hemorrhagia, hearing loss and otitis. Objective: Establish the age, sex, complications and foreign-bodies' type in external auditory meatus of 462 patients attended in a tertiary hospital. Method: A retrospective study of the cases of ear' foreign-bodies removed by the otorhinolaryngology service of a tertiary hospital in the period of January 1, 1999 to July 31, 2006. Results: The insects were the foreign-bodies more found. The major incidence of foreign-body in an ear was found in the age group above 16 years old and, in the male sex. The complications occurred mostly in the age group below 6 years old. Conclusion: The foreign-body' prevalence in an ear of the adults is high. The complications occur mostly in 0 to 6 years old age group. In our service, the insects are the most frequents and the responsible for the major part of the complications.

  13. The External Finance Premium and the Financial Accelerator: The Case of Turkey

    Directory of Open Access Journals (Sweden)

    Birgül Cambazoğlu

    2013-04-01

    Full Text Available The monetary transmission mechanisms have influence on saving and investment decisions of firms and households by affecting their balance sheets. This study examines the effects of monetary policy through the balance sheet channel (also known as 'financial accelerator', which affects net worth, liquidity and spending of firms and households through external financepremium. The aim of this study is to analyze the effect of monetary contraction which raised the external finance premium and thus the effect of the increase in the external finance premium which diminishes output for Turkey over the period of 2003:01-2010:08 by using VAR (vector autoregressive models, impulse-response analysis and forecast error variance decomposition. The results indicate that contractionary monetary policy shock, which led to increased external finance premium, negatively affected the manufacturing sector and decreased total output. In other words, the monetary shock negatively affected firms' balance sheets in the short-run.

  14. Case Study Teaching

    Science.gov (United States)

    Herreid, Clyde Freeman

    2011-01-01

    This chapter describes the history of case study teaching, types of cases, and experimental data supporting their effectiveness. It also describes a model for comparing the efficacy of the various case study methods. (Contains 1 figure.)

  15. Split thickness skin grafts in four cases of medial meatal fibrosis of the external auditory canal.

    Science.gov (United States)

    Ribeiro, Andreia; Leonardo, Abílio; e Rodrigues, Manuel Rodrigues; Lopes, Gustavo

    2015-01-01

    Medial meatal fibrosis is a rare condition in which the medial portion of the external auditory canal is obliterated with fibrous tissue. We selected 4 cases of patients with medial meatal fibrosis with a history of recurrent otorrhea who underwent surgery during the years of 2012 and 2013, presenting the surgical results here. Physical examination showed an obliterated external auditory canal and conductive hypoacusis. All cases were solved using a split thickness skin graft from the thigh. The surgical principles that appear to correlate with a favorable outcome are the removal of all fibrous tissue and unhealthy skin, a wide canaloplasty and the use of a split thickness skin graft. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

  16. A Case of Dysplastic Nevus of the External Auditory Canal Presenting with Conductive Hearing Loss

    OpenAIRE

    Kim, Chang Woo; Oh, So Jung; Rho, Young-Soo; Cho, Seong Jin; Koh, Eun Seok

    2009-01-01

    A nevus which is a benign melanocytic neoplasm rarely occurs within the external auditory canal (EAC). A dysplastic nevus presents atypical features both clinically and histologically, and is important as a potential precursor for melanoma. We present a case of a 33-year-old female patient with a dysplastic nevus in her EAC. Physical examination revealed a protruding mass arising from the posterior wall of the left cartilaginous EAC. The mass showed clinically characteristic findings of a mel...

  17. External inflamatory root resorption: clinical case description using calcium hidroxide paste

    OpenAIRE

    Roberta LAMPING; Maekawa, Lilian Eiko; Sidnei MARCACCI; Nassri,Maria Renata Giazzi

    2005-01-01

    The occurrence of external root reabsorption can be associated to a persistent and chronic inflammatory process at the periapical area that determines the presence of bone rarefaction lesion promoted by some endogenous or exogenous irritant agent as predisponent factor. In these cases the only form to try to stop evolution is the agent remotion through endodontic treatment or reintervention. A female patient, 40 years old, presented sensibility at the element 11. The radiographic image showed...

  18. Project management case studies

    CERN Document Server

    Kerzner, Harold R

    2013-01-01

    A new edition of the most popular book of project management case studies, expanded to include more than 100 cases plus a ""super case"" on the Iridium Project Case studies are an important part of project management education and training. This Fourth Edition of Harold Kerzner''s Project Management Case Studies features a number of new cases covering value measurement in project management. Also included is the well-received ""super case,"" which covers all aspects of project management and may be used as a capstone for a course. This new edition:Contains 100-plus case studies drawn from re

  19. Feasibibility study - cases

    DEFF Research Database (Denmark)

    Lund, Henrik; Hvelplund, Frede Kloster; Sukkumnoed, Decharut

    2004-01-01

    The chapter presents two case studies to show the tools of feasibiliy studies within the context of technological innovation.......The chapter presents two case studies to show the tools of feasibiliy studies within the context of technological innovation....

  20. Dynamical responses to external stimuli for both cases of excitatory and inhibitory synchronization in a complex neuronal network.

    Science.gov (United States)

    Kim, Sang-Yoon; Lim, Woochang

    2017-10-01

    For studying how dynamical responses to external stimuli depend on the synaptic-coupling type, we consider two types of excitatory and inhibitory synchronization (i.e., synchronization via synaptic excitation and inhibition) in complex small-world networks of excitatory regular spiking (RS) pyramidal neurons and inhibitory fast spiking (FS) interneurons. For both cases of excitatory and inhibitory synchronization, effects of synaptic couplings on dynamical responses to external time-periodic stimuli S(t) (applied to a fraction of neurons) are investigated by varying the driving amplitude A of S(t). Stimulated neurons are phase-locked to external stimuli for both cases of excitatory and inhibitory couplings. On the other hand, the stimulation effect on non-stimulated neurons depends on the type of synaptic coupling. The external stimulus S(t) makes a constructive effect on excitatory non-stimulated RS neurons (i.e., it causes external phase lockings in the non-stimulated sub-population), while S(t) makes a destructive effect on inhibitory non-stimulated FS interneurons (i.e., it breaks up original inhibitory synchronization in the non-stimulated sub-population). As results of these different effects of S(t), the type and degree of dynamical response (e.g., synchronization enhancement or suppression), characterized by the dynamical response factor [Formula: see text] (given by the ratio of synchronization degree in the presence and absence of stimulus), are found to vary in a distinctly different way, depending on the synaptic-coupling type. Furthermore, we also measure the matching degree between the dynamics of the two sub-populations of stimulated and non-stimulated neurons in terms of a "cross-correlation" measure [Formula: see text]. With increasing A, based on [Formula: see text], we discuss the cross-correlations between the two sub-populations, affecting the dynamical responses to S(t).

  1. Double Sequential External Defibrillation and Survival from Out-of-Hospital Cardiac Arrest: A Case Report.

    Science.gov (United States)

    Johnston, Martin; Cheskes, Sheldon; Ross, Garry; Verbeek, P Richard

    2016-01-01

    Patients who present in ventricular fibrillation are typically treated with cardiopulmonary resuscitation (CPR), epinephrine, antiarrhythmic medications, and defibrillation. Although these therapies have shown to be effective, some patients remain in a shockable rhythm. Double sequential external defibrillation has been described as a viable option for patients in refractory ventricular fibrillation. To describe the innovative use of two defibrillators used to deliver double sequential external defibrillation by paramedics in a case of refractory ventricular fibrillation resulting in prehospital return of spontaneous circulation and survival to hospital discharge with good neurologic function. A 28-year-old female sustained a witnessed out-of-hospital cardiac arrest (OHCA). Bystander CPR was performed by her husband followed by paramedics providing high-quality CPR, antiarrhythmic medication, and 6 biphasic defibrillations using standard energy levels. Double sequential external defibrillation was applied and a return of spontaneous circulation was attained on scene and maintained through to arrival to the emergency department. Following admission to hospital the patient was diagnosed with long QT syndrome. An implantable cardioverter defibrillator was placed and the patient was discharged with a Cerebral Performance Category of 2 as well as a modified Rankin Scale of 2 after an 18-day hospital stay. The patient's functional status continued to improve post discharge. The addition of double sequential external defibrillation as part of a well-organized resuscitation effort may be a valid treatment option for OHCA patients who present in refractory ventricular fibrillation.

  2. Measurement of 9 mm cartridge case external temperatures and its forensic application.

    Science.gov (United States)

    Gashi, B; Edwards, M R; Sermon, P A; Courtney, L; Harrison, D; Xu, Y

    2010-07-15

    The external temperature of the cartridge cases of 9 mm parabellum ammunition during the firing sequence was measured by a series of methods. Using a thermal imaging camera was the most successful method and showed that aluminium alloy cases reached higher temperatures than did brass cases. Peak temperatures for brass cases were 336 K at the case mouth after 1.2 ms and 331 K at the case base after 2 ms. Corresponding temperatures for aluminium alloy cases were 363 K at the mouth after 0.8 ms and 372 K at the base after 1.2 ms. These times at temperature would not be sufficient to destroy any DNA residues left on the case. Measurement of the DNA of fired cartridges showed that DNA deposited on the cartridge case before firing was not affected by the temperatures reached during the firing sequence. Estimates of temperatures to be found in pure aluminium and mild steel cases were made, these indicating that pure aluminium would give higher temperatures than aluminium alloy and steel a lower temperature than for brass. (c) 2010 Elsevier Ireland Ltd. All rights reserved.

  3. External Validation of the HERNIAscore: An Observational Study.

    Science.gov (United States)

    Cherla, Deepa V; Moses, Maya L; Mueck, Krislynn M; Hannon, Craig; Ko, Tien C; Kao, Lillian S; Liang, Mike K

    2017-09-01

    The HERNIAscore is a ventral incisional hernia (VIH) risk assessment tool that uses only preoperative variables and predictable intraoperative variables. The aim of this study was to validate and modify, if needed, the HERNIAscore in an external dataset. This was a retrospective observational study of all patients undergoing resection for gastrointestinal malignancy from 2011 through 2015 at a safety-net hospital. The primary end point was clinical postoperative VIH. Patients were stratified into low-risk, medium-risk, and high-risk groups based on HERNIAscore. A revised HERNIAscore was calculated with the addition of earlier abdominal operation as a categorical variable. Cox regression of incisional hernia with stratification by risk class was performed. Incidence rates of clinical VIH formation within each risk class were also calculated. Two hundred and forty-seven patents were enrolled. On Cox regression, in addition to the 3 variables of the HERNIAscore (BMI, COPD, and incision length), earlier abdominal operation was also predictive of VIH. The revised HERNIAscore demonstrated improved predictive accuracy for clinical VIH. Although the original HERNIAscore effectively stratified the risk of an incisional radiographic VIH developing, the revised HERNIAscore provided a statistically significant stratification for both clinical and radiographic VIHs in this patient cohort. We have externally validated and improved the HERNIAscore. The revised HERNIAscore uses BMI, incision length, COPD, and earlier abdominal operation to predict risk of postoperative incisional hernia. Future research should assess methods to prevent incisional hernias in moderate-to-high risk patients. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  4. Primary Pleomorphic Adenoma of the External Auditory Canal: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Chizu Saito

    2014-01-01

    Full Text Available Background. Pleomorphic adenoma (PA is a benign tumour that mainly arises from salivary glands, and PA of the external auditory canal (EAC is very rare. The objective of this study was to clarify the clinical presentation and treatment of PA of the EAC. Method. The authors present a case of PA arising from the EAC together with a literature review. Results. A 40-year-old man complained of hearing loss and foreign-body sensation of the right ear. Clinical and radiological examinations revealed a well-defined tumour limited to the EAC, with no connection to the parotid gland. Preoperative fine-needle aspiration cytology findings were characteristic of PA. The tumour was removed en bloc with the overlying skin. Conclusion. PA of the EAC is very rare, and methods to rule out malignancy before treatment are lacking. Thus, long-term follow-up is necessary, because malignant tumours are common in the EAC and PA has malignant potential.

  5. [Chronic progressive external ophthalmoplegia: clinical and electromyographic manifestations in a series of cases].

    Science.gov (United States)

    Jiménez-Caballero, P E; Serviá, M; Cabeza, C I; Marsal-Alonso, C; Alvarez-Tejerina, A

    Chronic progressive external ophthalmoplegia (CPEO) is a common mitochondrial disease. The different conditions in this group of diseases overlap clinically, enzymatically and genetically. There is no effective treatment. Ptosis improves with corrective surgery involving tarsorrhaphy as a palliative measure. Code numbers were examined in a retrospective study conducted in order to search for patients with ptosis or ophthalmoplegia who had either visited or been admitted to the neurology department over the last 10 years. Data concerning these patients' clinical features and results of complementary tests were collected. Six patients with CPEO were identified, five of whom were females. Ages ranged from 44 to 72 years. All the patients had ptosis, although 50% were asymmetric. Half of them reported mild dysphagia while swallowing liquids. Levels of creatine phosphokinase and acetylcholine antireceptor antibodies were normal. Half the patients showed increased jitter and a muscle biopsy revealed that five of them had ragged red fibres. The most frequent enzyme deficit was complex I and IV deficiency. There were no familial forms; the most common genetic anomaly was single deletion in the mitochondrial deoxyribonucleic acid. In cases of ptosis and ophthalmoplegia that do not respond to anticholinesterases, knowledge of this condition makes it possible to avoid the use of immunosuppressant drugs, which have important side effects.

  6. The Perceived Impact of External Evaluation: The System, Organisation and Individual Levels-Estonian Case

    Science.gov (United States)

    Seema, Riin; Udam, Maiki; Mattisen, Heli; Lauri, Liia

    2017-01-01

    The purpose of this article is to provide an overview of how the employees of higher education institutions perceive the impact of external evaluations. The study was conducted using the concurrent mixed method and involved 361 employees from Estonian universities and professional higher education institutions. The results indicated that…

  7. Labour outcome of women with successful external cephalic version: a prospective study.

    Science.gov (United States)

    Jain, S; Mulligama, C; Tagwira, V; Guyer, C; Cheong, Y

    2010-01-01

    Labour outcome for women following successful external cephalic version (ECV) was evaluated in a prospective case control study. ECV was successfully performed on 93 women in a dedicated ECV clinic at St Mary's Hospital, Portsmouth between 2004 and 2006. In the study group, 50% (n = 93) of women had a successful ECV. There were 103 women in the control group. There was no significant difference in the rate of instrumental deliveries between the study and the control groups. The rate for caesarean section was higher in the ECV group (18.2, n = 93) compared with the control group (7.7, n = 103; p women undergoing ECV.

  8. Cracking the Case (Study).

    Science.gov (United States)

    DeCarolis, Sabrina

    1995-01-01

    Discusses how technical communicators can get their clients to participate in case studies (for use in marketing the technical communicator's services) by analyzing the case study strategy, selecting appropriate clients, understanding their concerns, and developing a professional presentation. (RS)

  9. External hydrocephalus (benign extra-axial collections of infancy) - review of 15 cases; Hidrocefalia externa colecao extra-axial benigna da infancia - revisao de 15 casos

    Energy Technology Data Exchange (ETDEWEB)

    Machado Junior, Marcos Alberto da Costa; Matos, Paulo Engracio de; Barbosa, Veronica Aline [Fundacao Monte Tabor, Salvador, BA (Brazil). Hospital Sao Rafael. Servico de Bioimagem; Vieira, Naiara Argollo [Hospital Salvador, BA (Brazil); Vieira, Lauro Conceicao Nascimento [Fundacao Monte Tabor, Salvador, BA (Brazil). Hospital Sao Rafael. Servico de Ressonancia Magnetica; Puglio, Nadja; Bacelar, Aroldo [Fundacao Monte Tabor, Salvador, BA (Brazil). Hospital Sao Rafael

    1997-03-01

    The authors studied 15 cases of external hydrocephalus over a 7-year period (September 1987 to May 1995). External hydrocephalus is a condition in which infants with rapidly enlarging heads are found to have a MRI showing widening of subarachnoid space with mild or no ventricular dilatation. Some of the MRI were compared with those of patients with cerebral atrophy and some etiopathogenic hypothesis are presented. These findings indicate that external hydrocephalus is an age-related self-limited condition occurring in infants with open cranial sutures and that it usually resolves without intervention after the second or third year of age. (author) 21 refs., 4 figs.

  10. EU External Relations Law: Text, Cases and Materials, Bart Van Vooren and Ramses A. Wessel, Cambridge University Press, UK, 2014

    DEFF Research Database (Denmark)

    Butler, Graham

    2014-01-01

    by the Treaties, and it is suitably placed to become the core text for teaching this expanding EU policy field. In their book, EU External Relations Law: Text, Cases and Materials, Van Vooren and Wessel seek to fill the gap in up-to-date literature from a legal standpoint in the field of external relations...

  11. Case study research.

    Science.gov (United States)

    Taylor, Ruth; Thomas-Gregory, Annette

    2015-06-10

    This article describes case study research for nursing and healthcare practice. Case study research offers the researcher an approach by which a phenomenon can be investigated from multiple perspectives within a bounded context, allowing the researcher to provide a 'thick' description of the phenomenon. Although case study research is a flexible approach for the investigation of complex nursing and healthcare issues, it has methodological challenges, often associated with the multiple methods used in individual studies. These are explored through examples of case study research carried out in practice and education settings. An overview of what constitutes 'good' case study research is proposed.

  12. [External lumbar drainage with volumetric continuing infusion pump in patients with cerebrospinal fluid leak. A case series].

    Science.gov (United States)

    Manso Melgosa, Ana Belén; García Gutiérrez, Helena; Fernández Porras, Mónica; Castrillo Manero, Ana Berta; Pérez Marijuán, Belén

    To describe the incidence and complications arising in a number of cases of patients with cerebrospinal fluid leak treated by external lumbar drainage with infusion pump (IP) volumetric continuous from 2001 to 2014. Quantify cerebrospinal fluid leak closed by lumbar drainage with IP. Retrospective descriptive case series study. patients undergoing transsphenoidal pituitary surgery, Chiari surgery and laminectomy, that developed postoperative cerebrospinal fluid leak treated with continuous external lumbar drainage by IP. age, sex, type of intervention, variables related to the practice of the pump and complications. Average and medians were calculated for quantitative variables, frequencies and percentages for qualitative. Sample: 11 subjects. Incidence in running IP: disconnection, occlusion and acoustic alarm activation. Most frequently complication is headache; a case of pneumocephalus. The small number of subjects and the heterogeneity of these do not allow for comparison or establishing associations between variables. The resolution of the cerebrospinal fluid leak with continuous IP is lower in this study than others, and may be influenced by the small number of subjects. It should be noted the frequent activation of the pump alarm for no apparent cause. Protocol would be developed for preparing the IP team to reduce the acoustic alarm activation, and would make a prospective multicenter study. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  13. An Experimental Study on Internal and External Negotiation for Trade Agreements

    Directory of Open Access Journals (Sweden)

    Hankyoung Sung

    2017-06-01

    Full Text Available This paper experimentally studies the performance of negotiation considering individual and party, like a country, share of benefit over the best ones. It experiments two-stage bargaining games, internal and external negotiations. From the experimental results, this paper shows strong tendency to select fair allocation in the internal negotiations, but the tendency would be weaker with attractive outside option. In addition, the outside option may claim difference in individual benefit. From the regressions on individual performance in the negotiations, being a proposing party would matter to enhance the performance. However, relative individual performance within party fairness matters. Still attractive no-agreement options happen to break the tendency. As policy implication for trade negotiation, this paper warns that possible loss in individual benefit from not active participation to the external negotiations, no active role of proposer in case that players stick to internal allocations, and deviation of advantageous sector due to attractive outside options.

  14. Mycotic Aneurysm of External Carotid Artery following Traumatic Brain Injury: Case Report and Review of Literature.

    Science.gov (United States)

    Khalili, Hosseinali; Derakhshan, Nima; Malekmohammadi, Zahed; Ghaffarpasand, Fariborz

    2014-04-01

    Mycotic aneurysm of external carotid artery is extremely rare. We herein report a case of external carotid artery (ECA) aneurysm following severe traumatic brain injury. A 24-year-old man with severe traumatic brain injury (TBI) following a car accident was referred to Rajaee Trauma Center Emergency Room affiliated to Shiraz University of Medical Sciences in Shiraz, Iran. He underwent ventriculostomy on arrival for intracerebral pressure (ICP) monitoring and for a second time due to hydrocephalus following decompressive craniectomy. He developed fulminant meningitis and ventriculitis during his hospital course. A bulged pulsatile lesion under the frontotemporal scalp resulted into the suspicion to underlying vascular pathology. Six-vessel angiography of brain was done which revealed mycotic aneurysm of external carotid artery. The patient underwent a two-week course of a combination of intravenous antibiotics. Follow-up angiography was performed which confirmed successful treatment of mycotic aneurysm of ECA. Mycotic aneurysm of ECA is extremely rare. To our knowledge, this is the first report of mycotic aneurysm of ECA following severe TBI which was successfully treated with antimicrobial therapy.

  15. Revascularization Technique for the Treatment of External Inflammatory Root Resorption: A Report of 3 Cases.

    Science.gov (United States)

    Santiago, Cristina N; Pinto, Shirley S; Sassone, Luciana M; Hirata, Raphael; Fidel, Sandra R

    2015-09-01

    The current external inflammatory root resorption treatment protocol, which uses calcium hydroxide dressing, usually comprises multiple and long-term applications. In addition to the need for multiple appointments for calcium hydroxide replacement, the long-term maintenance of this compound in the root canal weakens dental structures. A modification of this therapy would be advisable. In this clinical investigation, 3 patients with external inflammatory root resorption were submitted to revascularization therapy protocol usually used in teeth with necrotic pulp and open apices. The teeth were treated with revascularization therapy protocol, which consisted of disinfecting the root canal system with triantibiotic paste, filling it with blood clot, and sealing of the root canal with mineral trioxide aggregate and bonded resin restoration. During the follow-up, the pathologic process was arrested with tissue repair in pre-existing radiolucent areas. Reduced mobility was observed in the treated teeth. The 3 cases were followed up for 30, 18, and 15 months, respectively. All teeth remained asymptomatic and retained function and physiological mobility. The therapy used in the revascularization procedure was efficient in the treatment of external inflammatory root resorption, reducing the number of appointments and increasing patient compliance. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  16. NEGLECTED POSTERIOR KNEE DISLOCATION TREATED WITH CLOSED MANIPULATION AND UNIPLANAR EXTERNAL FIXATOR : A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Manikumar

    2015-06-01

    Full Text Available Neglected traumatic posterior knee dislocations were rare in orthopaedic literature more so after a surgical intervention . Majority of the injuries are associated with vascular trauma and distal or proximal fractures and complete disruption of anterior and posterior cruciate ligaments and nerve traction injuries. Traumatic knee dislocations are therefore treated as an orthopaedic emergency. There were no definitive guide lines to open reduction as well as conservative methods of treatment. The end results of functional recovery are still controversial with residual posterior subluxation. Here we present a case of neglected posterior knee dislocation treated with closed manipulation and uni planar external fixator

  17. Adventitial cystic disease of the left external iliac vein: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Sang Hee; Shin, Hyun Woong; Lee, Yil Gi; Koo, Mi Jin [Daegu Fatima Hospital, Daegu (Korea, Republic of)

    2005-10-15

    Adventitial cystic disease (ACD) is a rare, but well-characterized vascular disease. It is most commonly seen in the popliteal artery, but it has also been reported in the venous system. The most commonly involved segment has been the common femoral vein; the disease resulted in luminal compromise and extremity swelling. We report here on a case of adventitial cystic disease of the left external iliac vein that was initially misdiagnosed as deep vein thrombosis in a 68-years-old man who presented with a painless swelling of his left leg.

  18. Prenatal Smoking and Internalizing and Externalizing Problems in Children Studied from Childhood to Late Adolescence

    Science.gov (United States)

    Ashford, Janka; Van Lier, Pol A. C.; Timmermans, Maartje; Cuijpers, Pim; Koot, Hans M.

    2008-01-01

    A study was conducted to evaluate whether prenatal smoking was only related to externalizing or both internalizing and externalizing problems in children from childhood to early adolescence. Results indicated that maternal smoking during pregnancy is an accurate predictor of internalizing and externalizing psychopathology among children.

  19. An Exploratory Study: Assessment of Modeled Dioxin Exposure in Ceramic Art Studios (External Review Draft)

    Science.gov (United States)

    EPA has released an external review draft entitled, An Exploratory Study: Assessment of Modeled Dioxin Exposure in Ceramic Art Studios(External Review Draft). The public comment period and the external peer-review workshop are separate processes that provide opportunities ...

  20. External ventricular drain causes brain tissue damage: an imaging study.

    Science.gov (United States)

    Ortolano, Fabrizio; Carbonara, Marco; Stanco, Antonella; Civelli, Vittorio; Carrabba, Giorgio; Zoerle, Tommaso; Stocchetti, Nino

    2017-10-01

    An external ventricular drain (EVD) is used to measure intracranial pressure (ICP) and to drain cerebrospinal fluid (CSF). The procedure is generally safe, but parenchymal sequelae are reported as a possible side effect, with variable incidence. We investigated the mechanical sequelae of EVD insertion and their clinical significance in acute brain-injured patients, with a special focus on hemorrhagic lesions. Mechanical sequelae of EVD insertion were detected in patients by computed tomography (CT) and magnetic resonance imaging (MRI), performed for clinical purposes. In 155 patients we studied the brain tissue surrounding the EVD by CT scan (all patients) and MRI (16 patients); 53 patients were studied at three time points (day 1-2, day 3-10, >10 days after EVD placement) to document the lesion time course. Small hemorrhages, with a hyperdense core surrounded by a hypodense area, were identified by CT scan in 33 patients. The initial average (hyper- + hypodense) lesion volume was 8.16 ml, increasing up to 15 ml by >10 days after EVD insertion. These lesions were not accompanied by neurologic deterioration or ICP elevation. History of arterial hypertension, coagulation abnormalities and multiple EVD insertions were significantly associated with hemorrhages. In 122 non-hemorrhagic patients, we detected very small hypodense areas (average volume 0.38 ml) surrounding the catheter. At later times these hypodensities slightly increased. MRI studies in 16 patients identified both intra- and extracellular edema around the catheters. The extracellular component increased with time. EVD insertion, even when there are no clinically important complications, causes a tissue reaction with minimal bleedings and small areas of brain edema.

  1. Study of Variations in External Morphology of Gall Bladder in Cadavers

    Directory of Open Access Journals (Sweden)

    J. Desai

    2015-06-01

    Full Text Available Background- In modern era increasing interventional and diagnostic procedures and laparoscopic cholecystectomy make study of variation in external morphology of gall bladder important .variation of morphology of gall bladder commonly encounter during radiological investigation a during surgeries. Objective- Aim of this literature was to study morphology of gallbladder in Gujarat region. Material and method:-Study was conducted on 50 gallbladder obtained from formalin fixed cadavers. Shape length and transverse diameter of gall bladder studied. Result: - Commonest shape observed in this study was pear shaped in 84% cases. Average length of gallbladder was found to be 9.5cm. Mean diameter of gall bladder was 3.6 cm, folding of neck and fundus observed in 8% cases. Conclusion: - Variation in extra hepatic billiary in not uncommon. Knowledge of this variation important for surgeon and radiologist for avoid iatrogenic injuries during procedures.

  2. External Cost Assessment of Nuclear Power Plant Accident considering Public Risk Aversion Behavior: the Korean Case

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Hun; Kang, Hyun Gook [KAIST, Daejeon (Korea, Republic of)

    2016-05-15

    The conventional approach for monetary valuation of NPP accident consequence consists of calculating the expected value of various accident scenarios. However, the main criticism of the conventional approach is that there is a discrepancy between the social acceptability of the risk and the estimated expected value of NPP accident. Therefore, an integrated framework for the estimation of the external cost associated with an NPP accident considering the public risk aversion behavior was proposed in this study based on the constructed theoretical framework for estimating both the value of statistical life (VSL) and the risk aversion coefficient associated with an NPP accident to take account of the accident cost into the unit electricity generation cost of NPP. To estimate both parameters, an individual-level survey was conducted on a sample of 1,364 participants in Korea. Based on the collected survey responses, both parameters were estimated based on the proposed framework and the external cost of NPP accident was estimated based on the consequence analysis and considering the direct cost factors for NPP accident. Internalization of external costs into the comprehensive energy production cost has been considered as a potentially efficient policy instrument for a more sustainable energy supply and use. However, the internalization of externalities, such as public health damage, have raised a number of generic policy issues in a nuclear energy sector, with specific challenges resulting from the distinct characteristics of external cost estimation. Especially, the major challenge remained to address the public safety concerns regarding a nuclear accident, which can be specified as low-probability high-consequence accident, driven by the aspects of public risk aversion.

  3. [External stability of the elbow after surgical treatment of epicondylitis. Presentation of a case].

    Science.gov (United States)

    Llop-Corbacho, A; Romero-Ruiz, J; Denia-Alarcón, N

    2014-01-01

    Elbow instability is a difficult to diagnose condition in certain cases, and could lead to some problems that limit daily functioning, such as joint blocks, bumps, projections, muscle weakness, and persistent pain. A case is presented of a patient with a clinical picture of epicondylitis, with a previous history of a fall on the affected arm. As there was no improvement after performing conventional non-aggressive treatment, surgery was performed on the affected tendon. The outcome of this was persistent pain and clinical instability of the elbow that ended up requiring surgery to reconstruct the ligament over the external complex. In follow-up 6 months after the operation, the clinical instability had disappeared, but there was still external discomfort and a 30° extension deficit. When faced with a picture of epicondylitis with a previous injury that does not respond to conventional therapies, it is important to take into account the possibility of an underlying elbow instability, ruling this out with a correct physical examination and, where necessary, with the appropriate complementary tests. Copyright © 2013 SECOT. Published by Elsevier Espana. All rights reserved.

  4. A Special Unique Solution Case of the Perspective-Three-Point Problem for External Parameter Calibration of an Omnidirectional Camera

    Directory of Open Access Journals (Sweden)

    Xiaoxiao Zhu

    2012-11-01

    Full Text Available In the field of machine vision, the multi-solution problem of the perspective-three-point (P3P camera pose estimation problem has been widely researched. Many researchers have tried to find unique solutions that will enable the use of the P3P method in practical applications such as the calibration of external parameters of a camera. Gao found a special case that is very simple and intuitive, but can only be used for a camera with a very large field of view. Therefore, it did not attract much attention. The purpose of this study was to analyse Gao's special case and use it for calibrating the external parameters of an omnidirectional camera, which is used widely because of its very large field of view. We first verify Gao's special case and extend its application. We then propose an iterative method for finding the unique solution. After this, we perform a simulation experiment to determine the effect of the configuration of the three control points on the accuracy of the unique solution. Finally, we use an application to examine the efficiency of the method.

  5. The case study approach

    Science.gov (United States)

    2011-01-01

    The case study approach allows in-depth, multi-faceted explorations of complex issues in their real-life settings. The value of the case study approach is well recognised in the fields of business, law and policy, but somewhat less so in health services research. Based on our experiences of conducting several health-related case studies, we reflect on the different types of case study design, the specific research questions this approach can help answer, the data sources that tend to be used, and the particular advantages and disadvantages of employing this methodological approach. The paper concludes with key pointers to aid those designing and appraising proposals for conducting case study research, and a checklist to help readers assess the quality of case study reports. PMID:21707982

  6. Case management: a case study.

    Science.gov (United States)

    Dring, R; Hiott, B; Elliott, K

    1994-06-01

    Prior to institution of case management Mr. G would have remained on the neuroscience acute care unit until nursing home placement could be arranged, a process which often took a year because of the severe shortage of Medicaid beds in South Carolina. Because case managers collaborated to identify and resolve the problem, the outcome for those such as Mr. G has changed. Case management facilitates movement of patients with complex problems from acute care to successful community reentry in a cost-effective manner.

  7. A case of the hepatic hilar bile duct cancer with external radiation. Efficacy and severe side effect of external radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Andoh, Hideaki; Yasui, Ouki; Ise, Norihito [Akita Univ. (Japan). School of Medicine

    2003-04-01

    Hepatic hilar bile duct cancer was difficult to cure by surgical treatment and its prognosis was very poor. We present the case of non-curative resection of hepatic hilar bile duct cancer, controlled with external radiation. 72 years-old-female, she complained jaundice and diagnosed hepatic hilar bile duct cancer with abdominal ultrasonography. Hepatic hilar resection was performed but curative resection could not be done, because cancer was diffusely spreaded to the hepatic and duodenal ends of the bile duct. After surgery, external radiation (1.8 Gy/day; total 50.4 Gy) was performed. Three months after operation, sometimes, cholangitis was occurred but we could not detect the intrahepatic bile duct dilatation and improved with antibiotics. After seven months, she was dead for sepsis, liver abscess and biliary cirrhosis. From autopsy findings, severe hepatic hilar fibrosis around the irradiation area, stenosis of the hepatico-jejunostomy and portal vein were existed but could not detect the remnant cancer cells. External radiation was sometimes effective, especially for this case. But we should consider the side effect of fibrosis and preventive treatments such as biliary stenting or early biliary drainage. (author)

  8. Internalizing externalities into capacity expansion planning: The case of electricity in Vietnam

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, Khanh Q. [Department of Energy Economics, Institute of Energy, 6 Ton That Tung, Dong da, Hanoi (Viet Nam); GreenTech Ltd., 31/43 Chua Boc, Dong da, Hanoi (Viet Nam)

    2008-05-15

    This paper examines the impacts of including external costs such as environmental and health damages from power production on power generation expansion planning in Vietnam. Using the MARKAL model and covering a 20-year period to 2025, the study shows that there are substantial changes in the generation structure in favor of renewable energy technologies and other low emitting technologies. These changes lead to a reduction in fossil fuel requirements, and consequently, a reduction of CO{sub 2}, NO{sub x}, SO{sub 2}, and PM emissions which could be expected to also reduce the associated environmental and human health impacts. The avoided external costs would be equivalent to 4.4 US cent/kWh. However, these gains are not free as the additional electricity production cost would be around 2.6 US cent/kWh higher if the switch to more expensive, but lower emitting technologies were made. The net benefit of internalizing these externalities is thus around 1.8 US cent/kWh. (author)

  9. The Common Agricultural Policy Role in Addressing External Shocks - The Case of Russian Import Ban

    Directory of Open Access Journals (Sweden)

    ANDREEA DRĂGOI

    2015-05-01

    Full Text Available The Common Agricultural Policy (CAP is one of the oldest and most controversial common policies and it is financed directly from the European Union budget. Some critics of CAP argue that especially in the context of the challenges brought by the international crisis, this policy represents a “burden” for the European budget. Our research aims to responds those critics by showing that CAP may represent an important tool for addressing the external shocks impact on agricultural sector of EU. In this view, we will highlight the role of CAP in sustaining the European farmer during the crisis generated by the Russian import ban, adopted as a response to the sanctions imposed by EU to the Russian Federation in the context of Ukrainian crisis. Using a quantitative and qualitative analysis we will assess how the CAP has supported the European agricultural sector and also the future measures that could be adopted to create a more flexible response in the case of other external shocks.

  10. Inequalities and externalities of power sector. A case of Broadlands hydropower project in Sri Lanka

    Energy Technology Data Exchange (ETDEWEB)

    Gunawardena, U.A.D. Prasanthi [Department of Forestry and Environmental Science, University of Sri Jayewardenepura, Nugegoda (Sri Lanka)

    2010-02-15

    The objective of the paper is to estimate environmental externalities related to a run of river project in Sri Lanka and to investigate inequity in distribution of impacts among different social groups. Diversion of the river resulted in loss of water sports (for high-income groups both local and remote), loss of historical monuments (for remote high-income groups) and recreation losses (for local poor). Removal of forest cover leads to loss of non-timber products (for local poor) and carbon storage (for remote high- and low-income groups). Loss of home garden productivity was borne by local poor groups. Benefit of the project, generation of 145 GWh annually, was a gain for the grid connected groups. The impacts were valued using various valuation methods. The base case of the cost benefit analysis resulted in NPV of US$ 11,335,730. When distributional weights are applied for different income groups, both the sign and magnitude of net benefits change. In order to be viable, the project needs diversion of at least 9% of generated electricity to the poorest households in the country. Implications for energy policy towards reducing externality and inequality impacts are also discussed. (author)

  11. Inequalities and externalities of power sector: A case of Broadlands hydropower project in Sri Lanka

    Energy Technology Data Exchange (ETDEWEB)

    Gunawardena, U.A.D. Prasanthi, E-mail: prasanthigunawardena@yahoo.co [Department of Forestry and Environmental Science, University of Sri Jayewardenepura, Nugegoda (Sri Lanka)

    2010-02-15

    The objective of the paper is to estimate environmental externalities related to a run of river project in Sri Lanka and to investigate inequity in distribution of impacts among different social groups. Diversion of the river resulted in loss of water sports (for high-income groups both local and remote), loss of historical monuments (for remote high-income groups) and recreation losses (for local poor). Removal of forest cover leads to loss of non-timber products (for local poor) and carbon storage (for remote high- and low-income groups). Loss of home garden productivity was borne by local poor groups. Benefit of the project, generation of 145 GWh annually, was a gain for the grid connected groups. The impacts were valued using various valuation methods. The base case of the cost benefit analysis resulted in NPV of US$ 11,335,730. When distributional weights are applied for different income groups, both the sign and magnitude of net benefits change. In order to be viable, the project needs diversion of at least 9% of generated electricity to the poorest households in the country. Implications for energy policy towards reducing externality and inequality impacts are also discussed.

  12. Revascularization procedure in an open apex tooth with external root resorption: A case report

    Directory of Open Access Journals (Sweden)

    Mahsa Dastpak

    2017-06-01

    Full Text Available External inflammatory root resorption (EIR represents a challenge in endodontic practice. EIR commonly occurs after dental trauma that results in periodontal ligament injury, pulp necrosis and subsequent infection.  Treatment of EIR is based on disinfecting the root canal system through chemomechanical procedures and then filling it with calcium hydroxide or triple antibiotic paste. Dental trauma commonly occurs in young patients whose teeth are not fully formed and have thin dentinal walls and open apices. Revascularization therapy has proven to be suitable for treatment of root canals of teeth with pulp necrosis and open apices. This case report presents successful revascularization treatment of a permanent immature tooth with external root resorption and chronic apical periodontitis. The tooth was treated by the protocol suggested by the American Association of Endodontics (AAE, consisted of disinfecting the root canal system, filling it with blood clot and sealing the root canal with mineral trioxide aggregate followed by bonded resin restoration. The symptoms disappeared, the size of the periapical lesion reduced and the tooth was asymptomatic during the 12 month follow up period.

  13. Human health-related externalities in energy system modelling the case of the Danish heat and power sector

    DEFF Research Database (Denmark)

    Zvingilaite, Erika

    2011-01-01

    and generalisations are needed. The way local externalities are included in the existing energy system models is identified and discussed in the paper. Only a few studies include localisation aspects when internalising local externalities in an energy system optimisation. The performed analysis of the Danish heat......This paper discusses methodology of energy system modelling when reduction of local externalities, such as damage to the human health from energy production-related air pollution, is in focus. Ideally, the local energy externalities should be analysed by adopting the impact pathway approach...... of ExternE study, and following the pollutants from their release to the personal uptake and resulting health effects. This would require inclusion of air pollution modelling and monetary valuation of the impacts into an energy system optimisation process. However, this approach involves a complex study...

  14. SASPEN Case Study

    African Journals Online (AJOL)

    Correspondence to: Ms A Prinsloo, e-mail: annettep@ananzi.co.za. SASPEN Case Study. This case study was presented and discussed at the recent SASPEN 2010 Congress by Prof O Goulet, University of Paris Descartes. The summarised discussion of the proceedings was prepared by Annette Prinsloo. Patient's course.

  15. A case of dysplastic nevus of the external auditory canal presenting with conductive hearing loss.

    Science.gov (United States)

    Kim, Chang Woo; Oh, So Jung; Rho, Young-Soo; Cho, Seong Jin; Koh, Eun Seok

    2009-12-31

    A nevus which is a benign melanocytic neoplasm rarely occurs within the external auditory canal (EAC). A dysplastic nevus presents atypical features both clinically and histologically, and is important as a potential precursor for melanoma. We present a case of a 33-year-old female patient with a dysplastic nevus in her EAC. Physical examination revealed a protruding mass arising from the posterior wall of the left cartilaginous EAC. The mass showed clinically characteristic findings of a melanocytic nevus. The patient underwent excisional biopsy via a transcanal approach under local anesthesia. Histopathological examination revealed an intradermal nevus with atypical melanocytes without pleomorphism. There was no evidence of recurrence two years after surgical excision.

  16. Surgical Technique for Pulled in Two Syndrome: Three Cases With Chronic Progressive External Ophthalmoplegia.

    Science.gov (United States)

    Jones, Alexander Matthew; Starte, Julia; Dunn, Hamish; Ahmad, Kate; Tan, Kimberley

    2017-11-17

    The authors describe three examples of "pulled in two syndrome" (PITS) from a series of 13 patients undergoing strabismus surgery with underlying chronic progressive external ophthalmoplegia (CPEO) and illustrate techniques for recovery of the "pulled in two" extraocular muscle should the complication arise. In all cases, a rectus muscle snapped under minimal tension while held on a strabismus hook during strabismus surgery. Two patients suffered from CPEO as a result of genetic mitochondrial disease, whereas one resulted from presumed mitochondrial toxicity induced by HAART. In cases 1 and 3, the proximal medial rectus segment was retrieved and reattached. In case 2, the fragmented superior rectus muscle was too friable to be reattached. All three patients were satisfied with the outcome, having reduced their angles of misalignment postoperatively. All three had improved cosmesis, and the two who had complained of diplopia preoperatively found their diplopia to be eliminated or improved. With anticipation of muscle friability in patients with previous extraocular surgery or degenerative muscle changes such as CPEO, the likelihood of the complication arising may be reduced. Should it occur, the loss of a snapped rectus muscle may be avoided through careful manipulation of the globe. [J Pediatr Ophthalmol Strabismus. 2017;54:e83-e87.]. Copyright 2017, SLACK Incorporated.

  17. Internal and external hazards inside the containment in case of an emergency situation

    Energy Technology Data Exchange (ETDEWEB)

    Abdelhady, Amr [Atomic Energy Authoriy (Egypt). Nuclear Research Center

    2017-11-15

    The objective of this paper is to estimating radionuclide concentrations in air and radiological dose consequences to indoor workers in a containment of MTR open pool type reactor during emergency situations. A postulated core degradation accident causes fission products to release and the ventilation system will be converted automatically from the normal situation into emergency situation in order to purify the contaminated air by forcing it to pass through a group of filters. The study computes internal and external worker doses from inhalation and submersion in a finite cloud of contaminated air during the emergency mode. A radiological toolbox version 2 was used to evaluate the radiation dose levels inside the containment.

  18. Life-saving automated external defibrillation in a teenager: a case report

    Directory of Open Access Journals (Sweden)

    Rey Corsino

    2007-09-01

    Full Text Available Abstract Background Adolescent sudden death during sport participation is commonly due to cardiac causes. Survival is more likely when an automated external defibrillator (AED is used soon after collapse. Case presentation We describe a case of sudden death in a 14 year old boy with two remarkable points, successful resuscitation at school using an AED and diagnosis of arrhythmogenic right ventricular cardiomyopathy (ARVC. Bystander cardiopulmonary resuscitation (CPR was immediately started by a witness and 5 minutes after the event the child was placed on an AED monitor that determined he was in a non shockable rhythm, therefore CPR was continued. Two minutes later, the AED monitor detected a shockable rhythm and recommended a shock, which was then administered. One minute after the shock, a palpable pulse was detected and the child began to breathe by himself. Four days after cardiac arrest, the boy was conversing and self-caring. Cardiac magnetic resonance imaging was suggestive of ARVC. Conclusion Ventricular fibrillation secondary to ARVC may be a devastating event and places young patients and athletes at high risk of sudden death. Immediate CPR and AED have been demonstrated to be lifesaving in such events. Therefore, we suggest that schools should have teachers skilled in CPR and accessible AEDs.

  19. Standard External Doppler Fetal Heart Tracings versus External Fetal Electrocardiogram in Very Preterm Gestation: A Pilot Study.

    Science.gov (United States)

    Fruhman, Gary; Gavard, Jeffrey A; McCormick, Kristina; Wilson-Griffin, Judy; Amon, Erol; Gross, Gilad A

    2016-10-01

    Introduction Very preterm babies can be difficult to monitor using standard external Doppler fetal heart tracings (eFHR). External fetal electrocardiogram (fECG) is a potential alternative. Methods This was a prospective observational pilot study of hospitalized patients at 24 to 28 weeks' gestation. A total of 30 women were traced for up to 2 hours using eFHR followed by up to 2 hours using fECG. The percentage of time the fetal heart rate was traced during the 2-hour window for each modality was calculated. Differences of ≥ 60, ≥ 80, and ≥ 90% total time traced were compared between modalities using McNemar's test. Differences were also assessed for each method between nonobese (body mass index [BMI] Superior performance was found with eFHR at ≥ 60% (93.3 vs. 46.7%, p performance in very preterm gestation was worse than conventional eFHR, although fECG may have a role in nonobese patients.

  20. Six Heliport Case Studies

    National Research Council Canada - National Science Library

    Peisen, Deborah

    1997-01-01

    .... This report evaluates the dynamics of heliport development and operation in order to achieve greater success rate in the future through the case study investigation of six heliports that have both succeeded and failed...

  1. HYDROGEOLOGIC CASE STUDIES

    Science.gov (United States)

    Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

  2. External genitalia gunshot wounds: a ten-year experience with fifty-six cases.

    Science.gov (United States)

    Brandes, S B; Buckman, R F; Chelsky, M J; Hanno, P M

    1995-08-01

    To determine the appropriate methods for the diagnosis and management of gunshot injuries to the external genitalia. Retrospective analysis. Fifty-six patients with gunshot wounds (GSWs) to the external genitalia were seen over the last 10 years. All patients underwent physical examination, radiographic staging, and surgical exploration, according to protocol. There were 25 testicular, 19 scrotal soft tissue, 14 penile, 4 epididymal, 4 urethral, 4 vasal, and 3 superficial scrotal skin injuries. When possible, all injuries, except for the vasal and 1 urethral injury, were primarily repaired with excellent long-term results. Orchiectomy was required in half of testes struck by gunshots. Associated injuries with single GSWs were mostly to the proximity soft tissue and were amenable to conservative management. Major associated injuries were present in patients with multiple GSWs. In the absence of a suspected major associated injury, genital GSWs required only two diagnostic studies, a retrograde urethrogram for suspected urethral injury and a routine abdominal radiograph. Gunshot injuries to the penis or perineum, blood at the penile meatus, or gross hematuria were highly suggestive of urethral injury. Successful management of genital GSWs is dependent upon prompt surgical exploration, conservative debridement, and primary repair.

  3. Implementation of the external cephalic version in breech delivery. Dutch national implementation study of external cephalic version

    Directory of Open Access Journals (Sweden)

    Papatsonis Dimitri N

    2010-05-01

    Full Text Available Abstract Background Breech presentation occurs in 3 to 4% of all term pregnancies. External cephalic version (ECV is proven effective to prevent vaginal breech deliveries and therefore it is recommended by clinical guidelines of the Royal Dutch Organisation for Midwives (KNOV and the Dutch Society for Obstetrics and Gynaecology (NVOG. Implementation of ECV does not exceed 50 to 60% and probably less. We aim to improve the implementation of ECV to decrease maternal and neonatal morbidity and mortality due to breech presentations. This will be done by defining barriers and facilitators of implementation of ECV in the Netherlands. An innovative implementation strategy will be developed based on improved patient counselling and thorough instructions of health care providers for counselling. Method/design The ultimate purpose of this implementation study is to improve counselling of pregnant women and information of clinicians to realize a better implementation of ECV. The first phase of the project is to detect the barriers and facilitators of ECV. The next step is to develop an implementation strategy to inform and counsel pregnant women with a breech presentation, and to inform and educate care providers. In the third phase, the effectiveness of the developed implementation strategy will be evaluated in a randomised trial. The study population is a random selection of midwives and gynaecologists from 60 to 100 hospitals and practices. Primary endpoints are number of counselled women. Secondary endpoints are process indicators, the amount of fetes in cephalic presentation at birth, complications due to ECV, the number of caesarean sections and perinatal condition of mother and child. Cost effectiveness of the implementation strategy will be measured. Discussion This study will provide evidence for the cost effectiveness of a structural implementation of external cephalic versions to reduce the number of breech presentations at term. Trial

  4. Chaitanya case study

    International Development Research Centre (IDRC) Digital Library (Canada)

    lremy

    “Those Who Dream Make a Difference”. Some of Kalpana's written work includes, a study titled Sexual Harassment in. University Campus, published in the TISS Journal; a national level study on Federations coordinated by Sa_dhan;. Networking of SHGs - a case study of Devoshi village, published in Swaskhati journal; etc ...

  5. STUDYING DEFORMATIONS OF AN FLAT TRUSS STRUCTURE STATICALLY INDETERMINATED EXTERNALLY

    Directory of Open Access Journals (Sweden)

    Kirsanov Mikhail Nikolaevich

    2017-08-01

    Full Text Available A flat statically determinate parallel-chord truss structure has a cross-shaped grid and rests upon two rigid pin-bearing supports. Loads in bars are determined in a symbol form using the method of joint isolation by the computer mathematics Maple system. The peculiarity of the considered truss structure is its external static indeterminacy. In fact, all efforts and reactions of supports can be determined from the equilibrium conditions. But the inconvenience is necessary to consider the equilibrium of all the nodes of the truss. The Ritter cross-section method is not applicable to this truss structure. The sections that cut the truss into two parts and pass through the three rods, here exist only for several rods of the extreme panels. The purpose of this paper is to calculate a truss structure with a different number of panels in analytical and numerical form. Finite element calculation method with the use of software LISA 8.0 is applied. It’s noted that a truss structure is kinetically changeable when the number of spans is odd. The corresponding plan of probable velocities is given. In order to receive analytic dependence of deflection on the span number, the induction method and Maxwell-Moor formula has been applied. The operators of the compilation and solution of recurrence equations are involved in determining the general terms of the coefficient sequences. The formulas for calculation of loads in the most compressed bars of a truss structure were received.

  6. Cutaneous Neuroendocrine Carcinoma of the External Auditory Canal: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Yi-Ke Li

    2012-01-01

    Full Text Available Cutaneous neuroendocrine carcinoma (cNEC is rarely seen in the external ear. In this paper, we newly describe a patient with cNEC in his right external auditory canal, followed by a further discussion on the clinical features, diagnosis, and treatments of cNEC of the external ear. A review of the literature showed that cNEC of the external auditory canal generally presents as asymptomatic and that pathology yields the most confirmative diagnosis. A wide resection with adjuvant radiotherapy and chemotherapy is recommended. The overall prognosis of this condition is poor.

  7. ExternE National Implementation Finland

    Energy Technology Data Exchange (ETDEWEB)

    Pingoud, K.; Maelkki, H.; Wihersaari, M.; Pirilae, P. [VTT Energy, Espoo (Finland); Hongisto, M. [Imatran Voima Oy, Vantaa (Finland); Siitonen, S. [Ekono Energy Ltd, Espoo (Finland); Johansson, M. [Finnish Environment Institute, Helsinki (Finland)

    1999-07-01

    ExternE National Implementation is a continuation of the ExternE Project, funded in part by the European Commission's Joule III Programme. This study is the result of the ExternE National Implementation Project for Finland. Three fuel cycles were selected for the Finnish study: coal, peat and wood-derived biomass, which together are responsible for about 40% of total electricity generation in Finland and about 75% of the non-nuclear fuel based generation. The estimated external costs or damages were dominated by the global warming (GW) impacts in the coal and peat fuel cycles, but knowledge of the true GW impacts is still uncertain. From among other impacts that were valued in monetary terms the human health damages due to airborne emissions dominated in all the three fuel cycles. Monetary valuation for ecosystem impacts is not possible using the ExternE methodology at present. The Meri-Pori power station representing the coal fuel cycle is one of the world's cleanest and most efficient coal-fired power plants with a condensing turbine. The coal is imported mainly from Poland. The estimated health damages were about 4 mECU/kWh, crop damages an order of magnitude lower and damages caused to building materials two orders of magnitude lower. The power stations of the peat and biomass fuel cycles are of CHP type, generating electricity and heat for the district heating systems of two cities. Their fuels are of domestic origin. The estimated health damages allocated to electricity generation were about 5 and 6 mECU/kWh, respectively. The estimates were case-specific and thus an generalisation of the results to the whole electricity generation in Finland is unrealistic. Despite the uncertainties and limitations of the methodology, it is a promising tool in the comparison of similar kinds of fuel cycles, new power plants and pollution abatement technologies and different plant locations with each other. (orig.)

  8. A case of ventricular fibrillation not detected by an automated external defibrillator

    Directory of Open Access Journals (Sweden)

    Shigetoshi Sakabe, MD

    2008-01-01

    Full Text Available We report a case of ventricular fibrillation (VF which an automated external defibrillator (AED could not detect. A 13-year-old girl collapsed just after playing basketball. Cardio pulmonary resuscitation (CPR was started immediately and 5 minutes later an AED was applied by a rescue team. The monitor of the AED displayed typical VF, but the AED did not detect it as VF. The VF was not detected during 2 more attempts. Detection occurred on the fourth attempt, and counter-shock was successfully delivered, but the process took an extra 9 minutes. After the event, the girl was diagnosed with a latent type of prolonged QT syndrome. We analyzed the reason why the VF was not detected by the AED and found that the ECG detected by the AED fell outside the device’s parameters for ventricular tachycardia (VT or VF. We emphasize that the AED is an excellent device, but we should also be aware of its limitations.

  9. A hard choice (case study)

    OpenAIRE

    KRAVCHENKO NATALIYA A.; KUZNETSOVA SVETLANA A.

    2014-01-01

    The case describes the problems of strategic choice: a small company successfully working in the engineering market (automation of technological processes) in the electric power industry has to make a decision on its further development in a changing external environment and increased competition. The case was carried out to be used in training programs of different levels within the courses “Strategic Management”, “Innovation Management”, “Strategic Analysis Methods”, “Change Management” whe...

  10. Application of largest Lyapunov exponent analysis on the studies of dynamics under external forces

    Science.gov (United States)

    Odavić, Jovan; Mali, Petar; Tekić, Jasmina; Pantić, Milan; Pavkov-Hrvojević, Milica

    2017-06-01

    Dynamics of driven dissipative Frenkel-Kontorova model is examined by using largest Lyapunov exponent computational technique. Obtained results show that besides the usual way where behavior of the system in the presence of external forces is studied by analyzing its dynamical response function, the largest Lyapunov exponent analysis can represent a very convenient tool to examine system dynamics. In the dc driven systems, the critical depinning force for particular structure could be estimated by computing the largest Lyapunov exponent. In the dc+ac driven systems, if the substrate potential is the standard sinusoidal one, calculation of the largest Lyapunov exponent offers a more sensitive way to detect the presence of Shapiro steps. When the amplitude of the ac force is varied the behavior of the largest Lyapunov exponent in the pinned regime completely reflects the behavior of Shapiro steps and the critical depinning force, in particular, it represents the mirror image of the amplitude dependence of critical depinning force. This points out an advantage of this technique since by calculating the largest Lyapunov exponent in the pinned regime we can get an insight into the dynamics of the system when driving forces are applied. Additionally, the system is shown to be not chaotic even in the case of incommensurate structures and large amplitudes of external force, which is a consequence of overdampness of the model and the Middleton's no passing rule.

  11. Successful new product development through external collaboration : the case of SMEs in the medical devices sector

    NARCIS (Netherlands)

    Pullen, A.J.J.

    2010-01-01

    This research focuses on the challenges faced by small and medium sized companies (SMEs) in New Product Development and the importance of the external network in this situation. The literature clearly identifies the internal and external organization as two factors that influence innovation

  12. [Relationship between alcohol consumption and external causes of death based on the forensic autopsy cases in Yamaguchi].

    Science.gov (United States)

    Hakucho, Ayako; Kawamura, Haruka; Liu, Jinyao; Liu, Xu; Takase, Izumi; Fujimiya, Tatsuya

    2014-06-01

    We analyzed forensic autopsy cases to assess the relationship between alcohol consumption and external causes of death. We divided 605 autopsy cases which had been performed from 2000 to 2011 at our department into Alcohol group (n = 172, 28.4%) and Non-alcohol group (n = 433, 71.6%) according to whether alcohol could be detected in the deceased's blood. The individuals' sex and age, season when the death occurred, cause of death, type of death and circumstances of death were analyzed. Alcohol group had a significantly higher ratio of males and younger ages (both p < 0.05). There was no significant between-group difference regarding the seasons when the deaths occurred. Alcohol group had significantly greater rates of spinal injuries, abdominal injuries, traffic accidents, and accidental drowning. "Bicycling" was revealed as a related factor of the traffic accidents only in Alcohol group. In contrast, "accident on the expressway," "riding a motorcycle," and "a passenger in a vehicle" were related factors only in Non-alcohol group. We concluded that the factors of male gender and middle-to-senior age are responsible for the increased risk of external causes of death after alcohol consumption, and that alcohol consumption is one of the risk factors for accidental death. In Japan, drunk-driving-related accidents have shown a downward trend whereas bicycling-related accidents have shown an upward trend, and similar results were obtained in the present study. The low awareness of drinking-induced pitfalls may be responsible for drinking-related bicycle accidents.

  13. Spatiotemporal neurodynamics underlying internally and externally driven temporal prediction: a high spatial resolution ERP study.

    Science.gov (United States)

    Mento, Giovanni; Tarantino, Vincenza; Vallesi, Antonino; Bisiacchi, Patrizia Silvia

    2015-03-01

    Temporal prediction (TP) is a flexible and dynamic cognitive ability. Depending on the internal or external nature of information exploited to generate TP, distinct cognitive and brain mechanisms are engaged with the same final goal of reducing uncertainty about the future. In this study, we investigated the specific brain mechanisms involved in internally and externally driven TP. To this end, we employed an experimental paradigm purposely designed to elicit and compare externally and internally driven TP and a combined approach based on the application of a distributed source reconstruction modeling on a high spatial resolution electrophysiological data array. Specific spatiotemporal ERP signatures were identified, with significant modulation of contingent negative variation and frontal late sustained positivity in external and internal TP contexts, respectively. These different electrophysiological patterns were supported by the engagement of distinct neural networks, including a left sensorimotor and a prefrontal circuit for externally and internally driven TP, respectively.

  14. Discrepancy in perception of bullying experiences and later internalizing and externalizing behavior: A prospective study.

    Science.gov (United States)

    Hwang, Soonjo; Kim, Young Shin; Koh, Yun-Joo; Bishop, Somer; Leventhal, Bennett L

    2017-09-01

    Discrepancy in perception of bullying experiences may lead to later internalizing or externalizing behavior in adolescents. A 1,663 South Korean 7th and 8th graders (mean age: 13.1 and 14.1 years old), were seen for a follow-up study to examine the relationships between the discrepancy in perception of their bullying experiences (defined as discrepancy between self- and peer-reports of bullying experiences) and internalizing or externalizing behavior at follow-up. Bullying was assessed by self- and peer-report. The discrepancy in perception of bullying experiences was defined by the concordance or discordance between self- and peer-reports. Internalizing and externalizing behavior was evaluated using the Youth Self Report and Child Behavior Checklist, at baseline and follow-up. Two by two ANCOVA was performed with a factorial design, categorizing discrepancy in perception of bullying experiences based on the agreement between self-report and peer-report. Internalizing/externalizing behavior-at-follow-up was used as an outcome, adjusting for other known risk factors for internalizing/externalizing behavior, including baseline internalizing/externalizing behavior, and bullying experiences. Adolescents with perceptions of bullying experiences discrepant from peer-reports showed increased internalizing/externalizing behavior at follow-up. Bullying also stands out as an independent risk factor for the development of future externalizing behavior even among adolescents with accurate perceptions of bullying experiences. These specific groups of youth warrant more focused assessment and intervention. © 2017 Wiley Periodicals, Inc.

  15. External facilitators and interprofessional facilitation teams: a qualitative study of their roles in supporting practice change.

    Science.gov (United States)

    Lessard, Sylvie; Bareil, Céline; Lalonde, Lyne; Duhamel, Fabie; Hudon, Eveline; Goudreau, Johanne; Lévesque, Lise

    2016-07-16

    Facilitation is a powerful approach to support practice change. The purpose of this study is to better understand the facilitation roles exercised by both external facilitators and interprofessional facilitation teams to foster the implementation of change. Building on Dogherty et al.'s taxonomy of facilitation activities, this study uses an organizational development lens to identify and analyze facilitation roles. It includes a concise definition of what interprofessional facilitation teams actually do, thus expanding our limited knowledge of teams that act as change agents. We also investigate the facilitation dynamics between change actors. We carried out a qualitative analysis of a 1-year process of practice change implementation. We studied four family medicine groups, in which we constituted interprofessional facilitation teams. Each team was supported by one external facilitator and included at least one family physician, one case manager nurse, and health professionals located on or off the family medicine group's site (one pharmacist, plus at least one nutritionist, kinesiologist, or psychologist). We collected our data through focus group interviews with the four teams, individual interviews with the two external facilitators, and case audit documentation. We analyzed both predetermined (as per Dogherty et al., 2012) and emerging facilitation roles, as well as facilitation dynamics. A non-linear framework of facilitation roles emerged from our data, based on four fields of expertise: change management, project management, meeting management, and group/interpersonal dynamics. We identified 72 facilitation roles, grouped into two categories: "implementation-oriented" and "support-oriented." Each category was subdivided into themes (n = 6; n = 5) for clearer understanding (e.g., legitimation of change/project, management of effective meetings). Finally, an examination of facilitation dynamics revealed eight relational ties occurring within and/or between

  16. Objectivist case study research

    DEFF Research Database (Denmark)

    Ridder, Hanne Mette Ochsner; Fachner, Jörg

    2016-01-01

    In order to comprehend the impact of music therapy or music therapy processes, a researcher might look for an approach where the topic under investigation can be understood within a broader context. This calls for a rich inclusion of data and consequently a limited number of participants and may...... be achieved through the use of objectivist case study research. The strength of the case study design is that it allows for uncovering or suggesting causal relationships in real-life settings through an intensive and rich collection of data. According to Hilliard (1993), the opposite applies for extensive...... designs, in which a small amount of data is gathered on a large number of subjects. With the richness of data, the intensive design is ―the primary pragmatic reason for engaging in single-case or small N research‖ (p. 374) and for working from an idiographic rather than a nomothetic perspective....

  17. Decreasing Complications of Quadricepsplasty for Knee Contracture after Femoral Fracture Treatment with an External Fixator: Report of Four Cases

    Directory of Open Access Journals (Sweden)

    Naoya Kashiwagi

    2013-01-01

    Full Text Available Introduction: In performing quadricepsplasty for contracture that develops after application of an external fixator for femoral fractures, surgeons must be aware of the potential risk for re-fracture and pin-related problems. The purpose of this report is to highlight these not well-detailed complications and to discuss specific findings and treatment suggestions.Case Report: 4 men (mean age, 40 years presenting with secondary to contracture that developed after application of an external fixator for femoral fractures were included in this study. The radiographs showed union across the fracture site however two of these patients couldn't stand on one leg raising suspicion about the union status. A computed tomographic image indeed demonstrated limited continuity of the cortex. Bone grafting was performed prior to quadricepsplasty. The mean extension and flexion before the quadricepsplasty were 0o and 570 , respectively. At the final follow-up examination, the mean active flexion of the knee had increased to 98o.Results: The incidence of re-fracture during and after quadricepsplasty has been reported to be between 10 and 25%. There are 2 preoperative features that may mislead surgeons into believing that complete union of the fractures has been attained: one is the patient's ability to stand on a single leg, and the other is the fact that plain radiographs may lend themselves to different interpretations. In such cases, computed tomography will provide evidence of the continuity of the cortical bone. Bone grafting in 2 of our patients is thought to have prevented the postoperative complications of re-fracture. Complications at pin sites induce contracture at surrounding structures. When extreme tightness of the skin is noted, a tension-releasing procedure such as a skin graft should be performed.Conclusion: In conclusion, re-fracture or pin-site contracture should be carefully managed before quadricepsplasty, because the patients who need a

  18. Effect of an external electric field on the dissociation energy and the electron density properties: The case of the hydrogen bonded dimer HF⋯HFa)

    Science.gov (United States)

    Mata, Ignasi; Molins, Elies; Alkorta, Ibon; Espinosa, Enrique

    2009-01-01

    The effect of a homogeneous external electric field parallel to the hydrogen bond in the FH⋯FH dimer has been studied by theoretical methods. The quantum theory of atoms in molecules methodology has been used for analyzing the electron distribution of the dimer, calculated with different hydrogen bond distances and external field magnitudes. It is shown that an electric field in the opposite direction to the dipole moment of the system strengthens the interaction due to a larger mutual polarization between both molecules and increases the covalent character of the hydrogen bond, while an external field in the opposite direction has the inverse effect. The properties of the complex at its equilibrium geometry with applied field have been calculated, showing that dependencies between hydrogen bond distance, dissociation energy, and properties derived from the topological analysis of the electron distribution are analogous to those observed in families of XDH⋯AY complexes. The application of an external field appears as a useful tool for studying the effect of the atomic environment on the hydrogen bond interaction. In the case of FH⋯FH, both the kinetic energy density and the curvature of the electron density along the hydrogen bond at the bond critical point present a surprisingly good linear dependence on the dissociation energy. The interaction energy can be modeled by the sum of two exponential terms that depend on both the hydrogen bond distance and the applied electric field. Moreover, as indicated by the resulting interaction energy observed upon application of different external fields, the equilibrium distance varies linearly with the external field, and the dependence of the dissociation energy on either the hydrogen bond distance or the external electric field is demonstrated to be exponential.

  19. A Psychobiographical Case Study

    African Journals Online (AJOL)

    The secondary objective was to illustrate and test the relevance of Levinsonian theory as applied .... Levinson's theory was selected for this psychobiographical case study due to (a) its focus on the individual's entire lifespan,. (b) its amalgamation of other theories, ...... ship with an object has great meaning (as did Jobs's.

  20. 425 Case study

    African Journals Online (AJOL)

    Marinda

    Case Study. 29. SAJAA 2009;15(3) • Jun/Jul. Anaesthesia management of acute aortic dissection type B in Marfan syndrome complicating end-stage pregnancy a Laudanski K, MD, b Robicsek S, MD, PhD a Department of Anesthesiology and Critical Care, Beth Israel and Deaconess Hospital, Harvard Medical School, ...

  1. Two African Case Studies

    African Journals Online (AJOL)

    Cyril I. Obi: Resources, Population and Conflicts: Two African Case Studies 57 social relations, which worsen existing ethnic tensions. It resorts to violence, coercion and ... utilisation away from local needs and local markets towards the demands of the international market”. The alienation of the peasants from their land–the ...

  2. Chronic progressive external ophthalmoplegia: II. A qualitative and quantitative electronmicroscopy study of skeletal muscles

    Directory of Open Access Journals (Sweden)

    Elza Dias-Tosta

    1988-06-01

    Full Text Available This study quantifies the maior electron microscopic changes in limb muscle biopsies from 31 out of 34 patients with the syndrome of chronic progressive external ophthalmoplegia. Patients were divided into three clinical groups - A 10 sporadic cases with muscle weakness only; B 9 familial cases with muscle weakness only; C 15 cases with muscle weakness and one or more of the following features: pigmentary retinopathy, cerebellar ataxia, pyramidal signs and peripheral neuropathy. Electron microscopic mitochondrial abnormalities were found in all groups (8 patients from group A, 3 from group B, 14 from group C. Quantitative measurements of certain muscle fibre constituents, using a point-counting technique, revealed decreased myofibril volume-fractions and increased volume-fractions of mitochondria, glycogen and lipid in some biopsies from each group. Mitochondrial volume-fractions correlated positively with lipid content, the proportion of type 1 fibres, and the percentage of fibres with increased oxidative enzyme activity. The three groups defined clinically showed no significant differences in terms of the relative proportions of these measured constituents.

  3. Study of external dynamic flap loads on a 6 percent B-1B model

    Science.gov (United States)

    Seiner, John M.; Manning, James C.; Capone, Francis J.; Pendergraft, Odis C., Jr.

    1991-01-01

    The origin of dynamic pressure loads on external divergent engine nozzle flaps of the B-1B aircraft was investigated in the NASA/LaRC 16 foot transonic tunnel using a 6 percent full span model with powered engine nacelles. External flap dynamic loads and afterbody drag associated with flap removal were measured using this model. Both dry and max. A/B power nozzles were evaluated in this study. As a result of this study, the principal mechanisms responsible for high dynamic external flap loads were determined along with performance penalty associated with flap removal.

  4. External and Internal Barriers to Studying Can Affect Student Success and Retention in a Diverse Classroom

    National Research Council Canada - National Science Library

    Laurence Clement

    2016-01-01

    .... It tests whether instructors’ expectations of study time were realistic for community college students and whether students reported facing external barriers, such as job and family responsibilities, or internal barriers...

  5. A Case Study: action based Entrepreneurship Education

    OpenAIRE

    Jacobsen, Petter Jacob

    2011-01-01

    This paper contributes by providing suggestions on how to analyze business ideas forexploitation in an entrepreneurial education context, and how the institution can provide support activities to enhance the chance of successful exploitation. Active learning has become the preferred choice of teaching entrepreneurship and external ideas are used to provide the students with business opportunities to exploit. An instrumentaø case study on the Norwegian University of Science and Technology Sc...

  6. Cholesteatoma associated with squamous cell carcinoma of the external auditory canal: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Olfa Ben Gamra

    2015-11-01

    Conclusion: SCC of the external auditory canal can mimic cholesteatoma. A precise diagnosis of the disease is important to predict the treatment outcome. Optimal management relies on early surgery and postoperative radiotherapy, thus offering the greatest chance of cure.

  7. An anatomical study of the lumbar external foraminal ligaments: appearance at MR imaging.

    Science.gov (United States)

    Marić, Dušica L; Krstonošić, Bojana; Erić, Mirela; Marić, Dušan M; Stanković, Milan; Milošević, Nebojša T

    2015-01-01

    The purpose of this study was to examine the MRI appearance of the ligaments within the external space of the lumbar intervertebral foramen by correlating MR images with the corresponding anatomic dissection of the cadaver lumbar spine. This was a two part study. Part I of the anatomic study consisted of the dissection of lumbar specimens from one embalmed adult male cadaver. At each lumbar level the external ligamentous structures were identified and their origin, insertion and position were determined. Part II of the study consisted of the anatomical analysis of the external transforaminal ligaments in the 180 lumbar intervertebral foramina on the MR images (1.5 T) in the sagittal plane. The diagnostic procedure was performed on 18 individuals from 18 to 25 years of age. The external transforaminal ligaments were observed at all levels and from both sides in the lumbar intervertebral foramen. The presence of the superior corporotransverse ligament was found in 45.56% intervertebral foramina, while the inferior corporotransverse ligament was found in 61.67% intervertebral foramina in the MRI. Our results confirm that external transforaminal ligaments are common structures in the intervertebral foramen. The results of this study show that the external transforaminal ligaments can be clearly visualized in MR images. It is crucial to have previous knowledge of the cadaveric specimens to recognize the transforaminal ligaments in MR images. The presence of these ligaments is clinically important because the ligaments could be the cause of nerve root compression or the low back pain syndrome.

  8. Public health surveillance of automated external defibrillators in the USA: protocol for the dynamic automated external defibrillator registry study.

    Science.gov (United States)

    Elrod, JoAnn Broeckel; Merchant, Raina; Daya, Mohamud; Youngquist, Scott; Salcido, David; Valenzuela, Terence; Nichol, Graham

    2017-03-29

    Lay use of automated external defibrillators (AEDs) before the arrival of emergency medical services (EMS) providers on scene increases survival after out-of-hospital cardiac arrest (OHCA). AEDs have been placed in public locations may be not ready for use when needed. We describe a protocol for AED surveillance that tracks these devices through time and space to improve public health, and survival as well as facilitate research. Included AEDs are installed in public locations for use by laypersons to treat patients with OHCA before the arrival of EMS providers on scene. Included cases of OHCA are patients evaluated by organised EMS personnel and treated for OHCA. Enrolment of 10 000 AEDs annually will yield precision of 0.4% in the estimate of readiness for use. Enrolment of 2500 patients annually will yield precision of 1.9% in the estimate of survival to hospital discharge. Recruitment began on 21 Mar 2014 and is ongoing. AEDs are found by using multiple methods. Each AED is then tagged with a label which is a unique two-dimensional (2D) matrix code; the 2D matrix code is recorded and the location and status of the AED tracked using a smartphone; these elements are automatically passed via the internet to a secure and confidential database in real time. Whenever the 2D matrix code is rescanned for any non-clinical or clinical use of an AED, the user is queried to answer a finite set of questions about the device status. The primary outcome of any clinical use of an AED is survival to hospital discharge. Results are summarised descriptively. These activities are conducted under a grant of authority for public health surveillance from the Food and Drug Administration. Results are provided periodically to participating sites and sponsors to improve public health and quality of care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  9. Case Studies - Cervical Cancer

    Centers for Disease Control (CDC) Podcasts

    2010-10-15

    Dr. Alan Waxman, a professor of obstetrics and gynecology at the University of New Mexico and chair of the American College of Obstetricians and Gynecologists (ACOG) committee for the underserved, talks about several case studies for cervical cancer screening and management.  Created: 10/15/2010 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  10. Qualitative Case Study Guidelines

    Science.gov (United States)

    2013-11-01

    methods in public relations and marketing communications. New York, Routledge 166-185 13. Denzin , N. K. (1978) The Research Act: A Theoretical...Introduction to Sociological Methods. 2nd ed. New York, McGraw-Hill 14. Denzin , N. K. and Lincoln, Y. S. (2011) The SAGE Handbook of Qualitative...The Art of Science. In: Denzin , N. K. and Lincoln, Y. S. (eds.) Handbook of Qualitative Research. Thousand Oaks, Sage 19. GAO (1990) Case Study

  11. Holographic study of the QCD matter under external conditions

    Directory of Open Access Journals (Sweden)

    Katanaeva Alisa

    2017-01-01

    We use methods of the bottom-up AdS/QCD approach to bring out the phase structure of several holographic models in which transition to a deconfined phase is related to a (first order Hawking-Page phase transition. The impact of phenomenological model parameters on the critical temperature and chemical potential is studied in detail. Comparison of the model predictions with results of experimental investigations, lattice QCD simulations and other methods is also done.

  12. A study on corium behaviour under external vessel cooling

    Energy Technology Data Exchange (ETDEWEB)

    Park, Rae Joon; Kim, Sang Baik; Kang, Kyung Ho; Koo, Kil Mo; Kim, Hee Dong

    2000-04-01

    This study presents the results of evaluation and analysis on the second phase of the RASPLAV project for three years between July 1, 1997 and June 30, 2000. In the RASPLAV Phase II study, two large-scale experiments of RASPLAV-AW-200-3, 4 were conducted to estimate the heat flux distribution in the corium and thermal interaction between the corium and the reactor vessel. Several small-scale experiments such as TULPAN, TF, and STF were conducted to analyze thermal stratification and additive effect of core materials on corium behavior. The Salt experiments were conducted to estimate the crust and the mushy region formation, as well as natural convection heat transfer in the corium. Material properties of the corium and the salt were measured in the RASPLAV project. During the RASPLAV-AW-200-3 test, approximately 22 kg of the corium leaked from the test furnace, because Fe from the FeO, which was additive to reduce the melting temperature of fuel pellet, interacted with Tungsten protector. It is concluded from the AW-200-3 test results that the oxidized U-Zr-O is not separated. From the RASPLAV-AW-200-4 test results, the C-32 fuel with the miscibility gap and low content of carbon was not separated thermally. The carbon is known as a dominant factor in the thermal stratification of the corium from the small and medium scale test results such as TULPAN, TF, and STF. The fuel composition, test method and condition in the RASPLAV-AW-2003,4 were selected using the small and medium scale test results. It is confirmed from the Salt test that the analytical model of the CONV code predicts heat transfer with crust formation in the molten pool very well.

  13. Endoscopic treatment of the external snapping hip syndrome: surgical technique and report of two cases.

    Science.gov (United States)

    Kunac, Nino; Trsek, Denis; Medancić, Nenad; Starcević, Damir; Haspl, Miroslav

    2012-12-01

    Snapping hip or coxa saltans is a condition characterized by an audible and/or palpable snapping during hip movement and can be associated with pain around the hip. There are various causes of this condition and can be divided into two types: extra-articular and intra-articular. The most common type is the external extra-articular, where the snapping is due to thickened posterior part of the iliotibial band or anterior part of the gluteus maximus muscle sliding over the greater trochanter during hip movement. Two patients with external snapping hip are presented, who were treated with our original endoscopic iliotibial band release and greater trochanteric bursectomy. There were no surgical complications and the patients did not experience snapping or pain in the hip during 24-month follow-up period. Results of various open techniques and one endoscopic technique in the treatment of external snapping hip are also reported.

  14. Implementation of the external cephalic version in breech delivery. Dutch national implementation study of external cephalic version

    NARCIS (Netherlands)

    Vlemmix, F.; Rosman, A.N.; Fleuren, M.A.H.; Rijnders, M.E.B.; Beuckens, A.; Haak, M.C.; Akerboom, B.M.C.; Bais, J.M.J.; Kuppens, S.M.I.; Papatsonis, D.N.; Opmeer, B.C.; Post, J.A.M. van der; Mol, B.W.J.; Kok, M.

    2010-01-01

    Background: Breech presentation occurs in 3 to 4% of all term pregnancies. External cephalic version (ECV) is proven effective to prevent vaginal breech deliveries and therefore it is recommended by clinical guidelines of the Royal Dutch Organisation for Midwives (KNOV) and the Dutch Society for

  15. Implementation of the external cephalic version in breech delivery Dutch national implementation study of external cephalic version

    NARCIS (Netherlands)

    Vlemmix, Floortje; Rosman, Ageeth N.; Fleuren, Margot A. H.; Rijnders, Marlies E. B.; Beuckens, Antje; Haak, Monique C.; Akerboom, Bettina M. C.; Bais, Joke M. J.; Kuppens, Simone M. I.; Papatsonis, Dimitri N.; Opmeer, Brent C.; van der Post, Joris A. M.; Mol, Ben Willem J.; Kok, Marjolein

    2010-01-01

    ABSTRACT: BACKGROUND: Breech presentation occurs in 3 to 4 % of all term pregnancies. External cephalic version (ECV) is proven effective to prevent vaginal breech deliveries and therefore it is recommended by clinical guidelines of the Royal Dutch Organisation for Midwives (KNOV) and the Dutch

  16. The Association of Externalizing Behavior and Parent-Child Relationships: An Intergenerational Study.

    Science.gov (United States)

    Brook, Judith S; Lee, Jung Yeon; Finch, Stephen J; Brown, Elaine N

    2012-06-01

    We investigated the influence of the child's behavior on the quality of the mutual parent-child attachment relationships across three generations. We did so using a prospective longitudinal study which spanned 20 years from adolescence through adulthood. Study participants completed in-class questionnaires as students in the East Harlem area of New York City at the first wave and provided follow-up data at 4 additional points in time. 390 participants were included in these analyses; 59% female, 45% African American, and 55% Puerto Rican. Using structural equation modeling, we determined that externalizing behavior in the child was negatively related to the mutual parent-child attachment relationship for two generations of children. We also found continuity in externalizing behavior for the participant over time and from the participant to his/her child. Additionally, we found continuity in the quality of the mutual attachment relationship from the participant's relationship with his/her parents to the participant's relationship with his/her child. Finally, the mutual attachment relationship of the participant with his/her parents had a negative association with the participant's externalizing behavior in adulthood. Based on these results, we propose that family interventions should focus on the role of the child's externalizing behavior in the context of the parent-child attachment relationship. Furthermore, we suggest that prevention programs should address externalizing behavior as early as possible, as the effects of externalizing behavior in adolescence can persist into adulthood and extend to the next generation.

  17. ExternE transport methodology for external cost evaluation of air pollution (DK)

    Energy Technology Data Exchange (ETDEWEB)

    Solvang Jensen, S.; Berkowicz, R.; Brandt, J. [National Environmental Research Inst., Dept. of Atmospheric Environment (Denmark); Willumsen, E.; Kristensen, N.B. [COWI (Denmark)

    2004-07-01

    The report describes how the human exposure estimates based on NERI's human exposure modelling system (AiGIS) can improve the Danish data used for exposure factors in the ExternE Transport methodology. Inititally, a brief description of the ExternE Transport methodology is given and it is summarised how the methodology has been applied so far in a previous Danish study. Finally, results of a case study are reported. Exposure factors have been calculated for various urban categories in the Greater Copenhagen Area. (au)

  18. Case Study - Alpha

    Directory of Open Access Journals (Sweden)

    Stephen Leybourne

    2016-11-01

    Full Text Available This case study was developed from an actual scenario by Dr. Steve Leybourne of Boston University.  The case documents the historical evolution of an organization, and has been used successfully in courses dealing with organizational and cultural change, and the utilization of ‘soft skills’ in project-based management. This is a short case, ideal for classroom use and discussion.  The issues are easily accessible to students, and there is a single wide ranging question that allows for the inclusion of many issues surrounding strategic decision-making, and behavioural and cultural change. Alpha was one of the earlier companies in the USA to invest in large, edge-of-town superstores, with plentiful free vehicle parking, selling food and related household products. Alpha was created in the 1950s as a subsidiary of a major publicly quoted retail group.  It started business by opening a string of very large discount stores in converted industrial and warehouse premises in the south of the United States. In the early days shoppers were offered a limited range of very competitively priced products. When Alpha went public in 1981 it was the fourth largest food retailer in the US, selling an ever-widening range of food and non-food products.  Its success continued to be based on high volume, low margins and good value for money, under the slogan of ‘Alpha Price.’

  19. A cadaveric study involving variations in external morphology of gall bladder

    Directory of Open Access Journals (Sweden)

    Anjankar Vaibhav Prakash, Panshewdikar Pradnyesh N, Joshi DS, Anjankar Ashish Prakash

    2013-04-01

    Full Text Available Background: Variations in the pattern of the extra hepatic biliary tract are usual and are commonly encountered during some radiological investigations or in operation theaters. Such Variations of the morphology of Gall bladder have been well documented in the literature for many years but a detail morphological study of variations of the gall bladder and its incidence is very rare. In this era of quick results, increasing use of diagnostic and interventional procedures makes it important to study variations of gall bladder morphology. Most of the interventional procedures in this modern era are done laparoscopically and there is tremendous increase in the number of laparoscopic cholecystectomies. So, sound knowledge of possible variations in morphology of gall bladder is important. Materials and Methods: This study was undertaken on 90 cadaveric liver and gall bladder specimens in terms of length, maximum transverse diameter, shape, external variations of gall bladder, Interior and length of gall bladder below the inferior border of the liver. Results: GB had length ranging between 7 and 10 cm, transverse diameter between 2 and 5 cm. The commonest shape observed in this study was pear shaped in 82.22% of cases. The length of gall bladder below the inferior border of liver varied between 0.4 and 2.5 cm. Conclusion: The growing importance of such variations, lie not only from the point of biliary disease but also with respect to the various invasive techniques in the diagnosis and treatment of gall bladder and extrahepatic bile duct disease.

  20. Osseointegration Implant Post Coupling With External Prosthetic Limb – Continuation of Previous Case Reports “Stage III”

    OpenAIRE

    Ronald Hillock, MD; Danny Tatum, BCP; Edward Dolegowski, PT

    2014-01-01

    An ongoing update of the progress case report for the first patient treated with the Longitude™ osseointegration prosthesis implanted in an amputated residual femur is presented. The patient was given an intensive physical therapy program of strengthening and conditioning in anticipation of coupling to the external prosthesis. A custom prosthesis was fabricated based on the Plie’ 2.0 microprocessor knee system. The patient was then successfully trained on use and care of the prosthesis for am...

  1. OBSESSIONS: CASE REPORT STUDY

    Directory of Open Access Journals (Sweden)

    Miloš Židanik

    2004-01-01

    Full Text Available Background. Obsessions are one of the most refractory psychiatric disorders. The therapeutic guidelines include a psychopharmacotherapy and the use of behavioural and supportive psychotherapy.Methods. This case report study presents a patient with a homicide obsessions at the forefront and narcissistic personality disorder in background. The use of analytical oriented psychotherapy, which helped to resolve axis-1 symptoms, is described.Conclusions. In the therapy of patients it is important to have the knowledge about the national therapeutic guidelines and critical distance toward them as well. Which therapy to use should be decided by the individual patient’s needs.

  2. Integrated torrefaction vs. external torrefaction - A thermodynamic analysis for the case of a thermochemical biorefinery

    DEFF Research Database (Denmark)

    Clausen, Lasse Røngaard

    2014-01-01

    that the biomass to syngas efficiency can be increased from 63% to 86% (LHV-dry) when switching from external torrefaction to integrated torrefaction. The second part of the analysis showed that the total energy efficiency (biomass to methanol + net electricity) could be increased from 53% to 63% when switching...

  3. Effects of Decreasing External Incentives on Higher Education--Reflections from the Case of Taiwan

    Science.gov (United States)

    Lin, Yung-feng

    2016-01-01

    Widened participation in post-compulsory and higher education is generally regarded as a result of the growing recognition of the internal and external benefits of higher education, which are categorised either as a private or public good. However, a question can be raised: once these incentives become less promising or less evident, will a strong…

  4. Chronic progressive external ophthalmoplegia (CPEO) with 'ragged red fibers'--a case report.

    Science.gov (United States)

    Kim, J. S.; Kim, C. J.; Chi, J. G.; Myung, H. J.

    1989-01-01

    Chronic progressive external ophthalmoplegia (CPEO) is a rare clinical syndrome characterized by slowly progressive paralysis of extraocular muscles. We report a male patient who had a 20 year history of CPEO. Histological examination of left deltoid muscle showed characteristic ragged red fibers. Electron microscopy revealed a number of abnormal mitochondria which contain paracrystalline inclusion bodies. PMID:2597365

  5. Chronic progressive external ophthalmoplegia (CPEO) with 'ragged red fibers'--a case report.

    OpenAIRE

    Kim, J. S.; Kim, C. J.; Chi, J. G.; Myung, H. J.

    1989-01-01

    Chronic progressive external ophthalmoplegia (CPEO) is a rare clinical syndrome characterized by slowly progressive paralysis of extraocular muscles. We report a male patient who had a 20 year history of CPEO. Histological examination of left deltoid muscle showed characteristic ragged red fibers. Electron microscopy revealed a number of abnormal mitochondria which contain paracrystalline inclusion bodies.

  6. Treatment of unstable distal radius fractures: non-invasive dynamic external fixator versus volar locking plate - functional and radiological outcome in a prospective case-controlled series.

    Science.gov (United States)

    Bajwa, Ali S; Rammappa, Manju; Lee, Ling; Nanda, Rajesh

    2015-12-16

    Distal radius fracture (DRF) is a common injury and various treatment modalities including open reduction and internal fixation (ORIF) with volar locking plate are available. More recently, a non-invasive external fixator has been used. To prospectively compare the use of a non-invasive external fixator with early dynamisation for DRF against ORIF with volar locking plate control group. Consecutive patients with closed DRF were included in a prospective case-controlled study. Patients were assigned to non-invasive external fixator or ORIF. Minimum follow-up was two years. Follow-up was at weeks 2, 4, 6, 8, 12, 26 and at one and two-year post-operatively. The outcome measures included demographic details, injury mechanism, AO fracture type, risk factors, body mass index (BMI), ulnar styloid fracture and dorsal comminution, radiographs, grip strength and DASH score. Consecutive 50 patients were treated either with non-invasive external fixator (25/50) or with ORIF (25/50) and the mean age of the two groups was 53 years (SD 17.1) and 49 years (SD 19.5), respectively. Demographics were matched in two groups. In the non-invasive external fixator group, there were 10 AO Type-A, 5 Type-B and 10 Type-C fractures. The ORIF group included 8 Type-A, 6 Type-B and 11 Type-C fractures. The mean DASH score at three-months and one-year post-injury in non-invasive fixator group was 12.2 (SD 3.1) and 3.5 (SD 0.7), respectively, significantly greater than those of ORIF group 14.5 (SD 5.6) and 11.2 (SD 4.4), respectively (p invasive external fixator can give functional results superior to ORIF at three-months and the trend is maintained at one and two-year post-operatively.

  7. Koebner Phenomenon Triggered by External Dacryocystorhinostomy Scar in a Patient With Psoriasis: A Case Report and Literature Review.

    Science.gov (United States)

    Ganguly, Anasua Kapoor; Laghimsetty, Srujana; Bhagyalakshmi, Nirupama

    2017-11-27

    Koebner phenomenon is the development of isomorphic pathologic lesions on a wound of a patient with preexisting cutaneous disease, most commonly psoriasis. An elderly male with palmoplantar psoriasis developed periocular psoriasis in the form of blepharitis and conjunctivitis following an external dacryocystorhinostomy as a manifestation of Koebner phenomenon. Immediate diagnosis and treatment with topical steroids led to complete recovery. Thus, the authors report the first case of Koebner phenomenon in ophthalmic literature, with a review of previously published postsurgical cases of Koebnerization in psoriasis patients. All surgeons should be aware of its existence and warn susceptible patients regarding its occurrence.

  8. A pilot study to determine whether external stabilisation of the chest ...

    African Journals Online (AJOL)

    Objectives. This was a pilot study to determine whether external stabilisation of the chest wall with a splint reduces the need for mechanical ventilation in preterm infants, within the first 7 days after study entry. Design. This was a non-blinded prospective randomised controlled study. After consent was obtained, babies were ...

  9. A Study on Ganui-Dae’s External Form and Its Modeling for Restoration

    Directory of Open Access Journals (Sweden)

    Min-Soo Lee

    2013-12-01

    Full Text Available Ganui-Dae, built in the reign of King Sejong, Joseon Dynasty, is a comprehensive observatory. It has various instruments for observation and time signal such as Ganui, Gyupyo(Gnomon, water-hammering type Honui and Honsang, and so on. Studying on Ganui-Dae has been focused on its location, history, criterion, etc, so far. However, studying on its external form and construction method has been conducted insufficiently. This study suggests the model for restoration of Ganui-Dae. The model is based on the analysis about external form of Ganui-Dae in various antique maps, and its construction method in those days.

  10. Conventional external irradiation alone as adjuvant treatment in resectable pancreatic cancer; Results of a prospective study

    Energy Technology Data Exchange (ETDEWEB)

    Bosset, J.F.; Pavy, J.J.; Gillet, M.; Mantuon, G.; Pelissier, E.; Schraub, S. (Centre Hospitalier Universitaire, 25 - Besancon (France))

    1992-07-01

    Between 1/85 and 1/90, 14 consecutive patients were entered into a prospective study of conventional adjuvant post-operative external beam radiotherapy after complete resection for a pancreatic adeno-carcinoma. The surgical procedure was a Whipple resection in 9 patients, a distal pancrea-tectomy in 1 patient. There were 3 T[sub 1b], 8 T[sub 2] and 3 T[sub 3] tumors (UICC 1987); nodal involvement was present in 5 cases. The radiotherapy was delivered using a 4-field box technique with a 23 x MV photon beam. All patients received a total dose of 54 Gy to the tumor bed. The mean treated volume was 900 cm[sup 3]. Acute toxicities consisted mainly of weight loss (mean: 2 kg). Two patients had a grade 2 diarrhea and 2 patients a grade 2 gastritis. Late effects were minimal and only observed in 2 patients. The overall loco-regional recurrence (LR) rate was 50%. The median disease-free survival was 12 months, and the median survival was 23 months. This post-operative conventional radiotherapy treatment gives results that are comparable to the results of GITSG-adjuvant study using a combination of split-course radiotherapy and 5-fluorouracil (5-FU). (author). 46 refs.; 1 fig.; 1 tab.

  11. Management of External Invasive Cervical Resorption Tooth with Mineral Trioxide Aggregate: A Case Report

    Directory of Open Access Journals (Sweden)

    Anuja Ikhar

    2013-01-01

    Full Text Available Invasive cervical resorption is entirely uncommon entities and the etiology is poorly understood. A 19 year old patient presented with fractured upper left central incisor and sinus tract opening on the distobuccal aspect in cervical region. Radiographic examination shows irregular radiolucency over the coronal one-third and it extended externally towards the external invasive resorption. After sectional obturation, the defect was accessed surgically. The resorption area was chemomechanically debrided using irrigant solution. Fibre post placement using flowable composite resin and Mineral Trioxide Aggregate (MTA was used to fill the resorptive defect, and the coronal access was temporarily sealed. Composite restoration was subsequently replaced with ceramic crown after 4 years. Radiographs at 1 and 4 years showed adequate repair of the resorption and endodontic success. Clinically and radiographically the tooth was asymptomatic, and no periodontal pocket was found after a 4-year followup.

  12. Revascularization procedure in an open apex tooth with external root resorption: A case report

    OpenAIRE

    Mahsa Dastpak; Hamid Jafarzadeh; Elham Najafi

    2017-01-01

    External inflammatory root resorption (EIR) represents a challenge in endodontic practice. EIR commonly occurs after dental trauma that results in periodontal ligament injury, pulp necrosis and subsequent infection.  Treatment of EIR is based on disinfecting the root canal system through chemomechanical procedures and then filling it with calcium hydroxide or triple antibiotic paste. Dental trauma commonly occurs in young patients whose teeth are not fully formed and have thin dentinal walls ...

  13. Sudden parental death from external causes and risk of suicide in the bereaved offspring: A national study.

    Science.gov (United States)

    Burrell, Lisa Victoria; Mehlum, Lars; Qin, Ping

    2018-01-01

    Previous research has revealed an association between parental bereavement from external causes and risk of suicide in offspring. Few studies have however provided insights into specific influences of cause of death, gender of the deceased and bereaved, age at bereavement and suicide, and time since bereavement. The present nested case-control study was based on data from three longitudinal registers. Subjects comprised 19 015 persons who died from suicide at an age of 11-64 years during 1969-2012 (cases), and 332 046 live comparison individuals matched for gender and date of birth. Information about deceased parents' cause and date of death, and sociodemographic data was retrieved and merged. Data were analysed with conditional logistic regression. Losing a parent to suicide, transport accidents and other external causes of death was associated with an increased suicide risk in offspring. Parental suicide was associated with a substantially higher suicide risk than transport accidents and other external causes. These effects were equally strong for daughters and sons, and for the loss of a mother, father or both parents. Suicide risk was highest in younger bereaved offspring, and bereavement had both short and long-term impacts on suicide risk. In conclusion, all offspring exposed to parental death by external causes have an increased suicide risk, independent of factors related to the exposure. The consequences are long lasting, and offspring should be offered follow-up in primary healthcare. Younger offspring bereaved by parental suicide have the highest risk and may be targeted for prevention and intervention programs in specialist healthcare. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Externally Prestressed Monolithic and Segmental Concrete Beams under Torsion: a Comparative Finite Element Study

    Energy Technology Data Exchange (ETDEWEB)

    Al-Gorafi, M A; Ali, A A A; Jaafar, M S [Department of Civil Engineering, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor (Malaysia); Othman, I [Department of Civil Engineering, University Of Malaya, 50603 Kuala Lumpur (Malaysia); Anwar, M P, E-mail: gorafimg@gmail.com [Housing Research Centre, University Putra Malaysia, 43400 UPM Serdang, Selangor (Malaysia)

    2011-02-15

    Externally Prestressed segmental beams are widely used in the construction of bridge structures today. These beams have many attractive advantages for rehabilitation and strengthening of existing structures as well. However, segmental beams experience significant effect under combined stresses at the joint interfaces between segments. This paper presents a finite element study on the effect of torsion on the structural behavior of both external prestressed monolithic and segmental concrete beams. Geometric and material nonlinearities were included in the study. The results show significant difference in the behavior of monolithic and segmental beams under torsion.

  15. Externally Prestressed Monolithic and Segmental Concrete Beams under Torsion: a Comparative Finite Element Study

    Science.gov (United States)

    Al-Gorafi, M. A.; Ali, A. A. A.; Othman, I.; Jaafar, M. S.; Anwar, M. P.

    2011-02-01

    Externally Prestressed segmental beams are widely used in the construction of bridge structures today. These beams have many attractive advantages for rehabilitation and strengthening of existing structures as well. However, segmental beams experience significant effect under combined stresses at the joint interfaces between segments. This paper presents a finite element study on the effect of torsion on the structural behavior of both external prestressed monolithic and segmental concrete beams. Geometric and material nonlinearities were included in the study. The results show significant difference in the behavior of monolithic and segmental beams under torsion.

  16. Treatment of Recurrent Eczematous External Otitis with Honey Eardrops: A Proof-of-Concept Study.

    Science.gov (United States)

    Henatsch, Darius; Nabuurs, Cindy H; van de Goor, Rens M; Wolffs, Petra F; Stokroos, Robert J

    2017-10-01

    Eczematous external otitis is a chronic inflammatory disease and often difficult to treat. Our objective was to investigate the clinical effect and in vitro antibacterial potential of medical honey eardrops as treatment of eczematous external otitis. In a prospective study, 15 patients diagnosed with recurrent eczematous external otitis were treated with medical honey eardrops for 2 weeks. The following clinical outcomes were evaluated: visual analog scale of ear complaints, score of eczema, and eradication of bacterial infection. Furthermore, the antibacterial effect of honey eardrops against different bacterial strains was tested in vitro. Treatment resulted in less discomfort and itching and decreased signs of eczema, with high patient satisfaction and without adverse reactions. Honey eardrops showed a strong in vitro inhibitory activity against all tested strains but did not eradicate Staphylococcus aureus infection in vivo. The results of this preliminary study indicate a possible role of honey eardrops in eczematous ear disease.

  17. Implementation of external cephalic version in the Netherlands : a retrospective cohort study

    NARCIS (Netherlands)

    Vlemmix, F.; Rosman, A.N.; Hoven, S. te; Berg, S. van de; Fleuren, M.A.H.; Rijnders, M.E.; Beuckens, A.; Mol, B.W.J.; Kok, M.

    2014-01-01

    Background: External cephalic version (ECV) reduces the rate of elective cesarean sections as a result of breech presentation. Several studies have shown that not all eligible women undergo an ECV attempt. The aim of this study was to evaluate the implementation of ECV in the Netherlands and to

  18. Outcomes of Global Education: External and Internal Change Associated with Study Abroad

    Science.gov (United States)

    Miller-Perrin, Cindy; Thompson, Don

    2014-01-01

    This chapter provides an overview of external and internal changes associated with collegiate study abroad experiences. A brief review of the research literature is included along with recent research that sheds light on potential mechanisms associated with study abroad-related change. Recommendations for enhancing outcomes associated with study…

  19. Simulation studies on the effect of a buffer layer on the external ...

    Indian Academy of Sciences (India)

    Wintec

    Simulation studies on the effect of a buffer layer on the external parameters of hydrogenated amorphous silicon p–i–n ... studied material because of its tremendous potential in the fabrication of low cost solar cells for .... Miro Zeman 1999 Amorphous semiconductor analysis users manual, Version 3.0, TU Delft. Petit A M H N ...

  20. External Ocular Manifestations in Autosomal Dominant Dystrophic Epidermolysis Bullosa; a Case Report

    Directory of Open Access Journals (Sweden)

    Manizheh Mahdavi

    2008-11-01

    Full Text Available

    PURPOSE: To present a case of autosomal dominant dystrophic epidermolysis bullosa with symblepharon formation due to eye rubbing. CASE REPORT: A 10-year-old girl suffering from blistering and ulcerative lesions of the trunk and palms and dystrophic nails since childhood was referred to our clinic with a symblepharon connecting the medial portion of the right upper lid to the superonasal quadrant of the cornea. The central cornea in both eyes exhibited mild subepithelial opacification. She had history of eye rubbing due to foreign body sensation in the right eye, resulting in red eye and blister-like conjunctival lesions since three years ago. She had previously undergone surgical symblepharon removal leading to more severe recurrence of the condition. CONCLUSION: Dominant dystrophic epidermolysis bullosa may be accompanied by external ocular manifestations. Protection of the eye from minor trauma such as rubbing may help prevent ocular complications.

  1. Mortality from suicide and other external cause injuries in China: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Duan Xiufang

    2011-01-01

    Full Text Available Abstract Background Premature death from suicide is a leading cause of death worldwide. However, the pattern and risk factors for suicide and other external cause injuries are not well understood. This study investigates mortality from suicide and other injuries and associated risk factors in China. Methods A prospective cohort study of 169,871 Chinese adults aged 40 years and older was conducted. Mortality due to suicide or other external cause injuries was recorded. Results Mortality from all external causes was 58.7/100,000 (72.3 in men and 44.4 in women: 14.1/100,000 (14.2 in men and 14.2 in women for suicide and 44.6/100,000 (58.1 in men and 30.2 in women for other external cause injuries. Transport accidents (17.2/100,000 overall, 23.4 in men and 10.8 in women, accidental poisoning (7.5/100,000 overall, 10.2 in men and 4.8 in women, and accidental falls (5.7/100,000 overall, 6.5 in men and 5.0 in women were the three leading causes of death from other external cause injuries in China. In the multivariable analysis, male sex (relative risk [RR] 1.56, 95% confidence interval [CI] 1.03-2.38, age 70 years and older (2.27, 1.29-3.98, living in north China (1.68, 1.20-2.36 and rural residence (2.82, 1.76-4.51 were associated with increased mortality from suicide. Male sex (RR 2.50, 95% CI 1.95-3.20, age 60-69 years (1.93, 1.45-2.58 and 70 years and older (3.58, 2.58-4.97, rural residence (2.29, 1.77-2.96, and having no education (1.56, 1.00-2.43 were associated with increased mortality from other external cause injuries, while overweight (0.60, 0.43-0.83 was associated with decreased risk of mortality from other external cause injuries. Conclusions External cause mortality has become a major public health problem in China. Developing an integrated national program for the prevention of mortality due to external cause injuries in China is warranted.

  2. What do external consultants from private and not-for-profit companies offer healthcare commissioners? A qualitative study of knowledge exchange.

    Science.gov (United States)

    Wye, Lesley; Brangan, Emer; Cameron, Ailsa; Gabbay, John; Klein, Jonathan H; Anthwal, Rachel; Pope, Catherine

    2015-02-25

    The use of external consultants from private and not-for-profit providers in the National Health Service (NHS) is intended to improve the quality of commissioning. The aim of this study was to learn about the support offered to healthcare commissioners, how external consultants and their clients work together and the perceived impact on the quality of commissioning. NHS commissioning organisations and private and not-for-profit providers. Mixed methods case study of eight cases. 92 interviews with external consultants (n=36), their clients (n=47) and others (n=9). Observation of 25 training events and meetings. Documentation, for example, meeting minutes and reports. Constant comparison. Data were coded, summarised and analysed by the research team with a coding framework to facilitate cross-case comparison. In the four contracts presented here, external providers offered technical solutions (eg, software tools), outsourcing and expertise including project management, data interpretation and brokering relationships with experts. In assessing perceived impact on quality of commissioning, two contracts had limited value, one had short-term benefits and one provided short and longer term benefits. Contracts with commissioners actively learning, embedding and applying new skills were more valued. Other elements of success were: (1) addressing clearly agreed problems of relevance to managerial and operational staff (2) solutions co-produced at all organisational levels (3) external consultants working directly with clients to interpret data outputs to inform locally contextualised commissioning strategies. Without explicit knowledge exchange strategies, outsourcing commissioning to external providers resulted in the NHS clients becoming dependent. NHS commissioning will be disadvantaged if commissioners both fail to learn in the short term from the knowledge of external providers and in the longer term lose local skills. Knowledge exchange mechanisms are a vital

  3. What do external consultants from private and not-for-profit companies offer healthcare commissioners? A qualitative study of knowledge exchange

    Science.gov (United States)

    Wye, Lesley; Brangan, Emer; Cameron, Ailsa; Gabbay, John; Klein, Jonathan H; Anthwal, Rachel; Pope, Catherine

    2015-01-01

    Objectives The use of external consultants from private and not-for-profit providers in the National Health Service (NHS) is intended to improve the quality of commissioning. The aim of this study was to learn about the support offered to healthcare commissioners, how external consultants and their clients work together and the perceived impact on the quality of commissioning. Setting NHS commissioning organisations and private and not-for-profit providers. Design Mixed methods case study of eight cases. Data collection 92 interviews with external consultants (n=36), their clients (n=47) and others (n=9). Observation of 25 training events and meetings. Documentation, for example, meeting minutes and reports. Analysis Constant comparison. Data were coded, summarised and analysed by the research team with a coding framework to facilitate cross-case comparison. Results In the four contracts presented here, external providers offered technical solutions (eg, software tools), outsourcing and expertise including project management, data interpretation and brokering relationships with experts. In assessing perceived impact on quality of commissioning, two contracts had limited value, one had short-term benefits and one provided short and longer term benefits. Contracts with commissioners actively learning, embedding and applying new skills were more valued. Other elements of success were: (1) addressing clearly agreed problems of relevance to managerial and operational staff (2) solutions co-produced at all organisational levels (3) external consultants working directly with clients to interpret data outputs to inform locally contextualised commissioning strategies. Without explicit knowledge exchange strategies, outsourcing commissioning to external providers resulted in the NHS clients becoming dependent. Conclusions NHS commissioning will be disadvantaged if commissioners both fail to learn in the short term from the knowledge of external providers and in the longer

  4. Inflammatory external root resorption following surgical treatment for intra-bony defects: a report of two cases involving Emdogain and a review of the literature.

    Science.gov (United States)

    St George, Geoffrey; Darbar, Ulpee; Thomas, Gareth

    2006-06-01

    Enamel matrix-derived proteins have been shown to regenerate periodontal tissues lost as a result of disease in humans. Emdogain, a commercial preparation of porcine enamel matrix derivative (EMD), has been shown to induce new cementum, periodontal ligament and bone formation in human periodontal defects. Although a number of studies have reported successful outcomes, local adverse effects have so far not been reported in the literature. This case report describes two examples of external inflammatory resorption following surgical root surface debridement and the use of Emdogain. The treatment in both cases involved raising a full-thickness flap following completion of non-surgical therapy. The granulation tissue from the defect was removed and the root surfaces debrided. Emdogain was applied following the manufacturers' instructions and involved conditioning the root surfaces with Pref-Gel and applying the Emdogain to the defect. The flaps were sutured and the site reviewed regularly. Radiographs were taken before the treatment was undertaken and also at 6 months to assess the healing of the defect. External inflammatory root resorption was observed on the treated teeth 6-24 months after therapy. External inflammatory root resorption may be an unusual adverse event following Emdogain treatment.

  5. [The study of the modification of the natural resonance of the external ear following tympanoplasty].

    Science.gov (United States)

    Balestri, J A; Mazzoni, A; Fornasari, V; Costa, A; Battazzi, P; Danesi, G

    1995-08-01

    The shape, position and amplitude of the natural resonance curve of external ear is related to sensation evoked in a subject by sound coming from the external environment. The involution of this curve varies from individual and is the sum of the effects provoked on the incident sound by the head, auricle and the conformation of canal (EEE = External Ear Effect). Natural amplification supplied by the system allows the individual to distinguish natural sound, whose being natural make them pleasant to hear. Any interventions that modifies the anatomy of the auricle and/or the canal activity alternates the REUR (Real Ear Unaided Response) to some degree. Restoration of basic anatomical conditions are choice of interventions which displace the curve only slightly allows a physiological sensation of sound to be maintained. Surgeon often neglect this little studied aspect preferring to evaluate this work in terms of quantity thus rather ignoring the quality of sound achieved.

  6. Effects of external magnetic field on biodistribution of nanoparticles: A histological study

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Tony [Department of Neurology, Chang Gung University College of Medicine and Memorial Hospital, 199 Tung-Hwa N Rd, Taipei, Taiwan (China); Hua, M.-Y. [Department of Chemical and Material Engineering, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan, Taiwan (China); Chen Jyhping [Department of Chemical and Material Engineering, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan, Taiwan (China); Wei, K.-C. [Department of Neurosurgery, Chang Gung University College of Medicine and Memorial Hospital, 199 Tung-Hwa N Rd, Taipei, Taiwan (China); Jung, S.-M. [Department of Pathology, Chang Gung University College of Medicine and Memorial Hospital, 199 Tung-Hwa N Rd, Taipei, Taiwan (China); Chang, Y.-J. [Department of Neurology, Chang Gung University College of Medicine and Memorial Hospital, 199 Tung-Hwa N Rd, Taipei, Taiwan (China); Jou, M.-J. [Department of Physiology and Pharmacology, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan 333, Taiwan (China); Ma, Y.-H. [Department of Physiology and Pharmacology, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan 333, Taiwan (China)]. E-mail: yhma@mail.cgu.edu.tw

    2007-04-15

    This study investigates the effect of external magnetic fields on the biodistribution of nanoparticles (NP). A NdFeB magnet of 2.4 kG was externally applied over the left femoral artery or right kidney. The 250 nm dextran-coated Fe{sub 3}O{sub 4} NP was injected via tail vein in healthy rats, and organs were taken 1 or 24 h later. Prussian blue stain revealed that NP were more rapidly retained in the liver and spleen than in the lungs. NP aggregation observed in the kidney and femoral artery after application of external magnets was time dependent. Hollow organs such as the intestine, colon, and urinary bladder retained little NP.

  7. Corporate risk and external sourcing: A study of Scandinavian multinational firms

    DEFF Research Database (Denmark)

    Aabo, Tom; Pantzalis, Christos; Sørensen, Helle

    2016-01-01

    External sourcing from foreign suppliers is an important aspect of the firm’s internationalization. However, data on such sourcing is available from neither databases nor annual reports. Thus, the corporate risk implications of such sourcing have not been studied previously. We obtain the necessary...... data by surveying Scandinavian non-financial firms. We find that highly international firms reduce corporate risk by externally sourcing from foreign suppliers both compared to sourcing from own production facilities abroad (due to superior flexibility) and compared to domestic sourcing (due...

  8. Computational Fluid Dynamic Simulation (CFD and Experimental Study on Wing-external Store Aerodynamic Interference

    Directory of Open Access Journals (Sweden)

    Tholudin Mat Lazim

    2004-01-01

    Full Text Available The main objective of the present work is to study the effect of an external store to a subsonic fighter aircraft. Generally most modern fighter aircraft is designed with an external store installation. In this project a subsonic fighter aircraft model has been manufactured using a computer numerical control machine for the purpose of studying the effect of the external store aerodynamic interference on the flow around the aircraft wing. A computational fluid dynamic (CFD and wind tunnel testing experiments have been carried out to ensure the aerodynamic characteristic of the model then certified the aircraft will not facing any difficulties in stability and controllability. In the CFD experiment, commercial CFD code is used to simulate the interference and aerodynamic characteristics of the model. Subsequently, the model together with an external store was tested in a low speed wind tunnel with test section sized 0.45 m×0.45 m. Result in the two-dimensional pressure distribution obtained by both experiments are comparable. There is only 12% deviation in pressure distribution found in wind tunnel testing compared to the result predicted by the CFD. The result shows that the effect of the external storage is only significant at the lower surface of the wing and almost negligible at the upper surface of the wing. Aerodynamic interference is due to the external storage were mostly evidence on a lower surface of the wing and almost negligible on the upper surface at low angle of attack. In addition, the area of influence on the wing surface by store interference increased as the airspeed increase. 

  9. A hinged external fixator for complex elbow dislocations: A multicenter prospective cohort study

    Directory of Open Access Journals (Sweden)

    Verleisdonk Egbert JMM

    2011-06-01

    Full Text Available Abstract Background Elbow dislocations can be classified as simple or complex. Simple dislocations are characterized by the absence of fractures, while complex dislocations are associated with fractures of the radial head, olecranon, or coronoid process. The majority of patients with these complex dislocations are treated with open reduction and internal fixation (ORIF, or arthroplasty in case of a non-reconstructable radial head fracture. If the elbow joint remains unstable after fracture fixation, a hinged elbow fixator can be applied. The fixator provides stability to the elbow joint, and allows for early mobilization. The latter may be important for preventing stiffness of the joint. The aim of this study is to determine the effect of early mobilization with a hinged external elbow fixator on clinical outcome in patients with complex elbow dislocations with residual instability following fracture fixation. Methods/Design The design of the study will be a multicenter prospective cohort study of 30 patients who have sustained a complex elbow dislocation and are treated with a hinged elbow fixator following fracture fixation because of residual instability. Early active motion exercises within the limits of pain will be started immediately after surgery under supervision of a physical therapist. Outcome will be evaluated at regular intervals over the subsequent 12 months. The primary outcome is the Quick Disabilities of the Arm, Shoulder, and Hand score. The secondary outcome measures are the Mayo Elbow Performance Index, Oxford Elbow Score, pain level at both sides, range of motion of the elbow joint at both sides, radiographic healing of the fractures and formation of periarticular ossifications, rate of secondary interventions and complications, and health-related quality of life (Short-Form 36. Discussion The outcome of this study will yield quantitative data on the functional outcome in patients with a complex elbow dislocation and who are

  10. Termination: A Case Study.

    Science.gov (United States)

    Friedberg, Ahron L

    2015-12-01

    In this article I posit and examine certain criteria and qualities for ending an analysis. The case study describes the end phase of a four-year psychoanalysis in which the patient's decision to move to another area forced the end of his analysis. We continued to explore and work through his core neurotic conflicts that included issues of competitive rivalry, dominance and submission, control, and anxiety about birth and death. A shift in the transference from me as a negative father to me as a supportive but competitive older brother was also examined in the context of ending treatment as well as other aspects of the transference. In addition, we analyzed the meaning of his ending treatment based on an extra-analytic circumstance. In discussing this phase of treatment, the definition and history of the term "termination" and its connotations are reviewed. Various criteria for completing an analysis are examined, and technical observations about this phase of treatment are investigated. It was found that while a significant shift in the transference occurred in this phase of the patient's analysis, conflicts related to the transference were not "resolved" in the classical sense. Terminating treatment was considered as a practical matter in which the patient's autonomy and sense of choice were respected and analyzed.

  11. Ceruminous Adenoma of the External Auditory Canal: A Case Report with Imaging and Pathologic Findings

    Directory of Open Access Journals (Sweden)

    George Psillas

    2015-01-01

    Full Text Available Ceruminous adenomas are benign tumors that are rare in humans and present with a nonspecific symptomatology. The treatment of choice is surgical excision. We present an 87-year-old woman who presented with a reddish, tender, round, soft mass of the outer third of the inferior wall of the left external auditory canal, discharging a yellowish fluid upon pressure. Coincidentally, due to her poor general condition, this patient also showed symptoms consistent with chronic otitis media, parotitis, and cervical lymphadenopathy, such as otorrhea, through a ruptured tympanic membrane and swelling of the parotid gland and cervical lymph nodes. The external auditory canal lesion was surgically excised under general anesthesia, utilizing a transmeatal approach. The pathological diagnosis was ceruminous gland adenoma. The tumor was made of tubular and cystic structures and embedded in a fibrous, focally hyalinized stroma. Immunohistochemistry confirmed the presence of two distinct cell populations. The luminal cells expressed keratin 7, while peripheral (basal cells expressed keratins 5/6, S100 protein, and p63. The apocrine gland-related antigen GCDFP-15 was focally expressed by tumor cells. The postoperative course was uneventful and at the 2-year follow-up no recurrence of the ceruminous adenoma was noted.

  12. Pacemaker System Malfunction Resulting from External Electrical Cardioversion: A Case Report

    Directory of Open Access Journals (Sweden)

    Taku Nishida, MD

    2009-01-01

    Full Text Available In May 2005 a 68-year-old woman received a VDD pacemaker implantation in the right pectoral region at our hospital for the treatment of complete atrioventricular block. In July 2008, she was diagnosed with dilated cardiomyopathy based on histological testing. In November 2008, she developed syncope due to ventricular tachycardia while at another hospital. She underwent external electrical cardioversion with an anterior-lateral paddle position using a single shock of 100 J. This shock led to severe bradycardia resulting in a transfer to our hospital. The physician who provided the shock could not have been aware that the patient had an implanted pacemaker. The skin above the pulse generator was burned. The electrocardiogram showed no pacing spikes or ventricular escape rhythm. Investigation of the pacemaker 3 hours after cardioversion revealed reprogramming of the device and a marked rise in the lead impedance (>3,000 ohm. Removal of the generator and implantation of a biventricular cardioverter defibrillator were required. The emergency situation, the small size of the generator, the small incision made using the buried suture method, and the patient's obesity all probably contributed to the physician's not noticing the implanted pacemaker. It is important to increase awareness of the severe consequences that may follow if the physician administering external defibrillation does not know about the patient's implanted pacemaker.

  13. The Protective Effects of Adaptability, Study Skills, and Social Skills on Externalizing Student-Teacher Relationships

    Science.gov (United States)

    Fisher, Sycarah D.; Reynolds, Jennifer L.; Sheehan, Chelsea E.

    2016-01-01

    Although students with externalizing behaviors inherently exhibit behaviors that contribute to poor teacher relationships, little research has examined the positive characteristics these students may possess that serve to facilitate positive teacher relationships. This study explores the moderating effects of adaptability, social skills, and study…

  14. Simulation studies on the effect of a buffer layer on the external ...

    Indian Academy of Sciences (India)

    Device modeling of –– junction amorphous silicon solar cells has been carried out using the amorphous semiconductor analysis (ASA) simulation programme. The aim of the study was to explain the role of a buffer layer in between the - and -layers of the –– solar cell on the external parameters such as dark ...

  15. Externalizing Behavior Problems and Cigarette Smoking as Predictors of Cannabis Use: The TRAILS Study

    Science.gov (United States)

    Korhonen, Tellervo; van Leeuwen, Andrea Prince; Reijneveld, Sijmen A.; Ormel, Johan; Verhulst, Frank C.; Huizink, Anja C.

    2010-01-01

    Objective: To examine externalizing behavior problems and cigarette smoking as predictors of subsequent cannabis use. Method: Dutch adolescents (N = 1,606; 854 girls and 752 boys) from the TRacking Adolescents' Individual Lives Survey (TRAILS) ongoing longitudinal study were examined at baseline (ages 10-12 [T1]) and at two follow-up assessments…

  16. Circulation Policies for External Users: A Comparative Study of Public Urban Research Institutions

    Science.gov (United States)

    Weare, William H., Jr.; Stevenson, Matthew

    2012-01-01

    This article is a study of the policies that govern the use of the university library by external users at Indiana University-Purdue University Indianapolis (IUPUI) and 12 peer institutions used by IUPUI for comparative purposes. A search of each institution's Web site was conducted as well as interviews with circulation librarians and managers.…

  17. Externalizing behavior problems and cigarette smoking as predictors of cannabis use : the TRAILS Study

    NARCIS (Netherlands)

    Korhonen, T.; van Leeuwen, A.P.; Reijneveld, S.A.; Ormel, J.; Verhulst, F.C.; Huizink, A.C.

    Objective: To examine externalizing behavior problems and cigarette smoking as predictors Of Subsequent cannabis use. Method: Dutch adolescents (N = 1,606; 854 girls and 752 boys) from the TRacking Adolescents' Individual Lives Survey (TRAILS) ongoing longitudinal study were examined at baseline

  18. Social Status of Adolescents with an Early Onset of Externalizing Behavior: The SNARE Study

    Science.gov (United States)

    Franken, Aart; Harakeh, Zeena; Veenstra, Rene; Vollebergh, Wilma; Dijkstra, Jan Kornelis

    2017-01-01

    This study investigated the social status (i.e., popularity, likeability, and friendships) of adolescents with an early onset of externalizing behavior (i.e., alcohol use, tobacco use, and antisocial behavior). Building on Moffitt's dual-taxonomy model, it was hypothesized that early onset adolescents were more popular, but not necessarily more…

  19. Natural Learning Case Study Archives

    Science.gov (United States)

    Lawler, Robert W.

    2015-01-01

    Natural Learning Case Study Archives (NLCSA) is a research facility for those interested in using case study analysis to deepen their understanding of common sense knowledge and natural learning (how the mind interacts with everyday experiences to develop common sense knowledge). The database comprises three case study corpora based on experiences…

  20. Spontaneous temporomandibular joint herniation into the external auditory canal through a patent foramen of Huschke: A case report

    Directory of Open Access Journals (Sweden)

    Kyeong Hwa Ryu, M.D.

    2017-06-01

    Full Text Available Temporomandibular joint herniation (TMJ can be caused by inflammation, trauma, tumor, or otologic procedures. However, spontaneous TMJ herniation can also occur as a result of a congenital bony defect in the external auditory canal (EAC, known as the patent foramen of Huschke (PFH, and occurs in 0.4% of the population. Herein, the authors present a case of spontaneous TMJ herniation through the PFH with clicking tinnitus. The patient underwent the surgical repair of bony defect in the EAC with placement of titanium mesh, and the symptom disappeared after surgery. They also review the relevant literature regarding this disease and discuss its embryologic development and clinical significance.

  1. Percutaneous ethanol sclerotherapy for recurrent adventitial cystic disease of external iliac vein after surgical treatment: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Ann, Jun Hyung; Kim, Jeong Ho; Byun, Sung Su; Kang, Jin Mo; Kim, Hyung Sik; Choi, Hye Young [Gachon University Gil Medical Center, Incheon (Korea, Republic of)

    2015-12-15

    Adventitial cystic disease (ACD) is a rare, but well-characterized vascular disease. It is most commonly seen in the popliteal artery, but it has also been reported in the venous system. The most commonly involved segment has been the common femoral vein; the disease resulted in luminal compromise and extremity swelling. We report here on a case of percutaneous aspiration and ethanol sclerotherapy for recurrent ACD after surgery of the external iliac vein in a 70-year-old man who presented with a painless swelling of his left leg.

  2. Could Externalized St. Jude Medical Riata® Lead Be a Culture Medium of a Polymicrobial Endocarditis? A Clinical Case

    Directory of Open Access Journals (Sweden)

    Zefferino Palamà

    2017-01-01

    Full Text Available We report the case of a man affected by polymicrobial endocarditis developed on a St. Jude Medical Riata lead with a malfunction because of the outsourcing of conductors. The patient was treated with antibiotic targeted therapy and showed different bacteria at the blood cultures and then underwent transvenous leads extraction. Vegetations were highlighted on the caval, atrial, and ventricular tracts of the Riata lead, but the cultures were all negative. The externalization of Riata lead may cause the malfunction but it could also promote bacterial colonies and vegetations. In conclusion, looking for early signs of infection is mandatory during Riata leads follow-up checks.

  3. Regional Externalities

    NARCIS (Netherlands)

    Heijman, W.J.M.

    2007-01-01

    The book offers practical and theoretical insights in regional externalities. Regional externalities are a specific subset of externalities that can be defined as externalities where space plays a dominant role. This class of externalities can be divided into three categories: (1) externalities

  4. The Tensions between Internal and External Multilateralism in the Case Law of the Court of Justice of the European Union Concerning International Agreements

    DEFF Research Database (Denmark)

    Cebulak, Pola

    2016-01-01

    the framework of EU external relations (Council of the European Union 2003; European Commission 2006 and 2014). This commitment might seem natural, the EU being a multilateral organization itself. However, this intuition that the EU – as an internally multilateral actor – should also display more commitment...... to multilateralism externally appears problematic. This chapter examines the articulation between this internal and external multilateralism of the EU in the case-law of the Court of Justice of the EU (CJEU). It asks the question whether the main tool of legal interpretation deployed by the Court – teleological...... interpretation – is inherently biased towards the internal or external perspective....

  5. Externality costs of the coal-fuel cycle: The case of Kusile Power Station

    Directory of Open Access Journals (Sweden)

    Nonophile P. Nkambule

    2017-09-01

    Full Text Available Coal-based electricity is an integral part of daily life in South Africa and globally. However, the use of coal for electricity generation carries a heavy cost for social and ecological systems that goes far beyond the price we pay for electricity. We developed a model based on a system dynamics approach for understanding the measurable and quantifiable coal-fuel cycle burdens and externality costs, over the lifespan of a supercritical coal-fired power station that is fitted with a flue-gas desulfurisation device (i.e. Kusile Power Station. The total coal-fuel cycle externality cost on both the environment and humans over Kusile's lifespan was estimated at ZAR1 449.9 billion to ZAR3 279 billion or 91c/kWh to 205c/kWh sent out (baseline: ZAR2 172.7 billion or 136c/kWh. Accounting for the life-cycle burdens and damages of coal-derived electricity conservatively, doubles to quadruples the price of electricity, making renewable energy sources such as wind and solar attractive alternatives. Significance: The use of coal for electricity generation carries a heavy cost for social and ecological systems that goes far beyond the price we pay for electricity. The estimation of social costs is particularly important to the electric sector because of non-differentiation of electricity prices produced from a variety of sources with potentially very dissimilar environmental and human health costs. Because all electricity generation technologies are associated with undesirable side effects in their fuelcycle and lifespan, comprehensive comparative analyses of life-cycle costs of all power generation technologies is indispensable to guide the development of future energy policies in South Africa.

  6. Diagnosis-based and external cause-based criteria to identify adverse drug reactions in hospital ICD-coded data: application to an Australia population-based study

    Directory of Open Access Journals (Sweden)

    Wei Du

    2017-04-01

    Full Text Available Objectives: External cause International Classification of Diseases (ICD codes are commonly used to ascertain adverse drug reactions (ADRs related to hospitalisation. We quantified ascertainment of ADR-related hospitalisation using external cause codes and additional ICD-based hospital diagnosis codes. Methods: We reviewed the scientific literature to identify different ICD-based criteria for ADR-related hospitalisations, developed algorithms to capture ADRs based on candidate hospital ICD-10 diagnoses and external cause codes (Y40–Y59, and incorporated previously published causality ratings estimating the probability that a specific diagnosis was ADR related. We applied the algorithms to the NSW Admitted Patient Data Collection records of 45 and Up Study participants (2011–2013. Results: Of 493 442 hospitalisations among 267 153 study participants during 2011–2013, 18.8% (n = 92 953 had hospital diagnosis codes that were potentially ADR related; 1.1% (n = 5305 had high/very high–probability ADR-related diagnosis codes (causality ratings: A1 and A2; and 2.0% (n = 10 039 had ADR-related external cause codes. Overall, 2.2% (n = 11 082 of cases were classified as including an ADR-based hospitalisation on either external cause codes or high/very high–probability ADR-related diagnosis codes. Hence, adding high/very high–probability ADR-related hospitalisation codes to standard external cause codes alone (Y40–Y59 increased the number of hospitalisations classified as having an ADR-related diagnosis by 10.4%. Only 6.7% of cases with high-probability ADR-related mental symptoms were captured by external cause codes. Conclusion: Selective use of high-probability ADR-related hospital diagnosis codes in addition to external cause codes yielded a modest increase in hospitalised ADR incidence, which is of potential clinical significance. Clinically validated combinations of diagnosis codes could potentially further enhance capture.

  7. The study of the dynamics of erythrocytes under the influence of an external electric field

    Science.gov (United States)

    Mamaeva, Sargylana N.; Maksimov, Georgy V.; Antonov, Stepan R.

    2017-11-01

    A mathematical model is considered for the determination of the surface charge of an erythrocyte with its shape approximated by a surface of revolution of the second order, and the investigation of the dynamics of erythrocytes under the influence of an external electric field. In the first part of this work, the electrical surface charge of the erythrocyte of the patient was calculated with the assumption that the change in the shape and size of the red blood cells leads to stabilization of the electric field, providing a normal electrostatic repulsion. In the second part of the work, the research results of dynamics of changes in the morphology of erythrocytes under the influence of an external electric field depending on the values of their surface charge and resistance of blood plasma is presented. In the course of the work, the dependence of the surface charge of red blood cells from their shape and size is presented. The determination of the relationship between the value of the charge field and the surface of erythrocytes in norm and in pathology is shown. The dependence of the velocity of the erythrocytes on the characteristics of the external electric field, surface charge of the erythrocyte and properties of the medium is obtained. The results of this study can be applied indirectly to diagnose diseases and to develop recommendations for experimental studies of hemodynamics under the influence of various external physical factors.

  8. A computable phenotype for asthma case identification in adult and pediatric patients: External validation in the Chicago Area Patient-Outcomes Research Network (CAPriCORN).

    Science.gov (United States)

    Afshar, Majid; Press, Valerie G; Robison, Rachel G; Kho, Abel N; Bandi, Sindhura; Biswas, Ashvini; Avila, Pedro C; Kumar, Harsha Vardhan Madan; Yu, Byung; Naureckas, Edward T; Nyenhuis, Sharmilee M; Codispoti, Christopher D

    2017-10-13

    Comprehensive, rapid, and accurate identification of patients with asthma for clinical care and engagement in research efforts is needed. The original development and validation of a computable phenotype for asthma case identification occurred at a single institution in Chicago and demonstrated excellent test characteristics. However, its application in a diverse payer mix, across different health systems and multiple electronic health record vendors, and in both children and adults was not examined. The objective of this study is to externally validate the computable phenotype across diverse Chicago institutions to accurately identify pediatric and adult patients with asthma. A cohort of 900 asthma and control patients was identified from the electronic health record between January 1, 2012 and November 30, 2014. Two physicians at each site independently reviewed the patient chart to annotate cases. The inter-observer reliability between the physician reviewers had a κ-coefficient of 0.95 (95% CI 0.93-0.97). The accuracy, sensitivity, specificity, negative predictive value, and positive predictive value of the computable phenotype were all above 94% in the full cohort. The excellent positive and negative predictive values in this multi-center external validation study establish a useful tool to identify asthma cases in in the electronic health record for research and care. This computable phenotype could be used in large-scale comparative-effectiveness trials.

  9. Childhood internalizing and externalizing problems predict the onset of clinical panic attacks over adolescence: the TRAILS study.

    Science.gov (United States)

    Mathyssek, Christina M; Olino, Thomas M; Verhulst, Frank C; van Oort, Floor V A

    2012-01-01

    Panic attacks are a source of individual suffering and are an independent risk factor for later psychopathology. However, much less is known about risk factors for the development of panic attacks, particularly during adolescence when the incidence of panic attacks increases dramatically. We examined whether internalizing and externalizing problems in childhood predict the onset of panic attacks in adolescence. This study is part of the TRacking Adolescents' Individual Lives Survey (TRAILS), a Dutch longitudinal population cohort study (N = 1,584). Internalizing and Externalizing Problems were collected using the Youth Self-Report (YSR) and the parent-report Child Behavior Checklist (CBCL) at baseline (age 10-12). At age 18-20, DSM-IV defined panic attacks since baseline were assessed with the Composite International Diagnostic Interview (CIDI). We investigated whether early adolescent Internalizing and Externalizing Problems predicted panic attacks between ages 10-20 years, using survival analysis in univariate and multivariate models. There were N = 314 (19.8%) cases who experienced at least one DSM-IV defined panic attack during adolescence and N = 18 (1.2%) who developed panic disorder during adolescence. In univariate analyses, CBCL Total Problems, Internalizing Problems and three of the eight syndrome scales predicted panic attack onset, while on the YSR all broad-band problem scales and each narrow-band syndrome scale predicted panic attack onset. In multivariate analyses, CBCL Social Problems (HR 1.19, ppanic attack onset. Risk indicators of panic attack include the wide range of internalizing and externalizing problems. Yet, when adjusted for co-occurring problem behaviors, Social Problems were the most consistent risk factor for panic attack onsets in adolescence.

  10. Childhood internalizing and externalizing problems predict the onset of clinical panic attacks over adolescence: the TRAILS study.

    Directory of Open Access Journals (Sweden)

    Christina M Mathyssek

    Full Text Available BACKGROUND: Panic attacks are a source of individual suffering and are an independent risk factor for later psychopathology. However, much less is known about risk factors for the development of panic attacks, particularly during adolescence when the incidence of panic attacks increases dramatically. We examined whether internalizing and externalizing problems in childhood predict the onset of panic attacks in adolescence. METHOD: This study is part of the TRacking Adolescents' Individual Lives Survey (TRAILS, a Dutch longitudinal population cohort study (N = 1,584. Internalizing and Externalizing Problems were collected using the Youth Self-Report (YSR and the parent-report Child Behavior Checklist (CBCL at baseline (age 10-12. At age 18-20, DSM-IV defined panic attacks since baseline were assessed with the Composite International Diagnostic Interview (CIDI. We investigated whether early adolescent Internalizing and Externalizing Problems predicted panic attacks between ages 10-20 years, using survival analysis in univariate and multivariate models. RESULTS: There were N = 314 (19.8% cases who experienced at least one DSM-IV defined panic attack during adolescence and N = 18 (1.2% who developed panic disorder during adolescence. In univariate analyses, CBCL Total Problems, Internalizing Problems and three of the eight syndrome scales predicted panic attack onset, while on the YSR all broad-band problem scales and each narrow-band syndrome scale predicted panic attack onset. In multivariate analyses, CBCL Social Problems (HR 1.19, p<.05, and YSR Thought Problems (HR 1.15, p<.05 and Social Problems (HR 1.26, p<.01 predicted panic attack onset. CONCLUSION: Risk indicators of panic attack include the wide range of internalizing and externalizing problems. Yet, when adjusted for co-occurring problem behaviors, Social Problems were the most consistent risk factor for panic attack onsets in adolescence.

  11. 425 Case study

    African Journals Online (AJOL)

    Marinda

    provides superior pain control, acceptable haemodynamic stability and good fetal outcome if carefully titrated. The risk of spinal anaesthesia is hypotension, infection, and bleeding.8 The latter complication is important if cardiopulmonary bypass will have to be used. In that case the intrathecal catheter should be retained.

  12. Preservation of the External Jugular Vein in Bilateral Radical Neck Dissections: Technique in Two Cases and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Rodrigo Lima Bastos da Rocha

    2015-01-01

    Full Text Available Context. The possibility of cephalic venous hypertension with the resultant facial edema and elevated cerebrospinal fluid pressure continues to challenge head and neck surgeons who perform bilateral radical neck dissections during simultaneous or staged procedures. Case Report. The staged procedure in patients who require bilateral neck dissections allows collateral venous drainage to develop, mainly through the internal and external vertebral plexuses, thereby minimizing the risks of deleterious consequences. Nevertheless, this procedure has disadvantages, such as a delay in definitive therapy, the need for a second hospitalization and anesthesia, and the risk of cutting lymphatic vessels and spreading viable cancer cells. In this paper, we discuss the rationale and feasibility of preserving the external jugular vein. Considering the limited number of similar reports in the literature, two cases in which this procedure was accomplished are described. The relevant anatomy and technique are reviewed and the patients’ outcomes are discussed. Conclusion. Preservation of the EJV during bilateral neck dissections is technically feasible, fast, and safe, with clinically and radiologically demonstrated patency.

  13. Environmental externalities related to power production on biogas and natural gas based on the EU ExternE methodology

    DEFF Research Database (Denmark)

    Nielsen, Per Sieverts; Ibsen, Liselotte Schleisner

    1998-01-01

    This paper assesses the environmental impacts and external costs from selected electricity generation systems in Denmark. The assessment is carried out as part of the ExternE National Implementation, which is the second phase of the ExternE project and involves case studies from all Western Europ...... show that estimated damages due to the greenhouse effect are predominant, however, the uncertainty is high. The predominant damage at the local and regional level is related to emission of NOx, which results in effects on public health....

  14. Consultoria externa em reforma do Estado tem função técnica ou estratégica? Um estudo de caso Does external consultancy in State reform have a technical or a strategic role? A case study

    Directory of Open Access Journals (Sweden)

    Maria Eliza Gonçalves de Siqueira

    2008-02-01

    Full Text Available Este artigo analisa o papel da consultoria organizacional externa (GVconsult/FGV em dois projetos de desestatização previstos no Programa de Reforma do Estado de Pernambuco, no período 1999-2000: o da Centrais de Abastecimento de Pernambuco (Ceasa-PE e o do Centro de Convenções (Cecon. O caminho metodológico foi a aproximação gradativa ao objeto de estudo, partindo de suposições iniciais e pontos críticos que serviram de orientação para a investigação. O trabalho de campo foi constituído por 31 entrevistas semi-estruturadas, em três rodadas, e os textos submetidos a uma análise semântico-pragmática da conversação (Mattos, 2005. A história do caso mostrou que a consultoria organizacional exerceu função técnica auxiliar ao governo de Pernambuco no Programa de Reforma do Estado, de acordo com diretrizes bem definidas e limitações impostas pela equipe do governo. Constatou-se também que, apesar de os conceitos da Reforma do Estado de Pernambuco terem origem nas concepções de Estado dos mentores acadêmicos da FGV e esposadas pelo governo federal (1995-98, não foram os consultores da GVconsult que as trouxeram, mas, sim, os formuladores das políticas públicas do governo de Pernambuco que as colheram diretamente do governo federal e da FGV.This article analyzes the role of Getulio Vargas Foundation external organizational consultancy services (GVconsult, São Paulo, Brazil to two destatization projects in the Pernambuco State Reform Project during 1999-2000: at Pernambuco Produce Whole-sale Market (Ceasa-PE and at the Convention Center (Cecon. The methodological strategy was to gradually approach the object of study, so that initial assumptions and critical points guided the study. The fieldwork involved 31 semi-structured interviews, in three rounds, and the texts were submitted to a semantic and pragmatic conversation analysis (Mattos, 2005. The case history showed that the organizational consultancy had a

  15. Externalizing Behaviors in Toddlerhood: A Longitudinal Study on the Role of Child and Parental Characteristics

    OpenAIRE

    van Aken, A.A.A.M.

    2008-01-01

    According to recent theories, both person characteristics and environmental characteristics have to be taken into account in order to understand individual development. In line with these theories, the present thesis focused on the ways in which child characteristics and parental characteristics interplay in affecting an important negative outcome in toddlerhood; externalizing behaviors. To investigate these issues, five empirical studies were conducted. Participants of these studies were 117...

  16. Hypnosis for the control of pain associated with external cephalic version: a comparative study.

    Science.gov (United States)

    Guittier, Marie-Julia; Guillemin, Francis; Farinelli, Edith Brandao; Irion, Olivier; Boulvain, Michel; de Tejada, Begoña Martinez

    2013-10-01

    To assess the effectiveness of hypnosis to reduce pain and facilitate external cephalic version (ECV). Cohort study. Geneva University Hospitals, Switzerland. 63 women attempting ECV under hypnosis from 2010 to 2011 were compared with 122 women who received standard care from 2005 through 2008. Immediately after the ECV attempt, both groups completed the same questionnaire evaluating the participants' pain (visual analogue and verbal rating scales) and experience with the procedure. Physicians also completed a questionnaire that elicited their views on the effect of hypnosis on the intervention. A chi-squared test was used to compare differences in proportions, and the Mann-Whitney U test was used for differences in continuous variables. A thematic content analysis of the obstetricians' responses to the open question regarding their experience of hypnotist accompaniment was also performed. Pain evaluated by women (visual analogue and verbal rating scales) and success rate of ECV. Pain intensity reported by women did not significantly differ between the hypnosis group and the standard care group (visual analogue scale score, 6.0 versus 6.3, respectively; p=.25; difference for verbal rating scale, p=0.31. In 72% of cases, physicians reported that hypnosis facilitated the procedure. The success rates in both groups were not significantly different (30% with hypnosis compared with 38% without; p=.31). Most women in both groups found the ECV attempt painful and a source of anxiety but would undergo it again if necessary. Hypnosis accompaniment during ECV does not reduce pain intensity associated with the procedure or improve the probability of a successful version.

  17. An autopsy case of chronic progressive external ophthalmoplegia with renal insufficiency.

    Science.gov (United States)

    Yuri, Takashi; Kondo, Yaeko; Kohno, Keiko; Lei, Yen-Chang; Kanematsu, Seika; Kuwata, Maki; Iwasaka, Toshiji; Tsubura, Airo

    2008-12-01

    An autopsy of a 44-year-old Japanese woman with mitochondrial cytopathy confirmed the presence of chronic progressive external ophthalmoplegia (CPEO). Immunohistochemistry using antimitochondrial antibody was performed to observe the ultrastructure of the skeletal muscle and renal tissues. The patient was born of consanguineous parents, developed normally, and was of average intelligence. At 22 years of age, the patient noticed hearing loss, and subsequently, over time, developed a progressive generalized muscle weakness, which included limitation of eye movement and ptosis. At age 41, a muscle biopsy was performed using the modified Gomori trichrome method and demonstrated the presence of ragged red fibers. After the evaluation of her results in conjunction with her clinical course, she was diagnosed with CPEO. Renal insufficiency was discovered at age 30, and the patient died at the age of 44 of respiratory failure caused by respiratory muscle weakness and pneumonia. The autopsy revealed fiber size variation within the skeletal muscle, and an antimitochondrial antibody analysis demonstrated the accumulation of mitochondria between the bundles of myofibrils, as well as in subsarcolemmal locations. Ultrastructurally, abnormal mitochondria with disoriented cristae and paracrystalline inclusions were seen. Although no remarkable histological changes were noted in the kidneys, tubular epithelial cells exhibited accumulated abnormal mitochondria, similar to those seen in the skeletal muscle. Because mitochondrial diseases can affect other energy-dependent organs in addition to the skeletal muscle, immunohistochemical examinations employing an antimitochondrial antibody are useful for obtaining further ultrastructural observations that can assist in making a distinct diagnosis of this systemic disorder.

  18. Emotion, Engagement, and Case Studies

    Science.gov (United States)

    Herreid, Clyde Freeman; Terry, David R.; Lemons, Paula; Armstrong, Norris; Brickman, Peggy; Ribbens, Eric

    2014-01-01

    Three college faculty taught large general biology classes using case studies and personal response systems (clickers). Each instructor taught the same eight cases in two different sections, except the questions within the cases differed. In one section the questions were lower order (LO) factual inquiries, and in the other they were largely…

  19. The effect of infected external computers on the spread of viruses: A compartment modeling study

    Science.gov (United States)

    Yang, Lu-Xing; Yang, Xiaofan

    2013-12-01

    Inevitably, there exist infected computers outside of the Internet. This paper aims to understand how infected external computers affect the spread of computer viruses. For that purpose, a new virus-antivirus spreading model, which takes into account the effect of infected/immune external computers, is established. A systematic study shows that, unlike most previous models, the proposed model admits no virus-free equilibrium and admits a globally asymptotically stable viral equilibrium. This result implies that it would be practically impossible to eradicate viruses on the Internet. As a result, inhibiting the virus prevalence to below an acceptable level would be the next best thing. A theoretical study reveals the effect of different parameters on the steady virus prevalence. On this basis, a number of suggestions are made so as to contain virus spreading.

  20. Theory Testing Using Case Studies

    DEFF Research Database (Denmark)

    Møller, Ann-Kristina Løkke; Dissing Sørensen, Pernille

    2014-01-01

    testing using case studies, including the associated research goal, analysis, and generalisability. We argue that research designs for theory testing using case studies differ from theorybuilding case study research designs because different research projects serve different purposes and follow different......The appropriateness of case studies as a tool for theory testing is still a controversial issue, and discussions about the weaknesses of such research designs have previously taken precedence over those about its strengths. The purpose of the paper is to examine and revive the approach of theory...... research paths....

  1. [External otitis].

    Science.gov (United States)

    Olina, Massimo; Cametti, Massimiliano; Guglielmetti, Chiara; Gattoni, Massimo; Leigheb, Giorgio; Pia, Francesco

    2002-02-01

    Otitis externa is one of the most common diseases in ORL practice, during summer; the treatment of otitis externa may be simple and easy or protracted and frustrating, also with fatal outcome. Many local factors may interfere with the normal defences against infections in the external auditory canal. Removing or dissolving the cerumen by water or other instruments eliminates an important barrier to infections: its acids inhibit the growth of bacteria (Staphylococcus aureus and Pseudomonas aeruginosa) and fungi (Aspergillus). Also skin abrasions or irritation, allergic diseases and many systemic condition like anaemia, vitamin deficiency, endocrine disorders (diabetes) and various forms of dermatitis cause a lower resistance to infections in external auditory canal. Even if the prognosis remains benign in the majority of cases, important complications could appear like: malignant otitis externa, facial nerve paralysis, tympanic bone osteomyelitis, pericondrytis. Successful treatment depends on a proper diagnosis and therapy: the most important factor in the treatment is repeated debridement of the external auditory canal by the physician. The use of Castellani' Tintura rubra, hydroalcoholic solution of phenic fuchsin, can be very effective for bacteria and mycotic eradication. Culturing of ear canal infection could be performed on the second or third visit if the otitis externa is not responding to therapy. Complication are not frequent, but malignant otitis externa can be mortal. Dermatological consultation is often necessary for correct diagnosis.

  2. Gravity versus manual external rotation stress view in evaluating ankle stability: a prospective study.

    Science.gov (United States)

    LeBa, Thu-Ba; Gugala, Zbigniew; Morris, Randal P; Panchbhavi, Vinod K

    2015-06-01

    The purpose of this prospective study was to determine whether gravity versus manual external rotation stress testing effectively detects widening of the medial clear space in isolated ankle fractures when compared with the uninjured contralateral side. Manual external rotation stress and gravity stress tests were performed on injured and uninjured ankles of ankle fracture patients in a clinic setting. Medial clear space measurements were recorded and differences between gravity and manual stress views were determined. Twenty consecutive patients with ankle injury were enrolled in the study. When compared with the uninjured side, gravity stress views showed a statistically significant (P = .017) increase in medial clear space widening (1.85 ± 1.07 mm) compared with manual stress view widening (1.35 ± 1.04 mm). This study suggests that gravity stress views are as effective as manual external rotation stress views in detecting medial clear space widening in isolated fibular fractures. Diagnostic, Level II: Prospective, comparative trial. © 2014 The Author(s).

  3. External costs related to power production technologies. ExternE national implementation for Denmark

    Energy Technology Data Exchange (ETDEWEB)

    Schleisner, L.; Sieverts Nielsen, P.

    1997-12-01

    The objective of the ExternE National Implementation project has been to establish a comprehensive and comparable set of data on externalities of power generation for all EU member states and Norway. The tasks include the application of the ExternE methodology to the most important fuel cycles for each country as well as to update the already existing results; to aggregate these site- and technology-specific results to more general figures. The current report covers the results of the national implementation for Denmark. Three different fuel cycles have been chosen as case studies. These are fuel cycles for an offshore wind farm and a wind farm on land, a decentralised CHP plant based on natural gas and a decentralised CHP plant based on biogas. The report covers all the details of the application of the methodology to these fuel cycles aggregation to a national level. (au) EU-JOULE 3. 59 tabs., 25 ills., 61 refs.

  4. Posterior odontoid process angulation in pediatric Chiari I malformation: an MRI morphometric external validation study.

    Science.gov (United States)

    Ladner, Travis R; Dewan, Michael C; Day, Matthew A; Shannon, Chevis N; Tomycz, Luke; Tulipan, Noel; Wellons, John C

    2015-08-01

    OBJECT Osseous anomalies of the craniocervical junction are hypothesized to precipitate the hindbrain herniation observed in Chiari I malformation (CM-I). Previous work by Tubbs et al. showed that posterior angulation of the odontoid process is more prevalent in children with CM-I than in healthy controls. The present study is an external validation of that report. The goals of our study were 3-fold: 1) to externally validate the results of Tubbs et al. in a different patient population; 2) to compare how morphometric parameters vary with age, sex, and symptomatology; and 3) to develop a correlative model for tonsillar ectopia in CM-I based on these measurements. METHODS The authors performed a retrospective review of 119 patients who underwent posterior fossa decompression with duraplasty at the Monroe Carell Jr. Children's Hospital at Vanderbilt University; 78 of these patients had imaging available for review. Demographic and clinical variables were collected. A neuroradiologist retrospectively evaluated preoperative MRI examinations in these 78 patients and recorded the following measurements: McRae line length; obex displacement length; odontoid process parameters (height, angle of retroflexion, and angle of retroversion); perpendicular distance to the basion-C2 line (pB-C2 line); length of cerebellar tonsillar ectopia; caudal extent of the cerebellar tonsils; and presence, location, and size of syringomyelia. Odontoid retroflexion grade was classified as Grade 0, > 90°; Grade I,85°-89°; Grade II, 80°-84°; and Grade III, < 80°. Age groups were defined as 0-6 years, 7-12 years, and 13-17 years at the time of surgery. Univariate and multivariate linear regression analyses, Kruskal-Wallis 1-way ANOVA, and Fisher's exact test were performed to assess the relationship between age, sex, and symptomatology with these craniometric variables. RESULTS The prevalence of posterior odontoid angulation was 81%, which is almost identical to that in the previous report

  5. Consortium Purchases: Case Study for a Cost-Benefit Analysis.

    Science.gov (United States)

    Scigliano, Marisa

    2002-01-01

    Discusses library cooperation and academic library consortia and presents a case study of a Canadian consortia that conducted a cost-benefit analysis for purchasing an electronic resource. Reports on member library subscription costs, external economic factors, value of patron time saved, costs and benefits for patrons, and net savings. (LRW)

  6. GP experiences of partner and external peer appraisal: a qualitative study

    Science.gov (United States)

    McKinstry, Brian; Peacock, Heather; Shaw, Johnstone

    2005-01-01

    Background Appraisal is being adopted both in the UK and internationally as a means of aiding personal development for family doctors. However, it is not clear by whom they should be appraised. Aim To explore attitudes of GPs towards being appraised by externally appointed GP colleagues and by their own partners. Design of study Semi-structured interviews of GPs who had experienced both forms of appraisal. Setting Lothian, Scotland. Method Sixty-six GPs agreed to take part in a study of partner (n = 46) and external (n = 20) peer-based appraisal. Six months later this group was followed up by questionnaire to determine views of the process, in order to obtain a purposeful sample of 13 GPs who were interviewed in depth. Results We uncovered concern and a need for clarity about the linkage of appraisal to revalidation. Interviewees felt that the potentially charged nature of appraisal could lead to collusion between appraiser and appraisee, which may lead to a superficial engagement. Similarly, lack of local knowledge of an appraisee potentially enabled a strategy of avoidance. GPs opting for partner appraisal were less likely to undergo appraisal due to lack of protected time. Conclusion There are reported advantages and disadvantages to having an external peer or partner appraisal. The relationship between revalidation and appraisal needs to be clarified as this leads to collusion and avoidance strategies by both appraisers and appraisees. Good training is required to both recognise and address these strategies. Protected time is essential for effective appraisal. PMID:16004740

  7. Nested case-control studies.

    Science.gov (United States)

    Ernster, V L

    1994-09-01

    The nested case-control study design (or the case-control in a cohort study) is described here and compared with other designs, including the classic case-control and cohort studies and the case-cohort study. In the nested case-control study, cases of a disease that occur in a defined cohort are identified and, for each, a specified number of matched controls is selected from among those in the cohort who have not developed the disease by the time of disease occurrence in the case. For many research questions, the nested case-control design potentially offers impressive reductions in costs and efforts of data collection and analysis compared with the full cohort approach, with relatively minor loss in statistical efficiency. The nested case-control design is particularly advantageous for studies of biologic precursors of disease. To advance its prevention research agenda, NIH might be encouraged to maintain a registry of new and existing cohorts, with an inventory of data collected for each; to foster the development of specimen banks; and to serve as a clearinghouse for information about optimal storage conditions for various types of specimens.

  8. Theory testing using case studies

    DEFF Research Database (Denmark)

    Dissing Sørensen, Pernille; Løkke Nielsen, Ann-Kristina

    Case studies may have different research goals. One such goal is the testing of small-scale and middle-range theories. Theory testing refers to the critical examination, observation, and evaluation of the 'why' and 'how' of a specified phenomenon in a particular setting. In this paper, we focus...... on the strengths of theory-testing case studies. We specify research paths associated with theory testing in case studies and present a coherent argument for the logic of theoretical development and refinement using case studies. We emphasize different uses of rival explanations and their implications for research...... design. Finally, we discuss the epistemological logic, i.e., the value to larger research programmes, of such studies and, following Lakatos, conclude that the value of theory-testing case studies lies beyond naïve falsification and in their contribution to developing research programmes in a progressive...

  9. 451 Case studies Cardiac

    African Journals Online (AJOL)

    Marinda

    There appears to be a general agreement that 2% lignocaine with 1:200,000 epinephrine should be used whenever possible specially while using volatile anaesthetics like halothane. Various studies were done comparing varying doses of epinephrine in combination with local anaesthetics and studying their effects.

  10. Adding random case analysis to direct observation (ARCADO) - Updating the external clinical teaching visit to improve general practice registrar assessments.

    Science.gov (United States)

    Ingham, Gerard; Fry, Jennifer; Ward, Bernadette

    2016-12-01

    In response to the advent of competency-based training and the increase in the number of general practice registrars, the Australian general practice education community is seeking valid, reliable, time-efficient and cost-efficient tools to assess registrars. Despite the central role of the external clinical teaching visit (ECTV) in formative assessment of general practice registrars, the ECTV has been an infrequent subject of research or evaluation. The objective of this article is to report on the development of a new approach to ECTV that adds random case analysis to direct observation of consultations - ARCADO ECTV. ARCADO ECTV is a flexible, acceptable and time-efficient formative assessment. The two assessment approaches in the ARCADO ECTV provide complementary insights into the registrar's performance. At least three observed consultations are required to ensure adequate assessment of communications skills. Medical records need to be of recent consultations. There is scope for development of the ARCADO ECTV as a summative assessment.

  11. Online Collaborative Case Study Learning

    Science.gov (United States)

    Lee, Kathryn

    2007-01-01

    Case study learning was integrated into a course designed to improve students' potential for academic success and increase student retention. Case studies related to self-regulation of behavior, motivation, and cognition for academic tasks were used to prompt students' critical thinking and facilitate deep learning of self-regulation topics,…

  12. 473 case studies.indd

    African Journals Online (AJOL)

    Case Studies: Systemic complications following absolute alcohol embolisation of scalp arteriovenous malformation. 2010;16(2). S Afr J Anaesthesiol Analg. Case study: Systemic complications following absolute alcohol embolisation of scalp arteriovenous malformation a AgrawalS, MD, PDCC a Payal YS, MD b BurathokiS ...

  13. Fuzzy-Set Case Studies

    Science.gov (United States)

    Mikkelsen, Kim Sass

    2017-01-01

    Contemporary case studies rely on verbal arguments and set theory to build or evaluate theoretical claims. While existing procedures excel in the use of qualitative information (information about kind), they ignore quantitative information (information about degree) at central points of the analysis. Effectively, contemporary case studies rely on…

  14. External Beam Radiotherapy for Focal Lymphoepithelioma-Like Carcinoma in the Urinary Bladder: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Nobuhiro Kushida

    2015-01-01

    Full Text Available Lymphoepithelioma is a malignant epithelial tumor in the nasopharynx characterized by prominent lymphoid infiltration. Carcinomas that resemble lymphoepitheliomas have been called lymphoepithelioma-like carcinomas and have been reported in other organs. A tumor in the bladder is categorized by the percentage of the total area occupied by the lymphoepithelioma-like carcinoma pattern, with the prognosis dependent on the percentage. We present an 81-year-old man with stage 3 chronic obstructive pulmonary disease and a history of aortic aneurysm repair. The computed tomography scans indicated thickening and irregularity of the bladder wall, with left external iliac lymph node metastasis. His diagnosis was bladder cancer, and the clinical stage was evaluated as T3N1M0. Transurethral resection of the bladder tumor was performed, and the pathological specimen showed that the tumor was composed of undifferentiated malignant cells with sheets and nests arranged in a syncytial pattern, as well as an urothelial carcinoma lesion. A prominent lymphoid reaction accompanied the tumor. The pathological diagnosis was focal-type lymphoepithelioma-like carcinoma containing a component of urothelial carcinoma G3>G2. His general condition was such that he could not tolerate radical cystectomy or systemic chemotherapy. External beam radiotherapy (total 60 Gy was given to the bladder, including the lymph node metastatic lesion. No cancer recurrence was detected by regular follow-up computed tomography and cystoscopy. He eventually died of other causes 48 months later. Although treatment for focal lymphoepithelioma-like carcinoma generally requires multifocal therapies, in the present case, the bladder became tumor free. We also summarize previously reported lymphoepithelioma-like carcinoma cases treated with radiotherapy.

  15. [Manipulative reduction and external fixation with cardboard splint for the treatment of calcaneal fractures: a 60-case report].

    Science.gov (United States)

    Hao, Bo-Chuan; Xie, Ke-Bo

    2014-07-01

    To investigate the therapeutic effects of manipulative reduction for calcaneal fractures. From January 2009 to June 2012, 53 cases (60 affected feet) of Sanders type I-IV calcaneal fractures were treated by manipulative reduction and external fixation with cardboard splint,including 45 males and 8 females with an average age of (33.5 +/- 1.54) years old ranging from 18 to 65. The course of disease ranged 0.5 h to 7 d. Before treatment the feet were swelling, ache and activity limitation in evidence, some feet were wide flat deformity, the cortical bone was broken in the imaging examination. All selected cases were evaluated using Creighton-Nebraska health foundation assessment scale for fractures of calcaneus. All cases were followed up at 12 months after treatment, 13 feet got excellent curative effect, 34 good, 11 moderate and 2 poor. Manipulative reduction for Sanders type I-IV calcaneal fractures could get excellent curative effect. Manipulative reduction for calcaneal fractures could avoid surgical trauma while assure high curative effects. Manipulative reduction is not only economical and easy therapy, but also can restore maximum function of the calcaneus with few complications and facilitate early rehabilitation of ankle and joint function.

  16. Rehabilitation considerations for a patient with external hemipelvectomy and hemisacrectomy for recurrent soft tissue pelvic sarcoma: a case report.

    Science.gov (United States)

    Schaal Wilson, Rachel E

    2015-01-01

    External hemipelvectomy (EHP) is an uncommon procedure involving surgical amputation of the lower extremity and hemipelvis. Soft tissue sarcomas of the pelvis are rare and accompanied by a high risk of disease progression after surgical intervention. The purpose of this case report is to describe the rehabilitation considerations and importance of interdisciplinary collaboration to achieve functional goals to allow discharge with improved independence and decreased caregiver burden. A 58-year-old Caucasian male patient underwent a hemipelvectomy and hemisacrectomy for treatment of a recurrent pelvic soft tissue sarcoma following 4 months of bed confinement secondary to pain and weakness of the involved lower extremity. This report outlines the physical therapy interventions during 3 weeks of inpatient rehabilitation. This case demonstrates that continuous interdisciplinary care of a complex patient with EHP and hemisacrectomy contributes to significant improvement in functional mobility exceeding prior level of function. This case is particularly interesting because in addition to having a rare diagnosis and undergoing an uncommon surgical procedure, this patient was confined to bed for 4 months prior to surgical intervention, and thus began rehabilitation with a baseline of limited functional mobility and high caregiver burden.

  17. Advancement of the external oblique muscle flap to improve the waistline: a study in cadavers.

    Science.gov (United States)

    Nahas, F X

    2001-08-01

    Waist definition is an important goal of abdominoplasty. The purpose of this report is to study the effect of advancement and rotation of the external oblique muscles in the waistline. Twenty cadavers were dissected. Two parameters were analyzed: measurement of the waist circumference and the width of overlapped skin flaps of the abdomen in the midline. Three stages of dissection were compared: (1) initial stage, in which the myoaponeurotic structure of the anterior abdominal wall was intact; (2) stage 1, after advancement of the rectus muscles and its anterior aponeurosis toward the midline; and (3) stage 2, after advancement and rotation of the external oblique muscle. A significant statistical difference was found when waist circumference measured before dissection was compared with values obtained after the procedure. When the width of the overlapped skin flaps was compared during the different stages of dissection, a significant statistical difference was observed after each stage (paired t test). Therefore, the approximation of the rectus muscles alone improves the waistline, and when associated with external oblique muscle flap advancement and rotation, the cosmetic result in this area is even better. In conclusion, the procedure described decreases waist circumference and improves the frontal view of the waist.

  18. An experimental study on coolability through the external reactor vessel cooling according to RPV insulation design

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Kyoung Ho; Koo, Kil Mo; Park, Rae Joon; Cho, Young Ro; Kim, Sang Baik

    2004-01-01

    LAVA-ERVC experiments have been performed to investigate the effect of insulation design features on the water accessibility and coolability in case of the external reactor vessel cooling. Alumina iron thermite melt was used as corium stimulant. And the hemispherical test vessel is linearly scaled-down of RPV lower plenum. 4 tests have been performed varying the melt composition and the configuration of the insulation system. Due to the limited steam venting capacity through the insulation, steam binding occurred inside the annulus in the LAVA- ERVC-1, 2 tests which were performed for simulating the KSNP insulation design. This steam binding brought about incident heat up of the vessel outer surface at the upper part in the LAVA-ERVC-1, 2 tests. On the contrary, in the LAVA-ERVC-3, 4 tests which were performed for simulating the APR1400 insulation design, the temperatures of the vessel outer surface maintained near saturation temperature. Sufficient water ingression and steam venting through the insulation lead to effective cooldown of the vessel characterized by nucleate boiling in the LAVA-ERVC-3, 4 tests. From the LAVA-ERVC experimental results, it could be preliminarily concluded that if pertinent modification of the insulation design focused on the improvement of water ingression and steam venting should be preceded the possibility of in-vessel corium retention through the external vessel cooling could be considerably increased.

  19. national Case study

    African Journals Online (AJOL)

    expansive orientation to knowledge and pedagogical content knowledge is required, if quality education is to emerge. The study provides a revised conceptual framework for the Teacher. Development Network (TEDN) programme, with guidance on key elements necessary to take the programme forward in Phase 2.

  20. Southern Appalachian Case Study

    Science.gov (United States)

    Charles C. van Sickle

    1999-01-01

    The Southern Appalachian study covers a region of 37.4 million acres. Its mountains, foothills, and valleys stretch from northern Virginia and northern West Virginia to northern Georgia and Alabama. When Native Americans came to the region, forests dominated the landscape and they still do, covering 70% of the land (Figure 32.1). Terrain characteristics are...

  1. Case study: Tourism marketing

    OpenAIRE

    Kennell, James

    2014-01-01

    Tourism can be a challenging subject for students because it is both dynamic and susceptible to economic turbulence and shifts in trends. Tourism: A Modern Synthesis is an essential textbook for tourism students looking for a clear and comprehensive introduction to their studies which helps overcome these challenges. The authors apply a strong business approach to the subject reflecting developments in the teaching and content of modern courses and the text covers both key principles and cont...

  2. Multimodality cranial image fusion using external markers applied via a vacuum mouthpiece and a case report

    Energy Technology Data Exchange (ETDEWEB)

    Sweeney, R.A.; Seydl, K.; Lukas, P. [Dept. of Radiotherapy-Radiooncology, Univ. Hospital Innsbruck (Austria); Bale, R.J.; Trieb, T. [Dept. of Radiology 1, Interdisciplinary Stereotactic Intervention- and Planning Lab. (SIP-LAB), Univ. Hospital Innsbruck (Austria); Moncayo, R.; Donnemiller, E. [Dept. of Nuclear Medicine, Univ. Hospital Innsbruck (Austria); Eisner, W.; Burtscher, J. [Dept. of Neurosurgery, Univ. Hospital Innsbruck (Austria); Stockhammer, G. [Dept. of Neurology, Univ. Hospital Innsbruck (Austria)

    2003-04-01

    Purpose: To present a simple and precise method of combining functional information of cranial SPECT and PET images with CT and MRI, in any combination. Material and Methods: Imaging is performed with a hockey mask-like reference frame with image modality-specific markers in precisely defined positions. This frame is reproducibly connected to the VBH vacuum mouthpiece, granting objectively identical repositioning of the frame with respect to the cranium. Using these markers, the desired 3-D imaging modalities can then be manually or automatically registered. This information can be used for diagnosis, treatment planning, and evaluation of follow-up, while the same vacuum mouthpiece allows precisely reproducible stereotactic head fixation during radiotherapy. Results: 244 CT and MR data sets of 49 patients were registered to a root square mean error (RSME) of 0.9 mm (mean). 64 SPECT-CT fusions on 18 of these patients gave an RMSE of 1.4 mm, and 40 PET-CT data sets of eight patients were registered to 1.3 mm. An example of the method is given by means of a case report of a 52-year-old patient with bilateral optic nerve meningioma. Conclusion: This technique is a simple, objective and accurate registration tool to combine diagnosis, treatment planning, treatment, and follow-up, all via an individualized vacuum mouthpiece. Especially for low-resolution PET and even more so for some very diffuse SPECT data sets, activity can now be accurately correlated to anatomic structures. (orig.)

  3. IVHS institutional issues and case studies : Travtek case study

    Science.gov (United States)

    1994-04-01

    This operational test case study is one of six performed in response to a Volpe : National Transportation Systems Center technical task directive (TTD) to : Science Applications International Corporation (SAIC) entitled, IVHS : Institutional Issue...

  4. IVHS institutional issues and case studies : ADVANCE case study

    Science.gov (United States)

    1994-04-01

    This operational test case study is one of six performed in response to a Volpe : National Transportation Systems Center technical task directive (TTD) to : Science Applications International Corporation (SAIC) entitled, IVHS : Institutional Issue...

  5. THERMOHALINE INSTABILITIES INSIDE STARS: A SYNTHETIC STUDY INCLUDING EXTERNAL TURBULENCE AND RADIATIVE LEVITATION

    Energy Technology Data Exchange (ETDEWEB)

    Vauclair, Sylvie; Theado, Sylvie, E-mail: sylvie.vauclair@irap.omp.eu [Universite de Toulouse, UPS-OMP and CNRS, Institut de Recherche en Astrophysique et Planetologie, 14 avenue Edouard Belin, F-31400 Toulouse (France)

    2012-07-01

    We have derived a new expression for the thermohaline mixing coefficient in stars, including the effects of radiative levitation and external turbulence, by solving Boussinesq equations in a nearly incompressible stratified fluid with a linear approximation. It is well known that radiative levitation of individual elements can lead to their accumulation in specific stellar layers. In some cases, it can induce important effects on the stellar structure. Here we confirm that this accumulation is moderated by thermohaline convection due to the resulting inverse {mu}-gradient. The new coefficient that we have derived shows that the effect of radiative accelerations on the thermohaline instability itself is small. This effect must however be checked in all computations. We also confirm that the presence of large horizontal turbulence can reduce or even suppress the thermohaline convection. These results are important as they concern all the cases of heavy element accumulation in stars. Computations of radiative diffusion must be revisited to include thermohaline convection and its consequences. It may be one of the basic reasons for the fact that the observed abundances are always smaller than those predicted by pure atomic diffusion. In any case, these processes have to compete with rotation-induced mixing, but this competition is more complex than previously thought due to their mutual interaction.

  6. Case Studies in Science Ethics

    Science.gov (United States)

    Williams, Karen

    2010-03-01

    Everyone in science should have ethics education training. I have seen graduate students taken advantage of by their mentors. Many of us have seen misconduct...but what should we do about it? Young scientists are often unaware of the rules in science and make mistakes because of their ignorance of the rules in that particular field of study. Then there are an increasing number of cases in the news of overt cases of misrepresentation in science. All are welcome to attend this discussion of case studies. A case study on topics such as: how to treat data properly, how our values in science affect our work, who gets authorship on scientific papers, who is first author on a paper, what you should do if you uncover misconduct or plagiarism in your university, and we will discuss the scientist's role in society. This will be a painless, non-confrontational small group, then large group discussion of each case

  7. Final report on case studies

    DEFF Research Database (Denmark)

    Ljungberg, Daniel; McKelvey, Maureen; Lassen, Astrid Heidemann

    2012-01-01

    Case study as a research design means investigating a single or multiple instance(s) or setting(s) (i.e. a case) and its entire context to explain a phenomenon and its processes. This is achieved through detailed understanding, usually comprised of multiple sources of information. In this way, ca...

  8. Network cities and externalities

    Directory of Open Access Journals (Sweden)

    Rafael Boix Domènech

    2004-01-01

    Full Text Available The concept of «agglomeration economies» explains the existence of advantages derived from the concentration of population and activity. However, it does not explain the existence of spatially dynamic external economies. Network economies generated in networks of cities correspond to this last type, since they are generated from the interaction between urban units, linked by a network relationship. The objective of this research is to advance in the study of the relationship between the networks of cities and the generation of external economies. The research is divided in four parts: first we expose the link between networks of cities and external economies. The second part outlines a model for the combined measuring of the concentration and network economies. The third part explains the results of applying the model to a case of study: the network of cities of Catalonia. The results suggest that there is a causal relationship between the organization of the urban units forming networks of cities and the generation of external economies that affect growth and economic development. Finally, conclusions and policy implications are drawn up.

  9. External iliac artery thrombosis associated with the ilio-inguinal approach in the management of acetabular fractures: a case report

    Directory of Open Access Journals (Sweden)

    Klos Kajetan

    2008-01-01

    Full Text Available Abstract Introduction The ilio-inguinal approach has come to be used routinely in the management of acetabular fractures involving the anterior wall. Thrombotic complications following surgery via this route are a serious, but rare, complication. Case presentation We report the case of a 66-year-old male patient who slipped on an icy pavement and fell on his left hip. He sustained a comminuted acetabular fracture (a transtectal T-fracture with an incomplete posterior stem through the ischial tuberosity, and was operated on five days later, via an ilio-inguinal approach. In the recovery room, his left lower limb was found to be cool and pale. Immediate re-exploration showed a left external iliac artery thrombosis, and thrombectomy was performed. In the surgical management of acetabular fractures, thrombosis of a major pelvic artery is a rare but potentially devastating complication. We discuss the possible aetiology (initial vessel trauma versus iatrogenic, intraoperative arterial injury and pathomechanism, and wish to draw attention to this complication and to recommend ways in which it can be prevented. Conclusion We recommend circulation monitoring in patients with acetabular fractures, especially where nerve blocks and/or deep sedation/analgesia have been used. High-risk patients should be identified and subjected to intensive preoperative screening, including ultrasonography and if necessary angiography.

  10. Shuttle Transportation System Case-Study Development

    Science.gov (United States)

    Ransom, Khadijah

    2012-01-01

    A case-study collection was developed for NASA's Space Shuttle Program. Using lessons learned and documented by NASA KSC engineers, analysts, and contractors, decades of information related to processing and launching the Space Shuttle was gathered into a single database. The goal was to provide educators with an alternative means to teach real-world engineering processes and to enhance critical thinking, decision making, and problem solving skills. Suggested formats were created to assist both external educators and internal NASA employees to develop and contribute their own case-study reports to share with other educators and students. Via group project, class discussion, or open-ended research format, students will be introduced to the unique decision making process related to Shuttle missions and development. Teaching notes, images, and related documents will be made accessible to the public for presentation of Space Shuttle reports. Lessons investigated included the engine cutoff (ECO) sensor anomaly which occurred during mission STS-114. Students will be presented with general mission infom1ation as well as an explanation of ECO sensors. The project will conclude with the design of a website that allows for distribution of information to the public as well as case-study report submissions from other educators online.

  11. Clinical results of resection arthrodesis by triangular external fixation for posttraumatic arthrosis of the ankle joint in 89 cases

    Directory of Open Access Journals (Sweden)

    Kiene J

    2009-01-01

    Full Text Available Abstract The methods for ankle arthrodesis differ significantly, probably a sign that no method is clearly superior to others. In the last ten years there is a clear favour toward internal fixation. We retrospectively evaluate the technique and evaluate the clinical long term results of external fixation in a triangular frame. Patients and Methods From 1994 to 2001 a consecutive series of 95 patients with end stage arthritis of the ankle joint were treated. Retrospectively the case notes were evaluated regarding trauma history, medical complaints, further injuries and illnesses, walking and pain status and occupational issues and the clinical examination before arthrodesis. Mean age at the index procedure was 45.4 years (18-82, 67 patients were male (70.5%. Via a bilateral approach the malleoli and the joint surfaces were resected. An AO fixator was applied with two Steinmann-nails inserted with approximately 8 cm distance in the distal tibia, one in the neck of the talus and one in the dorsal calcaneus. The fixator was removed after approximately 12 weeks. Follow up examination at mean 4.4 years included a standardised questionnaire and a clinical examination including the criteria of the AOFAS-Score and radiographs. Results: Due to different complications, 8 (8.9% further surgical procedures were necessary including 1 below knee amputation. In 4 patients a non-union of the ankle arthrodesis developed (4.5%. The mean AOFAS score improved from 20.8 to 69.3 points. Conclusion Non-union rates and clinical results of arthrodesis by triangular external fixation of the ankle joint do not differ to internal fixation methods. The complication rate and the reduced patient comfort reserve this method mainly for infected arthritis and complicated soft tissue situations.

  12. HYDROGEOLOGIC CASE STUDIES (CHICAGO, IL)

    Science.gov (United States)

    Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

  13. HYDROGEOLOGIC CASE STUDIES (DENVER PRESENTATION)

    Science.gov (United States)

    Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

  14. Hydrogeologic Case Studies (Seattle, WA)

    Science.gov (United States)

    Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

  15. Umbilical cord blood testosterone and childhood internalizing and externalizing behavior: a prospective study.

    Directory of Open Access Journals (Sweden)

    Monique Robinson

    Full Text Available Antenatal testosterone exposure influences fetal neurodevelopment and gender-role behavior in postnatal life and may contribute to differences in developmental psychopathology during childhood. We prospectively measured the associations between umbilical cord blood testosterone levels at birth and childhood behavioral development in both males and females from a large population based sample. The study comprised 430 females and 429 males from the Western Australian Pregnancy Cohort (Raine Study where umbilical cord blood had been collected. Total testosterone concentrations were determined by mass spectrometry and bioavailable testosterone (BioT levels were calculated. At two, five, eight and ten years of age, the participants completed the Child Behavior Checklist (CBCL. Linear regression models were used to analyse the relationship between BioT concentrations (in quartiles and CBCL scores (total, internalizing, externalizing and selected syndrome. Boys had higher mean CBCL T-scores than girls across all ages of follow-up. There was no significant relationship between cord blood BioT quartiles and CBCL total, internalizing and externalizing T-scores at age two or five to ten combined. In the syndrome score analyses, higher BioT quartiles were associated with significantly lower scores for attention problems for boys at age five, eight and ten, and greater withdrawal symptoms in pre-school girls (age five. We did not identify a consistent relationship between antenatal testosterone exposure and total, internalizing or externalizing behavioral difficulties in childhood. Higher umbilical cord BioT levels were associated with lower scores for attention problems in boys up to 10 years and more withdrawn behavior in 5-year-old girls; however, these findings were not consistent across ages and require further investigation in a larger sample.

  16. Does Gender Moderate the Relations Between Externalizing Behavior and Key Emergent Literacy Abilities? Evidence From a Longitudinal Study.

    Science.gov (United States)

    Allan, Nicholas P; Joye, Shauna W; Lonigan, Christopher J

    2017-05-01

    There is a significant negative relation between externalizing behavior and emergent literacy skills among preschool children. The purpose of this study was to examine the impact of gender on the predictive relation of externalizing behavior and emergent literacy in a group of 178 preschool children (mean age = 48.50 months, SD = 3.66; 48% boys). Externalizing behaviors predicted emergent literacy over time. Distinct patterns of predictive associations dependent on gender were found. Girls with higher levels of externalizing behaviors experienced less change in their vocabulary skills compared with the vocabulary change shown by girls with lower levels of these problem behaviors. The results suggest that early identification programs that include externalizing behavior problems and their relation with emergent literacy development should account for potential gender differences. A theoretical framework in which girls with behavior problems receive less opportunity for vocabulary acquisition is presented.

  17. Vertically transmitted HPV-dependent squamous cell carcinoma of the external auditory canal. Case report of a child

    Energy Technology Data Exchange (ETDEWEB)

    Snietura, Miroslaw; Pakulo, Slawomir; Kopec, Agnieszka; Piglowski, Wojciech; Stanek-Widera, Agata [Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Tumor Pathology Department, Gliwice (Poland); Chelmecka-Wiktorczyk, Liliana [University Children' s Hospital of Cracow, Department of Oncology and Hematology, Cracow (Poland); Drabik, Grazyna [University Children' s Hospital of Cracow, Pathology Department, Cracow (Poland); Kosowski, Bogdan [NZOZ Prosmed, Cracow (Poland); Wyrobek, Lukasz [University Children' s Hospital of Cracow, Department of Radiology, Cracow (Poland); Balwierz, Walentyna [University Children' s Hospital of Cracow, Department of Oncology and Hematology, Cracow (Poland); Jagiellonian University in Cracow, Clinic of Oncology and Hematology, Polish-American Pediatric Institute, Cracow (Poland)

    2017-02-15

    There is much evidence that high-risk human papillomavirus (HPV) plays a causative role in a subset of head and neck squamous cell cancer (HNSCC) in adults. HPV-positive tumors behave differently even in their response to treatment and are therefore a distinct subset. Both HPV-positive and HPV-negative tumors of the head and neck region are usually in the domain of adults and cases in children are rare; thus when a 2-year-old child was diagnosed with this cancer in the external auditory canal, an in-depth assessment of the tumor was considered necessary. A 2-year-old girl was born to a HPV-positive mother who was diagnosed with cervical cancer during pregnancy. The child was delivered by caesarean section and the mother died of her cancer 7 months after delivery. After the diagnosis of locally invasive HPV-positive squamous cell cancer of the external auditory canal, the child was treated surgically, and with chemotherapy and radiotherapy. Full remission was obtained lasting up to 325 weeks since treatment was started, resulting in over 6 years of disease-free survival. This is the first case of advanced, HPV-related HNSCC in a 2-year-old child, in whom the tumor was located in the external auditory canal and who made a dramatic recovery after treatment with nonradical surgery, chemotherapy and radiotherapy. The child has currently been disease free for 6 years. This case supports the observation that HPV-related HNSCC tumors appear to respond favorably to treatment despite the patient's young age and the clinically advanced stage of the tumor. (orig.) [German] Es gibt reichlich Belege dafuer, dass das menschliche Papillomavirus vom Hochrisikotyp (HR-HPV) in einigen Faellen von Plattenepithelkarzinomen des Kopf- und Halsbereichs (HNSCC) eine Schluesselrolle spielt. HPV-positive Tumoren verhalten sich anders, auch bezueglich des Ansprechens auf die Behandlung. Deswegen stellen sie eine separate biologische Gruppe dar. Sowohl HPV-positive als auch HPV

  18. Subungual squamous cell carcinoma: A case study.

    Science.gov (United States)

    Neill, Cory J

    2017-01-01

    The purpose of this case study is to describe a dosimetric delivery of radiation to a superficial disease process involving the skin and bone of the distal finger. A 76-year-old male patient presented with a subungual squamous cell carcinoma (SCC) of the left distal index finger with bony involvement. The patient refused conventional surgical treatment but agreed to external beam radiation therapy (EBRT). There is a gap in the current literature describing how to successfully immobilize fingers and which EBRT modality is dosimetrically advantageous in treating them. The construction of a simple immobilization method with the patient in a reproducible position is described. The use of photons and electrons were compared ultimately showing photons to be dosimetrically advantageous. Long-term efficacy of the treatment was not evaluated because of patient noncompliance. Copyright © 2017 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

  19. Case studies of attacks on communication networks

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Sin Bok; Han, Eon Suk [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1996-06-15

    Recently, as the computer hardware and communications are developed, the data exchange through inter-networking has been highlighted and the data is being recognized as a great asset. Most of the organizations, businesses and enterprises are open to the external world-computer communication networks, attention must be focused on the securities of the information infrastructure. A government organization has been developing 'Circuits Analyzers', and 'Hacker-Tracking Program' and is struggling to track down sneakers. In this report, we analyze the contents of the cases where the communication network has been invaded, from the past up until now in Korea. This report also contains the result of a study on E-mail security, for the protection of KAERI Integrated Management Information System under which utilizes the CALS concepts and web services. (Author)

  20. Long-term results after external radiotherapy in age-related macular degeneration. A prospective study

    Energy Technology Data Exchange (ETDEWEB)

    Prettenhofer, U.; Mayer, R.; Stranzl, H.; Oechs, A.; Hackl, A. [Dept. of Radiotherapy, Univ. Medical School, Graz (Austria); Haas, A. [Dept. of Opthalmology, Univ. Medical School, Graz (Austria)

    2004-02-01

    Purpose: to prospectively evaluate the short- and long-term efficacy of external radiotherapy (RT) in patients with age-related macular degeneration (AMD) by comparing two different dose schedules. Patients and methods: in this prospective, nonrandomized, comparative study including 80 patients, the efficacy of external RT with a total dose of 14.4 Gy (group A, n = 40) and 25.2 Gy (group B, n = 40) was compared. Patients of group a were irradiated between September 1995 and July 1996, patients of group b between August 1996 and November 1997. 67 patients presented with occult choroidal neovascularization (CNV), 13 with classic subfoveal lesions. Complete ophthalmologic investigation was performed before RT, at intervals of 3 months during the 1st year after RT, and of 6 months thereafter. Results: 12 months after RT, vision deteriorated in 85% (14.4 Gy) and 65% (25.2 Gy) of patients. Central visual field decreased with both dose schedules. There was no morphological benefit in neovascular changes. After 48 months, complete follow-up was possible in 46 patients who showed a significant loss of vision similar to the natural course of AMD. Conclusion: external RT of AMD with 14.4 Gy as well as with the escalated dose of 25.2 Gy showed a poor beneficial outcome after 6 and 12 months, respectively. After a follow-up of 4 years, visual outcome in irradiated patients was similar to the natural course of the disease. A conspicuous efficacy of RT in prevention of blindness could not be demonstrated. (orig.)

  1. External and Internal Barriers to Studying Can Affect Student Success and Retention in a Diverse Classroom

    Directory of Open Access Journals (Sweden)

    Laurence Clement

    2016-12-01

    Full Text Available Although a majority of under-represented minority (URM students begin their postsecondary education at community colleges, little is known about barriers to success and retention for transfer-bound science students. This study focuses on some of the barriers that affect these students’ ability to study adequately for a community college “gateway” course. It tests whether instructors’ expectations of study time were realistic for community college students and whether students reported facing external barriers, such as job and family responsibilities, or internal barriers to studying, such as lack of motivational, cognitive, and metacognitive abilities, all of which have been shown to impact academic success and retention. It also tests whether students who faced such barriers were less likely to succeed in and complete the course, as well as whether time spent studying was related to course success. The findings reported here show that community college students do not have enough available time to study and that external and internal barriers are both prevalent among these students. In addition, students who faced such barriers are more likely to fail or drop the class. Results also show that study time is positively correlated with retention, but not performance, as well as with some motivational, cognitive, and metacognitive dimensions of self-regulated learning. These findings lead to new questions, including whether student success in a community college class is associated with the use of cognitive and metacognitive learning strategies for students with no prior degrees, and whether increased course structure may improve success for college students with lower self-regulated abilities.

  2. External and Internal Barriers to Studying Can Affect Student Success and Retention in a Diverse Classroom.

    Science.gov (United States)

    Clement, Laurence

    2016-12-01

    Although a majority of under-represented minority (URM) students begin their postsecondary education at community colleges, little is known about barriers to success and retention for transfer-bound science students. This study focuses on some of the barriers that affect these students' ability to study adequately for a community college "gateway" course. It tests whether instructors' expectations of study time were realistic for community college students and whether students reported facing external barriers, such as job and family responsibilities, or internal barriers to studying, such as lack of motivational, cognitive, and metacognitive abilities, all of which have been shown to impact academic success and retention. It also tests whether students who faced such barriers were less likely to succeed in and complete the course, as well as whether time spent studying was related to course success. The findings reported here show that community college students do not have enough available time to study and that external and internal barriers are both prevalent among these students. In addition, students who faced such barriers are more likely to fail or drop the class. Results also show that study time is positively correlated with retention, but not performance, as well as with some motivational, cognitive, and metacognitive dimensions of self-regulated learning. These findings lead to new questions, including whether student success in a community college class is associated with the use of cognitive and metacognitive learning strategies for students with no prior degrees, and whether increased course structure may improve success for college students with lower self-regulated abilities.

  3. External and Internal Barriers to Studying Can Affect Student Success and Retention in a Diverse Classroom

    Science.gov (United States)

    Clement, Laurence

    2016-01-01

    Although a majority of under-represented minority (URM) students begin their postsecondary education at community colleges, little is known about barriers to success and retention for transfer-bound science students. This study focuses on some of the barriers that affect these students’ ability to study adequately for a community college “gateway” course. It tests whether instructors’ expectations of study time were realistic for community college students and whether students reported facing external barriers, such as job and family responsibilities, or internal barriers to studying, such as lack of motivational, cognitive, and metacognitive abilities, all of which have been shown to impact academic success and retention. It also tests whether students who faced such barriers were less likely to succeed in and complete the course, as well as whether time spent studying was related to course success. The findings reported here show that community college students do not have enough available time to study and that external and internal barriers are both prevalent among these students. In addition, students who faced such barriers are more likely to fail or drop the class. Results also show that study time is positively correlated with retention, but not performance, as well as with some motivational, cognitive, and metacognitive dimensions of self-regulated learning. These findings lead to new questions, including whether student success in a community college class is associated with the use of cognitive and metacognitive learning strategies for students with no prior degrees, and whether increased course structure may improve success for college students with lower self-regulated abilities. PMID:28101261

  4. External beam milli-PIXE as analytical tool for Neolithic obsidian provenance studies

    Energy Technology Data Exchange (ETDEWEB)

    Constantinescu, B.; Cristea-Stan, D. [National Institute for Nuclear Physics and Engineering Horia Hulubei, Bucharest-Magurele (Romania); Kovács, I.; Szõkefalvi-Nagy, Z. [Wigner Research Centre for Phyics, Institute for Particle and Nuclear Physics, Budapest (Hungary)

    2013-07-01

    Full text: Obsidian is the most important archaeological material used for tools and weapons before metals appearance. Its geological sources are limited and concentrated in few geographical zones: Armenia, Eastern Anatolia, Italian Lipari and Sardinia islands, Greek Melos and Yali islands, Hungarian and Slovak Tokaj Mountains. Due to this fact, in Mesolithic and Neolithic periods obsidian was the first archaeological material intensively traded even at long distances. To determine the geological provenance of obsidian and to identify the prehistoric long-range trade routes and possible population migrations elemental concentration ratios can help a 101, since each geological source has its 'fingerprints'. In this work external milli-PIXE technique was applied for elemental concentration ratio determinations in some Neolithic tools found in Transylvania and in the lron Gales region near Danube, and on few relevant geological samples (Slovak Tokaj Mountains, Lipari,Armenia). In Transylvania (the North-Western part of Romania, a region surrounded by Carpathian Mountains), Neolithic obsidian tools were discovered mainly in three regions: North-West - Oradea (near the border with Hungary, Slovakia and Ukraine), Centre -Cluj and Southwest- Banat (near the border with Serbia). A special case is lron Gales - Mesolithic and Early Neolithic sites, directly related to the appearance of agriculture replacing the Mesolithic economy based on hunting and fishing. Three long-distance trade routes could be considered: from Caucasus Mountains via North of the Black Sea, from Greek islands or Asia Minor via ex-Yugoslavia area or via Greece-Bulgaria or from Central Europe- Tokaj Mountains in the case of obsidian. As provenance 'fingerprints', we focused on Ti to Mn, and Rb-Sr-Y-Zr ratios. The measurements were performed at the external milli-PIXE beam-line of the 5MV VdG accelerator of the Wigner RCP. Proton energy of 3MeV and beam currents in the range of 1 ±1 D

  5. Five-Phase Modular External Rotor PM Machines with Different Rotor Poles: A Comparative Simulation Study

    Directory of Open Access Journals (Sweden)

    A. S. Abdel-Khalik

    2012-01-01

    Full Text Available The performance of fault-tolerant modular permanent magnet machines depends on the proper selection of the pole and slot numbers which result in negligible coupling between phases. The preferred slot and pole number combinations eliminate the effect of low-order harmonics in the stator magnetomotive force and thereby the vibration and stray loss are reduced. In this paper, three external rotor machines with identical machine dimensions are designed with different slots per phase per pole ratios. A simulation study is carried out using finite element analysis to compare the performance of the three machines in terms of machine torque density, ripple torque, core loss, and machine efficiency. A mathematical model based on the conventional-phase-model approach is also used for the comparative study. The simulation study is extended to depict machine performance under fault conditions.

  6. External hemipelvectomy as treatment for solitary coxofemoral metastasis from endometrial carcinoma: case report and review of the literature.

    Science.gov (United States)

    Vizzielli, Giuseppe; Fanfani, Francesco; Costantini, Barbara; Gallotta, Valerio; Scambia, Giovanni; Fagotti, Anna

    2012-05-01

    The best treatment for bone metastasis from endometrial cancer as a presenting feature is unclear. We report the first case in the literature of coxofemoral metastases from endometrial cancer treated by surgical approach. Then, after a careful review of the literature, we discuss the best therapeutic option for this subset of patients. A 62-year-old woman with pain, erythema and swelling of the left leg and no history of postmenopausal bleeding underwent biopsy of the leg, which revealed a moderately differentiated endometrial carcinoma, infiltrating muscle and adipose tissues. There were no other sites of distal spread. A literature review was conducted by searching the items 'endometrial cancer' and 'bone metastasis' in MEDLINE and EnBase up to September 2010. The patient was treated with neoadjuvant chemotherapy, but she did not show a clinical response. By considering her prognosis and quality of life, we decided to perform for the first time a total abdominal hysterectomy with bilateral salpingo-oophorectomy in addition to an external hemipelvectomy with a limb amputation and partial ilium and pubic preservation. Thirty months after the procedure the patient is still alive. No other similar results are present in the literature. Patients in good clinical condition with a single bone metastasis of endometrial cancer should be treated aggressively with surgery, as survival can be extended with an acceptable quality of life. © 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology.

  7. Lupus vulgaris of external nose.

    Science.gov (United States)

    Bhandary, Satheesh Kumar; Ranganna, B Usha

    2008-12-01

    Lupus vulgaris is the commonest form of cutaneous tuberculosis which commonly involve trunk and buttocks. Lupus vulgaris affecting nose and face, are rarely reported in India. This study reports an unusual case of lupus vulgaris involving the external nose that showed dramatic outcome after six months of anti- tubercular treatment.

  8. The Role of Self-Control and Early Adolescents? Friendships in the Development of Externalizing Behavior: The SNARE Study

    OpenAIRE

    Franken, Aart; Terrie E Moffitt; Steglich, Christian E. G.; Dijkstra, Jan Kornelis; Harakeh, Zeena; Vollebergh, Wilma A.M.

    2015-01-01

    This social network study investigated the moderating role of self-control in the association between friendship and the development of externalizing behavior: Antisocial behavior, alcohol use, tobacco use. Previous studies have shown inconsistent findings, and did not control for possible friendship network or selection effects. We tested two complementary hypotheses: (1) That early-adolescents with low self-control develop externalizing behavior regardless of their friends' behavior, or (2)...

  9. Case Study on Logistics Performance

    OpenAIRE

    Shahryar Sorooshian; Manimekalai Jambulingam; Javad Dodangeh

    2013-01-01

    The paper presents research carried out at a medium‐size manufacturing organization in east Asia. The study tries to highlight the importance of supply chain management; specifically, our aim for this study is to understand logistics and performance measurement in the logistics and supply chain, and we include a theoretical discussion of online data collected and a case study of the logistic performance of a real organization. The study also examines the performance of the selected company, i...

  10. Case Study of 'moral injury' : Format Dutch Case Studies Project

    NARCIS (Netherlands)

    Korver, Sjaak; Walton, Martin N.; van Loenen, Guus

    2017-01-01

    The case study ‘Moral Injury’ traces care provided by a chaplain in a mental health institution to a former military marksman named Hans. Hans was in care at a specialized unit for military veterans with traumas. He sought contact with a chaplain “to set things right with God” and wanted the

  11. Teaching Case: Enterprise Architecture Specification Case Study

    Science.gov (United States)

    Steenkamp, Annette Lerine; Alawdah, Amal; Almasri, Osama; Gai, Keke; Khattab, Nidal; Swaby, Carval; Abaas, Ramy

    2013-01-01

    A graduate course in enterprise architecture had a team project component in which a real-world business case, provided by an industry sponsor, formed the basis of the project charter and the architecture statement of work. The paper aims to share the team project experience on developing the architecture specifications based on the business case…

  12. Successful Treatment of Iatrogenic External Iliac Artery Perforation With Covered Stent: Case Report and Review of the Literature.

    Science.gov (United States)

    Awan, Muhammad Umer; Omar, Bassam; Qureshi, Ghazanfar; Awan, Ghulam Mustafa

    2017-10-01

    Retroperitoneal hemorrhage from iliac artery injury is a potentially serious complication of vascular interventional procedures leading to hemorrhagic shock and death if not diagnosed early and treated promptly. We report a 70-year-old male admitted to our facility with non-ST-elevation myocardial infarction, whose heart catheterization revealed left anterior descending artery (LAD) with 80% proximal, 95% mid and 100% distal disease. The left circumflex and right coronary arteries were 100% occluded proximally and received collaterals from the LAD. The patient declined coronary artery bypass surgery; therefore, the decision was made to perform high-risk percutaneous coronary intervention (PCI) of the LAD with Impella left ventricular assist device support. Left femoral artery angiogram revealed severely tortuous and calcified aorta, left external iliac and left common iliac arteries, and was accessed with 14-inch Impella sheath. He developed groin pain with mild hypotension thought to be due to sedation, which responded to intravenous fluids and dopamine. He underwent successful rotational atherectomy of the proximal and mid LAD with deployment of drug-eluting stents. Following PCI, he suffered acute profound hypotension necessitating intravenous fluids and vasopressor support with epinephrine. Emergency transthoracic echocardiogram did not reveal any pericardial effusion, and showed normal left ventricle and right ventricle systolic function. The Impella device was removed and selective left common iliac angiogram from the right femoral access revealed a vascular injury site with shift of the bladder to the right indicative of retroperitoneal hematoma. A digital subtraction angiogram revealed extravasation of blood at the vascular injury site. An 8.0 × 59 mm iCAST covered stent was deployed to the left external iliac artery with successful sealing of the perforation. The Impella device site was closed with two Perclose devices. The patient required 4 units of

  13. External approach to rhinoplasty.

    Science.gov (United States)

    Goodman, Wilfred S; Charbonneau, Paul A

    2015-07-01

    The technique of external rhinoplasty is outlined. Having reviewed 74 cases, its advantages and disadvantages are discussed. Reluctance to use this external approach seems to be based on emotional rather than radical grounds, for its seems to be the procedure of choice for many problems.

  14. Delivery through perineal body and severed external anal sphincter with an intact vaginal orifice during a precipitous labor: a case report.

    Science.gov (United States)

    Ismail, Khadijah Irfah; McDonnell, Brendan; O'Coigligh, Seosamh

    2015-05-01

    We present the case of a patient who delivered her baby through the perineal body with an intact vaginal introitus. Damage to the perineal body through its connection to the external anal sphincter can involve the rectovaginal septum with increased morbidity and thought to be linked to rectocele development.

  15. A clinical study of ligamentoaxis using an external fixator, modified frame in the management of a neglected, relapsed, resistant older congenital Talipes Equino varus child

    Directory of Open Access Journals (Sweden)

    Ajit Shinde

    2013-01-01

    Full Text Available Background: In an older, relapsed, recurrent, resistant Congenital Talipes Equino Varus (CTEV child with previous surgical scar, soft tissue release alone is often not sufficient for full correction, particularly at above 2 years of age. Here controlled, fractional differential distraction with Joshi′s external stabilization system is a useful option to correct all the deformities. It is a well-established modality but with complication rate of 30%, mainly related to pin loosening and infection leading to instability of frame. We aimed to study a method to increase stability of frame to reduce incidence of pin loosening, infection and to evaluate clinical and functional outcome of the modality along with modification. Materials and Methods: 117 children underwent Joshi′s external stabilization system procedure. The principle of correction applied in this study was fractional distraction. Patients were evaluated by Catteral and Simons criteria. Results: Excellent results were obtained in 68.50% of cases, good results in 23.90%, and poor results in 7.60% of the cases. The complication rate reduced to 3% pin tract infections, which eventually healed with outpatient treatment. Conclusion: Fractional distraction method by using Joshi′s External Stabilization System is an easy, simple, less invasive method, which corrects all the deformities in resistant, neglected, and relapsed cases of CTEV and modification of the frame we used proved to be beneficial. Teaching and awareness of parents regarding distraction schedule, stability of frame postoperative importance of wearing of corrected footwear for long period are important.

  16. eCompetence Case Studies

    DEFF Research Database (Denmark)

    Jensen, Helle Bækkelund

    2006-01-01

    In this paper we present some details of the processes undertaken in the European eCompetence Initiative. We present two illustrative and representative case studies. The research aims to identify and understand patterns of individual and organisational eCompetence approaches.......In this paper we present some details of the processes undertaken in the European eCompetence Initiative. We present two illustrative and representative case studies. The research aims to identify and understand patterns of individual and organisational eCompetence approaches....

  17. External closed-circuit cooling system for management of patients after device implantation: A feasibility study.

    Science.gov (United States)

    Giofrè, Fabrizio; Ferrari, Paola; Leidi, Cristina; Foschi, Maria Laura; Senni, Michele; De Filippo, Paolo

    2017-08-15

    In the first 24h after pacemaker or implantable cardioverter/defibrillator (ICD) implantation or replacement, the occurrence of hematoma and pain in the surgically treated region is not infrequent and may result in re-intervention and/or more severe complications, such as infections. Currently, the post-implant phase management is very empiric. The aim of this study was to test the clinical applicability and usefulness of an external close-circuit cooling system for the management of the early post-implant period in patients with high risk of hematoma due to anticoagulant and/or antiplatelet therapy. We studied 135 patients (78M; 71±11years) with high risk of hematoma occurrence after pace-maker (63 patients) or ICD (72 patients) implantation or replacement. Immediately after the intervention, a closed-circuit cooling system (CAREPACE™ system, Zamar, Italy) was externally applied on the pre-pectoral region to each patient and maintained for 24h. The system has a compressive pad and a refrigerating circuit in which non-toxic glycolic fluid is pumped. The fluid temperature was set and kept at 5°C for the whole period. The compressive and cooling effect of the system was well tolerated by all the patients at the temperature set. Four patients complained of noise due to machine operation, but in none the treatment was interrupted. The average length of hospital stay was 2.8±0.4days. No clinically significant hematoma was observed at discharge and after one month follow-up visit. This new system can be used for the management of the early phase after device implantation or replacement and appears clinically useful and well tolerated. Further studies on a larger scale are needed to test the potential reduction of post-intervention complications and the cost-effectiveness of this device. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Case Study on Logistics Performance

    Directory of Open Access Journals (Sweden)

    Shahryar Sorooshian

    2013-05-01

    Full Text Available The paper presents research carried out at a medium‐size manufacturing organization in east Asia. The study tries to highlight the importance of supply chain management; specifically, our aim for this study is to understand logistics and performance measurement in the logistics and supply chain, and we include a theoretical discussion of online data collected and a case study of the logistic performance of a real organization. The study also examines the performance of the selected company, identifies the problems and provides recommendations for improvements. This study can be a guide for business advisers and those interested in analysing company performance, especially from a logistics viewpoint. We also suggest the methodology of this case study for those who want to have a better understanding of a business environment before starting their own business, or for benchmarking practice during strategic planning.

  19. Maternal thyroid function and the outcome of external cephalic version: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    van der Donk Riet W

    2011-01-01

    Full Text Available Abstract Background To investigate the relation between maternal thyroid function and the outcome of external cephalic version (ECV in breech presentation. Methods Prospective cohort study in 141 women (≥ 35 weeks gestation with a singleton fetus in breech. Blood samples for assessing thyroid function were taken prior to ECV. Main outcome measure was the relation between maternal thyroid function and ECV outcome indicated by post ECV ultrasound. Results ECV success rate was 77/141 (55%, 41/48 (85% in multipara and 36/93 (39% in primipara. Women with a failed ECV attempt had significantly higher TSH concentrations than women with a successful ECV (p Conclusions Higher TSH levels increase the risk of ECV failure. Trial registration number ClinicalTrials.gov: NCT00516555

  20. Study of ancient Islamic gilded pieces combining PIXE-RBS on external microprobe with sem images

    Energy Technology Data Exchange (ETDEWEB)

    Ynsa, M.D.; Gutierrez, P.C.; Enguita, O. [Universidad Autonoma de Madrid, Centro de Micro-Analisis de Materiales (CMAM), Madrid (Spain); Chamon, J.; Pardo, A.I.; Arroyo, M.; Barrio, J. [Universidad Autonoma de Madrid, Dpto. Prehistoria y Arqueologia, Madrid (Spain); Gomez-Morilla, I. [Technische Universitaet Dresden, Institute fuer Stroemungsmechanik, Dresden (Germany); Ferretti, M. [CNR - Istituto per le Tecnologie Aplicate ai Beni Culturali, Monterotondo St., Roma (Italy); Climent-Font, A. [Universidad Autonoma de Madrid, Centro de Micro-Analisis de Materiales (CMAM), Madrid (Spain); Universidad Autonoma de Madrid, Dpto. Fisica Aplicada C-12, Madrid (Spain)

    2008-07-15

    Numerous metallic objects with very aesthetic and technological qualities have been recovered by archaeological excavations. Adequate processes of restoration and conservation treatments require the accurate determination of the elemental composition and distribution within the objects, as well as the identification of the nature and distribution of the corrosion products. Ideally the identification method should cause no alteration in the sample. In this work, different archaeological pieces with a gilded look have been characterized using simultaneously PIXE and RBS at the CMAM external microprobe in order to study the gilding metalworking done in the Iberian Peninsula during the Middle Ages. The gold layer thickness and its elemental concentrations of Ag, Au and Hg were determined by both techniques and compared with the scanning electron microscopy images obtained for some fragments of pieces. (orig.)

  1. A case of central diabetes insipidus after ketamine infusion during an external to internal carotid artery bypass.

    Science.gov (United States)

    Gaffar, Sharib; Eskander, Jonathan P; Beakley, Burton D; McClure, Brian P; Amenta, Peter; Pierre, Nakeisha

    2017-02-01

    We report the first teenage case of ketamine-induced transient central diabetes insipidus. The patient was an 18-year-old woman with moyamoya disease undergoing an external carotid to internal carotid bypass and given a low-dose ketamine infusion. After approximately 2 hours in the supine position, with 0.5 Minimum Alveolar Concentration (MAC) of sevoflurane, a propofol infusion at 50 μg/kg/min, a remifentanil infusion at 0.5 μg/kg/min, and a ketamine infusion at a dose of 10 μg/kg/min, this patient had an excessive urine output. Initially, the Foley catheter contained 50 mL of urine. She was given 1500 mL of crystalloid during the case but produced 2700 mL of urine output. Increasing urine output was noted 1 hour into the procedure around the time that the patient experienced a 2-minute Cushing-like response characterized by bradycardia and hypertension. Several I-Stat samples revealed a worsening hypernatremia. The decision was made to check the urine osmolality and treat the patient with 4 μg of desmopressin (DDAVP). Urine output began to slow down to a normal rate of 2 mg/kg/h, as the patient was transferred from the operating room to the computed tomographic (CT) scanning room for a CT and CT angiogram; both were unremarkable. The neurosurgery team waited until the next day to complete the procedure. The procedure was completed successfully and uneventfully the next day without a ketamine infusion as part of the general anesthetic plan. The Naranjo Adverse Drug Reaction score of 4 suggested a possible relationship between the patient's ketamine infusion and subsequent central diabetes insipidus. The 2 previous cases on this topic have suggested that ketamine, as an N-methyl-d-aspartate receptor antagonist, inhibits vasopressin release in the neurohypophysis. Urine output, urine osmolarity, and serum osmolarity should be monitored in patients given ketamine anesthetic; desmopressin should be present to prevent dangerous long-term sequela. Copyright © 2016

  2. Scientific team effectiveness and the external CEO: A study of biotechnology university spin-offs

    NARCIS (Netherlands)

    van der Steen, Marianne; Englis-Danskin, Paula; Englis, Basil George

    2013-01-01

    This paper presents an empirical exploration of the effectiveness of scientific teams and the role of an external CEO in the spin-off formation process. The paper contributes to the literature by focusing on the role of the experienced or 'external' entrepreneur (their commercial resources and

  3. Scientific Team Effectiveness and the External CEO: A Study of Biotechnology University Spin-Offs

    Science.gov (United States)

    van der Steen, Marianne; Englis, Paula Danskin; Englis, Basil G.

    2013-01-01

    This paper presents an empirical exploration of the effectiveness of scientific teams and the role of an external CEO in the spin-off formation process. The paper contributes to the literature by focusing on the role of the experienced or "external" entrepreneur (their commercial resources and capabilities) in the early phase of spin-off…

  4. Internal versus external preference analysis : an exploratory study on end-user evaluation

    NARCIS (Netherlands)

    Kleef, van E.; Trijp, van H.C.M.; Luning, P.A.

    2006-01-01

    Internal and external preference analysis emphasise fundamentally different perspectives on the same data. We extend the literature on comparisons between internal and external preference analysis by incorporating the perspective of the end user of the preference analysis results. From a conceptual

  5. Case Studies in Sports Nutrition.

    Science.gov (United States)

    Clark, Nancy

    1988-01-01

    This article presents case studies of two athletes who wanted to affect a change in their body weight in order to enhance athletic performance. Each athlete's problem and the nutrition approach used to solve it are discussed. Caloric values of fast foods are listed. (JL)

  6. The reflexive case study method

    DEFF Research Database (Denmark)

    Rittenhofer, Iris

    2015-01-01

    This paper extends the international business research on small to medium-sized enterprises (SME) at the nexus of globalization. Based on a conceptual synthesis across disciplines and theoretical perspectives, it offers management research a reflexive method for case study research of postnationa...

  7. The Role of Self-Control and Early Adolescents' Friendships in the Development of Externalizing Behavior: The SNARE Study.

    Science.gov (United States)

    Franken, Aart; Moffitt, Terrie E; Steglich, Christian E G; Dijkstra, Jan Kornelis; Harakeh, Zeena; Vollebergh, Wilma A M

    2016-09-01

    This social network study investigated the moderating role of self-control in the association between friendship and the development of externalizing behavior: Antisocial behavior, alcohol use, tobacco use. Previous studies have shown inconsistent findings, and did not control for possible friendship network or selection effects. We tested two complementary hypotheses: (1) That early-adolescents with low self-control develop externalizing behavior regardless of their friends' behavior, or (2) as a result of being influenced by their friends' externalizing behavior to a greater extent. Hypotheses were investigated using data from the SNARE (Social Network Analysis of Risk behavior in Early adolescence) study (N = 1144, 50 % boys, M age 12.7, SD = 0.47). We controlled for selection effects and the network structure, using a data-analysis package called SIENA. The main findings indicate that personal low self-control and friends' externalizing behaviors both predict early adolescents' increasing externalizing behaviors, but they do so independently. Therefore, interventions should focus on all early adolescents' with a lower self-control, rather than focus on those adolescents with a lower self-control who also have friends who engage in externalizing behavior.

  8. An unusual case: right proximal ureteral compression by the ovarian vein and distal ureteral compression by the external iliac vein

    Directory of Open Access Journals (Sweden)

    Halil Ibrahim Serin

    2015-12-01

    Full Text Available A 32-years old woman presented to the emergency room of Bozok University Research Hospital with right renal colic. Multidetector computed tomography (MDCT showed compression of the proximal ureter by the right ovarian vein and compression of the right distal ureter by the right external iliac vein. To the best of our knowledge, right proximal ureteral compression by the ovarian vein together with distal ureteral compression by the external iliac vein have not been reported in the literature. Ovarian vein and external iliac vein compression should be considered in patients presenting to the emergency room with renal colic or low back pain and a dilated collecting system.

  9. Mergers and Acquisitions - Case Study

    OpenAIRE

    Vedele, Sebastiano

    2011-01-01

    The thesis generally talks about mergers & acquisitions, discussing definitions, differences and reasons behind an M&A. I have analyzed what is a merge and what is an acquisition. Why companies combine themselves through an M&A. What are advantages and disadvantages about an M&A. After that the work is followed by a case study, which focuses on Fiat and Chrysler. With regards to this point, the case touches all the steps of the agreement between the two car automakers providing numbers, perce...

  10. Mode of childbirth and neonatal outcome after external cephalic version: A prospective cohort study.

    Science.gov (United States)

    Rosman, A N; Vlemmix, F; Ensing, S; Opmeer, B C; Te Hoven, S; Velzel, J; de Hundt, M; van den Berg, S; Rota, H; van der Post, J A M; Mol, B W J; Kok, M

    2016-08-01

    to assess the mode of childbirth and adverse neonatal outcomes in women with a breech presentation with or without an external cephalic version attempt, and to compare the mode of childbirth among women with successful ECV to women with a spontaneous cephalic presentation. prospective matched cohort study. 25 clusters (hospitals and its referring midwifery practices) in the Netherlands. Data of the Netherlands perinatal registry for the matched cohort. singleton pregnancies from January 2011 to August 2012 with a fetus in breech presentation and a childbirth from 36 weeks gestation onwards. Spontaneous cephalic presentations (selected from national registry 2009 and 2010) were matched in a 2:1 ratio to cephalic presentations after a successful version attempt. Matching criteria were maternal age, parity, gestational age at childbirth and fetal gender. Main outcomes were mode of childbirth and neonatal outcomes. of 1613 women eligible for external cephalic version, 1169 (72.5%) received an ECV attempt. The overall caesarean childbirth rate was significantly lower compared to women who did not receive a version attempt (57% versus 87%; RR 0.66 (0.62-0.70)). Women with a cephalic presentation after ECV compared to women with a spontaneous cephalic presentation had a decreased risk for instrumental vaginal childbirth (RR 0.52 (95% CI 0.29-0.94)) and an increased risk of overall caesarean childbirth (RR 1.7 (95%CI 1.2-2.5)). women who had a successful ECV are at increased risk for a caesarean childbirth but overall, ECV is an important tool to reduce the caesarean rate. ECV is an important tool to reduce the caesarean section rates. Copyright © 2016. Published by Elsevier Ltd.

  11. Enterpreneural ekosystem insights: Case study

    Directory of Open Access Journals (Sweden)

    Taušl Procházková Petra

    2016-03-01

    Full Text Available Entrepreneurial ecosystem is recently in increasing focus of scholars. There are several members of the entrepreneurial ecosystem shifting towards an entrepreneurial society. This paper explores how various regional members inside of the ecosystem are helping in spreading the entrepreneurial thoughts and shifting individuals and the general opinion from managed economy towards an entrepreneurial society. To unpack these activities inside of the entrepreneurial ecosystem, first the understanding of ecosystem and its dimensions is conceptualized. Then a case study is provided. The case study examines regional activities of several ecosystem players. The findings highlight several aspects regarding the entrepreneurial ecosystem and activities fostering its flourishing. Rather than focus on a comprehensive study about effectiveness of public policy makers, the paper concentrate on examining and mainly understanding some representatives of the ecosystem. These individuals are understood as a means to promote and support entrepreneurial society, ecosystem.

  12. An unusual case of multiple aortic abnormalities: total occlusion of aortic arch, left external iliac artery, and bicuspid aortic valve in a 21-year-old man.

    Science.gov (United States)

    Tanindi, Asli; Tavil, Yusuf; Mutluay, Ruya; Taktak, Hacer; Cengel, Atiye

    2007-03-01

    An unusual case of total occlusion of aorta just distal to the left subclavian artery, bicuspid aortic valve, and occluded left external iliac artery in a 21-year-old man who was admitted with headache and severe hypertension is presented. We wish to report this case because so far there have been none reported with such multiple aortic abnormalities, although several documented cases of isolated total occlusion of aorta exist. Our patient underwent a successful surgical correction, i.e., patch plasty to the coarcted segment and end to side - end to side aortal-aortal bypass with Dacron graft.

  13. Experimental study of the effect of external counterpulsation on blood circulation in the lower extremities.

    Science.gov (United States)

    Cai, D; Wu, R; Shao, Y

    2000-08-01

    A bidirectional ultrasonic Doppler flowmeter with direct single sideband separation was used to measure blood flow in the femoral and dorsalis pedis arteries of 18 normal volunteers. Changes in blood-flow velocity and volume during external counterpulsation (ECP) with various sustaining times (the time for maintaining pressure) for inflation were studied. The results showed that blood-flow velocity in the femoral and dorsalis pedis arteries is increased significantly by ECP, but the change is not closely related to the duration of inflation. For a short sustaining time, the net forward blood-flow volume in arteries increased remarkably, but at longer sustaining times it dropped back significantly to a value even lower than that before ECP. The sustaining time for inflation to produce the maximum net forward flow volume (the optimal sustaining time of inflation) was found to be at one-quarter to one-third of the cardiac cycle. In a second study, changes in the calibre of the femoral artery and its collateral and anastomotic branches in the hind extremities in 5 dogs before and after ECP with an optimal sustaining time of inflation were examined by femoral arteriography. The experiments showed that the patency of collateral and anastomotic branches of the femoral artery was greater before than after ECP. The study suggests that ECP could be an effective treatment for improving the blood circulation in extremities.

  14. International external quality assessment study for molecular detection of Lassa virus.

    Directory of Open Access Journals (Sweden)

    Sergejs Nikisins

    2015-05-01

    Full Text Available Lassa virus (LASV is a causative agent of hemorrhagic fever in West Africa. In recent years, it has been imported several times to Europe and North America. The method of choice for early detection of LASV in blood is RT-PCR. Therefore, the European Network for Diagnostics of 'Imported' Viral Diseases (ENIVD performed an external quality assessment (EQA study for molecular detection of LASV. A proficiency panel of 13 samples containing various concentrations of inactivated LASV strains Josiah, Lib-1580/121, CSF, or AV was prepared. Samples containing the LASV-related lymphocytic choriomeningitis virus (LCMV and negative sera were included as specificity controls. Twenty-four laboratories from 17 countries (13 European, one African, one Asian, two American countries participated in the study. Thirteen laboratories (54% reported correct results, 4 (17% laboratories reported 1 to 2 false-negative results, and 7 (29% laboratories reported 3 to 5 false-negative results. This EQA study indicates that most participating laboratories have a good or acceptable performance in molecular detection of LASV. However, several laboratories need to review and improve their diagnostic procedures.

  15. Reciprocal Relations Between Harsh Discipline and Children's Externalizing Behavior in China: A 5-Year Longitudinal Study.

    Science.gov (United States)

    Wang, Meifang; Liu, Li

    2017-02-01

    This research examined the overtime reciprocal relations between maternal and paternal harsh discipline and children's externalizing behavior. Seven hundred two father-mother dyads of children (6-9 years of age at baseline) completed measures of parental harsh discipline and children's externalizing behavior at five time points, 1 year apart. Autoregressive latent trajectory models revealed that maternal and paternal corporal punishment predicted subsequent children's externalizing behavior (parent-driven effects), whereas children's externalizing behavior predicted subsequent maternal and paternal psychological aggression (child-driven effects). The parent-driven effects became stronger, whereas the child-driven effects were equally strong across time. Furthermore, the parent-driven effects for corporal punishment were found for both boys and girls, whereas the child-driven effects for psychological aggression were found only for boys. © 2017 The Authors. Child Development © 2017 Society for Research in Child Development, Inc.

  16. Links between internal and external cooperation in product development : An exploratory study

    NARCIS (Netherlands)

    Hillebrand, B; Biemans, WG

    While there is an overwhelming amount of publications on cooperation in product development projects, they mainly,focus on cooperation between business functions within an organization (internal cooperation) or on cooperation between organizations (external cooperation). Yet the relationship between

  17. Bosnia-Herzegovina case study

    OpenAIRE

    Wise, Laura

    2017-01-01

    During the war in Bosnia-Herzegovina from 1992-1995, issues of inclusion and protection of ethno-national groups were key sticking points throughout the peace process. Over twenty years since the Dayton Peace Agreement was signed in 1995, questions of equality and stability continue to challenge attempts to reform Bosnia-Herzegovina’s institutional configuration. This case study traces how ethno-national group inclusion was negotiated both during and after the peace process, and how the compl...

  18. A Case Study of Israel

    OpenAIRE

    Getz, Daphne; Goldberg, Itzhak

    2016-01-01

    This case study of Israel's ICT sector highlights the important role of the government in the emergence of Israel as a power house of high-tech in information and communications technology, by laying the foundations for private industry to support innovation, and through heavy investment in building the much-needed human capital resource. The main strategic asset is human resources. The quality of human capital is essential to innovation and economic growth. Skilled human re...

  19. External validity study of a personality disorders screening test in a community sample

    OpenAIRE

    Carvalho, Lucas de Francisco

    2017-01-01

    Abstract Background A screening test for personality disorders was recently developed in Brazil, the Dimensional Clinical Personality Inventory – screening version (IDCP-SV). However, no relationship between this screening measure and other scales or external criteria was tested. Objective To seek for validity evidence based on related criteria (e.g., other psychological tests) and external criteria (e.g., sample demographics). Methods Sample comprised 804 participants from São Paulo (B...

  20. External Costs of Transport

    OpenAIRE

    INFRAS, UNIVERSITAT KARLRUHE

    2014-01-01

    This study is an update of a former UIC study on external effects (IFRAS / IWW 2000). It aims at improving the empirical basis of external costs of transport based on the actual state of the art of cost estimation methodologies reflecting also recent studies on external costs of transport on a European level (especially UNITE).The following dimensions are considered:- cost categories- contries- base year- differentiation by means of transport 

  1. Case Study: Guidelines for Producing Videos to Accompany Flipped Cases

    Science.gov (United States)

    Prud'homme-Généreux, Annie; Schiller, Nancy A.; Wild, John H.; Herreid, Clyde Freeman

    2017-01-01

    Three years ago, the "National Center for Case Study Teaching in Science" (NCCSTS) was inspired to merge the case study and flipped classroom approaches. The resulting project aimed to create the materials required to teach a flipped course in introductory biology by assigning videos as homework and case studies in the classroom. Three…

  2. External tube drainage or omentoplasty in the management of residual hepatic hydatid cyst cavity: a prospective randomized controlled study [Externe Schlauchdrainage oder Omentumplastik bei der Behandlung von Echinococcus-Zysten (Finnenblasen: eine prospektive randomisierte Studie

    Directory of Open Access Journals (Sweden)

    Abbas, M.

    2013-07-01

    Full Text Available [english] Background: Surgical procedures advocated for management of residual hepatic hydatid cyst cavity have been a subject of controversy. The aim of this study was to compare omentoplasty (OP and external tube drainage (ETD.Material and methods: This was a prospective randomized controlled study conducted on radiologically documented cases of hepatic hydatidosis (n=50 in a tertiary care hospital of Kashmir. Patients were divided into two groups; in one group ETD was performed and in another OP was done.Results: Twenty-eight patients were offered ETD and 22 OP. There was no statistically significant difference in mean operative time. The overall complication rate was higher in ETD (42.86% as compared to OP (22.73%. In ETD group two patients had bile leak and infection of residual cavity each; whereas no such complication was seen in OP. The mean pain scores were elevated in ETD (p[german] Einleitung: Die chirurgischen Verfahren zur Behandlung von vorhandenen Echinococcus-Zysten in der Leber werden kontrovers beurteilt. Das Ziel dieser Studie war es, die Omentumplastik (OP mit dem externen Schlauch-Drainageverfahren (ETD zu vergleichen.Material und Methoden: Eine prospektive randomisierte, kontrollierte Studie an radiologisch nachgewiesenen Fällen von Leberechinococcose (n=50 wurde in einem Krankenhaus der Maximalversorgung von Kashmir durchgeführt. Die Patienten wurden in zwei Gruppen eingeteilt: Bei der einen Gruppe wurde die externe Schlauchdrainage (ETD durchgeführt, die andere Gruppe wurde operativ mit Omentumplastik (OP behandelt.Ergebnisse: 28 Patienten erhielten das ETD-Verfahren und 22 wurden operativ mit Omentumplastik (OP behandelt. Die gesamte Komplikationsrate war bei ETD höher (42,86 %, verglichen mit dem OP-Verfahren (22,73 %. In den ETD-Gruppen entstanden bei zwei Patienten Gallenfisteln und Infektionen der Zysten, während in der Kontrollgruppe keine Komplikationen beobachtet wurden. Bei der ETD-Gruppe waren die

  3. Internalizing and externalizing traits predict changes in sleep efficiency in emerging adulthood: An actigraphy study

    Directory of Open Access Journals (Sweden)

    Ashley eYaugher

    2015-10-01

    Full Text Available Research on psychopathology and experimental studies of sleep restriction support a relationship between sleep disruption and both internalizing and externalizing disorders. The objective of the current study was to extend this research by examining sleep, impulsivity, antisocial personality traits, and internalizing traits in a university sample. Three hundred and eighty six individuals (161 males between the ages of 18 and 27 years (M = 18.59, SD = 0.98 wore actigraphs for 7 days and completed established measures of disorder-linked personality traits and sleep quality (i.e., Personality Assessment Inventory, Triarchic Psychopathy Measure, Barratt Impulsiveness Scale-11, and the Pittsburgh Sleep Quality Index. As expected, sleep measures and questionnaire scores fell within the normal range of values and sex differences in sleep and personality were consistent with previous research results. Similar to findings in predominantly male forensic psychiatric settings, higher levels of impulsivity predicted poorer subjective sleep quality in both women and men. Consistent with well-established associations between depression and sleep, higher levels of depression in both sexes predicted poorer subjective sleep quality. Bidirectional analyses showed that better sleep efficiency decreases depression. Finally, moderation analyses showed that gender does have a primary role in sleep efficiency and marginal effects were found. The observed relations between sleep and personality traits in a typical university sample add to converging evidence of the relationship between sleep and psychopathology and may inform our understanding of the development of psychopathology in young adulthood.

  4. A Horneyan analytic perspective on couple therapy: a case study.

    Science.gov (United States)

    Horwitz, N M

    1994-09-01

    This paper describes the study, diagnosis, and course of treatment of a marital couple incorporating Horney theory as a basis for understanding. The case illustrates how fundamental features of Horney theory--character structure, pride positions, attacks on the idealized image, alienated aspects of self, externalization and counter-externalization-can be illuminated in the expanded context of a specific other, the spouse, as background. In a marriage characterized by conflict, omnipresent struggles for authority, and malignantly destructive communication, the wife adopts a position of self-effacement externalizing expansiveness to her husband while the husband adopts an expansive-detached position externalizing both expansiveness and self-effacement to the wife. Externalizations from the wife include a form that has not been described in the psychoanalytic literature of the Horney school: indirect active externalization. As shown, the wife attributes an idealization of her husband to third parties. We observe, too, that the husband's reasonableness and the wife's emotional stridency have the effect of attacking the idealized image of the other. Defenses are mobilized in order to repair hurt pride reactions: for the husband, the wife's stridency is an assault on his sense of himself as a principled, virtous man. For the wife, the husband's reasonableness is experienced as an assault on her sense of herself as a caring wife and mother. In order to block their pride responses and attacks on each other's idealized image, which made conjoint sessions antagonistic and unproductive for a time, a "glass wall" technique was employed for some months that enabled each to speak to the other through me. I struggled against the temptation of siding with the husband's rationality and seeing the wife as secondary. I came to understand that the husband's reasonableness was oppressive for the wife. In order for the wife to feel understood empathically, I needed to fill the role of

  5. Evaluation of the internal oblique, external oblique, and transversus abdominalis muscles in patients with ankylosing spondylitis: an ultrasonographic study.

    Science.gov (United States)

    Üşen, Ahmet; Kuran, Banu; Yılmaz, Figen; Aksu, Neşe; Erçalık, Cem

    2017-11-01

    The objectives of the study are to compare abdominal muscle thickness in ankylosing spondylitis (AS) patients with healthy subjects and determine the factors affecting these muscle thickness. Thirty-five male patients with a previous diagnosis of AS according to the Modified New York criteria and a control group consisting of 35 healthy male individuals were included in this cross-sectional and case-control study. Thicknesses of the internal oblique (IO), external oblique (EO), and transversus abdominalis (TrA) muscles were measured with ultrasound (US). AS patients were classified according to the International Physical Activity Questionnaire (IPAQ). There were 35 AS patients with a mean age of 35.17 ± 8.05 years and 35 healthy subjects with a mean age 32.57 ± 7.05 years. No significant difference was observed between the groups in terms of abdominal muscle thicknesses (p > 0.005). When the AS patients were classified according to the IPAQ scores, thicknesses of the IO and TrA muscles were significantly lower in patients who had the low level of IPAQ scores (p < 0.05). In the light of our first and preliminary results, muscle thickness of the IO, EO, and TrA muscles were similar in AS patients to healthy subjects. However, AS patients who had lower level of physical activity have also reduced thickness of IO and TrA muscles.

  6. Osteoma de meato acústico externo: relato de nove casos e revisão de literatura Osteoma of external acoustic meato: report of nine cases and literature review

    Directory of Open Access Journals (Sweden)

    José Ricardo G. Testa

    2003-08-01

    Full Text Available Osteoma de meato acústico externo corresponde a um crescimento ósseo anormal e benigno, que se desenvolve abaixo da pele do conduto e pode causar obstrução total ou parcial do meato acústico externo. FORMA DE ESTUDO: Estudo de série. MATERIAL E MÉTODO: Apresentamos neste estudo nove casos de osteoma de meato acústico externo. A idade dos pacientes variou de 23 anos (idade mínima e 70 anos (idade máxima, sendo a média 40,6 anos. Desses nove pacientes, 5 eram do sexo feminino e 4 eram do sexo masculino. RESULTADO: Os sintomas mais comuns foram: hipoacusia, causada pela obstrução parcial ou total do conduto, otites externas recorrentes e também impactação de cerume de difícil remoção. CONCLUSÃO: A conduta nos casos apresentados foi cirúrgica, com boa evolução, não ocorrendo recidivas.The osteoma of external acoustic meatus corresponds to an abnormal and benign bony growth, that is developed under the skin of the auditory canal and that can cause total or partial obstruction of the external acoustic meatus. STUDY DESIGN: Serie study. MATERIAL AND METHOD: We reported in this study nine cases of osteoma of external acoustic meatus. The patients' ages varied between 23 and 70 years old, being the average age 40,6 years. These patients were 5 of the feminine sex and 4 were of the masculine sex. RESULTS: The more common symptoms were hipoacusia, caused by the partial or total obstruction of the canal, appealing external otitis and also the accumulation of cerumen deep in the external auditory canal with difficult removal. CONCLUSION: We recommended in the presented cases surgical treatment, which had good evolution, with no recidivism.

  7. A case study of Impetigo

    Directory of Open Access Journals (Sweden)

    Mansouri P

    1993-05-01

    Full Text Available This is a report of a case study on 234 patients with impetigo who referred to Razi Dermatology Hospital from April to November, 1989. Treatment was started immediately after obtaining direct smear and performing culture and antibiotic sensitivity test. The most common organism responsible for impetigo was the coagulase-positive staphylococcus (71%. In 13.7% of the cases, the coagulase-negative staphylococcus was grown on culture media, but none of the cultures showed streptococcus as the main organism. Treatment was started with oral penicillin V, oral erythromycin, benzathine penicillin G injection, oral cephalexin, and topical fuccidin. Clinical and bacteriological evaluation after 3-7 days showed that it is preferable to use oral cephalexin instead of other protocols such as oral erythromycin, which has previously been the drug of choice for impetigo. In addition, topical fuccidin with a 75% curative rate was the first drug for treatment, with the same effect as the oral cephalexin

  8. Chronic progressive external ophthalmoplegia: I. A quantitative histochemical study of skeletal muscles

    Directory of Open Access Journals (Sweden)

    Elza Dias-Tosta

    1988-06-01

    Full Text Available This study quantitates the major morphological and cytochemical changes in limb muscle biopsies from 37 patients with the, syndrome of chronic progressive external ophthalmoplegia (CPEO. The aim was to assess the value of limb muscle biopsy in the diagnosis of this syndrome; to define the myopathological changes and to determine whether there were any specific clinico-pathological correlations. Patients were divided into three clinical groups - 11 patients with CPEO with facial and/or limb muscle weakness; 10 with CPEO with facial and/or limb muscle weakness and a positive family history; 16 with CPEO with one or more of the following: pigmentary retinopathy, cerebellar ataxia, pyramidal signs and peripheral neuropathy. The following parameters were measured: the proportions of histochemical fibre types, the muscle fibre areas and the percentage of muscle fibres showing increased oxidative enzyme activity. Pooled results for each of the clinical categories were compared. Statistical analysis of fibre areas and the percentage of fibres with increased oxidative enzyme activity, showed that group 2 differed from the others (p < 0.05. Patients in group 2 showed the highest incidence of type 1 fibre hypertrophy, type 2A atrophy and the lowest incidence of fibres with increased oxidative activity. Fibre type disproportions occurred in all three groups but the differences were not significant.

  9. Experimental study on malfunction of pacemakers due to exposure to different external magnetic fields.

    Science.gov (United States)

    Tiikkaja, Maria; Alanko, Tommi; Lindholm, Harri; Hietanen, Maila; Hartikainen, Juha; Toivonen, Lauri

    2012-06-01

    Cardiac pacemaker malfunction due to exposure to magnetic fields may cause serious problems in some work environments for workers having cardiac pacemakers. The aim of this study was to find the magnetic field interference thresholds for several commonly used pacemaker models. We investigated 16 pacemakers from three different manufacturers with the frequency range of 2 to 1,000 Hz, using sinusoidal, pulse, ramp, and square waveforms. The magnetic fields were produced by a computer-controlled Helmholtz coil system. Pacemaker malfunction occurred in six of 16 pacemakers. Interaction developed almost immediately after high-intensity magnetic field exposure started. With each waveform, at least two pacemakers exhibited interference. In most exposure settings, there was no interference at magnetic field levels below the international occupational safety limits. Nevertheless, some frequencies using ramp or square waveforms interfered with pacemakers even at levels below public exposure limits. The occurrence of interference depended greatly on the waveform, frequency, magnetic field intensity, and the sensing configuration of the pacemaker. Unipolar configurations were more susceptible for interference than the bipolar ones. In addition, magnetic fields perpendicular to the pacemaker loops were more likely to cause interference than parallel fields. There is a need for further investigations on pacemaker interference caused by different external magnetic fields to ensure safe working environment to workers with a pacemaker.

  10. Analysis of serum magnesium ions in dogs exposed to external stress: A pilot study

    Directory of Open Access Journals (Sweden)

    Izumi Ando

    2017-12-01

    Full Text Available Magnesium ions (Mg2+ are essential for various enzymatic reactions in the body associated with energy production and activation of the muscles and nerves. Mg2+ is also involved in blood pressure regulation, maintenance of body temperature, and glucose metabolism. Although various factors including foods and physical conditions have been reported to change serum Mg2+ status in humans, serum Mg2+ in dogs exposed to external stress has been unclear. In this study, we examined serum levels of Mg2+ in dogs at different conditions using the guide dog candidates for the blind. Serum Mg2+ was decreased in winter and increased in summer. Guide dog candidates in an elementary class of the training showed markedly lower levels of serum Mg2+, compared with that of dogs in an advanced class. When healthy adult dogs were subjected to forced exercise using a treadmill, a significant reduction in serum Mg2+ levels was observed, particularly in winter. These findings suggest that serum levels of Mg2+ may be influenced by weather fluctuation such as air temperature, nervousness in unaccustomed situations, age, and physical stress induced by exercise. The results indicate that Mg2+ supplementation should be considered for working dogs, dogs moving or traveling to a new environment, and dogs during winter.

  11. Summary of Building Protection Factor Studies for External Exposure to Ionizing Radiation

    Energy Technology Data Exchange (ETDEWEB)

    Dillon, Michael B. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Kane, Jave [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Nasstrom, John [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Homann, Steve [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Pobanz, Brenda [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2016-02-17

    Radiation dose assessments are used to help inform decisions to minimize health risks in the event of an atmospheric release of radioactivity including, for example, from a Radiological Dispersal Device, an Improvised Nuclear Device detonation, or a Nuclear Power Plant accident. During these incidents, radiation dose assessments for both indoor and outdoor populations are needed to make informed decisions. These dose assessments inform emergency plans and decisions including, for example, identifying areas in which people should be sheltered and determining when controlled population evacuations should be made. US dose assessment methodologies allow consideration of the protection, and therefore dose reduction, that buildings provide their occupants. However, these methodologies require an understanding of the protection provided by various building types that is currently lacking. To help address this need, Lawrence Livermore National Laboratory, in cooperation with Sandia National Laboratories and the Nuclear Regulatory Commission, was tasked with (a) identifying prior building protection studies, (b) extracting results relevant to US building construction, and (c) summarizing building protection by building type. This report focuses primarily on the protection against radiation from outdoor fallout particles (external gamma radiation).

  12. Review of the Elementary Particles Physics in the External Electromagnetic Fields Studies at KEK

    Science.gov (United States)

    Konstantinova, O. Tanaka

    2017-03-01

    High Energy Accelerator Research Organization (KEK [1]) is a world class accelerator-based research laboratory. The field of its scientific interests spreads widely from the study of fundamental properties of matter, particle physics, nuclear physics to materials science, life science, technical researches, and industrial applications. Research outcomes from the laboratory achieved making use of high-energy particle beams and synchrotron radiation. Two synchrotron facilities of KEK, the Photon Factory (PF) ring and the Photon Factory Advanced Ring (PF-AR) are the second biggest synchrotron light source in Japan. A very wide range of the radiated light, from visible light to X-ray, is provided for a variety of materials science, biology, and life science [2]. KEK strives to work closely with national and international research institutions, promoting collaborative research activities. Advanced research and facilities provision are key factors to be at the frontier of the accelerator science. In this review I am going to discuss KEK overall accelerator-based science, and to consider light sources research and development. The state of arts of the current projects with respect to the elementary particles physics in the external electromagnetic fields is also stressed here.

  13. Risk scores for outcome in bacterial meningitis: Systematic review and external validation study.

    Science.gov (United States)

    Bijlsma, Merijn W; Brouwer, Matthijs C; Bossuyt, Patrick M; Heymans, Martijn W; van der Ende, Arie; Tanck, Michael W T; van de Beek, Diederik

    2016-11-01

    To perform an external validation study of risk scores, identified through a systematic review, predicting outcome in community-acquired bacterial meningitis. MEDLINE and EMBASE were searched for articles published between January 1960 and August 2014. Performance was evaluated in 2108 episodes of adult community-acquired bacterial meningitis from two nationwide prospective cohort studies by the area under the receiver operating characteristic curve (AUC), the calibration curve, calibration slope or Hosmer-Lemeshow test, and the distribution of calculated risks. Nine risk scores were identified predicting death, neurological deficit or death, or unfavorable outcome at discharge in bacterial meningitis, pneumococcal meningitis and invasive meningococcal disease. Most studies had shortcomings in design, analyses, and reporting. Evaluation showed AUCs of 0.59 (0.57-0.61) and 0.74 (0.71-0.76) in bacterial meningitis, 0.67 (0.64-0.70) in pneumococcal meningitis, and 0.81 (0.73-0.90), 0.82 (0.74-0.91), 0.84 (0.75-0.93), 0.84 (0.76-0.93), 0.85 (0.75-0.95), and 0.90 (0.83-0.98) in meningococcal meningitis. Calibration curves showed adequate agreement between predicted and observed outcomes for four scores, but statistical tests indicated poor calibration of all risk scores. One score could be recommended for the interpretation and design of bacterial meningitis studies. None of the existing scores performed well enough to recommend routine use in individual patient management. Copyright © 2016 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  14. An experimental study of hypervapotron structure in external reactor vessel cooling

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, Yufeng; Zhang, Ming [State Nuclear Power Technology R& D Center (Beijing), Beijing (China); Hou, Fangxin [Institute of Nuclear and New Energy Technology, Tsinghua University, Beijing (China); Gao, Tianfang [State Nuclear Power Technology R& D Center (Beijing), Beijing (China); Chen, Peipei, E-mail: chenpeipei@snptc.com.cn [State Power Investment Group Corporation, Beijing (China)

    2016-07-15

    Highlights: • Experiments are performed to study the application of hypervapotron in ERVC design. • CHF experiments on two surfaces are conducted under different flow conditions. • Hypervapotron improves CHF performance by 40–60% compared with smooth surface. • Visualization shows fin structure removes vapor mushroom for better liquid supply. - Abstract: In vessel retention (IVR) is one of the key strategies for many advanced LWR designs to mitigate postulated severe accidents. The success of IVR substantially relies on external reactor vessel cooling (ERVC) by which the decay heat is removed from the melt core in the reactor vessel lower head. The main challenge of IVR is to provide an adequate safety margin of ERVC against critical heat flux (CHF) of subcooled flow boiling in the reactor lower head flow channel. Due to uncertainties in corium melt pool configuration, large CHF margin of ERVC is usually required by regulatory authorities to demonstrate reliability of severe accident mitigation methods. Various CHF enhancement designs have been proposed and studied in literature. In this paper, an experimental study of hypervapotron structure as a novel design to improve CHF performance of ERVC is conducted. Hypervapotron is chosen as one of the potential engineering options for International Thermonuclear Experimental Reactor (ITER) program as a divertor structure to remove highly intense heat from fusion chamber. This study is to conduct CHF experiments at typical PWR ERVC working conditions. The CHF experiments are performed in a 30 mm by 61 mm rectangular flow channel with a 200 mm long heated surface along the flow direction. Both smooth and hypervapotron surface are tested at various inclination angles of the test section to simulate various positions of the reactor lower head. The hypervapotron is found to have a 40–60% CHF improvement compared with the smooth surface. The high speed visualization indicates that hypervapotron is able to

  15. Early Adolescent Friendship Selection Based on Externalizing Behavior: the Moderating Role of Pubertal Development. The SNARE Study.

    Science.gov (United States)

    Franken, Aart; Prinstein, Mitchell J; Dijkstra, Jan Kornelis; Steglich, Christian E G; Harakeh, Zeena; Vollebergh, Wilma A M

    2016-11-01

    This study examined friendship (de-)selection processes in early adolescence. Pubertal development was examined as a potential moderator. It was expected that pubertal development would be associated with an increased tendency for adolescents to select their friends based on their similarities in externalizing behavior engagement (i.e., delinquency, alcohol use, and tobacco use). Data were used from the first three waves of the SNARE (Social Network Analysis of Risk behavior in Early adolescence) study (N = 1144; 50 % boys; M age  = 12.7; SD = 0.47), including students who entered the first year of secondary school. The hypothesis was tested using Stochastic Actor-Based Modeling in SIENA. While taking the network structure into account, and controlling for peer influence effects, the results supported this hypothesis. Early adolescents with higher pubertal development were as likely as their peers to select friends based on similarity in externalizing behavior and especially likely to remain friends with peers who had a similar level of externalizing behavior, and thus break friendship ties with dissimilar friends in this respect. As early adolescents are actively engaged in reorganizing their social context, adolescents with a higher pubertal development are especially likely to lose friendships with peers who do not engage in externalizing behavior, thus losing an important source of adaptive social control (i.e., friends who do not engage in externalizing behavior).

  16. Estimating External Costs of Transportation in Regional Areas: Using Available Statistical Data the Case of the Region of Campania

    Directory of Open Access Journals (Sweden)

    Mariano Gallo

    2010-04-01

    Full Text Available In this paper simplified methods for estimating the external costs due to transportation in regional areas are proposed. The methods are based on data available by national and regional statistical sources and do not need specific surveys; they allow obtaining approximate estimates useful for a preliminary evaluation of transportation plans, policies and projects. In more detail, a negative externality is defined as a cost that is produced by subject A and is borne by subject B; moreover, subject A does not consider the effects of his/her behavior on subject B and does not compensate subject B for the costs that this last one is forced to bear. In this paper after a literature review on methodologies proposed for estimating external costs, in national and international ambits, the main external costs produced by transportation systems in the Region of Campania are estimated. The main external costs considered are: greenhouse gas emissions, air pollution, noise, accidents and congestion. In the paper the secondary external costs are neglected; the main ones are: water and soil pollution; landscape and nature damages; upstream and downstream effects; visual intrusion; separation effects; soil occupancy. In this paper the external costs estimated are the ones produced not only by road traffic, that anyway is the main “culprit”, but also by rail and air transportation systems. The evaluation of external costs has required the collection of several data on the regional mobility and the estimation of veh-kms per year produced in Campania by cars and freight vehicles. The estimation of veh-kms per year is based on circulating vehicles, subdivided by the COPERT classification, and on average yearly distances covered by each vehicle class. Other regional statistical data are collected about regional rail transport and air services at the main airports of the region. Moreover, since the evaluation of some external costs is based on damages on human

  17. Study on highway transportation greenhouse effect external cost estimation in China

    Science.gov (United States)

    Chu, Chunchao; Pan, Fengming

    2017-03-01

    This paper focuses on estimating highway transportation greenhouse gas emission volume and greenhouse gas external cost in China. At first, composition and characteristics of greenhouse gases were analysed about highway transportation emissions. Secondly, an improved model of emission volume was presented on basis of highway transportation energy consumption, which may be calculated by virtue of main affecting factors such as the annual average operation miles of each type of the motor vehicles and the unit consumption level. the model of emission volume was constructed which considered not only the availability of energy consumption statistics of highway transportation but also the greenhouse gas emission factors of various fuel types issued by IPCC. Finally, the external cost estimation model was established about highway transportation greenhouse gas emission which combined emission volume with the unit external cost of CO2 emissions. An example was executed to confirm presented model which ranged from 2011 to 2015 Year in China. The calculated result shows that the highway transportation total emission volume and greenhouse gas external cost are growing up, but the unit turnover external cost is steadily declining. On the whole overall, the situation is still grim about highway transportation greenhouse gas emission, and the green transportation strategy should be put into effect as soon as possible.

  18. Internal Interest or External Performing? A Qualitative Study on Motivation and Learning of 9th Graders in Thailand Basic Education

    Science.gov (United States)

    Loima, Jyrki; Vibulphol, Jutarat

    2014-01-01

    This qualitative research was the first academic attempt to study and discuss the internal and external motivation in learning of students in basic education schools in Thailand. The study addressed two research questions to analyze similarities and differences in learning motivation or interest and teachers' enhancement or discouragement. 1) What…

  19. Neurobiological correlates of externalizing and prosocial behavior in school-age children : A study on truths and lies

    NARCIS (Netherlands)

    S. Thijssen (Sandra)

    2015-01-01

    markdownabstractThis thesis describes a series of studies on the neurobiological correlates of externalizing and prosocial behavior in six-to ten-year old children. Chapter 1 provides an outline and describes the background and aims of our work. The studies described in this thesis are embedded in

  20. The role of self-control and early adolescents' friendships in the development of externalizing behavior : The SNARE study

    NARCIS (Netherlands)

    Franken, Aart; Moffitt, Terrie E.; Steglich, Christian E. G.; Dijkstra, Jan Kornelis; Harakeh, Zeena; Vollebergh, Wilma A. M.

    This social network study investigated the moderating role of self-control in the association between friendship and the development of externalizing behavior: Antisocial behavior, alcohol use, tobacco use. Previous studies have shown inconsistent findings, and did not control for possible

  1. Genital HPV infection progression to external genital lesions: The HIM Study

    Science.gov (United States)

    Sudenga, Staci L.; Ingles, Donna J.; Pierce Campbell, Christine M.; Lin, Hui-Yi; Fulp, William J.; Messina, Jane L.; Stoler, Mark H.; Abrahamsen, Martha; Villa, Luisa L.; Lazcano-Ponce, Eduardo; Giuliano, Anna R.

    2015-01-01

    Background Human papillomavirus (HPV) causes two types of external genital lesions (EGLs) in men: genital warts (condyloma) and penile intraepithelial neoplasia (PeIN). Objective The purpose of this study was to describe genital HPV progression to a histopathologically confirmed HPV-related EGL. Design, Setting and Participants A prospective analysis nested within the HPV Infection in Men (HIM) Study was conducted among 3033 men. At each visit, visually distinct EGLs were biopsied, subjected to pathological evaluation, and categorized by pathological diagnoses. Genital swabs and biopsies were used to identify HPV types using the Linear Array genotyping method for swabs and INNO-LiPA for biopsies. Outcome Measurements EGL incidence was determined among 1788 HPV-positive men, and cumulative incidence rates at 6, 12, and 24 months were estimated. The proportion of HPV infections that progressed to EGL was also calculated, along with median time to EGL development. Results and Limitations Among 1788 HPV-positive men, 92 developed an incident EGL during follow-up (9 PeIN and 86 condyloma). During the first 12 months of follow-up, 16% of men with a genital HPV6 infection developed a HPV6-positive condyloma, and 22% of genital HPV11 infections progressed to an HPV11-positive condyloma. During the first 12-months of follow-up, 0.5% of men with a genital HPV16 infection developed an HPV16-positive PeIN. Although we expected PeIN to be a rare event, the sample size for PeIN (n=10) limited the types of analyses that could be performed. Conclusions Most EGLs develop following infection with HPV 6, 11, or 16, all of which could be prevented with the 4-valent HPV vaccine. Patient Summary In this study, we looked at genital HPV infections that can cause lesions in men. The HPV that we detected within the lesions could be prevented through a vaccine. PMID:26051441

  2. Genital Human Papillomavirus Infection Progression to External Genital Lesions: The HIM Study.

    Science.gov (United States)

    Sudenga, Staci L; Ingles, Donna J; Pierce Campbell, Christine M; Lin, Hui-Yi; Fulp, William J; Messina, Jane L; Stoler, Mark H; Abrahamsen, Martha; Villa, Luisa L; Lazcano-Ponce, Eduardo; Giuliano, Anna R

    2016-01-01

    Human papillomavirus (HPV) causes two types of external genital lesions (EGLs) in men: genital warts (condyloma) and penile intraepithelial neoplasia (PeIN). The purpose of this study was to describe genital HPV progression to a histopathologically confirmed HPV-related EGL. A prospective analysis nested within the HPV Infection in Men (HIM) study was conducted among 3033 men. At each visit, visually distinct EGLs were biopsied; the biopsy specimens were subjected to pathologic evaluation and categorized by pathologic diagnoses. Genital swabs and biopsies were used to identify HPV types using the Linear Array genotyping method for swabs and INNO-LiPA for biopsy specimens. EGL incidence was determined among 1788 HPV-positive men, and cumulative incidence rates at 6, 12, and 24 mo were estimated. The proportion of HPV infections that progressed to EGL was also calculated, along with median time to EGL development. Among 1788 HPV-positive men, 92 developed an incident EGL during follow-up (9 PeIN and 86 condyloma). During the first 12 mo of follow-up, 16% of men with a genital HPV 6 infection developed an HPV 6-positive condyloma, and 22% of genital HPV 11 infections progressed to an HPV 11-positive condyloma. During the first 12 mo of follow-up, 0.5% of men with a genital HPV 16 infection developed an HPV 16-positive PeIN. Although we expected PeIN to be a rare event, the sample size for PeIN (n=10) limited the types of analyses that could be performed. Most EGLs develop following infection with HPV 6, 11, or 16, all of which could be prevented with the 4-valent HPV vaccine. In this study, we looked at genital human papillomavirus (HPV) infections that can cause lesions in men. The HPV that we detected within the lesions could be prevented by a vaccine. Copyright © 2015 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  3. Qualitative Case Study Research as Empirical Inquiry

    Science.gov (United States)

    Ellinger, Andrea D.; McWhorter, Rochell

    2016-01-01

    This article introduces the concept of qualitative case study research as empirical inquiry. It defines and distinguishes what a case study is, the purposes, intentions, and types of case studies. It then describes how to determine if a qualitative case study is the preferred approach for conducting research. It overviews the essential steps in…

  4. The internal and external customer focused process improvement and the performance analysis studies in healthcare systems

    Directory of Open Access Journals (Sweden)

    Piril Tekin

    2017-07-01

    Full Text Available Purpose: The main contribution of this paper is to generate an optimum solution for capacity planning and appointment scheduling issues, which are frequently encountered in clinical flows with various route and treatment periods at dental hospitals. Design/methodology/approach: It is essential to define the system well in order to ensure that the working staff and patients use their time very efficiently and that the process flows continuously. By having examined a sample healthcare system through the help of a study addressed in such context, studies on process improvement in line with the dissatisfactions of the working staff and patients have been carried out. Within the scope of the study, the operation of 7 Departments in a dental hospital undergoing a treatment process have been reviewed and examined. The problems encountered as result of the observations made are discussed in detail, and formerly and recently designed system performance analyses are conducted by having performed the respective process improvement studies. The relevant samplings of this study are modeled via the Arena Simulation Program. The data of the previous four months is used in the parameters, which are used through the modellings. The system data are entered by taking into account seasonal characteristics of the data. Findings: The analyses are made as a consequence of such study that has been addressed, it is established that the efficiency of the internal customers of the hospital increases substantially, and that the waiting durations of the dental patients decrease and in turn, the external customer satisfaction increases drastically. Research limitations/implications: Under the scope of the present study, 7 different treatment processes are analysed in a dental hospital in Cukurova Region with a significant patient potential. The treatment clinics present in the hospital are radiology, periodontology, surgery, treatment, orthodontics and prosthesis. These

  5. MULTIPLE PERSONALITY: CASE REPORT STUDY

    Directory of Open Access Journals (Sweden)

    Miloš Židanik

    2004-07-01

    Full Text Available Background. Multiple personality disorder is characterised by splited individual ego-states and splited professional community arguing whether this disorder actually exists or not.Methods. In this case report study a supportive psychodynamic psychotherapy of a patient with multiple personality disorder is presented, that lasted for 4.5 years and resulted in ego-reintegration.Conclusions. The spliting between different ego-states is powered by unneutralised aggression with the possibility of hetero- and autoaggressive behaviour. Therefore the patient in the analytically oriented psychotherapeutic process is at high risk and a safe therapeutic (e. g. in-patient setting has to be provided.

  6. INTERIORITY - a prefab case study

    DEFF Research Database (Denmark)

    Hvejsel, Marie Frier

    and furnishing articulation hereof. In the second volume of the thesis; ‘INTERIORITY: a prefab case study’ this theory of interiority has been endeavored applied in a specific prefab project concerning the development of a novel prefab building system and housing series in collaboration with the Danish prefab......, tectonically. Hence, it has been a particular idea of the study to explore the relation between furniture, the spatial envelope itself, and its construct by using furniture as an architectural concept. Consequently, the thesis has specifically investigated whether this notion of interiority, describing...

  7. Overview of the Case Studies

    DEFF Research Database (Denmark)

    Cameron, Ian; Gani, Rafiqul

    2011-01-01

    A series of case studies are used to illustrate many of the underlying modelling principles within the book. To facilitate this, the ICAS-MoT modelling tool has been used. A wide range of application areas have been chosen to ensure that the principal concepts of effective and efficient modelling...... are exercised. Conceptual frameworks for single and multiscale problems are given and explained. The importance of the steps is also explained, through annotated schematic diagrams. The important issues around workflow and data flow are given in diagrammatic form....

  8. Making Room for Children's Autonomy: Maria Montessori's Case for Seeing Children's Incapacity for Autonomy as an External Failing

    Science.gov (United States)

    Frierson, Patrick R.

    2016-01-01

    This article draws on Martha Nussbaum's distinction between basic, internal, and external (or combined) capacities to better specify possible locations for children's "incapacity" for autonomy. I then examine Maria Montessori's work on what she calls "normalization", which involves a release of children's capacities for…

  9. Hospital Waste Management - Case Study

    Directory of Open Access Journals (Sweden)

    Beatriz Edra

    2017-07-01

    Full Text Available The importance of waste management in hospitals is indisputable in preserving the environment and protecting public health, but management models are rarely discussed. This study presents the legal and conceptual frameworks of good waste management practices applicable to hospitals and associated indicators. As a case study, the overall performance of Hospital Centre of São João, in Porto, was analysed based on published reports. Data on the production of waste in their different typologies were collected from 2010 to 2016, enabling a correlation of the waste production with the kg/bed/day indicator. The aim of this study was to gather data and discuss trends in a real scenario of evolution over a six-year period in order to contribute to a future research proposal on indicators that can be used as reference for benchmarking the construction of methodological guides for hospital waste management.

  10. Study of defensive methods and mechanisms in developmental, emotional (internalization), and disruptive behavior (externalization) disorders.

    Science.gov (United States)

    Jamilian, H R; Zamani, N; Darvishi, M; Khansari, M R

    2014-09-18

    We need to find a way for adaptation with inherent unpleasantness of being human condition and conflicts that it caused, as we did not fail. Methods that we used for adaptation are named defense. This research have performed with the aim of study and compare defensive mechanisms and methods of Developmental, Emotional (Internalization), and Disruptive behavior (Externalization) disorders. Method, sample of this research included 390 family that are by available sampling method are selected. Tools of research were structured clinical interview of forth cognitive and statistical guide of psychopathic disorders for axis I and the way used for assess defensive mechanisms is defensive method 40 question's questionnaires of Andrews (1993). The data are compared by statistical methods comparison of averages and one way variance analysis and HSD tests and results show that undeveloped defensive mechanisms in by developmental disorder family (25.2 ± 3.7) mean and standard deviation, it is most used mechanism and in disruptive behavior disorder family by (11.2 ± 1.9) mean and standard deviation is used least mechanism and in developed mechanism of emotional disorder family by (7.8 ± 3.1) mean and standard deviation is most used mechanism and in developmental disorder family by (4.3 ± 1.5) mean and standard deviation is least mechanism in neuroticism patient, social phobia affected emotional disorder family (15.6 ± 2.6) and disruptive behavior disorder family have least mean and standard deviation (9.2 ± 1.7) (p< 0.005). Recent research shows significant of study defensive mechanism in psychopathic family of disorder children that affecting on the way of life of persons and interpersonal and intrapersonal relations and method of solving problem in family of them in life, so defensive mechanisms require more attention.

  11. Effect of maternal intravenous fluid therapy on external cephalic version at term: a prospective cohort study.

    Science.gov (United States)

    Burgos, Jorge; Quintana, Eider; Cobos, Patricia; Osuna, Carmen; Centeno, María del Mar; Melchor, Juan Carlos

    2014-12-01

    We sought to analyze whether maternal intravenous fluid therapy prior to external cephalic version (ECV) increases the amount of amniotic fluid and the success rate of the procedure. This was a prospective single-center cohort study of 200 women with a consecutive cohort of 100 pregnant women with a breech presentation at term who were administered intravenous fluid therapy with 2 L of hypotonic saline before the version attempt, compared to a control cohort of 100 pregnant women not given hydration treatment. The mean increase in the amniotic fluid index (AFI) after intravenous maternal hydration was 3.75 ± 2.71 cm. The amount of fluid before hydration was the only variable found to be associated with increases in amniotic fluid levels, both in absolute and relative terms (odds ratio, -0.21; 95% confidence interval, -0.37 to -0.05 and odds ratio, -4.62; 95% confidence interval, -6.17 to -3.06; P intravenous fluid therapy. The ECV success rate was 43% in the study group compared to 47% in the control group (P = .67). The success rate was significantly lower the larger the relative increase in the AFI, although no correlation was found in absolute terms (χ(2) for linear trend = 0.03 and 0.34, respectively). Maternal intravenous fluid therapy with 2 L of hypotonic saline prior to ECV is an effective and safe technique for increasing the AFI. However, its use in ECV does not increase the success rate of the procedure. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Chronic progressive external ophthalmoplegia: MR spectroscopy and MR diffusion studies in the brain.

    Science.gov (United States)

    Heidenreich, Jens O; Klopstock, Thomas; Schirmer, Timo; Saemann, Philipp; Mueller-Felber, Wolfgang; Auer, Dorothee P

    2006-09-01

    The purpose of our study was to show how, despite pathognomonic signs of cerebral involvement in chronic progressive external ophthalmoplegia (CPEO), mitochondrial respiratory chain insufficiency is associated with increased lactate and reduced N-acetylaspartate. CPEO and mitochondrial myopathy are caused by mitochondrial DNA mutations leading to impaired oxidative phosphorylation. Cortical and subcortical metabolites, cerebral diffusivity, and structural MRI were assessed to characterize possible subclinical cerebral pathology in CPEO. Ten patients with CPEO (n = 8), mitochondrial myopathy (n = 1), and Kearns-Sayre syndrome (n = 1) and 13 control group volunteers were studied by MRI, both long TE (144) proton MR spectroscopic imaging (1H MRSI), and diffusion-weighted imaging. Relative concentrations of N-acetylaspartate, choline, creatine, and lactate were estimated by Linear Combination of Model Spectra (LCModel) in healthy-appearing white matter, gray matter, and white matter hyperintensities. Of five patients with cortical atrophy, it was moderate in three and severe in two. One patient had severe and four had moderate cerebellar atrophy. Six of 10 patients showed unspecific white matter lesions, whereas the remainder had hyperintensities in the pyramidal tract (n =2) and middle cerebellar peduncle (n = 1) despite clinical signs. No basal ganglia lesions were found. Physiologic metabolite ratios were normal and lactate was absent in supratentorial healthy-appearing cortex and subcortical white matter. Global diffusion histogram metrics revealed no abnormalities. Normal spectroscopic imaging in radiologic unaffected brain and healthy global brain parenchymal diffusion findings do not support the hypothesis of a generalized cerebral energy loss in CPEO. Bilateral structural alteration of central motor pathways in two patients without clinical pyramidal signs may, however, reflect subclinical axonal injury in predilection sites in some patients.

  13. Computational Fluid Dynamic Simulation (CFD and Experimental Study on Wing-external Store Aerodynamic Interference of a Subsonic Fighter Aircraft

    Directory of Open Access Journals (Sweden)

    Tholudin Mat Lazim

    2003-01-01

    Full Text Available The main objective of the present work is to study the effect of an external store on a subsonic fighter aircraft. Generally most modern fighter aircrafts are designed with an external store installation. In this study, a subsonic fighter aircraft model has been manufactured using a computer numerical control machine for the purpose of studying the effect of the aerodynamic interference of the external store on the flow around the aircraft wing. A computational fluid dynamic (CFD simulation was also carried out on the same configuration. Both the CFD and the wind tunnel testing were carried out at a Reynolds number 1.86×105 to ensure that the aerodynamic characteristic can certify that the aircraft will not be face any difficulties in its stability and controllability. Both the experiments and the simulation were carried out at the same Reynolds number in order to verify each other. In the CFD simulation, a commercial CFD code was used to simulate the interference and aerodynamic characteristics of the model. Subsequently, the model together with an external store was tested in a low speed wind tunnel with a test section sized 0.45 m×0.45 m. Measured and computed results for the two-dimensional pressure distribution were satisfactorily comparable. There is only a 19% deviation between pressure distribution measured in wind tunnel testing and the result predicted by the CFD. The result shows that the effect of the external storage is only significant on the lower surface of the wing and almost negligible on the upper surface of the wing. Aerodynamic interference due to the external store was most evident on the lower surface of the wing and almost negligible on the upper surface at a low angle of attack. In addition, the area of influence on the wing surface by the store interference increased as the airspeed increased.

  14. Treatment of age-related subfoveal choroidal neovascularization by low-dose external radiation. A preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Harino, Seiyo; Oshima, Yusuke; Tsujikawa, Kaoru; Oh, Ami; Sugimoto, Kiyoshi [Yodogawa Christian Hospital, Osaka (Japan); Murayama, Shigeyuki; Inoue, Toshihiko

    1997-04-01

    We applied low dose external beam radiation (6MV) to 17 eyes of 17 patients (Mean age 70.9 years, range 58-85) who had subfoveal choroidal neovascularization associated with age-related macular degeneration. None of the cases were suitable for photocoagulation according to the Macular Photo-coagulation Study protocol, and no feeding vessels underlying choroidal neovascular membrane could be detected. Corrected visual acuity ranged from 0.02 to 0.6 before treatment. The patients were divided into two groups. One group of 11 eyes was treated with 10 Gy and the other group of 6 eyes with 21 Gy. Mean follow up period was 347{+-}89 (mean{+-}standard deviation) days in the 10 Gy group and 312{+-}100 days in the 21 Gy group. We evaluated the outcome as `effective` if no progression in neovascular membrane was found by ophthalmoscopic and angiographic examination. Only 3 eyes (21%) of patients in the 10 Gy group and 2 eyes (33%) in 21 Gy group showed any effect. Although the rate of progression in choroidal neovascular membrane was significantly smaller in the 10 and 21 Gy group than in the controls, the corrected visual acuity in the treated group was not improved over that of the controls. No serious complications were seen. Only one case showed a stabilized neovascular membrane in the control group of 7 patients. Although the present results seem to be worse than those in previous reports, the efficacy of this treatment still needs to be evaluated because no beneficial strategies in the treatment of subfoveal neovascularization have been established. (author)

  15. Case Studies in Fracture Mechanics

    Science.gov (United States)

    1977-06-01

    stress. This has been confirmed on low strength aluminium alloy I beams, tested in four point bend- ing, where fracture could not be induced because...applying the fracture data to ET design was to establish a weld acceptance criteria. Here, we decided to consider every weld defect (porosity, dross ...or proof test. CONCLUS IONS In the past the acceptance of internal and external defects in welds, (porosity, dross , cracks, inclusions, and lack-of

  16. Physiologic amputation: a case study.

    Science.gov (United States)

    Long, Jeri; Hall, Virginia

    2014-03-01

    Acute limb ischemia is a complication of severe peripheral arterial disease that can be a threatening limb as well as life. Multiple procedures exist today to help revascularize extremities; however, even with the latest technologies, surgical amputation of the limb may still be necessary. Cryoamputation, or physiologic amputation, is a method used to treat patients who are hemodynamically unstable for the operating room and who are in need of urgent amputation owing to arterial ischemia. This procedure is used in the rare instance where not only a persons' limb is threatened, but also their life. This is a case study regarding one patient who presented to the hospital with limb-threatening ischemia who became hemodynamically unstable owing to the rhabdomyolysis associated with the ischemia of his lower extremity. Cryoamputation was used to stabilize the patient and prevent further deterioration, so that he could safely undergo surgical amputation of the limb without an increase in mortality risk. Cryoamputation must be followed by formal surgical amputation when the patient is hemodynamically stabilized. It is not a limb salvaging, procedure but it is a life-saving procedure. This case study demonstrates the usefulness of the procedure and discusses the technique used for cryoamputation. Copyright © 2014 Society for Vascular Nursing, Inc. Published by Mosby, Inc. All rights reserved.

  17. Experimental study of reinforced concrete pile caps with external, embedded and partially embedded socket with smooth interface

    Directory of Open Access Journals (Sweden)

    R. Barros

    Full Text Available On Precast concrete structures the column foundation connections can occur through the socket foundation, which can be embedded, partially embedded or external, with socket walls over the pile caps. This paper presents an experimental study about two pile caps reinforced concrete with external, partially embedded and embedded socket submitted to central load, using 1:2 scaled models. In the analyzed models, the smooth interface between the socket walls and column was considered. The results are compared to a reference model that presents monolithic connections between the column and pile cap. It is observed that the ultimate load of pile cap with external sockets has the same magnitude as the reference pile cap, but the ultimate load of models with partially embedded and embedded socket present less magnitude than the reference model.

  18. Secondary nailing after external fixation for tibial shaft fracture: risk factors for union and infection. A 55 case series.

    Science.gov (United States)

    Roussignol, X; Sigonney, G; Potage, D; Etienne, M; Duparc, F; Dujardin, F

    2015-02-01

    Secondary intramedullary nailing (SIN) following external fixation (EF) of tibial shaft fracture is controversial, notably due to the infection risk, which is not precisely known. The present study therefore analysed a continuous series of tibial shaft SIN, to determine (1) infection and union rates, and (2) whether 1-stage SIN associated to EF ablation increased the risk of infection. Factors exist for union and onset of infection following tibial shaft SIN. A retrospective series of SIN performed between 1998 and 2012 in over 16-year-old patients with non-pathologic tibial shaft fracture was analysed. EF pin site infection was an exclusion criterion. Fractures were graded according to AO and Gustilo classifications. Study parameters were: time to SIN, 1- versus 2-stage procedure, bacteriologic results on reaming product, post-nailing onset of infection, and time to union. Fifty-five patients (55 fractures) were included. There were 16 closed and 39 open fractures: 7 Gustilo type I, 26 type II and 6 type IIIA; 33 AO type A, 14 type B and 8 type C. Mean time to SIN was 9 ± 9.6 weeks (range, 4 days to 12 months). There were 23 1-stage procedures, and 32 two-stage procedures with a mean 12-day interval (range, 4-30 days). Twelve reaming samples were biologically positive without secondary infection. There were 4 septic complications (3 abscesses, 1 osteomyelitis), and 1 aseptic non-union required re-nailing. The union rate was 96%. The sole factor of poor prognosis was severity of fracture opening. One-stage SIN did not increase infection risk. The present results were better than reported in the literature, where the rates of Gustilo IIIA and IIIB fracture and pin site infection are, however, higher. Tibial shaft SIN is a reliable procedure, with infection risk correlating with Gustilo type and time to surgery. Surgery should be early, before onset of EF pin site infection. A 1-stage attitude appears feasible in early SIN. Level IV. Retrospective study type

  19. Accounting for external costs in a study of a Swedish district-heating system. An assessment of environmental policies

    Energy Technology Data Exchange (ETDEWEB)

    Fahlen, E.; Ahlgren, E.O. [Energy Systems Technology, Division of Energy Technology, Department of Energy and Environment, Chalmers University of Technology, SE-412 96 Goeteborg (Sweden)

    2010-09-15

    Sweden has historically had strict emission control by implementation of economic policy instruments with the aim of internalising the external costs of air pollution. This study aims to evaluate how well current Swedish policy instruments reflect the environmental costs associated with heat generation in several district-heating (DH) plants in the DH system of Goeteborg. Furthermore, it aims to simulate and evaluate the operation of the DH system based on its social cost-effectiveness which takes into account the DH system's private and external costs (non-internalised environmental costs). The study shows that the economic policy instruments do not fully internalise all external costs whereas for certain technologies, the costs in terms of taxes, emission permits, environmental fees, etc. are higher than the environmental costs caused by the pollutants, given the environmental cost estimates used in the study. The simulation results show that the deviating internalisation of external costs affects the economic ranking of the different plants within the studied DH system. The estimated loss in social-cost effectiveness of the operation of the DH system of Goeteborg is noticable but relatively small if compared to the variable heat generation costs for most of the studied DH plants. (author)

  20. Accounting for external costs in a study of a Swedish district-heating system - An assessment of environmental policies

    Energy Technology Data Exchange (ETDEWEB)

    Fahlen, E., E-mail: elsaf@chalmers.s [Energy Systems Technology, Division of Energy Technology, Department of Energy and Environment, Chalmers University of Technology, SE-412 96 Goeteborg (Sweden); Ahlgren, E.O. [Energy Systems Technology, Division of Energy Technology, Department of Energy and Environment, Chalmers University of Technology, SE-412 96 Goeteborg (Sweden)

    2010-09-15

    Sweden has historically had strict emission control by implementation of economic policy instruments with the aim of internalising the external costs of air pollution. This study aims to evaluate how well current Swedish policy instruments reflect the environmental costs associated with heat generation in several district-heating (DH) plants in the DH system of Goeteborg. Furthermore, it aims to simulate and evaluate the operation of the DH system based on its social cost-effectiveness which takes into account the DH system's private and external costs (non-internalised environmental costs). The study shows that the economic policy instruments do not fully internalise all external costs whereas for certain technologies, the costs in terms of taxes, emission permits, environmental fees, etc. are higher than the environmental costs caused by the pollutants, given the environmental cost estimates used in the study. The simulation results show that the deviating internalisation of external costs affects the economic ranking of the different plants within the studied DH system. The estimated loss in social-cost effectiveness of the operation of the DH system of Goeteborg is noticable but relatively small if compared to the variable heat generation costs for most of the studied DH plants.

  1. Student Composed Case Study in Adolescent Psychology.

    Science.gov (United States)

    McManus, John L.

    1986-01-01

    Describes a variation of the case study method where adolescent psychology students composed hypothetical cases, proposed solutions to problems, and surveyed other groups regarding case dilemmas and adolescent issues. (Author/JDH)

  2. Using correspondence analysis in multiple case studies

    NARCIS (Netherlands)

    Kienstra, N.H.H.; van der Heijden, P.G.M.

    2015-01-01

    In qualitative research of multiple case studies, Miles and Huberman proposed to summarize the separate cases in a so-called meta-matrix that consists of cases by variables. Yin discusses cross-case synthesis to study this matrix. We propose correspondence analysis (CA) as a useful tool to study

  3. Using Correspondence Analysis in Multiple Case Studies

    NARCIS (Netherlands)

    Kienstra, Natascha; van der Heijden, Peter G.M.

    2015-01-01

    In qualitative research of multiple case studies, Miles and Huberman proposed to summarize the separate cases in a so-called meta-matrix that consists of cases by variables. Yin discusses cross-case synthesis to study this matrix. We propose correspondence analysis (CA) as a useful tool to study

  4. Five Misunderstandings About Case-Study Research

    DEFF Research Database (Denmark)

    Flyvbjerg, Bent

    2006-01-01

    This article examines five common misunderstandings about case-study research: (a) theoretical knowledge is more valuable than practical knowledge; (b) one cannot generalize from a single case, therefore, the single-case study cannot contribute to scientific development; (c) the case study is most...

  5. Genetic and environmental influences on externalizing behavior and alcohol problems in adolescence: a female twin study.

    Science.gov (United States)

    Knopik, Valerie S; Heath, Andrew C; Bucholz, Kathleen K; Madden, Pamela A F; Waldron, Mary

    2009-09-01

    Genetic and environmental contributions to the observed correlations among DSM-IV ADHD problems [inattentive (INATT) and hyperactive/impulsive (HYP/IMP) behaviors], conduct problems (CDP) and alcohol problems (AlcProb) were examined by fitting multivariate structural equation models to data from the Missouri Adolescent Female Twin Study [N=2892 twins (831 monozygotic pairs, 615 dizygotic pairs)]. Based on results of preliminary regression models, we modified the structural model to jointly estimate (i) the regression of each phenotype on significant familial/prenatal predictors, and (ii) genetic and environmental contributions to the residual variance and covariance. Results suggested that (i) parental risk factors, such as parental alcohol dependence and regular smoking, increase risk for externalizing behavior; (ii) prenatal exposures predicted increased symptomatology for HYP/IMP (smoking during pregnancy), INATT and CDP (prenatal alcohol exposure); (iii) after adjusting for measured familial/prenatal risk factors, genetic influences were significant for HYP/IMP, INATT, and CDP; however, similar to earlier reports, genetic effects on alcohol dependence symptoms were negligible; and (iv) in adolescence, correlated liabilities for conduct and alcohol problems are found in environmental factors common to both phenotypes, while covariation among impulsivity, inattention, and conduct problems is primarily due to genetic influences common to these three behaviors. Thus, while a variety of adolescent problem behaviors are significantly correlated, the structure of that association may differ as a function of phenotype (e.g., comorbid HYP/IMP and CDP vs. comorbid CDP and AlcProb), a finding that could inform different approaches to treatment and prevention.

  6. Uptake of external cephalic version for term breech presentation: an Australian population study, 2002-2012.

    Science.gov (United States)

    Bin, Yu Sun; Roberts, Christine L; Nicholl, Michael C; Ford, Jane B

    2017-07-26

    The safety, efficacy, and cost-effectiveness of external cephalic version (ECV) for term breech presentation has been demonstrated. Clinical guidelines recommend ECV for all eligible women, but the uptake of this procedure in the Australian healthcare setting is unknown. This study aimed to describe ECV uptake in New South Wales, the most populous state of Australia, during 2002 to 2012. Data from routine hospital and birth records were used to identify ECVs conducted at ≥36 weeks' gestation. Women with ECV were compared to women who were potentially eligible for but did not have ECV. Eligibility for ECV was based on clinical guidelines. For those with ECV, birth outcomes following successful and unsuccessful procedures were examined. In N = 32,321 singleton breech pregnancies, 10.5% had ECV, 22.3% were ineligible, and 67.2% were potentially eligible but did not undergo ECV. Compared to women who were eligible but who did not attempt ECV, those who had ECV were more likely to be older, multiparous, overseas-born, public patients at delivery, and to deliver in tertiary hospitals in urban areas (p ECV smoked during pregnancy, fewer were morbidly obese, and fewer had a hypertensive disorder of pregnancy, compared to those who were eligible. Caesarean section occurred in 25.9% of successful compared to 95.6% of unsuccessful ECVs. Infant outcomes did not differ by ECV success. The majority of women with a breech presentation did not receive ECV. It is unclear whether this is attributable to issues with service provision or low acceptability among women. Policies to improve access to and information about ECV appear necessary to improve uptake among women with term breech presentation. Improved data collection around the diagnosis of breech presentation, ECV attempts, and outcomes may help to identify specific barriers to ECV uptake.

  7. Attitudes of Academic Staff towards Their Own Work and towards External Evaluation, from the Perspective of Self-Determination Theory: Estonian Case

    Science.gov (United States)

    Seema, Riin; Udam, Maiki; Mattisen, Heli

    2016-01-01

    The purpose of this study was to ascertain the attitudes of academic staff towards their own work as well as towards external evaluations. The study was based on (1) an analysis of assessment reports of institutional accreditations conducted by the Estonian Quality Agency for Higher and Vocational Education and (2) self-determination theory on…

  8. Study of etchants for corrosion-resistant metals, space shuttle external tank

    Science.gov (United States)

    Simmons, J. R.

    1980-01-01

    Acceptable etchant concentrations and application and removal procedures for etching austenitic stainless steel, nickel base alloys, and titanium alloys (annealed) employed on the external tank were formulated. The etchant solutions were to be capable of removing a minimum of 0.4 mils of surface material in less than one hour.

  9. Mode of childbirth and neonatal outcome after external cephalic version: A prospective cohort study

    NARCIS (Netherlands)

    Rosman, A. N.; Vlemmix, F.; Ensing, S.; Opmeer, B. C.; te Hoven, S.; Velzel, J.; de Hundt, M.; van den Berg, S.; Rota, H.; van der Post, J. A. M.; Mol, B. W. J.; Kok, M.

    2016-01-01

    to assess the mode of childbirth and adverse neonatal outcomes in women with a breech presentation with or without an external cephalic version attempt, and to compare the mode of childbirth among women with successful ECV to women with a spontaneous cephalic presentation. prospective matched cohort

  10. Chronic Stressors and Adolescents' Externalizing Problems : Genetic Moderation by Dopamine Receptor D4. The TRAILS Study

    NARCIS (Netherlands)

    Zandstra, Anna Roos E; Ormel, Johan; Hoekstra, Pieter J; Hartman, Catharina A

    2017-01-01

    The existing literature does not provide consistent evidence that carriers of the Dopamine D4 Receptor 7-repeat allele are more sensitive to adverse environmental influences, resulting in enhanced externalizing problems, compared to noncarriers. One explanation is that the adverse influences

  11. A phylogenetic study on Cossidae (Lepidoptera: Ditrysia) based on external adult morphology

    NARCIS (Netherlands)

    Schoorl, J.W.

    1990-01-01

    A revised classification of the Cossidae is provided. Five cossid subfamilies, of which Chilecomadiinae is new, are recognized. The external adult morphology of many genera and species is described with special attention paid to the thoracic sclerites, including wing bases. Cladograms of the genera

  12. Meta-externalism vs meta-internalism in the study of reference

    NARCIS (Netherlands)

    Cohnitz, Daniel; Haukioja, Jussi

    2013-01-01

    We distinguish and discuss two different accounts of the subject matter of theories of reference, meta-externalism and meta-internalism. We argue that a form of the meta-internalist view, "moderate meta-internalism", is the most plausible account of the subject matter of theories of reference. In

  13. External validity of ST elevation myocardial infarction trials : The Zwolle studies

    NARCIS (Netherlands)

    Rasoul, Saman; Ottervanger, Jan Paul; Dambrink, Jan-Henk E.; de Boer, Menko-Jan; Hoorntje, Jan C. A.; Gosselink, A. T. Marcel; Zijlstra, Felix; Suryapranata, Harry; van 't Hof, Arnoud W. J.

    2007-01-01

    Background: Guidelines are mainly based upon results of randomised controlled clinical trials. However, due to low external validity of these trials, their results can not reasonably be applied to all patients in routine practice. In our hospital, all patients with ST-elevation myocardial infarction

  14. Transactional Associations among Teacher Support, Peer Social Preference, and Child Externalizing Behavior: A Four-Wave Longitudinal Study

    Science.gov (United States)

    Leflot, Geertje; van Lier, Pol A. C.; Verschueren, Karine; Onghena, Patrick; Colpin, Hilde

    2011-01-01

    The links between children's externalizing behaviors and two characteristics of children's social interactions within the classroom, namely, peer social preference and received support from the teacher, were studied in 570 children followed from their 2nd- to 3rd-grade years of elementary school. Data consisted of peer and teacher reports of…

  15. Heavy Metal and Hip-Hop Style Preferences and Externalizing Problem Behavior: A Two-Wave Longitudinal Study

    Science.gov (United States)

    Selfhout, Maarten H. W.; Delsing, Marc J. M. H.; ter Bogt, Tom F. M.; Meeus, Wim H. J.

    2008-01-01

    This study examines (a) the stability of Dutch adolescents' preferences for heavy metal and hip-hop youth culture styles, (b) longitudinal associations between their preferences and externalizing problem behavior, and (c) the moderating role of gender in these associations. Questionnaire data were gathered from 931 adolescents between the ages of…

  16. Childhood Peer Rejection and Aggression as Predictors of Adolescent Girls' Externalizing and Health Risk Behaviors: A 6-Year Longitudinal Study

    Science.gov (United States)

    Prinstein, Mitchell J.; La Greca, Annette M.

    2004-01-01

    This 6-year longitudinal study examined girls' peer-nominated social preference and aggression in childhood as predictors of self- and parent-reported externalizing symptoms, substance use (i.e.. cigarette, alcohol, and marijuana use), and sexual risk behavior in adolescence. Participants were 148 girls from diverse ethnic backgrounds, who were…

  17. Assessing the external validity of model-based estimates of the incidence of heart attack in England: a modelling study

    Directory of Open Access Journals (Sweden)

    Peter Scarborough

    2016-11-01

    Full Text Available Abstract Background The DisMod II model is designed to estimate epidemiological parameters on diseases where measured data are incomplete and has been used to provide estimates of disease incidence for the Global Burden of Disease study. We assessed the external validity of the DisMod II model by comparing modelled estimates of the incidence of first acute myocardial infarction (AMI in England in 2010 with estimates derived from a linked dataset of hospital records and death certificates. Methods Inputs for DisMod II were prevalence rates of ever having had an AMI taken from a population health survey, total mortality rates and AMI mortality rates taken from death certificates. By definition, remission rates were zero. We estimated first AMI incidence in an external dataset from England in 2010 using a linked dataset including all hospital admissions and death certificates since 1998. 95 % confidence intervals were derived around estimates from the external dataset and DisMod II estimates based on sampling variance and reported uncertainty in prevalence estimates respectively. Results Estimates of the incidence rate for the whole population were higher in the DisMod II results than the external dataset (+54 % for men and +26 % for women. Age-specific results showed that the DisMod II results over-estimated incidence for all but the oldest age groups. Confidence intervals for the DisMod II and external dataset estimates did not overlap for most age groups. Conclusion By comparison with AMI incidence rates in England, DisMod II did not achieve external validity for age-specific incidence rates, but did provide global estimates of incidence that are of similar magnitude to measured estimates. The model should be used with caution when estimating age-specific incidence rates.

  18. Case Study: A Picture Worth a Thousand Words? Making a Case for Video Case Studies

    Science.gov (United States)

    Pai, Aditi

    2014-01-01

    A picture, they say, is worth a thousand words. If a mere picture is worth a thousand words, how much more are "moving pictures" or videos worth? The author poses this not merely as a rhetorical question, but because she wishes to make a case for using videos in the traditional case study method. She recommends four main approaches of…

  19. STS Case Study Development Support

    Science.gov (United States)

    Rosa de Jesus, Dan A.; Johnson, Grace K.

    2013-01-01

    The Shuttle Case Study Collection (SCSC) has been developed using lessons learned documented by NASA engineers, analysts, and contractors. The SCSC provides educators with a new tool to teach real-world engineering processes with the goal of providing unique educational materials that enhance critical thinking, decision-making and problem-solving skills. During this third phase of the project, responsibilities included: the revision of the Hyper Text Markup Language (HTML) source code to ensure all pages follow World Wide Web Consortium (W3C) standards, and the addition and edition of website content, including text, documents, and images. Basic HTML knowledge was required, as was basic knowledge of photo editing software, and training to learn how to use NASA's Content Management System for website design. The outcome of this project was its release to the public.

  20. Prediction models for the mortality risk in chronic dialysis patients: a systematic review and independent external validation study

    Directory of Open Access Journals (Sweden)

    Ramspek CL

    2017-09-01

    Full Text Available Chava L Ramspek,1 Pauline WM Voskamp,1 Frans J van Ittersum,2 Raymond T Krediet,3 Friedo W Dekker,1 Merel van Diepen1 On behalf of the NECOSAD study group 1Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, 2Department of Nephrology, VU University Medical Center, 3Department of Nephrology, Academic Medical Center, Amsterdam, The Netherlands Objective: In medicine, many more prediction models have been developed than are implemented or used in clinical practice. These models cannot be recommended for clinical use before external validity is established. Though various models to predict mortality in dialysis patients have been published, very few have been validated and none are used in routine clinical practice. The aim of the current study was to identify existing models for predicting mortality in dialysis patients through a review and subsequently to externally validate these models in the same large independent patient cohort, in order to assess and compare their predictive capacities.Methods: A systematic review was performed following the preferred reporting items for systematic reviews and meta-analyses (PRISMA guidelines. To account for missing data, multiple imputation was performed. The original prediction formulae were extracted from selected studies. The probability of death per model was calculated for each individual within the Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD. The predictive performance of the models was assessed based on their discrimination and calibration.Results: In total, 16 articles were included in the systematic review. External validation was performed in 1,943 dialysis patients from NECOSAD for a total of seven models. The models performed moderately to well in terms of discrimination, with C-statistics ranging from 0.710 (interquartile range 0.708–0.711 to 0.752 (interquartile range 0.750–0.753 for a time frame of 1 year. According to the calibration, most

  1. Religious Congregations’ Involvement in HIV: A Case Study Approach

    Science.gov (United States)

    Mendel, Peter J.; Palar, Kartika; Kanouse, David E.; Bluthenthal, Ricky N.; Castaneda, Laura Werber; Corbin, Dennis E.; Domínguez, Blanca X.; Hawes-Dawson, Jennifer; Mata, Michael A.; Oden, Clyde W.

    2011-01-01

    Comparative case studies were used to explore religious congregations’ HIV involvement, including types and extent of activities, interaction with external organizations or individuals, and how activities were initiated and have changed over time. The cases included 14 congregations in Los Angeles County representing diverse faith traditions and races-ethnicities. Activities fell into three broad categories: (1) prevention and education; (2) care and support; and (3) awareness and advocacy. Congregations that engaged early in the epidemic focused on care and support while those that became involved later focused on prevention and education. Most congregations interacted with external organizations or individuals to conduct their HIV activities, but promoting abstinence and teaching about condoms were conducted without external involvement. Opportunities exist for congregations to help address a variety of HIV-related needs. However, activities that are mission-congruent, such as providing pastoral care for people with HIV, raising HIV awareness, and promoting HIV testing, appear easier for congregations to undertake than activities aimed at harm reduction. PMID:20953903

  2. Public claims about automatic external defibrillators: an online consumer opinions study.

    Science.gov (United States)

    Money, Arthur G; Barnett, Julie; Kuljis, Jasna

    2011-05-18

    Patients are no longer passive recipients of health care, and increasingly engage in health communications outside of the traditional patient and health care professional relationship. As a result, patient opinions and health related judgements are now being informed by a wide range of social, media, and online information sources. Government initiatives recognise self-delivery of health care as a valuable means of responding to the anticipated increased global demand for health resources. Automated External Defibrillators (AEDs), designed for the treatment of Sudden Cardiac Arrest (SCA), have recently become available for 'over the counter' purchase with no need for a prescription. This paper explores the claims and argumentation of lay persons and health care practitioners and professionals relating to these, and how these may impact on the acceptance, adoption and use of these devices within the home context. We carry out a thematic content analysis of a novel form of Internet-based data: online consumer opinions of AED devices posted on Amazon.com, the world's largest online retailer. A total of #83 online consumer reviews of home AEDs are analysed. The analysis is both inductive, identifying themes that emerged from the data, exploring the parameters of public debate relating to these devices, and also driven by theory, centring around the parameters that may impact upon the acceptance, adoption and use of these devices within the home as indicated by the Technology Acceptance Model (TAM). Five high-level themes around which arguments for and against the adoption of home AEDs are identified and considered in the context of TAM. These include opinions relating to device usability, usefulness, cost, emotional implications of device ownership, and individual patient risk status. Emotional implications associated with AED acceptance, adoption and use emerged as a notable factor that is not currently reflected within the existing TAM. The value, credibility and

  3. Public Claims about Automatic External Defibrillators: An Online Consumer Opinions Study

    Science.gov (United States)

    2011-01-01

    Background Patients are no longer passive recipients of health care, and increasingly engage in health communications outside of the traditional patient and health care professional relationship. As a result, patient opinions and health related judgements are now being informed by a wide range of social, media, and online information sources. Government initiatives recognise self-delivery of health care as a valuable means of responding to the anticipated increased global demand for health resources. Automated External Defibrillators (AEDs), designed for the treatment of Sudden Cardiac Arrest (SCA), have recently become available for 'over the counter' purchase with no need for a prescription. This paper explores the claims and argumentation of lay persons and health care practitioners and professionals relating to these, and how these may impact on the acceptance, adoption and use of these devices within the home context. Methods We carry out a thematic content analysis of a novel form of Internet-based data: online consumer opinions of AED devices posted on Amazon.com, the world's largest online retailer. A total of #83 online consumer reviews of home AEDs are analysed. The analysis is both inductive, identifying themes that emerged from the data, exploring the parameters of public debate relating to these devices, and also driven by theory, centring around the parameters that may impact upon the acceptance, adoption and use of these devices within the home as indicated by the Technology Acceptance Model (TAM). Results Five high-level themes around which arguments for and against the adoption of home AEDs are identified and considered in the context of TAM. These include opinions relating to device usability, usefulness, cost, emotional implications of device ownership, and individual patient risk status. Emotional implications associated with AED acceptance, adoption and use emerged as a notable factor that is not currently reflected within the existing TAM

  4. Public Claims about Automatic External Defibrillators: An Online Consumer Opinions Study

    Directory of Open Access Journals (Sweden)

    Barnett Julie

    2011-05-01

    Full Text Available Abstract Background Patients are no longer passive recipients of health care, and increasingly engage in health communications outside of the traditional patient and health care professional relationship. As a result, patient opinions and health related judgements are now being informed by a wide range of social, media, and online information sources. Government initiatives recognise self-delivery of health care as a valuable means of responding to the anticipated increased global demand for health resources. Automated External Defibrillators (AEDs, designed for the treatment of Sudden Cardiac Arrest (SCA, have recently become available for 'over the counter' purchase with no need for a prescription. This paper explores the claims and argumentation of lay persons and health care practitioners and professionals relating to these, and how these may impact on the acceptance, adoption and use of these devices within the home context. Methods We carry out a thematic content analysis of a novel form of Internet-based data: online consumer opinions of AED devices posted on Amazon.com, the world's largest online retailer. A total of #83 online consumer reviews of home AEDs are analysed. The analysis is both inductive, identifying themes that emerged from the data, exploring the parameters of public debate relating to these devices, and also driven by theory, centring around the parameters that may impact upon the acceptance, adoption and use of these devices within the home as indicated by the Technology Acceptance Model (TAM. Results Five high-level themes around which arguments for and against the adoption of home AEDs are identified and considered in the context of TAM. These include opinions relating to device usability, usefulness, cost, emotional implications of device ownership, and individual patient risk status. Emotional implications associated with AED acceptance, adoption and use emerged as a notable factor that is not currently reflected

  5. Cholesteatoma of the external ear canal: etiological factors, symptoms and clinical findings in a series of 48 cases

    DEFF Research Database (Denmark)

    Gaihede, Michael Lyhne

    2006-01-01

    (n = 2), and otorrhea (n = 1). Similar symptoms were found in secondary EECC, but less pronounced. In total the temporomandibular joint was exposed in 11 cases, while the mastoid and middle ear was invaded in six and three cases, respectively. In one primary case the facial nerve was exposed...

  6. Prevalence of externalized conductors in Riata and Riata ST silicone leads: results from the prospective, multicenter Riata Lead Evaluation Study.

    Science.gov (United States)

    Hayes, David; Freedman, Roger; Curtis, Anne B; Niebauer, Mark; Neal Kay, G; Dinerman, Jay; Beau, Scott

    2013-12-01

    Following a class I recall of St. Jude Medical Riata/Riata ST silicone implantable cardioverter-defibrillator leads, we report on the phase I results of the Riata Lead Evaluation Study, a prospective, multicenter investigation to assess the prevalence of externalized conductors (ECs) and the electrical dysfunction in these leads. We enrolled patients previously implanted with Riata/Riata ST leads and performed cinefluoroscopy using multiple views. A physician panel adjudicated the images for the presence of EC. The prevalence of EC was stratified and compared by lead model and patient characteristics. Upon occurrence of a lead revision, another physician panel determined whether electrical dysfunction had occurred based on predefined criteria. Seven hundred seventy six patients with Riata/Riata ST silicone leads (8Fr/7Fr = 66.6%/33.4%; single-/dual-coil = 12.9%/87.1%) across 23 centers were analyzed. Implant duration was 4.8 ± 0.9 years for 7Fr and 6.5 ± 1.6 years for 8Fr leads (P leads for the entire study population (9.3% vs 24.2%, P leads implanted ≤6 years (9.4% vs 18.8%, P = .006). Other than lead size, there were no significant differences in lead, patient, or electrical characteristics between leads with and without EC. Over a period of 9.8 ± 2.0 months, the overall prevalence of electrical dysfunction was 1.3% (confidence interval 0.49%-2.1%), with only 3 of 10 cases occurring in leads with EC. Larger-diameter Riata leads were more prone to EC than smaller-diameter Riata ST leads. The prevalence of electrical dysfunction was not associated with EC. Copyright © 2013 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  7. Checklists for external validity

    DEFF Research Database (Denmark)

    Dyrvig, Anne-Kirstine; Kidholm, Kristian; Gerke, Oke

    2014-01-01

    RATIONALE, AIMS AND OBJECTIVES: The quality of the current literature on external validity varies considerably. An improved checklist with validated items on external validity would aid decision-makers in judging similarities among circumstances when transferring evidence from a study setting to ...

  8. A study of external fuel vaporization. [for aircraft gas turbine engines

    Science.gov (United States)

    Szetela, E. J.; Chiappetta, L.; Baker, C. E.

    1981-01-01

    Candidate external vaporizer designs for an aircraft gas turbine engine are evaluated with respect to fuel thermal stability, integration of the vaporizer system into the aircraft engine, engine and vaporizer dynamic response, startup and altitude restart, engine performance, control requirements, safety, and maintenance. The selected concept is shown to offer potential gains in engine performance in terms of reduced specific fuel consumption and improved engine thrust/weight ratio. The thrust/weight improvement can be traded against vaporization system weight.

  9. Dynamic Ultrasonography of the Deep External Rotator Musculature of the Hip: A Descriptive Study.

    Science.gov (United States)

    Battaglia, Patrick J; Mattox, Ross; Haun, Daniel W; Welk, Aaron B; Kettner, Norman W

    2016-07-01

    No detailed reports exist describing the methodology of ultrasound image acquisition of the deep external rotator muscles of the hip. Because gluteal pain and sciatica are common, ultrasound may be a useful dynamic imaging adjunct in the evaluation of these patients. To describe dynamic ultrasonography of the deep external rotator muscles of the hip for diagnostic purposes. Descriptive. University radiology department. Participants (n = 25; 14 male) without gluteal pain or sciatica were enrolled (mean age 27.6 ± 4.7 years; mean body mass index 26.0 ± 4.1 kg/m(2)). Ultrasonographic cine clips oriented to the long axis of each deep external rotator muscle were captured. In addition, cine clips of the piriformis tendon and obturator internus tendon were obtained. Cine clips were analyzed approximately 1 week after completion of image acquisition independently by 2 blinded raters. A 5-point Likert scale to evaluate the diagnostic utility of the ultrasound image. The modal Likert scores for rater 1 were as follows: piriformis muscle = 4; piriformis tendon = 4; superior gemellus muscle = 3; obturator internus muscle = 4; obturator internus tendon = 4; inferior gemellus muscle = 4; quadratus femoris muscle = 4. The modal scores for rater 2 were: piriformis muscle = 4; piriformis tendon = 3; superior gemellus muscle = 4; obturator internus muscle = 3; obturator internus tendon = 4; inferior gemellus muscle = 3; quadratus femoris muscle = 4. Dynamic ultrasonography may be useful to image the hip deep external rotator musculature for diagnostic purposes and therefore aid in the evaluation of gluteal pain and sciatica. Future work should investigate the reliability and validity of ultrasonography in the evaluation of pathology of these muscles. Copyright © 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  10. Dynamic vs static external fixation of distal radial fractures: A randomized study

    Directory of Open Access Journals (Sweden)

    Vikas Kulshrestha

    2011-01-01

    Materials and Methods : Sixty adult patients with displaced unstable comminuted fractures of the distal radius were randomly allocated either to the dynamic (n=30 or static (n=30 fixator groups. Patients in the dynamic fixator group were managed with closed reduction and application of Penning-type articulated fixator (Orthofix, Srl, Italy; the injured wrist was partially dynamized at 3 weeks. Patients in the static group were managed with monoplanar static external fixator of Joshi′s external stabilizing system (JESS type fixator. In both groups, the fixator was maintained for 6-8 weeks. The patients were followed-up over 2 years. The primary outcome measures were the functional outcome as measured using the Gartland and Werley and DASH scores and anatomical outcome as measured using the Lindstrom score. The secondary objective was to correlate anatomical and functional outcomes and to look at overall local complications. Results : Palmar tilt was better restored in the Penning fixator group (P<0.0001. There was reduced loss of ulnar tilt (P=0.05 and radial height (P=0.04 in the Penning fixator group. Gartland and Werley score was better in the Penning fixator group at each time point of the follow-up. The DASH score was similar in the two groups at 2 years (P=0.14. There was poor correlation (0.19 between functional outcome and anatomical restoration at 2 years. Conclusions : In the management of displaced unstable comminuted fracture of the distal radius, use of an articulated multiplanar external fixator, allowing partial dynamization of the injured wrist at 3 weeks, resulted in improved early functional and anatomical outcome as compared to static external fixation. However, there was no significant difference in functional outcome at 2 years.

  11. An initial study on external warning signals for Quiet Road Transport Vehicles

    OpenAIRE

    Hwang, Isabel

    2016-01-01

    The increasing number of electric and hybrid vehicles in urban areas has shown to be beneficial in reducing both air and noise pollution. However, the lack of sound when driving at low speed has negatively affected the pedestrian safety since many rely on the vehicle sound for orientation. Regulatory bodies have therefore introduced minimum sound requirements for all silent vehicles, which has resulted in a key challenge for car manufacturers to develop external warning signature sounds. The ...

  12. Towards a Symbiotic Relationship Between Academic Libraries and Disciplinary Data Repositories: A Dryad and University of Michigan Case Study

    National Research Council Canada - National Science Library

    Katherine G. Akers; Jennifer A. Green

    2014-01-01

    ... into external disciplinary data repositories. In this paper, we focus on the University of Michigan Library and Dryad, a repository for scientific and medical data, as a case study to explore possible forms of partnership between academic...

  13. Symmetry of external auditive meatus. A pilot study on human skulls.

    Science.gov (United States)

    Mizgiryte, Simona; Vaitelis, Julius; Barkus, Arunas; Zaleckas, Linas; Pletkus, Rolandas; Auskalnis, Adomas

    2014-01-01

    OBJECTIVES. To evaluate the perpendicularity of the line connecting external auditive meatus to the midsagital plane and the palatal suture as a midsagittal symmetry reference line. Setting and Sample Population - 62 randomly chosen human skulls from osteological collection (Vilnius University). MATERIAL AND METHODS. The skulls were photographed (Nikon 40 D, Nikkor lens 50 mm) from basal, frontobasal and frontal views. Photos were analysed with Adobe Photoshop CS5 (Adobe). The first line connected frontal points of external auditive meatus and the angle to the midsagittal plane was measured. The second line (the palatal suture) was compared to the median sagittal plane. Data was analysed with SPSS 17 (IBM). RESULTS. The mean value for the angles of the line between the external auditive meatus and the midsagittal plane in basal views was 90.12° (SD=1.48°) and in frontobasal 90.36° (SD=2.25°). No statistically significant differences were found between groups of age and sex. The inter-rater agreement for evaluation of the adequacy of palatal suture with the midsagital plane was high (Cohen's Kappa 0.702 (pplane has a characteristic fluctuating asymmetry. The congruence of palatal suture and midsagital plane is debatable.

  14. The Causal Role of Alcohol Use in Adolescent Externalizing and Internalizing Problems: A Mendelian Randomization Study.

    Science.gov (United States)

    Chao, Miao; Li, Xinying; McGue, Matt

    2017-11-01

    The co-occurrence of alcohol use and externalizing/internalizing problems threatens adolescents' mental health. Research on whether alcohol use and these problems are causal and the direction of the potential causal relationships is needed to understand the mechanisms of the co-occurrence. A Mendelian randomization analysis was conducted in which the aldehyde dehydrogenase 2 (ALDH2) rs671 polymorphism was used as an instrumental variable for alcohol use phenotypes. In total, 1,608 Chinese adolescents (mean age 14.11 ± 1.83 years) were genotyped for the ALDH2 rs671 polymorphism. Three externalizing problems (aggression, delinquency, and attention problems) were measured with the Youth Self-Report inventory, and 2 internalizing problems (depression and anxiety) were measured with the self-reported Children's Depression Inventory and the Trait subscale of the State-Trait Anxiety Inventory. Alcohol use was positively associated with all 3 externalizing and 2 internalizing problems, and the ALDH2 polymorphism had a significant effect on alcohol use. Aggression and attention problems were also significantly affected by the ALDH2 polymorphism, whereas no significant association was observed between the ALDH2 polymorphism and delinquency, anxiety, or depression. The results suggest that alcohol use is a cause of adolescent aggression and attention problems but not adolescent delinquency, anxiety, or depression. Copyright © 2017 by the Research Society on Alcoholism.

  15. Experimental study and advanced CFD simulation of fire safety performance of building external wall insulation system

    Directory of Open Access Journals (Sweden)

    Yan Zhenghua

    2013-11-01

    Full Text Available Large scale fire tests of building external wall insulation system were conducted. In the experiment, thermal-couples were mounted to measure the insulation system surface temperature and the gas temperature inside rooms at the second and third floors. Photos were also taken during the fire tests. The measurement provides information of the ignition and fire spread of the external insulation system which consists of surface protection layer, glass fibre net, bonding thin layer, anchor and the load bearing wall. Comprehensive simulations of the fire tests were carried out using an advanced CFD fire simulation software Simtec (Simulation of Thermal Engineering Complex [1, 2], which is now released by Simtec Soft Sweden, with the turbulent flow, turbulent combustion, thermal radiation, soot formation, convective heat transfer, the fully coupled three dimensional heat transfer inside solid materials, the ‘burn-out' of the surface protection layer and the pyrolysis of the insulation layer, etc, all computed. The simulation is compared with experimental measurement for validation. The simulation well captured the burning and fire spread of the external insulation wall.

  16. The Limitation of Applying Heat to the External Lid Surface: A Case of Recalcitrant Meibomian Gland Dysfunction.

    Science.gov (United States)

    Kenrick, Christen J; Alloo, Sabiha S

    2017-01-01

    The effects on the inner surface temperatures of the upper and lower eyelids of four commercial heat therapies were compared for an individual with recalcitrant meibomian gland dysfunction. Three therapies (Bruder mask, Blephasteam, and MiBoFlo) involved the application of heat to the external lid surface, and the fourth (LipiFlow) applied heat to the internal lid surface. Only LipiFlow was effective in elevating the inner surface temperatures to the reported 40°C therapeutic threshold for melting obstructed meibum.

  17. The Limitation of Applying Heat to the External Lid Surface: A Case of Recalcitrant Meibomian Gland Dysfunction

    Directory of Open Access Journals (Sweden)

    Christen J. Kenrick

    2017-01-01

    Full Text Available The effects on the inner surface temperatures of the upper and lower eyelids of four commercial heat therapies were compared for an individual with recalcitrant meibomian gland dysfunction. Three therapies (Bruder mask, Blephasteam, and MiBoFlo involved the application of heat to the external lid surface, and the fourth (LipiFlow applied heat to the internal lid surface. Only LipiFlow was effective in elevating the inner surface temperatures to the reported 40°C therapeutic threshold for melting obstructed meibum.

  18. The Limitation of Applying Heat to the External Lid Surface: A Case of Recalcitrant Meibomian Gland Dysfunction

    OpenAIRE

    Christen J. Kenrick; Sabiha S. Alloo

    2017-01-01

    The effects on the inner surface temperatures of the upper and lower eyelids of four commercial heat therapies were compared for an individual with recalcitrant meibomian gland dysfunction. Three therapies (Bruder mask, Blephasteam, and MiBoFlo) involved the application of heat to the external lid surface, and the fourth (LipiFlow) applied heat to the internal lid surface. Only LipiFlow was effective in elevating the inner surface temperatures to the reported 40°C therapeutic threshold for me...

  19. WP4 Case study: INFORSE

    DEFF Research Database (Denmark)

    Elle, Morten; van Gameren, Valentine; Pel, Bonno

    2015-01-01

    The INFORSE case consists of an analysis of the transnational network INFORSE (International Network for Sustainable Energy), the Danish local initiative VE and the Belgian local initiative APERe. All three are dealing with renewable energy and energy savings. The link between INFORSE and VE...... the INFORSE case....

  20. Catalog of NASA-Related Case Studies

    Data.gov (United States)

    National Aeronautics and Space Administration — The OCKO has developed over 50 case studies to enhance learning at workshops, training, retreats and conferences. Case studies make mission knowledge attractive and...

  1. From the Skin to the Brain: Pathophysiology of Colonization and Infection of External Ventricular Drain, a Prospective Observational Study.

    Science.gov (United States)

    Mounier, Roman; Lobo, David; Cook, Fabrice; Martin, Mathieu; Attias, Arie; Aït-Mamar, Bouziane; Gabriel, Inanna; Bekaert, Olivier; Bardon, Jean; Nebbad, Biba; Plaud, Benoît; Dhonneur, Gilles

    2015-01-01

    Ventriculostomy-related infection (VRI) is a serious complication of external ventricular drain (EVD) but its natural history is poorly studied. We prospectively tracked the bacteria pathways from skin towards ventricles to identify the infectious process resulting in ventriculostomy-related colonization (VRC), and VRI. We systematically sampled cerebrospinal fluid (CSF) on a daily basis and collected swabs from both the skin and stopcock every 3.0 days for microbiological analysis including in 101 neurosurgical patient. Risk factors for positive event defined as either VRC or VRI were recorded and related to our microbiological findings. A total of 1261 CSF samples, 473 skin swabs, and 450 stopcock swabs were collected. Skin site was more frequently colonized than stopcock (70 (60%) vs 34 (29%), p = 0.023), and earlier (14 ±1.4 vs 24 ±1.5 days, p<0.0001). Sixty-one (52%) and 32 (27%) skin and stopcock sites were colonized with commensal bacteria, 1 (1%) and 1 (1%) with pathogens, 8 (7%) and 1 (1%) with combined pathogens and commensal bacteria, respectively. Sixteen positive events were diagnosed; a cutaneous origin was identified in 69% of cases. The presence of a pathogen at skin site (6/16 vs 4/85, OR: 11.8, [2.5-56.8], p = 0.002) and CSF leakage (7/16 vs 6/85, OR 10 [2.4-41.2], p = 0.001)) were the two independent significant risk factors statistically linked to positive events occurrence. Our results suggest that VRC and VRI mainly results from an extra-luminal progression of pathogens initially colonizing the skin site where CSF leaks.

  2. From the Skin to the Brain: Pathophysiology of Colonization and Infection of External Ventricular Drain, a Prospective Observational Study.

    Directory of Open Access Journals (Sweden)

    Roman Mounier

    Full Text Available Ventriculostomy-related infection (VRI is a serious complication of external ventricular drain (EVD but its natural history is poorly studied. We prospectively tracked the bacteria pathways from skin towards ventricles to identify the infectious process resulting in ventriculostomy-related colonization (VRC, and VRI. We systematically sampled cerebrospinal fluid (CSF on a daily basis and collected swabs from both the skin and stopcock every 3.0 days for microbiological analysis including in 101 neurosurgical patient. Risk factors for positive event defined as either VRC or VRI were recorded and related to our microbiological findings. A total of 1261 CSF samples, 473 skin swabs, and 450 stopcock swabs were collected. Skin site was more frequently colonized than stopcock (70 (60% vs 34 (29%, p = 0.023, and earlier (14 ±1.4 vs 24 ±1.5 days, p<0.0001. Sixty-one (52% and 32 (27% skin and stopcock sites were colonized with commensal bacteria, 1 (1% and 1 (1% with pathogens, 8 (7% and 1 (1% with combined pathogens and commensal bacteria, respectively. Sixteen positive events were diagnosed; a cutaneous origin was identified in 69% of cases. The presence of a pathogen at skin site (6/16 vs 4/85, OR: 11.8, [2.5-56.8], p = 0.002 and CSF leakage (7/16 vs 6/85, OR 10 [2.4-41.2], p = 0.001 were the two independent significant risk factors statistically linked to positive events occurrence. Our results suggest that VRC and VRI mainly results from an extra-luminal progression of pathogens initially colonizing the skin site where CSF leaks.

  3. A qualitative interview study exploring pregnant women’s and health professionals’ attitudes to external cephalic version

    Science.gov (United States)

    2013-01-01

    Background Women who have a breech presentation at term have to decide whether to attempt external cephalic version (ECV) and how they want to give birth if the baby remains breech, either by planned caesarean section (CS) or vaginal breech birth. The aim of this study was to explore the attitudes of women with a breech presentation and health professionals who manage breech presentation to ECV. Methods We carried out semi-structured interviews with pregnant women with a breech presentation (n=11) and health professionals who manage breech presentation (n=11) recruited from two hospitals in North East England. We used purposive sampling to include women who chose ECV and women who chose planned CS. We analysed data using thematic analysis, comparing between individuals and seeking out disconfirming cases. Results Four main themes emerged from the data collected during interviews with pregnant women with a breech presentation: ECV as a means of enabling natural birth; concerns about ECV; lay and professional accounts of ECV; and breech presentation as a means of choosing planned CS. Some women’s attitudes to ECV were affected by their preferences for how to give birth. Other women chose CS because ECV was not acceptable to them. Two main themes emerged from the interview data about health professionals’ attitudes towards ECV: directive counselling and attitudes towards lay beliefs about ECV and breech presentation. Conclusions Women had a range of attitudes to ECV informed by their preferences for how to give birth; the acceptability of ECV to them; and lay accounts of ECV, which were frequently negative. Most professionals described having a preference for ECV and reported directively counselling women to choose it. Some professionals were dismissive of lay beliefs about ECV. Some key challenges for shared decision making about breech presentation were identified: health professionals counselling women directively about ECV and the differences between evidence

  4. 18F-FDG Pet-Guided External Beam Radiotherapy in Iodine-Refractory Differentiated Thyroid Cancer: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Eleonora Farina

    2017-01-01

    Full Text Available Introduction. To evaluate the clinical response rate after a postoperative 18F-FDG PET/CT guided external beam radiotherapy (EBRT in Iodine-refractory differentiated thyroid cancer. Material and Methods. Patients with thyroid cancer locally recurrent after total thyroidectomy plus metabolic radiotherapy and treated with radical EBRT were included. Inclusion criteria were detectable thyroglobulin (Tg, negative postmetabolic radiotherapy whole body scintigraphy, and no surgical indications. The pretreatment 18F-FDG PET/CT resulted positive in all cases (loggia, lymph nodes, and lung. EBRT was delivered with IMRT-SIB technique. A 18F-FDG PET/CT revaluation and Tg dosage were performed 3 months after the treatment. Results. Sixteen consecutive patients were included in this analysis (median follow-up: 6–44 months. Post-EBRT 18F-FDG PET/CT showed CR in 43.7%, PR in 31.2%, SD in 25.0% patients, and PD due to lung metastases in 12.5%. Overall response rate was 75.0% (CI 95%: 41.4–93.3%. Tg levels decreased in 75.0% with a median Δ of 68.0%. Two-year PFS and OS rates were 80.0% and 93.0%, respectively. Acute G3 toxicity occurred in 18.7% and late G2 toxicity in 12.5%. Conclusions.  18F-FDG PET/CT was useful in target definition for radiotherapy planning, identifying positive areas not detected with 131I scintigraphy. IMRT based EBRT was feasible and our results encourage future prospective studies. This clinical trial is registered with ID: NCT03191643.

  5. A qualitative interview study exploring pregnant women’s and health professionals’ attitudes to external cephalic version

    Directory of Open Access Journals (Sweden)

    Say Rebecca

    2013-01-01

    Full Text Available Abstract Background Women who have a breech presentation at term have to decide whether to attempt external cephalic version (ECV and how they want to give birth if the baby remains breech, either by planned caesarean section (CS or vaginal breech birth. The aim of this study was to explore the attitudes of women with a breech presentation and health professionals who manage breech presentation to ECV. Methods We carried out semi-structured interviews with pregnant women with a breech presentation (n=11 and health professionals who manage breech presentation (n=11 recruited from two hospitals in North East England. We used purposive sampling to include women who chose ECV and women who chose planned CS. We analysed data using thematic analysis, comparing between individuals and seeking out disconfirming cases. Results Four main themes emerged from the data collected during interviews with pregnant women with a breech presentation: ECV as a means of enabling natural birth; concerns about ECV; lay and professional accounts of ECV; and breech presentation as a means of choosing planned CS. Some women’s attitudes to ECV were affected by their preferences for how to give birth. Other women chose CS because ECV was not acceptable to them. Two main themes emerged from the interview data about health professionals’ attitudes towards ECV: directive counselling and attitudes towards lay beliefs about ECV and breech presentation. Conclusions Women had a range of attitudes to ECV informed by their preferences for how to give birth; the acceptability of ECV to them; and lay accounts of ECV, which were frequently negative. Most professionals described having a preference for ECV and reported directively counselling women to choose it. Some professionals were dismissive of lay beliefs about ECV. Some key challenges for shared decision making about breech presentation were identified: health professionals counselling women directively about ECV and the

  6. [Case-non case studies: Principles, methods, bias and interpretation].

    Science.gov (United States)

    Faillie, Jean-Luc

    2017-10-31

    Case-non case studies belongs to the methods assessing drug safety by analyzing the disproportionality of notifications of adverse drug reactions in pharmacovigilance databases. Used for the first time in the 1980s, the last few decades have seen a significant increase in the use of this design. The principle of the case-non case study is to compare drug exposure in cases of a studied adverse reaction with that of cases of other reported adverse reactions and called "non cases". Results are presented in the form of a reporting odds ratio (ROR), the interpretation of which makes it possible to identify drug safety signals. This article describes the principle of the case-non case study, the method of calculating the ROR and its confidence interval, the different modalities of analysis and how to interpret its results with regard to the advantages and limitations of this design. Copyright © 2017 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

  7. Intravitreal Aflibercept in Recalcitrant Radiation Maculopathy due to External Beam Radiotherapy for Nasopharyngeal Cancer: A First Case Report.

    Science.gov (United States)

    Loukianou, Eleni; Loukianou, Georgia

    2017-01-01

    To present the safety and efficacy of intravitreal aflibercept (Eylea) in a patient with radiation maculopathy secondary to external beam radiotherapy for nasopharyngeal cancer unresponsive to other therapeutic options. A 73-year-old female presented with decreased visual acuity in both eyes 18 months after completing 47 external beam cycles of radiation for nasopharyngeal cancer. On presentation, her best corrected visual acuity was 6/60 in the right eye and counting fingers from 1 meter in the left eye. She received 5 bevacizumab injections in the right eye and 7 bevacizumab injections in the left eye over the last year without any improvement. A treatment with intravitreal injections of aflibercept was recommended in both eyes. The patient received 3 intravitreal aflibercept injections (2 mg/0.05 mL) in each eye every 4 weeks. The visual acuity improved from 6/60 to 6/12 in the right eye and from counting fingers to 6/36 in the left eye. Biomicroscopy showed less exudates, hemorrhages, and microaneurysms. Optical coherence tomography revealed reduced central retinal thickness in both eyes after 1-3 intravitreal aflibercept injections. Intravitreal aflibercept should be regarded a safe and effective treatment in patients with recalcitrant macular edema due to radiation maculopathy.

  8. Intravitreal Aflibercept in Recalcitrant Radiation Maculopathy due to External Beam Radiotherapy for Nasopharyngeal Cancer: A First Case Report

    Directory of Open Access Journals (Sweden)

    Eleni Loukianou

    2017-02-01

    Full Text Available Purpose: To present the safety and efficacy of intravitreal aflibercept (Eylea in a patient with radiation maculopathy secondary to external beam radiotherapy for nasopharyngeal cancer unresponsive to other therapeutic options. Methods: A 73-year-old female presented with decreased visual acuity in both eyes 18 months after completing 47 external beam cycles of radiation for nasopharyngeal cancer. On presentation, her best corrected visual acuity was 6/60 in the right eye and counting fingers from 1 meter in the left eye. She received 5 bevacizumab injections in the right eye and 7 bevacizumab injections in the left eye over the last year without any improvement. A treatment with intravitreal injections of aflibercept was recommended in both eyes. Results: The patient received 3 intravitreal aflibercept injections (2 mg/0.05 mL in each eye every 4 weeks. The visual acuity improved from 6/60 to 6/12 in the right eye and from counting fingers to 6/36 in the left eye. Biomicroscopy showed less exudates, hemorrhages, and microaneurysms. Optical coherence tomography revealed reduced central retinal thickness in both eyes after 1–3 intravitreal aflibercept injections. Conclusion: Intravitreal aflibercept should be regarded a safe and effective treatment in patients with recalcitrant macular edema due to radiation maculopathy.

  9. Case management roles of clinicians: a research case study.

    Science.gov (United States)

    Sterling, Y M; Noto, E C; Bowen, M R

    1994-07-01

    The purpose of this research multiple case study was to determine case management roles as demonstrated by four clinicians employed at a university medical center. Multiple sources of evidence were used to collect data, including interviews, nonparticipant observations, and chart audits. Case management was defined by the clinicians as a process for delivery of health care at the institution studied. Despite a lack of a uniform framework for case management practice, the clinicians used similar case management components. Chart audits demonstrated deficits and inconsistency in documentation that were supported by interview and observations. It was recommended that exposure to formal case management models and theory could strengthen clinical practice in this area. Additionally, investigation of factors that facilitate and/or impede consistent documentation of interventions and patient outcomes, particularly by CNSs is recommended.

  10. Innovative Interpretive Qualitative Case Study Research Method ...

    African Journals Online (AJOL)

    lc2o

    Systems theory is used to explore innovation, change and ... methodology for aligning an innovative, interpretive qualitative case .... importance. Researchers can adopt either a single-case or multiple-case study design depending on the phenomenon in question. A single-case design could be criticized for its inability to ...

  11. Concentrated photovoltaics, a case study

    Directory of Open Access Journals (Sweden)

    Antonini Piergiorgio

    2014-01-01

    Full Text Available Concentrated Photovoltaics (CPV, once a niche technology, has now reached the maturity and reliability for large scale power generation. Especially in regions where temperatures are very high, the use of high efficiency triple junction solar cells with concentrating optics allows stable energy yield. Thus CPV can be seen as complementary and not in concurrence with silicon photovoltaics. The state of the art, the advantages and limitations of this technology will be shown. Among the main advantages of CPV is the possibility of a much higher energy supply, when compared to silicon photovoltaics, both comparing CPV and silicon with same area or the same installed power. The use of recycled and recyclable materials allows a more environmentally friendly production. The possibility to couple CPV with desalination facilities, energy storage will be analysed. As an example a case study of a CPV installation in Northern Italy is discussed. Here the use of mature technologies, derived from automotive and lighting sectors resulted in a simple and efficient module.

  12. Case Studies of Environmental Visualization

    Directory of Open Access Journals (Sweden)

    Panagiotis Patlakas

    2017-09-01

    Full Text Available The performance gap between simulation and reality has been identified as a major challenge to achieving sustainability in the Built Environment. While Post-Occupancy Evaluation (POE surveys are an integral part of better understanding building performance, and thus addressing this issue, the importance of POE remains relatively unacknowledged within the wider Built Environment community. A possible reason that has been highlighted is that POE survey data is not easily understood and utilizable by non-expert stakeholders, including designers. A potential method by which to address this is the visualization method, which has well established benefits for communication of big datasets. This paper presents two case studies where EnViz (short for “Environmental Visualization”, a prototype software application developed for research purposes, was utilized and its effectiveness tested via a range of analysis tasks. The results are discussed and compared with those of previous work that utilized variations of the methods presented here. The paper concludes by presenting the lessons drawn from the five-year period of EnViz, emphasizing the potential of environmental visualization for decision support in environmental design and engineering for the built environment, and suggests directions for future development.

  13. Case Study: The Chemistry of Cocaine

    Science.gov (United States)

    Dewprashad, Brahmadeo

    2011-01-01

    This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's case study focuses on the chemistry of cocaine to teach a number of core concepts in organic chemistry. It also requires that students read and analyze an original research paper on…

  14. Accelerated action of external sulfate and chloride to study corrosion of tensile steel in reinforced concrete

    Directory of Open Access Journals (Sweden)

    M. A. G. Silva

    2017-10-01

    Full Text Available Corrosion of the reinforcing steel may cause significant loss of strength of reinforced concrete structures. The study focuses on accelerating such corrosion and examining the degradation of (i the compressive strength of concrete due to sodium sulfate in a wet atmosphere; and (ii the flexural strength by a solution of sodium sulfate and sodium chloride. Three types of concrete were used and different beam specimens were reinforced by steel rebars of different diameters (6, 8 and 10mm, part of the beams being pre-cracked. The concrete with least strength allowed higher sulfate penetration along the entire process and the compressive strength increased slightly, possibly due to lower porosity of concrete after contamination. The results of the flexural tests showed decrease of strength in all cases. Pre-cracked beams exhibited smaller influence of porosity of concrete. Beams with 6mm rebars showed the largest loss of strength due to the contamination and corrosion process

  15. Nonlinear increasing axial gap stiffness in type II external skeletal fixation: a mechanical study.

    Science.gov (United States)

    Kowaleski, Michael P; Marston, Mathew T; Kraus, Karl H

    2003-01-01

    To quantify the effect on gap stiffness and cranial to caudal bending stiffness of conversion of the 6 distal clamps of planar bilateral fixator models to sliding clamps and the effect of attachment of composite beams to the sliding clamp models. Mdash;Mechanical testing performed on models. Five models using birch dowels and a commercially available external skeletal fixator system. A segmentally comminuted, middiaphyseal fracture was simulated with the use of wooden dowels, and a bilateral 6-pin fixator was applied to create each of 5 models. The models were mechanically tested with all fixed clamps, with the 6 distal clamps converted to sliding clamps and with composite beams attached to the sliding clamp models. Testing was carried out in axial loading with physiologically relevant loads for a canine model, and in bending in the cranial to caudal plane. Sliding clamp fixators with composite beams attached exhibited a nonlinear increase in axial loading gap stiffness as load increased. The composite beam group also exhibited an increase in cranial to caudal bending stiffness as compared with fixed clamp and sliding clamp models. Using composite beam elements, planar bilateral external fixators can be constructed such that the fracture site would undergo controlled amounts of displacement at low loads and lessening displacement at higher loads. The nonlinear stiffness profile attained by the addition of composite beam elements to a planar external fixator allows controlled axial micromotion at the fracture site. Because controlled axial micromotion appears to stimulate fracture healing, a nonlinear stiffness profile of this type should enhance fracture healing. Copyright 2003 by The American College of Veterinary Surgeons

  16. Checklist for the qualitative evaluation of clinical studies with particular focus on external validity and model validity

    Directory of Open Access Journals (Sweden)

    Vollmar Horst C

    2006-12-01

    Full Text Available Abstract Background It is often stated that external validity is not sufficiently considered in the assessment of clinical studies. Although tools for its evaluation have been established, there is a lack of awareness of their significance and application. In this article, a comprehensive checklist is presented addressing these relevant criteria. Methods The checklist was developed by listing the most commonly used assessment criteria for clinical studies. Additionally, specific lists for individual applications were included. The categories of biases of internal validity (selection, performance, attrition and detection bias correspond to structural, treatment-related and observational differences between the test and control groups. Analogously, we have extended these categories to address external validity and model validity, regarding similarity between the study population/conditions and the general population/conditions related to structure, treatment and observation. Results A checklist is presented, in which the evaluation criteria concerning external validity and model validity are systemised and transformed into a questionnaire format. Conclusion The checklist presented in this article can be applied to both planning and evaluating of clinical studies. We encourage the prospective user to modify the checklists according to the respective application and research question. The higher expenditure needed for the evaluation of clinical studies in systematic reviews is justified, particularly in the light of the influential nature of their conclusions on therapeutic decisions and the creation of clinical guidelines.

  17. Computational study of engine external aerodynamics as a part of multidisciplinary optimization procedure

    Science.gov (United States)

    Savelyev, Andrey; Anisimov, Kirill; Kazhan, Egor; Kursakov, Innocentiy; Lysenkov, Alexandr

    2016-10-01

    The paper is devoted to the development of methodology to optimize external aerodynamics of the engine. Optimization procedure is based on numerical solution of the Reynolds-averaged Navier-Stokes equations. As a method of optimization the surrogate based method is used. As a test problem optimal shape design of turbofan nacelle is considered. The results of the first stage, which investigates classic airplane configuration with engine located under the wing, are presented. Described optimization procedure is considered in the context of multidisciplinary optimization of the 3rd generation, developed in the project AGILE.

  18. Employing external facilitation to implement cognitive behavioral therapy in VA clinics: a pilot study

    Directory of Open Access Journals (Sweden)

    Blevins Dean

    2010-10-01

    Full Text Available Abstract Background Although for more than a decade healthcare systems have attempted to provide evidence-based mental health treatments, the availability and use of psychotherapies remains low. A significant need exists to identify simple but effective implementation strategies to adopt complex practices within complex systems of care. Emerging evidence suggests that facilitation may be an effective integrative implementation strategy for adoption of complex practices. The current pilot examined the use of external facilitation for adoption of cognitive behavioral therapy (CBT in 20 Department of Veteran Affairs (VA clinics. Methods The 20 clinics were paired on facility characteristics, and 23 clinicians from these were trained in CBT. A clinic in each pair was randomly selected to receive external facilitation. Quantitative methods were used to examine the extent of CBT implementation in 10 clinics that received external facilitation compared with 10 clinics that did not, and to better understand the relationship between individual providers' characteristics and attitudes and their CBT use. Costs of external facilitation were assessed by tracking the time spent by the facilitator and therapists in activities related to implementing CBT. Qualitative methods were used to explore contextual and other factors thought to influence implementation. Results Examination of change scores showed that facilitated therapists averaged an increase of 19% [95% CI: (2, 36] in self-reported CBT use from baseline, while control therapists averaged a 4% [95% CI: (-14, 21] increase. Therapists in the facilitated condition who were not providing CBT at baseline showed the greatest increase (35% compared to a control therapist who was not providing CBT at baseline (10% or to therapists in either condition who were providing CBT at baseline (average 3%. Increased CBT use was unrelated to prior CBT training. Barriers to CBT implementation were therapists' lack of

  19. Suicides, homicides, accidents, and other external causes of death among blacks and whites in the Southern Community Cohort Study.

    Directory of Open Access Journals (Sweden)

    Jennifer S Sonderman

    Full Text Available Prior studies of risk factors associated with external causes of death have been limited in the number of covariates investigated and external causes examined. Herein, associations between numerous demographic, lifestyle, and health-related factors and the major causes of external mortality, such as suicide, homicide, and accident, were assessed prospectively among 73,422 black and white participants in the Southern Community Cohort Study (SCCS. Hazard ratios (HR and 95% confidence intervals (CI were calculated in multivariate regression analyses using the Cox proportional hazards model. Men compared with women (HR = 2.32; 95% CI: 1.87-2.89, current smokers (HR = 1.74; 95% CI: 1.40-2.17, and unemployed/never employed participants at the time of enrollment (HR = 1.67; 95% CI 1.38-2.02 had increased risk of dying from all external causes, with similarly elevated HRs for suicide, homicide, and accidental death among both blacks and whites. Blacks compared with whites had lower risk of accidental death (HR = 0.46; 95% CI: 0.38-0.57 and suicide (HR = 0.55; 95% CI: 0.31-0.99. Blacks and whites in the SCCS had comparable risks of homicide death (HR = 1.05; 95% CI: 0.63-1.76; however, whites in the SCCS had unusually high homicide rates compared with all whites who were resident in the 12 SCCS states, while black SCCS participants had homicide rates similar to those of all blacks residing in the SCCS states. Depression was the strongest risk factor for suicide, while being married was protective against death from homicide in both races. Being overweight/obese at enrollment was associated with reduced risks in all external causes of death, and the number of comorbid conditions was a risk factor for iatrogenic deaths. Most risk factors identified in earlier studies of external causes of death were confirmed in the SCCS cohort, in spite of the low SES of SCCS participants. Results from other epidemiologic cohorts are needed to confirm the novel findings

  20. Variant Anatomy of the External Jugular Vein | Olabu | Anatomy ...

    African Journals Online (AJOL)

    Variant anatomy of the external jugular vein is important when performing invasive procedures in the neck. Although there are a number of case reports on some of these variations, there are few descriptive cross-sectional regarding the same. This study therefore aimed at describing the variant anatomy of the external ...

  1. Study of evaluation methods for in-vessel corium retention through external vessel cooling and safety of reactor cavity

    Energy Technology Data Exchange (ETDEWEB)

    Huh, Hoon; Chang, Soon Heung; Choi, Tae Hoon; Kim, Hyun Sop; Yang, Soo Hyung; Kim, Soo Hyung; Kim, Seung Hop; An Hyung Taek; Jeong, Yong Hoon; Huh, Gyun Young [Korea Advanced Institute of Science and Technology, Taejon (Korea, Republic of)

    1998-03-15

    Cooling methodologies for the molten corium resulted from the severe accident of the nuclear power plant is suggested as one of most important items for the safety of the NPP. In this regard, considerable experimental and analytical works have been devoted. In the 1st phase of this project, present status related to the external reactor vessel cooling for the retention of the corium in the reactor vessel and corium at the reactor cavity have been investigated and preliminary studies have been accomplished for the detail evaluation of the each cooling methodology. The preliminary studies include the analysis and detail investigation of the possible phenomena, investigation of the heat transfer correlations and preliminary evaluation of the external reactor vessel cooling using the developed computer code.

  2. Demystifying Instructional Innovation: The Case of Teaching with Case Studies

    Science.gov (United States)

    Kantar, Lina D.

    2013-01-01

    Issues emerging from instructional innovation are inevitable, yet basing any curriculum shift on a theoretical framework is paramount. This paper grounds the case-based pedagogy in three learning theories: behaviorism, cognitivism, and constructivism. The three theories are described and situated in relation to the case study method. An…

  3. External validity study of a personality disorders screening test in a community sample

    Directory of Open Access Journals (Sweden)

    Lucas de Francisco Carvalho

    Full Text Available Abstract Background A screening test for personality disorders was recently developed in Brazil, the Dimensional Clinical Personality Inventory – screening version (IDCP-SV. However, no relationship between this screening measure and other scales or external criteria was tested. Objective To seek for validity evidence based on related criteria (e.g., other psychological tests and external criteria (e.g., sample demographics. Methods Sample comprised 804 participants from São Paulo (Brazil, most female and college students, with mean age equal to 29.65 (SD = 10.73. They answered the IDCP-SV and another screening for personality disorders (IPDS, a depression measure (EBADEP-screening, a scale assessing reasoning for living (EMVIVER, and a self-report for personality disorders categories assessment (SCID-II-PQ. Results IDCP-SV identified 46.4% of community sample as positive for personality disorders. The positive group showed the great mean for almost all comparisions, including psychological tests and the demographics characteristics, including large expressive effect sizes. Discussion Data suggest that the IDCP-SV discriminates a similar percentage of people from the community to what was reported previously using other screening measures; besides, the mean comparisons between groups showed good discriminative capacity by IDCP-SV items.

  4. Childhood Internalizing and Externalizing Problems Predict the Onset of Clinical Panic Attacks over Adolescence: The TRAILS Study

    OpenAIRE

    Mathyssek, Christina; Olino, Thomas; Verhulst, Frank; Oort, Floor

    2012-01-01

    textabstractBackground: Panic attacks are a source of individual suffering and are an independent risk factor for later psychopathology. However, much less is known about risk factors for the development of panic attacks, particularly during adolescence when the incidence of panic attacks increases dramatically. We examined whether internalizing and externalizing problems in childhood predict the onset of panic attacks in adolescence. Method: This study is part of the TRacking Adolescents' In...

  5. External Auditors and Corporate Corruption: Implications for External Audit Regulators

    National Research Council Canada - National Science Library

    Kassem, Rasha; Higson, Andrew W

    2016-01-01

      The purpose of the current study is to examine the responsibility of external auditors in relation to corporate corruption and to highlight the implications of this for external audit regulators...

  6. Case Studies Approach in Tourism Destination Branding Research

    Directory of Open Access Journals (Sweden)

    Adeyinka-Ojo S.F.

    2014-01-01

    Full Text Available A review of literature indicates that there are different types of qualitative research methods such as action research, content analysis, ethnography, grounded theory, historical analysis, phenomenology and case study. However, which approach is to be used depends on several factors such as the nature and objectives of the research. The aim of this paper is to focus on the research methodology aspects of applying case study as a research approach and its relevance in tourism destination branding research specifically on a single case study (SCS context. There are arguments that the SCS is a weak research strategy. Some of the potentials or shortcomings highlighted in the literature include the primitive nature of SCS, flexibility of sample technique, data collection method and data analysis. Others include lack of rigour, reliability, validity, credibility of findings and generalisation. This paper has adopted content analysis of the literature on tourism destination branding. Findings indicate that the quality of SCS can be verified using specific case study tactics for four design tests such as validity (construct, internal and external; and reliability using the case study protocol. Theoretical implication suggests that SCS is an empirical enquiry use to understand complex phenomena and favoured by practitioners.

  7. Music preferences, friendship, and externalizing behavior in early adolescence: A SIENA examination of the music marker theory using the SNARE Study

    OpenAIRE

    Franken, Aart; Keijsers, L.G.M.T.; Dijkstra, Jan Kornelis; ter Bogt, Tom

    2017-01-01

    Music Marker Theory posits that music is relevant for the structuring of peer groups and that rock, urban, or dance music preferences relate to externalizing behavior. The present study tested these hypotheses, by investigating the role of music preference similarity in friendship selection and the development of externalizing behavior, while taking the effects of friends? externalizing behavior into account. Data were used from the first three waves of the SNARE (Social Network Analysis of R...

  8. SPHENOCHOANAL POLYP: A CASE STUDY

    Directory of Open Access Journals (Sweden)

    Gaurav

    2015-09-01

    Full Text Available Sphenochoanal polyp is a rare clinical occurrence as compared to the much common antro - choanal polyp. It originates from the sphenoid sinus and extends into the choana via the sphenoid ostium. We present a case of spheno - choanal polyp and its clinical features and surgical management is discussed. Our aim in this case was to properly d elineate the origin of the polyp and differentiate it from other lesions such as the antro - choanal polyp and meningocele, followed by meticulous endoscopic excision of the polyp

  9. Five misunderstandings about case study research

    DEFF Research Database (Denmark)

    Flyvbjerg, Bent

    2004-01-01

    This article examines five common misunderstandings about case-study research: (1) Theoretical knowledge is more valuable than practical knowledge; (2) One cannot generalize from a single case, therefore the single case study cannot contribute to scientific development; (3) The case study is most...... and concludes with the Kuhnian insight that a scientific discipline without a large number of thoroughly executed case studies is a discipline without systematic production of exemplars, and that a discipline without exemplars is an ineffective one. Social science may be strengthened by the execution of more...

  10. Five misunderstandings about Case-study Research

    DEFF Research Database (Denmark)

    Flyvbjerg, Bent

    This article examines five common misunderstandings about case-study research: (1) Theoretical knowledge is more valuable than practical knowledge; (2) One cannot generalize from a single case, therefore the single case study cannot contribute to scientific development; (3) The case study is most...... and concludes with the Kuhnian insight that a scientific discipline without a large number of thoroughly executed case studies is a discipline without systematic production of exemplars, and that a discipline without  exemplars is an ineffective one. Social science may be strengthened by the execution of more...

  11. Case report: endodontic and surgical treatment of an upper central incisor with external root resorption and radicular cyst following a traumatic tooth avulsion.

    Science.gov (United States)

    Lux, Hans-Christian; Goetz, Falko; Hellwig, Elmar

    2010-11-01

    In the age group between 6 and 12 years, trauma to the upper incisors happens frequently. In the case of avulsion, a replantation is the state-of-the-art treatment; however, it may lead to several complications, particularly if suitable posttraumatic management is not carried out. External cervical resorptions as well as apical granuloma and cysts due to microbial contamination of the root canal are common complications. In the presented trauma case, a conservative approach was chosen to treat a large cystic lesion combined with cervical and apical resorptions. After initial placement of Ledermix and calcium hydroxide into the root canal, a marsupialization with the temporary insertion of an obturator was performed. The gradual reduction led to a fast recovery of the bony defect and a root canal filling was placed. The 2-year follow-up showed an improved condition. All adjacent teeth remained vital during the course of the treatment. Copyright © 2010 Mosby, Inc. All rights reserved.

  12. Vidi, vini, vinci: External ophthalmomyiasis infection that occurred, and was diagnosed and treated in a single day: A rare case report

    Directory of Open Access Journals (Sweden)

    Kamlesh Thakur

    2009-01-01

    Full Text Available Ophthalmomyiasis is an infestation of eye with larvae or maggots of certain flies. Oestrus ovis (sheep nasal botfly belonging to family Oestridae is the most common cause of human myiasis. We describe here an acute presentation of a case of external ophthalmomyiasis, i.e., infestation of conjunctiva due to first instar larvae of Oestrus ovis. In this case report the occurrence, diagnosis and treatment all took place in the setting of a single day. Prompt treatment by removal of larvae mechanically followed by instillation of antibiotic and steroid eye drops helped to prevent serious complications. The taxonomic identification of fly is also important as some fly species are capable of penetrating deeper tissues of eyes, which is sight threatening.

  13. Vidi, vini, vinci: External ophthalmomyiasis infection that occurred, and was diagnosed and treated in a single day: A rare case report

    Science.gov (United States)

    Thakur, Kamlesh; Singh, Gagandeep; Chauhan, Smriti; Sood, Anuradha

    2009-01-01

    Ophthalmomyiasis is an infestation of eye with larvae or maggots of certain flies. Oestrus ovis (sheep nasal botfly) belonging to family Oestridae is the most common cause of human myiasis. We describe here an acute presentation of a case of external ophthalmomyiasis, i.e., infestation of conjunctiva due to first instar larvae of Oestrus ovis. In this case report the occurrence, diagnosis and treatment all took place in the setting of a single day. Prompt treatment by removal of larvae mechanically followed by instillation of antibiotic and steroid eye drops helped to prevent serious complications. The taxonomic identification of fly is also important as some fly species are capable of penetrating deeper tissues of eyes, which is sight threatening. PMID:20927210

  14. Making a case for case studies in psychotherapy training

    DEFF Research Database (Denmark)

    Mackrill, Thomas Edward; Iwakabe, Shigeru

    2013-01-01

    The evidence debate in psychotherapy pays little attention to developing an evidence base for training practices. Understanding effective training requires an examination of what makes training work. This article examines the role of case studies in psychotherapy training. This has not been...... articulated explicitly or researched systematically in spite of its cardinal importance. An analysis of the role of case studies in psychotherapy training is presented. Reading, watching, or hearing about cases can offer novice psychotherapists access to a closed world; access to psychological theory...... to collaborate with other professionals. The paper presents directions for future research into psychotherapy training, specifically proposing an international survey of training practices at psychotherapy training institutions....

  15. Phencyclidine Intoxication Case Series Study.

    Science.gov (United States)

    Dominici, Paul; Kopec, Kathryn; Manur, Rashmi; Khalid, Abdullah; Damiron, Kathia; Rowden, Adam

    2015-09-01

    Phencyclidine (PCP) is a synthetic compound derived from piperidine and used as an anesthetic and hallucinogenic. Little has been recently published regarding the clinical presentation of PCP intoxication. PCP use as a recreational drug is resurging. Our objective was to describe clinical findings in patients presenting to the emergency department (ED) under the influence of PCP. This was a case series study conducted at a tertiary care center with an annual census of 100,000 patients/year. Emergency physicians, residents, physician assistants, and research assistants identified patients with possible PCP intoxication. Self-reported PCP use, report by bystanders or Emergency Medical Services (EMS) staff, was used in this process. A structured data collection form was completed, documenting both clinical and behavioral events observed by the treating team during the ED visit. We collected data on 219 patients; 184 were analyzed; two patients were excluded secondary to incomplete data. The mean age of patients was 32.5 years (±7 years) with 65.2 % being males. PCP use was self-reported by 60.3 % of patients. Of the 184 patients, 153 (83.1 %) received a urine drug screen (UDS); 152 (98.7 %) were positive for PCP. On arrival, 78.3 % of patients were awake and alert, and 51.6 % were oriented to self, time/date, and place. Mean physiological parameters were the following: heart rate 101.1 bpm (±24.3), RR 18.9 bpm (±3.4), BP 146.3 (±19.4)/86.3 (±14.0) mmHg, 36.9° C (±0.5), and pulse oximetry 98.2 % (±1.9). Clinical findings were the following: retrograde amnesia in 46 (25 %), horizontal nystagmus in 118 (64.1 %), vertical nystagmus in 90 (48.9 %), hypertension in 87 (47.3 %), and agitation in 71 (38.6 %). Concomitant use of at least one other substance was reported by 99 (53.8 %) patients. The mean length of stay in the ED for all subjects was 261.1 (±172.8) minutes. Final disposition for 152 (82.6 %) patients was to home. Of the 184 patients, 14 (7.6 %) required

  16. Study of Internal and External Leaks in Tests of Anode-Supported SOFCs

    DEFF Research Database (Denmark)

    Rasmussen, Jens Foldager Bregnballe; Hendriksen, Peter Vang; Hagen, Anke

    2008-01-01

    A planar anode-supported solid oxide fuel cell (SOFC) has been tested to investigate gas tightness of the electrolyte and the applied seals. Gas leaks reduce the efficiency of the SOFC and it is thus important to determine and minimise them. Probe gases (He and Ar) and a Quadrupole Mass...... difference between the anode and the cathode gas compartment, and can thus be described as diffusion driven. External leaks between the surroundings and the anode, but not the cathode gas compartment was observed. They were influenced by the pressure difference and are thus driven by both concentration...... and pressure gradients. The measured gas leaks deduced from the probe gas experiments and the total leak calculated from the deviation between the Emf defined by the gases and the cell OCV (which contains all gas leaks as well as effects of electronic leaks) were compared. Good agreement between the two...

  17. Internal and External Factors Related to Burnout among Iron and Steel Workers: A Cross-Sectional Study in Anshan, China

    Science.gov (United States)

    Guo, Haiqiang; Guo, Huifang; Yang, Yilong; Sun, Baozhi

    2015-01-01

    Background Burnout is a syndrome of emotional exhaustion, cynicism and reduced professional efficacy, which can result from long-term work stress. Although the burnout level is high among iron and steel workers, little is known concerning burnout among iron and steel worker. This study aimed to evaluate the burnout and to explore its associated internal and external factors in iron and steel workers. Methods A cross-sectional survey was conducted in iron and steel workers at the Anshan iron-steel complex in Anshan, northeast China. Self-administered questionnaires were distributed to 1,600 workers, and finally 1,300 questionnaires were returned. Burnout was measured using the Chinese version of the Maslach Burnout Inventory-General Survey (MBI-GS). Effort-reward imbalance (ERI), perceived organizational support (POS), and psychological capital (PsyCap) were measured anonymously. A hierarchical regression model was applied to explore the internal and external factors associated with burnout. Results Mean MBI-GS scores were 13.11±8.06 for emotional exhaustion, 6.64±6.44 for cynicism, and 28.96±10.39 for professional efficacy. Hierarchical linear regression analysis showed that ERI and POS were the most powerful predictors for emotional exhaustion and cynicism, and PsyCap was the most robust predictor for high professional efficacy. Conclusions Chinese iron and steel workers have a high level of burnout. Burnout might be associated with internal and external factors, including ERI, POS, and PsyCap. Further studies are recommended to develop an integrated model including both internal and external factors, to reduce the level of ERI, and improve POS and workers’ PsyCap, thereby alleviating the level of burnout among iron and steel workers. PMID:26575031

  18. Internal and External Factors Related to Burnout among Iron and Steel Workers: A Cross-Sectional Study in Anshan, China.

    Science.gov (United States)

    Guo, Haiqiang; Guo, Huifang; Yang, Yilong; Sun, Baozhi

    2015-01-01

    Burnout is a syndrome of emotional exhaustion, cynicism and reduced professional efficacy, which can result from long-term work stress. Although the burnout level is high among iron and steel workers, little is known concerning burnout among iron and steel worker. This study aimed to evaluate the burnout and to explore its associated internal and external factors in iron and steel workers. A cross-sectional survey was conducted in iron and steel workers at the Anshan iron-steel complex in Anshan, northeast China. Self-administered questionnaires were distributed to 1,600 workers, and finally 1,300 questionnaires were returned. Burnout was measured using the Chinese version of the Maslach Burnout Inventory-General Survey (MBI-GS). Effort-reward imbalance (ERI), perceived organizational support (POS), and psychological capital (PsyCap) were measured anonymously. A hierarchical regression model was applied to explore the internal and external factors associated with burnout. Mean MBI-GS scores were 13.11±8.06 for emotional exhaustion, 6.64±6.44 for cynicism, and 28.96±10.39 for professional efficacy. Hierarchical linear regression analysis showed that ERI and POS were the most powerful predictors for emotional exhaustion and cynicism, and PsyCap was the most robust predictor for high professional efficacy. Chinese iron and steel workers have a high level of burnout. Burnout might be associated with internal and external factors, including ERI, POS, and PsyCap. Further studies are recommended to develop an integrated model including both internal and external factors, to reduce the level of ERI, and improve POS and workers' PsyCap, thereby alleviating the level of burnout among iron and steel workers.

  19. Internalisation of an externality and profitability: Based on an empirical study of in the food industry

    Directory of Open Access Journals (Sweden)

    Fumihiko Isada

    2014-09-01

    Full Text Available The objective of this research was to verify empirically that internalising externalities of private enterprises contributes to profitability on a long-term basis. One of the significant transitions of the economic environment globally at the beginning of this century has been the rapid economic growth of emerging countries. On the other hand, there is apprehension also about various social problems due to the rapid industrialisation of such emerging countries, or improvement in the living standard. Political-economist Malthus (1798 warned of such a drain on resources and energy, and the ravaging of the natural environment at the beginning of the nineteenth century. Present-day Malthusians warn of ruin because of the exhaustion of resources and environmental deterioration resulting from active business activity. This aims to tighten up regulations as "a governmental role" to the so-called "market failure." Mill (1848 introduced the concept of “stationary state” in the "philosophy of economics." On the other hand, Robert Solow (1956 highlighted the significance of technological progress as a factor of economic growth. In terms of the positive role of a private company, Porter et al. (2011 called it the strategy of shared-value creation. It is internalisation of the externality on a market transaction. In terms of research methodology, statistical verification was carried out based on the sustainability statement, the various publicity materials and the financial data released by each company. In conclusion, when private enterprises adopt sustainability activity positively, a consumer value, corporate value and social value are expanded cyclically.

  20. Theoretical study of the adsorption of DNA bases on the acidic external surface of montmorillonite.

    Science.gov (United States)

    Mignon, Pierre; Sodupe, Mariona

    2012-01-14

    In the present study, DFT periodic plane wave calculations, at the PBE-D level of theory, were carried out to investigate the interaction of DNA nucleobases with acidic montmorillonite. The surface model was considered in its octahedral (Osub) and tetrahedral (Tsub) substituted forms, known to have different acidic properties. The adsorption of adenine, guanine and cytosine was considered in both orthogonal and coplanar orientations with the surface, interacting with the proton via a given heteroatom. In almost all considered cases, adsorption involved the spontaneous proton transfer to the nucleobase, with a more pronounced character in the Osub structures. The binding energy is about 10 kcal mol(-1) larger for Osub than for Tsub complexes mainly due to the larger acidity in Osub surfaces and due to the better stabilization by H-bond contacts between the negatively charged surface and the protonated base. The binding energy of coplanar orientations of the base is observed to be as large as the orthogonal ones due to a balance between electrostatic and dispersion contributions. Finally the binding of guanine and adenine on the acidic surface amounts to 50 kcal mol(-1) while that of cytosine rises to 44 kcal mol(-1).

  1. Drive Electric Vermont Case Study

    Energy Technology Data Exchange (ETDEWEB)

    Wagner, Fred [Energetics Incorporated, Columbia, MD (United States); Roberts, Dave [Vermont Energy Investment Corporation (VEIC), Burlington, VT (United States); Francfort, Jim [Idaho National Lab. (INL), Idaho Falls, ID (United States); White, Sera [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-03-01

    Currently in the United States, the heavy majority of plug-in electric vehicle (PEV) sales have been in highly conducive, selected, metropolitan areas; opposed to more broad distribution across the country. The U.S. Department of Energy’s EV Everywhere Grand Challenge is looking carefully at the barriers and opportunities that exist to enable small and midsize communities to partake in the PEV market and benefit from the economic and environmental advantages of PEVs. In order to gain insight into these challenges and barriers, DOE selected a success story (i.e., Drive Electric Vermont) as the subject of this case study, as the state of Vermont is tied with Detroit, Michigan in having the highest percentage of 2014 (most recent complete data) PEV registrations for cold weather U.S. cities and has seen more than a sixfold increase in charging stations over the last three years. The overall objective of this case study was to use the lessons learned from Drive Electric Vermont to determine what activities are most effective at encouraging acquisitions of PEVs and deployment of charging infrastructure in small to midsize communities, prioritizing and sequencing their implementation, identifying robust means for extrapolation, and applying this understanding to other small to midsize communities across the nation. The Drive Electric Vermont Program was formed in 2012 with a goal of increasing the use of electrified transportation in Vermont through policy development, education and outreach, and infrastructure development. The Drive Electric Vermont Program can be broadly broken into four components: (1) strategic planning/leadership, (2) stakeholder/partnership development, (3) education and outreach, and (4) incentives. The early phases of the program focused heavily on strategic planning, and stakeholder and partnership development, followed by a transition to education and outreach activities, charging infrastructure development, and grant and incentive programs

  2. Quantitative digital subtraction radiography in the assessment of external apical root resorption induced by orthodontic therapy: a retrospective study.

    Science.gov (United States)

    Sunku, Raghavendra; Roopesh, R; Kancherla, Pavan; Perumalla, Kiran Kumar; Yudhistar, Palla Venkata; Reddy, V Sridhar

    2011-11-01

    The objective of this study was to evaluate density changes around the apices of teeth during orthodontic treatment by using digital subtraction radiography to measure the densities around six teeth (maxilla central incisors, lateral incisors, and canines) before and after orthodontic treatment in 36 patients and also assess treatment variables and their coorelation with root resorption. A total of 36 consecutive patient files were selected initially. The selected patients presented with a class I or II relationship and were treated with or without premolar extractions and fixed appliances. Some class II patients were treated additionally with extraoral forces or functional appliances. External apical root resorption (EARR) per tooth in millimeters was calculated and was also expressed as a percentage of the original root length. Image reconstruction and subtraction were performed using the software Regeemy Image Registration and Mosaicing (version 0.2.43-RCB, DPI-INPE, Sao Jose dos Campos, Sao Paulo, Brazil) by a single operator. A region of interest (ROI) was defined in the apical third of the root and density calibration was made in Image J® using enamel (gray value = 255) as reference in the same image. The mean gray values in the ROIs were reflective of the change in the density values between the two images. The root resorption of the tooth and the factors of malocclusion were analyzed with a one-way ANOVA. An independent t-test was performed to compare the mean amount of resorption between male and female, between extraction and nonextraction cases. The density changes after orthodontic treatment were analyzed using the Wilcoxon signedrank test. In addition, the density changes in different teeth were analyzed using the Kruskal-Wallis test. The cut-off for statistical significance was a p-value of 0.05. All the statistical analyses were carried out using SPSS (version 13.0 for Windows, Chicago, IL, USA). Gender, the age at which treatment was started and

  3. Music Preferences, Friendship, and Externalizing Behavior in Early Adolescence: A SIENA Examination of the Music Marker Theory Using the SNARE Study.

    Science.gov (United States)

    Franken, Aart; Keijsers, Loes; Dijkstra, Jan Kornelis; Ter Bogt, Tom

    2017-08-01

    Music Marker Theory posits that music is relevant for the structuring of peer groups and that rock, urban, or dance music preferences relate to externalizing behavior. The present study tested these hypotheses, by investigating the role of music preference similarity in friendship selection and the development of externalizing behavior, while taking the effects of friends' externalizing behavior into account. Data were used from the first three waves of the SNARE (Social Network Analysis of Risk behavior in Early adolescence) study (N = 1144; 50% boys; M age  = 12.7; SD = 0.47), including students who entered the first-year of secondary school. Two hypotheses were tested. First, adolescents were expected to select friends based both on a similarity in externalizing behavior and music genre preference. Second, a preference for rock, urban, or dance, music types was expected to predict the development of externalizing behavior, even when taking friends' influence on externalizing behavior into account. Stochastic Actor-Based Modeling indicated that adolescents select their friends based on both externalizing behavior and highbrow music preference. Moreover, both friends' externalizing behavior and a preference for dance music predicted the development of externalizing behavior. Intervention programs might focus on adolescents with dance music preferences.

  4. Roadmaster Roading Contractors Case Study

    Directory of Open Access Journals (Sweden)

    Hazel Taylor

    1999-01-01

    Full Text Available Systems analysis students seldom experience the practical difficulties of the initial investigation into a client’s requirements. They get little chance to practice the skills they need to investigate complex and confused problem situations, or to appreciate the wider organizational issues that can impact on a situation. This teaching case is designed to give students the opportunity to practice and apply investigation skills and to challenge them to consider the wider work environment when considering possible solutions to a problem situation. The case is conducted as a role-play, with students acting as systems analysts and teaching staff role-playing the clients. The students develop a report analyzing the client’s situation based on the issues that arise during the interviews. Feed-back sessions focus on discussing how well the students applied various interviewing strategies previously covered in lectures, and on the wider organizational problems that could impact proposed information system solutions.

  5. Brands Repositioning: Brazilian case studies

    OpenAIRE

    Serralvo, Francisco Antonio; Furrier, Márcio Tadeu

    2008-01-01

    Based on the assumption of the increasing relevance of both brand positioning and equity in the context of marketing management in competitive environments, the objective of this work was to deepen the existing knowledge on the brand repositioning process. Four theoretical models of reference obtained after literature review supported the empiric verification represented by content analysis of six reports (cases) of Brazilian brands repositioning experiences awarded with the “Top of Marketing...

  6. On the contribution of external cost calculations to energy system governance: the case of a potential large-scale nuclear accident

    NARCIS (Netherlands)

    Laes, E.; Meskens, G.; van der Sluijs, J.P.

    2011-01-01

    The European Commission's ExternE Project has made major advances in the quantification of external costs of electricity. Although some impacts cannot be valued, important conclusions are possible. This paper outlines some provisional implications for energy policy. External costs are technology

  7. Evaporation of water droplets on Pt-surface in presence of external electric field—A molecular dynamics study

    Science.gov (United States)

    Hens, Abhiram; Biswas, Gautam; De, Sudipta

    2015-09-01

    Evaporation of a sessile droplet on a hot solid substrate is an important problem in fluid mechanics. It is relevant to theoretical issues in heat transfer as well as several practical applications. This study investigates the spreading and evaporation of a nanoscale water droplet on a solid platinum surface. The major objective was to analyze the effect of an external electric field on these phenomena. Varying the intensity and direction of the external electric field, a series of molecular dynamics simulations were carried out to understand these phenomena at a molecular level. The results reveal that a horizontal electric field assists in droplet spreading, whereas a vertical electric field enhances the rate of evaporation for a certain range of field intensities. It also shows that the substrate temperature plays an important role in such processes. It is seen that the effect of an external electric field on droplet evaporation becomes significant at an intermediate range of surface temperatures and this effect is not clearly visible for either very high or very low range of surface temperatures.

  8. Study of transport phenomena in laser-driven, non- equilibrium plasmas in the presence of external magnetic fields

    Science.gov (United States)

    Kemp, G. Elijah; Mariscal, D. A.; Williams, G. J.; Blue, B. E.; Colvin, J. D.; Fears, T. M.; Kerr, S. M.; May, M. J.; Moody, J. D.; Strozzi, D. J.; Lefevre, H. J.; Klein, S. R.; Kuranz, C. C.; Manuel, M. J.-E.; Gautier, D. C.; Montgomery, D. S.

    2017-10-01

    We present experimental and simulation results from a study of thermal transport inhibition in laser-driven, mid-Z, non-equilibrium plasmas in the presence external magnetic fields. The experiments were performed at the Jupiter Laser Facility at LLNL, where x-ray spectroscopy, proton radiography, and Brillouin backscatter data were simultaneously acquired from sub-critical-density, Ti-doped silica aerogel foams driven by a 2 ω laser at 5 ×1014 W /cm2 . External B-field strengths up to 20 T (aligned antiparallel to the laser propagation axis) were provided by a capacitor-bank-driven Helmholtz coil. Pre-shot simulations with Hydra, a radiation-magnetohydrodyanmics code, showed increasing electron plasma temperature with increasing B-field strength - the result of thermal transport inhibition perpendicular to the B-field. The influence of this thermal transport inhibition on the experimental observables as a function of external field strength and target density will be shown and compared with simulations. This work was performed under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract No. DE-AC52-07NA27344 and funded by LDRD project 17-ERD-027.

  9. Diagnosis of artificially induced external root resorption using conventional intraoral film radiography, CCD, and PSP: an ex vivo study.

    Science.gov (United States)

    Kamburoğlu, Kivanç; Tsesis, Igor; Kfir, Anda; Kaffe, Israel

    2008-12-01

    To compare diagnosis of artificially induced external root resorption cavities using conventional intraoral film radiography (Kodak Insight), CCD sensor (Sopix wireless) and PSP sensor (Orex Digident). Two mandibles were obtained from cadavers and teeth extracted from their alveolus. Artificial external root resorptions were simulated using ISO 0.5 mm, 0.8 mm, and 1.2 mm diameter round burs by drilling to the entire depth in different locations at the cervical, middle, and apical thirds of the proximal and buccal root surfaces of 6 teeth in increasing order. Conventional and digital radiographs were obtained from 3 different views of each tooth in 3 steps (small = 0.5 mm; medium = 0.8 mm; and large = 1.2 mm diameter round burs). Three observers examined all images for the presence of resorption cavities. In the first session, each image was evaluated separately; in the second, examiners had access to all views. Data were statistically analyzed using 4-way analysis of variance. Pair-wise comparison between receptors, projection views, size, and location were made by Tukey test. Higher proportions of correct readings were obtained with the conventional film (Kodak Insight) and CCD receptor compared with the PSP receptor used in this study (PSP intraoral film and CCD sensor produced similar results in diagnosing simulated external root resorption.

  10. Structure and dynamics of CaO films: A computational study of an effect of external static electric field

    Science.gov (United States)

    Kuklin, Mikhail S.; Bazhenov, Andrey S.; Honkala, Karoliina; Tosoni, Sergio; Pacchioni, Gianfranco; Häkkinen, Hannu

    2017-04-01

    Oxide films play a significant role in a wide range of industrial fields, mostly due to the thickness-dependent variation of their properties. Recently, it has been proposed based on the experimental study that carrier transport in CaO films proceeds via strong phonon excitations with a variable signal depending on the film thickness. In this paper, we report a detailed investigation in the frame of the density functional theory of structural and electronic properties of freestanding and Mo(100)-supported CaO films, as well as phonons therein, as functions of the film thickness and intensity of the external static electric field. Our calculations demonstrate that phonon frequencies negligibly depend on the external electric field. A small gradual increase of the energy of CaO phonons upon increase of the film thickness was found to be in line with earlier experimental findings. The effect of Mo support was observed in the systematic decrease of the energy of phonons. The applied electric field showed a minor effect on the structure of CaO films, whereas electronic properties of the oxide were significantly affected. In particular, the band gap of CaO films was found to gradually decrease with the growing intensity of the external electric field, while the effect is a more pronounced for thicker films. Overall, our paper provides innovative insights into the mechanism of electron transport and electronic properties of CaO films that might lead to new potential applications of oxide materials.

  11. Laboratory study on the hygroscopic behavior of external and internal C2-C4 dicarboxylic acid-NaCl mixtures.

    Science.gov (United States)

    Ma, Qingxin; Ma, Jinzhu; Liu, Chang; Lai, Chengyue; He, Hong

    2013-09-17

    Atmospheric aerosol is usually found to be a mixture of various inorganic and organic components in field measurements, whereas the effect of this mixing state on the hygroscopicity of aerosol particles has remained unknown. In this study, the hygroscopic behavior of mixtures of C2-C4 dicarboxylic acids and NaCl was investigated. For both externally and internally mixed malonic acid-NaCl and succinic acid-NaCl particles, correlation between water content and chemical composition was observed and the water content of these mixtures at relative humidity (RH) above 80% can be well predicted by the Zdanovskii-Stokes-Robinson (ZSR) method. In contrast, a nonlinear relation between the total water content of the mixtures and the water content of each chemical composition separately was found for oxalic acid-NaCl mixtures. Compared to the values predicted by the ZSR method, the dissolution of oxalic acid in external mixtures resulted in an increase in the total water content, whereas the formation of less hygroscopic disodium oxalate in internal mixtures led to a significant decrease in the total water content. Furthermore, we found that the hygroscopicity of the sodium dicarboxylate plays a critical role in determining the aqueous chemistry of dicarboxylic acid-NaCl mixtures during the humidifying and dehumidifying process. It was also found that the hydration of oxalic acid and the deliquescence of NaCl did not change in external oxalic acid-NaCl mixtures. The deliquescence relative humidity (DRHs) for both malonic acid and NaCl decreased in both external and internal mixtures. These results could help in understanding the conversion processes of dicarboxylic acids to dicarboxylate salts, as well as the substitution of Cl by oxalate in the atmosphere. It was demonstrated that the effect of coexisting components on the hygroscopic behavior of mixed aerosols should not be neglected.

  12. LENGTH CHANGE OF THE SHORT EXTERNAL ROTATORS OF THE HIP IN COMMON STRETCH POSITIONS: A CADAVERIC STUDY.

    Science.gov (United States)

    McGovern, Ryan P; Kivlan, Benjamin R; Martin, RobRoy L

    2017-12-01

    Stretching of the deep rotators of the hip is commonly employed in patients with lumbosacral, sacroiliac, posterior hip, and buttock pain. There is limited research demonstrating the effectiveness of common stretching techniques on the short external rotators of the hip. The objective of this study was to evaluate length change during stretching of the superior and inferior fibers of the piriformis, superior gemellus, obturator internus, and inferior gemellus. Repeated-measures laboratory controlled cadaveric study. Seventeen hip joints from nine embalmed cadavers (5 male; 4 female) with an age between 49-96 years were skeletonized. Polypropylene strings were attached from the origin to insertion sites of the short external rotators. The change of length (mm) noted by excursion of the strings was used as a proxy for change in muscle length, when the hip was moved from the anatomical position to four specific stretch positions: 1) 45 ° internal rotation from hip neutral flexion/extension, 2) 45 ° external rotation from 90 ° hip and knee flexion, 3) 30 ° adduction from 90 ° of hip and knee flexion, and 4) 30 ° of adduction with the hip and knee flexed so the lateral malleolus contacted the lateral femoral epicondyle of the contralateral limb , were recorded. There was a significant effect on string displacement by stretch position, F (15,166) = 14.67, p obturator internus and inferior gemellus had the largest string displacement with 45 ° internal rotation from neutral flexion/extension. While all stretch positions caused a significant string displacement indicating length changes of the deep rotators of the hip, the three stretch positions that caused the greatest change were: 1) 30 ° adduction from 90 ° of hip and knee flexion, 2) 45 ° internal rotation from neutral flexion/extension, and 3) 45 ° external rotation with 90 ° hip and knee flexion. This study has clinical implications for the effectiveness of specific stretching

  13. Process Evaluation to Explore Internal and External Validity of the "Act in Case of Depression" Care Program in Nursing Homes

    NARCIS (Netherlands)

    Leontjevas, R.; Gerritsen, D.L.; Koopmans, R.T.C.M.; Smalbrugge, M.; Vernooij-Dassen, M.F.J.

    2012-01-01

    Background: A multidisciplinary, evidence-based care program to improve the management of depression in nursing home residents was implemented and tested using a stepped-wedge design in 23 nursing homes (NHs): " Act in case of Depression" (AiD). Objective: Before effect analyses, to evaluate AiD

  14. Process evaluation to explore internal and external validity of the "Act in Case of Depression" care program in nursing homes.

    NARCIS (Netherlands)

    Leontjevas, R.; Gerritsen, D.L.; Koopmans, R.T.C.M.; Smalbrugge, M.; Vernooij-Dassen, M.J.F.J.

    2012-01-01

    BACKGROUND: A multidisciplinary, evidence-based care program to improve the management of depression in nursing home residents was implemented and tested using a stepped-wedge design in 23 nursing homes (NHs): "Act in case of Depression" (AiD). OBJECTIVE: Before effect analyses, to evaluate AiD

  15. Study on Case Teaching of Financial Management

    Science.gov (United States)

    Che, Zhenghong; Che, Zhengmei

    2011-01-01

    Case teaching is an efficient teaching method of management. It plays an important role to enhance the students' ability to practice the theory. However, case teaching of financial management has not achieved the expected results. The paper aims to study the importance, characteristics and corresponding methods of case teaching method of financial…

  16. Associative Visual Agnosia: A Case Study

    OpenAIRE

    A. Charnallet; Carbonnel, S.; David, D.; Moreaud, O.

    2008-01-01

    We report a case of massive associative visual agnosia. In the light of current theories of identification and semantic knowledge organization, a deficit involving both levels of structural description system and visual semantics must be assumed to explain the case. We suggest, in line with a previous case study [1], an alternative account in the framework of (non abstractive) episodic models of memory [4].

  17. Associative visual agnosia: a case study.

    Science.gov (United States)

    Charnallet, A; Carbonnel, S; David, D; Moreaud, O

    2008-01-01

    We report a case of massive associative visual agnosia. In the light of current theories of identification and semantic knowledge organization, a deficit involving both levels of structural description system and visual semantics must be assumed to explain the case. We suggest, in line with a previous case study, an alternative account in the framework of (non abstractive) episodic models of memory.

  18. Fire safety case study of a railway tunnel: Smoke evacuation

    Directory of Open Access Journals (Sweden)

    van Maele Karim

    2007-01-01

    Full Text Available When a fire occurs in a tunnel, it is of great importance to assure the safety of the occupants of the tunnel. This is achieved by creating smoke-free spaces in the tunnel through control of the smoke gases. In this paper, results are presented of a study concerning the fire safety in a real scale railway tunnel test case. Numerical simulations are performed in order to examine the possibility of natural ventilation of smoke in inclined tunnels. Several aspects are taken into account: the length of the simulated tunnel section, the slope of the tunnel and the possible effects of external wind at one portal of the tunnel. The Fire Dynamics Simulator of the National Institute of Standards and Technology, USA, is applied to perform the simulations. The simulations show that for the local behavior of the smoke during the early stages of the fire, the slope of the tunnel is of little importance. Secondly, the results show that external wind and/or pressure conditions have a large effect on the smoke gases inside the tunnel. Finally, some idea for the value of the critical ventilation velocity is given. The study also shows that computational fluid dynamics calculations are a valuable tool for large scale, real life complex fire cases. .

  19. Effects of external inspection on sepsis detection and treatment: a study protocol for a quasiexperimental study with a stepped-wedge design.

    Science.gov (United States)

    Hovlid, Einar; Frich, Jan C; Walshe, Kieran; Nilsen, Roy M; Flaatten, Hans Kristian; Braut, Geir Sverre; Helgeland, Jon; Teig, Inger Lise; Harthug, Stig

    2017-09-05

    Inspections are widely used in health care as a means to improve the health services delivered to patients. Despite their widespread use, there is little evidence of their effect. The mechanisms for how inspections can promote change are poorly understood. In this study, we use a national inspection campaign of sepsis detection and initial treatment in hospitals as case to: (1) Explore how inspections affect the involved organizations. (2) Evaluate what effect external inspections have on the process of delivering care to patients, measured by change in indicators reflecting how sepsis detection and treatment is carried out. (3) Evaluate whether external inspections affect patient outcomes, measured as change in the 30-day mortality rate and length of hospital stay. The intervention that we study is inspections of sepsis detection and treatment in hospitals. The intervention will be rolled out sequentially during 12 months to 24 hospitals. Our effect measures are change on indicators related to the detection and treatment of sepsis, the 30-day mortality rate and length of hospital stay. We collect data from patient records at baseline, before the inspections, and at 8 and 14 months after the inspections. We use logistic regression models and linear regression models to compare the various effect measurements between the intervention and control periods. All the models will include time as a covariate to adjust for potential secular changes in the effect measurements during the study period. We collect qualitative data before and after the inspections, and we will conduct a thematic content analysis to explore how inspections affect the involved organisations. The study has obtained ethical approval by the Regional Ethics Committee of Norway Nord and the Norwegian Data Protection Authority. It is registered at www.clinicaltrials.gov (Identifier: NCT02747121). Results will be reported in international peer-reviewed journals. NCT02747121; Pre-results. © Article

  20. Case Studies in Neurocritical Care.

    Science.gov (United States)

    Sakusic, Amra; Rabinstein, Alejandro A

    2016-08-01

    The practice of neurocritical care encompasses multiple acute neurologic and neurosurgical diseases and requires detailed knowledge of neurology and critical care. This article presents 5 cases that illustrate just some of the conditions encountered in the daily practice of neurocritical care and exemplify some of the common diagnostic, therapeutic, and prognostic challenges facing the neurointensivist. Life-threatening medical complications after severe acute ischemic stroke, seizures and extreme agitation from autoimmune encephalitis, refractory seizures after subdural hemorrhage, neurologic and systemic complications related to aneurysmal subarachnoid hemorrhage, and status epilepticus after cardiac arrest are discussed in this article. Published by Elsevier Inc.

  1. External legitimation in international new ventures

    DEFF Research Database (Denmark)

    Turcan, Romeo V.

    2012-01-01

    This paper explores within the framework of new venture legitimation how and why international new ventures acquire external legitimacy and strive for survival in the face of critical events. Following a longitudinal multiple-case study methodology that was adopted for the purpose of theory...

  2. Career readiness and externalizing behaviors of children affected by maternal HIV/AIDS: 15-year outcomes of the PACT study

    OpenAIRE

    Murphy, Debra A.; Marelich, William D.; Herbeck, Diane M.; Cook, Mekeila

    2016-01-01

    The purpose of this 15-year longitudinal study was to assess the effects of maternal HIV/AIDS on child/adolescent career readiness and externalizing behaviors. Interviews were conducted with 66 pairs of healthy children and their mothers living with HIV/AIDS (MLH), who are participants in the Parents And children Coping Together (PACT) project begun in 1997. All study participants were English or Spanish speaking. About half (48.5%) of the youth were female. Maternal health status (e.g., vira...

  3. Experimental Study on Hygrothermal Deformation of External Thermal Insulation Cladding Systems with Glazed Hollow Bead

    Directory of Open Access Journals (Sweden)

    Houren Xiong

    2016-01-01

    Full Text Available This research analyzes the thermal and strain behavior of external thermal insulation cladding systems (ETICS with Glazed Hollow Beads (GHB thermal insulation mortar under hygrothermal cycles weather test in order to measure its durability under extreme weather (i.e., sunlight and rain. Thermometers and strain gauges are placed into different wall layers to gather thermal and strain data and another instrument measures the crack dimensions after every 4 cycles. The results showed that the finishing coat shrank at early stage (elastic deformation and then the finishing coat tends to expand and become damaged at later stage (plastic deformation. The deformation of insulation layer is similar to that of the finishing coat but its variation amplitude is smaller. Deformation of substrate expanded with heat and contracted with cold due to the small temperature variation. The length and width of cracks on the finishing coat grew as the experiment progressed but with a decreasing growth rate and the cracks stopped growing around 70 cycles.

  4. Opportunistic screening for osteoporosis on routine computed tomography? An external validation study

    Energy Technology Data Exchange (ETDEWEB)

    Buckens, Constantinus F. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Universitair Medisch Centrum Utrecht, Department of Radiology, Utrecht (Netherlands); Dijkhuis, Gawein; Jong, Pim A. de [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Keizer, Bart de [University Medical Center Utrecht, Department of Nuclear Medicine, Utrecht (Netherlands); Verhaar, Harald J. [University Medical Center Utrecht, Department of Geriatric Medicine, Utrecht (Netherlands)

    2015-07-15

    Opportunistic screening for osteoporosis using computed tomography (CT) examinations that happen to visualise the spine can be used to identify patients with osteoporosis. We sought to verify the diagnostic performance of vertebral Hounsfield unit (HU) measurements on routine CT examinations for diagnosing osteoporosis in a separate, external population. Consecutive patients who underwent a CT examination of the chest or abdomen and had also received a dual-energy X-ray absorptiometry (DXA) test were retrospectively included. CTs were evaluated for vertebral fractures and vertebral attenuation (density) values were measured. Diagnostic performance measures and the area under the receiver operator characteristics curve (AUC) for diagnosing osteoporosis were calculated. Three hundred and two patients with a mean age of 57.9 years were included, of which 82 (27 %) had osteoporosis according to DXA and 65 (22 %) had vertebral fractures. The diagnostic performance for vertebral HU measurements was modest, with a maximal AUC of 0.74 (0.68 - 0.80). At that optimal threshold the sensitivity was 62 % (51 - 72 %) and the specificity was 79 % (74 - 84 %). We confirmed that simple trabecular vertebral density measurements on routine CT contain diagnostic information related to bone mineral density as measured by DXA, albeit with substantially lower diagnostic accuracy than previously reported. (orig.)

  5. Study on visual image information detection of external angle weld based on arc welding robot

    Science.gov (United States)

    Liu, Xiaorui; Liu, Nansheng; Sheng, Wei; Hu, Xian; Ai, Xiaopu; Wei, Yiqing

    2009-11-01

    Nowadays, the chief development trend in modern welding technology is welding automation and welding intelligence. External angle weld has a certain proportion in mechanical manufacture industries. In the real-time welding process, due to hot deformation and the fixture of workpieces used frequently, torch will detach welding orbit causes deviation, which will affect welding quality. Therefore, elimination weld deviation is the key to the weld automatic tracking system. In this paper, the authors use the self-developed structured light vision sensor system which has significant advantage compared with arc sensors to capture real-time weld images. In the project of VC++6.0 real-time weld image processing, after binaryzation with threshold value seventy, 3*1 median filter, thinning, obtain weld main stripe. Then, using the extraction algorithm this paper proposed to obtain weld feature points, and compute position of weld. Experiment result verified that the extraction algorithm can locate feature points rapidly and compute the weld deviation accurately.

  6. Comparative study of polyacrylamid gels and thermoluminescent dosimeters used in external radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Guillerminet, C. [CREST UMR-CNRS6174, University of Franche-Comte, Pole Universitaire, 4 place Tharradin, BP71427, F25211 Montbeliard (France); Gschwind, R. [CREST UMR-CNRS6174, University of Franche-Comte, Pole Universitaire, 4 place Tharradin, BP71427, F25211 Montbeliard (France)]. E-mail: regine.gschwind@pu-pm.univ-fcomte.fr; Makovicka, L. [CREST UMR-CNRS6174, University of Franche-Comte, Pole Universitaire, 4 place Tharradin, BP71427, F25211 Montbeliard (France); Spevacek, V. [CTU, Faculty of Nuclear Science and Physical Engineering, Brehova 7, 11519 Prague 1 (Czech Republic); Soukoup, M. [CTU, Faculty of Nuclear Science and Physical Engineering, Brehova 7, 11519 Prague 1 (Czech Republic); Novotny, J. [Hospital Na Homolce, Departement of Medical Physics, Roentgenova 2, 15000 Prague 5 (Czech Republic)

    2005-01-01

    Applications of polyacrylamid gels present a great interest in the development of 3D experimental dosimetry. The expansive application of this material will increase possibilities of dose control in external radiotherapy and contribute to increased precision of medical treatments. To develop this material, the dose response of the polyacrylamid gels was compared with that of other methods using detectors and simulations, such as an ionisation chamber, thermoluminescent dosimeters, and Monte-Carlo simulations (BEAM code). The curves of dose response in water, corresponding to a typical clinical situation, were compared for polyacrylamid gels and a cylindrical ionisation chamber (1.125cm3) under the same conditions. Three photon energies, X25, X15 and X6, from a linear accelerator SATURNE 43 were tested. A good correlation was shown with maximal differences between compared curves down to 3%.Polyacrylamid gels were used in the presence of radiation field heterogeneities, using {sup 60}Co. The polyacrylamid gels were compared with thermoluminescence dosimeters inside a polyvinylidene fluoride phantom. The latter presents a density close to bone and a volume similar to that of a human skull. The dimensions of the phantom do not allow the simple use of ionisation chambers, and therefore we opted for thermoluminescent dosimeters of the type 'GR200A', and for Monte-Carlo simulations. The results obtained under identical conditions inside the phantom showed good agreement between these different methods.

  7. Use of external defibrillator jacket to facilitate safe delivery of radiotherapy for lung cancer - a report of two cases.

    Science.gov (United States)

    Bowers, Robert W; Scott, Paul A; Roberts, Paul R

    2014-01-01

    The increasing rate of implantable cardioverter defibrillator (ICD) implantation coupled with shared risk factors between lung cancer and ischemic cardiac disease means that the need for radiotherapy in cardiac device patients is set to become commonplace. We describe two cases referred to our electrophysiology service over a 6-month period. Both had been diagnosed with lung cancer in tissue directly posterior to a previously implanted ICD device. The cases highlight the risks to device function caused by ionizing radiation, the practical difficulties and ethical dilemmas of delivering radiotherapy to cardiac device patients safely and a novel setting for the use of a wearable defibrillator system. Copyright © 2013 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

  8. Studying external and lateral music in odes and sonnets of Zahir Fryabi

    Directory of Open Access Journals (Sweden)

    mohammad fouladi

    2016-06-01

    Full Text Available Abstract Zahir Fryabi is one of the famous people in Persian poet especially sonnet. He played a fundamental role in formation, evolution and promotion of Persian sonnet. The current research searches this question using SPSS software and statistical tests such as ANOVA: how are the most important musical effect (external and lateral used in lyrics of Zahir? What are the most important factors in developing and promoting his lyrics? What are the results of comparing this issue and his odes? The current research comes to the result that in external music of sonnets, Zahir used 5 Bahrs (poetry and 10 weights in his 58 sonnets that is an acceptable statistics rather than sonnets. Although there is not that much variety in using Bahrs; also, his odes are more various than sonnets but totally, his poets are not very versatile in terms of weight. Zahir has tried to prevent using low-applicable and unpleasant weights and this factor itself represents his soft, beauty and melodious sonnets. Among the used Bahrs and weights in his sonnet, Raml Bahr and “Faelaten Faelaten Faelaten Faelen” weight that is calm and usually sad weight, has a specific status. However, it seems logical due to his irritable spirit and types of words he used in his sonnet. On the other hand, Zahir has a significant interest in using high applicable and pleasant weights of Persian poet, both in odes and in sonnets; one can find almost an half of Persian weight in his odes, in terms of variety that has a rather acceptable variety. One of Zahir weakness is that he did not much use Dowri weight that affect richness of verbal music and it has not a significant growth in his sonnets and odes. On lateral music, words of rhyme in sonnets and odes have a significant ear catching aspect due to using high sounds. In the shared letters of rhyme, poet used high applicable and soft letter such as “an”, “ar” and “A” in sonnet which are representative of his subtlety sonnet

  9. Peyton's 4-Steps-Approach in comparison: Medium-term effects on learning external chest compression – a pilot study

    Directory of Open Access Journals (Sweden)

    Münster, Tobias

    2016-08-01

    Full Text Available Introduction: The external chest compression is a very important skill required to maintain a minimum of circulation during cardiac arrest until further medical procedures can be taken. Peyton’s 4-Steps-Approach is one method of skill training, the four steps being:Based on CPR skill training, this method is widely, allegedly predominantly used, although there are insufficient studies on Peyton’s 4-Steps-Approach for skill training in CPR in comparison with other methods of skill training. In our study, we compared the medium- term effects on learning external chest compression with a CPR training device in three different groups: PEY (Peyton’s 4-Steps-Approach, PMOD (Peyton’s 4-Steps-Approach without Step 3 and STDM, the standard model, according to the widely spread method “see one, do one” (this is equal to Peyton’s step 1 and 3.Material and Methods: This prospective and randomised pilot study took place during the summer semester of 2009 at the SkillsLab and Simulation Centre of the University of Cologne (Kölner interprofessionelles Skills Lab und Simulationszentrum - KISS. The subjects were medical students (2 and 3 semester. They volunteered for the study and were randomised in three parallel groups, each receiving one of the teaching methods mentioned above. One week and 5/6 months after the intervention, an objective, structured single assessment was taken. Compression rate, compression depth, correct compressions, and the sum of correct checklist items were recorded. Additionally, we compared cumulative percentages between the groups based on the correct implementation of the resuscitation guidelines during that time.Results: The examined sample consisted of 134 subjects (68% female; age 22±4; PEY: n=62; PMOD: n=31; STDM: n=41. There was no difference between the groups concerning age, gender, pre-existing experience in CPR or time of last CPR course. The only significant difference between the groups was the mean

  10. Ethical issues in case study publication: "making our case(s)" ethically.

    Science.gov (United States)

    McCurdy, David B; Fitchett, George

    2011-01-01

    As chaplains develop richly detailed case studies for publication, ethical questions about case study construction and publication are emerging. Concerns about seeking patients' permission to publish material about them suggest additional questions and raise broad confidentiality and privacy issues. Confidentiality-related practices in health care and psychotherapy provide the most extensive guidance for chaplains, but healthcare chaplaincy has roots in religious and professional traditions with distinct notions of confidentiality that deserve consideration. Single case studies do not appear to be "research" requiring informed consent, yet their publication exposes patients to some risk of harm. Obtaining the patient's/"case study subject's" permission to publish, disguising non-essential information, and allowing the patient to review the case study can mitigate the risks. Striking a balance between protecting patients and providing sufficient detail to make case studies useful is a central ethical challenge of case study publication.

  11. The new Vancouver Chest Pain Rule using troponin as the only biomarker: an external validation study.

    Science.gov (United States)

    Cullen, Louise; Greenslade, Jaimi H; Than, Martin; Brown, Anthony F T; Hammett, Christopher J; Lamanna, Arvin; Flaws, Dylan F; Chu, Kevin; Fowles, Lindsay F; Parsonage, William A

    2014-02-01

    To externally evaluate the accuracy of the new Vancouver Chest Pain Rule and to assess the diagnostic accuracy using either sensitive or highly sensitive troponin assays. Prospectively collected data from 2 emergency departments (EDs) in Australia and New Zealand were analysed. Based on the new Vancouver Chest Pain Rule, low-risk patients were identified using electrocardiogram results, cardiac history, nitrate use, age, pain characteristics and troponin results at 2 hours after presentation. The primary outcome was 30-day diagnosis of acute coronary syndrome (ACS), including acute myocardial infarction, and unstable angina. Sensitivity, specificity, positive predictive values and negative predictive values were calculated to assess the accuracy of the new Vancouver Chest Pain Rule using either sensitive or highly sensitive troponin assay results. Of the 1635 patients, 20.4% had an ACS diagnosis at 30 days. Using the highly sensitive troponin assay, 212 (13.0%) patients were eligible for early discharge with 3 patients (1.4%) diagnosed with ACS. Sensitivity was 99.1% (95% CI 97.4-99.7), specificity was 16.1 (95% CI 14.2-18.2), positive predictive values was 23.3 (95% CI 21.1-25.5) and negative predictive values was 98.6 (95% CI 95.9-99.5). The diagnostic accuracy of the rule was similar using the sensitive troponin assay. The new Vancouver Chest Pain Rule should be used for the identification of low risk patients presenting to EDs with symptoms of possible ACS, and will reduce the proportion of patients requiring lengthy assessment; however we recommend further outpatient investigation for coronary artery disease in patients identified as low risk. © 2013.

  12. Radionuclide study of platelets and prosthetic interactions: External versus specimen quantitation

    Energy Technology Data Exchange (ETDEWEB)

    Nordestgaard, A.G.; Marcus, C.S.; Wilson, S.E. (Harbor-UCLA Medical Center, Torrance (USA))

    1988-01-01

    Twenty-nine New Zealand white rabbits were allocated to undergo insertion of either polytetrafluoroethylene (PTFE) (n = 22) or microporous silicone rubber (SR) (n = 7), 3-mm diameter, 10-mm long aortic grafts. Animals with PTFE grafts received aspirin (ASA) 10 mg/kg/d and dipyridamole (DPM) 10 mg/kg/d (n = 11) or placebo (n = 11). Autologous In-111-oxine-labeled platelets were reinfused on reestablishment of blood flow through the graft. Using gamma camera images, an external graft platelet accumulation index (E-GPAI) was calculated as the In-111 activity in the graft area to the reference aorta at 24, 48, and 72 hours post implantation. Mean E-GPAI +/- SEM values for the ASA/DPM (n = 4) and control groups (n = 7) were 1.13 +/- 0.16 and 1.34 +/- 0.05 (NS) at 24 hours, 1.20 +/- 0.16 and 1.33 +/- 0.07 (NS) at 48 hours, and 1.38 +/- 0.07 and 1.35 +/- 0.10 (NS) at 72 hours, respectively. A similar internal graft platelet accumulation index (I-GPAI) was constructed based on In-111 activity in excised grafts and reference aorta measured in a scintillation counter. Mean I-GPAI +/- SEM values for the PTFE ASA/DPM (n = 9) and control groups (n = 8) at 48 hours post implantation were 43.1 +/- 2.7 and 216.8 +/- 73.9 (P = 0.05), respectively. I-GPAI values for the SR grafts were 192.5 +/- 43.1. The E-GPAI was not sensitive enough to demonstrate the effect of antiplatelet medication on platelet accumulation on the PTFE grafts.

  13. External validation of prognostic models to predict risk of gestational diabetes mellitus in one Dutch cohort: prospective multicentre cohort study.

    Science.gov (United States)

    Lamain-de Ruiter, Marije; Kwee, Anneke; Naaktgeboren, Christiana A; de Groot, Inge; Evers, Inge M; Groenendaal, Floris; Hering, Yolanda R; Huisjes, Anjoke J M; Kirpestein, Cornel; Monincx, Wilma M; Siljee, Jacqueline E; Van 't Zelfde, Annewil; van Oirschot, Charlotte M; Vankan-Buitelaar, Simone A; Vonk, Mariska A A W; Wiegers, Therese A; Zwart, Joost J; Franx, Arie; Moons, Karel G M; Koster, Maria P H

    2016-08-30

     To perform an external validation and direct comparison of published prognostic models for early prediction of the risk of gestational diabetes mellitus, including predictors applicable in the first trimester of pregnancy.  External validation of all published prognostic models in large scale, prospective, multicentre cohort study.  31 independent midwifery practices and six hospitals in the Netherlands.  Women recruited in their first trimester (diabetes mellitus of any type were excluded.  Discrimination of the prognostic models was assessed by the C statistic, and calibration assessed by calibration plots.  3723 women were included for analysis, of whom 181 (4.9%) developed gestational diabetes mellitus in pregnancy. 12 prognostic models for the disorder could be validated in the cohort. C statistics ranged from 0.67 to 0.78. Calibration plots showed that eight of the 12 models were well calibrated. The four models with the highest C statistics included almost all of the following predictors: maternal age, maternal body mass index, history of gestational diabetes mellitus, ethnicity, and family history of diabetes. Prognostic models had a similar performance in a subgroup of nulliparous women only. Decision curve analysis showed that the use of these four models always had a positive net benefit.  In this external validation study, most of the published prognostic models for gestational diabetes mellitus show acceptable discrimination and calibration. The four models with the highest discriminative abilities in this study cohort, which also perform well in a subgroup of nulliparous women, are easy models to apply in clinical practice and therefore deserve further evaluation regarding their clinical impact. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  14. Modelling soft error probability in fi rmware: A case study | Kourie ...

    African Journals Online (AJOL)

    This case study involves an analysis of firmware that controls explosions in mining operations. The purpose is to estimate the probability that external disruptive events (such as electro-magnetic interference) could drive the firmware into a state which results in an unintended explosion. Two probabilistic models are built, ...

  15. A review of case studies evaluating economic incentives to promote occupational safety and health

    NARCIS (Netherlands)

    Elsler, D.; Treutlein, D.; Rydlewska, I.; Frusteri, L.; Krüger, H.; Veerman, T.; Eeckelaert, L.; Roskams, N.; Broek, K. van den; Taylor, T.N.

    2010-01-01

    Objectives: In many European countries, external economic incentives are discussed as a policy instrument to promote occupational safety and health (OSH) in enterprises. This narrative case study review aims to support policy-makers in organizations providing such incentives by supplying information

  16. Effect of Co-60 external irradiation on the active testes of house sparrow, Passer domesticus (Linnaeus), 1. Histopathological studies

    Energy Technology Data Exchange (ETDEWEB)

    Kumar, M.; Kumar, A. (Himachal Pradesh Univ., Simla (India). Dept. of Bio-Sciences); Mathur, R.S.

    1981-06-01

    Adult male house sparrows were exposed to Co-60 external irradiation at doses of 475, 712 and 950 R. The dose rate was 100 R/hr at a distance of one foot. The birds were autopsied at intervals of 1, 3, 5, 7 and 15 days after irradiation. Testes were studied for histopathological damage produced. There was a significant loss of the testicular weight 3 days after irradiation. The seminiferous tubules showed pyknosis, karyolysis and depletion of spermatogonial cells. Maximum damage was observed in the testis exposed to 950 R. However, there was no change in the Sertoli and Leydig cells.

  17. A Numerical Study on the Impact of Wind Gust Frequency on Air Exchanges in Buildings with Variable External and Internal Leakages

    Directory of Open Access Journals (Sweden)

    Dimitrios Kraniotis

    2014-03-01

    Full Text Available Wind-driven air infiltration has been recognized among the major reasons for energy loss in buildings, and the impact to energy efficiency under steady conditions has been reported and issued as part of many building codes. The nearly zero-energy building demand makes uncontrolled leakage paths even more undesired and creates the need for further investigation of their behavior under unsteady wind conditions. The present numerical study examines the role of wind gustiness on instantaneous infiltration rates of a low-rise building. For this purpose, two levels of gust frequency Ω have been simulated, expressed as a sinusoidal factor in the wind profile formula. In parallel, a ratio α is employed to represent seven different cases of external leakages distribution, while five scenarios of compartmentalization and internal leakages shows the impact of the latter on the dynamics of building air exchange rates. The results indicate that higher wind gustiness results in higher ACH, marking out gusts as a potential critical factor under unsteady climate conditions. The infiltration rates shown in relation to the leakage distribution ratio α provide arguments for the importance of the detailed detection of external leakages while the comparison of the different internal-volume-scenario highlights the key-role of internal leakages control towards a drastic reduction of infiltration rates.

  18. Leishmaniasis in dogs: Case study

    Directory of Open Access Journals (Sweden)

    Aleksić Jelena

    2009-01-01

    Full Text Available The paper presents a case of leishmaniasis in a 2.5-month-old dog imported from France. The clinical examination established a generally poor state of health, expressed cachexia, atrophy of the temporal musculature, weakness of movement, as well as abnormally long and brittle nails. There was also hyperkeratosis of the nose tip and paws. A histological examination of biopsy sections of the altered skin parts showed inflammatory changes in the area of the dermis, together with infiltration of macrophages and a smaller number of lymphocytes, plasmocytes and neutrophil granulocytes in the area around the sebaceous glands and hair follicles. The determined changes correspond to superficial dermatitis. Edema followed by partial degeneration of connective-tissue fibers is observed in connective tissue. A smaller number of intracellular parasitic forms was established in mononuclear cells. A smaller number of oval amastigotes with round dark red nucleis were observed in sections stained using the Gimza method in the cytoplasm of macrophages located in the dermis, but also extracellularly. It was concluded that the dog was diseased with leishmaniasis on the grounds of the clinical picture and the microscopic findings.

  19. Phase-space quantum mechanics study of two identical particles in an external oscillatory potential

    Science.gov (United States)

    Nieto, Luis M.; Gadella, Manuel

    1993-01-01

    This simple example is used to show how the formalism of Moyal works when it is applied to systems of identical particles. The symmetric and antisymmetric Moyal propagators are evaluated for this case; from them, the correct energy levels of energy are obtained, as well as the Wigner functions for the symmetric and antisymmetric states of the two identical particle system. Finally, the solution of the Bloch equation is straightforwardly obtained from the expressions of the Moyal propagators.

  20. Geothermal Exploration Case Studies on OpenEI (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Young, K.; Bennett, M.; Atkins, D.

    2014-03-01

    The U.S. Geological Survey (USGS) resource assessment (Williams et al., 2008) outlined a mean 30 GWe of undiscovered hydrothermal resource in the western United States. One goal of the U.S. Department of Energy's (DOE) Geothermal Technology Office (GTO) is to accelerate the development of this undiscovered resource. DOE has focused efforts on helping industry identify hidden geothermal resources to increase geothermal capacity in the near term. Increased exploration activity will produce more prospects, more discoveries, and more readily developable resources. Detailed exploration case studies akin to those found in oil and gas (e.g. Beaumont and Foster, 1990-1992) will give developers central location for information gives models for identifying new geothermal areas, and guide efficient exploration and development of these areas. To support this effort, the National Renewable Energy Laboratory (NREL) has been working with GTO to develop a template for geothermal case studies on the Geothermal Gateway on OpenEI. In 2012, the template was developed and tested with two case studies: Raft River Geothermal Area (http://en.openei.org/wiki/Raft_River_Geothermal_Area) and Coso Geothermal Area (http://en.openei.org/wiki/Coso_Geothermal_Area). In 2013, ten additional case studies were completed, and Semantic MediaWiki features were developed to allow for more data and the direct citations of these data. These case studies are now in the process of external peer review. In 2014, NREL is working with universities and industry partners to populate additional case studies on OpenEI. The goal is to provide a large enough data set to start conducting analyses of exploration programs to identify correlations between successful exploration plans for areas with similar geologic occurrence models.

  1. A Comparative Comment on the Case Studies

    DEFF Research Database (Denmark)

    Kjeldsen, Christian Christrup; Ley, Thomas; Jensen, Niels Rosendal

    2012-01-01

    Denne konklusion sammenfatter hovedtrækkene af de gennemførte case studies i WorkAble-projektet. Vigtige pointer er, at unge på tværs af de forskellige case studies har vanskeligt ved at blive hørt og taget alvorligt. I stedet spises de af med "realistisk vejledning" eller dårlige uddannelses- og...

  2. Embedded nursing practice: a case study.

    Science.gov (United States)

    Bott, M

    1997-01-01

    Nurses' utilization of case study analysis often focuses on medically-based knowledge which is intertwined within our daily practice. Reflection on nurse-patient interactions with nursing theory as the analytic tool is infrequently undertaken. The case study analysis presented within this paper analyzes an exemplar utilizing the theoretical works of Patricia Benner.

  3. Self-Employment Training Programs: Case Studies.

    Science.gov (United States)

    Lamb, Melissa, Ed.; And Others

    This self-employment training program case study booklet has been developed for general use in exploring the feasibility of this kind of development tool. The case studies describe a number of comprehensive, self-employment training and assistance programs, from the local to the national level. Chapter II includes information on the training plan,…

  4. The Danish National Case Study Report

    DEFF Research Database (Denmark)

    Brodersen, Søsser; Jørgensen, Michael Søgaard

    Three case studies from Danish science shops within the environmental field are analysed with respect to societal background, interaction between the involved actors and the societal impact of the co-operation. The report is one of the seven national case study reports from the EU...

  5. Portfolio Manager Selection – A Case Study

    DEFF Research Database (Denmark)

    Christensen, Michael

    2017-01-01

    Within a delegated portfolio management setting, this paper presents a case study of how the manager selection process can be operationalized in practice. Investors have to pursue a thorough screening of potential portfolio managers in order to discover their quality, and this paper discusses how...... such a screening process can be performed—represented by a case study....

  6. Using Case Studies to Teach Courtesy Strategies.

    Science.gov (United States)

    Moore, Patrick

    1990-01-01

    Explains some courtesy techniques that technical professionals can use to deal with interpersonal problems that arise in writing situations. Presents three case studies with sample responses to show how case studies can teach these courtesy strategies to technical writing students. (MM)

  7. A Case Study of "Empathetic Teaching Artistry"

    Science.gov (United States)

    Risner, Doug

    2014-01-01

    This case study is one of twenty cases derived from Anderson and Risner's international study of teaching artists in dance, and theatre, which investigated participants' (n=172) artistic and academic preparation in dance, and theatre, initial entry into the teaching artist field, rewards, challenges, and obstacles in participants' work, artists'…

  8. A theoretical performance study of an external cavity fiber Fabry-Perot interferometer for displacement measurement

    Science.gov (United States)

    Arumugam, Kumar

    The objective of this research is to explore a mathematical model developed by Wilkinson and Pratt for the external cavity fiber-based Fabry-Perot interferometer (EFPI) and to create a Michelson interferometer setup to validate a frequency modulation component of this model. A laser diode with nominal wavelength 635 nm is modulated by oscillating the diode current of maximum amplitude 22.62 mA to create correspondingly varying wavelength. Experiments are included to evaluate a rotating vector representation of the modulation harmonics in the signal received at the photodetector as of a cube corner translated by a piezo-electric actuator is displaced. Wavelength modulation as a function of diode current, the coherence length of the laser, and characteristics of the modulation harmonics are evaluated. A real time DAQ system and two lock-in amplifiers are utilized for detecting three side-band harmonics of the signal. For short range displacements this interferometer setup is monitored using a capacitance displacement sensor. The capacitance displacement measurement differed from the Michelson interferometer by 160 nm. The piezoelectric stage actuated with a 15 V Ramp signal produced 2.54 mum displacement of the cube corner. The setup is tested with Ramp signals of 75 V to 1.5 V and with the Ramp periods of 1 to 20 seconds to find the resolution of the interferometer, modulation of the wavelength sensitivity and the coherence length of the laser as 10.53 nm, 1.786 nm·A-1 and >1 m respectively. The best quadrature signal achieved corresponded to modulating the laser at amplitude of 18.86 mA at 1 kHz frequency with a path length difference of 6.35 mm. The amplitude comparison of side-band harmonics with Bessel function curves is consistent with a modulation amplitude of 1.28 rad corresponding to amplitude ratios of 0.5 (second and first) , 0.15 (third and second) and 0.06 (third and first) in the first through third Bessel function values.

  9. Modulating protein behaviors on responsive surface by external electric fields: A molecular dynamics study

    Energy Technology Data Exchange (ETDEWEB)

    Xie, Yun, E-mail: xieyunxx@gdpu.edu.cn; Pan, Yufang; Zhang, Rong; Liang, Ying; Li, Zhanchao

    2015-01-30

    phosphate groups after overcoming a slight energy barrier. Under three states, the basic backbone structures of Cyt c are well kept within the simulation time since the conformation of Cyt c is mainly affected by the surface-generated electric fields, whose strengths are modulated by the external electric fields and are not strong enough to deform protein. The results indicate the possibility of regulating protein behaviors, including promoting or retarding protein adsorption and regulating protein orientations, on responsive surfaces by applying electric fields on the surfaces without worrying protein deformation, which may be helpful in the applications of protein separation and controlled drug delivery.

  10. Neutron reflectivity and external reflection FTIR studies of DL-aspartic acid crystallization beneath nylon 6 spread films.

    Science.gov (United States)

    Jamieson, Matthew J; Cooper, Sharon J; Miller, Aline F; Holt, Stephen A

    2004-04-27

    The crystallization of DL-aspartic acid beneath nylon 6 spread films has been studied for 150% supersaturated systems using neutron reflectivity and external reflection FTIR. The neutron reflectivity data showed the gradual incorporation of DL-aspartic acid within a nylon 6 spread film layer over a period of 6-8 h, culminating in over 50 vol % of the "film" layer comprising DL-aspartic acid. Accumulation of further DL-aspartic acid material to produce microscopic/macroscopic surface crystals occurred, but on a more limited scale, resulting in approximately 1-5% surface coverage of crystals over the same period. External reflection FTIR studies revealed very weak bands attributable to DL-aspartic acid in surface regions devoid of visible crystals, in agreement with the neutron reflectivity studies. In regions with visible crystals, much larger and sharper DL-aspartic acid bands were seen. Changes in the intensity of the nylon 6 NH stretch band were often observed during the visible crystallization and dissolution of DL-aspartic acid and were consistent with the reversible accumulation of nylon 6 around the growing crystals.

  11. External factors and the interference of L1 Estonian on L2 English pronunciation: An apparent-time study

    Directory of Open Access Journals (Sweden)

    Kristiina Ader

    2015-04-01

    Full Text Available This study focusses on external factors of second language learning (L2 and their effect on L2 sound production. The aim was to find out whether young adults whose first language (L1 is Estonian speak L2 English with less accent than older speakers of L1 Estonian. Prior studies have claimed that more exposure to the target language lessens the effect of L1 interference (internal factors (e.g. Piske et al. 2001, Muñoz, Llanes 2014. An apparent-time study was imple- mented in order to test whether a change in learner setting (i.e. limited exposure to the target language vs. abundant exposure shows any evidence which can be explained by such external factors. Data was elicited from the speech samples of 97 speakers of L1 Estonian and L1 interference effects were analysed sound by sound. The results show that the younger generation displays less L1 Estonian interference than the older generation. Both greater exposure to the target language and earlier age of L2 learning onset correlate with the ability to produce more sounds target-like.

  12. Five case studies of multifamily weatherization programs

    Energy Technology Data Exchange (ETDEWEB)

    Kinney, L; Wilson, T.; Lewis, G. [Synertech Systems Corp. (United States); MacDonald, M. [Oak Ridge National Lab., TN (United States)

    1997-12-31

    The multifamily case studies that are the subject of this report were conducted to provide a better understanding of the approach taken by program operators in weatherizing large buildings. Because of significant variations in building construction and energy systems across the country, five states were selected based on their high level of multifamily weatherization. This report summarizes findings from case studies conducted by multifamily weatherization operations in five cities. The case studies were conducted between January and November 1994. Each of the case studies involved extensive interviews with the staff of weatherization subgrantees conducting multifamily weatherization, the inspection of 4 to 12 buildings weatherized between 1991 and 1993, and the analysis of savings and costs. The case studies focused on innovative techniques which appear to work well.

  13. Theoretical pluralism in psychoanalytic case studies

    Science.gov (United States)

    Willemsen, Jochem; Cornelis, Shana; Geerardyn, Filip M.; Desmet, Mattias; Meganck, Reitske; Inslegers, Ruth; Cauwe, Joachim M. B. D.

    2015-01-01

    The aim of this study is to provide an overview of the scientific activity of different psychoanalytic schools of thought in terms of the content and production of case studies published on ISI Web of Knowledge. Between March 2013 and November 2013, we contacted all case study authors included in the online archive of psychoanalytic and psychodynamic case studies (www.singlecasearchive.com) to inquire about their psychoanalytic orientation during their work with the patient. The response rate for this study was 45%. It appears that the two oldest psychoanalytic schools, Object-relations psychoanalysis and Ego psychology or “Classical psychoanalysis” dominate the literature of published case studies. However, most authors stated that they feel attached to two or more psychoanalytic schools of thought. This confirms that the theoretical pluralism in psychoanalysis stretches to the field of single case studies. The single case studies of each psychoanalytic school are described separately in terms of methodology, patient, therapist, or treatment features. We conclude that published case studies features are fairly similar across different psychoanalytic schools. The results of this study are not representative of all psychoanalytic schools, as some do not publish their work in ISI ranked journals. PMID:26483725

  14. Theoretical pluralism in psychoanalytic case studies.

    Science.gov (United States)

    Willemsen, Jochem; Cornelis, Shana; Geerardyn, Filip M; Desmet, Mattias; Meganck, Reitske; Inslegers, Ruth; Cauwe, Joachim M B D

    2015-01-01

    The aim of this study is to provide an overview of the scientific activity of different psychoanalytic schools of thought in terms of the content and production of case studies published on ISI Web of Knowledge. Between March 2013 and November 2013, we contacted all case study authors included in the online archive of psychoanalytic and psychodynamic case studies (www.singlecasearchive.com) to inquire about their psychoanalytic orientation during their work with the patient. The response rate for this study was 45%. It appears that the two oldest psychoanalytic schools, Object-relations psychoanalysis and Ego psychology or "Classical psychoanalysis" dominate the literature of published case studies. However, most authors stated that they feel attached to two or more psychoanalytic schools of thought. This confirms that the theoretical pluralism in psychoanalysis stretches to the field of single case studies. The single case studies of each psychoanalytic school are described separately in terms of methodology, patient, therapist, or treatment features. We conclude that published case studies features are fairly similar across different psychoanalytic schools. The results of this study are not representative of all psychoanalytic schools, as some do not publish their work in ISI ranked journals.

  15. Functional magnetic resonance imaging study of external source memory and its relation to cognitive insight in non-clinical subjects.

    Science.gov (United States)

    Buchy, Lisa; Hawco, Colin; Bodnar, Michael; Izadi, Sarah; Dell'Elce, Jennifer; Messina, Katrina; Lepage, Martin

    2014-09-01

    Previous research has linked cognitive insight (a measure of self-reflectiveness and self-certainty) in psychosis with neurocognitive and neuroanatomical disturbances in the fronto-hippocampal neural network. The authors' goal was to use functional magnetic resonance imaging (fMRI) to investigate the neural correlates of cognitive insight during an external source memory paradigm in non-clinical subjects. At encoding, 24 non-clinical subjects travelled through a virtual city where they came across 20 separate people, each paired with a unique object in a distinct location. fMRI data were then acquired while participants viewed images of the city, and completed source recognition memory judgments of where and with whom objects were seen, which is known to involve prefrontal cortex. Cognitive insight was assessed with the Beck Cognitive Insight Scale. External source memory was associated with neural activity in a widespread network consisting of frontal cortex, including ventrolateral prefrontal cortex (VLPFC), temporal and occipital cortices. Activation in VLPFC correlated with higher self-reflectiveness and activation in midbrain correlated with lower self-certainty during source memory attributions. Neither self-reflectiveness nor self-certainty significantly correlated with source memory accuracy. By means of virtual reality and in the context of an external source memory paradigm, the study identified a preliminary functional neural basis for cognitive insight in the VLPFC in healthy people that accords with our fronto-hippocampal theoretical model as well as recent neuroimaging data in people with psychosis. The results may facilitate the understanding of the role of neural mechanisms in psychotic disorders associated with cognitive insight distortions. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

  16. Career readiness and externalizing behaviors of children affected by maternal HIV/AIDS: 15-year outcomes of the PACT study.

    Science.gov (United States)

    Murphy, Debra A; Marelich, William D; Herbeck, Diane M; Cook, Mekeila

    2016-01-01

    The purpose of this 15-year longitudinal study was to assess the effects of maternal HIV/AIDS on child/adolescent career readiness and externalizing behaviors. Interviews were conducted with 66 pairs of healthy children and their mothers living with HIV/AIDS (MLH), who are participants in the Parents And children Coping Together (PACT) project begun in 1997. All study participants were English or Spanish speaking. About half (48.5%) of the youth were female. Maternal health status (e.g., viral load biomedical marker, illness symptoms, physical functioning and depression) and child/adolescent outcomes (e.g., career readiness, conduct disorder, drug use, sexual behaviors, parent attachment and youth autonomy) were assessed over 20 time-points. Individual growth and GEE logistic regression models showed lower variability in maternal viral load was positively associated with better career readiness and parent attachment among adolescent/young adults. Externalizing behaviors (conduct disorder, alcohol and crystal methamphetamine use) were positively associated with maternal depression. Adolescent coping efficacy was shown to be a protective factor when applied to models on career readiness. Stability in MLH health positively affects children's career readiness over time, particularly career planning and career choices. The finding that adolescent coping efficacy may act as a protective factor against poor career planning has important implications for developing interventions to assist children in coping with parental HIV.

  17. Distress and academic achievement among adolescents of affluence: a study of externalizing and internalizing problem behaviors and school performance.

    Science.gov (United States)

    Ansary, Nadia S; Luthar, Suniya S

    2009-01-01

    The main objectives of this study were to prospectively examine the relationship between externalizing (substance use and delinquency) and internalizing (depression and anxiety) dimensions and academic achievement (grades and classroom adjustment), as well as continuity over time in these domains, within a sample of wealthy adolescents followed from 10th to 12th grades (n = 256). In both parts of the study, cluster analyses were used to group participants at 10th grade and then group differences were evaluated on adjustment outcomes over time. In Part 1, problem behavior clusters revealed differences on academic indices with the two marijuana using groups--marijuana users and multiproblem youth--exhibiting the worst academic outcomes at all three waves. For Part 2, the two lowest achieving groups reported the highest distress across all externalizing dimensions over time. Stability across the three waves was found for both personal and academic competence as well as the associations between these two domains. Results are discussed in relation to intervention efforts targeting wealthy students at risk.

  18. Career readiness and externalizing behaviors of children affected by maternal HIV/AIDS: 15-year outcomes of the PACT study

    Science.gov (United States)

    Murphy, Debra A.; Marelich, William D.; Herbeck, Diane M.; Cook, Mekeila

    2017-01-01

    The purpose of this 15-year longitudinal study was to assess the effects of maternal HIV/AIDS on child/adolescent career readiness and externalizing behaviors. Interviews were conducted with 66 pairs of healthy children and their mothers living with HIV/AIDS (MLH), who are participants in the Parents And children Coping Together (PACT) project begun in 1997. All study participants were English or Spanish speaking. About half (48.5%) of the youth were female. Maternal health status (e.g., viral load biomedical marker, illness symptoms, physical functioning and depression) and child/adolescent outcomes (e.g., career readiness, conduct disorder, drug use, sexual behaviors, parent attachment and youth autonomy) were assessed over 20 time-points. Individual growth and GEE logistic regression models showed lower variability in maternal viral load was positively associated with better career readiness and parent attachment among adolescent/young adults. Externalizing behaviors (conduct disorder, alcohol and crystal methamphetamine use) were positively associated with maternal depression. Adolescent coping efficacy was shown to be a protective factor when applied to models on career readiness. Stability in MLH health positively affects children’s career readiness over time, particularly career planning and career choices. The finding that adolescent coping efficacy may act as a protective factor against poor career planning has important implications for developing interventions to assist children in coping with parental HIV. PMID:28983322

  19. External and internal factors influencing self-directed online learning of physiotherapy undergraduate students in Sweden: a qualitative study.

    Science.gov (United States)

    Hammarlund, Catharina Sjödahl; Nilsson, Maria H; Gummesson, Christina

    2015-01-01

    Online courses have become common in health sciences education. This learning environment can be designed using different approaches to support student learning. To further develop online environment, it is important to understand how students perceive working and learning online. The aim of this study is to identify aspects influencing students' learning processes and their adaptation to self-directed learning online. Thirty-four physiotherapy students with a mean age of 25 years (range, 21 to 34 years) participated. Qualitative content analysis and triangulation was used when investigating the students' self-reflections, written during a five week self-directed, problem-oriented online course. Two categories emerged: 'the influence of the structured framework' and 'communication and interaction with teachers and peers.' The learning processes were influenced by external factors, e.g., a clear structure including a transparent alignment of assignments and assessment. Important challenges to over-come were primarily internal factors, e.g., low self-efficacy, difficulties to plan the work effectively and adapting to a new environment. The analyses reflected important perspectives targeting areas which enable further course development. The influences of external and internal factors on learning strategies and self-efficacy are important aspects to consider when designing online courses. Factors such as pedagogical design, clarity of purpose, goals, and guidelines were important as well as continuous opportunities for communication and collaboration. Further studies are needed to understand and scaffold the motivational factors among students with low self-efficacy.

  20. Environmental contracting: a case study

    OpenAIRE

    Kubiak, Joseph C.

    1994-01-01

    Approved for public release, distribution unlimited The end of cold war levels of defense expenditures has promoted the reduction in the number of defense-related companies, creating potential monopolistic economic scenarios for defense procurement. This thesis studies one methodology to deal with these scenarios, based on the Baron-Myerson monopolist regulation mechanisms. The Baron-Myerson mechanism provides a tool to regulate monopolists when their costs are unknown or cannot be measure...